骨延长术治疗下肢骨髓炎性骨缺损的临床研究

背景:下肢骨髓炎性骨缺损的修复方法很多,其中骨延长术是一种通过骨骼牵引矫正肢体长度不均衡而被广泛应用于创伤及骨感染、肿瘤、先天性畸形等疾病的综合性技术。目的:探讨骨延长术治疗下肢慢性骨髓炎性骨缺损的术后缺损部位延长效果以及并发症情况。方法:回顾性分析2016年3月至2018年4月采用骨延长术治疗的32例下肢骨髓炎性骨缺损患者,男20例,女12例;年龄22~52岁,平均(37.9±11.3)岁。患者均为下肢骨折术后并发慢性骨髓炎、骨不连,入院前有2~4次手术史,病程12~36个月,平均(24.9±8.5)个月。骨髓炎部位为股骨22例,胫骨10例;缺损大小为2~4 cm,平均(3.2±0.6)cm。清创术后同期行骨延长术治疗,术后定期进行X线检查,随访观察缺损部位的成骨情况,末次随访时采用Paley评分对骨不连愈合情况进行疗效评估。结果:全部获得随访,随访时间为16~28个月,平均(22.6±6.4)个月。本组患者中,治疗效果获优26例,良6例。32例患者骨延长区骨再生情况均良好,患肢骨延长长度为6~10 cm,平均(7.9±1.4)cm,外固定架佩戴时间为5~11个月,平均(8.2±2.8)个月。骨延长术治疗期间,除发生针道感染、术区疼痛外,无软组织感染、血管以及神经损伤等并发症的发生。结论:清创后行骨延长术可重建下肢骨髓炎性骨缺损部位的长度,患者下肢骨和关节功能恢复良好,是治疗下肢骨髓炎性骨缺损的一种有效方法。     

肱骨远端难治性骨不连的修复

目的 探索肱骨远端难治性骨缺损与骨不连的显微外科修复方法。方法 肱骨远端骨缺损与骨不连12例，均有外科手术史及植骨史，病程8个月～3年10个月，平均12．5个月。肢体短缩4～11cm，其中8例假关节形成，4例缺损3～5cm。采用解剖钢板固定为支架，取吻合血管的腓骨移植修复，移植腓骨长5～15cm，平均8．5cm。结果 术后12例均获随访3～18个月，平均8．5个月。移植腓骨3～8个月全部愈合，随愈合时间延长，移植腓骨增粗，髓腔再通。退行变的肘关节面骨质恢复正常，肘关节伸屈、前臂旋转功能获得恢复，肢体短缩获得纠正，持重及精细操作均达到满意效果。结论 钢板内固定加吻合血管腓骨移植用于邻近关节疑难骨缺损、骨不连的修复，可重建关节功能，免除关节假体置换。     

组织瓣移植联合骨延长技术分期修复烧创伤后下肢严重软组织与骨缺损

目的探讨组织瓣移植联合骨延长技术修复烧创伤后下肢严重软组织与骨缺损的临床效果。方法2010年1月—2015年12月,收治严重股骨或胫骨合并皮肤软组织缺损患者11例。男10例,女1例;年龄19~37岁,平均28岁。致伤原因:交通事故伤8例,高压电烧伤2例,CO中毒烧伤1例。伤后至该次入院时间为3~14 d,平均6.5 d。骨缺损长度8~18 cm,平均14 cm;皮肤软组织缺损范围13 cm×8 cm~25 cm×19 cm。一期彻底去除坏死组织和病变股骨或胫骨断端,组织瓣修复软组织缺损;二期采用Orthofix单边外固定延长架或Ilizarov环形外固定延长架修复骨缺损。结果术后1例修复术后2个月皮瓣下出现一窦道,经扩创、去除坏死股骨、抗生素骨水泥间隔物填充后愈合;其余患者切口均Ⅰ期愈合。骨延长期间,1例出现针道感染,经换药和加强护理后控制感染。患者截骨段延长8~18 cm,平均14 cm;停止延长后外固定支架继续保留4~12个月,平均6.5个月。患者骨缺损均修复,骨愈合时间为12~22个月,平均17个月。患者均获随访,随访时间8~24个月,平均15个月。患者治疗期间均未出现血管、神经损伤,术后未见骨髓炎、再骨折等并发症发生,下肢功能恢复较好。结论组织瓣移植联合骨延长技术修复烧创伤后下肢严重软组织与骨缺损可获较好疗效。     

抗生素骨水泥联合Ilizarov技术在长骨感染性骨缺损治疗中的应用

目的探讨抗生素骨水泥联合Ilizarov技术个性化治疗长骨感染性骨缺损的方法和临床疗效。方法自2011年6月至2017年1月,我院应用Ilizarov技术个性化治疗股骨、胫骨、肱骨骨折术后感染性骨缺损21例,男14例,女7例;年龄18～65岁,平均37岁。其中胫骨骨缺损12例,清创后骨缺损范围平均7.2cm;股骨骨缺损7例,清创后骨缺损范围平均8.5cm;肱骨骨缺损2例,清创后骨缺损范围平均6cm。手术分两期进行:一期彻底清创,植入含敏感抗生素骨水泥,采用单边或环形外固定架固定,预留截骨延长的外固定架长度,控制感染;二期感染消灭后,根据Ilizarov技术进行截骨延长。结果所有患者术后随访12～24个月,平均18.5个月。外固定架固定时间9～21个月,平均17.2个月。外固定架指数(external fixation index,EFI)平均为2.38个月/cm。采用伊里扎洛夫方法研究与应用学会(association for the study and application of the method of Ilizarov,ASAMI)评价标准评价,骨性结果:优13例,良6例,中2例,优良率为90.5%;功能结果:优11例,良7例,中3例,优良率为85.7%。结论抗生素骨水泥联合Ilizarov技术可有效控制感染,纠正患肢畸形,重建肢体的功能,是治疗长骨感染性骨缺损的有效方法。     

肱骨骨不连的手术治疗

目的探讨肱骨骨不连的手术治疗方法及疗效。方法1998年12月～2005年5月共收治肱骨骨不连患者25例,均为肱骨骨折内固定术后发生骨不连,其中3例并发骨髓炎,6例合并不同程度肱骨骨缺损,骨缺损长度为3～6cm。骨不连病程8个月～5年。15例行吻合血管游离腓骨移植,10例采用加压交锁髓内针进行肱骨固定并辅以自体骨植骨。结果术后25例均得到随访,时间6个月～6年2个月。吻合血管游离腓骨移植组中移植的腓骨段均与肱骨干形成骨性愈合,平均骨性愈合时间为3．1个月；交锁髓内针组平均骨愈合时间为3．8个月。按Crates和Whittle肩肘关节功能评价标准,腓骨移植组：优9例,良4例,差2例；交锁髓内针组：优5例,良3例,差2例。结论应用加压交锁髓内针辅以自体骨移植对硬化性肱骨骨不连是一种有效的外科治疗方法；对合并骨髓炎、大段骨缺损及严重骨质疏松的肱骨骨不连,采用吻合血管游离腓骨移植可一期进行修复与重建。     

无植骨Ilizarov外固定技术治疗股骨萎缩性骨不连

目的探讨无植骨Ilizarov外固定技术治疗股骨萎缩性骨不连的临床疗效。方法回顾分析2010年10月—2017年1月收治的12例股骨萎缩性骨不连患者临床资料,男8例,女4例;年龄24～61岁,平均41.7岁。7例骨不连位于股骨中上段,5例位于股骨远端或髁上。病程1～9年,平均3.7年。既往手术1～9次,平均2.8次。手术取出原固定物,清理骨不连骨折端,安装Ilizarov环形外固定器,骨缺损长度4 cm者术中直接加压固定;患侧肢体较健侧短缩2.5 cm者术中行股骨近端闭合截骨加装骨延长组件,备术后肢体延长;所有患者未植骨。记录患者外固定器佩戴时间、骨不连临床愈合时间、并发症发生情况;采用Paley等的骨不连评价标准评价疗效。结果术后患者均获随访,随访时间24～50个月,平均30个月。12例骨不连均达临床愈合,愈合时间6.0～23.5个月,平均11.5个月。外固定器佩戴时间为7～25个月,平均13.5个月。末次随访时采用Paley等的骨不连评价标准,优6例、良4例、可2例,优良率83.3%。4例股骨成角畸形7°,伸膝功能无明显影响,未再行截骨手术等特殊处理。2例术后患侧肢体短缩2.5 cm,通过穿补高鞋替代;4例跨膝关节固定患者术后膝关节活动度丢失10～30°;10例发生针道感染,其中4例感染并固定针松动者给予拔针后更换位置重新固定,余6例感染但固定针未松动者通过局部换药、针道护理及口服抗炎药物感染控制。无深部感染和血管神经损伤等并发症发生。结论 Ilizarov外固定技术治疗股骨萎缩性骨不连骨愈合率较高,相对微创、无需植骨,初步临床效果确切,对于多次手术失败的患者同样有效。治疗时需要重视术后外固定器护理及康复训练。     

一期骨短缩与二期骨延长术治疗感染性胫骨骨缺损

目的探讨一期骨短缩与二期骨延长术治疗感染性胫骨骨缺损的临床疗效。方法回顾性分析自2008-07—2018-12采用一期骨短缩、二期Ilizarov骨延长术治疗的30例感染性胫骨骨缺损。观察术后伤口愈合、骨愈合、下肢功能恢复和并发症情况。骨愈合与下肢功能恢复情况按照Ilizarov技术研究与应用学会标准进行评价。结果 30例均获得随访,随访时间平均18.5(12～30)个月。术后伤口愈合良好,无感染复发。短缩骨愈合时间6～8个月,平均7.3个月;延长段骨愈合时间6～11个月,平均7.7个月;愈合指数为1.5～1.7个月,平均1.6个月。骨愈合分级:优21例,良7例,可1例,差1例。下肢功能恢复分级:优14例,良13例,可2例,差1例。并发症情况:针道感染4例,邻近关节挛缩或僵硬3例,足下垂2例,骨不愈合1例,暂时性腓总神经损伤1例,针道松动1例。结论在严格控制伤口感染的前提下,一期骨短缩、二期Ilizarov骨延长技术治疗感染性胫骨骨缺损可同时修复皮肤软组织缺损和胫骨缺损,具有简化伤口闭合、促进缺损骨愈合、骨愈合率较高、骨整体愈合时间短、并发症相对较少、肢体功能恢复满意等优点。     

骨痂延长术治疗肱骨大段骨缺损性骨不连

目的应用骨痂延长术治疗肱骨大段骨缺损性骨不连并对其临床疗效进行评价。方法20例肱骨大段骨缺损性骨不连均采用骨痂延长术进行治疗。结果术后随访1～2年,20例患者骨不连全部治愈,2例伴有桡神经损伤症状者术后恢复。结论骨痂延长术是治疗肱骨大段骨缺损性骨不连较好方法。     

下肢骨不连后骨缺损的手术治疗

目的　探讨下肢缺损性骨不连各种治疗方法的优缺点和适应证 ,提出选择最佳治疗方案的意见。方法　回顾分析 1 2年来收治下肢缺损性骨不连 5 3例的临床资料。采用髓内和 /或髓外植骨、加压钢板或交锁髓内钉固定方法治疗 4 2例 ,其中股骨33例 ,胫骨 9例 ;采用Ilizarov技术治疗 1 1例 ,其中股骨 1例 ,胫骨 1 0例。结果　全部骨不连均顺利愈合 ,骨缺损均得到修复。植骨内固定方法骨愈合时间 4～ 2 4个月 ,平均 6个月 ,患肢负重及关节活动恢复较快 ;外固定器固定方法骨愈合时间 6～2 0个月 ,平均 9个月 ,患肢负重及关节活动恢复较慢。结论　明确提出应将局部软组织情况作为重要根据选择治疗方案的观点 ;植骨内固定方法要求植骨充分、内固定牢靠 ,强调植骨方式对骨结构重建有重要意义 ;对有骨与软组织缺损、骨外露的感染性骨不连的治疗 ,应采用Ilizarov技术 ,即先切除病损骨 ,行骨输送修复骨缺损 ,软组织创面可同时缩小、愈合 ,创面未愈合者再行皮瓣转移术     

腓骨骨皮瓣移植修复肢体复合组织缺损

目的总结腓骨骨皮瓣移植修复肢体外伤性复合组织缺损的临床修复效果。方法依照患者肢体复合组织缺失情况及全身状况,采用腓骨骨皮瓣移植进行修复,其中男9例,女3例。年龄12～45岁。胫骨缺损伴腓骨骨折2例,单纯胫骨缺损2例,桡骨缺损2例,尺骨缺损3例,跟骨缺损1例,第1跖骨缺损2例;骨缺损长度4.2～10.6cm,平均7.8cm;皮肤缺损10.0cm×4.5cm～27.0cm×15.0cm。合并胫前和(或)胫后动脉损伤2例,胫后神经损伤2例,腓总神经损伤1例。一期修复4例,延期修复8例。骨皮瓣游离移植手术9例,推移手术2例,逆行移位手术1例。4例于术后3～6个月行二期肌腱移位动力重建术。行腕、踝关节融合术各1例。结果术后出现静脉危象及腓总神经牵拉性损伤各1例,经探查、大隐静脉移植等对症治疗,12例骨皮瓣全部成活。术后随访6～24个月,移植腓骨与受区断端均达骨性愈合,肢体功能均得到良好恢复。供区未出现膝及踝关节运动障碍。结论采用急诊或延期的腓骨骨皮瓣移植手术,可较好地修复肢体长管状骨干和软组织复合组织缺损。应注意受区移植腓骨皮瓣术后的感觉功能重建。     

Ilizarov bone transport for massive tibial bone defects

This article reports the treatment of massive tibial bone defects by bone transport using the Ilizarov external fixator. Fifteen patients were treated using this technique (3 females and 12 males). The defect size ranged between 7 and 22 cm (average: 10.6 cm). Etiology was infected nonunion in 9 patients, nonunion in 5 patients, and recurrent giant-cell tumor in 1 patient. The affected site was the tibial diaphysis in 10 patients, the lower tibial metaphysis in 4, and the upper tibial epiphysis in 1 patient. The external fixation time ranged from 9 months to 17 months (average: 12.27 months). External fixation index ranged from 21.8 to 42.5 day/cm (average: 35.7 day/cm). There was no recurrence of infection, no recurrence of the tumor, nor fractures after frame removal. We had to graft the docking site in 2 patients for delayed union and 2 patients developed equinus deformity and had tenoplasty for the Achilles tendon at the time of frame removal. Four patients had pin tract infection at > or =1 of the wires and this was successfully treated by antibiotic injection at the wire site. This study suggests that Ilizarov bone transport is a reliable method to fill massive bone defects.     

微创Ilizarov外固定架治疗胫骨感染性骨不连

目的评价Ilizarov外固定架下采用骨延长技术治疗胫骨感染性骨不连的临床结果及功能情况。方法22例胫骨感染性骨不连患者感染端进行清创后骨缺损的长度为4．1～12．6（6．72±2．42）cm。其中21例为小面积软组织缺损者,采用局部皮瓣转移覆盖,1例大面积软组织缺损者（8cm×5cm）,采用腓肠肌皮瓣转移术覆盖创面,22例均采用Ilizarov外固定架进行骨延长治疗。结果22例均获得随访,时间12～24（17．64±3．84）个月。骨不连均获得愈合,愈合时间7～19（9．86±3．01）个月,感染均得到控制。10例在延长过程中有局部针道渗液,治疗后愈合。牵引成骨的长度为4．1～12．6（6．72±2．42）cm。根据Paley骨折愈合评分标准：优13例,良7例,中2例。结论对于胫骨感染性骨不连,使用Ilizarov外固定架进行骨延长治疗临床结果及功能恢复满意。     

Ilizarov treatment of tibial nonunions with bone loss

Twenty-five patients aged 19-62 years were treated for tibial nonunions (22 atrophic, three hypertrophic) with bone loss (1-23 cm, mean 6.2 cm) by the Ilizarov technique and fixator. Thirteen had chronic osteomyelitis, 19 had a limb-length discrepancy (2-11 cm), 12 had a bony defect (1-16 cm), and 13 had a deformity. Six had a bone defect with no shortening, 13 had shortening with no defect, and six had both a bone defect and shortening. Nonunion, bone defects, limb shortening, and deformity can all be addressed simultaneously with the Ilizarov apparatus. Bone defects were closed from within without bone grafts by the Ilizarov bone transport technique of sliding a bone fragment internally, producing distraction osteogenesis behind it until the defect is bridged (internal lengthening). Length was reestablished by distraction of a percutaneous corticotomy or through compression and subsequent distraction of the pseudarthrosis site (external lengthening). Distraction osteogenesis resulting from both processes obviated the need for a bone graft in every case. Deformity was corrected by means of hinges on the apparatus. Infection was treated by radical resection of the necrotic bone and internal lengthening to regenerate the excised bone. Union was achieved in all cases. The mean time to union was 13.6 months, but it was only 10.6 months if the time taken for unsuccessful compression-distraction of the nonunion is eliminated from the calculation. The bone results were excellent in 18 cases, good in five, and fair in two based on union in all cases, persistent infection in three, deformity in four, and limb shortening in one. The functional results were excellent in 16 cases, good in seven, fair in one, and poor in one based on return to work and daily activities in all cases, limp in four cases, equinus deformity in five cases, dystrophy in four cases, pain in four cases, and voluntary amputation for neurogenic pain in one case.     

Free non-vascularised fibular graft for treatment of post-traumatic bone defects

Post-traumatic bone defects usually occur from severe high-velocity injuries due to road traffic accidents; they may be difficult to fill. We have managed defects of long bones by the use of free non-vascularised fibular grafts harvested subperiosteally and held by screw fixation of the fibular strut ends to the ends of the bone defect, combined with an external fixator in 8 tibial defects and with a plate and screws in 2 ulnae and 2 humeri. Twelve patients, eleven male and one female, with a mean average age of 25 years (range 12-40), underwent this procedure. Eleven grafts (92%) united at both ends within an average of 4 months (range, 3 to 5 months). The defect lengths averaged 7 cm (range from 6 to 10 cm). The long-term follow-up showed complete 'tibialisation' of the fibula. Non-vascularised fibular graft, compared to microvascular reconstruction and Ilizarov techniques, is a simple procedure that is still valid to bridge bone defects successfully in selected cases.     

手风琴技术促进骨搬移延长骨段骨质矿化的临床观察

目的:探讨骨搬移治疗胫骨骨缺损时采用"手风琴"技术对延长骨段骨质矿化的影响.方法:自2017 年5 月至2019 年10 月,采用Ilizarov 骨搬移技术治疗胫骨骨缺损患者22 例,在骨搬移结束后,采用随机数字表法将22例患者随机分为两组.观察组11例,男9例,女2例;年龄20～60(42.6±13.3)岁;骨缺损...     

Ilizarov外固定架在胫骨截骨延长治疗中的应用

目的：探讨Ilizarov外固定架在胫骨截骨延长治疗中的应用。方法：1990年1月～2002年12月对66例应用Ilizarov外固定架进行胫骨截骨延长的患者手术疗效进行分析。结果：延长长度最长9．3cm，最短5．7cm，平均7．3cm；延长时间24～128d，平均62d；拆架时间2．5～10个月，平均6．0个月；愈合指数27～56d／cm，平均34d／cm。无严重并发症发生，其中1例术后出现腓总神经损伤症状；4例出现不同程度的针道感染；6例出现膝关节屈曲受限；4例出现跟腱挛缩致足呈马蹄畸形。给予对症处理后好转。结论：应用Ilizarov外固定架技术对于胫骨截骨延长是一种有效的方法。     

骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效分析

背景：胫骨骨折术后感染性大段骨缺损的发生率高,治疗困难,效果不理想。目前,骨缺损修复方法包括皮瓣覆盖＋自体骨移植术、异体骨或异种骨移植、带血供腓骨移植、骨延长和骨搬移术。目的：探讨骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效。方法：选取2010年9月至2014年9月收治的胫骨骨折术后感染性大段骨缺损患者40例,男24例,女16例;年龄18~64岁,平均（42.8±12.1）岁。将患者随机分成两组各20例,一组采用Orthofix单臂外固定延长架截骨延长,另一组采用Ilizarov环形外固定延长架截骨延长,术后随访对比两组患者的手术时间、手术出血量、HHS膝关节功能评分、Baird-Jackson踝关节功能评分。结果：Orthofix单臂外固定延长架的手术时间较短、手术出血量较少,与Ilizarov环形外固定延长架比较均有统计学差异（P〈0.05）。两组患者的术后HHS膝关节功能评分、Baird-Jackson踝关节功能评分均较术前有明显提高（P〈0.01）。结论：骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效佳,可较好地改善患者的膝关节和踝关节功能。其中Orthofix单臂外固定延长架能减少手术创伤,安全性较高,但骨搬运过程中容易发生延长骨成角和偏移;Ilizarov环形外固定延长架的术中应用置入较多钢针,移动时可造成部分皮瓣坏死和血管损伤,应避免在皮瓣覆盖创面的胫骨大段骨缺损患者中使用。     

The treatment of infected nonunion of the tibia following intramedullary nailing by the Ilizarov method

The purpose of this study was to demonstrate the effectiveness of the Ilizarov method and circular external fixator in order to eradicate the infection and restore bone union, limb anatomy and functionality in cases with infected nonunion of the tibia following intramedullary nailing.During 7 years nine patients suffering from infected nonunion of the tibia after intramedullary nailing were treated in our department. The series comprised seven men and two women with an average age of 39.7 years (range 21-75 years). The patients had previously undergone an average of 4.8 operations (range 3-6 operations). Active purulent bone infection occurred in all nine patients. Bone defect was present in all patients with a mean size of 5 cm (range 2-12 cm). In three cases with bone defect less than 2 cm, monofocal compression osteosynthesis technique was used. In the rest cases where bone defect exceeded 2 cm, bifocal consecutive distraction-compression osteosynthesis technique was applied. Three patients required a local gastrocnemius flap. The mean follow-up period was 26.6 months (range 13-42 months). Results were evaluated using Paley's functional and radiological scoring system.Bone union was achieved in all nine patients without recurrence of infection during the follow-up period. Bone results were graded as excellent in five cases and good in the rest four cases. Functional results were graded as excellent in three cases, good in four and fare in two cases. Mean external fixation time was 187.4 days (range 89-412 days) and mean lengthening index was 32 days/cm (range 27-39 days/cm). Complications observed included eight grade II pin tract infections, axial deformity at the lengthening site in two cases and at the nonunion site in another two cases. Ankle joint stiffness was detected in five cases.The Ilizarov method may be an effective method in infected nonunions of the tibia following intramedullary nailing.     

Outcomes of post-traumatic tibial osteomyelitis treated with an Orthofix LRS versus an Ilizarov external fixator

ObjectiveTo compare the therapeutic effects of the Orthofix limb reconstruction system (LRS) versus the Ilizarov external fixator on osteomyelitis of a tibial bone defect.Materials and methodsAmong 153 patients hospitalized for bone lengthening therapy from January 1, 1996 to January 1, 2015, 129 patients were selected for a retrospective analysis. Forty-three of the candidate patients were treated using the Orthofix LRS and the other 86 were treated using an Ilizarov external fixator. The average follow-up was 96 months. We evaluated the patients at follow-up visits, and compared the length of time the patients wore the fixation devices. We also examined the scores of Activities of Daily Living (ADL) tests and a Self-rated Anxiety Scale (SAS), the range of motion, and the incidence of pin track infections.ResultsThe results indicated that both approaches were effective for treating the bone defect. Compared with the patients who wore an Ilizarov fixator for the treatment of post-traumatic osteomyelitis, those who wore an Orthofix LRS tended to be more satisfied with their quality of life and the outcome after the operation.ConclusionAlthough both approaches were effective for treating the bone defect, the overall patient outcomes were superior for the Orthofix LRS, suggesting that it should be considered as the first option in the treatment of traumatic osteomyelitis of the tibial diaphysis.     

Ten year experience with use of Ilizarov bone transport for tibial defects

Tibial defects greater than 4 cm and secondary to high-energy trauma or debridement for infected nonunion pose a significant challenge to the treating orthopaedic surgeon. Twelve patients who had been treated with Ilizarov bone transport for tibial defects over the past ten years were retrospectively reviewed. All patients were male with an average age of thirty-two. Ten of the twelve limbs were categorized as Grade IIIB fractures initially. The average tibial defect at initiation of bone transport was 9.45 cm (range 4 to 20 cm). The mean external fixator time (EFT) was 16.7 months with a mean external fixator index (EFI) of 2.0 months per centimeter. There were a total of 36 complications. Twenty were minor, fourteen were major without sequelae and two were major with sequelae. Overall bone results were good or excellent in nine patients. Overall functional results were good or excellent in eight patients. Ten patients achieved union after Ilizarov bone transport. Use of Ilizarov bone transport can be an effective tool for treating large tibial defects. However, the treatment time is lengthy with a considerable risk of complications.