Bone healing by using Ilizarov external fixation combined with flexible intramedullary nailing versus Ilizarov external fixation alone in the repair of tibial shaft fractures: experimental study.
OBJECTIVE
Our research was aimed at studying the radiographic and histological outcomes of using flexible intramedullary nailing (FIN) combined with Ilizarov external fixation (IEF) versus Ilizarov external fixation alone on a canine model of an open tibial shaft fracture.


METHODS
Transverse diaphyseal tibial fractures were modelled in twenty dogs. Fractures in the dogs of group 1 (n = 10) were stabilized with the Ilizarov apparatus while it was combined with FIN in group 2 (n = 10).


RESULTS
On day 14, a bone tissue envelope started developing round the FIN wires. Histologically, we revealed only endosteal bone union in group 1 while in group 2 the radiographs revealed complete bone union on day 28. At the same time-point, the areas of cancellous and mature lamellar bone tissues were observed in the intermediary area in group 2. The periosteal layers were formed of the trabeculae net of lamellar structure and united the bone fragments. The frame was removed at 30 days after the fracture in group 2 and after 45 days in group 1 according to bone regeneration.


CONCLUSIONS
The combination of the Ilizarov apparatus and FIN accelerates bone repair and augments stabilization of tibial shaft fractures as compared with the use of the Ilizarov fixation alone.
Laboratory for Limb Lengthening and Deformity Correction, Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics, 6 M. Ulianova Street, Kurgan 640014, Russia.
A V
AV
Popkov
Laboratory for Limb Lengthening and Deformity Correction, Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics, 6 M. Ulianova Street, Kurgan 640014, Russia.
N A
NA
Kononovich
Laboratory of Morphology, Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopedics, 6 M. Ulianova Street, Kurgan 640014, Russia.
E N
EN
Gorbach
National Research Tomsk Polytechnic University, 30 Lenin Avenue, Tomsk, Russia.
S I
SI
Tverdokhlebov
Laboratory of Morphology, Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopedics, 6 M. Ulianova Street, Kurgan 640014, Russia.
Y M
YM
Irianov
Laboratory for Limb Lengthening and Deformity Correction, Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics, 6 M. Ulianova Street, Kurgan 640014, Russia.
D A
DA
Popkov
D000818:Animals; D001858:Bone Nails / Q000662:veterinary; D004285:Dogs; D016267:External Fixators / Q000662:veterinary; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D018889:Ilizarov Technique; D016268:Internal Fixators / Q000662:veterinary; D011859:Radiography; D013977:Tibia / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*