Ilizarov Technique of Lengthening and Then Nailing for Height Increase

Emara, Khaled; Farouk, Amr; Diab, Rami

doi:10.1177/230949901101900215

Cited by 16 publications

(14 citation statements)

References 21 publications

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“…A bridge was applied using Ilizarov device accessories ( Figure 6) on an outpatient basis, and the procedure was continued with no negative effect on the final outcome. Complications of premature consolidation of the regenerate bone, joint stiffness, limb-length discrepancy, nerve palsy, neurapraxia, rotational deformity, or anterior knee pain, although reported by others, 12,13 were not encountered in the current study. No deep infection occurred.…”

Section: Complicationscontrasting

confidence: 55%

Safe Cosmetic Leg Lengthening for Short Stature: Long-term Outcomes

Elbatrawy¹,

Ragab²

2015

Orthopedics

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It is well known that limb lengthening is performed to treat limb-length discrepancies resulting from congenital anomalies and developmental problems. However, few studies discuss lengthening for cosmetic purposes. The current authors conducted a prospective study with long-term follow-up. From July 2002 through June 2007, 133 patients requested that their height be increased. Fifty-two were approved to undergo limb-lengthening surgery. Two were lost to final follow-up, leaving 50 in the study group. For all patients, the Ilizarov ring external fixator was applied with a maximum-stability technique that achieved frame stability and allowed patients to ambulate with a walker from the first week postoperatively. The method requires close follow-up for early detection of problems. Physiotherapy improved ankle function and prevented plantar flexion deformity, which can occur during lengthening. Excellent final outcomes were achieved in all patients except one, who required additional surgery. The Ilizarov device is a safe tool for limb lengthening in individuals of short stature when applied with the authors' maximum stability technique. To the authors' knowledge, this is the first article on this topic to report long-term results (minimum 5-year follow-up for all patients). Many factors influence the outcome of lengthening surgery performed with Ilizarov devices: the material of the rings, the use of a hybrid technique combining pins and wires, the diameter and number of pins over each bone segment, the size of the rings around the limb, the surgical technique for pin insertion, and the use of hydroxyapatite-coated pins or regular stainless pins.

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Section: Complicationscontrasting

confidence: 55%

Safe Cosmetic Leg Lengthening for Short Stature: Long-term Outcomes

Elbatrawy¹,

Ragab²

2015

Orthopedics

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“…There are several surgical techniques proposed to shorten the duration of external fixation in treatment of bone infection. That includes lengthening then nailing technique [6] , and lengthening over nail [7] , and hemicorticotomy [8] , and many other techniques. On the other hand there are several biological techniques proposed to shorten duration of external fixation: for example early bone graft for the docking site [9] , platelet rich plasma [10] , bone marrow injection [11] , and many other techniques.…”

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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“…The same technique is being used to increase the height of somatically normal persons who report negative feelings regarding their short stature [2,6,11,20] deriving from cosmetic, social, and occupational concerns.…”

Section: Introductionmentioning

confidence: 99%

Cosmetic Lower Limb Lengthening by Ilizarov Apparatus: What are the Risks?

Новиков

Subramanyam

Muradisinov

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Compelled by the psychosocial implications of short stature, patients with short stature are increasingly undergoing distraction osteogenesis for cosmetic limb lengthening. To the degree that this is true, evaluation of the risks and benefits of this treatment are very important, but to date, there are few studies reporting on using distraction osteogenesis for this indication. Questions/purposes We reviewed a group of patients undergoing cosmetic lower-extremity lengthening in terms of (1) soft tissue challenges, (2) bone-related complications, and (3) functional and subjective clinical outcomes. Methods The study was retrospective by reviewing data from medical records and radiographs. Between 1983 and 2006, we treated 138 somatically normal patients with bilateral lower-limb distraction osteogenesis for cosmetic purposes at our center using an Ilizarov external fixator, of whom 131 (95%; 65 males, 66 females) had complete clinical and radiographic data a minimum of 1 year after treatment (mean, 6 years; range, 1-14 years) and were reviewed for this report. The mean age of these patients was 25 years (range, 14-68 years) and their mean preoperative height was 159 cm (range, 130-174 cm). One hundred twenty-four (95%) patients had lengthening of the tibia alone, of which 66 (53%) were monofocal and 58 (47%) were bifocal. Six patients (4.58%) had crossed contralateral lengthening of the femur and tibia and one patient (0.76%) had bilateral lengthening of the femur. The mean height gained was 6.9 cm (range, 2-13 cm), 7.3 cm (range, 3.5-13 cm) in males and 6.5 cm (range, 2-13 cm) in females. The mean lengthening, maturation, and external fixator indexes were 12 days/cm (range, 4.3-24 days/cm), 19 days/cm (range, 5.2-63 days/cm), and 31 days/cm (range, 12-78 days/cm), respectively. Results Forty-eight patients (37%) had 59 complications related to treatment. Thirty-seven were soft tissue related (28%), of which 17 (46%) needed reinterventions, and 22 were bone related (17%), of which 16 (73%) needed reinterventions. At final followup, the outcome was excellent for 72 patients (55%), good for 52 (40%), satisfactory for six (4.58%), and poor for one (0.77%). One

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Ilizarov Technique of Lengthening and Then Nailing for Height Increase

Abstract: Most complications related to patient discomfort and psychological stress, which were important issues in this type of patients.

Cited by 16 publications

References 21 publications

Safe Cosmetic Leg Lengthening for Short Stature: Long-term Outcomes

Safe Cosmetic Leg Lengthening for Short Stature: Long-term Outcomes

Cost of external fixationvsexternal fixation then nailing in bone infection

Cosmetic Lower Limb Lengthening by Ilizarov Apparatus: What are the Risks?

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