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Casestudies  >  Complex Fractures  >   Bone Loss   >   Distal to proximal Bone Transport

 

Bone Loss

 
 

          comminuted  and compound high energy fracture of tibia                  treated with monolateral fixation and repeated debridements of dead an dying bone fragments resulted in a large bone gap                              unable to walk and bear weight in a monolateral fixator  

26 yr old sustained acomminuted compound fracture which was treated with a monolateral fixator. To eradicate infection bone was resected to the extent that a 9 cm gap was created at the end of 15 months of treatment.

 

                                  ilizarov fixator is well tolerated and weight bearing walking is easy and essential for bone to form.                                   distal corticotomy with good regenerate formation is seen. Upper tibial gap is         narrowing

The ilizarov fixator was applied with thin wires at the lower tibia and a lower tibial low energy corticotomy was performed  and the intermediate gragment is gradually transported proximally.
 There is a foot frame necessary to give stability to prevent equinus deformity after distal lengthening. When specific rules are followed, walking is easy and pain-free.
                   

                                good union with full weight bearing is possible. Limb is also of equal length.        There is no shortening, infection or deformity.                                               post-operative x-ray shows sound union of upper NonUnion. 9 cm long regenerate bone is healed well. There is noresidual infection, deformity or shortening.

Result after 11 months of treatment. The upper tibial gap is completely filled up and the NonUnion is completely healed. Infection is eradicated.