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A treatment for large defects of the tibia caused by infected nonunion: Ilizarov method with bone segment extension

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Objectives

To investigate the efficacy of the Ilizarov technique with bone segment extension in tibial infected nonunion.

Methods

From September 2003 to June 2011, we treated 30 patients (21 males, 9 females; age 19–49 years, mean 34.1 years) for tibial infected nonunion with bone defects. Eleven cases were compound fractures internally fixed with steel plates, nine were compound fractures internally fixed with IM Nails, eight were compound fractures externally fixed with external fixation devices, and two were closed fractures internally fixed with steel plates. All 30 patients underwent debridement followed by the Ilizarov technique using bone segment extension.

Results

After follow-up of 12 months–6 years (mean 29 months), stable union of fracture was achieved in all 30 patients. The time from bone fracture to union was 6–24 months, mean 8.8 months; external fixation was in place for 8–14 months, mean 10 months. External fixation index was 41 days/cm. Complications were three cases of pin site infection, one skin allergy, two fractures malunion, one early mineralization and one wire breakage. There were no cases of deep infection, nonunion or stiffness of the knee joint. According to the Paley fracture healing score criteria, 30 cases had excellent outcomes and two were good.

Conclusions

The Ilizarov technique with bone segment extension is effective in treating tibial infected nonunion with large bone defects.

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References

  1. Gualdrini G, Stagni C, Fravisini M, Giunti A (2002) Infected nonunion of the femur. Chir Organi Mov 87:225–233

    CAS  PubMed  Google Scholar 

  2. Motsitsi NS (2008) Management of infected nonunion of long bones: the last decade (1996–2006). Injury 39:155–160

    Article  CAS  PubMed  Google Scholar 

  3. Farmanullah, Khan MS, Awais SM (2007) Evaluation of management of tibial non-union defect with Ilizarov fixator. J Ayub Med Coll Abbottabad 19:34–36

  4. Jain AK, Sinha S (2005), Infected nonunion of the long bones. Clin Orthop Relat Res 431:57–65

    Article  PubMed  Google Scholar 

  5. Kim H et al (2009) Tibial lengthening using a reamed type intramedullary nail and an Ilizarov external fixator. Int Orthop 33:835–841

    Article  PubMed Central  PubMed  Google Scholar 

  6. Paley D et al. (1989) Ilizarov treatment of tibial nonunions with bone loss. Clin Orthop Relat Res 241:146–165

    PubMed  Google Scholar 

  7. Rodriguez-Merchan EC, Forriol F (2004) Nonunion: general principles and experimental data. Clin Orthop Relat Res 418:4–12

    Article  Google Scholar 

  8. Patzakis MJ, Zalavras CG (2005) Chronic posttraumatic osteomyelitis and infected nonunion of the tibia: current management concepts. J Am Acad Orthop Surg 13:417–427

    PubMed  Google Scholar 

  9. May JW Jr, Jupiter JB, Weiland AJ, Byrd HS (1989) Clinical classification of post-traumatic tibial osteomyelitis. J Bone Joint Surg Am 71:1422–1428

    PubMed  Google Scholar 

  10. Mechrefe AP, Koh EY, Trafton PG, DiGiovanni CW (2006) Tibial nonunion. Foot Ankle Clin 11:1–18

    Article  PubMed  Google Scholar 

  11. Lazzarini L, Mader JT, Calhoun JH (2004) Osteomyelitis in long bones. J Bone Joint Surg Am 86-A:2305–2318

    PubMed  Google Scholar 

  12. Ilizarov GA (1989) The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. Clin Orthop Relat Res 238:249–281

    PubMed  Google Scholar 

  13. Abdel-Aal AM (2006) Ilizarov bone transport for massive tibial bone defects. Orthopedics 29:70–74

    PubMed  Google Scholar 

  14. Saridis A et al (2006) The use of the Ilizarov method as a salvage procedure in infected nonunion of the distal femur with bone loss. J Bone Joint Surg Br 88:232–237

    Article  CAS  PubMed  Google Scholar 

  15. Ilizarov GA (1990) Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res 250:8–26

    PubMed  Google Scholar 

  16. Mullins MM, Davidson AW, Goodier D, Barry M (2003) The biomechanics of wire fixation in the Ilizarov system. Injury 34:155–157

    Article  CAS  PubMed  Google Scholar 

  17. 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 

Download references

Acknowledgments

The authors did not receive grants or funding in support or preparation of this article. No commercial entity paid or directed any benefits to any research fund, educational institution, or nonprofit organization with which the authors are affiliated or associated.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Tianjin Medical University General Hospital, No. 154 Anshan Road, Tianjin, 300052, China

    K. Xu, C.-G. Wang & Z.-J. Li

  2. Immunology Department, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070, China

    Z.-J. Li

  3. Department of Orthopedics, Tianjin Hospital, Tianjin, 300211, China

    X. Fu

  4. Department of Rehabilitation, Tianjin Hospital, Tianjin, 300211, China

    Y.-M. Li

Authors
  1. K. Xu
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  2. X. Fu
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  3. Y.-M. Li
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  4. C.-G. Wang
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  5. Z.-J. Li
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Corresponding author

Correspondence to Z.-J. Li.

Additional information

K. Xu and X. Fu contributed equally to this study.

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Xu, K., Fu, X., Li, YM. et al. A treatment for large defects of the tibia caused by infected nonunion: Ilizarov method with bone segment extension. Ir J Med Sci 183, 423–428 (2014). https://doi.org/10.1007/s11845-013-1032-9

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  • DOI: https://doi.org/10.1007/s11845-013-1032-9

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