Distraction osteogenesis for bone repair in the 21st century: Lessons learned

Catagni, Maurizio A.; Guerreschi, Francesco; Lovisetti, Luigi

doi:10.1016/j.injury.2011.04.004

Cited by 56 publications

(37 citation statements)

References 7 publications

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“…Progressive correction of the deformity and shortening is possible at the same time by this instrument. [3][4][5]19,20 The overall goal in the reconstruction of an infected nonunion of long bone involves more than control of infection and includes creation of a healed, aligned and drainage free limb which is functionally better than a amputated and prosthetic fitted limb. Several factors must be considered in reconstruction of bone including the patient's age, socioeconomic status, metabolic status, mobility of the knee, foot and ankle, integrity of neurovascular structures and also the patient's motivation.…”

Section: -10mentioning

confidence: 99%

Management of infected non-unions of long bones using limb reconstruction system (LRS) fixator

et al. 2017

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Background: Due to increasing number of high-energy traumatic events, the incidence of complex and compound fractures are also in the rise. Such fractures are often exposed to various environmental contaminants, inadequate debridement and sometimes erroneous decision making leading to cases of infected nonunions. Eradication of infection in such cases and achieving union may sometimes pose serious challenge to orthopaedic surgeons. Presence of comminution, bone gap or deformity can seriously complicate the situation. No definite surgical technique has been found to be full proof in dealing with these infected nonunion cases. In this scenario the limb reconstruction system (LRS) fixator is emerging as a useful option for infected nonunions with deformity or gap nonunion.Methods: Twenty seven cases of infected nonunions involving tibia (n=19), femur (n=7) and humerus (n=1) were treated by LRS fixators after debridement of the infected nonunion site. Flap cover procedure was done as per necessity. Bone gaps and limb length discrepancies were dealt with bone transport or limb lengthening by the LRS instrument. Weight-bearing and removal of fixator was decided according to the radiological evidence of healing.Results: All the nonunions and the regeneration sites healed uneventfully, although the union time was varied (range, 21-52 weeks). Commonest complication was pin-tract infection and pain. The mean lower extremity functional score (LEFS) was 60.3 out of 80. Conclusions: LRS fixator is an excellent tool for management of infected nonunions which is easy to apply, comfortable for the patient with minimum complications and predictable as well as reproducible outcomes.

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Section: -10mentioning

confidence: 99%

Management of infected non-unions of long bones using limb reconstruction system (LRS) fixator

et al. 2017

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“…Auch zur Behandlung von Regeneratinsuffizienzen finden sich Erfahrungsberichte mit Beckenkammblut, allerdings ohne Angaben zu Heilungsraten [6]. Hernigou et al [15] konnten zeigen, dass die osteogene Potenz durch Konzentrierung des Knochenmarkaspirats angehoben werden kann [15].…”

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Kallusaugmentation mit konzentriertem Beckenkammaspirat

Geßmann

Köller

Dudda

et al. 2012

Trauma Berufskrankh

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“…Im klinischen Alltag der Gliedmaßenre-konstruktion sind die Grenzen vom hypotrophen Kallusregenerat [2] zum kompletten Regeneratversagen fließend. Diese Komplikation steht im Fokus der Nachsorge, und Rozbruch u. Ilizarov [16] widmeten diesem Problem ein ganzes Kapitel.…”

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“…1 8 Injektion von BMP-7 mit Jamshidi-Nadel unter Bildwandlerkontrolle in den nicht hinreichend durchbauten Kallus mit einem radiologischen Score von 3 Punkten (keine Kortikalis durchgehend durchbaut) Abb. 2 …”

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“…), um nur einige Beispiele zu nennen.Tab 2. Patienten mit Anwendung von BMP-7 oder -2 zur Therapie des Regeneratversagens BMP "bone morphogenetic protein", m männlich, RIA "reamer irrigator aspirator", w weiblich a Die Angaben zu Alter und Distraktionslänge beziehen sich auf alle 5, die restlichen Angaben nur auf die ersten 4 Patienten mit bereits ausreichender Nachbeobachtungszeit Tab 1.…”

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Komplikationen des Segmenttransports

Wagner

Militz

Högel

et al. 2012

Trauma Berufskrankh

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LeitthemaDer Segmenttransport zur Rekonstruktion von Röhrenknochendefekten über 2 cm Länge ist z. B. nach radikaler Sanierung von Knocheninfektionen ein sicheres Verfahren zur Wiederherstellung der anatomischen Extremitätenlänge. Die Regeneratinsuffizienz ist eine regelhaft auftretende, aber seltene Komplikationsmöglichkeit. Ilizarov [7] beschrieb einen 100%igen Behandlungserfolg, falls keine Reinfektion eintritt, räumte aber ein, dass selten eine bis zu Jahre dauernde Tragzeit des Ringfixateurs erforderlich wird. Genaue Zahlen über die Häufigkeit der Regeneratinsuffizienz fehlen in der Literatur.

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Distraction osteogenesis for bone repair in the 21st century: Lessons learned

Cited by 56 publications

References 7 publications

Management of infected non-unions of long bones using limb reconstruction system (LRS) fixator

Management of infected non-unions of long bones using limb reconstruction system (LRS) fixator

Kallusaugmentation mit konzentriertem Beckenkammaspirat

Komplikationen des Segmenttransports

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