Ilizarov bone transport after massive tibial trauma: Case report.
BACKGROUND
This is a case report of extreme lengthening of the tibia of about 14.5cm using bone transport technique following road traffic accident trauma to the lower limbs. The management of the subsequent massive skeletal defects was challenging to orthopedic surgeons. Based on reported cases, the highest tibial lengthening was 22cm using bifocal transport, while the highest unifocal tibial lengthening reached 14.5cm.


METHODS
A 20-year-old male driver was brought to the emergency department after a road traffic accident. The patient had a right Gustilo IIIA segmental open tibia fracture with bone loss and other severe injuries. The tibial defect was 14.5cm and the patient was then admitted for Ilizarov application six months after the accident. Although this case was particularly complicated, full limb length was restored.


CONCLUSIONS
The management of this case was directed to correct the deformities and achieve equal length of both limbs to restore the normal function. Several new techniques have been developed recently to fill large bone defects. Limb lengthening using bone transport technique by application of Ilizarov ring fixator has been suggested as the leading option in filling massive bone gaps.


CONCLUSIONS
The use of bone transport technique using Ilizarov external rings has proved to be a minimally invasive and reliable method in managing massive bone defects. Accurate application of the Ilizarov frame and proper transport of the middle segment are important factors alleviating the risk for deviation of the transported segment. However, due to the need for regular follow-ups and monitoring, it demands high compliance from the patient to achieve optimal results.
Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia. Electronic address: ZahraniN@ngha.med.sa.
Nader S
NS
Alkenani
College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. Electronic address: Mariam.osfoor@gmail.com.
Mariam A
MA
Alosfoor
College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia. Electronic address: Araifi.ak@gmail.com.
Abdulaziz K
AK
Al-Araifi
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: halanuaim@gmail.com.
Hala A
HA
Alnuaim
Bone lengthening; Distraction osteogenesis; Ilizarov technique
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