Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved

Borzunov, D.Yu.; Kolchin, Sergei N; Malkova, Tatiana A

doi:10.5312/wjo.v11.i6.304

Cited by 37 publications

(39 citation statements)

References 78 publications

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“…Unfortunately, the ability to obtain good bone quality faster was lost by bone transport in the distal as a result. Even the joint stiffness occurred here more and worse knee motion was brought, since the adjacent relationship to knee [15,[42][43][44]. Therefore, the quadriceps plasty methods and their modi cations may be a resolution to knee stiffness.…”

Section: Discussionmentioning

confidence: 99%

Complications Associated with Bifocal Bone Transport Using Unilateral External Rail Fixator in the Reconstruction of Femur Defects Caused by Infection: Outcome Analysis of 76 Patients

Peng

Liu

Tian

et al. 2021

Preprint

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Background: The purpose of this study is to evaluate the outcomes of single-level bone transport in the treatment of femoral bone defects after radical debridement, which were caused by infections.Methods: Clinical and radiographic data of patients with infected femoral nonunion treated with a unilateral external fixator (Orthofix limb reconstruction system, LRS) at our hospital from 2010 to 2019 were analyzed retrospectively. The Association for the Study and Application of the Method of Ilizarov (ASAMI) standard was applied to assess the bone and functional outcomes and postoperative complications evaluated by Paley classification. Results: Seventy-six cases of infected femoral bone defects (31 proximal, 19 intermediate, and 26 distal) were managed by single-level bone transport using a unilateral external fixator with a mean follow-up time of 30.8 (23 to 41) months. There were 58 men (76.3%) and 18 women (23.6%), with a mean age of 38.8 years (range, 23 – 60 years). The bone union was achieved in 76 cases with a mean time of 6.9 months (range, 5-8 months). Complications included 29 cases (38.1%) of pin tract infection, 7 cases (9.2%) of muscle contractures, 3 cases (7.9%) of joint stiffness, 13 cases (17.1%) of axial deviation, 2 cases (2.6%) of delayed union, one case (1.3%) of nonunion, and none (0%) of transport gap re-fracture. One patient (1.3%) was scheduled for knee arthroplasty when bone transport treatment ended.Conclusions: Bone transport in the reconstruction of femoral bone defects using unilateral external rail fixator had a satisfactory rate of bone healing and limb function recovery. Complications of distal femoral bone transport were more severe than other sites, but the complication rate was the least of the three. Complications of the proximal were comparable to the intermediate, and soft-tissue-related complications were more likely to occur in the intermediate transport.

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Section: Discussionmentioning

confidence: 99%

Complications Associated with Bifocal Bone Transport Using Unilateral External Rail Fixator in the Reconstruction of Femur Defects Caused by Infection: Outcome Analysis of 76 Patients

Peng

Liu

Tian

et al. 2021

Preprint

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“…For example, bulky Ilizarov apparatus leads to physical stress due to the inconvenience of sleeping and personal hygiene, negatively impacting patients’ mental health. A long treatment period increases the risk of pin tract infections and hospitalisation expenses [ 2 ]. Reconstruction medicine is searching for novel methods that optimise and shorten the regenerative process.…”

Section: Discussionmentioning

confidence: 99%

“…Segmental long bone defects caused by high-energy trauma, traffic accident, and military activities remain a surgical challenge. There are more than 4.5 million bone reconstruction procedures worldwide, and bone defects lead to significant negative consequences or disability if not managed using appropriate approaches [ 1 , 2 ]. Distraction osteogenesis (DO) and the Ilizarov external ring fixator developed by G.A.…”

Section: Introductionmentioning

confidence: 99%

“…Distraction osteogenesis (DO) and the Ilizarov external ring fixator developed by G.A. Ilizarov have now been acknowledged in the orthopaedic world as one of the most important strategies for bone defect reconstruction [ 2 , 3 ]. DO procedures comprise three phases: the latency phase after the application of external fixation, the distraction phase implementing gradual and continuous distraction, and the consolidation phase for bone quality strengthening and bone remodelling [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Screen Key Genes Associated with Distraction-Induced Osteogenesis of Stem Cells Using Bioinformatics Methods

Chen

Hua

Song

2021

IJMS

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Applying mesenchymal stem cells (MSCs), together with the distraction osteogenesis (DO) process, displayed enhanced bone quality and shorter treatment periods. The DO guides the differentiation of MSCs by providing mechanical clues. However, the underlying key genes and pathways are largely unknown. The aim of this study was to screen and identify hub genes involved in distraction-induced osteogenesis of MSCs and potential molecular mechanisms. Material and Methods: The datasets were downloaded from the ArrayExpress database. Three samples of negative control and two samples subjected to 5% cyclic sinusoidal distraction at 0.25 Hz for 6 h were selected for screening differentially expressed genes (DEGs) and then analysed via bioinformatics methods. The Gene Ontology (GO) terms and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment were investigated. The protein–protein interaction (PPI) network was visualised through the Cytoscape software. Gene set enrichment analysis (GSEA) was conducted to verify the enrichment of a self-defined osteogenic gene sets collection and identify osteogenic hub genes. Results: Three hub genes (IL6, MMP2, and EP300) that were highly associated with distraction-induced osteogenesis of MSCs were identified via the Venn diagram. These hub genes could provide a new understanding of distraction-induced osteogenic differentiation of MSCs and serve as potential gene targets for optimising DO via targeted therapies.

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“…The management of bone defects and nonunion continues to be a subject of great interest in the international orthopedic literature[ 30 , 31 ]. A contemporary surgeon has a number of options with proven clinical evidence for management of bone defects and nonunion.…”

Section: Current Clinical Practice and Research In The Ilizarov Techniques Of Bone Reconstructionmentioning

confidence: 99%

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)

Malkova

Borzunov

2021

WJO

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The Ilizarov method is one of the current methods used in bone reconstruction. It originated in the middle of the past century and comprises a number of bone reconstruction techniques executed with a ring external fixator developed by Ilizarov GA. Its main merits are viable new bone formation through distraction osteogenesis, high union rates and functional use of the limb throughout the course of treatment. The study of the phenomenon of distraction osteogenesis induced by tension stress with the Ilizarov apparatus was the impetus for advancement in bone reconstruction surgery. Since then, the original method has been used along with a number of its modifications developed due to emergence of new fixation devices and techniques of their application such as hexapod external fixators and motorized intramedullary lengthening nails. They gave rise to a relatively new orthopedic subspecialty termed “limb lengthening and reconstruction surgery”. Based on a comprehensive literature search, we summarized the recent clinical practice and research in bone reconstruction by the Ilizarov method with a special focus on its modification and recognition by the world orthopedic community. The international influence of the Ilizarov method was reviewed in regard to the origin country of the authors and journal’s rating. The Ilizarov method and other techniques based on distraction osteogenesis have been used in many countries and on all populated continents. It proves its international significance and confirms the greatest contribution of Ilizarov GA to bone reconstruction surgery.

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Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved

Cited by 37 publications

References 78 publications

Complications Associated with Bifocal Bone Transport Using Unilateral External Rail Fixator in the Reconstruction of Femur Defects Caused by Infection: Outcome Analysis of 76 Patients

Complications Associated with Bifocal Bone Transport Using Unilateral External Rail Fixator in the Reconstruction of Femur Defects Caused by Infection: Outcome Analysis of 76 Patients

Screen Key Genes Associated with Distraction-Induced Osteogenesis of Stem Cells Using Bioinformatics Methods

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)

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Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved

Cited by 37 publications

References 78 publications

Complications Associated with Bifocal Bone Transport Using Unilateral External Rail Fixator in the Reconstruction of Femur Defects Caused by Infection: Outcome Analysis of 76 Patients

Complications Associated with Bifocal Bone Transport Using Unilateral External Rail Fixator in the Reconstruction of Femur Defects Caused by Infection: Outcome Analysis of 76 Patients

Screen Key Genes Associated with Distraction-Induced Osteogenesis of Stem Cells Using Bioinformatics Methods

International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100thbirthday of G. A. Ilizarov)

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Product

Resources

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International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100^thbirthday of G. A. Ilizarov)