Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment

Krappinger, Dietmar; Irenberger, Alexander; Zegg, Michael; Huber, B.

doi:10.1007/s00402-013-1712-y

Cited by 57 publications

(50 citation statements)

References 19 publications

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“…These results are not directly comparable as no soft-tissue reconstruction was performed in their series. However, the functional outcomes compared favorably in the bone transport group, and in the In the HRQoL assessment by Knappinger et al 33 of a group quite similar to the present study, a high physical and low mental score of SF-36 modules compared to the general population was found at a mean of 3.6 years after trauma. In the present series, the follow-up assessment revealed decreased mobility and higher discomfort and symptoms compared to those of an age-standardized general population.…”

Section: Discussionmentioning

confidence: 47%

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Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Repo

Barner-Rasmussen

Roine

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Summary Background: Extensive compound tibial fractures present reconstructive challenges. The present study aimed to assess the outcomes of microvascular latissimus dorsi (LD) flap combined with the Ilizarov technique for extensive compound tibial fractures with bone loss and bone healing complications. Methods: Patient records were reviewed retrospectively. The Lower Extremity Functional Scale (LEFS), the Disabilities of the Arm, Hand and Shoulder (DASH), and the 15D healthrelated quality of life (HRQoL) instrument were applied. Results: Between 1989 and 2014, 16 patients underwent reconstruction with a microvascular LD flap and bone transport (11/16) or late bone lengthening (5/16). The mean clinical follow-up time was 6.6 (standard deviation (SD): 6.5) years. Three patients had minor complications requiring reoperation. Partial necrosis of one flap required late flap reconstruction in one case. Late bone grafting was used to enhance union in eight of 16 cases. The mean new bone gain was 3.8 cm (SD: 2.5).Overall, 11 patients completed the questionnaires in a mean of 22.3 years (SD: 2.4) after surgery. The main findings revealed a relatively good function of the reconstructed limb and good shoulder function. The mean HRQoL was comparable to that of an age-standardized sample of the general population.

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Section: Discussionmentioning

confidence: 47%

“…2,3,32,33 However, it remains indisputable that the main disadvantage of the Ilizarov technique is the tedious process with external fixation that may take months to perform. Intense pin-track pain appeared in two patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Repo

Barner-Rasmussen

Roine

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Ilizarov has studied the effect of fracture stabilization and subsequent reconstruction of injured limb by using ring fixators. 8,9,18,19 He studied the effects of gradual stretching of tissue by distraction and its effect on stimulation of tissue growth and regeneration. Based on this basic principle, he developed the concept of distraction histogenesis.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of the results of compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators

Pal

Kumar

et al. 2015

Chinese Journal of Traumatology

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a b s t r a c tPurpose: Ilizarov ring fixator and limb reconstruction system (LRS) fixators have been used in the management of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated. Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing. Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures. Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators. Methods: This prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, India and included 32 patients of compound tibial shaft fractures with or without infected nonunion. There were 26 males and 6 females and the average age was 40 years. Patients were randomly divided into two groups (n ¼ 16 for each): one underwent Ilizarov fixation and the other received LRS fixation. Cases were followed up for 3e24 months, 6 months on average from September 2012 to October 2014. Functional and radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators. Results: Union was achieved in all cases. Radiological outcome was found excellent in 68.75%, good in 18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators. Functional result was satisfactory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs. 31.25%. Conclusion: In our short-term assessment, LRS fixators show a better result than Ilizarov fixators in terms of fracture union and functional outcome with soft tissue care and limb length.

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“…Application of an external fixator, which imparts prolonged limb stability, and use of Ilizarov principles allow the surgeon to adequately débride nonviable bone and soft tissues with less apprehension of massive bone defects [3,8,18,21,27,34]. However, the prolonged use of an external fixator is a burden for patients with time-dependent incidence of complications [13,26,31].…”

Section: Discussionmentioning

confidence: 99%

Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

Bernstein

Fragomen

Sabharwal

et al. 2015

Clin Orthop Relat Res

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Background Limb salvage in the presence of posttraumatic tibial bone loss can be accomplished using the traditional Ilizarov method of distraction osteogenesis with circular external fixation. Internal fixation placed at the beginning of the consolidation phase, so-called integrated fixation, may allow for earlier removal of the external fixator but introduces concerns about cross-contamination from the additional open procedure and maintenance of bone regenerate stability. Questions/purposes Among patients deemed eligible for integrated fixation, we sought to determine: (1) Does integrated fixation decrease the time in the external fixator? (2) Is there a difference in the rate of complications between the two groups? (3) Are there differences in functional and radiographic results between integrated fixation and the traditional Ilizarov approach of external fixation alone? Methods Between January 2006 and December 2012, we treated 58 patients (58 tibiae) with posttraumatic tibial bone loss using the Ilizarov method. Of those, 30 patients (52%) were treated with the ''classic technique'' (external fixator alone) and 28 (48%) were treated with the ''integrated technique'' (a combination of an external fixator and plating or insertion of an intramedullary nail). During that period, the general indications for use of the integrated technique were closed physes, no active infection, and a healed soft tissue envelope located at the intended internal fixation site; the remainder of the patients were treated with the classic technique. Followup on 30 (100%) and 28 (100%) patients in the classic and integrated techniques, respectively, was achieved at a minimum of 1 year (mean, 3 years; range, 1-8 years). Adverse events were reported as problems, obstacles, and complications according to the One of the authors (ATF) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: consultant for Smith & Nephew, Inc (Memphis, TN, USA), and Synthes (Paoli, PA, USA) in the amount of less than USD 10,000. One of the authors (SRR) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: Smith & Nephew, Inc in the amount of less than USD 10,000. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investi...

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Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment

Cited by 57 publications

References 19 publications

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Comparative study of the results of compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators

Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

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