Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects
Abstract Background Traumatic tibial defect complicated with soft tissue defect is a difficult problem in clinic. Vascularized iliac crest bone flap (VIBF) and Ilizarov bone transport are effective methods to treat tibial defects with limited defect length, which most need to be explored accordingly...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03783-9 |
| _version_ | 1797827454844272640 |
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| author | Zhe-ming Cao Xin-lei Sui Yu Xiao Li-ming Qing Pan-feng Wu Ju-yu Tang |
| author_facet | Zhe-ming Cao Xin-lei Sui Yu Xiao Li-ming Qing Pan-feng Wu Ju-yu Tang |
| author_sort | Zhe-ming Cao |
| collection | DOAJ |
| description | Abstract Background Traumatic tibial defect complicated with soft tissue defect is a difficult problem in clinic. Vascularized iliac crest bone flap (VIBF) and Ilizarov bone transport are effective methods to treat tibial defects with limited defect length, which most need to be explored accordingly. Methods In this study, a total of 68 patients with traumatic tibial defect (ranging from 4 to 10 cm) and large soft tissue defect were collected retrospectively. The soft tissue defects were repaired by latissimus dorsal musculocutaneous flap (LD), anterolateral thigh flap (ALTF) or both. Thirty-three cases were treated with vascularized iliac crest bone flap transplantation and 35 cases were treated with Ilizarov bone transport. Intraoperative and postoperative follow-up data (including operation time, blood loss, bone union time, external fixation time, external fixation index, complication rate, reoperation rate, and functional evaluation) were recorded, and comparative analysis was performed. Results The median follow-up time was 32 months. Compared with Ilizarov group, the VIBF group exhibited statistically faster bone union time (6.3 ± 1.0 vs. 18.2 ± 3.0 months). Moreover, the VIBF group showed shorter EFT (7.3 ± 1.0 vs. 19.2 ± 3.0 months) and a better EFI (34.8 ± 9.2 vs. 84.2 ± 23.7 days/cm). The excellent and good rate of lower limb appearance evaluation in VIBP group was significantly better than that in Ilizarov group. The complication rate and reoperation rate were significantly higher in Ilizarov group. Conclusion In summary, compared with Ilizarov bone transport, VIBP has the advantages of faster healing, shorter external fixation time, lower complication and reoperation rate, and better appearance within the limited defect length. Ilizarov bone transport is still preferred when the defect length exceeds the maximum repair length of the iliac flap. The daily handling required by bone transport process is painful. Level of evidence III, Case–control study. |
| first_indexed | 2024-04-09T12:48:35Z |
| format | Article |
| id | doaj.art-9cde5cd42f744d4dbffe94e524bb1777 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T12:48:35Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-9cde5cd42f744d4dbffe94e524bb17772023-05-14T11:22:37ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-05-011811910.1186/s13018-023-03783-9Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defectsZhe-ming Cao0Xin-lei Sui1Yu Xiao2Li-ming Qing3Pan-feng Wu4Ju-yu Tang5Department of Orthopedics, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Xiangya Hospital, Central South UniversityDepartment of Orthopedics, Xiangya Hospital, Central South UniversityAbstract Background Traumatic tibial defect complicated with soft tissue defect is a difficult problem in clinic. Vascularized iliac crest bone flap (VIBF) and Ilizarov bone transport are effective methods to treat tibial defects with limited defect length, which most need to be explored accordingly. Methods In this study, a total of 68 patients with traumatic tibial defect (ranging from 4 to 10 cm) and large soft tissue defect were collected retrospectively. The soft tissue defects were repaired by latissimus dorsal musculocutaneous flap (LD), anterolateral thigh flap (ALTF) or both. Thirty-three cases were treated with vascularized iliac crest bone flap transplantation and 35 cases were treated with Ilizarov bone transport. Intraoperative and postoperative follow-up data (including operation time, blood loss, bone union time, external fixation time, external fixation index, complication rate, reoperation rate, and functional evaluation) were recorded, and comparative analysis was performed. Results The median follow-up time was 32 months. Compared with Ilizarov group, the VIBF group exhibited statistically faster bone union time (6.3 ± 1.0 vs. 18.2 ± 3.0 months). Moreover, the VIBF group showed shorter EFT (7.3 ± 1.0 vs. 19.2 ± 3.0 months) and a better EFI (34.8 ± 9.2 vs. 84.2 ± 23.7 days/cm). The excellent and good rate of lower limb appearance evaluation in VIBP group was significantly better than that in Ilizarov group. The complication rate and reoperation rate were significantly higher in Ilizarov group. Conclusion In summary, compared with Ilizarov bone transport, VIBP has the advantages of faster healing, shorter external fixation time, lower complication and reoperation rate, and better appearance within the limited defect length. Ilizarov bone transport is still preferred when the defect length exceeds the maximum repair length of the iliac flap. The daily handling required by bone transport process is painful. Level of evidence III, Case–control study.https://doi.org/10.1186/s13018-023-03783-9Tibia defectsVascularized iliac crest bone flapIlizarov bone transportComparative study |
| spellingShingle | Zhe-ming Cao Xin-lei Sui Yu Xiao Li-ming Qing Pan-feng Wu Ju-yu Tang Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects Journal of Orthopaedic Surgery and Research Tibia defects Vascularized iliac crest bone flap Ilizarov bone transport Comparative study |
| title | Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects |
| title_full | Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects |
| title_fullStr | Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects |
| title_full_unstemmed | Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects |
| title_short | Efficacy comparison of vascularized iliac crest bone flap and Ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects |
| title_sort | efficacy comparison of vascularized iliac crest bone flap and ilizarov bone transport in the treatment of traumatic bone defects of the tibia combined with large soft tissue defects |
| topic | Tibia defects Vascularized iliac crest bone flap Ilizarov bone transport Comparative study |
| url | https://doi.org/10.1186/s13018-023-03783-9 |
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