Skip to main content
Top
Published in: International Orthopaedics 4/2013

01-04-2013 | Original Paper

Ilizarov non-free bone plasty for extensive tibial defects

Authors: Dmitry Y. Borzunov, Alexander V. Chevardin

Published in: International Orthopaedics | Issue 4/2013

Login to get access

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.
Literature
1.
go back to reference Kanczler JM, Oreffo RO (2008) Osteogenesis and angiogenesis: the potential for engineering bone. Eur Cell Mater 15:100–114PubMed Kanczler JM, Oreffo RO (2008) Osteogenesis and angiogenesis: the potential for engineering bone. Eur Cell Mater 15:100–114PubMed
2.
go back to reference Green SA (1994) Skeletal defects. A comparison of bone grafting and bone transport for segmental skeletal defects. Clin Orthop 301:111–117PubMed Green SA (1994) Skeletal defects. A comparison of bone grafting and bone transport for segmental skeletal defects. Clin Orthop 301:111–117PubMed
3.
go back to reference 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):263–267PubMed 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):263–267PubMed
4.
go back to reference Cierny G, Zorn KE (1994) Segmental tibial defects. Comparing conventional and Ilizarov methodologies. Clin Orthop 301:118–123PubMed Cierny G, Zorn KE (1994) Segmental tibial defects. Comparing conventional and Ilizarov methodologies. Clin Orthop 301:118–123PubMed
5.
go back to reference 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 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
6.
go back to reference 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):1035–1040PubMedCrossRef 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):1035–1040PubMedCrossRef
7.
go back to reference 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)PubMedCrossRef 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)PubMedCrossRef
8.
go back to reference 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):17–25PubMedCrossRef 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):17–25PubMedCrossRef
9.
go back to reference 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):339–346PubMedCrossRef 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):339–346PubMedCrossRef
10.
go back to reference Ilizarov GA (1992) Pseudoarthrosis and defects of long tubular bones. In: Transosseous osteosynthsis. Springer, Berlin Heidelberg, pp 453–494CrossRef Ilizarov GA (1992) Pseudoarthrosis and defects of long tubular bones. In: Transosseous osteosynthsis. Springer, Berlin Heidelberg, pp 453–494CrossRef
12.
go back to reference 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 280:143–152PubMed 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 280:143–152PubMed
13.
go back to reference 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 280:136–142PubMed 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 280:136–142PubMed
14.
go back to reference Lenoble E, Lewertowski JM, Goutallier D (1995) Reconstruction of compound tibial and soft tissue loss using a traction histogenesis technique. J Trauma 39(2):356–360PubMedCrossRef Lenoble E, Lewertowski JM, Goutallier D (1995) Reconstruction of compound tibial and soft tissue loss using a traction histogenesis technique. J Trauma 39(2):356–360PubMedCrossRef
16.
go back to reference Borzunov DY (2012) Long bone reconstruction using multilevel lengthening of bone defect fragments. Int Orthop 36(8):1695–1700PubMedCrossRef Borzunov DY (2012) Long bone reconstruction using multilevel lengthening of bone defect fragments. Int Orthop 36(8):1695–1700PubMedCrossRef
17.
go back to reference 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):817–825PubMedCrossRef 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):817–825PubMedCrossRef
18.
go back to reference 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):770–775PubMedCrossRef 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):770–775PubMedCrossRef
19.
go back to reference Morsi E (2002) Tibial reconstruction using a non-vascularised fibular transfer. Int Orthop 26(6):377–380PubMedCrossRef Morsi E (2002) Tibial reconstruction using a non-vascularised fibular transfer. Int Orthop 26(6):377–380PubMedCrossRef
20.
go back to reference 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):555–563PubMedCrossRef 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):555–563PubMedCrossRef
21.
go back to reference 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):1457–1466PubMed 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):1457–1466PubMed
22.
go back to reference 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 448:208–216PubMedCrossRef 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 448:208–216PubMedCrossRef
23.
go back to reference 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):1627–1630PubMedCrossRef 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):1627–1630PubMedCrossRef
24.
go back to reference 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):31–39PubMedCrossRef 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):31–39PubMedCrossRef
Metadata
Title
Ilizarov non-free bone plasty for extensive tibial defects
Authors
Dmitry Y. Borzunov
Alexander V. Chevardin
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 4/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-1799-3

Other articles of this Issue 4/2013

International Orthopaedics 4/2013 Go to the issue