Bone transport techniques in posttraumatic bone defects

Rigal, Sylvain; Merloz, P.; Nen, D. Le; Mathevon, H.; Masquelet, A. C.

doi:10.1016/j.otsr.2011.11.002

Cited by 113 publications

(66 citation statements)

References 11 publications

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“…2,3,32,33 However, it remains indisputable that the main disadvantage of the Ilizarov technique is the tedious process with external fixation that may take months to perform. Intense pin-track pain appeared in two patients.…”

Section: Discussionmentioning

confidence: 99%

“…Compound tibia fracture with significant zone of injury or sequelae of bone healing complications can be managed with complex methods including the Ilizarov technique of distraction osteogenesis, 1,2 the Masquelet technique, 3 or vascular bone transfers, such as the iliac crest and fibula. 4 In cases of extensive soft-tissue loss, local or pedicled muscle flaps or free flaps may be indicated.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Repo

Barner-Rasmussen

Roine

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Summary Background: Extensive compound tibial fractures present reconstructive challenges. The present study aimed to assess the outcomes of microvascular latissimus dorsi (LD) flap combined with the Ilizarov technique for extensive compound tibial fractures with bone loss and bone healing complications. Methods: Patient records were reviewed retrospectively. The Lower Extremity Functional Scale (LEFS), the Disabilities of the Arm, Hand and Shoulder (DASH), and the 15D healthrelated quality of life (HRQoL) instrument were applied. Results: Between 1989 and 2014, 16 patients underwent reconstruction with a microvascular LD flap and bone transport (11/16) or late bone lengthening (5/16). The mean clinical follow-up time was 6.6 (standard deviation (SD): 6.5) years. Three patients had minor complications requiring reoperation. Partial necrosis of one flap required late flap reconstruction in one case. Late bone grafting was used to enhance union in eight of 16 cases. The mean new bone gain was 3.8 cm (SD: 2.5).Overall, 11 patients completed the questionnaires in a mean of 22.3 years (SD: 2.4) after surgery. The main findings revealed a relatively good function of the reconstructed limb and good shoulder function. The mean HRQoL was comparable to that of an age-standardized sample of the general population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Repo

Barner-Rasmussen

Roine

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…ii) Good clinical efficacy of calcium sulfate as a bone substitute. In a previous study regarding the use of calcium sulfate as a bone graft substitute to repair bone defects ranging from 13-138 cm 3 , Kumar et al (15) concluded that calcium sulfate is a safe, efficient and easily available bone graft substitute for the treatment of osseous defects. Similarly, in a 3-year randomized controlled trial, Di Alberti et al (16) also reported good outcomes of calcium sulfate as a carrier for regeneration of human bone defects.…”

Section: Calcium Sulfate Can Induce the Formation Of Membranementioning

confidence: 99%

“…Autologous bone graft is not recommended for reconstruction of massive bone defects due to its increased risk of resorption (2). Vascularized fibular autograft and the Ilizarov bone transfer technique are the most frequently used methods for reconstruction of extensive bone defects (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Possibility of one-stage surgery to reconstruct bone defects using the modified Masquelet technique with degradable calcium sulfate as a cement spacer: A case report and hypothesis

Jiang

Qin

et al. 2016

Biomedical Reports

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Abstract. In addition to autologous bone graft, vascularized fibular autograft and Ilizarov bone transfer, the Masquelet technique is another effective method to reconstruct bone defects. This technique was initially proposed in 1986 and consists of two stages. At the first stage, radical debridement is required and subsequently, a polymethylmethacrylate (PMMA) cement spacer is implanted at the site of the bone defects. At the second stage, when the PMMA-induced membrane is formed 6-8 weeks later, the cement spacer is carefully removed in order to not disturb the induced membrane and the bone graft is performed to fill the bone defects. Although this technique has resulted in satisfactory outcomes in the reconstruction of bone defects, the PMMA spacer used to induce membrane is not degradable and requires surgical removal. In recent years, calcium sulfate has been used as a localized antibiotic delivery vehicle and bone substitute due to its superiorities over PMMA, particularly its completely degradable nature. The present study identified that calcium sulfate can also induce the formation of a membrane. In addition, we hypothesized that the degradability of calcium sulfate may allow one-stage reconstruction of bone defects. The current study presents a clinical case report and review of the literature. IntroductionThe aim of bone defect reconstruction is to regenerate bone loss and restore limb function (1). Several approaches can be adopted in the clinic, including autologous bone graft, vascularized fibular autograft and the Ilizarov bone transfer technique. Autologous bone graft is not recommended for reconstruction of massive bone defects due to its increased risk of resorption (2). Vascularized fibular autograft and the Ilizarov bone transfer technique are the most frequently used methods for reconstruction of extensive bone defects (3-5).The Masquelet technique is another effective way to repair extensive bone defects. This two-staged method for bone reconstruction was first described by Masquelet et al in 1986 (6). The first-stage surgery includes radical debridement of bone and soft tissues, followed by implantation of a polymethylmethacrylate (PMMA) cement spacer at the site of the bone defects. The cement spacer is expected to obviate invasion of fibrous tissue at the recipient site (mechanical role) and induce the surrounding membrane (biological role) (7). After a duration of 6 to 8 weeks, a PMMA-induced pseudosynovial membrane formed. At the second-stage surgery, the cement spacer is removed carefully in order to maintain the already formed membrane and cause minimal disturbance. Following this, the defect is filled with morcellised cancellous autologous bone graft. Masquelet et al (6) reported that this method could repair a bone defect of 25 cm in length.Since the first study, the Masquelet technique has been widely used to resolve massive bone defects caused by different diseases and achieved clinical efficacy (8-12). However, efficacy in the cases managed by the Masquelet technique does not me...

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“…The treatment of posttraumatic diaphyseal bone defects (BD) calls for a number of techniques including bone transport techniques , shortening, compression-distraction at the fracture site, shortening followed by lengthening in a corticotomy distant from the site and segmental bone transport [1]. the earliest treatment for these problems included amputation or shortening where as more recent treatments have included bone lengthening, bone grafting, titanium mesh cage packed with allograft and distraction osteogenesis [2].…”

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confidence: 99%

Management of bone defect of humerus by Ilizarov method

Barawi¹

2016

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Bone transport techniques in posttraumatic bone defects

Abstract: Level IV. Retrospective study.

Cited by 113 publications

References 11 publications

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Possibility of one-stage surgery to reconstruct bone defects using the modified Masquelet technique with degradable calcium sulfate as a cement spacer: A case report and hypothesis

Management of bone defect of humerus by Ilizarov method

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