Results of the Treatment of Infected Nonunions of the Lower Limbs Using the Ilizarov Method

Dróżdż, M.; Rak, Stanisław; Bartosz, Paweł; Białecki, Jerzy; Marczyński, Wojciech

doi:10.5604/15093492.1237999

Cited by 7 publications

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“…The treatment of nonunion is complex and associated with numerous complications [1], [8], [9], [11], [14], [15], [19], [21], [28]. The Ilizarov method is an internationally recognised and preferred method for the treatment of nonunion [1], [2], [7]- [12], [14], [15], [18], [19]- [21], [28], [29]. Most patients treated with this method have good results and achieve bone union [1], [2], [8]- [10], [12], [15], [20], [21], [28], [29].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Kozłowska¹,

Pawik²,

Szelerski³

et al. 2020

Acta Bioeng Biomech

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Purpose: The biomechanics of the musculoskeletal system in patients after tibial nonunion treatment using the Ilizarov method have not yet been fully explored. From the orthopaedic and patient point of view, after the treatment, an assessment should be carried out of the biomechanics of the musculoskeletal system. The aim of this study was to assess the body balance of patients treated with the Ilizarov method for tibial nonunion. Methods: The research group included 24 individuals with a mean age of 55 years, who were treated for aseptic tibial nonunion with the Ilizarov method. The control group was matched to the study group in terms of gender and age, and consisted of 32 subjects with a mean age of 50.5 years and no significant medical history. This study evaluated the balance of patients with the use of pedobarography. Results: In the control group, a statistically significantly shorter path of centre of gravity was observed. There were no statistical differences between the study and control groups for the field area of the centre of gravity. There were no statistical differences between the study and control groups for the minor axis length or major axis length of the centre of gravity. There was a relationship between the centre of pressure path length and the age of the participants in both the control group and the study group. Conclusions: Treatment of patients with tibial nonunion with the Ilizarov fixator achieves similar balance to healthy volunteers. In the pedobarographic evaluation, patients treated for tibial nonunion using the Ilizarov method had similar statics of the musculoskeletal system to healthy volunteers.

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Section: Introductionmentioning

confidence: 99%

“…Most patients treated with this method have good results and achieve bone union [1], [2], [8]- [10], [12], [15], [20], [21], [28], [29]. However, several authors have reported unsatisfactory results of tibial nonunion treatment, where not all patients achieved bone union [7], [11], [14], [19].…”

Section: Introductionmentioning

confidence: 99%

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Kozłowska¹,

Pawik²,

Szelerski³

et al. 2020

Acta Bioeng Biomech

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“…1). All of these adversely affect the course of treatment and increase the risk of treatment failure [1][2][3][4][5][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In nonunions of the tibia, the Ilizarov method helps achieve bone union, eliminate possible infections, equalize limb length, and correct any deformities that may have developed over the course of treatment [1-5, 7-12, 14-18, 20-22].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors claim that bone transport combined with the use of external xators carries a higher risk of complications and yields worse outcomes in comparison with other methods of tibial nonunions treatment [2,5,11]. Most of the available analyses concern infected nonunions of the tibia [1,2,[6][7][8][9][10][11][12][13][15][16][17][18][19][20][21][22], whereas few reports discuss the treatment of tibia nonunion that is uncomplicated by infection [3,4,5,14].…”

Section: Introductionmentioning

confidence: 99%

“…Depending on the employed treatment strategy and surgical technique primary bone union was achieved in a range from 73.7-96.2% of patients, with a refracture rate of 31.6% in one of the subgroups[19]. Dróżdż et al achieved bone union in 86% of 54 patients with infected nonunions of the tibia treated with the Ilizarov method[20]. Marsh et al assessed the treatment outcomes of the Ilizarov method employed in 46 patients with nonunions of the tibia.…”

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The outcomes of Ilizarov treatment in aseptic nonunions of the tibia stratified by treatment strategies and surgical techniques

Szelerski

Kozłowska

Żarek

et al. 2020

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INTRODUCTIONNonunions of the tibia, particularly those located in the distal third of the bone, are relatively common in clinical practice. There is no gold standard for the treatment of nonunions of the tibia. The purpose of our study was to assess the results of treatment with the Ilizarov method in patients with aseptic nonunions of the tibia, depending on the employed treatment strategies and surgical techniques.MATERIALS AND METHODSA total of 75patients with Ilizarov treatment of aseptic nonunions of the tibia were evaluated in the study. The patients’s mean age at the beginning of treatment was 46years.The mean follow-up period was 10years and 11months.The evaluated patients underwent either closed technique or open technique. The operators used one of two treatment strategies: neutral fixation without compression or continued compression.The following were assessed: rates of union, ASAMI bone scores, ASAMI functional scores, treatment time, complications, duration of hospital stay.RESULTS: Bone union was achieved in all of the75evaluated patients. The results of most analyses showed no significant differences in the assessed variables, except for the ASAMI functional scores, which were higher in the group of patients who underwent closed surgery (Me=6.00vs.Me=4.00).DISCUSSIONWe observed better ASAMI functional score outcomes in the patients who underwent closed fixation than in the open fixation group.The different surgical techniques and treatment strategies had no effect on the number of complications, rates of bone union,length of hospital stay,duration of Ilizarov treatment,or ASAMI bone scores.For managing nonunions of the tibia we recommend the technique of closed fixation without continued compression.The Ilizarov method in the treatment of nonunions of the tibia gives good outcomes.Level of EvidenceDiagnostic Level IV

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A new criterion for assessing Ilizarov treatment outcomes in nonunion of the tibia

Szelerski¹,

Kozłowska²,

Żarek³

et al. 2020

Arch Orthop Trauma Surg

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Introduction The purpose of this study was to assess a population of patients with nonunion of the tibia treated with the Ilizarov method in terms of achieved union rates and maintained union rates, determination of re-fracture factors, with a subsequent comparison of our findings with those reported in the available literature. Materials and methods This study was a retrospective assessment of 102 patients with nonunion of the tibia treated with the Ilizarov method in the period 2008-2015. The assessed parameters were bone union achieved during treatment, duration of stabilization with an Ilizarov external fixator, and maintained bone union at the last follow-up visit. Results The mean age at the start of treatment was 46.7 years (11-84 years). The mean follow-up period was 7 years (2-12 years). Bone union was achieved in all patients. The mean duration of Ilizarov stabilization in the study group was 7.9 months (2.8-20.7 months). The rate of union maintained at the last follow-up visit was 95.1%. Conclusions All patients in our study achieved bone union, which constitutes a better outcome than those reported on average in the literature (73.7-100%). The mean length of time which the Ilizarov external fixator was in place in our patients was 8.3 months, which is consistent with the data from literature. Infection, atrophic nonunion, nonunion in 1/3 distal of tibia, and close surgery technique are risk factors of re-fracture. None of the analyzed studies assessed the proportion of patients with maintained bone union. In our study, maintained bone union was observed in 95.1% of patients at the follow-up visit at least 2 years after treatment, which indicates excellent long-term treatment outcomes in nonunion of the tibia treated with the Ilizarov method.

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Results of the Treatment of Infected Nonunions of the Lower Limbs Using the Ilizarov Method

Cited by 7 publications

References 0 publications

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

The outcomes of Ilizarov treatment in aseptic nonunions of the tibia stratified by treatment strategies and surgical techniques

A new criterion for assessing Ilizarov treatment outcomes in nonunion of the tibia

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