Bone Healing by Using Ilizarov External Fixation Combined with Flexible Intramedullary Nailing versus Ilizarov External Fixation Alone in the Repair of Tibial Shaft Fractures: Experimental Study

Abstract

Purpose. Our research was aimed at studying the radiographic and histological outcomes of using flexible intramedullary nailing (FIN) combined with Ilizarov external fixation (IEF) versus Ilizarov external fixation alone on a canine model of an open tibial shaft fracture. Materials and Methods. Transverse diaphyseal tibial fractures were modelled in twenty dogs. Fractures in the dogs of group 1 (n = 10) were stabilized with the Ilizarov apparatus while it was combined with FIN in group 2 (n = 10). Results. On day 14, a bone tissue envelope started developing round the FIN wires. Histologically, we revealed only endosteal bone union in group 1 while in group 2 the radiographs revealed complete bone union on day 28. At the same time-point, the areas of cancellous and mature lamellar bone tissues were observed in the intermediary area in group 2. The periosteal layers were formed of the trabeculae net of lamellar structure and united the bone fragments. The frame was removed at 30 days after the fracture in group 2 and after 45 days in group 1 according to bone regeneration. Conclusion. The combination of the Ilizarov apparatus and FIN accelerates bone repair and augments stabilization of tibial shaft fractures as compared with the use of the Ilizarov fixation alone.

The formation of calcium phosphate coatings by pulse laser deposition on the surface of polymeric ferroelectric

“…AFM topography images for VDF-TeFE (a), HAP coating (c) and DCPA coating (e) and potential maps for VDF-TeFE (b), HAP coating (d) and DCPA coating (f).It is known that a rough surface structure of CaP coatings stimulates the attachment of osteoblasts and differentiation of multipotent MSC into osteoblasts in in vitro systems and bone formation in in vivo systems[45][46][47]. Thus, it can be assumed that the rough surface of the coatings formed in this work will facilitate attachment of osteoblasts and bone formation in vivo.…”

Biological activity of the implant for internal fixation

“…Osseointegration is one of the types of integration, namely, the integration of an implant and bone tissue. In orthopaedic surgery, osseointegration was first mentioned when intramedullary implants with a bioactive coating (thin titanium rods) were used to treat fractures using combined techniques (with Ilizarov's frame; Petrovskaya et al, ; Popkov et al, ; Popkov et al, ). However, many orthopaedic surgeons believe that external fixation devices cause considerable discomfort for the patient, especially in prolonged osteosynthesis (Erinle, Rack, Linnik, & Saldun, ).…”

Definite management of bilateral lower leg nonunion fractures by Ilizarov apparatus in polytraumatized patient: Case report

“…The combined techniques resulted in the reduction of the usual Ilizarov external fixation duration and good union rates [34][35][36]. Popkov et al [37] conducted a study which was aimed at revealing the differences in radiographic and histological outcomes of bone repair by using flexible intramedullary nailing combined with the Ilizarov external fixation versus the Ilizarov external fixation alone on a canine model of an open diaphyseal tibial fracture. They have concluded that their experimental study proves that the combination of the Ilizarov apparatus and flexible intramedullary nailing augments fixation stability of bone fragments, accelerates the repair of tibial shaft fractures, and can be used in clinical settings.…”