Long-Term Results and Costs of Muscle Flap Coverage With Ilizarov Bone Transport in Lower Limb Salvage

Lowenberg, David W.; Buntic, Rudolf F.; Buncke, Gregory M.; Parrett, Brian M.

doi:10.1097/bot.0b013e31828afde4

Cited by 64 publications

(55 citation statements)

References 26 publications

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“…2,3,32,33 However, it remains indisputable that the main disadvantage of the Ilizarov technique is the tedious process with external fixation that may take months to perform. Intense pin-track pain appeared in two patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Repo

Barner-Rasmussen

Roine

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Summary Background: Extensive compound tibial fractures present reconstructive challenges. The present study aimed to assess the outcomes of microvascular latissimus dorsi (LD) flap combined with the Ilizarov technique for extensive compound tibial fractures with bone loss and bone healing complications. Methods: Patient records were reviewed retrospectively. The Lower Extremity Functional Scale (LEFS), the Disabilities of the Arm, Hand and Shoulder (DASH), and the 15D healthrelated quality of life (HRQoL) instrument were applied. Results: Between 1989 and 2014, 16 patients underwent reconstruction with a microvascular LD flap and bone transport (11/16) or late bone lengthening (5/16). The mean clinical follow-up time was 6.6 (standard deviation (SD): 6.5) years. Three patients had minor complications requiring reoperation. Partial necrosis of one flap required late flap reconstruction in one case. Late bone grafting was used to enhance union in eight of 16 cases. The mean new bone gain was 3.8 cm (SD: 2.5).Overall, 11 patients completed the questionnaires in a mean of 22.3 years (SD: 2.4) after surgery. The main findings revealed a relatively good function of the reconstructed limb and good shoulder function. The mean HRQoL was comparable to that of an age-standardized sample of the general population.

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Section: Discussionmentioning

confidence: 99%

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Repo

Barner-Rasmussen

Roine

et al. 2016

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Lowenberg et al [15] reported a rate of 8.8% for docking-side nonunion even though they performed autogenous bone grafting at the docking side. Cierney and Zorn [16] recommended the use of an autogenous bone graft in cases of nonunion with more than 60 mm segmental bone loss defect.…”

Section: Discussionmentioning

confidence: 99%

Treatment of chronic osteomyelitis of the femur with combined technique

Gülabi

Erdem

Çeçen

2014

Eklem Hastalik Cerrahisi

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“…However, the conversion to internal fixation must avoid any iatrogenic contamination and be strong enough to stabilize the immature bone (regenerate) [1,9,25,28,39,41]. The onerous patient experience with traditional Ilizarov reconstruction is a powerful way to completely restore nearnormal anatomy and restoration of function in a cost-effective manner [23]. Improvement in the patient's treatment experience, through minimizing external fixator-related complications, should result in better patient outcomes; however, this needs to be supported by comparative studies.…”

Section: Discussionmentioning

confidence: 99%

Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

Bernstein

Fragomen

Sabharwal

et al. 2015

Clin Orthop Relat Res

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Background Limb salvage in the presence of posttraumatic tibial bone loss can be accomplished using the traditional Ilizarov method of distraction osteogenesis with circular external fixation. Internal fixation placed at the beginning of the consolidation phase, so-called integrated fixation, may allow for earlier removal of the external fixator but introduces concerns about cross-contamination from the additional open procedure and maintenance of bone regenerate stability. Questions/purposes Among patients deemed eligible for integrated fixation, we sought to determine: (1) Does integrated fixation decrease the time in the external fixator? (2) Is there a difference in the rate of complications between the two groups? (3) Are there differences in functional and radiographic results between integrated fixation and the traditional Ilizarov approach of external fixation alone? Methods Between January 2006 and December 2012, we treated 58 patients (58 tibiae) with posttraumatic tibial bone loss using the Ilizarov method. Of those, 30 patients (52%) were treated with the ''classic technique'' (external fixator alone) and 28 (48%) were treated with the ''integrated technique'' (a combination of an external fixator and plating or insertion of an intramedullary nail). During that period, the general indications for use of the integrated technique were closed physes, no active infection, and a healed soft tissue envelope located at the intended internal fixation site; the remainder of the patients were treated with the classic technique. Followup on 30 (100%) and 28 (100%) patients in the classic and integrated techniques, respectively, was achieved at a minimum of 1 year (mean, 3 years; range, 1-8 years). Adverse events were reported as problems, obstacles, and complications according to the One of the authors (ATF) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: consultant for Smith & Nephew, Inc (Memphis, TN, USA), and Synthes (Paoli, PA, USA) in the amount of less than USD 10,000. One of the authors (SRR) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: Smith & Nephew, Inc in the amount of less than USD 10,000. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investi...

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Long-Term Results and Costs of Muscle Flap Coverage With Ilizarov Bone Transport in Lower Limb Salvage

Abstract: The long-term results and costs of bone transport and flap coverage strongly support complex limb salvage in this patient population.

Cited by 64 publications

References 26 publications

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique: A cross-sectional study of long-term outcomes

Treatment of chronic osteomyelitis of the femur with combined technique

Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

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