Abstract:

Objective To explore the clinical value of three⁃dimensional external fixation combined with inducing membrane technology for tibial infectious nonunion. Methods Retrospectively analyzed the clinical data of 68 patients with nonunion of tibal infection in our hospital from January 2015 to January 2017，32 cases receiving induced membrane technology and fixed treatment in phase Ⅱ were assigned to the control group，and 36 cases undergoing three⁃dimensional external fixation combined with inducing membrane technology were assigned to the treatment group. The postoperative bone defect healing and secondary recurrence of infection were compared between the two groups of patients，and Johner⁃Wruhs lower limb function scores were compared between the two groups of patients before and last follow⁃up. Results 88.9% of the patients in the treatment group had good bone repair after the second stage operation，and the imaging and clinical healing time were（6.58 ± 1.06）months and （8.32±1.14）months，respectively；87.5% in the control group had bone defects that were well repaired（P > 0.05）， but the imaging and clinical healing time（7.10 ± 1.02）months，（8.96 ± 1.25）months were longer than the treat⁃ ment group（t = 2.055，P = 0.044；t = 2.208，P = 0.031）；The postoperative knee flexion activity and ankle back extension of the treatment group were better than those of the control group（P < 0.05），and the proportion of sec⁃ ondary relapse infection in the treatment group was lower than that of the control group，the difference was statisti⁃ cally significant（P < 0.05）. At the last follow ⁃up，the excellent rate of the lower extremity function score of the treatment group was higher than that of the control group（P < 0.05）. Conclusion The three⁃dimensional external fixation stent combined with the inducing membrane technology has high clinical application value for tibial infec⁃ tious nonunion. The procedure is simple and has strong stability，which can not only ensure the blood supply of the periosteum to the greatest extent，but also promote the formation of the inducing membrane and reduce postopera⁃ tive complications. 

Key words:

three?dimensional external fixation stent, induced membrane technique, tibial fracture, infectious nonunion, clinical efficacy