Comparative analysis of free vascularized fibula grafting and Ilizarov bone transport in management of segmental long bone defect of the lower limb: A systematic review and meta-analysis.

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Abstract

Conflict of interest statement: The authors have no conflicts of interest to declare that are relevant to the content of this article. 18. J Orthop Surg Res. 2023 Nov 22;18(1):889. doi: 10.1186/s13018-023-04356-6. Docking site complications analysis of Ilizarov bone transport technique in the treatment of tibial bone defects. Feng D(#)(1), Zhang Y(#)(2), Wu W(3), Jia H(4), Ma C(5). Author information: (1)Department of Pain, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (2)International Medical Services, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (3)Department of Joint Surgery, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (4)Department of Pain, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. 13833308817@163.com. (5)Department of Orthopaedic, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China. 1516175919@qq.com. (#)Contributed equally BACKGROUND: Treating long bone defects of the extremities caused by trauma, infection, tumours, and nonunion has been challenging for clinical orthopaedic surgeons. Bone transport techniques have the potential to treat bone defects. However, inevitable docking site complications related to bone transport techniques have been reported in many studies. The purpose of this study was to investigate the risk factors associated with docking site complications in patients who underwent the Ilizarov bone transport technique for the treatment of tibial bone defects. METHODS: This retrospective study included 103 patients who underwent bone transport for the treatment of large bone defects in the tibia from October 2012 to October 2019. Patient demographic data, complications and clinical outcomes after a minimum of 2 years of follow-up were collected and retrospectively analysed. Additionally, univariate analysis and logistic regression analysis were used to analyse the factors that may affect the development of docking site complications in patients with tibial bone defects treated with the Ilizarov bone transport technique. The clinical outcomes were evaluated using the Association for the Study and Application of the Ilizarov criteria (ASAMI) at the last clinical follow-up. RESULTS: All 103 patients with an average follow-up of 27.5 months. The docking site complications rate per patient was 0.53, and delayed union occurred in 22 cases (21.4%), axial deviation occurred in 19 cases (18.4%) and soft tissue incarceration occurred in 10 cases (9.7%). According to the results of the logistic regression analysis, the bone defect length (P = 0.001, OR = 1.976), and bone defect of distal 1/3 (P = 0.01, OR = 1.976) were significantly correlated with delayed union. Bone defect length (P