Year 2024,
, 307 - 314, 25.03.2024
Ahmed Gaber Mostafa
,
Ayman Abdel Samad
,
Ahmed Saad
,
Hamdy Gabry
References
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- Dendrinos, G. K., Kontos, S. & Lyritsis, E. 1995. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg Am, 77, 835-46. [PubMed]
- Dickson, D. R., Moulder, E., Hadland, Y., Giannoudis, P. V. & Sharma, H. K. 2015. Grade 3 open tibial shaft fractures treated with a circular frame, functional outcome and systematic review of literature. Injury, 46, 751-8. [PubMed]
- Dimitriou, R., Jones, E., Mcgonagle, D. & Giannoudis, P. V. 2011. Bone regeneration: current concepts and future directions. BMC Medicine, 9, 66. [PubMed]
- Edwards, C. C. 1983. Staged reconstruction of complex open tibial fractures using Hoffmann external fixation. Clinical decisions and dilemmas. Clin Orthop Relat Res, 130-61. [PubMed]
- Foster, P. A., Barton, S. B., Jones, S. C., Morrison, R. J. & Britten, S. 2012. The treatment of complex tibial shaft fractures by the Ilizarov method. J Bone Joint Surg Br, 94, 1678-83. [PubMed]
- Fürmetz, J., Soo, C., Behrendt, W., Thaller, P. H., Siekmann, H., Böhme, J. & Josten, C. 2016. Bone Transport for Limb Reconstruction Following Severe Tibial Fractures. Orthop Rev (Pavia), 8, 6384. [PubMed]
- Krappinger, D., Irenberger, A., Zegg, M. & Huber, B. 2013. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment. Arch Orthop Trauma Surg, 133, 789-95. [PubMed]
- Magadum, M. P., Basavaraj Yadav, C. M., Phaneesha, M. S. & Ramesh, L. J. 2006. Acute compression and lengthening by the Ilizarov technique for infected nonunion of the tibia with large bone defects. J Orthop Surg (Hong Kong), 14, 273-9. [PubMed]
- Marcellin-Little, D. J. 1999. Fracture treatment with circular external fixation. Vet Clin North Am Small Anim Pract, 29, 1153-70, vii. [PubMed]
- Nauth, A., Mckee, M. D., Einhorn, T. A., Watson, J. T., Li, R. & Schemitsch, E. H. 2011. Managing bone defects. J Orthop Trauma, 25, 462-6. [PubMed]
- Robinson, C. M., Mclauchlan, G., Christie, J., Mcqueen, M. M. & Court-Brown, C. M. 1995. Tibial fractures with bone loss treated by primary reamed intramedullary nailing. J Bone Joint Surg Br, 77, 906-13. [PubMed]
- Sen, C., Kocaoglu, M., Eralp, L., Gulsen, M. & Cinar, M. 2004. Bifocal compression-distraction in the acute treatment of grade III open tibia fractures with bone and soft-tissue loss: a report of 24 cases. J Orthop Trauma, 18, 150-7. [PubMed]
- Testa, G., Vescio, A., Aloj, D. C., Costa, D., Papotto, G., Gurrieri, L., Sessa, G. & Pavone, V. 2020. Treatment of Infected Tibial Non-Unions with Ilizarov Technique: A Case Series. J Clin Med, 9. [PubMed]
- Zhang, Y., Wang, Y., Di, J. & Peng, A. 2018. Double-level bone transport for large post-traumatic tibial bone defects: a single centre experience of sixteen cases. Int Orthop, 42, 1157-1164. [PubMed]
Distraction Osteogenesis by Ring Fixator in Post Traumatic Tibial Bone Loss
Year 2024,
, 307 - 314, 25.03.2024
Ahmed Gaber Mostafa
,
Ayman Abdel Samad
,
Ahmed Saad
,
Hamdy Gabry
Abstract
Background: Reconstructing segmental bone loss defects presents a significant challenge within the field of orthopedics. The purpose of this study is to assess the clinical and radiological results of using the Ilizarov technique for tibia reconstruction following traumatic bone loss. Methods: This study was a prospective study involving 30 patients who experienced tibial bone loss in the diaphysis or metaphysis following trauma. These patients were treated with a ring fixator (Ilizarov) from March 2021 to February 2023. Unfortunately, five patients were lost to follow-up, leaving a cohort of 25 patients who were observed for a duration ranging from 9 to 12 months. Results: The current study involved 25 patients with post-traumatic tibial bone loss. The age range was 14 to 48 years, with a mean age of 28.4±8.8 years. Among the cases, 18 had a moderate defect (72%), which was significantly higher than those with a minor defect (20%) (P ≤ 0.05). Deformity was less than 7° in most cases (96%), while only one case had deformity greater than 7° (4%) (P ≤ 0.05(. Leg length discrepancy was less than 2.5 cm in the majority (96%), with only one case having a 3 cm length discrepancy (4%) (P ≤ 0.05). By the end of the follow-up period, all patients showed perfect union, enabling them to engage in daily activities post-operatively. Conclusion: The success of corticotomy and solid docking relies on well-vascularized bone and soft tissue. Soft tissue compromise at the corticotomy site can hinder healthy tissue regeneration.
Ethical Statement
Ethical approval of the study was obtained from the Institutional Review Board, Faculty of Medicine, Beni Suef University (Approval No: FMBSUREC/03012021/Gabry). Written informed consent to participate in this study was provided by the participants.
Thanks
None to be declared
References
- Adamczyk, A., Meulenkamp, B., Wilken, G. & PAPP, S. 2020. Managing bone loss in open fractures. OTA Int, 3, e059. [PubMed]
- Dendrinos, G. K., Kontos, S. & Lyritsis, E. 1995. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg Am, 77, 835-46. [PubMed]
- Dickson, D. R., Moulder, E., Hadland, Y., Giannoudis, P. V. & Sharma, H. K. 2015. Grade 3 open tibial shaft fractures treated with a circular frame, functional outcome and systematic review of literature. Injury, 46, 751-8. [PubMed]
- Dimitriou, R., Jones, E., Mcgonagle, D. & Giannoudis, P. V. 2011. Bone regeneration: current concepts and future directions. BMC Medicine, 9, 66. [PubMed]
- Edwards, C. C. 1983. Staged reconstruction of complex open tibial fractures using Hoffmann external fixation. Clinical decisions and dilemmas. Clin Orthop Relat Res, 130-61. [PubMed]
- Foster, P. A., Barton, S. B., Jones, S. C., Morrison, R. J. & Britten, S. 2012. The treatment of complex tibial shaft fractures by the Ilizarov method. J Bone Joint Surg Br, 94, 1678-83. [PubMed]
- Fürmetz, J., Soo, C., Behrendt, W., Thaller, P. H., Siekmann, H., Böhme, J. & Josten, C. 2016. Bone Transport for Limb Reconstruction Following Severe Tibial Fractures. Orthop Rev (Pavia), 8, 6384. [PubMed]
- Krappinger, D., Irenberger, A., Zegg, M. & Huber, B. 2013. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment. Arch Orthop Trauma Surg, 133, 789-95. [PubMed]
- Magadum, M. P., Basavaraj Yadav, C. M., Phaneesha, M. S. & Ramesh, L. J. 2006. Acute compression and lengthening by the Ilizarov technique for infected nonunion of the tibia with large bone defects. J Orthop Surg (Hong Kong), 14, 273-9. [PubMed]
- Marcellin-Little, D. J. 1999. Fracture treatment with circular external fixation. Vet Clin North Am Small Anim Pract, 29, 1153-70, vii. [PubMed]
- Nauth, A., Mckee, M. D., Einhorn, T. A., Watson, J. T., Li, R. & Schemitsch, E. H. 2011. Managing bone defects. J Orthop Trauma, 25, 462-6. [PubMed]
- Robinson, C. M., Mclauchlan, G., Christie, J., Mcqueen, M. M. & Court-Brown, C. M. 1995. Tibial fractures with bone loss treated by primary reamed intramedullary nailing. J Bone Joint Surg Br, 77, 906-13. [PubMed]
- Sen, C., Kocaoglu, M., Eralp, L., Gulsen, M. & Cinar, M. 2004. Bifocal compression-distraction in the acute treatment of grade III open tibia fractures with bone and soft-tissue loss: a report of 24 cases. J Orthop Trauma, 18, 150-7. [PubMed]
- Testa, G., Vescio, A., Aloj, D. C., Costa, D., Papotto, G., Gurrieri, L., Sessa, G. & Pavone, V. 2020. Treatment of Infected Tibial Non-Unions with Ilizarov Technique: A Case Series. J Clin Med, 9. [PubMed]
- Zhang, Y., Wang, Y., Di, J. & Peng, A. 2018. Double-level bone transport for large post-traumatic tibial bone defects: a single centre experience of sixteen cases. Int Orthop, 42, 1157-1164. [PubMed]