Tibial bone loss and soft-tissue defect treated simultaneously with Ilizarov-technique--a case report

Bundgaard, Karin; Christensen, Knud Stenild

doi:10.1080/000164700317381306

Cited by 23 publications

(18 citation statements)

References 6 publications

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“…In a case report [9] skin expansion was performed using a mandibular reconstruction plate to cover an exposed bone. In another [3], tibial bone loss and soft-tissue defect was treated by gradual anterior angulation, compression and then straightening.…”

Section: Discussionmentioning

confidence: 99%

Ilizarov external fixator for open fractures of the tibial shaft

Hosny

Fadel

2003

International Orthopaedics

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Between December 1993 and 1999 we treated 34 open tibial diaphyseal fractures. Thirty patients were available for evaluation with a mean follow-up after fracture union of 40.5 (24-80) months. Patient average age was 33.1 (15-71) years. Two fractures were grade I, 16 grade II, six grade IIIA, five grade IIIB and one grade IIIC. The wound was debrided and the bone fixed with Ilizarov device. Soft-tissue healing was achieved through Z-plasty, delayed primary closure, split-thickness skin grafting, pedicle flaps and skin traction, and all fractures united with an average 5.6 (3-15.4) months. In 28 patients the results were excellent and good, in one fair and in one poor. Despite numerous complications the use of Ilizarov external fixator provides initial and definitive fracture stability.

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Section: Discussionmentioning

confidence: 99%

Ilizarov external fixator for open fractures of the tibial shaft

Hosny

Fadel

2003

International Orthopaedics

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“…2 Its disadvantages are the need for microsurgical skills, 2-4 possibility of total necrosis due to anastomotic complications, 5 donor site morbidity, 2,3,6 and occasional stress fracture. 7 On the other hand, Ilizarov bone transport can correct associated deformity 8 and shortening, address small areas of soft tissue defects, 9 and allow immediate mobilization. Its disadvantages are long duration of treatment especially in long defects 10,11 pain accompanying the transport, 11 frequency of pin tract infection, [10][11][12] and occasional nonunion at the docking site.…”

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confidence: 99%

Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport: A comparative study

et al. 2008

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There are several options for the treatment of traumatic tibial defects. Among these options, free vascularized fibula and Ilizarov bone transport are well-known and effective techniques. The differences between both techniques and the indications for each of them are not well studied in the literature. Between September 1995 and December 2004, Ilizarov bone transport and free vascularized fibula were used to treat 25 traumatic bone. Patients were divided into two groups, Ilizarov group (12) and free fibula group (13). Preoperative data, operative data, duration of treatment, functional outcome, range of motion loss, number of secondary procedures, and type and rate of complications were compared in both groups. All the cases were ultimately united in both groups. Operative time and blood loss were significantly higher in the free fibula group. Although external fixation time was longer in the Ilizarov group, the overall duration of treatment was similar. Range of motion loss was less in the Ilizarov group, but the overall functional outcome was similar. There was no difference in complication rate, or number secondary procedures. Defect size was found to have the most significant effect on the results. Results were much better in the free fibula group when the defect length was 12 cm or more while the results were better in Ilizarov group when the defect length was less than 12 cm. We recommend using free vascularized fibula for traumatic tibial defects of 12 cm or more, whenever experience is available.

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“…Seven of the eight soft tissue defects were closed with soft-tissue transport and achieved healing. Then, several other scholars also reported this technique when treating tibial bone loss and soft-tissue defect [24][25][26]. This technique emphasises no ap transfer to cover the wound when performing bone transport to manage bone and soft-tissue defects which has no bone exposure after debridement.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Fan

et al. 2020

Preprint

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Background The study was designed to investigate the safety and efficacy of trifocal bone transport (TFT) and soft-tissue transport with the Ilizarov technique for large posttraumatic tibial bone and soft tissue defects. Methods We retrospectively reviewed 31 patients with massive posttraumatic tibial bone and soft tissue defects from May 2009 to May 2016. All of the eligible patients were managed by TFT and soft-tissue transport. The median age was 33.4 years (range, 2-58 years). The mean defect of bone was 11.87cm ± 2.78cm (range, 8.2-18.2cm) after radical resection performed by TFT. The soft tissue defects ranged from 7cm x 8cm to 24cm x 12cm. The observed results included bone union time, wound close time and true complications. The Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system was used to assess bone and functional results and postoperative complications were evaluated by Paley classification. Results The mean duration of follow-up after frame removal was 32 months (range, 12-96 months). All cases achieved complete union in both the elongation sites and the docking sites, and eradication of infection. The mean bone transport time was 94.04 ± 23.33 days (range, 63.7-147 days). The mean external fixation time was 22.74 ± 6.82 months (range, 14-37 months), and the mean external fixation index (EFI) was 1.91 ± 0.3 months/cm (range, 1.2–2.5 months/cm). The bone results were excellent in 6 patients, good in 14 patients, fair in 8 patients and poor in 3 patients. The functional results were excellent in 8 patients, good in 15 patients, fair in 5 patients and poor in 3 patients. Conclusion The TFT in concert with soft-tissue transport technique can be used successfully to manage large tibial bone and soft-tissue defects. Soft-tissue transport can offer a feasible method for the defects with good soft tissue coverage on the bone ends. However, imprecision in the series results precludes a definitive conclusion, and comparative study is needed to assess whether soft-tissue transport is more effective than flap transfer for such soft-tissue defect.

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Tibial bone loss and soft-tissue defect treated simultaneously with Ilizarov-technique--a case report

Cited by 23 publications

References 6 publications

Ilizarov external fixator for open fractures of the tibial shaft

Ilizarov external fixator for open fractures of the tibial shaft

Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport: A comparative study

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

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