Ankle Salvage Following Nonunion of Distal Tibia Fractures

Lovisetti, Giovanni; Кириенко, А. И.; Myerson, C Lucas; Vulcano, Ettore

doi:10.1177/1071100718781327

Cited by 8 publications

(5 citation statements)

References 49 publications

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“…[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Chin et al 12 evaluated the outcomes of treating 13 patients with nonunion of the distal tibia and reported that all patients had radiographic and clinical 12 In the treatment of noninfected and infected periarticular distal tibial nonunion, the Ilizarov fixator has been used for ankle sparing by achieving union and functional ankle joint. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] It has also been used for arthrodesis or resection arthrodesis with or without segment transport in cases with permanent articular surface destruction with or without bone loss. [5][6][7][8][9][10][11][12][13][14]…”

Section: Discussionmentioning

confidence: 99%

“…Although there is controversy regarding the effect of ankle arthrodesis on adjacent-joint arthritic changes, adverse effects of ankle fusion have been reported, including decreased walking speed and stride length. [27][28][29][30] Thomas et al 31 reported that ankle arthrodesis resulted in an alteration of hindfoot function and gait with significantly reduced AOFAS scores and increased Ankle Osteoarthritis Scale (AOS) scores for disability.…”

Section: Discussionmentioning

confidence: 99%

“…In the treatment of noninfected and infected periarticular distal tibial nonunion, the Ilizarov fixator has been used for ankle sparing by achieving union and functional ankle joint 8–27 . It has also been used for arthrodesis or resection arthrodesis with or without segment transport in cases with permanent articular surface destruction with or without bone loss 5–17 …”

Section: Discussionmentioning

confidence: 99%

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Management of Nonunion of Distal Tibial Periarticular Fractures Using Ilizarov External Fixator

Zayda,

Badr

2023

Techniques in Foot &Amp; Ankle Surgery

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Nonunion of the periarticular distal tibial fractures is a challenging issue with limited options for treatment. The study aims to evaluate the outcomes of treatment of non-united periarticular distal tibial fractures using Ilizarov external fixation. A retrospective study included 16 patients with distal tibial fracture nonunion treated with Ilizarov fixator from 2014 to 2019 with a minimum 1-year follow-up after frame removal. Fibular plating was done in 8 cases and supplementary interfragmentary screws at the nonunion site in 5 cases. Primary or delayed bone graft was used in 11 patients. The ASAMI protocol was used to assess the bone and functional results. The American Orthopaedic Foot and Ankle Society (AOFAS) scale was used to assess the functional outcomes. Study included 9 males and 7 females, mean age of 47.4±14.1 years. 15 cases had previous surgeries for nonunion. 7 had active infection. duration of nonunion was 24.1±13.2 months. Mean duration of fixation was 5.7±1.0 months. Mean follow-up was 21.8±8.5 months. Mean AOFAS score improved from 52.4±3.7 preoperatively to 85.4±9.8 at the latest follow-up (P<0.001). Finally, the infection was resolved, and union was achieved in all patients. Bone results were excellent in 3 cases and good in 13, whereas functional results were excellent in 6 cases, good in 8, fair in 1, and poor in 1. Ilizarov fixator is a reliable option for treating nonunion in the periarticular distal tibial fractures. It provides secure fixation for short distal fragments, especially with history of infection, those with bad skin conditions, previous failed internal fixation, and osteopenic bone. Level of Evidence: Level IV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management of Nonunion of Distal Tibial Periarticular Fractures Using Ilizarov External Fixator

Zayda,

Badr

2023

Techniques in Foot &Amp; Ankle Surgery

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“…Unlike easy achievement of anatomical reduction in oblique fracture or transverse fracture, the spiral fracture can often only achieve functional reduction. Furthermore, the blood supply of the middle and lower tibia is single, so both fracture and surgical procedures are easy to destroy the blood supply of the site of the fracture, thereby resulting in complications such as delayed fracture healing and nonunion [ 22 , 23 ]. We retrospectively summarized the treatment and healing of the fractures and found that the degree of reduction of the fracture and whether the site of fracture was incised were two key factors affecting fracture healing and efficacy.…”

Section: Discussionmentioning

confidence: 99%

Effect of Different Reduction Intramedullary Nails on Spiral Fracture of Middle and Lower Tibia

Shi

Liang

et al. 2022

Contrast Media & Molecular Imaging

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Objective. To compare the efficacy of different reduction and intramedullary nailing in the treatment of spiral fracture of middle and lower tibia. Method. A total of 96 patients with spiral fractures of middle and lower tibia treated with intramedullary nails were retrospectively analyzed. The patients were divided into closed functional reduction group, open anatomical reduction group, and closed anatomical reduction group according to different treatment methods. The operation time, intraoperative blood loss, intraoperative fluoroscopy times, fracture healing time, fracture nonunion, wound complications, and healing conditions of the three groups were compared. Results. The operation time and intraoperative fluoroscopy times of patients in the closed anatomical reduction group were significantly increased compared with those in the closed functional reduction group, while the fracture healing time was significantly reduced. However, patients in the open reduction group had significantly more intraoperative blood loss than those in the closed reduction group. The mean follow-up duration of patients was 15.81 ± 3.25 months. Open anatomical reduction was found to have a higher complication rate during follow-up. Specifically, a total of 3 cases recovered after 2 times of surgical treatment. 6 cases showed a small gap at the fracture end which did not affect the function. Conclusion. In the treatment of middle and lower spiral fracture of tibia, closed anatomical reduction and intramedullary nail internal fixation have shorter fracture healing time, less blood loss, and fewer complications, which can act as the first surgical choice. However, open reduction and intramedullary nailing have a high complication rate, which is not recommended.

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“…In a retrospective study by Lovisetti et al ., 19 21 patients underwent BT with preservation of the ankle joint, resulting in complete fracture healing at the final follow‐up (mean follow‐up: 14.6 months). The authors concluded that the preserved ankle bone transport technique is an effective alternative to bone grafting and arthodesis for the treatment of periarticular bone nonunion at the distal tibia.…”

Section: Bone Transport Technique In Lower Extremity Bonesmentioning

confidence: 99%

Advances in the Application of Bone Transport Techniques in the Treatment of Bone Nonunion and Bone Defects

Li,

Liu,

et al. 2023

Orthopaedic Surgery

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Bone nonunion and bone defects frequently occur following high‐energy open injuries or debridement surgeries, presenting complex challenges to treatment and significantly affecting patients' quality of life. At present, there are three primary treatment options available for addressing bone nonunion and bone defects: vascularized bone grafts, the Masquelet technique, and the Ilizarov technique. The Ilizarov technique, also known as distraction osteogenesis, is widely favored by orthopedic surgeons because of several advantages, including minimal soft tissue requirements, low infection risk, and short consolidation time. However, in recent years, the application of the Masquelet technique has resulted in novel treatment methods for managing post‐traumatic bone infections when bone defects are present. Although these new techniques do not constitute a panacea, they continue to be the most commonly employed options for treating complex large bone nonunion and bone defects. This review evaluates the currently available research on the Ilizarov and Masquelet bone transport techniques applied at various anatomical sites. Additionally, it explores treatment durations and associated complications to establish a theoretical foundation that can guide clinical treatment decisions and surgical procedures for the management of bone nonunion and bone defects.

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Ankle Salvage Following Nonunion of Distal Tibia Fractures

Abstract: Level IV, case series.

Cited by 8 publications

References 49 publications

Management of Nonunion of Distal Tibial Periarticular Fractures Using Ilizarov External Fixator

Management of Nonunion of Distal Tibial Periarticular Fractures Using Ilizarov External Fixator

Effect of Different Reduction Intramedullary Nails on Spiral Fracture of Middle and Lower Tibia

Advances in the Application of Bone Transport Techniques in the Treatment of Bone Nonunion and Bone Defects

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