Limb Reconstruction
A 34-year-old construction worker presents 8 months following a Gustilo IIIB open tibial fracture complicated by chronic osteomyelitis. After radical debridement, he has a 7cm segmental tibial bone defect. The soft tissues have healed well and there is no active infection (ESR 12, CRP less than 5). The decision is made to proceed with bone transport using an Ilizarov ring fixator. The corticotomy is performed in the proximal tibial metaphysis. Regarding Ilizarov bone transport:
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The optimal rate of distraction is 1mm per day, typically divided into 4 increments of 0.25mm every ...
The latency period before commencing transport is typically 7-10 days to allow initial callus format...
Docking site problems including delayed union occur in 30-50% of cases and represent the most common...
The regenerate bone formed during transport is histologically identical to fracture callus and follo...
Bifocal bone transport using two separate transport segments can reduce treatment time by approximat...
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