Clinical strategies at the docking site of distraction osteogenesis: Are open procedures superior to the simple compression of Ilizarov?

Lovisetti, Giovanni; Sala, Francesco

doi:10.1016/s0020-1383(13)70014-7

Cited by 18 publications

(24 citation statements)

References 22 publications

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“…Routine docking site revision with bone grafting provides the greatest opportunity for the most reliable and rapid union by optimizing bone contact and congruity. Most authors currently recommend routine staged docking site revisions during bone transport [15,16,36,38,39,41,42,51] , although this is not unanimous [48,52] .…”

Section: Discussionmentioning

confidence: 99%

Bone transport versus acute shortening for the management of infected tibial non-unions with bone defects

Tetsworth

Paley

Şen

et al. 2017

Injury

108

113

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Section: Discussionmentioning

confidence: 99%

Bone transport versus acute shortening for the management of infected tibial non-unions with bone defects

Tetsworth

Paley

Şen

et al. 2017

Injury

108

113

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show abstract

“…In case 2 there was a delayed consolidation after the NAL procedure. However, comparative studies between open, closed or endoscopic docking procedures did not show any difference in bony healing [12,13]. Biz et al [14] presented a case series of non unions and re-fractures at the consolidated docking site, treated by intramedullary nailing, achieving union and complete bone healing [14].…”

Section: Discussionmentioning

confidence: 99%

Knee Arthrodesis in Severe Injured Knee Joints

Žák¹,

Tiefenboeck²,

Wozasek³

2016

J Trauma Treat

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In this report we present our experiences with knee arthrodesis nails as a secondary salvage procedure after severe knee injuries at a level-one trauma centre. Exemplary two cases of subtotal amputation are discussed. Both cases, of totally destroyed knee joints, were treated with a unilateral external fixator, shortening and secondary bifocal distraction osteogenesis. In one case nailing after lengthening (NAL) was performed and in the second case nailing had to be performed as fracture treatment 20 years after bony consolidation at the docking site.

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“…But the disadvantage is the longer duration of external fixation with more risk of pin tract infection, and joint stiffness, discomfort, and other complications of long duration of external fixation [18] . Patients who chosen this line of treatment had autogenous bone graft surgery at the docking site to avoid slow healing of the docking site with no internal fixation and continued with external fixation till full healing [21] . The other choice was removal of external fixation and replacement by intramedullary nail.…”

Section: Techniquementioning

confidence: 99%

“…In one technique the external fixation is removed early after eradication of infection and finishing segment transfer, and replaced by intramedullary nail [18][19][20] . The other technique is to continue with external fixation till full healing of the fracture, docking site, and distraction callus [21][22][23] . Both techniques showed comparable long term outcome [18] .…”

Section: Introductionmentioning

confidence: 99%

Cost of external fixationvsexternal fixation then nailing in bone infection

Emara

Diab

Ghafar

2015

WJO

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AIM:To study the cost benefit of external fixation vs external fixation then nailing in treatment of bone infection by segment transfer. METHODS:Out of 71 patients with infected nonunion tibia treated between 2003 and 2006, 50 patients fitted the inclusion criteria (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. RESULTS:The cost of hospital stay and surgery in the group of external fixation only was 22.6 ± 3.3 while the cost of hospital stay and surgery in the group of early external fixation removal and replacement by intramedullary nail was 26.0 ± 3.2. The difference was statistically significant regarding the cost of hospital stay and surgery in favor of the group of external fixation only. The total cost of medical care (surgery, hospital stay, treatment outside the hospital including medications, dressing, physical therapy, outpatient laboratory work, etc .) in group of external fixation only was 63.3 ± 15.1, and total absence from work was 38.6 ± 6.6 wk. While the group of early removal of external fixation and replacement by IM nail, total cost of medical care was 38.3 ± 6.4 and total absence from work or school was 22.7 ± 4.1. The difference was statistically significant regarding the total cost and absence from work in favor of the group of early removal and replacement by IM nail. CONCLUSION:Early removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance, and health authorities. Core tip: Fifty patients with infected nonunion tibia (26 patients were treated by external fixation only, and 24 patients were treated by external fixation early removal after segment transfer and replacement by internal fixation). Cost of inpatient treatment, total cost of inpatient and outpatient treatment till full healing, and the weeks of absence from school or work were calculated and compared between both groups. ORIGINAL ARTICLE Observational StudyEarly removal of external fixation and replacement by intramedullary nail in treatment of infected nonunion showed more cost effectiveness. Orthopaedic society needs to show the cost effectiveness of different procedures to the community, insurance and health authorities.Emara KM, Diab RA, Ghafar KAE. Cost of external fixation vs external fixation then nailing in bone infection.

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Clinical strategies at the docking site of distraction osteogenesis: Are open procedures superior to the simple compression of Ilizarov?

Cited by 18 publications

References 22 publications

Bone transport versus acute shortening for the management of infected tibial non-unions with bone defects

Bone transport versus acute shortening for the management of infected tibial non-unions with bone defects

Knee Arthrodesis in Severe Injured Knee Joints

Cost of external fixationvsexternal fixation then nailing in bone infection

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