A New Approach to the Management of Fixed Flexion Deformity of the Knee Using Ilizarov’s Principle of Distraction Histogenesis: A Preliminary Communication

Gaurav, Kulshrestha; Jog, Vilas

doi:10.1177/1534734610371559

Cited by 10 publications

(3 citation statements)

References 11 publications

(19 reference statements)

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“…Neurovascular injury is also a relatively common serious complication of external fixator distraction 22,23 . The Ilizarov technique distracted the joint slowly and steadily at a speed close to that of nerve regeneration, which could reduce the risk of neurovascular complications 24 . In this study, the distraction speed was adjusted according to the patient's compliance or whether there were neurological complications.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 The Ilizarov technique distracted the joint slowly and steadily at a speed close to that of nerve regeneration, which could reduce the risk of neurovascular complications. 24 In this study, the distraction speed was adjusted according to the patient's compliance or whether there were neurological complications. The pulse of the dorsalis pedis artery, the sensory changes of the lower limbs, the tension of the popliteal skin and the needle eye should be given close attention before and after each distraction.…”

Section: Discussionmentioning

confidence: 99%

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The Ilizarov technique in the management of haemophilic knee flexion contracture

et al. 2023

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Introduction:The Ilizarov technique has the potential to be an attractive option for severe knee flexion contracture (KFC) patients with a high risk of bleeding. However, studies on this technique in the management of haemophilic KFC are scarce. Aim:The purpose of this study was to review and analyse the results of the Ilizarov technique in correcting haemophilic KFC and to evaluate the safety and efficacy of this technique.Methods: Twelve male haemophilia patients with severe KFC who underwent distraction treatment using the Ilizarov technique from June 2013 to April 2019 were included in this study. The hospital day, flexion contracture, range of motion (ROM) of the knees, complications and functional outcomes were recorded and analysed. Functional outcomes were evaluated according to the Hospital for Special Surgery (HSS) knee scores of the preoperation, end of distraction and last follow-up. Results:The average preoperative flexion contracture and range of motion (ROM) of the knees were 55 ± 15 • and 66 ± 18 • , respectively. The average preoperative HSS knee score was 47 ± 5. The average duration of follow-up was 75.5 ± 30.1 months. All flexion contractures achieved full correction (≤5 • ) at the end of distraction, and the flexion contracture significantly decreased to 6 ± 5 • at the last follow-up (p < .0001).The ROM of the knees was significantly increased at the last follow-up compared with that before distraction treatment (p < .0001). The HSS knee scores at the end of distraction and at the last follow-up were both significantly higher than the preoperative HSS knee score (p < .0001). No major complications were encountered. Conclusions:This study provided evidence for the safety and effectiveness of Ilizarov technique plus physical therapy in the management of haemophilic KFC and accumulated clinical experience for the proper application of this technology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Ilizarov technique in the management of haemophilic knee flexion contracture

et al. 2023

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“…Makhdoom et al 36 observed pin-tract infection in 6 of 27 clubfoot deformities (22%). Gaurav and Vilas 37 found that pin-tract infection occurred in 2 (5%) of 26 patients with fixed flexion deformity of the knee. In the present study, superficial pin-tract infections were recorded in 2 of 6 patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Severe Postburn Contracture of the Elbow via Distraction With External Circular Frame in Pediatric Patient

Niu

Yin

et al. 2021

Ann Plast Surg

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Background Although external circular frame (ECF) has been widely used for the correction of knee and ankle deformities, few studies reported the use of ECF for the treatment of severe postburn elbow contracture and stiffness (SPECS). The purpose of this retrospective study was to investigate the effectiveness and safety of the distraction using ECF in treating SPECS. Methods After institutional review board approval, we implemented a retrospective single-center case series study composed of consecutive patients treated for SPECS at Chinese PLA General Hospital between January 2010 and January 2018. After scar release and skin grafting, distraction with ECF was performed for 4 to 6 weeks, and the frame was retained for 2 more weeks before removal. Four weeks of splinting and at least 1 year of rehabilitation were recommended. Patient demographics, active and passive range of motion (ROM) of the elbow at different time points (preoperative, postdistraction, and final follow-up), and complications were collected from the electronic medical record. The primary outcome was the long-term improvement of the ROM. Other outcomes included complications and recurrence. Results The ECF was used to treat SPECS in 6 patients (3 males and 3 females, average age of 11.7 ± 2.6 years). Scar release and distraction with ECF significantly increased both active (from 3° preoperative to 38.7° postdistraction) and passive (from 3.5° preoperative to 48.3° postdistraction) ROM over an average distraction duration of 5.2 weeks. The long-term improvement of active and passive ROM was 38° ± 13.4° and 46° ± 14.7°, respectively, over a median follow-up of 4.1 years. Pin-tract infection occurred in 2 patients and were treated with local wound care and oral antibiotics. A tendon readhesion developed in 1 of the 6 patients because of noncompliance with splinting and physiotherapy, and was treated with revision surgery. Conclusions The 3C strategy (i.e., contracture release, coverage of the defect with skin grafting, and correction of articular angle with gradual distraction using the ECF) is able to increase the ROM with minor complications. We recommend distraction with ECF as part of the treatment arsenal, particularly for severe contractures in which 1-stage correction is unfeasible because of considerable soft tissue shortening.

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The treatment of a malunited posterior pilon fracture with talar dislocation: A staged surgical treatment protocol

Qing

Zhang²,

Qin³

2023

Injury

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A New Approach to the Management of Fixed Flexion Deformity of the Knee Using Ilizarov’s Principle of Distraction Histogenesis: A Preliminary Communication

Cited by 10 publications

References 11 publications

The Ilizarov technique in the management of haemophilic knee flexion contracture

The Ilizarov technique in the management of haemophilic knee flexion contracture

Treatment of Severe Postburn Contracture of the Elbow via Distraction With External Circular Frame in Pediatric Patient

The treatment of a malunited posterior pilon fracture with talar dislocation: A staged surgical treatment protocol

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