The efficacy of ilizarov method for management of long tibial bone and soft tissue defect

Miraj, Faisal; Nugroho, Ahmad; Dalitan, Ivan Mucharry; Setyarani, Melitta

doi:10.1016/j.amsu.2021.102645

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…The initial search identified 1251 publications. Twenty-three of these met the eligibility criteria for the pooled analysis, including 1153 patients treated by distraction osteogenesis [ 8 , 12 , 14 , 15 , 22 – 28 , 31 – 42 ]. Details of each study are shown in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Details of each study are shown in Table 1 . Extracted data from each study and pooled analysis are shown in by docking site intervention group in Table 2 (planned intervention) [ 12 , 14 , 15 , 23 , 25 – 28 , 31 – 33 ] and Table 3 (observed) [ 8 , 24 , 33 , 38 – 42 ]. Where patients from a single study had different docking site protocols, these were included in the relevant group.…”

Section: Resultsmentioning

confidence: 99%

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Docking site interventions following bone transport using external fixation: a systematic review of the literature

Liodakis,

Giannoudis,

Harwood

et al. 2023

International Orthopaedics (SICOT)

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Purpose Although bone transport is a well-recognised technique to address segmental bone defects, optimal management of docking sites is not absolutely determined. Some surgeons routinely intervene in all cases, and others prefer to observe and intervene only if spontaneous union does not occur. Primary aim of the study was to compare rates of docking site union between patients who underwent routine docking site intervention and those who did not. Methods A systematic literature review using the keywords “bone transport”, “docking”, “tibia”, and “femur” was performed in PubMed using PRISMA guidelines. Studies published in English from January 2000 to August 2022 were included and assessed independently by two reviewers. Pooled analysis was undertaken dividing patients into two groups: those managed by routine intervention and those initially observed. Results Twenty-three clinical studies met the eligibility criteria for pooled analysis, including 1153 patients, 407 in the routine intervention and 746 in the observed group. The rate of union after initial treatment was 90% in the routine intervention group and 66% in the observed group (p < 0.0001). Overall union rates at the end of treatment were similar at 99% in both groups. Patients in the observed group required an average of 2.2 procedures to achieve union overall compared with 3.8 in the routine intervention group. Time in frame was similar between groups. Conclusion Based on the current literature, routine docking site interventions cannot be recommended, since this may lead to unnecessary interventions in two thirds of patients. Timely selective intervention in those at high risk or after a defined period of observation would appear to be a logical approach.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Docking site interventions following bone transport using external fixation: a systematic review of the literature

Liodakis,

Giannoudis,

Harwood

et al. 2023

International Orthopaedics (SICOT)

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“…Ankle stiffness was observed in 3 patients, with a lower incidence compared to the ilizarov technique. Besides, there was no significant difference in healing time and weight -bearing time of tibial defect treated by ICBG compared with VFG [ 29 ] and ilizarov technology [ 30 ]. Therefore, large ICBG for the treatment of CSBD can be advocated.…”

Section: Discussionmentioning

confidence: 99%

Free iliac crest grafting technology for the management of critical-sized tibial bone defect

Cheng,

Yao,

Liu

et al. 2024

BMC Musculoskelet Disord

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Objective To introduce the method and experience of treating critical-sized tibial bone defect by taking large iliac crest bone graft. Methods From January 2020 to January 2022, iliac crest bone grafting was performed in 20 patients (10 men and 10 women) with critical-sized tibial bone defect. The mean length of bone defect was 13.59 ± 3.41. Bilateral iliac crest grafts were harvested, including the inner and outer plates of the iliac crest and iliac spine. The cortical bone screw was used to integrate two iliac bone blocks into one complex. Locking plate was used to fix the graft-host complex, supplemented with reconstruction plate to increase stability when necessary. Bone healing was evaluated by cortical bone fusion on radiographs at follow-up, iliac pain was assessed by VAS score, and lower limb function was assessed by ODI score. Complications were also taken into consideration. Results The average follow-up time was 27.4 ± 5.6 (Range 24–33 months), the mean VAS score was 8.8 ± 1.9, the mean ODI score was 11.1 ± 1.8, and the number of cortical bone fusion in the bone graft area was 3.5 ± 0.5. Satisfactory fusion was obtained in all cases of iliac bone transplant-host site. No nonunion, shift or fracture was found in all cases. No infection and bone resorption were observed that need secondary surgery. One patient had dorsiflexion weakness of the great toe. Hypoesthesia of the dorsal foot was observed in 2 patients. Ankle stiffness and edema occurred in 3 patients. Complications were significantly improved by physical therapy and rehabilitation training. Conclusion For the cases of critical-sized tibial bone defect, the treatment methods are various. In this paper, we have obtained satisfactory results by using large iliac bone graft to treat bone defect. This approach can not only restore the integrity of the tibia, but also obtain good stability with internal fixation, and operation skills are more acceptable for surgeons. Therefore, it provides an alternative surgical method for clinicians.

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“…They found that radical débridement was the key step in achieving satisfactory bone formation and functional results. Miraj et al 13 reviewed 14 patients with infected tibial nonunions with long devascularized and infected bone segments who had undergone several débridements, bone grafting, or spacer and soft-tissue closure. The patients then underwent radical resection and bone transport.…”

Section: Discussionmentioning

confidence: 99%

The Management of Tibial Bone Defects: A Multicenter Experience of Hexapod and Ilizarov Frames

et al. 2023

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Introduction: Bone defects may be managed with bone transport or acute shortening and lengthening using circular external fixation devices. We performed a multicenter retrospective cohort study to compare the outcomes between the Ilizarov frames and hexapod frames for the management of bone defects. Methods: Patients treated for bone defects using either Ilizarov or hexapod frames were included for analysis in two specialist institutions. Primary outcomes were time to consolidation, bone healing index (BHI), and external fixator index (EFI). Radiographic parameters included the medial proximal tibial angle, lateral distal tibial angle, posterior proximal tibial angle, and anterior distal tibial angle. Results: There were 137 hexapods and 90 Ilizarov frames in total. The mean time to follow-up was 3.7 years in the hexapod group and 4.0 years in the Ilizarov group. Hexapods had a significantly lower time to consolidation (253 days versus 449 days) (P < 0.0001) and BHI (59.1 days/cm versus 87.5 days/cm) (P < 0.0001). Hexapods had a significantly better EFI (72.3 days/cm versus 96.1 days/cm) (P = 0.0009). Conclusion: Hexapods may confer a significant advantage over Ilizarov frames in the management of bone defects. Time to consolidation, radiographic parameters, BHI, and EFI are all superior in hexapods.

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The efficacy of ilizarov method for management of long tibial bone and soft tissue defect

Cited by 5 publications

References 25 publications

Docking site interventions following bone transport using external fixation: a systematic review of the literature

Docking site interventions following bone transport using external fixation: a systematic review of the literature

Free iliac crest grafting technology for the management of critical-sized tibial bone defect

The Management of Tibial Bone Defects: A Multicenter Experience of Hexapod and Ilizarov Frames

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