Ilizarov Fixator Combined With an Intramedullary Nail for Tibial Nonunions With Bone Loss: Is It Effective?

Abstract

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

“…This is decreased compared with other studies of Ilizarov tibial reconstruction, which have rates that range between 2.1 and 2.6 per patient [2,8,15,37]. There was no difference in the number or severity of adverse event in both groups.…”

“…Association for the Study and Application of Methods of Ilizarov bone results were excellent in all five patients. Four patients reported excellent Association for the Study and Application of Methods of Ilizarov function results, whereas one patient was reported as good [15]. In a study of 28 patients with open tibial fractures, Atef and El-Tantawy [2] reported 16 excellent results, nine good, two fair, and one poor.…”

“…At a mean followup of 30 months, they reported 100% good/excellent Association for the Study and Application of Methods of Ilizarov bone and 96% good/excellent Association for the Study and Application of Methods of Ilizarov function results [37]. Gulabi et al [15] reported on five patients treated with a lengthening over a nail technique for a mean 8.6-cm tibial bone loss. This technique differs from the majority of integrated fixation protocols that were used in the present study; nonetheless, they achieved 100% union rates and no refractures.…”

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

“…His treatment of choice was intramedullary nailing combined with bone resection, compression and distraction of the Ilizarov apparatus and autografting at the docking site. The grafts were harvested from the iliac crest [30]. In our case, the nail was already placed inside the bone.…”

What’s New in Limb Lengthening and Deformity Correction

“…Acute shortening of tibial defects of £4 cm displayed no arterial changes as monitored by intraoperative Doppler ultrasound and hallux pulse oximetry 69 . Five patients with tibial nonunions and bone loss were treated successfully with acute shortening and bone-grafting and gradual lengthening over a nail via a corticotomy at a different portion of the affected tibia 70 . Other reported methods for managing posttraumatic skeletal defects or voids include the induced membrane technique 71 , hybrid grafting using demineralized bone matrix and tricalcium phosphate 72 , nonvascularized fibular strut bone grafts 73 , combined Papineau debridement and Ilizarov bone transport with postoperative negative-pressure wound closure 74 , epidermatofascial osteoplasty 75 , and use of megaprostheses 76 .…”