"Accordion maneuver with Ilizarov” Regeneration process in managemet of non-union, hyporegeneration and infection with kept failure implant in situ: a research article

Abstract

Introduction: Accordion Maneuver is the “Bloodless Stimulation” of bone healing described by Professor G. A. Ilizarov. It converts biologically inactive tissue into tissue capable of neo-osteogenesis. The suggested management of non-union, hypo-regeneration and infection with implant failure by a single stage procedure with minimal or no debridement and if implant is provide sufficient stability it placed in situ. Purpose of the study: Purpose of this study to evaluates the clinical efficacy and highlights their relevance of AM with Ilizarov in present and future orthopedics practice. Methodology: This is a retrospective study of 3 years from 2019 to 2021. Apply AM with Ilizarov in the patient’s management of non-union, hypo-regeneration and infection with implant failure. Patients included ≥18 years, intra-articular fractures are excluded. Total patient 7. Patient`s age from 19-62 years. There were 5 male and 2 female patients. Affected bones were tibia-3, femur-2, humerus-1 and radius & ulna-1. Causes were fall and infection. Final diagnosis was broken implant-2, bending implant with quiescent type infected non-union-1, poly-trauma with broken implant -1 and infection -3. Primary fixation was done by ILIMN in 3 and DCP in 4 cases. We follow Baruah and Patowary suggested protocol of AM in all cases. Summary: After 3-7 months follow up, according to ASAMI score, there were 4 excellent and 3 good outcomes. As per Paley`s classification, in 3 cases found shortening and angulation deformity. We were successfully managed all cases by AM with Ilizarov, kept failure implant in situ. Conclusion: We pursue AM with Ilizarov kept failure implant in situ, as a single stage procedure for the treatment of the patients and found very good results. So, in future it may an ultimate procedure for the management of those helpless conditions.