The treatment of nonunion with bone loss and established deformity secondary to severe composite tissue defect remains a challenging problem. Mircrosurgical free tissue transfer has been major advance in the management of these compound
injuries.
We experienced 11 patients in whom limb reconstruction was accomplised by combining the Ilizarov technique with free tissue transfer from October, 1990 to March 1992.
The average duration of follow-up was 21.2 months ranging from 14 months to 31 months.
@ES The results of analysis were as follows;
@EN 1. There were 8 cases of infected tibial nonunion with bone loss, 2 cases of ankle deformity secondary to epiphyseal injury and 1 cases of infected tibial malunion with valgus deformity.
2. The average length of bone defect was 4.4cm in 8 cases in which internal lengthening was performed and average size of soft tissue defect or unstable skin with scar contracture was 4.6×9.3cm.
3. The combined reconstructions consisted of Ilizarov technique with 9 cases of parascapular flap, 1 case of inguinal flap and 2 cases of arterial pedicle flap.
4. The bone results were excellent in 7 cases, good in 3 cases, poor in 1 case and functional results were excellent in 4 cases, good in 5 cases, fair in 1 case and poor in 1 cases.
5. Satisfactory corrections were obtained in all of the 2 deformed patients
In conclusion, the combination of the Ilizarov technique and free tissue transfer can expand the reconstructive fields of the orthopedic microsurgeon; as well as shortening the treatment time and reducing disability.
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