Long-term complications of tibial injury

Abstract

The OBJECTIVE of the study, based on our own experience, was to determine the frequency, structure and specificity of long-term complications after replacement of soft tissue and leg bones defects, and to develop treatment tactics.METHODS AND MATERIALS. A retrospective study of the case of 53 patients who underwent treatment in the trauma department of the hospital for the period 2000 to 2008 was carried out. These patients had soft tissue wounds and circular defects of the tibial diaphysis because of severe open injuries of 17 (32.1 %) and gunshot wounds to the lower leg (36 (67.9 %). Patients underwent replacement of soft tissue and lower leg bones using the Ilizarov method and microsurgical reconstruction free flaps. The analysis of treatment results was carried out.RESULTS. After the end of inpatient treatment, patients were dynamic observation carried out. 39 (73.6 %) of 53 patients sought medical help, as for various complications, the average long-term follow-up was (42.2±5.5) months. The most frequent complications were relapses of soft tissue inflammation in 13.7 % and osteomyelitis in 24.5 % of cases, non-inflammatory complications were tibia fractures (5.7 %) and pseudarthrosis (7.6 %). The analysis of treatment methods of these complications is presented.CONCLUSION. Simultaneous replacement of extensive leg defects with a free vascularized flap and Ilizarov's distraction osteogenesis creates favorable conditions for wound healing and tibial restoration, however, in the long-term period there are complications in the form of recurrent osteomyelitis, tibia fractures and pseudarthrosis, which require specialized treatment based on a detailed analysis of the pathology and the previous treatment method.