Bone transport osteogenesis for treatment of canine osteomyelitis

2010 ◽  
Vol 23 (02) ◽  
pp. 134-140 ◽  
Author(s):  
S. W. Petersen ◽  
L. M. Déjardin ◽  
D. Ting
Keyword(s):  
Bone Defects ◽  
Bone Transport ◽  
Infected Nonunion ◽  
Non Union ◽  
Post Surgery ◽  
Bone Segment ◽  
Extensive Debridement ◽  
Segmental Bone ◽  
Osseous Defects

SummaryBone transport osteogenesis, as described by Ilizarov, has been used to resolve segmental bone defects in both human and veterinary patients. These defects are created when a large osseous tumour, sequestrum, or non-union fracture is resected. This report documents two cases in which the principle of bone transport osteogenesis was applied by utilising the Ilizarov technique to bridge large osseous defects resulting from debridement of an infected nonunion fracture (case 1) and debridement of a sequestrum (case 2). Defects were treated by transporting either a complete or a hemi-circumferential bone segment. Both cases had resolution of osteomyelitis, satisfactory fracture union, and functional usage of the limb 39 weeks and 15 weeks post-surgery, respectively. Although manageable complications were encountered during the treatment of these cases, the long-term clinical outcome was eventually favorable. The authors believe that bone transport osteogenesis offers a valid restorative option in the treatment of bone defects resulting from extensive debridement and sequestrectomy.

scholarly journals Treatment of diaphyseal forearm defects caused by infection using Ilizarov segmental bone transport technique

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yanshi Liu ◽  
Maimaiaili Yushan ◽  
Zhenhui Liu ◽  
Jialin Liu ◽  
Chuang Ma ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
External Fixator ◽  
Bone Defects ◽  
Bone Transport ◽  
Segmental Bone Transport ◽  
The Mean ◽  
Forearm Bone ◽  
Segmental Bone ◽  
Transport Technique

Abstract Background The Ilizarov segmental bone transport technique can be applied in the reconstruction of the bone defects with less invasive fashion and more versatility compared to other methods, while most studies were focused on the lower extremity. The purpose of this study was to evaluate the effectiveness of the Ilizarov segmental bone transport technique in the treatment of diaphyseal forearm bone defects caused by infection. Methods This study included 12 patients with diaphyseal forearm bone defects caused by infection, who underwent bone transport procedures using the monolateral external fixator at our institution from January 2010 to January 2018, including 10 males and 2 females with a mean age of 39 years (range 23–57 years). Patient’s demographic data and clinical outcomes at least two years follow-up after removing the external fixator were collected and retrospectively analyzed. The functional results were evaluated by the questionnaire of Disability of Arm, Shoulder and Hand (DASH) and the modified Mayo wrist score (MWS) at the final follow-up. Results There were 10 radii and 2 ulnae bone transport procedures collected. The average defect size was 5.1 cm (4-6.5 cm). All patients were successfully followed up with a mean period of 28.2 months (24 to 36 months) and achieved infection-free union. There was no recurrence of infection observed. The mean external fixation time was 232.6 days (182 to 276 days), and the mean external fixation index was 46.3 days/cm (40.9 to 61.8 days/cm). The mean DASH score was 30.6(18 to 49) preoperative, while 13.8 (5 to 26) at the final follow-up. The average modified MWS improved from 68.8 (55 to 80) pre-operatively to 83.8 (65 to 90) at the final follow-up. All the differences between the preoperative and final scores were statistically significant (p < 0.05). Almost all the patients achieved satisfactory clinical outcomes and were able to perform activities of daily living. Conclusions Ilizarov segmental bone transport technique is an alternative and effective method for the treatment of diaphyseal forearm bone defects caused by infection, and this method acquired satisfactory clinical outcomes.

scholarly journals Fibula-Assisted Segment Transport (FAST) for Defect Reconstruction after Resection of Tibial Adamantinoma: Report of Two Treatments

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
A. Rachbauer ◽  
A. Laufer ◽  
G. Gosheger ◽  
G. Toporowski ◽  
A. Frommer ◽  
...  
Keyword(s):  
Limb Lengthening ◽  
Bone Defects ◽  
Wide Resection ◽  
Leg Length ◽  
Segment Transport ◽  
Bone Segment ◽  
Segmental Bone ◽  
Bone Segment Transport ◽  
Large Bone ◽  
Large Bone Defects

Intramedullary limb lengthening via lengthening nails has been performed for more than three decades to overcome leg length inequalities. Plate-assisted bone segment transport (PABST) has recently been described for the reconstruction of segmental bone defects. We modified this procedure by using the ipsilateral fibula as a “biological plate” and report on its technical particularities and application in the reconstructive treatment of adamantinomas of the tibia in two patients. Both patients were successfully treated by wide resection and reconstruction of the tibial bone via bone segment transport through an expandable intramedullary nail using the remaining ipsilateral fibula to provide stabilization and guidance. This procedure was titled “fibula-assisted segment transport” (FAST). This is a new and promising technique that allows an entirely biological reconstruction of large bone defects of the tibia.

scholarly journals Implant Survival, Clinical Outcome and Complications of Megaprosthetic Reconstructions Following Sarcoma Resection

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 351
Author(s):  
Christoph Theil ◽  
Jan Schwarze ◽  
Georg Gosheger ◽  
Burkhard Moellenbeck ◽  
Kristian Nikolaus Schneider ◽  
...  
Keyword(s):  
High Risk ◽  
Clinical Outcome ◽  
Lower Limb ◽  
Functional Outcomes ◽  
Bone Defects ◽  
Implant Survival ◽  
Implant Survivorship ◽  
Orthopedic Oncology ◽  
Segmental Bone

Megaprosthetic reconstruction of segmental bone defects following sarcoma resection is a frequently chosen surgical approach in orthopedic oncology. While the use of megaprostheses has gained popularity over the last decades and such implants are increasingly used for metastatic reconstructions and in non-tumor cases, there still is a high risk of long-term complications leading to revision surgery. This article investigates current implant survivorship, frequency and types of complications as well as functional outcomes of upper and lower limb megaprosthetic reconstructions.

scholarly journals Use of Tantalum Trabecular Metal Cones for Management of Nonunion of the Distal Femur with Segmental Bone Defects: Technique and Case Series

2021 ◽  
Vol 11 (7) ◽  
Author(s):  
Alan W Reynolds ◽  
Patricia R Melvin ◽  
Eric J Yakish ◽  
Nicholas Sotereanos ◽  
Gregory T Altman ◽  
...  
Keyword(s):  
Distal Femur ◽  
Case Series ◽  
Bone Defects ◽  
Autologous Bone Graft ◽  
Trabecular Metal ◽  
Non Union ◽  
Segmental Bone ◽  
Keywords Femur ◽  
Segmental Bone Defects

Introduction: Segmental bone loss in the distal femur presents a challenge for reconstruction regardless of etiology. Use of tantalum trabecular metal cones with intramedullary fixation and autologous bone graft may be used as a salvage technique in difficult situations where other options have either been exhausted or are unavailable. Case Report: Surgical planning and technique for this approach to reconstruction are described. A retrospective review of five cases with >1 year of follow-up was performed to provide radiographic and clinical outcomes. All five patients had satisfactory outcomes with clinical union and retention of implants at final follow-up (average >4 years). Conclusions: Use of tantalum metal cones for reconstruction of distal femur nonunion with segmental bone defects can be a successful technique in a complex group of patients. Keywords: Femur, bone defect, non-union, induced membrane, tantalum.

scholarly journals Bone transport with magnetic intramedullary nails in long bone defects

2020 ◽  
Author(s):  
Selina Summers ◽  
Matija Krkovic
Keyword(s):  
Varus Deformity ◽  
Bone Defects ◽  
Bone Transport ◽  
Long Bone ◽  
Diaphyseal Bone ◽  
Sf 36 ◽  
Bone Segment ◽  
The Mean ◽  
Bone Segment Transport

Abstract Background This study describes the outcomes of internal bone transport with magnetic nails in five cases of traumatic segmental femoral bone defects. Methods Five patients with open fracture of the femur and diaphyseal bone loss were included between May 2018 and August 2020. The mean femoral defect was 8.7 cm (range 5.6–16.0). Intervention We used plate-assisted bone segment transport (PABST) with PRECICE magnetic nails. Results All five patients have fully consolidated. The mean consolidation time and index were 7.5 months and 0.8 mo/cm, respectively. The mean follow-up was 21.3 months. The main complications were reduced knee ROM, mild varus deformity and plate bending. Post-operative SF-36, Oxford Knee scores and ED-5Q-5L scores were also compiled for four of five patients. SF-36 and Oxford Knee scores were reported without pre-injury data for comparison. ED-5Q-5L index and VAS were compared UK population norm and were both found to be statistically insignificant (p = 0.071 and p = 0.068, respectively). Conclusion Bone transport with magnetic nails has the capacity to obtain good functional recovery in long bone defects despite variable outcome pictures. In response to variable outcome reporting in the literature, we propose a standard reporting template for future studies to facilitate more rigorous analyses.

Characterization of Tissue-Engineered Human Periosteum and Allograft Bone Constructs: The Potential of Periosteum in Bone Regenerative Medicine

2020 ◽  
Vol 209 (2–3) ◽  
pp. 128-143
Author(s):  
Qing Yu ◽  
Robin DiFeo Jacquet ◽  
William J. Landis
Keyword(s):  
Gene Expression ◽  
Tissue Engineering ◽  
Regenerative Medicine ◽  
Bone Formation ◽  
Bone Defects ◽  
Delayed Union ◽  
Non Union ◽  
Segmental Bone ◽  
First Time ◽  
Segmental Bone Defects

Delayed-union or non-union between a host bone and a graft is problematic in clinical treatment of segmental bone defects in orthopedic cases. Based on a preliminary study of human periosteum allografts from this laboratory, the present work has extensively investigated the use of human cadaveric tissue-engineered periosteum-allograft constructs as an approach to healing such serious orthopedic surgical situations. In this current report, human cadaveric periosteum-wrapped bone allografts and counterpart controls without periosteum were implanted subcutaneously in athymic mice (<i>nu/nu</i>) for 10, 20, and, for the first time, 40 weeks. Specimens were then harvested and assessed by histological and gene expression analyses. Compared to controls, the presence of new bone formation and resorption in periosteum-allograft constructs was indicated in both histology and gene expression results over 40 weeks of implantation. Of several genes also examined for the first time, <i>RANKL</i> and <i>SOST</i> expression levels increased in a statistically significant manner, data suggesting that bone formation and the presence of increasing numbers of osteocytes in bone matrices had increased with time. The tissue-engineering strategy described in this study provides a possible means of improving delayed-union or non-union at the healing sites of segmental bone defects or bone fractures. The potential of periosteum and its resident cells could thereby be utilized effectively in tissue-engineering methods and tissue regenerative medicine.

The Challenges of Monoaxial Bone Transport in Orthopedics and Traumatology

2017 ◽  
Vol 19 (4) ◽  
pp. 0-0 ◽  
Author(s):  
Michele Bisaccia ◽  
Giuseppe Rinonapoli ◽  
Luigi Meccariello ◽  
Auro Caraffa ◽  
Bartosz Cukierman ◽  
...  
Keyword(s):  
External Fixator ◽  
Bone Defects ◽  
Bone Transport ◽  
Lower Limbs ◽  
Limb Amputation ◽  
Soft Tissue Reconstruction ◽  
Non Union ◽  
Duration Of Hospitalization ◽  
Monolateral External Fixator

Background. Bone defects represent the main challenging problem for the orthopedic surgeon and, consequently, they increase the duration of hospitalization, risk of complications and health expenditures. The aim of our observational, descriptive and retrospective study is to evaluate the outcomes of patients treated with a mo­nolateral external fixator for bone defects greater than 3 cm. Material and methods. Between January 2003 and January 2013, 21 patients were treated at our center by bone transfer with a monolateral external fixator. The main etiologies were trauma in 17 cases (80.9%) and tumors in 4 cases (19.1%). Mean follow-up was 5 years for non-union and 3 years for tumors. Our clinical evaluation was based on ASAMI (Association for the Study ad Application of the Methods of Ilizarov) scores during this follow-up period. Results. The functional outcomes, based on ASAMI scores, were excellent in 12 cases, good in 7 and poor in 2. Conclusion. 1. A review of the literature related to our experience shows that bone transport is an effective tech­nique to repair loss of bone in the lower limbs. The use of a system of external fixation enables corrective actions throughout the treatment that can be in­dividualized on a case-by-case basis. In our experience, the LRS fixator (Orthofix) is a sta­ble, easy-to-use and very handy device. 2. In situations where soft tissue reconstruction procedures are needed, the size and shape of the splint should be such as not to constitute an obstacle. Fur­thermore, the use of pins rather than transfixation wires eliminates the risk of neuro / vascu­lar injury such as may occur during the application of a circular fixator. 3. The analysis of the cases presented here indicates that where possible the technique of bone transport produces good results and can often salvage the limb. Amputation should be reserved only for cases where the general and / or local preoperative status indicate that the surgeon can expect a poor result or when the compliance of the patient is determined to be inadequate.

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