Custom made Ilizarov ring fixator for fracture care in morbidly obese patients

Seybold, D.; Geßmann, Jan; Özokyay, L.; Frangen, T.M.; Muhr, G.; Graf, Markus

doi:10.1007/s00423-008-0351-1

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Standard fracture treatment is commonly associated with complications in patients with morbid obesity (BMI: >50 kg/m 2 ), the reason being the weight of the extremities and the amount of soft tissues around the fractured bones 8. Despite being the common orthopaedic injury, limited data are available regarding the management of femoral shaft fracture in obese individuals 1.…”

Section: Discussionmentioning

confidence: 99%

“…The current case was complicated further when multiple attempts were failed due to several reasons. Application of Ilizarov external fixator is recommended in obese patients in few studies,8 13 which was chosen with customised assembly. To the best of our knowledge, this is the first case report that has reported the management of an infected femoral nonunion with Ilizarov external fixator assembly in a morbidly obese patient.…”

Section: Discussionmentioning

confidence: 99%

“…Management through Ilizarov external fixator is not only less soft tissue compromising, but stable fixation can also be achieved making it suitable for obese patients 8 14. In these patients, the implants have to share the high loads due to increased body mass; therefore, it is recommended that while treating femoral shaft fractures, the construct strength should be ratcheted up 1 5.…”

Section: Discussionmentioning

confidence: 99%

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Management of femoral shaft infected nonunion through customised Ilizarov external fixator assembly in a morbidly obese patient

Ilyas¹,

Sattar²,

Zehra

et al. 2022

BMJ Case Rep

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A 19-year-old morbidly obese man presented with infected nonunion of femoral shaft fracture. Patient had history of 13 failed fixation surgeries, assessment revealed 3-centimetre limb-length discrepancy with 3-centimetre gap nonunion. Wound debridement, primary compression and external fixation using a customised Ilizarov external fixation assembly were planned. A four-ring customised assembly was applied. Partial weight bearing was allowed from first postoperative day on walker. Patient was kept on a monthly follow-up. After complete union at 10 months after surgery, frame was dynamised. After 6 months of dynamisation, frame was removed, at that time patient was full weight bearing. Knee was still stiff with a range of motion of 0°–20°, and there was 6 cm of limb length discrepancy, which was managed with a shoe raise. At 9 months after frame removal, patient is mobile with fully united bone. Ilizarov external fixator can be a good managing option in such difficult and complicated cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of femoral shaft infected nonunion through customised Ilizarov external fixator assembly in a morbidly obese patient

Ilyas¹,

Sattar²,

Zehra

et al. 2022

BMJ Case Rep

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“…In addition, external fixation is associated with less patient comfort and, for children, is often intolerable [15]. In cases of open tibia fractures in adults who have manifest neuropathy, which often is caused by diabetes mellitus, the use of an external fixateur is one treatment option for which good results have been described [16]. The primary use of the Ilizarov fixateur should be discussed in this case because the child had a manifest neuropathy.…”

Section: Discussionmentioning

confidence: 99%

Salvage procedures in lower-extremity trauma in a child with hereditary motor and sensory neuropathy type I: a case report

et al. 2012

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IntroductionFractures of the lower extremity are a common type of childhood injury and many can be treated without surgery. Dislocated and open fractures are an indication for fracture stabilization via either intramedullary nailing or, in the case of complicated fractures, external fixation. But if complications are likely because of diseases and disabilities (for example, a neuropathy) that can complicate the post-operative procedure and rehabilitation, what options does one have?Case presentationWe report a nine-year-old Caucasian girl who had hereditary motor and sensory neuropathy type I and who was admitted with a grade I open tibia fracture after a fall from a small height. Plain radiographs showed a dislocated tibia and fibula fracture. An open reduction with internal fixation with a compression plate osteosynthesis was performed, and soft tissue debridement combined with an external fixateur was undertaken. Three months later, she was re-admitted with localized swelling and signs of a local soft tissue infection in the middle of her tibia. Plain radiographs showed a non-union of the tibia fracture, and microbiological analysis confirmed a wound infection with cefuroxime-sensitive Staphylococcus aureus. Because of the non-union, the osteosynthesis was replaced with an Ilizarov external fixateur, and appropriate antibiotic therapy was initiated. Four months after the initial accident, the fracture was consolidated and we removed the external fixateur.ConclusionsIf there is a pre-existing neuropathy and if disease makes it difficult for a child to follow all post-operative instructions, salvage procedures should be kept in mind in case of complications. There are multiple therapeutic options, including osteosynthesis, intramedullary nailing systems, cast therapy, or an external fixateur like the Ilizarov or Taylor spatial frame system. The initial use of an external fixateur such as an Ilizarov or Taylor spatial frame in patients with pre-existing neuropathies should be kept in mind as a possible treatment option in complicated fractures, especially in a child with pre-existing neurological or endocrine pathologies.

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Treatment of tibial shaft nonunion with a retained nail in morbidly obese patients

Azzam

Gamal

Samy

2022

International Orthopaedics (SICOT)

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Custom made Ilizarov ring fixator for fracture care in morbidly obese patients

Abstract: The Ilizarov technique is a good fixation modality for stabilizing fractures of the lower limb in morbidly obese patients. Associated medical comorbidities are the limitations of successful fracture care.

Cited by 5 publications

References 14 publications

Management of femoral shaft infected nonunion through customised Ilizarov external fixator assembly in a morbidly obese patient

Management of femoral shaft infected nonunion through customised Ilizarov external fixator assembly in a morbidly obese patient

Salvage procedures in lower-extremity trauma in a child with hereditary motor and sensory neuropathy type I: a case report

Treatment of tibial shaft nonunion with a retained nail in morbidly obese patients

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