Ilizarov non-free bone plasty for extensive tibial defects

Borzunov, D.Yu.; Chevardin, Alexander V.

doi:10.1007/s00264-013-1799-3

Cited by 37 publications

(43 citation statements)

References 20 publications

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“…Paley et al stated that TFT achieved better results in cases of bone defect > 10 cm as compared to the other Ilizarov technique [18]. Chevardin et al [19] showed that the risk of hypoplastic bone formation increased in case of BFT regeneration of > 5 cm, and delayed osteogenesis occurred when the regeneration reached 8-10 cm. In our series, the mean bone defect size was 11.4 cm (range, 8-18.2).…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Fan

et al. 2020

Preprint

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Background The study was designed to investigate the safety and efficacy of trifocal bone transport (TFT) and soft-tissue transport with the Ilizarov technique for large posttraumatic tibial bone and soft tissue defects. Methods We retrospectively reviewed 31 patients with massive posttraumatic tibial bone and soft tissue defects from May 2009 to May 2016. All of the eligible patients were managed by TFT and soft-tissue transport. The median age was 33.4 years (range, 2-58 years). The mean defect of bone was 11.87cm ± 2.78cm (range, 8.2-18.2cm) after radical resection performed by TFT. The soft tissue defects ranged from 7cm x 8cm to 24cm x 12cm. The observed results included bone union time, wound close time and true complications. The Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system was used to assess bone and functional results and postoperative complications were evaluated by Paley classification. Results The mean duration of follow-up after frame removal was 32 months (range, 12-96 months). All cases achieved complete union in both the elongation sites and the docking sites, and eradication of infection. The mean bone transport time was 94.04 ± 23.33 days (range, 63.7-147 days). The mean external fixation time was 22.74 ± 6.82 months (range, 14-37 months), and the mean external fixation index (EFI) was 1.91 ± 0.3 months/cm (range, 1.2–2.5 months/cm). The bone results were excellent in 6 patients, good in 14 patients, fair in 8 patients and poor in 3 patients. The functional results were excellent in 8 patients, good in 15 patients, fair in 5 patients and poor in 3 patients. Conclusion The TFT in concert with soft-tissue transport technique can be used successfully to manage large tibial bone and soft-tissue defects. Soft-tissue transport can offer a feasible method for the defects with good soft tissue coverage on the bone ends. However, imprecision in the series results precludes a definitive conclusion, and comparative study is needed to assess whether soft-tissue transport is more effective than flap transfer for such soft-tissue defect.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Fan

et al. 2020

Preprint

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“…The authors retrospectively reviewed 16 patients with open fractures, includ-ing 11 patients with Gustilo-Anderson type IIIA fractures and 5 patients with Gustilo-Anderson type IIIB fractures who had dropped traumatic segmental bone fragments between January 2002 and January 2012. 8 Of these patients, 12 were men and 4 were women, with a mean age of 35.4 years (range, 19-47 years).…”

Section: Methodsmentioning

confidence: 99%

“…11 Commonly used methods for reconstruction of segmental bone defects are vascularized fibula autografts and the Ilizarov bone transfer technique. 1,[12][13][14][15][16] Vascularized fibula autografts contain an intrinsic blood supply and living bone cells that can provide well-perfused bone and the capability for osteogenesis. The healing process between the fibular graft and the host occurs in the same way as normal fracture healing, without creeping substitution or immunologic reaction.…”

Section: D B Amentioning

confidence: 99%

Reconstruction of Traumatic Bone Defect With In Situ Implantation of Dropped Traumatic Segmental Bone Fragments

Lin¹,

Luo²,

Lian³

et al. 2016

Orthopedics

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This study was conducted to determine whether in situ implantation of a dropped traumatic segmental bone fragment is safe and whether the authors' method would reduce the incidence of infectious and related complications. The authors retrospectively reviewed 16 patients with open fractures, including 11 with Gustilo-Anderson type IIIA fractures and 5 with Gustilo-Anderson type IIIB fractures who had a dropped traumatic segmental bone fragment between January 2002 and January 2012. Mean patient age was 35.4 years (range, 19-47 years). There were 10 femurs and 6 tibias. Average postoperative follow-up was 26.8 months (range, 12-60 months). The dropped traumatic segmental bone fragments were cleaned with 3% hydrogen peroxide, placed in separate sterile cups, and soaked in 1% iodophor for 30 minutes. Initial treatment included surgical debridement, wound irrigation, in situ implantation of the dropped traumatic segmental bone fragment, and temporary external fixation. Approximately 4 to 8 weeks later, after successful reconstruction of the soft tissue envelope, minimally invasive plate osteosynthesis was performed. Mean duration of treatment was 8 weeks (range, 6-14 weeks). All patients had fracture union at final follow-up. Mean healing time was 21.8 weeks (range, 14-48 weeks). One patient did not achieve primary union and required bone grafting. One patient with a Gustilo-Anderson type IIIB fracture had deep infection and removal of the dropped traumatic segmental bone fragment and bone grafting. According to the Klemm and Börner classification, 11 patients had excellent results, 3 had good results, and 2 had poor results. With adequate soft tissue coverage, this method was acceptable for the management of open fractures with bone defects.

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“…Bone defect larger than 8 cm or exceeded 40% of the injured bone underwent a double level bone transport [21][22][23] procedure. All the procedures were conducted by the same surgical team.…”

Section: Surgical Techniquementioning

confidence: 99%

Complications of bone transport technique using the Ilizarov method in the lower extremity: a retrospective analysis of 282 consecutive cases over 10 years

Liu

Yushan

Liu

et al. 2020

Preprint

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Background: The treatment of large bone defects in lower limbs is a serious challenge for orthopedic surgeons and patients. The bone transport technique using the Ilizarov method has become the main treatment option for the reconstruction of bone defect. However, inevitable difficulties and complications related to bone transport technique have been reported by many studies. The purpose of this study was to evaluate the effectiveness and complications of bone transport technique using Ilizarov method in the treatment of bone defect of lower extremity.Methods: The study was conducted on 282 patients who underwent bone transport procedures using Ilizarov method at our institution from January 2007 to June 2017. Patient’s demographic data, complications and clinical outcomes at minimum of two years follow-up were collected and retrospectively analyzed. All difficulties that related to bone transport were documented according to Paley’s classification. The clinical outcomes were evaluated using Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at last clinical visit. Results: There were 243 male and 39 females with a mean age of 40 years (range 18-65 years). The mean defect was 6.56±2.15 cm, whereas single level transport in 221 cases and double level transport in 61 cases. There were 189 problems, 166 obstacles and 406 complications (257 minor and 149 major complications), and the average complication rate per patients consists of 0.91 minor and 0.53 major complications. The top five complications were pin-site infection (65.96%), axial deviation (40.78%), joint stiffness (23.76%), soft tissue incarceration (22.34%) and delayed union of the docking site (13.48%).The ASAMI bony result was excellent in 233 patients, good in 32, fair in 5 and poor in 12. The ASAMI functional result was excellent in 136 patients, good in 88, fair in 47, poor in 11.Conclusion: Bone transport is a reliable method for reconstruction of bone defects in the femur and tibia. Awareness of predictable complications is beneficial to prevent or early detection of the expected complication which can improve the risk-benefit balance.

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Ilizarov non-free bone plasty for extensive tibial defects

Cited by 37 publications

References 20 publications

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Reconstruction of Traumatic Bone Defect With In Situ Implantation of Dropped Traumatic Segmental Bone Fragments

Complications of bone transport technique using the Ilizarov method in the lower extremity: a retrospective analysis of 282 consecutive cases over 10 years

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