Segmental tibial defects. Comparing conventional and Ilizarov methodologies.

Forty-four consecutive patients with segmental debridement defects of the tibia had limb-salvage surgery. Twenty-one patients (Group I) were managed using methods as described by Ilizarov. Twenty-three patients (Group II) underwent conventional treatment with massive cancellous grafts and tissue transfers. Total wound consolidation and infection arrest took place after the first treatment in 71% of the Ilizarov wounds and 74% of the conventionally treated wounds. The major complication rates were 33% and 60% for Groups I and II respectively. The patient population at highest risk for failure was the compromised host treated conventionally (44%). The cost for retreatment and overall success rate (95%) were the same for both groups. Ilizarov reconstructions averaged nine fewer hours in the operating theater, 23 fewer days in the hospital, five fewer months' disability (17 months versus 22 months), and a savings of nearly $30,000 per application.