Distraction osteogenesis for tibial nonunion with bone loss using combined Ilizarov and Taylor spatial frames versus a conventional circular frame

Abstract

This retrospective review assesses 55 tibial nonunions with bone loss to compare union achieved with combined Ilizarov and Taylor spatial frames (I–TSF) versus a conventional circular frame with the standard Ilizarov procedure. Seventeen (31 %) of the 55 nonunions were infected. Thirty patients treated with I–TSF were compared with 25 patients treated with a conventional circular frame. In the I–TSF group, an average of 7.6 cm of bone was resected and the lengthening index (treatment time in months divided by lengthening amount in centimeters) was 1.97. In the conventional circular frame group, a mean of 6.5 cm was resected and the lengthening index was 2.1. Consolidation at the docking site and at the regenerate bone occurred in 49 (89 %) of 55 cases after the first procedure. No statistically significant difference was shown between the two groups. Superiority of one modality of treatment over the other cannot be concluded from our data. Application of combined Ilizarov and Taylor spatial frames for bone transport is useful for treatment of tibial nonunion with bone loss. Level of evidence Case series, Level III.

Ilizarov bone transport and treatment of critical-sized tibial bone defects: a narrative review

“…In 6 of the 27 studies, infected and noninfected CSBD were mixed [19, 25, 29–32, 39]. Eighteen studies included only infected tibial CSBD.…”

“…In the remaining 202 cases, late grafting because of nonunion, plating and intramedullary nailing were performed, and there is not enough information to determine what has been done. Consolidation at the docking site and at the regenerated bone occurred in 49 (89%) of 55 cases after the first procedure [29]. Bone grafting at the docking site is frequently necessary after bone transport is complete.…”

“…In some studies, equinus deformity was noted under a separate column. In the 4 studies where there was no mention of joint stiffness, equinus deformity was reported [22, 27, 29, 39]. Of the 27 studies, 22 reported equinus deformity.…”

“…The criteria recommended by ASAMI were adopted to evaluate bone results and functional results in the studies. Sometimes, clinical efficacy was assessed using Paley’s grading system and patient satisfaction at the last follow-up [15, 16, 19–21, 23, 29, 37]. Bone results were evaluated in 20 studies by ASAMI criteria with data of 502 patients.…”

Short-term clinical effect of 3D printing techniques on the correction of complex malformations

“…Thirdly, the Taylor frame and Ilizarov external frame are commonly used in external frame fixation. The former is obviously better than the latter in the aspect of biomechanical stability and adjustment accuracy [12–14], and its ability to correct rotation is especially prominent; however, the disadvantage is that the costs and components replacement of Taylor frame in the later stage is relatively high, and it requires regulation prescription provided by both the doctor and the engineer, so it was only applied in patients with complex malformations in this study. In addition, the external fixator has advantages that internal fixation does not possess, such as slow adjustment after surgery, and the rare chance of neurovascular injury, etc.…”