Bone transport using the Ilizarov method: a review of complications in 100 consecutive cases

Abstract

We present the results of treatment of 100 patients (72 men, 28 women) by the Ilizarov method of bone transport using circular (55) and monolateral external fixators (45). A total of 26 femurs (18 monolateral, 8 circular) and 74 tibias (49 circular, 25 monolateral) was examined. There were no significant differences between the circular fixator and the monolateral fixator with regard to treatment time, complications in the treated bone segments or compliance with the presence of the fixator. The main complications (pseudoarthrosis at bone contact points after transport, insufficient ossification of lengthened bone, knee stiffness) were resolved with further treatment for all patients with the exception of one case which continued with repeated infections. The circular fixator allows for deformity corrections during bone transport but the monolateral fixator is tolerated better by patients, especially in those with femoral defects.

Outcome of distraction osteogenesis by ring fixator in infected, large bone defects of tibia

“…Iacobellis et al also recommended removal of interposed fibrous or cutaneous tissue at docking site to achieve union. 18 Soft tissue loss often complicates the treatment of tibial nonunion with bone loss and may require skin grafts, local pedicled muscle and myocutaneous flaps, and free flaps. Such surgery may require a microvascular team and increase hospitalization time, cost, and morbidity.…”

Tibial lengthening for unilateral Crowe type-IV developmental dysplasia of the hip

“…In our department, good results were achieved in fields of long bone nonunion and limb deformity after using the mono-lateral external fixator 78910. In a study done by Iacobellis et al .,22 no significant differences were observed between the ring fixator and the mono-lateral fixator, but patients tolerated the mono later fixator better. In our study, patients were encouraged to start earlier rehabilitation including ankle joint motion on the second postoperative day.…”

Treatment Of Post Traumatic Femoral Bone Loss Using Ilizarov External Fixator; Technical Difficulties and Complications Analysing Approach

“…For defects less than 6 centimeters in the femur or tibia acute collapse with lengthening can be done [15] , for larger defect more than 6 centimeters internal bone transport is used and acute collapse is avoided for fear of limb ischemia due to kink of the vessels at the compression site. Other authors consider the size of the defect suitable for acute collapse is a percent to total length of the femur; they stated that acute collapse can be done when the defect is up to 15% of the femoral length [16] . In this study acute collapse for bone defects less than six cm was performed but with precautions.…”