title: [BONE TRANSPORTATION BY RING TYPE EXTERNAL FIXATOR COMBINED WITH LOCKED INTRAMEDULLARY NAIL FOR TIBIAL NON-INFECTIOUS DEFECT].
abstract: OBJECTIVE
  To explore the effectiveness of bone transportation by ring type extenal fixator combined with locked intramedullary nail for tibial non-infectious defect.
  
  
  METHODS
  Between June 2008 and October 2012, 22 cases of tibial large segment defect were treated. There were 15 males and 7 females, aged 24-58 years (mean, 36.8 years), including 17 cases of postoperative nonunion or malunion healing, and 5 cases of large defect. After debridement, bone defect size was 5.0-12.5 cm (mean, 8.05 cm). Bone transportation was performed by ring type external fixator combined with locked intramedullary nail, the mean indwelling duration of external fixation was 10.2 months (range, 2-26 months); the external fixation index was 1.57 months/cm (range, 0.3-3.2 months/cm); and the mean length increase was 8.05 cm (range, 5.0-12.5 cm).
  
  
  RESULTS
  All patients were followed up 19-58 months (mean, 32 months). No infection occurred after operation and all patients obtained bony union, and the union time was 4.7-19.4 months (mean, 11.9 months). Complications included refracture (1 case), skin crease (1 case), lengthening failure (1 case), foot drop (2 cases), retractions of the transport segment (1 case), delay of mineralization (1 case), which were cured after corresponding treatment. According to Hohl knee evaluation system to assess knee joint function after removal of external fixator and intramedullary nail, the results were excellent in 15 cases, good in 5 cases, and fair in 2 cases, with an excellent and good rate of 90.9%; according to Baird-Jackson ankle evaluation system to evaluate ankle joint function, the results were excellent in 10 cases, good in 3 cases, fair in 7 cases, and poor in 2 cases, with an excellent and good rate of 59.1%.
  
  
  CONCLUSIONS
  Bone transportation by ring type external fixator combined with locked intramedullary nail could increase stability of extremities, allow early removal of external fixator and avoid axis shift of extremities, so it has good effect in treating tibial noninfectious defect.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Song
authors.initials: S
authors.lastname: Jia
authors.forename: Aidong
authors.initials: A
authors.lastname: Lu
authors.forename: Sihe
authors.initials: S
authors.lastname: Qin
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Ruizheng
authors.initials: R
authors.lastname: Hao
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Yongxin
authors.initials: Y
authors.lastname: Huo
authors.forename: Gang
authors.initials: G
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000843:Ankle Joint; D001858:Bone Nails; D016025:Bone Transplantation / Q000379:methods*; D003646:Debridement; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D013977:Tibia / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult