Ilizarov External Fixation and Then Nailing in Management of Infected Nonunions of the Tibial Shaft

Emara, Khaled; Allam, Mohamed Farouk

doi:10.1097/ta.0b013e3181569ecc

Cited by 35 publications

(31 citation statements)

References 26 publications

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“…To overcome patient discomfort, Emara and Allam advocated early removal of external fixator and replacement by intramedullary nail. 25 Half pin frame is another option which is user friendly and less time consuming. 4 Patient tolerability is better and that helps in early physiotherapy.…”

mentioning

confidence: 99%

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

Rohilla

Siwach

Devgan

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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mentioning

confidence: 99%

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

Rohilla

Siwach

Devgan

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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“…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] . The aim of the study is to compare the cost of the two different techniques including hospital and surgical cost, home care cost, and absence from work or school, and to define which would be more cost effective for the patient and the community.…”

Section: Introductionmentioning

confidence: 73%

“…This choice has the advantage of being safe with no need for another major surgery and less risk for recurrence of infection and this technique is classic and many literatures explained the long term outcome of this technique. 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] .…”

Section: Techniquementioning

confidence: 99%

“…The advantage of this choice is more comfort to the patient and easier physical therapy to regain range of movement and muscle strength. Disadvantage included risk of recurrence of infection due to implantation of hard ware, and risk of implant failure [18] . Patients who chosen this technique were taken to the operative theater for Ilizarov external fixation removal and replaced by Interlocking intramedullary nail and autogenous bone graft at the docking site.…”

Section: Techniquementioning

confidence: 99%

“…Both techniques involve segment transfer by Ilizarov external fixation. 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] .…”

Section: Introductionmentioning

confidence: 99%

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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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Tibial Nonunion with Angular Deformity Treated with Taylor Spatial Frame to Gradually Correct and Lengthen

Landge

Conway

2014

Limb Lengthening and Reconstruction Surgery Case Atlas

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Ilizarov External Fixation and Then Nailing in Management of Infected Nonunions of the Tibial Shaft

Cited by 35 publications

References 26 publications

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

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

Cost of external fixationvsexternal fixation then nailing in bone infection

Tibial Nonunion with Angular Deformity Treated with Taylor Spatial Frame to Gradually Correct and Lengthen

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