Objective The present study was performed to explore the clinical outcome of bone transport with the llizarov technique using an external fixator for treating infected bone defects of the tibia.Methods A total of 1 7 cases underwent elective llizarov surgery were enrolled in our hospital between Nov.2011 and Jan.2011.Bone transport was performed with llizarov circular external fixator.There were 1 3 males and 4 females,with average age of 3 6 years (range:20~59 years).The causes for bone defects included traffic accidents (9 cases),falling from a height (5 cases), bruise (3 cases).All patients were diagnosed with open fracture wounds:one with Gustilo Ⅱ open injury,five with Gustilo Ⅲ A open inj ury,seven with Gustilo Ⅲ A open inj ury and four with Gustilo Ⅲ C open inj ury.Five cases were found with bone defects on the left side,while twelve cases were found on the right sideBone defects in the upper seg-ments of the tibia were observed in 7 patients,in the middle segments of the tibia were observed in 6 patients and in the lower segments of tibia were in 4 cases.The length of defect of the tibia was 6~10 cm before bone transport.The area of the defective soft tissue after wound debridement was 3 cm×4 cm~7 cm×9 cm.The first-stage operation was con-ducted to clean the wound.First the infected bone segments were removedThen the bone cement beads were implanted or the wound was covered by VSD and flap to prevent wound infection.During elective llizarov surgery,bone transport technology using an external fixator was performed after transporting or forcing bone segments to make defective bone repair and reconstruction.Variable parameters including the length of bone detect and the duration of carrying the exter-nal fixator were recorded.Then function of inj ured limb was evaluated by scoring.Results All the patients were fol-lowed up for 10~22 months with an average of 13.5 months.In 12 cases of patients with postoperative flaps survived more than 5 cases of free skin graft or wound.Tibial bone segment shifting or extension of the 6~10 cm,with an aver-age of 7 cm;external fixator carry time 7~1 6 months,the defect of the tibia were obtained reconstruction,with an aver-age of 1 1 months.According to Paley standard to evaluate bone lengthening bone removal and functional results,1 3 ca-ses were excellent,good in 3 cases,1 cases,the excellent rate was 94.1%.Conclusion Given the advantages of short treatment duration and less complication,bone transport with the llizarov method and assisted with an external fixator was recommended for treating patients with infected bone defects of the tibiaMeanwhile,this technique also had an ex-cellent outcome for limb reconstruction and deformity correction.Our results provided a reference for the clinical appli-cation of this technique.%目的：探讨和总结择期 Ilizarov外固定架辅助下骨搬移技术治疗胫骨感染性骨缺损的治疗方法及临床效果。方法我院自2011年11月至2014年1月择期采用Ilizarov环形外固定架辅助下骨搬移技术治疗胫骨感染性骨缺损患者17例，男13例，女4例；年龄20～59岁，平均36岁。受伤原因：9例交通事故，5例高处跌落，3例砸伤，均系开放性骨折，其中 Gustilo Ⅱ型1例，Gustilo ⅢA型5例，Gustilo ⅢB型7例，Gustilo ⅢC型4例；左侧5例，右侧12例；骨缺损部位在胫骨上段7例，中段6例，下段4例。骨延长-骨搬移前骨缺损长度6～10 cm。感染创面清创后软组织缺损面积约3 cm×4 cm～7 cm×9 cm。一期手术清理创面：去除感染骨段、植入骨水泥链珠或以 VSD及皮瓣覆盖创面控制感染；择期应用 Ilizarov外固定架骨延长-骨搬移技术通过骨段输送或加压使骨缺损修复、重建。分析各项指标如骨缺损长度、携带外固定架时间等，并对患肢功能恢复程度进行评分。结果所有病例随访时间10～22个月，平均13．5个月。其中12例应用皮瓣患者术后均成活，余5例经游离植皮或换药愈合。胫骨骨段搬移或延长6～10 cm，平均7 cm；外固定架携带时间7～16个月，胫骨缺损均获得重建，平均11个月。根据 Paley标准评价骨延长-骨搬移结果及功能，优13例，良3例，可1例，优良率94．1％。结论择期Ilizarov外固定架辅助下骨搬移技术治疗胫骨感染性骨缺损具有治疗周期短、并发症少等特点，同时重建肢体及矫正畸形，疗效满意，值得临床推广及应用。
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