OBJECTIVE: To explore the clinical therapeutic effect and safety of application of Ilizarov technique combined with flap instant expansion technique in correcting tibia angular deformity combined with skin contracture by one stage.METHODS: From January 2010 to January 2013, 30 cases of tibial deformity with skin contracture were corrected by Ilizarov technique combined with flap instant expansion technique at one stage, including 21 males and 9 females with an average age of(40.2±5.5) years ranging from 25 to 60 years. All patients underwent regular reexamination of X-ray. After removal of the Ilizarov external fixation, knee joint function were assessed by American Hospital for Special Surgery (HSS) scoring criteria, and the pain was evaluated by visual simulation score(VAS).RESULTS: All patients were followed up for 6 to 35 months with an average of 22 months. Among them, the incision of 29 patients were primary healing, 1 patient had wound infection complicated by osteomyelitis, 2 patients complicated with fixed screw loosening, there were no expanded skin flap necrosis and neurovascular injury symptoms. The external fixators were removed at 4 to 7 months after operation with an average of(5.2±1.1) months. Correction angle was 10° to 35° degrees with an average of (25.5±3.5)°. HSS total score was 92.5±6.6 and the result was excellent in 25 cases, good in 4 cases, fair in 1 case; the VAS score was 1.2±1.5.CONCLUSIONS: The application of Ilizarov technique combined with flap instant expansion technique is a good method for correction of tibial angular deformity with skin contracture by one stage, with a shorter time of external fixation frame, without skin necrosis and neurological symptoms, early load exercise and improve the limb function.
Adult Amputation, Traumatic