Open segmental tibial bone defects treated with Ilizarov frame: a radiological and functional outcome study with average ten year follow-up.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI:10.1007/s00264-024-06277-3

Birendra Bahadur Chand, Ansul Rajbhandari, Ashok Kumar Banskota, Bibek Banskota

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Abstract

Purpose: Surgical reconstruction of large post-traumatic tibial bone and soft tissue defects following high-energy trauma presents a significant challenge for orthopaedic surgeons. This study aimed to evaluate the functional and radiological outcomes of large post-traumatic tibial bone and soft tissue defects managed by single or double-level bone transport using the Ilizarov technique.

Material & methods: 13 patients who underwent treatment for large tibial bone defects (Gustillo IIIa, IIIb, IIIc) along with soft tissue defects with Ilizarov from 2010 to 2020 A.D were included. ASAMI functional and radiological outcomes were assessed at the final follow-up to report the outcome.

Results: The mean age was 27.38 (18-48). An average bone defect was 7.69 cm (5-13 cm). Based upon the Gustillo-Anderson classification (GA), 2 (15%) of them were GA - 3 A, 7 (54%) were GA - 3B, and 4 (31%) were GA - 3 C. The average time of distraction was 11.76 weeks (8-16). The average time for the union was 37 weeks (27-48 weeks). The average bone lengthening was 7.69 cm (5-13 cm). The mean final leg length discrepancy (LLD) at the final follow-up was 1.96 cm (0-4 cm). The primary union was achieved in eight cases, and five required bone grafting at the docking site. Using the ASAMI (Association for the Study of the Method of Ilizarov) scoring system, the functional results were excellent in six and good in seven cases, while the bony results were excellent in eight, good in four and fair in one case.

Conclusion: Good to excellent functional and radiological scores (ASAMI) can be expected when using the Ilizarov frame for simultaneous treatment of the large tibial bone and soft tissue defect when this method is applied with correct principles.

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使用 Ilizarov 框架治疗开放性胫骨节段性骨缺损：平均十年随访的放射学和功能结果研究。

目的：高能量创伤后胫骨和软组织大面积缺损的手术重建对骨科医生来说是一项重大挑战。本研究旨在评估采用 Ilizarov 技术进行单层或双层骨搬运处理的创伤后胫骨和软组织大面积缺损的功能和放射学结果。材料和方法：纳入了 13 例在公元 2010 年至 2020 年期间接受 Ilizarov 治疗的胫骨大面积缺损（Gustillo IIIa、IIIb、IIIc）和软组织缺损患者。最后随访时对 ASAMI 功能和放射学结果进行评估，以报告结果：平均年龄为 27.38 岁（18-48 岁）。平均骨缺损为 7.69 厘米（5-13 厘米）。根据古斯蒂洛-安德森（Gustillo-Anderson）分类法（GA），其中 2 例（15%）为 GA - 3 A，7 例（54%）为 GA - 3 B，4 例（31%）为 GA - 3 C。骨结合的平均时间为 37 周（27-48 周）。平均骨延长时间为 7.69 厘米（5-13 厘米）。最后随访时的平均腿长差异（LLD）为 1.96 厘米（0-4 厘米）。8例患者实现了初次骨结合，5例患者需要在对接部位进行植骨。采用ASAMI（伊利扎洛夫方法研究协会）评分系统，功能结果为优的有6例，良的有7例；骨性结果为优的有8例，良的有4例，一般的有1例：结论：在使用伊利扎罗夫框架同时治疗胫骨大块骨质和软组织缺损时，如果遵循正确的原则，功能和放射学评分（ASAMI）可望达到良好至优秀。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.