Medial transport of the fibula using the Ilizarov device for reconstruction of a massive defect of the tibia in two children

Shiha, Anis; Khalifa, A. R. H.; Assaghir, Yasser; Kenawey, Mohamed

doi:10.1302/0301-620x.90b12.21378

Cited by 24 publications

(22 citation statements)

References 14 publications

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“…To date, the reported series of fibula tibilisation, though not large, have been encouraging for avoiding amputation [6,11,[22][23][24]. Ours is the largest historical series of patients, and demonstrates that the technique can be carefully carried out at a specific transporting rate thus reducing the incidence of peroneal neuropathy or paresis which could happen by acute fibula transfer in the conditions of scarred soft tissue.…”

Section: Discussionmentioning

confidence: 80%

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Ilizarov non-free bone plasty for extensive tibial defects

Borzunov

Chevardin

2013

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to present a retrospective comparative overview of the Ilizarov non-free bone plasty techniques of one-stage multilevel fragment lengthening and gradual tibilisation of the fibula used for extensive tibial defect management. Methods Extensive tibial defects in 83 patients were managed either by multilevel fragment lengthening (group I, n=41, mean defect size 13.1±0.9 cm) or gradual tibilisation of the fibula (group II, n = 42, mean defect size 12.5 ± 1.2 cm) using the Ilizarov apparatus. The initial findings, treatment protocols and outcomes of those patients treated within the period 1972-2011 were studied retrospectively by medical records and radiographs, and statistically assessed with Microsoft Excel and Attestat software. Results Group I had multilevel fragment lengthening over one stage that averaged 288.0±14.4 days. The mean total period of gradual tibilisation of the fibula in group II was 316.0±29.7 days. The patient's age in the latter group had an effect on the completeness of leg-length equalisation. Conclusions The techniques can be used to manage extensive tibial defects as all the defects bridged, leg-length discrepancy and deformity were corrected and patients were able to load their limbs.

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Section: Discussionmentioning

confidence: 80%

“…The fibula seems to be a good biological graft when used for the Ilizarov tibiofibular synostosis that is less traumatic and costly as there is no need to intervene on the contralateral segment. Gradual transport of the fibular fragment does not affect the nutrient vessels and results in regeneration and consolidation [6,11,[22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Ilizarov non-free bone plasty for extensive tibial defects

Borzunov

Chevardin

2013

International Orthopaedics (SICOT)

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“…The method of a vascularised fibular transfer may be excluded by infection or major soft tissue defects [19], and a considerable dissection of soft tissues and a satisfactory vascular anastomosis are required for the technique, so the treatment requires an experienced microsurgical team, and it is a demanding technique [20]. Tibio-fibular synopsis seeks to achieve a secure synostosis of the tibia and fibula in its eccentric position, this leads to asymmetrical loading through the fibula, which may be the failure reason for the treatment of massive tibial bone defects [9,21]. Ilizarov bone transport is a versatile method, it can be used to reconstruct bone defect and correct deformity simultaneously.…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral fibula transport for the treatment of massive tibial bone defects

Yin

Zhang

et al. 2015

Injury

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“…Large segmental defects of the tibia are challenging therapeutic problems (1,2,4,5,11,13). They can be caused by severe trauma, osteomyelitis, tumor resection, reconstruction or congenital etiologies such as agenesis or pseudoarthrosis of the tibia.…”

Section: Discussionmentioning

confidence: 99%

“…The reported time for hypertrophy of the fibula varies from one to two years or from two to four years; however, Tuli et al stated that no significant change in the diameter of the fibula is observed after five years (6,17). Fracture of tibialized fibula was not reported in most studies of fibular centralization with different techniques (3,5,6,(9)(10)(11). Keeting et al reported one stress fracture of the fibula in 16 cases of fibular transfer that were treated with sufficient immobilization time.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Segmental Loss of the Tibia by Tibialisation of the Fibula: A Review of the Literature

Rahimnia¹,

Fitoussi²,

Penneçot³

et al. 2012

Trauma Mon

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This study elaborates on the issue of segmental bone loss of the tibia and its treatment.Segmental defects of the tibia are challenging therapeutic problems for both the physician and the patient. These defects may be caused by severe trauma, infection, tumors and congenital processes. Several different techniques have been described for treatment of these defects including the Papineau technique, allograft reconstruction, bone transport using the Ilizarov frame, free vascularized fibular graft, tibiofibular synostosis and medial transport of the fibula with Tuli's technique, use of the Ilizarov frame and Huntington's procedure. All of these techniques have their specific advantages as well as disadvantages. Some of these techniques are used rarely i.e. the Papineau technique. The procedure of choice for most large tibial defects is bone transport with Ilizarov's technique; but in some cases the tibial remnant is inadequate for lengthening and we must use alternative treatments. In the three aforementioned techniques, the fibula is transferred with peroneal and anterior tibial muscles on a pedicle of peroneal vessels. This transfer retains a biological component of vital bone that allows for a shorter time for consolidation, increased remodeling potential and resistance to infection. It also has better long-term mechanical properties. Hypertrophy of the centralized fibula is described as attaining twice its original diameter or twice the size of the contralateral tibia. Hypertrophy has been seen in nearly all cases of the fibular centralization. Maximum hypertrophy is seen in children and besides patient age, is related to bony union and weight bearing. The reported time for hypertrophy of fibula varies from one to four years. No significant change in the diameter of the fibula was observed after five years. Fracture of tibialized fibula was not reported in many studies of fibular centralization with different techniques. In the reviewed articles, there were no cases of valgus deformity of the ankle. Either the patients were satisfied with the final results despite appearance of the lower extremity and the presence of some angular deformities, although in most cases, the deformities were mild. In this review we conclude that tibialisation of the fibula in selected cases is a reasonable alternative for the treatment of massive tibial defects.

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Medial transport of the fibula using the Ilizarov device for reconstruction of a massive defect of the tibia in two children

Cited by 24 publications

References 14 publications

Ilizarov non-free bone plasty for extensive tibial defects

Ilizarov non-free bone plasty for extensive tibial defects

Ipsilateral fibula transport for the treatment of massive tibial bone defects

Treatment of Segmental Loss of the Tibia by Tibialisation of the Fibula: A Review of the Literature

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