Outcomes of Tibial Nonunion in Older Adults Following Treatment Using the Ilizarov Method

Abstract INTRODUCTION: The purpose of this study was a comprehensive assessment of the dynamic parameters of gait in patients who underwent Ilizarov treatment for nonunion of the tibia. MATERIALS AND METHODS: The experimental group consisted of24 individuals treated with the Ilizarov method for nonunion of the tibia.The control group comprised31healthy individuals,matched for BMI,sex,and age.The dynamic gait parameters in patients and in the control group were measured with a Zebris pedobarographic platform. RESULTS: The treatment group and the control group showed statistically significant differences in terms of the following gait parameters:Maximum force 1NOL(non-operated-limb),Time maximum force1OL(operated-limb),Time maximum force 1 NOL,Maximum force 2NOL,Time maximum force 2OL,and Maximum force forefoot OL.Most of the evaluated gait parameters were bilaterally similar in patients group.The only significant differences between the operated and non-operated limb were seen in terms of Time maximum force 2and Maximum force forefoot. CONCLUSIONS: The most pronounced abnormalities in dynamic gait parameters were observed in the forefoot.The patients treated with the Ilizarov method did not achieve a complete normalization of dynamic gait parameters,as their gait parameters did not equal those measured in the control group.The Ilizarov method for the treatment of tibial nonunion helps restore a symmetrical distribution of gait parameter values between the affected limb and the healthy limb.Patients with tibial nonunion treated with the Ilizarov method continue to show some abnormalities in their dynamic gait parameters after treatment.

Download Full-text

Infected tibial nonunions: Treatment by the Ilizarov method - multicentric study

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1202065v ◽

2012 ◽

Vol 140 (1-2) ◽

pp. 65-70

Author(s):

Zoran Vukasinovic ◽

Dusko Spasovski ◽

Cedomir Vucetic ◽

Vesna Jovanovic ◽

Igor Seslija ◽

...

Keyword(s):

Average Length ◽

Functional Results ◽

Bone Transport ◽

Complex Problem ◽

Lower Limbs ◽

Ilizarov Method ◽

Local Infection ◽

Laboratory Findings ◽

Multicentric Study ◽

Tibial Nonunion

Introduction. Associated bone tissue defect and infection, commonly result in non-healing, i.e. by the development of infected tibial nonunion. Objective. The aim of the paper was to present experiences acquired in the treatment of this problem by the application of the Ilizarov method. Methods. The analyses enrolled 16 patients diagnosed with infected tibial nonunion. The Ilizarov method was used in all the patients, of type bilocal synchronous compressive-distractive or bilocal alternating compressive-distractive. Bone and functional results were classified as excellent, good, fair and poor. Total follow-up period of the patients was 48.77?41.57 months on the average. Results. Fifteen (93.75%) cases of nonunions were successfully healed. According to the laboratory findings of inflammation, the same patients were also successfully treated for local infection. The inequality of the lower limbs was also resolved by new bone formation of average length of 5.75?3.29 cm. Poor result was verified in one (6.25%) patient only. The patient satisfaction was scored 3.73?1.33 and physician?s satisfaction 4.33?1.11. Conclusion. The Ilizarov method with bone transport, because of being capable to solve simultaneously a local infection and tibial malalignement, and by substituting bone and soft tissue defects, thus enabling healing of until then unhealed bone, has shown as the best method in the treatment of this complex problem, infected tibial nonunions.

Download Full-text

War-related infected tibial nonunion with bone and soft-tissue loss treated with bone transport using the Ilizarov method

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-009-1014-6 ◽

2009 ◽

Vol 130 (6) ◽

pp. 739-749 ◽

Cited By ~ 26

Author(s):

Marko Bumbaširević ◽

Slavko Tomić ◽

Aleksandar Lešić ◽

Ivan Milošević ◽

Henry Dushan E. Atkinson

Keyword(s):

Soft Tissue ◽

Bone Transport ◽

Tissue Loss ◽

Ilizarov Method ◽

Tibial Nonunion ◽

Soft Tissue Loss

Download Full-text

Assessment of Gait after Treatment of Tibial Nonunion with the Ilizarov Method

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084217 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4217

Author(s):

Łukasz Pawik ◽

Felicja Fink-Lwow ◽

Andżelika Pajchert Kozłowska ◽

Łukasz Szelerski ◽

Sławomir Żarek ◽

...

Keyword(s):

Research Question ◽

Social Dimension ◽

Gait Velocity ◽

Control Group ◽

Ilizarov Method ◽

Healthy Individuals ◽

Time Step ◽

Abnormal Gait ◽

Gait Parameters ◽

Tibial Nonunion

Background: Tibial nonunion is a common bone union disorder leading to abnormal gait, and thus reducing quality of life in the social dimension. Research question: The aim of our work was to comprehensively assess gait parameters of patients who had undergone Ilizarov treatment for tibial nonunion compared to a control group of healthy individuals. Methods: This study evaluated patients treated for aseptic tibial nonunion with the Ilizarov method. 24 patients with a mean age of 55.0 years were included in the study. The control group consisted of 32 healthy volunteers with no significant medical history who were selected to match the gender and age of patients in the study group so that the groups were homogeneous. A Zebris Medical GmbH pedobarographic platform was used to assess the gait parameters. Results: For all gait parameters examined, force forefoot max, force backfoot max, step length, stance phase, swing phase and step time, we observed statistically significant differences between the group that had undergone treatment and the control group. In the group of patients, statistically significant differences between the operated lower limb and the non-operated limb were only observed for the force forefoot max and step time parameters (p = 0.029 and p = 0.045, respectively). Patients presented a longer loading of the operated limb (0.720 s) than the non-operated limb (0.635 s). For the stride time, step cadence and gait velocity parameters, healthy subjects achieved much better results during locomotion, and these differences were statistically significant at p < 0.001. Significance: Treatment of tibial nonunion with the Ilizarov method did not restore normal gait parameters in our group of patients. In fact, the gait parameters of patients were significantly worse than the healthy individuals in the control group. Furthermore, gait parameters following treatment were not symmetrical, and the dynamics of the musculoskeletal system remained impaired.

Download Full-text

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Acta of Bioengineering and Biomechanics ◽

10.37190/abb-01633-2020-01 ◽

2020 ◽

Vol 22 (3) ◽

Author(s):

Andżelika Pajchert-Kozłowska ◽

Łukasz Pawik ◽

Łukasz Szelerski ◽

Sławomir Żarek ◽

Radosław Górski ◽

...

Keyword(s):

Musculoskeletal System ◽

Control Group ◽

Ilizarov Method ◽

Study Group ◽

Control Groups ◽

Body Balance ◽

Centre Of Gravity ◽

Tibial Nonunion ◽

Axis Length ◽

And Control

Purpose: The biomechanics of the musculoskeletal system in patients after tibial nonunion treatment using the Ilizarov method have not yet been fully explored. From the orthopaedic and patient point of view, after the treatment, an assessment should be carried out of the biomechanics of the musculoskeletal system. The aim of this study was to assess the body balance of patients treated with the Ilizarov method for tibial nonunion. Methods: The research group included 24 individuals with a mean age of 55 years, who were treated for aseptic tibial nonunion with the Ilizarov method. The control group was matched to the study group in terms of gender and age, and consisted of 32 subjects with a mean age of 50.5 years and no significant medical history. This study evaluated the balance of patients with the use of pedobarography. Results: In the control group, a statistically significantly shorter path of centre of gravity was observed. There were no statistical differences between the study and control groups for the field area of the centre of gravity. There were no statistical differences between the study and control groups for the minor axis length or major axis length of the centre of gravity. There was a relationship between the centre of pressure path length and the age of the participants in both the control group and the study group. Conclusions: Treatment of patients with tibial nonunion with the Ilizarov fixator achieves similar balance to healthy volunteers. In the pedobarographic evaluation, patients treated for tibial nonunion using the Ilizarov method had similar statics of the musculoskeletal system to healthy volunteers.

Download Full-text

Assessment of Lower Limb Load Distribution in Patients Treated with the Ilizarov Method for Tibial Nonunion

Medical Science Monitor ◽

10.12659/msm.930849 ◽

2021 ◽

Vol 27 ◽

Author(s):

Łukasz Pawik ◽

Andżelika Pajchert-Kozłowska ◽

Łukasz Szelerski ◽

Sławomir Żarek ◽

Radosław Górski ◽

...

Keyword(s):

Lower Limb ◽

Load Distribution ◽

Ilizarov Method ◽

Tibial Nonunion ◽

Limb Load

Download Full-text

Cognitive control constrains memory attributions

Behavioral and Brain Sciences ◽

10.1017/s0140525x19001869 ◽

2019 ◽

Vol 42 ◽

Author(s):

Colleen M. Kelley ◽

Larry L. Jacoby

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Download Full-text

Cognitive Load Affects Speech Motor Performance Differently in Older and Younger Adults

Journal of Speech Language and Hearing Research ◽

10.1044/2018_jslhr-s-17-0222 ◽

2019 ◽

Vol 62 (5) ◽

pp. 1258-1277 ◽

Cited By ~ 1

Author(s):

Megan K. MacPherson

Keyword(s):

Older Adults ◽

Cognitive Load ◽

Motor Performance ◽

Age Groups ◽

Incongruent Condition ◽

Sentence Production ◽

Movement Duration ◽

Production Task ◽

Younger Adults ◽

Speech Motor

PurposeThe aim of this study was to determine the impact of cognitive load imposed by a speech production task on the speech motor performance of healthy older and younger adults. Response inhibition, selective attention, and working memory were the primary cognitive processes of interest.MethodTwelve healthy older and 12 healthy younger adults produced multiple repetitions of 4 sentences containing an embedded Stroop task in 2 cognitive load conditions: congruent and incongruent. The incongruent condition, which required participants to suppress orthographic information to say the font colors in which color words were written, represented an increase in cognitive load relative to the congruent condition in which word text and font color matched. Kinematic measures of articulatory coordination variability and movement duration as well as a behavioral measure of sentence production accuracy were compared between groups and conditions and across 3 sentence segments (pre-, during-, and post-Stroop).ResultsIncreased cognitive load in the incongruent condition was associated with increased articulatory coordination variability and movement duration, compared to the congruent Stroop condition, for both age groups. Overall, the effect of increased cognitive load was greater for older adults than younger adults and was greatest in the portion of the sentence in which cognitive load was manipulated (during-Stroop), followed by the pre-Stroop segment. Sentence production accuracy was reduced for older adults in the incongruent condition.ConclusionsIncreased cognitive load involving response inhibition, selective attention, and working memory processes within a speech production task disrupted both the stability and timing with which speech was produced by both age groups. Older adults' speech motor performance may have been more affected due to age-related changes in cognitive and motoric functions that result in altered motor cognition.

Download Full-text

Effects of Aging on the Subcortical Encoding of Stop Consonants

American Journal of Audiology ◽

10.1044/2020_aja-19-00044 ◽

2020 ◽

Vol 29 (3) ◽

pp. 391-403

Author(s):

Dania Rishiq ◽

Ashley Harkrider ◽

Cary Springer ◽

Mark Hedrick

Keyword(s):

Older Adults ◽

Repeated Measures ◽

Mixed Model ◽

Auditory Brainstem ◽

Auditory Brainstem Responses ◽

Aging Effects ◽

Formant Frequency ◽

Place Of Articulation ◽

Second Formant ◽

Effects Of Aging

Purpose The main purpose of this study was to evaluate aging effects on the predominantly subcortical (brainstem) encoding of the second-formant frequency transition, an essential acoustic cue for perceiving place of articulation. Method Synthetic consonant–vowel syllables varying in second-formant onset frequency (i.e., /ba/, /da/, and /ga/ stimuli) were used to elicit speech-evoked auditory brainstem responses (speech-ABRs) in 16 young adults ( M age = 21 years) and 11 older adults ( M age = 59 years). Repeated-measures mixed-model analyses of variance were performed on the latencies and amplitudes of the speech-ABR peaks. Fixed factors were phoneme (repeated measures on three levels: /b/ vs. /d/ vs. /g/) and age (two levels: young vs. older). Results Speech-ABR differences were observed between the two groups (young vs. older adults). Specifically, older listeners showed generalized amplitude reductions for onset and major peaks. Significant Phoneme × Group interactions were not observed. Conclusions Results showed aging effects in speech-ABR amplitudes that may reflect diminished subcortical encoding of consonants in older listeners. These aging effects were not phoneme dependent as observed using the statistical methods of this study.

Download Full-text

Partner-Specific Communication Deficits in Individuals With Alzheimer's Disease

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00094 ◽

2020 ◽

pp. 1-15

Author(s):

Eun Jin Paek ◽

Si On Yoon

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Referential Communication ◽

Sorting Task ◽

Audience Design ◽

Healthy Older Adults ◽

Communication Task ◽

Design Skills ◽

Referential Expressions

Purpose Speakers adjust referential expressions to the listeners' knowledge while communicating, a phenomenon called “audience design.” While individuals with Alzheimer's disease (AD) show difficulties in discourse production, it is unclear whether they exhibit preserved partner-specific audience design. The current study examined if individuals with AD demonstrate partner-specific audience design skills. Method Ten adults with mild-to-moderate AD and 12 healthy older adults performed a referential communication task with two experimenters (E1 and E2). At first, E1 and participants completed an image-sorting task, allowing them to establish shared labels. Then, during testing, both experimenters were present in the room, and participants described images to either E1 or E2 (randomly alternating). Analyses focused on the number of words participants used to describe each image and whether they reused shared labels. Results During testing, participants in both groups produced shorter descriptions when describing familiar images versus new images, demonstrating their ability to learn novel knowledge. When they described familiar images, healthy older adults modified their expressions depending on the current partner's knowledge, producing shorter expressions and more established labels for the knowledgeable partner (E1) versus the naïve partner (E2), but individuals with AD were less likely to do so. Conclusions The current study revealed that both individuals with AD and the control participants were able to acquire novel knowledge, but individuals with AD tended not to flexibly adjust expressions depending on the partner's knowledge state. Conversational inefficiency and difficulties observed in AD may, in part, stem from disrupted audience design skills.

Download Full-text