Ilizarov外固定架治疗胫骨骨缺损及骨短缩

目的探讨应用Ilizarov外固定架治疗胫骨骨不连及骨缺损的方法及临床疗效。方法对19例胫骨骨不连及骨短缩患者（肢体短缩4~17cm，平均9cm），根据Iuizarov治疗原则，采用微创截骨、直接拉伸延长或骨段滑移术修复骨缺损和延长肢体，在连续硬膜外麻醉下手术置入外固定架。骨不连者调整外固定架使骨断端对合并加压；骨缺损短缩者则做骨段搬移术或直接拉长。定期复查X片，直至骨愈合满意后拆除外固定架。结果本组术后经1～5年随访。所有骨缺损愈合，肢体长度恢复正常或接近正常，感染无复发。结论Ilizalov外固定架技术是治疗胫骨大段骨缺损的有效方法。软组织感染创面可在骨段滑移中逐渐缩小并闭合，骨感染可在骨段滑移中逐渐被控制并随骨连接而愈合。

Use ilizarov device to treat tibia bone defect and bone shortening

Objective To study the treatment of tibia bone defect and limbs shortening in adults with improved Illizarov technique. Method 19 patients with tibia bone defect were treated. The length of limb shortened ranging from 4 to 17 cm （mean 9 cm）, all the cases with bone defected were treated with external fixation and minimal incisional osteotomy. According to Illizarov method, the bone segmental rifting was used for nonunion and limb shortening respectively. Results After bone segment frifiing, the bone defect healed, the space of lengthening ossified well without bone graft. All the cases were followed up for 1 to 5 years. Limb length in all the cases returned to normac and bone defect was repaired without infection.Conclusion The technique of bone segment frifting is a simple and effective method for bone defect. Traumatic wound of soft tissue can decrease and close,and the bone infection can be controlled gradually during the bone segment frift. Finally, the infection can be healed with the bone union.