title: Bone transport for postinfectious segmental tibial bone defects with a combined ilizarov/taylor spatial frame technique.
abstract: OBJECTIVE
  To assess and compare the results of trifocal (two-level bone lengthening with compression at the nonunion site) and bifocal (one-level bone lengthening with compression at the nonunion site) bone transport using the Taylor Spatial Frame (TSF; Smith and Nephew, Inc, Memphis, TN) for postinfectious segmental tibial bone defects.
  
  
  METHODS
  Retrospective study of 12 patients with atrophic tibial nonunions. These patients were treated with resection of the nonunion followed by bone transport using the TSF for the segmental tibial bone defects. All patients were treated by the same surgeon (F.S.).
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  Twelve consecutive patients treated for postinfectious segmental tibial bone defects between November 2004 and September 2007.
  
  
  METHODS
  All patients were treated using the TSF for a trifocal or bifocal technique of bone transport along with associated soft tissue reconstructive surgeries. All patients were additionally treated with 45 days of culture-specific antibiotics.
  
  
  METHODS
  All patients were evaluated by the guidelines of the Association for the Study of the Method of Ilizarov.
  
  
  CONCLUSIONS
  All patients achieved complete union and eradication of infection. The results were evaluated according to Association for the Study of the Method of Ilizarov criteria: 83% were excellent and 17% were good in terms of bony outcomes; functional results were excellent in 50%, good in 42%, and fair in 8%. Combined Ilizarov/TSF trifocal and bifocal techniques for the treatment of segmental tibial bone defects achieve union without malalignment of the mechanical axis.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, Milan, Italy. sala.francesco@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Sala
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Thabet
authors.forename: Fabio
authors.initials: F
authors.lastname: Castelli
authors.forename: Anna N
authors.initials: AN
authors.lastname: Miller
authors.forename: Dario
authors.initials: D
authors.lastname: Capitani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lovisetti
authors.forename: Tazio
authors.initials: T
authors.lastname: Talamonti
authors.forename: Saurabh
authors.initials: S
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D016267:External Fixators; D005260:Female; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000601:surgery*; D013977:Tibia; D016896:Treatment Outcome; D055815:Young Adult