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

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.

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

2009 ◽  
Vol 130 (6) ◽  
pp. 739-749 ◽  
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

scholarly journals Presentation and management outcome of tibial infected non‑union with Ilizarov technique

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Karim Bakhsh ◽  
Atiq-Ur- Rehman ◽  
Faridullah Khan Zimri ◽  
Eid Mohammad ◽  
Wazir Ahmed ◽  
...  
Keyword(s):  
External Fixation ◽  
Case Series ◽  
Functional Results ◽  
Rehabilitation Medicine ◽  
Bone Transport ◽  
Fixation Index ◽  
Ilizarov Method ◽  
Fixation Time ◽  
Ilizarov Technique ◽  
Non Union

Objective: To document the presentation of tibial infected non-union and analyze the management outcome with Ilizarov technique in terms of bone results, functional outcome, bone transport time, external fixation time, external fixation index and any complications. Methods: This case series was conducted at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of 3-years. Results: There were 56 patients with 53(94.64%) males and 3(5.35%) females. The age range was 16-50 years with a mean of 32.58±9.98years. According to ASAMI criteria, bone results were excellent in 37(66%), good in 10(17.85%), fair in 6(10.71%) and poor in 3(5.35%). The functional results were excellent in 37(66%), good in 9(16%), fair in 7(12.5%) and poor in 3(5.35%). The bone union rate was 98.21%. Conclusion: Ilizarov method beautifully addresses the formidable issue of infected non union of tibia with good outcome in terms of bone healing and infection eradication. The treatment period is relatively lengthy and hence patience on part of patient as well as the surgical team is imperative for achieving favourable outcomes. How to cite this:Bakhsh K, Atiq-Ur-Rehman, Zimri FK, Mohammad E, Ahmed W, Saaiq M. Presentation and management outcome of tibial infected non‑union with Ilizarov technique. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.67 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Complications of bone transport technique using the Ilizarov method in the lower extremity: a retrospective analysis of 282 consecutive cases over 10 years

2020 ◽  
Author(s):  
Yanshi Liu ◽  
Maimaiaili Yushan ◽  
Zhenhui Liu ◽  
Jialin Liu ◽  
Chuang Ma ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Clinical Outcomes ◽  
Bone Defect ◽  
Demographic Data ◽  
Bone Defects ◽  
Bone Transport ◽  
Lower Limbs ◽  
Ilizarov Method ◽  
Major Complications ◽  
Transport Technique

Abstract Background: The treatment of large bone defects in lower limbs is a serious challenge for orthopedic surgeons and patients. The bone transport technique using the Ilizarov method has become the main treatment option for the reconstruction of bone defect. However, inevitable difficulties and complications related to bone transport technique have been reported by many studies. The purpose of this study was to evaluate the effectiveness and complications of bone transport technique using Ilizarov method in the treatment of bone defect of lower extremity.Methods: The study was conducted on 282 patients who underwent bone transport procedures using Ilizarov method at our institution from January 2007 to June 2017. Patient’s demographic data, complications and clinical outcomes at minimum of two years follow-up were collected and retrospectively analyzed. All difficulties that related to bone transport were documented according to Paley’s classification. The clinical outcomes were evaluated using Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at last clinical visit. Results: There were 243 male and 39 females with a mean age of 40 years (range 18-65 years). The mean defect was 6.56±2.15 cm, whereas single level transport in 221 cases and double level transport in 61 cases. There were 189 problems, 166 obstacles and 406 complications (257 minor and 149 major complications), and the average complication rate per patients consists of 0.91 minor and 0.53 major complications. The top five complications were pin-site infection (65.96%), axial deviation (40.78%), joint stiffness (23.76%), soft tissue incarceration (22.34%) and delayed union of the docking site (13.48%).The ASAMI bony result was excellent in 233 patients, good in 32, fair in 5 and poor in 12. The ASAMI functional result was excellent in 136 patients, good in 88, fair in 47, poor in 11.Conclusion: Bone transport is a reliable method for reconstruction of bone defects in the femur and tibia. Awareness of predictable complications is beneficial to prevent or early detection of the expected complication which can improve the risk-benefit balance.

scholarly journals Complications of bone transport technique using the Ilizarov method in the lower extremity: a retrospective analysis of 282 consecutive cases over 10 years

2020 ◽  
Author(s):  
Yanshi Liu ◽  
Maimaiaili Yushan ◽  
Zhenhui Liu ◽  
Jialin Liu ◽  
Chuang Ma ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Bone Defect ◽  
Demographic Data ◽  
Joint Stiffness ◽  
Bone Defects ◽  
Bone Transport ◽  
Lower Limbs ◽  
Ilizarov Method ◽  
Major Complications ◽  
Transport Technique

Abstract Background: The treatment of large bone defects in lower limbs is a serious challenge for orthopedic surgeons and patients. The bone transport technique according to the Ilizarov method characterized with versatile abilities and has become the main option for the reconstruction of bone defect. However, inevitable difficulties as complications related to bone transport technique have been reported by many studies. Complications which could affect on the clinical outcomes remain a major concern. The purpose of this study was to evaluate the effectiveness and complications of bone transport technique using Ilizarov method in the treatment of bone defect in lower extremity.Methods: The study was conducted on 282 patients who underwent bone transport procedures using Ilizarov method at our institution from January 2007 to June 2017. Patient’s demographic data, complications and clinical outcomes at two years follow-up were collected and retrospectively analyzed. All difficulties that related to bone transport were documented according to Paley’s classification. The clinical outcomes were evaluated using Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at last clinical visit.Results: There were 243 male and 39 females with a mean age of 40 years (range 18-65 years). The mean defect was 6.56±2.15 cm, whereas single level transport in 221 cases and double level transport in 61 cases. A total of 189 problems, 166 obstacles and 406 complications (257 minor and 149 major complications) were observed，the average complication rate per patients consists of 0.91 minor and 0.53 major complications. The top five complications were pin-site infection (65.96%), axial deviation (40.78%), joint stiffness (23.76%), soft tissue incarceration (22.34%) and delayed union of the docking site (13.48%).The ASAMI bony result was excellent in 233 patients, good in 32, fair in 5 and poor in 12. The ASAMI functional result was excellent in 136 patients, good in 88, fair in 47, poor in 11 and failure in 0.Conclusion: Bone transport is a reliable method for reconstruction of bone defects in the femur and tibia caused by variety of reasons. Particular attention, patient’s compliance and experience of the surgeon contribute the satisfactory results.

Results of the Treatment of Infected Nonunions of the Lower Limbs Using the Ilizarov Method

2017 ◽  
Vol 19 (2) ◽  
pp. 111-125 ◽  
Author(s):  
Marek Dróżdż ◽  
Stanisław Rak ◽  
Paweł Bartosz ◽  
Jerzy Białecki ◽  
Wojciech Marczyński
Keyword(s):  
Soft Tissues ◽  
Bone Fractures ◽  
Good Condition ◽  
High Energy ◽  
Bone Transport ◽  
Lower Limbs ◽  
Bone Union ◽  
Long Bone ◽  
Ilizarov Method ◽  
Infected Nonunion

Background. Infected nonunion is a complex complication of the treatment of long bone fractures. An in creased incidence of injuries, including high energy injuries (often open ones), contributes to a higher incidence of nonunion. These primarily infected injuries cause osteomyelitis, which prevents bone union, resulting in an infected nonunion. The Ilizarov method meets the biological and biomechanical treatment requirements, opti mising the process of inflammation healing and producing bone union. Material and methods. A total of 54 patients were treated in 2000–2014 for nonunion in the lower limbs with the Ilizarov method, which was used after previous treatment had failed. The subjects underwent intra operative resection of the locus of infection, sequestrectomy and a Judet procedure, followed by the use of the Ilizarov apparatus and bone transport, depending on the defect. Results. Inflammation healed in 52 patients (96%) and bone union was achieved in 46 patients (86%). Good outcomes with healed inflammation and bone union were reported in 76% of the cases, fair outcomes with tem porary elimination of the inflammation and without bone union in 16%, and poor outcomes without inflam ma tion healing and without bone union in 7%. Conclusions. Treatment of infected nonunion can only be effective after eliminating endogenous inflamma tory foci, covering skin defects, ensuring a good condition of the skin and soft tissues, restoring normal blood supply to the bone fragments, and good biomechanical fixation of the fragments with dynamisation or compression. The Ilizarov method is a method of choice in the treatment of cases of infected nonunion where other treatments have failed.

scholarly journals Assessment of the distribution of load on the lower limbs and balance before and after ankle arthrodesis with the Ilizarov method

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Piotr Morasiewicz ◽  
Grzegorz Konieczny ◽  
Maciej Dejnek ◽  
Wiktor Urbański ◽  
Szymon Łukasz Dragan ◽  
...  
Keyword(s):  
Ankle Arthrodesis ◽  
Lower Limbs ◽  
Ilizarov Method ◽  
Before And After

Dynamic Gait Parameters in Patients with Nonunion of the Tibia Following Treatment with the Ilizarov Method

2021 ◽  
Author(s):  
Andzelika Pajchert Kozlowska ◽  
Lukasz Pawik ◽  
Lukasz Szelerski ◽  
Slawomir Zarek ◽  
Radoslaw Górski ◽  
...  
Keyword(s):  
Maximum Force ◽  
Control Group ◽  
Ilizarov Method ◽  
Dynamic Parameters ◽  
Symmetrical Distribution ◽  
Gait Parameters ◽  
Tibial Nonunion ◽  
Parameter Values ◽  
Dynamic Gait ◽  
Experimental Group

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.

scholarly journals 665. Key Clinical and Laboratory Features in Early Diagnosis of Ehrlichiosis in an Endemic Area of Long Island, New York

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S240-S241
Author(s):  
Olga Kaplun ◽  
Kalie Smith ◽  
Teresa Khoo ◽  
Eric Spitzer ◽  
Fredric Weinbaum ◽  
...  
Keyword(s):  
New York ◽  
Clinical Presentation ◽  
Average Length ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Suffolk County ◽  
University Hospital ◽  
Laboratory Findings ◽  
Significant Difference

Abstract Background Human monocytic ehrlichiosis (HME) is a tick-borne disease caused by Ehrlichia chafeensis in the northeast United States. Suffolk County, New York has the highest amount of HME cases in NY (176 from 2010 to 2014). Our aim is to identify risk factors for HME and compare clinical presentation and laboratory findings of young vs. older adults. Methods A retrospective chart review from January 1, 2014 to December 31, 2017 was performed on all patients ≥18 years who presented to the ER at Stony Brook University Hospital (SBUH) or Stony Brook Southampton Hospital (SBSH) with (i) ICD-9 code 082.4 or ICD-10 code A77.40 and (ii) a positive E. Chafeensis PCR. Data were collected on demographics, clinical presentation, and laboratory results. Results Twenty-seven cases of HME were found and separated into Group 1 (G1, n = 10) or Group 2 (G2, n = 17) based on age (Table 1). G1 had a significantly higher chance of being Hispanic than G2. Twenty-four of the 27 patients (89%) were hospitalized with an average length of stay of 3.4 days (range 1–14 days).The only significant difference in clinical presentation was that G1 was more likely to have myalgia (P = 0.02). 40% or more of patients in both groups presented with an acute kidney injury and the average length of hospital stay in days was 4.0 ± 2.9 and 3.2 ± 3.1 for G1 and G2, respectively. The number of cases overall have increased 6.0% per year between 2014 and 2017. Thrombocytopenia presented in all cases. Conclusion. HME is prevalent in Suffolk County. Clinical presentation and laboratory findings were largely similar between the two groups, except the younger population more often presented with myalgia. A risk factor in this study was to be young and Hispanic, likely due to occupational exposure. Disclosures All authors: No reported disclosures.

scholarly journals Tibial bone defects treated by internal bone transport using the Ilizarov method

1998 ◽  
Vol 22 (5) ◽  
pp. 293-297 ◽  
Author(s):  
H.-R. Song ◽  
S.-H. Cho ◽  
K.-H. Koo ◽  
S.-T. Jeong ◽  
Y.-J. Park ◽  
...  
Keyword(s):  
Bone Defects ◽  
Bone Transport ◽  
Ilizarov Method ◽  
Tibial Bone

Anatomy of the Lateral Plantar Ligaments of the Transverse Metatarsal Arch

2019 ◽  
Vol 41 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Lyndon Mason ◽  
Malwattage Lara Tania Jayatilaka ◽  
Andrew Fisher ◽  
Lauren Fisher ◽  
Eric Swanton ◽  
...  
Keyword(s):  
Clinical Relevance ◽  
Average Length ◽  
Lower Limbs ◽  
Human Anatomy ◽  
Lateral Instability ◽  
First Metatarsal ◽  
Plantar Aspect ◽  
Lisfranc Ligament ◽  
The University ◽  
Middle Column

Background: While the anatomy of the Lisfranc complex is well understood, the lateral tarsometatarsal ligamentous structures, in contrast, are less well studied. Our aim in this study was to identify an anatomical explanation as to why the second to fifth metatarsals function as a unit in homolateral and divergent midfoot injuries. Methods: Eleven cadaveric lower limbs, preserved in formaldehyde, were examined at the University of Liverpool Human Anatomy and Resource Centre. Each of the lower limbs was dissected to identify the plantar aspect of the transverse metatarsal arch. Results: On removal of the long plantar ligament, the peroneal longus tendon was visible, as was its insertion onto the first metatarsal base. A lateral Lisfranc ligament (which was a transverse suspensory metatarsal ligament) spanned between the bases of the second and fifth metatarsals in all specimens with an average length of 33.7 mm and width of 4.6 mm. This ligament has not previously been described. It was noted that in all specimens, the long plantar ligament blended with the lateral Lisfranc ligament. In addition to the lateral Lisfranc ligament, separate intermetatarsal ligaments were identifiable connecting each metatarsal. The long plantar ligament provided a connection through the lateral Lisfranc ligament connecting the transverse and longitudinal arches of the foot. Conclusion: We found a plantar ligament that provided connection through the long plantar ligament of both the transverse and the longitudinal arches. It spanned from the second to the fifth metatarsal, which we believe may explain that in some cases, lateral instability can be overcome when the middle column is stabilized. Clinical Relevance: We suspect that in the majority of homolateral and divergent types of tarsometatarsal injuries that the lateral Lisfranc ligament remains intact and thus it has significant clinical ramifications.

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