EFFICACY OF THE EXTERNAL FIXATION OF LOCKING COMPRESSION PLATE IN COMBINATION WITH THE AUTOLOGOUS ILIAC CREST GRAFT ON THE BONE NOUNION AT THE DOCKING SITE AFTER TIBIAL BONE TRANSPORT

Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China

Objective: To explore the curative efficacy of treatment of ununion of the docking sites after tibial transport by locking compression plate external fixation combined with autologous ilium grafting.

Methods: From February 2015 to June 2016, 12 patients with ununion of the docking sites after tibial transport were treated by locking compression plate external fixation combined with autologous ilium grafting, including 8 males and 4 females; aged 25-51 with the average age of 38.5 years. The reasons for bone transport were traumatic osteomyelitis with segmental bone defect. There was 5cm-11cm tibial transport with the average of 8.7cm; fixed by external fixators in 10-25 months with the average of 15.2 months. At the last follow-up, the curative effect was evaluated according to the standard of fracture healing.

Results: On average the 12 were followed up for 14.3 months (from 11 to 21 months), the docking sites were healed well in 8-12 months with the average of 9.7 months after operations, fixated by LCP for 10-15 months with the average time of 13.2 months. There was no LCP loose or broken. 1 case suffered the pin track infection, 2 case suffered skin ulceration caused by limb swelling and LCP compression. The function of the knee joint and ankle joint after removal of LCP external fixation was not significantly changed compared with that of the external fixator. The Iliac donor site and bone graft area were all healed well.

Conclusion: LCP external fixation is an effective method for treatment of ununion of the docking sites after tibial transport, with stable fixation, less injury in soft tissue, significant effect, and the appearance of miniature. Compared with the traditional external fixation, LCP is more easily accepted by patients, and worthy of clinical application. However, there is higher requirements at some aspects like the operation technology and postoperative care.