Limb lengthening and deformity correction in children with abnormal bone

Попков, А. В.; Dučić, Siniša; Lazović, Mikan; Lascombes, P.; Popkov, Dmitry

doi:10.1016/j.injury.2019.03.045

Cited by 21 publications

(14 citation statements)

References 29 publications

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“…Limb lengthening techniques play an increasingly important role in the field of pediatrics orthopedics with regard to length discrepancy, angular deformities (referable either to fractures sequelae or congenital malformations), and short stature correction[ 1 - 4 ]. The osteogenesis distraction is a reparative process involving not only the bone but also the soft tissues including the muscles, nerves, and skin.…”

Section: Introductionmentioning

confidence: 99%

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Masci¹,

Palmacci²,

Vitiello³

et al. 2021

WJO

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BACKGROUND Limb lengthening techniques play an increasingly important role in the pediatric orthopedic field. The principles of the osteogenesis distraction bonded traditionally with external fixators; however, the recent deployment of fully implantable systems has been able to overcome severities related to external fixators. The PRECICE ® is an implantable limb lengthening intramedullary nail system that is remotely controlled and magnetically driven. AIM To review the current literature available on this matter in order to assess the PRECICE clinical and radiological outcomes and its possible complications in a population of pediatric patients undergoing limb lengthening. METHODS Only five studies met the inclusion criteria and were consequently included in the review for a total of 131 patients and 135 femurs. The clinical and radiological outcomes of interest were: the main lengthening obtained, the distraction rate, the period of time to full weight bearing, the consolidation index, and the Association for the Study and Application of Methods of Ilizarov score. RESULTS In conclusion, data collected from the articles under investigation were comparable with the exception of the consolidation index. Unfortunately, the study population was too small and the patients’ follow-up was too short to make definitive conclusions. CONCLUSION This review shows that the PRECICE Nail System is still a therapeutic challenge in limb lengthening for pediatric orthopedic surgeons; however, careful pre-operative planning and an accurate surgical technique could allow the correction of more complex deformities with a low rate of complications.

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Section: Introductionmentioning

confidence: 99%

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Masci¹,

Palmacci²,

Vitiello³

et al. 2021

WJO

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“…It is necessary to monitor the closeness of the dangerous strut and the tibial limb in real-time to avoid unnecessary collisions during the actual correction, which is essential to ensure the safety of the patient. 25,41 The closer the closeness is to the threshold, the more likely it is to collide.…”

Section: Discussionmentioning

confidence: 99%

“…Through searching the literature, it was found that only a few researchers reported on the collision between the external fixator and the limbs in orthopedics. 20,21,25,40,41 They just put forward the importance of avoiding collision in the application of external fixators 20,25,41 or investigated the influence of the collision on the correction ability of the fixator through the method of clinical observation. 21,40 However, they did not put forward a corresponding collision detection algorithm for the capability test.…”

Section: Discussionmentioning

confidence: 99%

Influence of parameter deviation on the closeness of the tibial limb and external fixator based on a novel collision detection algorithm

Zuo

et al. 2021

Numer Methods Biomed Eng

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The Ortho‐SUV frame (OSF) is a hexapod external fixator widely applied in orthopedics deformity correction. The possibility of collision between OSF's struts and the soft tissue is an essential but overlooked issue. To avoid the issue, a novel collision detection algorithm is established based on a cone‐cylinder model of the tibial limb‐strut interaction for detecting the closeness of the tibial limb and external fixator. The algorithm is constructed using the vector analysis based on the model of the minimum distance between the truncated cone generatrix and the cylinder axis. The motion simulation is performed on the overall alignment through the Solidworks‐motion module to verify the feasibility of the algorithm. Subsequently, the installation parameter deviations of the bone‐fixator system are described to investigate the influence of orientation and position deviation on the closeness of the tibial limb and external fixator through the numerical method. The investigation results show that the orientation deviation γ (around the z‐axis), the position deviation τ1 and τ2 (along the x and y‐axes, respectively) have greater sensitivity to closeness and the influence of multiple deviations on the closeness has the property of superposition. The proposed algorithm can assist clinicians to strictly design and appraise frame configurations prior to their application to avoid the collision between the external fixator and the limbs during the correction. It has great application significance in the development of computer‐aided correction software.

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“…The combined modifications used currently are lengthening over nail and lengthening and then nailing techniques[ 6 ]. One more combined technology is the use of flexible intramedullary HA-coated wires along with the Ilizarov apparatus[ 51 ]. These techniques apply external fixators in the lengthening procedure and intramedullary nails in the regenerate consolidation phase to protect the regenerate.…”

Section: Current Clinical Practice and Research In The Ilizarov Techniques Of Bone Reconstructionmentioning

confidence: 99%

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)

Malkova

Borzunov

2021

WJO

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The Ilizarov method is one of the current methods used in bone reconstruction. It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixator developed by Ilizarov GA. Its main merits are viable new bone formation through distraction osteogenesis, high union rates and functional use of the limb throughout the course of treatment. The study of the phenomenon of distraction osteogenesis induced by tension stress with the Ilizarov apparatus was the impetus for advancement in bone reconstruction surgery. Since then, the original method has been used along with a number of its modifications developed due to emergence of new fixation devices and techniques of their application such as hexapod external fixators and motorized intramedullary lengthening nails. They gave rise to a relatively new orthopedic subspecialty termed “limb lengthening and reconstruction surgery”. Based on a comprehensive literature search, we summarized the recent clinical practice and research in bone reconstruction by the Ilizarov method with a special focus on its modification and recognition by the world orthopedic community. The international influence of the Ilizarov method was reviewed in regard to the origin country of the authors and journal’s rating. The Ilizarov method and other techniques based on distraction osteogenesis have been used in many countries and on all populated continents. It proves its international significance and confirms the greatest contribution of Ilizarov GA to bone reconstruction surgery.

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Limb lengthening and deformity correction in children with abnormal bone

Cited by 21 publications

References 29 publications

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Influence of parameter deviation on the closeness of the tibial limb and external fixator based on a novel collision detection algorithm

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)

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Limb lengthening and deformity correction in children with abnormal bone

Cited by 21 publications

References 29 publications

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Limb lengthening with PRECICE magnetic nail in pediatric patients: A systematic review

Influence of parameter deviation on the closeness of the tibial limb and external fixator based on a novel collision detection algorithm

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100thbirthday of G. A. Ilizarov)

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International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)