Clinical Outcomes of Ilizarov Bone Transport for Distal Tibial Defects in Refractory Osteomyelitis: A Retrospective Study.

IF 2.8 3区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics
Therapeutics and Clinical Risk Management Pub Date : 2025-09-17 eCollection Date: 2025-01-01 DOI:10.2147/TCRM.S525768
Abudusalamu Alimujiang, Qiyu Jia, Jian Guo, Jun Zhang, Xi Wang, Meng Zhao, Meidege Ouzhabayier, Yingbo Wang, Chuang Ma
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引用次数: 0

Abstract

Background: Distal tibial defects following refractory osteomyelitis pose a significant orthopedic challenge, necessitating effective reconstruction. The Ilizarov bone transport technique is a potential treatment option, but its clinical outcomes specifically for distal tibial infectious defects need further evaluation.

Methods: In this retrospective observational single-arm study, we analyzed the clinical data of 22 patients who had undergone multiple debridements for refractory distal tibial osteomyelitis (DTO) and had associated bone defects, and were subsequently treated with the Ilizarov bone transport technique. Following debridement surgery, bone transport treatment was administered. Regular X-ray examinations, rehabilitation guidance, and follow-up were conducted to assess infection control, bone healing, limb function recovery, and complications. Therapeutic effects were evaluated using the Association for the Study and Application of Methods of Ilizarov (ASAMI), Visual Analog Scale (VAS) score, Activities of Daily Living (ADL) score, and American Orthopaedic Foot & Ankle Society (AOFAS) score improvement.

Results: The mean follow-up was 29.32±20.92 months, with an average of 3.77±1.83 debridements. All bone defects healed, though 5 patients later required ankle arthrodesis. Complications included pin tract infection (n=10), axial deviation (n=3), ankle joint stiffness (n=2), non-union at the docking site (n=2), and delayed consolidation (n=2). At the last follow-up, ASAMI bone results: 15 excellent, 5 good, 2 poor (90.9% superiority rate). ASAMI functional results: 6 excellent, 14 good, 1 fair, 1 poor (90.9% superiority rate). VAS decreased from 4.86±0.83 to 0.5±0.66 (p<0.001). ADL improved from 80 (78.75-85) to 92.5 (90-95) (p<0.001). AOFAS score increased from 32 (25-38.25) to 82 (77-87.5) (p<0.001), with an 86.4% overall superiority rate.

Conclusion: Bone transport post - debridement is a valuable salvage for reconstructing distal tibial defects post-refractory osteomyelitis, with high safety, healing rate, and good efficacy. However, further comparative studies are warranted to confirm its advantages over other treatments.

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Ilizarov骨运输治疗难治性骨髓炎胫骨远端缺损的临床效果:回顾性研究。
背景:难治性骨髓炎后的胫骨远端缺损对骨科造成了重大挑战,需要进行有效的重建。Ilizarov骨运输技术是一种潜在的治疗选择,但其临床结果特别是胫骨远端感染性缺陷需要进一步评估。方法:在这项回顾性观察性单臂研究中,我们分析了22例因难治性胫骨远端骨髓炎(DTO)并伴有骨缺损而行多次清创手术并随后采用Ilizarov骨转运技术治疗的患者的临床资料。清创手术后,进行骨运输治疗。定期进行x线检查、康复指导和随访,以评估感染控制、骨愈合、肢体功能恢复和并发症。采用Ilizarov方法研究与应用协会(ASAMI)、视觉模拟量表(VAS)评分、日常生活活动(ADL)评分和美国骨科足踝学会(AOFAS)评分改善来评估治疗效果。结果:平均随访29.32±20.92个月,平均清创3.77±1.83次。所有骨缺损均愈合,但5例患者后来需要进行踝关节融合术。并发症包括针道感染(n=10)、轴向偏离(n=3)、踝关节僵硬(n=2)、对接部位不愈合(n=2)和延迟实变(n=2)。末次随访ASAMI骨结果:优15例,良5例,差2例(优良率90.9%)。ASAMI功能结果:优6例,良14例,一般1例,差1例(优良率90.9%)。VAS由4.86±0.83降至0.5±0.66。结论:骨转运清创后修复难治性骨髓炎后胫骨远端缺损是一种有价值的修复方法,安全性高,治愈率高,疗效好。然而,需要进一步的比较研究来证实其优于其他治疗方法。
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来源期刊
Therapeutics and Clinical Risk Management
Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-
CiteScore
5.30
自引率
3.60%
发文量
139
审稿时长
16 weeks
期刊介绍: Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.
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