Analysis of functional outcomes and complications of tibial bone defects treated with Ilizarov bone transport technique.

Background: Trifocal bone transport (TF) rather than bifocal bone transport (BF) can shorten the treatment time when treating of large bone defect in tibia. However, few studies have reported efficacy and complications among different bone transport.

Aim: To evaluate the effectiveness and complications of bone transport technique for the treatment of large bone defect in tibia.

Methods: The retrospective study including 48 patients who underwent bone transport for the treatment of large bone defect in tibia from May 2015 to September 2019. A total of 30 were treated by bifocal bone transport (BF group) and 18 by trifocal bone transport (TF group). Patient demographic data, intraoperative outcomes, postoperative variables, complications and clinical outcomes of the two groups were recorded and compared at a minimum follow-up of 24 months. Postoperative complications were also evaluated according to Paley classification. Based on the Association for the Study and Application of Methods of Ilizarov (ASAMI) standard, the bone and functional results were evaluated at the last clinical follow-up.

Results: All patients with an average follow-up of 27.5 months. All patients achieved complete union in the docking site and consolidation in the regenerate bone. Compared to the BF group, the TF group had a longer bone defect length(9.08 ± 1.74 > 6.33 ± 3.15, P < 0.01) but a shorter external fixation index (42.22 ± 2.41 < 65.82 ± 6.98, P < 0.001). The mean number of complications per patient was 1.6 and 1.7 for BF and TF patients (P > 0.05). At the postoperative follow-up, there were no significant differences between the 2 groups in the bone and functional results (P > 0.05).

Conclusion: For tibial bone defects, both bifocal and trifocal bone transport can achieve good clinical results. Compared to the bifocal bone transport, The trifocal bone transport can significantly shorten the external fixation index without increasing the incidence of associated complications.