Staged Protocol for the Treatment of Chronic Tibial Shaft Osteomyelitis With Ilizarov’s Technique Followed by the Application of Intramedullary Locked Nail

Lin, Chun Cheng; Chen, Chuan-Mu; Chiu, Fang-Yao; Su, Yu‐Ping; Liu, Chien Lin; Chen, Tain Hsiung

doi:10.3928/01477447-20121120-23

Cited by 26 publications

(26 citation statements)

References 28 publications

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“…Therefore, how to reduce complications and defects has become a subject of clinical research. Recently, some scholars [7][8][9] reported improved Ilizarov bone transport with less complications, that is, when the docking site is closed or di cult to heal, the external xator was removed and then converted to internal xation (plate or intramedullary nail). However, it usually takes 1-2 weeks or more for the pin-track to heal before a new implant is implanted.…”

Section: Introductionmentioning

confidence: 99%

Retraction of transporting bone segment during Ilizarov bone transport

Yin

Wu³

et al. 2020

Preprint

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Background: Retraction of transporting bone segment (TBS) may occur when the TBS fixator was removed prior to full consolidation of the distracted callus, which has adverse effect on the healing of the docking site. However, there are few reports on the retraction of TBS. The purpose of this study is to analyze the causes and risk factors of retraction of TBS.Methods: The clinical data of 37 cases with tibial bone defect treated by Ilizarov bone transport were analyzed retrospectively, in whom the TBS fixator was removed prior to full consolidation of the distracted callus and union of the docking site. Bivariate correlation was used to analyze relationship between the retraction distance of TBS and potential risk factors including age, gender, course, length of bone defect, number of operations, size of TBS, transport distance, timing and time interval of removal of TBS fixator. Risk factors with significant level were further identified using multivariate linear regression.Results: Bivariate correlation showed that the timing of removal was negatively correlated while the time interval and transport distance were positively correlated with the retraction distance（p<0.05), the age, gender, course, length of bone defect, size of TBS and number of operations were not correlated with the retraction distance（p>0.05). Multivariate linear regression of the 3 risk factors showed that the timing of removal and time interval were the main risk factors for the retraction distance (p<0.05), but the transport distance was not (p>0.05).Conclusion: The traction forces of TBS endured from the soft tissues and the unconsolidated distracted callus have elastic properties, which can make retraction of TBS. The timing of removal and time interval are the main factors of retraction distance. In the case of early removal, another external fixation should be performed or quickly converted to internal fixation to avoid the adverse effect of more retraction.

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Section: Introductionmentioning

confidence: 99%

Retraction of transporting bone segment during Ilizarov bone transport

Yin

Wu³

et al. 2020

Preprint

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“…Therefore, how to reduce complications and defects has become a clinical research topic. Recently, some scholars [7][8][9] reported improved Ilizarov bone transport with less complications, in which external fixator was removed when the docking site are closing or showing difficulty in healing and then plate or intramedullary nail was used as a relay internal fixation. Sometimes, the TBS fixator or total external fixator must be removed in advance in cases with pin-track problem (pin-track infection or associated with loosening) which is not effective for conservative treatment, and then internal fixation is used.…”

Section: Introductionmentioning

confidence: 99%

Retraction of transporting bone segment during Ilizarov bone transport

Yin

et al. 2020

Preprint

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Objective To investigate the cause and relevant factors of retraction of transporting bone segment (TBS) after removal of its fixator during Ilizarov bone transport. Methods The clinical data of 37 cases with tibial bone defect treated by Ilizarov bone transport, in whom the TBSs were removed before mature of mineralization of the distraction callus and union of the docking site, were analyzed retrospectively. Bivariate correlation was used to analyze relationship between retraction distance of TBS and age, gender, disease course, length of bone defect, times of pre-operation, size of TBS, transport distance, cause of removal, timing and time interval of removal of TBS fixator. Risk factors with significant level were further identified using multivariate linear regression. Results Bivariate correlation analysis showed that the timing of removal was negatively correlated with the retraction distance, the time interval, cause of removal, transport distance and size of TBS were positively correlated with the transport distance(all p<0.05), whereas the age, gender, disease course, length of bone defect and times of pre-operation were not correlated with the transport distance(p>0.05). Multivariate linear regression analysis of the 5 risk factors showed that the timing of removal, transport distance and cause of removal were independent risk factors for the retraction distance (p<0.05), of which, the timing of removal had the greatest impact, followed by the transport distance and cause of removal. The transport distance and time interval were not significant for the retraction (p>0.05). Conclusion The TBS is subjected to distraction force from all the adherent soft tissues during Ilizarov bone transport, which has elastic properties and can make a retraction of TBS if its fixator is removed before mature of mineralization of the distraction callus and union of the docking site. The retraction distance is related to the TBS size, transport distance, timing and time interval of removal of TBS fixator. Importantly, the timing of removal and transport distance are the main factors for the retraction, especially the timing of removal had the greatest impact.

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“…5 cm können relativ zuverlässig mit dem Segmenttransport über Marknagel oder Fixateur externe behandelt werden. [20][21][22] Nach anfänglichen Erfolgen der Defektrekonstruktion mit der Masquelet-Technik scheint dieses Verfahren für größere Defekte (> 5 cm) nur bedingt geeignet [23,24].…”

Section: Rekonstruktionunclassified

Infekt bei intramedullärem Implantat

Militz¹

2017

OP-JOURNAL

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EinleitungMit der klinischen Etablierung der Marknagelosteosynthese durch Kuentscher DiagnostikDie Diagnostik der Infektion bei intramedullärem Implantat entspricht den Prinzipien der septischen Chirurgie und wird wesentlich vom klinischen Verlauf, den Laborbefunden und der Bildgebung bestimmt. Beweisend für die Infektion sind der positive mikrobiologische und der histologische Befund. Allerdings stehen diese Informationen erst postoperativ zur Verfügung.Anamnestisch sind offene Frakturen, lange OP-Zeiten, Wundheilungsstörungen, "Allergien", Antibiotikagabe etc. hinweisend auf eine Infektion.

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Staged Protocol for the Treatment of Chronic Tibial Shaft Osteomyelitis With Ilizarov’s Technique Followed by the Application of Intramedullary Locked Nail

Cited by 26 publications

References 28 publications

Retraction of transporting bone segment during Ilizarov bone transport

Retraction of transporting bone segment during Ilizarov bone transport

Retraction of transporting bone segment during Ilizarov bone transport

Infekt bei intramedullärem Implantat

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