Outcomes of the Ilizarov frame use in elderly patients

Iliopoulos, Efthymios; Morrissey, Natasha; Cho, Seok; Khaleel, A.

doi:10.1016/j.jos.2017.03.002

Cited by 15 publications

(14 citation statements)

References 19 publications

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“….6 years (range[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The average patient's age at the time of surgery was 50.2 ± 11.3 years (range 28-78) in the FG and 28.6 ± 10.5 years (range 16-50) in the DG.…”

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confidence: 99%

Functional outcome and complications after treatment of comminuted tibial fractures or deformities using Ilizarov bone transport: a single-center study at 15- to 30-year follow-up

Biz

Crimì

Fantoni

et al. 2020

Arch Orthop Trauma Surg

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Introduction The aim of this retrospective study was to evaluate long-term outcomes and complications of a single-center and single-surgeon patient series of isolated and comminuted tibial fractures with bone defects or tibial deformities treated by Ilizarov bone transport. Materials and methods Data from a consecutive series of patients with isolated comminuted tibial fractures (Fracture Group: FG) or deformities (Deformity Group: DG) treated between 1987 and 2002 were included. For clinical assessment, the Lower Extremities Functional Scale was used; complications were recorded according to the Dindo classification and statistical analysis was performed. Results Overall, 72 patients were enrolled with a mean follow-up of 21.6 years (range 15-30) a mean LEFS of 36.4 (range 0-100). In the FG, the mean LEFS was 21.3 (range 0-98.75), and the external fixation time (EFT) lasted 7.6 months (range 3-18 months) months. In the DG, the mean LEFS was 76.7 (range 55-100), and the EFT was 10.6 months (range 3-20 months). Between the two groups, the clinical evaluation was significantly different, while the EFT was not (p = 0.14). In the FG, the worst results were obtained in the cases of open fractures with a higher percentage of complications and the need for further surgical procedures. The cumulative rate of complications was 55.6% during the first 36 months and 66.7% at the minimum follow-up of 180 months. Conclusions Ilizarov bone transport, even at a long follow-up period, proved to be an effective technique for both definitive treatment of comminuted tibial fractures with bone defects or tibial deformities. Although our functional outcomes were lower in patients with exposed fractures, they were in line with the literature, but not influenced by the EFT when properly managed. Most complications occurred during the first 3 years; however, they could also arise much later, even until almost 30 years.

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confidence: 99%

Functional outcome and complications after treatment of comminuted tibial fractures or deformities using Ilizarov bone transport: a single-center study at 15- to 30-year follow-up

Biz

Crimì

Fantoni

et al. 2020

Arch Orthop Trauma Surg

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“…However, the literature about the weight-bearing status after circular frame fixation is more homogeneous with early weight bearing being the prevalent option of the surgeons. 13 , 37 Elsoe et al 17 kept their patients treated with circular frame non-weight bearing for the first 6 post-operative weeks.…”

Section: Discussionmentioning

confidence: 99%

Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

Iliopoulos¹,

Galanis

2020

SAGE Open Medicine

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Background: Tibial plateau fractures are frequent injuries that orthopaedic surgeons face. It has been reported that they have a significant negative impact on the patients’ lives, decreasing their quality of live, keeping them of work for long periods of time and reducing their activity levels. Aim: Interestingly, there is not enough focus in the literature about the post-operative rehabilitation of these patients. The aim of the present review is to investigate this field of the literature and try to give answers in four main questions: the range of motion exercises post-surgery, the immobilisation, the weight-bearing status and the ongoing rehabilitation. Materials and Methods: A literature search was conducted using the PubMed and the Google Scholar search engines. A total of 39 articles met the criteria to be included in the study. Results: The literature about this subject is scarce and controversial. Early range of motion exercises should be encouraged as soon as possible after the procedure. The immobilisation after plate fixation does not seem to be correlated with any benefits to the patients. The weight-bearing status of the patients was the most controversial in the literature with the early weight-bearing gaining ground at the most recent studies. Tibia plateau fractures can have significant impact on the patients’ lives, so ongoing rehabilitation with focus on quadriceps strengthening and proprioception exercises is recommended. Conclusion: The present literature review illuminates the controversy that exists in the literature about the physiotherapy following tibia plateau fracture fixation. Early range of motion exercises and early weight bearing should be encouraged. Immobilisation does not seem to provide any benefit. Ongoing rehabilitation should be considered with the view of better clinical outcomes.

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“…Some studies have reported that a major advantage of Ilizarov external fixation is the ability to achieve rigid fixation for osteoporotic bones, which can be obtained through the insertion of multiple thin, straight wires [7][8][9]. Beris et al reported that Ilizarov external fixation is a feasible and effective treatment option, because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients treated for periprosthetic fractures [7].…”

Section: Discussionmentioning

confidence: 99%

“…Schreiner et al reported that periprosthetic tibial fractures predominantly affect elderly patients with reduced bone quality and have a high complication rate [12]. Osteoporosis makes the use of internal fixation devices for periprosthetic tibial fractures more challenging in elderly patients [9,12].…”

Section: Discussionmentioning

confidence: 99%

Ilizarov external fixation for a periprosthetic tibial fracture in severe osteoporosis: a case report

Nozaka

Miyakoshi

Satô

et al. 2020

BMC Musculoskelet Disord

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Background: The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is rising due to the increasing number of TKAs performed annually and the growing elderly population. A periprosthetic fracture of the proximal tibia following TKA is a rare injury that may be a challenging clinical scenario. Case presentation: The case of an 84-year-old woman who sustained a periprosthetic tibial fracture 10 years after a TKA is presented. This patient had multiple risk factors. The fracture was not deemed amenable to conventional treatment because the bone fragment was too small. This patient underwent fixation of her tibial fracture above the TKA using a five-ring Ilizarov external fixator. This allowed immediate full weight-bearing. The fixator was removed at 12 weeks, at which time the fracture was solidly healed. At the most recent follow-up, 2 years from injury, she was fully weight-bearing without walking aids and had a knee range of motion (ROM) of 0-110°. Conclusion: To the best of our knowledge, this is the first report in which Ilizarov external fixation has been used for a periprosthetic tibial fracture after TKA.

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Outcomes of the Ilizarov frame use in elderly patients

Cited by 15 publications

References 19 publications

Functional outcome and complications after treatment of comminuted tibial fractures or deformities using Ilizarov bone transport: a single-center study at 15- to 30-year follow-up

Functional outcome and complications after treatment of comminuted tibial fractures or deformities using Ilizarov bone transport: a single-center study at 15- to 30-year follow-up

Physiotherapy after tibial plateau fracture fixation: A systematic review of the literature

Ilizarov external fixation for a periprosthetic tibial fracture in severe osteoporosis: a case report

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