Segmental Resection and Bone Transport Distraction Osteogenesis in the Management of Chronic Osteomyelitis

2003 ◽  
Vol 11 ◽  
pp. 130-133
Keyword(s):  
Distraction Osteogenesis ◽  
Chronic Osteomyelitis ◽  
Bone Transport ◽  
Segmental Resection

scholarly journals Unprecedented tibial bone lengthening of 33.5 cm by distraction osteogenesis for the reconstruction of a subtotal tibial bone defect. A case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Abdulnassir Ali ◽  
Ying Ren ◽  
Chun-Hao Zhou ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Bone Defect ◽  
Distraction Osteogenesis ◽  
Chronic Osteomyelitis ◽  
Weight Bearing ◽  
Lower Leg ◽  
Bone Lengthening ◽  
Case Presentation ◽  
Tibial Length ◽  
Tibial Bone ◽  
The Right

Abstract Background We present a case of an immense unprecedented tibial bone lengthening of 33.5 cm. The management of chronic osteomyelitis of the right tibia with subtotal tibial bone defect, talus defect and equinus ankle deformity. We demonstrate limb reconstruction by distraction osteogenesis and correction of ankle deformity with the Ilizarov technique. Limb salvage was preferred as an alternative to amputation to restore basic limb function. Case presentation A 16-year-old male patient fell and injured his right lower leg. He attempted to treat the symptoms with traditional home remedies. During 15 months of self-treating, he developed osteomyelitis of the right tibia and had lost function in his foot. Radiology revealed immense bone defect of the right tibia, including talus bone defect and equinus deformity of the calcaneus. The patient’s right tibia was non weight-bearing, had drainage sinus just below his knee and a large scar anteriorly along the entire length of the tibia. Conclusion Upon completion of treatment, the patient was able to avoid amputation of his leg with partially restored function for weight-bearing. He carried himself without assistance after 3 years of lost function in his right leg. Tibial bone distraction osteogenesis of 33.5 cm was done after 90% of the tibial length was defected. To the best of our best knowledge, this case is one of a kind to achieve distraction of tibial bone to such length.

Distraction osteogenesis for reconstruction after mandibular segmental resection

2002 ◽  
Vol 93 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Tetsu Takahashi ◽  
Masayuki Fukuda ◽  
Takahiro Aiba ◽  
Katsuyuki Funaki ◽  
Takayoshi Ohnuki ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Segmental Resection

scholarly journals Biomechanics of the Canine Mandible During Bone Transport Distraction Osteogenesis

2014 ◽  
Vol 136 (11) ◽  
Author(s):  
Uriel Zapata ◽  
Paul C. Dechow ◽  
Ikuya Watanabe ◽  
Mohammed E. Elsalanty ◽  
Lynne A. Opperman
Keyword(s):  
Distraction Osteogenesis ◽  
Bone Transport ◽  
Bony Tissue ◽  
Mechanical Responses ◽  
Biomechanical Response ◽  
Valid Predictor ◽  
Interesting Correlation ◽  
Predicted Values ◽  
The Relationship ◽  
Stress Patterns

This study compared biomechanical patterns between finite element models (FEMs) and a fresh dog mandible tested under molar and incisal physiological loads in order to clarify the effect of the bone transport distraction osteogenesis (BTDO) surgical process. Three FEMs of dog mandibles were built in order to evaluate the effects of BTDO. The first model evaluated the mandibular response under two physiological loads resembling bite processes. In the second model, a 5.0 cm bone defect was bridged with a bone transport reconstruction plate (BTRP). In the third model, new regenerated bony tissue was incorporated within the defect to mimic the surgical process without the presence of the device. Complementarily, a mandible of a male American foxhound dog was mechanically tested in the laboratory both in the presence and absence of a BTRP, and mechanical responses were measured by attaching rosettes to the bone surface of the mandible to validate the FEM predictions. The relationship between real and predicted values indicates that the stress patterns calculated using FEM are a valid predictor of the biomechanics of the BTDO procedures. The present study provides an interesting correlation between the stiffness of the device and the biomechanical response of the mandible affected for bone transport.

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

Clinical course, complication rate and outcome of segmental resection and distraction osteogenesis after chronic tibial osteitis

Injury ◽  
2013 ◽  
Vol 44 (8) ◽  
pp. 1049-1056 ◽  
Author(s):  
Ulrich Spiegl ◽  
Robert Pätzold ◽  
Jan Friederichs ◽  
Sven Hungerer ◽  
Matthias Militz ◽  
...  
Keyword(s):  
Distraction Osteogenesis ◽  
Complication Rate ◽  
Clinical Course ◽  
Segmental Resection

Chronic long bone osteomyelitis

2011 ◽  
Author(s):  
Peter Calder
Keyword(s):  
Soft Tissues ◽  
Chronic Osteomyelitis ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Autologous Bone Graft ◽  
Bone Transport ◽  
Soft Tissue Defect ◽  
Long Bone ◽  
Space Management ◽  
Secondary Intention

Pathological features of chronic osteomyelitis♦ Necrotic bone♦ Compromised soft tissues with reduction in vascularity♦ Ineffective host response♦ Sequestrum formation♦ New bone formation from viable periosteum and endosteum♦ Formation of involucrum:Treatment principles in chronic osteomyelitis♦ Surgical debridement – remove all devitalized necrotic tissue♦ Dead space management:• Soft tissue defect – avoid healing by secondary intention. Consider local and free flaps• Bone defects – small structural with autologous bone graft, consider Papineau ‘open bone grafting’ where free tissue transfer is not an option, distraction osteogenesis with bifocal and bone transport for large defects including fibula transfer♦ Bone stability – movement needs to be eliminated♦ Antibiotic therapy – based on culture and sensitivity, local administration with PMMA beads or collagen sponge, Lautenbach procedure in resistant cases.

Experimental Study of Mandibular and Malar Distraction Osteogenesis Using Deos Device

2010 ◽  
Vol 89-91 ◽  
pp. 165-170
Author(s):  
Guillaume Dubois ◽  
Anne Sophie Bonnet ◽  
Paul Lipiński
Keyword(s):  
Distraction Osteogenesis ◽  
Bone Transport ◽  
Fortran Program ◽  
Equilibrium Analysis ◽  
Time Dependent ◽  
Important Data ◽  
Clinical Issue ◽  
Distraction Device ◽  
Labview Program ◽  
Early Phases

Distraction Osteogenesis (DO) is a surgical technique used to reconstruct bone defects. In the maxillofacial specialty, it account for one of the best procedures to treat severe traumas as ballistic wounds. The evolution of forces acting during DO is known to be strongly linked with the clinical issue of the treatment. In this context, the aim of this study was to determine the time-dependent forces supported by a distraction device (DEOS, OBL, France), particularly indicated for severe traumas. Bone transport forces were evaluated for two patients undergoing respectively mandibular and malar DO following a gunshot wound. In order to evaluate the distraction forces, some fixing pins of the distraction device were equipped with strain gauges. Strain values were recorded by means of a data acquisition system (SCXI, National Instruments, USA) connected to a PC computer and executing a LabView program (National Instruments, USA). Records started about one minute before the DO activation and ended about one hour later. Eighteen measurements were done for both cases during the early phases of the treatment. An equilibrium analysis was achieved in order to determine the force and moment acting in bone regenerate from strains in the pins. This procedure was coded through a Fortran program, allowing to plot the evolution of DO force and moment. The present work confirmed the time-dependent feature of the bone regenerate mechanical behaviour. Important data have been obtained concerning forces and their evolution for both mandibular and malar DO.

scholarly journals Architecture and Microstructure of Cortical Bone in Reconstructed Canine Mandibles After Bone Transport Distraction Osteogenesis

2011 ◽  
Vol 89 (5) ◽  
pp. 379-388 ◽  
Author(s):  
Uriel Zapata ◽  
Emily K. Halvachs ◽  
Paul C. Dechow ◽  
Mohammed E. Elsalanty ◽  
Lynne A. Opperman
Keyword(s):  
Cortical Bone ◽  
Distraction Osteogenesis ◽  
Bone Transport

scholarly journals Distraction Osteogenesis of the Maxillofacial Region

2021 ◽  
pp. 1969-1995
Author(s):  
R. S. Neelakandan
Keyword(s):  
Bone Graft ◽  
Distraction Osteogenesis ◽  
Gold Standard ◽  
Clinical Condition ◽  
Bone Transport ◽  
Rigid Fixation ◽  
Maxillofacial Region ◽  
Long Term Stability ◽  
Osseointegrated Implants

AbstractMaxillomandibular reconstruction requires bone graft, heavy rigid fixation armamentarium and long hospitalization periods. Even with all this the final outcomes are still unpredictable. Patients treated with transport distraction osteogenesis present a better clinical condition, in terms of osteogenesis & histogenesis - identical to adjoining structures. It also has the benefit of producing a good quality and quantity of bone & mucosa, ideal for placement of osseointegrated implants. Thus, bone transport for maxillomandibular reconstruction has now become a gold standard for functional as well as esthetic reconstruction, offering a long term stability.

scholarly journals Intramedullary reaming and irrigation and antibiotic-loaded calcium sulfate implantation for the treatment of infection after intramedullary nailing: a retrospective study of 19 cases

2020 ◽  
Author(s):  
Hong-An Zhang ◽  
Chun-Hao Zhou ◽  
Xiang-Qing Meng ◽  
Jia Fang ◽  
Cheng-He Qin
Keyword(s):  
Intramedullary Nailing ◽  
Distraction Osteogenesis ◽  
Intramedullary Nail ◽  
Calcium Sulfate ◽  
Bone Fractures ◽  
Weight Bearing ◽  
Bone Transport ◽  
Complication Rates ◽  
Nail Removal

Abstract Background: The incidence of intramedullary infection is increasing with increased use of intramedullary fixation for long bone fractures. However, appropriate treatment for infection after intramedullary nailing is unclear. The purpose of this study was to report the results of our treatment protocol for infection after intramedullary nailing: intramedullary nail removal, local debridement, reaming and irrigation, and antibiotic-loaded calcium sulfate implantation with or without segmental bone resection and distraction osteogenesis. Methods: We retrospectively reviewed the records of patients with an infection after intramedullary nailing treated from 2014 to 2017 at our center. Patients with follow-up of less than 24 months, received other treatment methods, or those with serious medical conditions were excluded from the analysis. Patients met the criteria were treated as described above, followed by distraction osteogenesis in 9 cases to repair bone defect. The infection remission rate, infection recurrence rate, and post-operative complication rates were assessed. Results: A total of 19 patients were included in the analysis. All of patients had satisfactory outcomes with an average follow-up of 38.1 ± 9.4 months (range, 24 to 55months). Eighteen patients (94.7%) achieved infection remission; 1 patient (5.3%) developed a reinfection that resolved after repeat debridement. Nine patients with bone defects (average size 4.7 ± 1.3 cm; range, 3.3 to 7.6 cm) were treated with bone transport which successfully restored the length of involved limb. The mean bone transport duration was 10.7 ± 4.0 months (range, 6.7 to 19.5 months). The majority of patients achieved full weight bearing and became pain free during the follow-up period. Postoperative complications mainly included prolonged aseptic drainage (7/19; 36.8%), re-fracture (1/19; 5.3%) and joint stiffness, which were successfully managed by regular dressing changes and re-fixation, respectively. Conclusion: Intramedullary nail removal, canal reaming and irrigation, and antibiotic-loaded calcium sulfate implantation (with or without distraction osteogenesis) is effective for treating infections after intramedullary nailing.

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