Acute shortening and lengthening versus bone transport using the Ilizarov fixator in the management of atrophic tibial non unions

Abstract

The Ilizarov method is well established in the treatment of atrophic tibial non-unions. It is able to address the problems of an avascular segment, infection, deformity and limb length discrepancy. In this study it is compared acute shortening and then subsequent lengthening against bone transport in the treatment of tibial non-unions. It is recommend that where feasible, acute shortening is preferable to bone transport because of the shorter treatment time, lesser procedures needed to union, lower rate of complications and lower need for secondary intervention(61). In some circumstances however, this may not be possible for a large bone defect more than 5 cm as the true limitation of acute shortening procedure is the blood supply to the foot because shortening more than 5 cm in the tibia lead to torturous blood vessels and compromise blood supply. So in large tibial bone defects we can use bone transport technique safely without vascular compromise(60).