Ilizarov technique: Bone transport versus bone shortening-lengthening for tibial bone and soft-tissue defects

2018 ◽  
Vol 23 (2) ◽  
pp. 341-345 ◽  
Author(s):  
Yongwei Wu ◽  
Qudong Yin ◽  
Yongjun Rui ◽  
Zhenzhong Sun ◽  
Sanjun Gu
Keyword(s):  
Soft Tissue ◽  
Bone Transport ◽  
Ilizarov Technique ◽  
Soft Tissue Defects ◽  
Tibial Bone ◽  
Bone Shortening ◽  
Tissue Defects

scholarly journals Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Runguang Li ◽  
Guozheng Zhu ◽  
Chaojie Chen ◽  
Yirong Chen ◽  
Gaohong Ren
Keyword(s):  
Soft Tissue ◽  
Deep Infection ◽  
Bone Transport ◽  
Fixation Time ◽  
Ilizarov Technique ◽  
Soft Tissue Defects ◽  
Flap Surgery ◽  
Tibial Bone ◽  
Tissue Defects

Objective. To evaluate the surgical efficacy of bone transport (Ilizarov technique) plus “shortening-lengthening,” “flap surgery,” and “open bone transport” as individualized treatments for traumatic composite tibial bone and soft tissue defects. Methods. We retrospectively analyzed sixty-eight cases (mean age: 35.69 years, (range, 16–65)) treated from July 2014 to June 2017, including 29 middle, 18 distal, and 21 proximal tibial bone defects (4–18 cm, mean: 7.97 cm) with soft tissue defects (2.5 cm × 4.0 cm to 30.0 cm × 35.0 cm after debridement). We adopted the bone transport external fixator to fix the fracture after debriding the defect parts. In the meantime, we adopted the “shortening-lengthening technique,” “flap surgery,” and “open bone transport” as individualized treatment based on the location, range, and severity of the composite tibial bone and soft tissue defects. Postoperative follow-up was carried out. Surgical efficacy was assessed based on (1) wound healing; (2) bone defect healing rate; (3) external fixation time and index; (4) incidence/recurrence of deep infection; (5) postoperative complications; and (6) Association for the Study and Application of the Methods of Ilizarov (ASAMI) score. Results. The mean duration from injury to reconstruction was 22 days (4–80 d), and the mean postoperative follow-up period was 30.8 months (18–54 m). After the repair and reconstruction, 2 open bone transport patients required infected bone removal first before continuing the bone transport treatment. No deep infection (osteomyelitis) occurred or recurred in the remaining patients, and no secondary debridement was required. Some patients had complications after surgery. All the postoperative complications, including flap venous crisis, nail channel reaction, bone nonunion, mechanical axis deviation, and refracture, were improved or alleviated. External fixation time was 12.5 ± 3.41 months, and the index was 1.63 ± 0.44. According to the ASAMI score, 76.47% of the outcomes were good/excellent. Conclusion. The Ilizarov technique yields satisfactory efficacy for composite tibial bone and soft tissue defects when combined with “shortening-lengthening technique,” “flap surgery,” and “open bone transport” with appropriate individualized treatment strategies.

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

2021 ◽  
Author(s):  
Yong-Qing Xu ◽  
Xin-Yu Fan ◽  
Xiao-Qing He ◽  
Hong Jie Wen
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Functional Results ◽  
Bone Transport ◽  
Fixation Index ◽  
Soft Tissue Defects ◽  
Safety And Efficacy ◽  
Tibial Bone ◽  
The Mean ◽  
Tissue Defects

Abstract Background Large post-traumatic tibial bone defects combined with soft tissue defects are a common orthopedic clinical problem associated with poor outcomes when treated using traditional surgical methods. 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: TFT, in conjunction with soft tissue transport technique, can give good results in most patients (in this article, good and excellent results were observed in 64% of patients). Soft tissue transport is a feasible method in providing good soft tissue coverage on the bone ends. Although it has no advantages over microvascular techniques, it might be an good alternative in the absence of an experienced flap surgeon. Nonetheless, high-quality controlled studies are needed to assess its long-term safety and efficacy.

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

2020 ◽  
Author(s):  
Yong-Qing Xu ◽  
Xin-Yu Fan ◽  
Xiao-Qing He ◽  
Hong Jie Wen
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Functional Results ◽  
Bone Transport ◽  
Fixation Index ◽  
Soft Tissue Defects ◽  
Safety And Efficacy ◽  
Tibial Bone ◽  
The Mean ◽  
Tissue Defects

Abstract Background Large post-traumatic tibial bone defects combined with soft tissue defects are a common orthopedic clinical problem associated with poor outcomes when treated using traditional surgical methods. 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: TFT, in conjunction with soft tissue transport technique, can give good results in most patients (in this article, good and excellent results were observed in 64% of patients). Soft tissue transport is a feasible method in providing good soft tissue coverage on the bone ends. Although it has no advantages over microvascular techniques, it might be an good alternative in the absence of an experienced flap surgeon. Nonetheless, high-quality controlled studies are needed to assess its long-term safety and efficacy.

scholarly journals Correction to: Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong-Qing Xu ◽  
Xin-Yu Fan ◽  
Xiao-Qing He ◽  
Hong-Jie Wen
Keyword(s):  
Soft Tissue ◽  
Bone Transport ◽  
Soft Tissue Defects ◽  
Tibial Bone ◽  
Tissue Defects

An amendment to this paper has been published and can be accessed via the original article.

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

2020 ◽  
Author(s):  
Yong-Qing Xu ◽  
Xin-Yu Fan ◽  
Xiao-Qing He ◽  
Hong Jie Wen
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Functional Results ◽  
Bone Transport ◽  
Fixation Index ◽  
Soft Tissue Coverage ◽  
Soft Tissue Defects ◽  
Tibial Bone ◽  
The Mean ◽  
Tissue Defects

Abstract 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.

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

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yong-Qing Xu ◽  
Xin-Yu Fan ◽  
Xiao-Qing He ◽  
Hong-Jie Wen
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Functional Results ◽  
Bone Transport ◽  
Fixation Index ◽  
Soft Tissue Defects ◽  
Safety And Efficacy ◽  
Tibial Bone ◽  
The Mean ◽  
Tissue Defects

Abstract Background Large post-traumatic tibial bone defects combined with soft tissue defects are a common orthopedic clinical problem associated with poor outcomes when treated using traditional surgical methods. 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 11.87 cm ± 2.78 cm (range, 8.2–18.2 cm) after radical resection performed by TFT. The soft tissue defects ranged from 7 cm × 8 cm to 24 cm × 12 cm. 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: TFT, in conjunction with soft tissue transport technique, can give good results in most patients (in this article, good and excellent results were observed in 64% of patients). Soft tissue transport is a feasible method in providing good soft tissue coverage on the bone ends. Although it has no advantages over microvascular techniques, it might be an good alternative in the absence of an experienced flap surgeon. Nonetheless, high-quality controlled studies are needed to assess its long-term safety and efficacy.

Reconstruction of Soft Tissue Defects and Bone Loss in the Tibia by Flap Transfer and Bone Transport by Distraction Osteogenesis

2020 ◽  
Vol 84 (5S) ◽  
pp. S202-S207 ◽  
Author(s):  
Abulaiti Abula ◽  
Maimaiaili Yushan ◽  
Peng Ren ◽  
Alimujiang Abulaiti ◽  
Chuang Ma ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Distraction Osteogenesis ◽  
Bone Transport ◽  
Soft Tissue Defects ◽  
Flap Transfer ◽  
Tissue Defects
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