The Ilizarov Method In Nonunion, Malunion And Infection Of Fractures

Marsh, David; Shah, Snehal; Elliott, Jonathan; Kurdy, Nasser

doi:10.1302/0301-620x.79b2.6636

Cited by 112 publications

(49 citation statements)

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“…This differs from other literature from Asia and the Western world which report the tibia and forearm with the highest rates [7,[17][18][19]. The role of traditional bonesetting in African society is documented in other studies [20][21][22].…”

Section: Discussioncontrasting

confidence: 66%

Long Bone Non-Unions and Malunions: Risk Factors and Treatment Outcomes in Calabar, Southern Nigeria

Ikpeme¹,

Mkpanam²,

Abang³

et al. 2013

OJO

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Background: Diaphyseal non-unions and malunions constitute significant morbidities in fracture care. Fracture treatment modalities seek to restore anatomic orientation and functional rehabilitation as soon as possible after a fracture incident. Malunions and non unions present a treatment challenge with the need for prolonged hospitalization, multiple surgical interventions and economic burden. In the developing world, traditional bonesetting practices are popular and these often result in a host of preventable complications. The added socioeconomic costs of treating these complications present a considerable strain on the resources of these already fragile economies and households. Aim: To document the risk factors, treatment options and outcomes for diaphyseal non-unions and malunions in our environment. Patients and Methods: Fifty-two consecutive patients comprising 37 non-unions and 15 malunions who presented in the orthopaedic unit of a tertiary hospital in Southern Nigeria were evaluated. Information sought included biodata, location of pathology, type of incident fracture, local risk factors including traditional bonesetting; treatment options and final outcomes. Information obtained was analyzed using SPSS version 20 (IBM, New York). Results are presented in simple frequency tables. Results: There were 34 males and 18 females (M:F = 1.9:1) with a mean age of 38.76 ± 14.55 years. There were 37 non-unions and 15 malunions. The femur was the commonest site of pathology in 21 (40.4%) cases, and among the non-unions, the atrophic variety was the commonest type (n = 26; 70.3%). The mean fracture-to-surgery interval was 11.35 ± 7.95 months and traditional bonesetting was the commonest risk factor (n = 36; 69.2%). Plate and screw Osteosynthesis with bonegraft augmentation was the commonest treatment modality and the overall union rate was 94%. Conclusion: Traditional bonesetting plays a major role in the health seeking behaviour of many African societies. The complications are varied and add to the overall socioeconomic burden of fracture care in these developing economies. Identification of traditional bonesetting practices as an important risk factor should translate into a focus on these practices in preventive public health decisions in fracture care. Continuing public health education backed by political will and can potentially drive a paradigm shift in health seeking attitudes in the developing world.

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Section: Discussioncontrasting

confidence: 66%

Long Bone Non-Unions and Malunions: Risk Factors and Treatment Outcomes in Calabar, Southern Nigeria

Ikpeme¹,

Mkpanam²,

Abang³

et al. 2013

OJO

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“…None of the above mentioned techniques afford the surgeon the ability to correct deformities, eliminate prolonged preoperative and postoperative antibiotic therapy, regenerate new bone without the use of bone graft, progressively lengthen the extremity, transport internal bone for filling the defect, and allow weight bearing during the treatment period simultaneously. This study and many other studies confirm that all of these capabilities are possible with application of the Ilizarov ring external fixator [3,12,14,15,21].…”

Section: Discussionsupporting

confidence: 81%

The Ilizarov Ring External Fixator in Complex Open Fractures of the Tibia

Hasankhani

Payvandi²,

Birjandinejad

2006

Eur J Trauma

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Introduction: Complex open fracture of the tibia particularly with bone defect and infection is one of the major problems in orthopedic surgery. There are many available alternatives in the management of these fractures. Aim: The purpose of this study is to evaluate the results and efficacy of the Ilizarov ring external fixator in treating complex open fractures of the tibia. Materials and Methods: We treated 25 patients with complex open fracture of the tibia using the Ilizarov ring external fixator between March 1999 and February 2002.The open fractures were type IIIA, type IIIB , and type IIIC in 19, 9, and 4 patients, respectively. There were 11 patients with bone loss ranging from 3 to 9 cm (average bone loss 5 cm), and 10 patients with infection. There were 11 one-level tibial transports, 5 bone graftings at the docking site, 6 internal fixations with bone grafting because of pin tract infection. Results: Results were divided into bone and functional categories [according to the association for the study and application of the method of Ilizarov (ASAMI) classification]. The bony results were excellent in 18 patients (56.2%), good in 4 (12.5%), fair in 3 (9.4%), and poor in 7 (21.9 %). The functional results were excellent in 7 (21.9%) patients, good in 14 (43.7%), fair in 4 (12.5%), and poor in 7 (21.9%). Conclusion: The Ilizarov ring external fixator is an effective a salvage procedure in the treatment of complex open fractures of the tibia as it allows for the simultaneous treatment of bone loss, infection, non-union, and deformity.

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“…No major complications were noted but significant problems were observed mostly in patients with a history of smoking and diabetes mellitus, which has also been reported in the literature. [29][30][31] In addition, recent literature has advocated the concept of internal pedal amputation in diabetic patients with multiple foot bony segmental osteomyelitis. According to the investigator, this method of pedal amputation consists of resection of the metatarsals, midtarsal bones, or talus with preservation of the toes and soft tissue envelope.…”

Section: Discussionmentioning

confidence: 99%