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Ilizarov non-free bone plasty for extensive tibial defects

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Abstract

Purpose

The purpose of this study was to present a retrospective comparative overview of the Ilizarov non-free bone plasty techniques of one-stage multilevel fragment lengthening and gradual tibilisation of the fibula used for extensive tibial defect management.

Methods

Extensive tibial defects in 83 patients were managed either by multilevel fragment lengthening (group I, n = 41, mean defect size 13.1 ± 0.9 cm) or gradual tibilisation of the fibula (group II, n = 42, mean defect size 12.5 ± 1.2 cm) using the Ilizarov apparatus. The initial findings, treatment protocols and outcomes of those patients treated within the period 1972–2011 were studied retrospectively by medical records and radiographs, and statistically assessed with Microsoft Excel and Attestat software.

Results

Group I had multilevel fragment lengthening over one stage that averaged 288.0 ± 14.4 days. The mean total period of gradual tibilisation of the fibula in group II was 316.0 ± 29.7 days. The patient’s age in the latter group had an effect on the completeness of leg-length equalisation.

Conclusions

The techniques can be used to manage extensive tibial defects as all the defects bridged, leg-length discrepancy and deformity were corrected and patients were able to load their limbs.

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References

  1. Kanczler JM, Oreffo RO (2008) Osteogenesis and angiogenesis: the potential for engineering bone. Eur Cell Mater 15:100–114

    PubMed  CAS  Google Scholar 

  2. Green SA (1994) Skeletal defects. A comparison of bone grafting and bone transport for segmental skeletal defects. Clin Orthop 301:111–117

    PubMed  Google Scholar 

  3. Rose RE (2002) The Ilizarov technique in the treatment of tibial bone defects. Case reports and review of the literature. West Indian Med J 51(4):263–267

    PubMed  CAS  Google Scholar 

  4. Cierny G, Zorn KE (1994) Segmental tibial defects. Comparing conventional and Ilizarov methodologies. Clin Orthop 301:118–123

    PubMed  Google Scholar 

  5. Judet H, Gilbert A, Mathoulin C, Judet J, Judet T, Siguier M, Brumpt B (1991) Reconstruction of loss of bony substance in limbs by free vascularized fibula transplant. Chirurgie 117(5–6):469–476 (in French)

    PubMed  CAS  Google Scholar 

  6. Atkins RM, Madhavan P, Sudhakar J, Whitwell D (1999) Ipsilateral vascularised fibular transport for massive defects of the tibia. J Bone Joint Surg Br 81(6):1035–1040

    Article  PubMed  CAS  Google Scholar 

  7. Kühner C, Simon R, Bernd L (2001) Vascularized fibula transplantation in orthopedic oncology. Personal experience and review of the literature. Orthopade 30(9):658–665 (in German)

    Article  PubMed  Google Scholar 

  8. Yokoyama K, Itoman M, Nakamura K, Tsukamoto T, Saita Y, Aoki S (2001) Free vascularized fibular graft vs. Ilizarov method for post-traumatic tibial bone defect. J Reconstr Microsurg 17(1):17–25

    Article  PubMed  CAS  Google Scholar 

  9. El-Gammal TA, Shiha AE, El-Deen MA, El-Sayed A, Kotb MM, Addosooki AI, Ragheb YF, Saleh WR (2008) Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport: a comparative study. Microsurgery 28(5):339–346

    Article  PubMed  Google Scholar 

  10. Ilizarov GA (1992) Pseudoarthrosis and defects of long tubular bones. In: Transosseous osteosynthsis. Springer, Berlin Heidelberg, pp 453–494

    Chapter  Google Scholar 

  11. Shevtsov VI, Makushin VD, Kuftyrev LM (2000) Defects of the lower limb bones. Treatment based on Ilizarov techniques. Chapters 8–12, pp 329–661. Zauralie, Kurgan http://www.ilizarov.ru/en/index.php?option=com_content&view=article&id=304&Itemid=328. Accessed 24 January 2013

  12. Cattaneo R, Catagni M, Johnson EE (1992) The treatment of infected nonunions and segmental defects of the tibia by the methods of Ilizarov. Clin Orthop 280:143–152

    PubMed  Google Scholar 

  13. Green SA, Jackson JM, Wall DM, Marinow H, Ishkanian J (1992) Management of segmental defects by the Ilizarov intercalary bone transport method. Clin Orthop Relat Res 280:136–142

    PubMed  Google Scholar 

  14. Lenoble E, Lewertowski JM, Goutallier D (1995) Reconstruction of compound tibial and soft tissue loss using a traction histogenesis technique. J Trauma 39(2):356–360

    Article  PubMed  CAS  Google Scholar 

  15. Gaidyshev IP (2004) Solutions for scientific and engineering tasks using Excel, VBA and C/C++. BHV-Peterburg, St. Petersburg (in Russian) http://www.ozon.ru/context/detail/id/1677525/. Accessed 24 January 2013

  16. Borzunov DY (2012) Long bone reconstruction using multilevel lengthening of bone defect fragments. Int Orthop 36(8):1695–1700

    Article  PubMed  Google Scholar 

  17. Lovisetti G, Sala AN, Miller AM, Thabed V, Zotolla D, Capitani F (2012) Clinical reliability of closed techniques and comparison with open strategies to achieve union at the docking site. Int Orthop 36(4):817–825

    Article  PubMed  Google Scholar 

  18. Kassab M, Samaha C, Saillant G (2003) Ipsilateral fibular transposition in tibial nonunion using Huntington procedure: a 12-year follow-up study. Injury 34(10):770–775

    Article  PubMed  CAS  Google Scholar 

  19. Morsi E (2002) Tibial reconstruction using a non-vascularised fibular transfer. Int Orthop 26(6):377–380

    Article  PubMed  Google Scholar 

  20. Laffosse JM, Accadbled F, Abid A, Kany J, Darodes P, Sales De Gauzy J (2007) Reconstruction of long bone defects with a vascularized fibular graft after tumor resection in children and adolescents: thirteen cases with 50-month follow-up. Rev Chir Orthop Reparatrice Appar Mot 93(6):555–563

    Article  PubMed  Google Scholar 

  21. Yazar S, Lin CH, Wei FC (2004) One-stage reconstruction of composite bone and soft-tissue defects in traumatic lower extremities. Plast Reconstr Surg 114(6):1457–1466

    PubMed  Google Scholar 

  22. Catagni MA, Camagni M, Combi A, Ottaviani G (2006) Medial fibula transport with the Ilizarov frame to treat massive tibial bone loss. Clin Orthop Relat Res 448:208–216

    Article  PubMed  Google Scholar 

  23. Shiha AE, Khalifa AR, Assaghir YM, Kenawey MO (2008) Medial transport of the fibula using the Ilizarov device for reconstruction of a massive defect of the tibia in two children. J Bone Joint Surg Br 90(12):1627–1630

    Article  PubMed  CAS  Google Scholar 

  24. Shafi R, Fragomen AT, Rozbruch SR (2009) Ipsilateral fibular transport using Ilizarov-Taylor spatial frame for a limb salvage reconstruction: a case report. HSS J 5(1):31–39

    Article  PubMed  Google Scholar 

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Acknowledgments

We greatly appreciate the contributions of Prof. V.I. Shevtsov and Prof. V.D. Makushin in the development of the techniques described.

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Correspondence to Dmitry Y. Borzunov.

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Borzunov, D.Y., Chevardin, A.V. Ilizarov non-free bone plasty for extensive tibial defects. International Orthopaedics (SICOT) 37, 709–714 (2013). https://doi.org/10.1007/s00264-013-1799-3

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  • DOI: https://doi.org/10.1007/s00264-013-1799-3

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