[Trifocal bone transport by using monolateral rail system in treatment of bone defects caused by post-traumatic tibial osteomyelitis].

To study the effectiveness of trifocal bone transport by using monolateral rail system in the treatment of bone defects caused by post-traumatic tibial osteomyelitis.The clinical data of 28 patients with tibial defects caused by post-traumatic osteomyelitis treated with trifocal bone transport technique by using monolateral rail system between January 2012 and June 2017 were retrospectively analyzed. There were 26 males and 2 females, aged 22-59 years (mean, 41.3 years). The causes of injury included 13 cases of traffic accident injury, 9 cases of falling from height, 4 cases of heavy object injury, and 2 cases of crushing injury. The disease duration was 4.5-17.0 months (mean, 7.1 months). The length of bone defect was 6.5-16.8 cm (mean, 10.3 cm). And the range of soft tissue defect ranged from 3.5 cm×2.0 cm to 18.0 cm×11.0 cm. The bone transporting time, external fixation time, duration of regenerate consolidation, and external fixation index were recorded, and the complications were observed. At last follow-up, the bone and functional results were evaluated according to the criteria given by Association for the Study and Application of the Method of the Ilizarov (ASAMI).All patients were successfully followed up after removing the external fixator with an average of 35 months (range, 24-65 months). The bone transporting time was 41-136 days (mean, 60.2 days), the external fixation time was 7.5-20.0 months (mean, 13.4 months), the external fixation index was 1.1-1.9 months/cm (mean, 1.4 months/cm), the duration of regenerate consolidation was 6.0-16.5 months (mean, 10.5 months). Pin tract infection occurred in 12 cases, delayed union on docking site was occurred in 9 cases, axial deviation was observed in 2 cases, poor regenerate consolidation was presented in 1 case, and refracture on docking site after fixator removal was occurred in 1 case. There was no recurrence of infection, amputation, vascular and neurologic complications, and osteofascial compartment syndrome. At last follow-up, according to ASAMI criterion, the bone healing results were excellent in 17 cases, good in 7 cases, and fair in 4 cases, with an excellent and good rate of 85.7%; the functional results were excellent in 15 cases, good in 10 cases, and fair in 3 cases, with an excellent and good rate of 89.3%.Trifocal bone transport by using monolateral rail system is an effective method in the treatment of bone defect caused by post-traumatic osteomyelitis which can reduce bone transport time, external fixation time, and complications.探讨单臂外固定架双节段骨搬移治疗胫骨创伤后骨髓炎骨缺损的疗效及并发症。.回顾性分析 2011 年 1 月—2017 年 6 月应用单臂外固定架双节段骨搬移治疗的 28 例胫骨创伤后骨髓炎骨缺损患者临床资料。男 26 例，女 2 例；年龄 22～59 岁，平均 41.3 岁。致伤原因：交通事故伤 13 例，高处坠落伤 9 例，重物砸伤 4 例，碾压伤 2 例。病程 4.5～17.0 个月，平均 7.1 个月。创伤后骨髓炎骨缺损长度为 6.5～16.8 cm，平均 10.3 cm。软组织缺损范围 3.5 cm×2.0 cm～18.0 cm×11.0 cm。记录骨搬移时间、外固定时间、延长区矿化时间、外固定指数，并观察患者并发症发生情况。末次随访时采用 Ilizarov 方法研究与应用协会（ASAMI）评分对骨愈合及功能恢复进行评价。.患者拆除外固定架后均获随访，随访时间 24～65 个月，平均 35 个月。骨搬移时间 41～136 d，平均 60.2 d；外固定时间 7.5～20.0 个月，平均 13.4 个月；外固定指数 1.1～1.9 个月/cm，平均 1.4 个月/cm；延长区矿化时间 6.0～16.5 个月，平均 10.5 个月。术后发生 12 例钉道感染，9 例骨搬移接触断端延迟愈合，2 例延长段出现力线偏移即轴向偏移，1 例出现延长区骨矿化不良，1 例在拆除外固定架后出现骨搬移接触断端再骨折。无感染复发、截肢、血管神经相关并发症及骨筋膜室综合征发生。末次随访时根据 ASAMI 评分标准：骨愈合获优 17 例、良 7 例、可 4 例，优良率 85.7%；功能恢复获优 15 例、良 10 例、可 3 例，优良率 89.3%。.应用单臂外固定架双节段骨搬移可有效减少骨搬移时间、外固定时间，降低治疗过程中并发症发生率，是治疗胫骨创伤后骨髓炎骨缺损的有效方法。.