Management of hypertrophic nonunion with failure of internal fixation by distraction osteogenesis

Xu, Jia; Jia, Yuechen; Kang, Qinglin; Chai, Yimin

doi:10.1016/j.injury.2015.06.020

Cited by 30 publications

(13 citation statements)

References 22 publications

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“…Distraction osteogenesis (DO) as described by Ilizarov is widely employed in the treatment of limb length discrepancy, nonunion, and bone defects caused by trauma or tumor resection . It has many advantages over conventional treatments including less operative time, bleeding, shorter duration of hospitalization, and lower costs.…”

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confidence: 99%

Staphylococcal enterotoxin C2 expedites bone consolidation in distraction osteogenesis

Sun

et al. 2016

J. Orthop. Res.

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Distraction osteogenesis (DO) technique could be used to manage large-size bone defect successfully, but DO process usually requires long duration of bone consolidation. Innovative approaches for augmenting bone consolidation are of great need. Staphylococcal enterotoxin C2 (SEC2) has been found to suppress osteoclastogenesis of mesenchymal stem cells in vitro. In this study, we investigated the effect of SEC2 on proliferation and osteogenic differentiation of rat bone marrow derived mesenchymal stem cells (rBMSCs). Further, we locally administrated SEC2 (10 ng/ml) or PBS into the distraction gap in Sprague-Dawley male rat DO model every 3 days till termination at 3 and 6 weeks. The regenerates were subjected to X-rays, micro-computed tomography, mechanical testing, histology, and immunohischemistry examinations to assess new bone quality. SEC2 had no effect on cell viability. The calcium deposition was remarkably increased and osteogenic marker genes were significantly up-regulated in rBMSCs treated with SEC2. In rat DO model, SEC2 group had higher bone volume/total tissue volume in the regenerates. At 6 weeks, mechanical properties were significantly higher in SEC2-treated tibiae comparing to the control group. Histological analysis confirmed that the new bone had improved quality in SEC2 treated group, where the osteocalcin and osterix expression in the regenerates was up-regulated, indicating faster bone formation. The current study demonstrated that SEC2 local injection promotes osteogenesis and enhanced bone consolidation in DO. The findings support application of SEC2 as a potential novel strategy to expedite bone consolidation in patients undergoing DO treatment. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1215-1225, 2017.

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confidence: 99%

Staphylococcal enterotoxin C2 expedites bone consolidation in distraction osteogenesis

Sun

et al. 2016

J. Orthop. Res.

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“…The treatment of nonunion is complex and associated with numerous complications [1], [8], [9], [11], [14], [15], [19], [21], [28]. The Ilizarov method is an internationally recognised and preferred method for the treatment of nonunion [1], [2], [7]- [12], [14], [15], [18], [19]- [21], [28], [29]. Most patients treated with this method have good results and achieve bone union [1], [2], [8]- [10], [12], [15], [20], [21], [28], [29].…”

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confidence: 99%

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Kozłowska¹,

Pawik²,

Szelerski³

et al. 2020

Acta Bioeng Biomech

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Purpose: The biomechanics of the musculoskeletal system in patients after tibial nonunion treatment using the Ilizarov method have not yet been fully explored. From the orthopaedic and patient point of view, after the treatment, an assessment should be carried out of the biomechanics of the musculoskeletal system. The aim of this study was to assess the body balance of patients treated with the Ilizarov method for tibial nonunion. Methods: The research group included 24 individuals with a mean age of 55 years, who were treated for aseptic tibial nonunion with the Ilizarov method. The control group was matched to the study group in terms of gender and age, and consisted of 32 subjects with a mean age of 50.5 years and no significant medical history. This study evaluated the balance of patients with the use of pedobarography. Results: In the control group, a statistically significantly shorter path of centre of gravity was observed. There were no statistical differences between the study and control groups for the field area of the centre of gravity. There were no statistical differences between the study and control groups for the minor axis length or major axis length of the centre of gravity. There was a relationship between the centre of pressure path length and the age of the participants in both the control group and the study group. Conclusions: Treatment of patients with tibial nonunion with the Ilizarov fixator achieves similar balance to healthy volunteers. In the pedobarographic evaluation, patients treated for tibial nonunion using the Ilizarov method had similar statics of the musculoskeletal system to healthy volunteers.

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“…When selecting suitable procedures for bone grafting with chronic infectious osteomyelitis patients, surgeons should take into account the strength and weakness of each method. There have been series of studies comparing the advantage between internal fixation and external fixation in noninfected tibia nonunion patients [ 17 – 19 ]. However, in the case of chronic infectious osteomyelitis, few studies were conducted.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis

Wang

Jiang

Deng

et al. 2017

BioMed Research International

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Background To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. Methods 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Results Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156 ± 23 minutes versus 162 ± 21 minutes), and time to union (11.1 ± 3.0 months versus 10.9 ± 3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. Conclusions It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.

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Management of hypertrophic nonunion with failure of internal fixation by distraction osteogenesis

Cited by 30 publications

References 22 publications

Staphylococcal enterotoxin C2 expedites bone consolidation in distraction osteogenesis

Staphylococcal enterotoxin C2 expedites bone consolidation in distraction osteogenesis

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis

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