Accordion Maneuver with Modified Ilizarov Frame for treatment of recalcitrant nonunion of shaft of femur in a patient with Pycnodysostosis

Baruah, Ranjit Kumar; Haque, Russel

doi:10.1016/j.jcot.2016.09.006

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…Orthopedic treatments (performed at least once in 35% of cases) such as osteosynthesis or immobilization were needed at least once for each of the adult subjects. Nonunion and complications following an orthopedic surgery have been described, [13][14][15][16] but were not observed in any of our subject. Other procedures, essentially ENT (47%) and maxillofacial (45%), were usually performed at young age (eg, myringotomy, tonsillectomy, maxillary expansion), and may have consequences on school attendance and social inclusion.…”

Section: Patient Carementioning

confidence: 66%

Pycnodysostosis: Natural history and management guidelines from 27 French cases and a literature review

et al. 2019

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Pycnodysostosis is a lysosomal autosomal recessive skeletal dysplasia characterized by osteosclerosis, short stature, acro‐osteolysis, facial features and an increased risk of fractures. The clinical heterogeneity of the disease and its rarity make it difficult to provide patients an accurate prognosis, as well as appropriate care and follow‐up. French physicians from the OSCAR network have been asked to fill out questionnaires collecting molecular and clinical data for 27 patients issued from 17 unrelated families. All patients showed short stature (mean = −3.5 SD) which was more severe in females (P = .006). The mean fracture rate was moderate (0.21 per year), with four fractures in total average. About 75% underwent at least one surgery, with an average number of 2.1 interventions per patient. About 50% required non‐invasive assisted ventilation due to sleep apnea (67%). About 29% showed psychomotor difficulties and 33% needed a school assistant or adapted schooling. No patient had any psychological evaluation or follow‐up. Molecular data were available for 14 families. Growth hormone administration was efficient on linear growth in 40% of cases. We propose several axis of management, such as systematic cerebral MRI for Chiari malformation screening at diagnosis and regular psychological follow‐up.

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Section: Patient Carementioning

confidence: 66%

Pycnodysostosis: Natural history and management guidelines from 27 French cases and a literature review

et al. 2019

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“…A modified form of this tool can be apply in hypo-regenerate state, developed in bone transport and docking site after acute docking or after internal bone transport. 2,24,29 Accordion Maneuver based on the principle of transformational osteogenesis,. 1 which control both healing and shape formation of bone and soft tissues.…”

Section: Accordion Maneuver (Am)mentioning

confidence: 99%

“…Cellular response to mechanical loading depends on: Cell type, Stage of differentiation, Type and magnitude of loading. 29 Fracture healing depending on; 1.Type of fractures 2. Fixation and 3.…”

Section: Mechanical and Cellular Event During Ammentioning

confidence: 99%

“…Now it is an establish fact that controlled distraction (cyclic alternate compression and distraction) stimulate new bone formation (regeneration) by intra-membranous ossification. 3,29 Figure 12 Illustration shows the osteogenic histological outcomes of tension versus compression. 5…”

Section: • Hifmentioning

confidence: 99%

“…Prior to removal of fixator, dinamization was done by loosening threaded rods, one (1) at a time at weekly intervals. 2,29 The outcome of Ilizarov treatment was assessed according to ASAMI bone and functional result criteria, also complication (Deformity) was evaluated as per Paley`s classification (Table 6,7). Accordion Maneuver (AM) is the "Bloodless Stimulation" of bone healing described by Professor Ilizarov.…”

Section: Assessment Of Bone Deformity Healing and Time Of Implant Rem...mentioning

confidence: 99%

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Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report

Rob¹,

Hossain²,

Mustof³

2022

MOJOR

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Introduction: Aim of this study to evaluate the clinical efficacy and highlight their relevance in present orthopedics practice where multiple newer choices have been become famous. Accordion maneuver design with modified Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection place dynamic compression plate (DCP) in situ. Femoral shaft fractures (FSFs) are frequently occurring injury due to RTA. Infection (0.4%) and non-union (1.1 - 14%) are the morbid complications of femur fractures. The healing rate for femora shaft non-unions is too high (90%).1 Accordion Maneuver (AM) is the “Bloodless Stimulation” of bone healing described by Professor G. A. Ilizarov. It comprises of alternate compression and distraction which produce stress in living tissue and also convert biologically inactive scar tissue at non-union site into tissue capable of neo-osteogenesis.2 The suggested treatment for quiescent type of infected non-union is a single stage procedure with minimal or no debridement and if implant is provide sufficient stability it placed in situ.3 Case Report: In the case, a 26 years man treated by DCP with MIPO for his Gustilo type – Ⅰ open, comminuted fracture of mid femoral shaft (Left) following RTA. Post-operative infection occurred within 2 weeks of operation. Infection controlled by exploration and surgical toileting with antibiotic. After four (4) months later he was sustained re-fractured with bending plate due to fall again. Finally he was diagnosed as H. Rosen`s type 3 Quiescent infected non-union (Oligotrophic) and Romano stage -1 post-implant infection with re-fracture mid shaft of left femur. Then he was treated following accordion principles with modified Ilizarov frame. AM was applied according to protocol of Baruah and Patowary of non-union treatment. Result: After complete union and consolidation, substantiated by radiological evidence Ilizarov apparatus was dispelled six (6) months later of installation without removal of plate and four (4) months of that finally plate was removed. After one (1) year and four (4) months of mounted Ilizarov frame, the patient was in full free movement of knee and hip. He had no problem during walking even running. Conclusion: We pursue for the treatment, accordion maneuver with Ilizarov apparatus, a single stage procedure in femoral shaft non-union and re-fracture with quiescent infection kept plate in situ. Few authors reported, Accordion Maneuver (AM) techniques with Ilizarov apply over intramedullary nail (IMN) in situ for aseptic non-union of femur. In this study, we discussed the role of this tool (AM) for the treatment of femoral shaft non-union and re-fracture with quiescent infection place plate (DCP) in situ.

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

Rob¹,

Hossain²

2023

MOJOR

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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.

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Accordion Maneuver with Modified Ilizarov Frame for treatment of recalcitrant nonunion of shaft of femur in a patient with Pycnodysostosis

Cited by 3 publications

References 5 publications

Pycnodysostosis: Natural history and management guidelines from 27 French cases and a literature review

Pycnodysostosis: Natural history and management guidelines from 27 French cases and a literature review

Accordion maneuver with Ilizarov placed plate in situ, in a case of femoral shaft non-union and refracture with quiescent infection, discussion on treatment strategies: a case report

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

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