Ilizarov Treatment Protocols in the Management of Infected Nonunion of the Tibia

Abstract

Level III.

Comparison of Ilizarov Bifocal, Acute Shortening and Relengthening with Bone Transport in the Treatment of Infected, Segmental Defects of the Tibia

“…Furthermore, recurrence of infection is common, affecting 10% to 20% of patients [11][12][13][14]. A structured approach, with adequate debridement, excision of necrotic tissue, antimicrobial therapy and reconstruction of the bone and soft tissues, is of immense importance to eradicate infection and restore function [15][16][17]. To manage the resulting bone defects, distraction osteogenesis techniques such as Ilizarov acute shortening with bifocal relengthening (ASR) and bone transport (BT) have been shown to be effective treatment options to achieve union and infection clearance [1,12,15,16,18].…”

“…A structured approach, with adequate debridement, excision of necrotic tissue, antimicrobial therapy and reconstruction of the bone and soft tissues, is of immense importance to eradicate infection and restore function [15][16][17]. To manage the resulting bone defects, distraction osteogenesis techniques such as Ilizarov acute shortening with bifocal relengthening (ASR) and bone transport (BT) have been shown to be effective treatment options to achieve union and infection clearance [1,12,15,16,18]. This technique permits not only the gradual restoration of the bone, but also deformity correction, correction of joint contractures, and rehabilitation, with early weight bearing to avoid muscle wasting and disuse osteopenia.…”

Biofabrication of SDF-1 Functionalized 3D-Printed Cell-Free Scaffolds for Bone Tissue Regeneration

“…Costs for tibia non-unions are doubled when compared to those without a non-union [3]. Although much knowledge was acquired during the last years for reconstruction of bone defects, e.g., employing new methods such as reaming irrigation aspiration (RIA) or concerning management of infected non-unions [4,5], the gold standard in therapy is still autologous bone grafting. This therapy requires additional interventions and, consequently, is combined with the risk of surgical complications and morbidity at the donor site.…”

The outcomes of Ilizarov treatment in aseptic nonunions of the tibia stratified by treatment strategies and surgical techniques

“…1). All of these adversely affect the course of treatment and increase the risk of treatment failure [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In nonunions of the tibia, the Ilizarov method helps achieve bone union, eliminate possible infections, equalize limb length, and correct any deformities that may have developed over the course of treatment [1-5, 7-12, 14-18, 20-22].…”

“…There is no gold standard for the treatment of nonunions of the tibia. Moreover, there are not many studies comparing the different tactics of surgical management [7,19]. Some authors claim that bone transport combined with the use of external xators carries a higher risk of complications and yields worse outcomes in comparison with other methods of tibial nonunions treatment [2,5,11].…”