Treatment of Tibial Bone Defect by Internal Bone Transport Using Ilizarov Method

Aims Many authors have reported a shorter treatment time when using trifocal bone transport (TFT) rather than bifocal bone transport (BFT) in the management of long segmental tibial bone defects. However, the difference in the incidence of additional procedures, the true complications, and the final results have not been investigated. Patients and Methods A total of 86 consecutive patients with a long tibial bone defect (≥ 8 cm), who were treated between January 2008 and January 2015, were retrospectively reviewed. A total of 45 were treated by BFT and 41 by TFT. The median age of the 45 patients in the BFT group was 43 years (interquartile range (IQR) 23 to 54). Results The size of the bone defect was significantly longer (p = 0.005), the number of previous operations was significantly higher (p < 0.001), the operating time was significantly longer (p < 0.001), and the bone transport distance was significantly increased (p = 0.017) in the TFT group. However, the external fixation time (p < 0.001), the healing index (p < 0.001), the number of additional procedures (p = 0.013), and the number of true complications (p < 0.001) were significantly reduced in this group. Both groups achieved highly satisfactory bone and functional results. Conclusion TFT can significantly reduce the treatment time, the number of additional surgical procedures, and true complications compared with BFT in the treatment of long segmental tibial bone defects.

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

10.21203/rs.3.rs-19335/v2 ◽

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.

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Case 28: Proximal Tibial Bone Defect Treated with Intentional Deformity and Bone Transport

Limb Lengthening and Reconstruction Surgery Case Atlas ◽

10.1007/978-3-319-18026-7_143 ◽

2015 ◽

pp. 197-202

Author(s):

Austin T. Fragomen

Keyword(s):

Bone Defect ◽

Bone Transport ◽

Tibial Bone

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

10.21203/rs.3.rs-19335/v1 ◽

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.

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