Osteocutaneous thermal necrosis of the leg salvaged by TSF/Ilizarov reconstruction. Report of 7 patients

Abstract

Injudicious reaming of the tibial shaft can lead to extreme local hyperthermia,

Clinical reliability of closed techniques and comparison with open strategies to achieve union at the docking site

“…The traditional Ilizarov approach consisted of simple compression of these tissues after bone transport was complete, and this was eventually associated with periods of distraction to stimulate osteogenesis [3,9,12,22,23]. More recently, however, some groups have expressed concern about the healing potential of this technique, proposing osteotomy of the docking ends and removal of the interposing tissue as a solution [6,13,19,21]. With this technique, a biological environment more like fracture healing is restored and consolidation is considered more predictable.…”

Salvage of an osteocutaneous thermonecrosis secondary to tibial reaming by the induced membrane procedure

“…Lovisetti et al. reported a series of seven patients treated at four different centres by internal bone transport using a circular external fixator. The amount of necrotic bone removed averaged 8 cm.…”

“…The treatment of osteocutaneous thermonecrosis is very challenging, as it has to address the problem of soft tissue coverage, polymicrobial infection, and large bone defect reconstruction. Among the previously reported cases of bone thermonecrosis, Ilizarov's bone transport treatment was performed in nine cases [27,31,32], autologous cancellous or corticocancellous bone grafts associated with hemisoleus muscle flaps in three cases [1,2], and osteoseptocutaneous fibular flap grafts in two cases [1]. Lovisetti et al [32] reported a series of seven patients treated at four different centres by internal bone transport using a circular external fixator.…”

Comparison of 39 post-traumatic tibia bone transports performed with and without the use of an intramedullary rod: the long-term outcomes

“…On the other hand, bone transport using external fixators alone, as first introduced by Ilizarov, requires long-term treatment with external fixators [13]. Complications are very common, including pin tract infections, joint stiffness, malalignment and refractures [14,15]. The treatment of choice depends on many factors such as vascularity, location, size and aetiology of the defect.…”