Infected Tibial Pseudarthrosis: A 2-Year Follow Up on Patients Treated by the Ilizarov Technique

Morandi, Massimo; Zembo, M.; Ciotti, Mauro

doi:10.3928/0147-7447-19890401-05

Cited by 40 publications

(2 citation statements)

References 10 publications

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“…This treatment is effective in clinical practice, but the recurrence rate of infection is very high. Morandi et al 29 reported in a retrospective study that although all patients with infected nonunion were cured by this method, the recurrence rate of healing infection was as high as 100%. For this reason, this method was improved and formed the Ilizarov technology today.…”

Section: Application In Infected Nonunionmentioning

confidence: 99%

Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects

Wang

et al. 2022

Orthopaedic Surgery

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The treatment of infected bone nonunion and bone defects is a considerable challenge in the orthopedics field. The standard clinical therapy methods include local free bone transplantation, vascularized bone graft, and the Ilizarov technique; the first two are controversial due to the iatrogenic self-injury. The Ilizarov bone transport technique has been widely used to treat infected bone nonunion and bone defects, and good clinical effect has been demonstrated. Yet, it brings many related complications, which exerts additional suffering to the patient. The best treatment is to combine bone defect rehabilitation with infection control, intramedullary nail fixation, appropriate time for bone grafts, beaded type scaffold slippage and new Taylor fixation, reducing the external fixation time and the incidence of complications, thereby reducing the occurrence of patients' physical and psychological problems. This review focuses on the induction, summary and analysis of the Ilizarov bone transport technique in the treatment of infected long bone nonunion with or without bone defects, providing new ideas and methods for orthopedic disease prevention and treatment by the Ilizarov technique, which is following the development direction of digital orthopedics.

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Section: Application In Infected Nonunionmentioning

confidence: 99%

Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects

Wang

et al. 2022

Orthopaedic Surgery

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“…Metody kalusdistrakce byly rozvíjeny od Codivillou aplikovaných pinů s trakcí k prolongaci přes Ilizarovem aplikované kruhové zevní fixátory po monolaterální fixátory umožňující dynamizaci (3,11). Kruhový fixátor je oblíben pro možnosti modelace svalku ve všech směrech včetně možnosti korekce úchylky a je často používán (10,22,27,28). Je hůře tolerován pacienty pro jeho objemnost a složitější pooperační ošetřování.…”

Section: úVodunclassified

Callus Distraction in the Treatment of Post-Traumatic Defects of the Femur and Tibia

Veselý¹,

Procházka²

2016

ACHOT

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PURPOSE OF THE STUDYEvaluation of the results in patients treated for post-traumatic defects by the method of callus distraction of the femur and tibia using a monolateral external fixator. MATERIAL AND METHODSThe group comprised 42 patients, 38 men and 4 woman, who underwent callus distraction using a monolateral external fixator in the Trauma Hospital Brno in the period from 2003 to 2010. The average age of the patients on the day gradual callus distraction was commenced was 32 (18-64) years. Post-traumatic bone defects were treated in 31 patients and deformities resulting from resection of post-traumatic infection loci in 11 patients. The tibia was involved in 34 and the femur in eight patients. The average follow-up in the out-patient department was 24.3 months (range, 7 to 118 months) after the fixator had been removed. The monolateral external fixator LRS Orthofix (Italy) was used in all patients. RESULTSThe average length of defects treated by callus distraction was 5.5 cm (3-16 cm). The average interval between osteotomy and distraction commencement was 6.1 days (4-8 days). The average duration of distraction was 74 days (33-162 days); the average time of fixator application was 168 days (138-416 days). The average healing index was 42 days per cm of bone (26-88 days per cm). The treatment of soft tissue loss during callus distraction was necessary in six patients (14.3%). Of these, two (4.8%) had local fasciocutaneous flap skin coverage, and four (9.5%) free issue transfer. A total of 38 complications were treated, i.e., 0.9 complication per each callus distraction of the femur or tibia. Of them, pin-tract infection was most frequent and was recorded in 21 patients (50%). It was usually managed by regimen arrangement and oral antibiotic therapy. The screw had to be removed due to septic loosening in five patients (11.9%). Breakage of a fixator pin occurred in three patients (7.1%). No fracture after fixator removal was recorded. Callus angulations were managed by correction of fixator during distraction in two patients (4,8%). In one patient (2.4%), premature healing of fibular osteotomy was treated by a new resection osteotomy. One patient (2.4%), following callus distraction, underwent Achilles tenotomy. The docking site after segmental bone transport did not heal in two patients (4.8%) who subsequently underwent revision surgery involving spongioplasty; bone union was achieved. Callus distraction in all patients was completed with the use of external fixators initially applied. All patients achieved full weight-bearing on the treated extremity. DISCUSSIONIn this study we evaluated the results of callus distraction carried out by means of a monolateral external fixator. This type of fixation seems very useful because the telescopic system allows for adjustment without necessity to change its assembly. Dynamic adjustment is important at the stage of callus maturation. A monolateral fixator is better tolerated by patients than is a circular fixator, though both systems give the same results. The process ...

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Biologic model of bone transport distraction osteogenesis and vascular response

DeCoster

Simpson

Wood

et al. 1999

Journal Orthopaedic Research

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We developed an experimental model in the rabbit of distraction osteogenesis through bone transport that closely corresponds to the clinical use of bone transport in humans. We also applied injection angiography to study the arterial response of a limb undergoing bone transport. This model includes a proximal osteotomy and bone transport to fill in a segmental tibial diaphyseal defect. Regenerate bone formed well in the gap that was created that trailed the transport segment, and slow healing at the docking site was observed, as seen in humans. The angiographic techniques clearly revealed, by radiography and anatomic dissection, the arterial response to bone transport. The results showed that the transport segment had an arterial supply after osteotomy and after transport. They also demonstrated an extensive increase in vessels in limbs that had undergone distraction osteogenesis, an observation made clinically in humans but not well demonstrated experimentally. Furthermore, angiography showed proximal stretching and distal kinking of the major artery of the leg. This model closely resembles distraction osteogenesis through bone transport in humans and definitively demonstrates that the transport segment can maintain blood supply and remain viable during the transport process. The results of this study provide a basis for further work on factors that enhance and interfere with successful bone transport in humans.

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Infected Tibial Pseudarthrosis: A 2-Year Follow Up on Patients Treated by the Ilizarov Technique

Cited by 40 publications

References 10 publications

Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects

Evolution and Development of Ilizarov Technique in the Treatment of Infected Long Bone Nonunion with or without Bone Defects

Callus Distraction in the Treatment of Post-Traumatic Defects of the Femur and Tibia

Biologic model of bone transport distraction osteogenesis and vascular response

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