scholarly journals Managing Difficult Fractures due to Ballistic Trauma with Ilizarov Ring Fixation

1970 ◽  
Vol 9 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Pankaj Chand ◽  
Roshan Lal Shrestha ◽  
Bachu Ram KC ◽  
Bhanu Chand Shah ◽  
Amit Joshi ◽  
...  
Keyword(s):  
Bone Loss ◽  
Weight Bearing ◽  
Joint Stiffness ◽  
Valgus Deformity ◽  
Bone Transport ◽  
Healing Time ◽  
Early Weight Bearing ◽  
Non Union ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator

20 fractures (7 femoral and 13 tibial) were treated with the illizarov apparatus between 2003 to 2006. Allwere old injuries, previously managed by internal fixation (intramedullary rods), external fixation (Hoffman'sexternal fixators), or conservatively with traction and plaster of paris slabs. Ilizarov fixators were appliedto manage infected non-union with or without bone loss and malunion. Corticotomy and bone transportwas carried out in cases with significant bone loss. In others without any limb shortening and minimalbony defect, bone grafting and compression was carried out. In one case valgus deformity along withnon-union was corrected. Early weight bearing with range of motion exercises for ankle and knee jointswere encouraged. Average fracture healing time was 12 months (8 to 18 months). All fractures healed with<5° of malalignment. Complications included pin site inflammation/ infection, muscle transfixation, kneeand ankle joint stiffness and a wire fracture. The ilizarov device provided definitive fixation with acceptableresults in all cases.Key words: Ilizarov ring fixator; distraction osteogenesis; bone transport; infective non-union;corticotomyDOI: 10.3126/mjsbh.v9i1.3482Medical Journal of Shree Birendra Hospital Vol.9(1) 2010 1-8

scholarly journals OSTEOGENESIS DISTRACTION USING COMBINED PLATE AND ILIZAROF FIXATOR IN THE TREATMENT OF BONE DEFECT: A CASE REPORT

Biomedika ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 113-120
Author(s):  
Misbahuddin Misbahuddin ◽  
Ismail Mariyanto
Keyword(s):  
Bone Loss ◽  
External Fixation ◽  
Bone Defect ◽  
Plate Fixation ◽  
Bone Transport ◽  
Fixation Index ◽  
Bone Fragment ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator ◽  
Bone Segment

Distraksi osteogenesis dan pemanjangan tulang telah digunakan untuk merekonstruksi hilangnya tulang dengan memungkinkan tulang baru terbentuk pada celah. Pada penelitian sebelumnya, pemanjangan tulang yang dipandu pelat telah berhasil mengobati hilangnya  tulang pada tulang paha, tibia, dan mandibula. Penelitian ini melaporkan sebuah kasus fraktur tibia dengan kehilangan tulang kominutif yang diobati dengan fiksasi pelat dan pemanjangan tulang dengan fiksator cincin Ilizarov. Pada saat pengaitan, ketika segmen pemanjangan dikompresi dengan fragmen tulang, fragmen tulang difiksasi dengan sekrup locking dan non-locking tambahan melalui pelat. Panjang defek tulang adalah 7 cm. Indeks pemanjangan atau fiksasi eksternal adalah 12,7 hari / cm. Pada kasus ini tidak ada pemendekan yang terjadi. Indeks konsolidasi radiografi rata-rata adalah 37 hari / cm. Kasus ini  mencapai regenerasi segmen tulang yang bebas infeksi dan hasil fungsional yang memuaskan. Teknik ini mengurangi durasi fiksasi eksternal selama fase konsolidasi, memungkinkan koreksi panjangtulang, dan penyelarasan dan waktu rehabilitasi yang lebih singkat.\Kata kunci: Defek Tulang, Transportasi Tulang, Osteogenesis Gangguan, Teknik Ilizarov, Osteogenesis Lempeng TulangOsteogenesis distraction and bone transport has been used to reconstruct bone loss defect by allowing new bone to form in the gap. In previous studies, plate-guided bone transport has been successfully to treat bone loss defect in the femur, tibia, and mandible. This study reports a case of fracture of tibia with comminutive bone loss treated with plate fixation and bone transport with Ilizarov ring fixator. At the time of docking, when the transport segment is compressed with bone fragment, the bone fragment is fixed with additional locking or nonlocking screws through the plate. The bone defect size was 7 cm. The lengthening/external fixation index was 12.7 days/cm. In this case there were no shortening that  present. The average radiographic consolidation index was 37 days/cm. This case achieved infection-free bone segment regeneration and satisfactorily functional outcome. This technique reduces the duration of external fixation during the consolidation phase, allows correction of length and alignment and provides earlier rehabilitation.Keywords: Bone Defect, Bone Transport, Distraction Osteogenesis, Ilizarov Technique, Bone Plate Osteogenesis

scholarly journals Evaluation of Results of Ilizarov Fixator and Methodology in Tibial Non- Union

2019 ◽  
Vol 15 (2) ◽  
pp. 98-102
Author(s):  
Jayabrata Ghosh ◽  
Prashanta Kumar Pujari
Keyword(s):  
Weight Bearing ◽  
Functional Results ◽  
Bone Transport ◽  
Functional Score ◽  
Early Weight Bearing ◽  
Non Union ◽  
Joint Mobilization ◽  
Formidable Challenge ◽  
Ilizarov Fixator ◽  
Hospital Study

Background: Treatment of non-union of tibial diaphyseal fractures has always posed a formidable challenge to surgeons. Persistant infection, deformity, bone loss, stiffness of joints and disability complicate the problem further. Ilizarov methodology tackles all the above problems simultaneously and offers a solution for non-union. Progressive new bone formation and increased vascularity following corticotomy and bone transport helps in filling bone gaps and promoting fracture union. Stability of the fixation allows early weight bearing, ambulation and joint mobilization. To evaluate the results of Ilizarov fixator in treating tibial non-union. Methods: This retrospective hospital study was conducted at Ramakrishna Mission Seva Pratishthan, Kolkata, India from August 2009 to February 2012. Forty two patients treated at this hospital between August 1994 and August 2011 with a minimum of 12 months follow up were included. The results were analysed on the outcome of bone and functional score using the Association for the Study and Applica-tion of the Method of Ilizarov (ASAMI) scoring system. Results: Of the 42 patients in this study, there were 28 (66.7%) excellent, 6 (14.3%) good, 5 (11.9%) fair and 3(7.1%) poor bone results and 17(40.5%) excellent, 20(47.6%) good, 2(4.8%) fair and 3(7.1%) poor functional results. Conclusions: Treatment of tibial non-unions with Ilizarov fixator is effective but not without considerable amount of complications and morbidity associated with it. The functional outcome was largely multifactorial and dependent on the final joint function, soft tissue condition and ability of the patient to return to activity.

scholarly journals Posteromedial fragment fixation through Lobenhoffer approach in tibial plateau fractures

2017 ◽  
Vol 3 (3) ◽  
pp. 497
Author(s):  
Vijaysing S. Chandele ◽  
Abhishek P. Bhalotia ◽  
Milind V. Ingle ◽  
Maroti R. Koichade
Keyword(s):  
Functional Outcome ◽  
Tibial Plateau ◽  
Weight Bearing ◽  
Oxford Knee Score ◽  
Tibial Plateau Fractures ◽  
Knee Score ◽  
Early Weight Bearing ◽  
Non Union ◽  
Approach Time

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Management of tibial plateau fractures with coronal fractures especially posteromedial fragment is frequent and challenging. This study was conducted to </span><span lang="EN-IN">evaluate the</span><span lang="EN-GB"> functional outcome of patients with tibial plateau fractures having posteromedial fragment treated with open reduction and internal fixation (ORIF) using Lobenhoffer approach</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">Thirty two patients with tibial plateau fractures having posteromedial fracture alone or part of bicondylar fracture was operated with ORIF using Lobenhoffer approach. Time to union, maintenance of alignment, rate of complications and functional outcome was assessed using Oxford knee score</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">The mean </span><span lang="EN-IN">time to healing was 16.4 weeks, without any complication in the form of non-union and infection. Malunion with secondary loss of alignment was seen in only one case due to fracture comminution and early weight bearing. Oxford knee score was good to excellent in all the cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">With recent development in understanding these fractures, ORIF gives excellent to good outcome in all patients operated through Lobenhoffer approach. Long term disability can be prevented by maintenance of adequate alignment and reduction through direct visualization of fracture</span><span lang="EN-IN">.</span></p>

scholarly journals Salvage of Infected Non-Union of the Tibia with An Ilizarov Ring Fixator

2015 ◽  
Vol 23 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Muhammad Shahid Khan ◽  
Haroon Rashid ◽  
Masood Umer ◽  
Irfan Qadir ◽  
Kamran Hafeez ◽  
...  
Keyword(s):  
Non Union ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator

Limited Bone Loss in the Hip and Heel After Reamed Intramedullary Fixation and Early Weight-bearing of Tibial Fractures

2001 ◽  
Vol 15 (8) ◽  
pp. 560-565 ◽  
Author(s):  
Abbas Emami ◽  
Sune Larsson ◽  
Einar Hellquist ◽  
Hans Mallmin
Keyword(s):  
Bone Loss ◽  
Weight Bearing ◽  
Tibial Fractures ◽  
Intramedullary Fixation ◽  
Early Weight Bearing

scholarly journals Immediate Weight Bearing after Bi-planar Plantar Fixation of Lapidus

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003 ◽  
Author(s):  
W. Bret Smith ◽  
Robert Santrock ◽  
Paul Dayton ◽  
Daniel Hatch
Keyword(s):  
Weight Bearing ◽  
Extended Period ◽  
Valgus Deformity ◽  
Radiographic Evaluation ◽  
Inclusion Criteria ◽  
Early Weight Bearing ◽  
Advantages And Disadvantages ◽  
Fusion Site ◽  
Correct Technique ◽  
Operative Limb

Category: Bunion Introduction/Purpose: There are many options when choosing to repair HAV (hallux abducto-valgus) deformity of the foot. The Lapidus procedure and its modifications are often selected to correct these deformities due to multiplanar correction at the CORA (center of rotational angulation). As with any surgical procedure, there are advantages and disadvantages when selecting the correct technique. One drawback often identified with the Lapidus procedure is the need for extended immobilization and the inability to weight bear for an extended period of time. The objectives of this study were to demonstrate a new, novel construct that can allow for immediate weight bearing after Lapidus arthrodesis with predictable outcomes. Methods: This IRB approved study was comprised of 4 centers that performed a specific modification of the Lapidus procedure with an identical fixation construct. The construct consisted of 2 mini-plates that were applied across the first tarsometatarsal (TMT) joint. The plates were applied while the joint was held in compression. The plates were oriented dorsal and plantar-medial allowing for a greater than 90° spread between plates for appropriate distribution of the forces and a true multi-planar construct. This concept takes into account biplanar stability as described by Kolner[1] and micromotion to stimulate secondary bone healing as described by Perren[2]. All patients were placed into a protective, cushioned dressing with a rigid bottom shoe or boot depending on surgeon preference. The patients were allowed weight-bear as tolerated with walker or crutches for safety as soon as the regional anesthesia dissipated to allow for complete sensation in the operative limb. Results: Twelve months of consecutive cases with immediate weight bearing and minimum follow-up of 6 months were included in the study. All cases that met inclusion criteria were included in the analysis; inclusion criteria were primary corrections of a HAV deformity with correction done via the described technique performed within the approved date range. Procedures not utilizing the described technique, revision procedures and procedures that extended the arthrodesis outside of the first TMT joint were excluded. Conclusion: Preoperative and postoperative measurements of 50 patients were obtained in this study. Radiographic evaluation of the fusion site was used to determine if the arthrodesis demonstrated healing at a minimum of 6 months. Other studies have shown early weight bearing (<3 weeks) is possible after the Lapidus procedure [3], this study demonstrated that immediate weight bearing after a modified Lapidus procedure is possible with a decreased reported nonunion rate (4.0%). This modified procedure did not result in a recurrence of the deformity. We expect continuation of the study to demonstrate that there are no long-term issues.

The Rationale of Osteotomy around the Knee

2017 ◽  
Vol 30 (05) ◽  
pp. 386-392 ◽  
Author(s):  
Philipp Lobenhoffer
Keyword(s):  
Sagittal Plane ◽  
Weight Bearing ◽  
Cartilage Damage ◽  
Frontal Plane ◽  
Varus Deformity ◽  
Valgus Deformity ◽  
Wedge Osteotomy ◽  
Early Weight Bearing ◽  
Plate Fixator ◽  
Closed Wedge

AbstractFrontal plane varus or valgus deformity causes overload in the ipsilateral compartment and may induce and accelerate cartilage damage. Osteotomy around the knee should be considered in symptomatic constitutional and posttraumatic metaphyseal deformities of more than 3-degree deviation. Age, grade of osteoarthritis, obesity, and nicotine consumption are no exclusion criteria for osteotomy. For correction of varus deformity, biplanar open wedge osteotomy of the tibia with fixation by a plate fixator has proven to be a safe and stable construct allowing for early weight-bearing. Valgus deformities of the tibia can be treated by biplanar closed wedge osteotomy of the proximal tibia. For femur deformities closed wedge biplanar osteotomy and fixation with a specific plate fixator is an attractive solution reducing implant-related morbidity. Osteotomy around the knee may also be used to protect cartilage reconstruction and meniscus transplantation. Corrections in the sagittal plane may improve the anteroposterior stability of the knee significantly and can be combined with frontal plane corrections.

scholarly journals Use of Ilizarov ring Fixator in the Management of Non-Union of Long Bones

2017 ◽  
Vol 05 (02) ◽  
pp. 17265-17268
Author(s):  
Dr Kishore S ◽  
Keyword(s):  
Long Bones ◽  
Non Union ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator

scholarly journals A retrospective study of ilizarov fixation in infected non-union tibia: 36 cases

2016 ◽  
Vol 2 (3) ◽  
pp. 70
Author(s):  
Rajesh Govindasamy ◽  
Ramkumar Gnanasundaram ◽  
Saravanan Kasirajan ◽  
Pajani Sengani ◽  
Jimmy J Meleppuram
Keyword(s):  
Functional Results ◽  
High Energy ◽  
Ilizarov Method ◽  
Non Union ◽  
Ring Fixator ◽  
Significant Challenge ◽  
Ilizarov Ring Fixator ◽  
Pin Tract Infection ◽  
Tract Infections ◽  
Ilizarov Fixation

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Infected non-union of tibia is most frequently met due to high energy trauma and it poses significant challenge to the treating orthopaedic surgeon. The aim of the study is to evaluate the clinical and functional results in treating infected non-union of tibia by Ilizarov method.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> 36 patients with infected non-union of tibia with bone loss; shortening and deformity treated were retrospectively analyzed in the institution during the period of May 2010 to May 2015 were included in the study. The results were evaluated according to association for the study and application of the methods of Ilizarov (ASAMI) criteria. The Pin tract infections were assessed by Moore and Dahl Grading.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The bony results were excellent in 65% patients, good in 20%, fair in 15%, and poor in nil. The functional results were excellent in 50% patients, good in 25%, fair in 15%, and poor in 10%. The most common recorded complication was pin tract infection.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Ilizarov ring fixator still remains an excellent treatment modality for tibial non-union as it addresses to the problems associated with it.</p>

scholarly journals TIBIAL-TALO-CALCANEUM ARTHRODESIS

2016 ◽  
Vol 23 (10) ◽  
pp. 1227-1231
Author(s):  
Saeed Ahmad ◽  
Mohammad Ikram ◽  
Ashfaq Ahmed ◽  
Amer Aziz ◽  
Shahzad Javed ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Intramedullary Fixation ◽  
X Rays ◽  
Radiological Outcome ◽  
Early Weight Bearing ◽  
Detailed History ◽  
Non Union ◽  
Case Period ◽  
Clinical And Radiological Outcome ◽  
Pain Improvement

Objectives: To determine the clinical and radiological outcome of Tibio-talocalcanealarthrodesis with Retrograde intramedullary SIGN Nail in patients with tibiotalar andsubtalar joint pathologies. Study Design: Descriptive case. Period: September 2012 to May2015. Setting: OPD or Emergency at Orthopaedics Unit of Ghurki Trust Teaching HospitalLahore. Materials and methods: 40 patients study. Detailed history, clinical examination andinvestigations were done after proper consent. Pre operative diagnosis was made on anteroposterior and lateral views of plan x rays. Retrograde Intramedullary fixation was done underimage control. All post operative patients were followed regularly on opd basis and outcomeof intramedullary fixation was determined on 6th post-operative month. Results: There were40 patients who underwent arthrodesis and fixation. There were 82.5% male and 22.5%female with mean age of 41.5 years. 95% of the patients having pain improvement whileonly 2.5% of the patients didn’t get benefit from it. Infection and non union were seen inonly 1 patient. Conclusion: retrograde sign nail is a good option for ankle and subtalar jointarthrodesis. Early weight bearing and healing in shorter period of time are its main advantages.

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