Treatment of complex nonunion of the shaft of the tibia using Ilizarov technique and its functional outcome

Abstract

Background:A complex nonunion of the shaft of the tibia is a major cause of morbidity and mortality in patients with lower extremity injuries.Aims:The aim of this study was to evaluate the outcome of the functional and radiological outcome of complex nonunion shaft of tibia, treated by radical debridement, Ilizarov ring fixator with compression and distraction osteogenesis.Methods:From 2005 to 2010, sixty cases of complex nonunion shaft of tibia were included in our study. All infected nonunions were managed by radical debridement, fixed with Ilizarov ring fixator, monofocal/bifocal compression, and distraction osteogenesis. The average duration of follow-up is 36 months (26–50 months). The functional evaluation was done by using Association for the Study and Application of Methods of Ilizarov (ASAMI) scoring system and bone union with serial radiographs.Results:All patients had a successful union. The mean time for union was 7 months (5–9 months). The mean time of fixator removal is 12 months (8–14 months). Every patient had pin tract infections which were successfully treated with oral antibiotics. Four patients had an equinus deformity, one patient had insignificant limb shortening (1.5 cm), and three patients had soft tissue dystrophy. Using the ASAMI scoring system, we obtained 45 excellent, 10 good, 3 fair, and 2 poor functional results.Conclusions:The Ilizarov technique for complex nonunions has a high rate of success in achieving union and eradicating infection, bone loss, and malalignment. Radical debridement is the key step to control bone infection.

The outcomes of Ilizarov treatment in aseptic nonunions of the tibia stratified by treatment strategies and surgical techniques

“…There are no available reports from studies assessing the duration of treatment with an external xator strati ed by different treatment strategies and surgical techniques. Overall, the mean duration of treatment ranges from 5.8 months to 13.5 months [2,3,4,5,6,8,9,13,16]. These gures are similar to ours.…”

“…1). All of these adversely affect the course of treatment and increase the risk of treatment failure [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In nonunions of the tibia, the Ilizarov method helps achieve bone union, eliminate possible infections, equalize limb length, and correct any deformities that may have developed over the course of treatment [1-5, 7-12, 14-18, 20-22].…”

“…Some authors claim that bone transport combined with the use of external xators carries a higher risk of complications and yields worse outcomes in comparison with other methods of tibial nonunions treatment [2,5,11]. Most of the available analyses concern infected nonunions of the tibia [1,2,[6][7][8][9][10][11][12][13][15][16][17][18][19][20][21][22], whereas few reports discuss the treatment of tibia nonunion that is uncomplicated by infection [3,4,5,14].…”

Effect of the needles with different nanostructured carbon coatings on the osteoporotic bone tissue in the experiment

“…The most effective method for patients' treatment with fractures and non-unions under immobilization osteoporosis (IOP) is transosseous osteosynthesis by G.A. Ilizarov (TOS) [5][6][7]. However, when standard metal fixators from medical steel were used, already on the 14 days after implantation an increase of dystrophic and sclerotic changes in the near-spine region of bone tissue were noted.…”

Ilizarov Fixator in Femoral Supracondylar Fractures: A Case Series with 1 - 6 - Year Follow-up

“…Also, it aids to create the repair of angulation, multiplanar stability, and rotation at the nonunion place (1,5). The current study reported the experience at a teaching hospital to manage femoral supracondylar fractures fixed by Ilizarov technique.…”