Operation procedures of the TIBT group

The lower leg was maintained in the center of the Ilizarov fixator. Parallel to the knee and ankle joint surface, the Ilizarov frame was fixed with Kirschner wires. According to the surgical plan, the distal or proximal tibial osteotomy was performed. Kirschner wires were inserted to fix the moving segment. Under fluoroscopy, the bone defect alignment was adjusted to ensure that there was no axis deviation. The wound was washed and sutured. One week after operation, the external fixator was adjusted for bone transport. After the docking site was in contact, continue to press appropriately to make the docking site heal. During the process of bone transport, the condition of nerves and blood vessels should be well monitored. The Ilizarov external fixator could be removed after the docking site was firmly healed and the transport section was completely mineralized. A typical case is shown in Fig. 5.

A 23-year-old female was diagnosed as severe tibial open fracture and treated with the TIBT technique. a X-rays after injury. b After debridement, X-rays of the affected tibia. c This patient was treated with the TIBT technique, 14 cm of tibial defects were observed. d–f The X-rays showed the bone transport process. g and h X-rays after removal of the Ilizarov external fixator. TIBT stands for traditional Ilizarov bone transport