ABSTRACT
AIMS: Many authors have reported a shorter treatment time when using trifocal bone transport (TFT) rather than bifocal bone transport (BFT) in the management of long segmental tibial bone defects. However, the difference in the incidence of additional procedures, the true complications, and the final results have not been investigated. PATIENTS AND METHODS: A total of 86 consecutive patients with a long tibial bone defect (≥ 8 cm), who were treated between January 2008 and January 2015, were retrospectively reviewed. A total of 45 were treated by BFT and 41 by TFT. The median age of the 45 patients in the BFT group was 43 years (interquartile range (IQR) 23 to 54). RESULTS: The size of the bone defect was significantly longer (p = 0.005), the number of previous operations was significantly higher (p < 0.001), the operating time was significantly longer (p < 0.001), and the bone transport distance was significantly increased (p = 0.017) in the TFT group. However, the external fixation time (p < 0.001), the healing index (p < 0.001), the number of additional procedures (p = 0.013), and the number of true complications (p < 0.001) were significantly reduced in this group. Both groups achieved highly satisfactory bone and functional results. CONCLUSION: TFT can significantly reduce the treatment time, the number of additional surgical procedures, and true complications compared with BFT in the treatment of long segmental tibial bone defects.
Subject(s)
Ilizarov Technique , Tibia/surgery , Tibial Fractures/surgery , Adult , Bone Transplantation , Female , Humans , Male , Middle Aged , Osteotomy , Retrospective Studies , Tibia/diagnostic imaging , Tibia/injuries , Tibial Fractures/etiology , Young AdultABSTRACT
The Ilizarov method for leg lengthening was used for cosmetic reasons in 54 patients with constitutional short stature. A mean lengthening of 7 cm with a low rate of complications produced an excellent or good outcome in all the patients, including improvement in psychological disturbances related to short stature. Those who undergo the procedure must be highly motivated, fully informed and understand the technique and possible complications. We suggest that the Ilizarov method for cosmetic limb lengthening is a technique without major complications. However, it requires careful follow-up, and the involvement of orthopaedic surgeons who are familiar with use of the circular frame and are experienced in limb lengthening and correction of deformity for pathological conditions.
Subject(s)
Growth Disorders/surgery , Ilizarov Technique , Leg/surgery , Plastic Surgery Procedures/methods , Adolescent , Adult , Body Height , External Fixators , Female , Follow-Up Studies , Growth Disorders/psychology , Humans , Ilizarov Technique/adverse effects , Male , Middle Aged , Patient Satisfaction , Patient Selection , Postoperative Care/methods , Treatment OutcomeABSTRACT
AIMS: Limb salvage surgery combined with tumour resection has become established in the management of pelvic tumours. However, subsequent reconstructive options for maintenance of quality of life lead to varied outcomes. We present a hitherto undescribed use of the Ilizarov technique as a second stage adjunct, for the optimisation of function, after first stage tumour resection and arthrodesis. METHODS: We describe the surgical technique used to address leg length discrepancy and abductor dysfunction following internal hemipelvectomy with ischifemoral arthrodesis. Distal femoral and distal tibial lengthening using circular frames, with a valgus subtrochanteric femoral osteotomy, enabled a rapid correction of both anomalies. Controlled varus correction at the distal femoral osteotomy site was performed to obtain a horizontal joint line at the knee. CONCLUSION: The Ilizarov technique is suitable for selected patients with tumour free survival following the initial resection. Our experience indicates that it is a good alternative to a mammoth one stage internal hemipelvectomy with reconstruction. The latter is often attempted even though there is a high risk of local recurrence and distant metastasis.
Subject(s)
Extremities/physiology , Extremities/surgery , Hemipelvectomy , Ilizarov Technique , Recovery of Function/physiology , Adult , Antineoplastic Combined Chemotherapy Protocols , Bone Lengthening , Bone Neoplasms/physiopathology , Bone Neoplasms/therapy , Early Ambulation , Fibrosarcoma/physiopathology , Fibrosarcoma/therapy , Humans , MaleABSTRACT
Various surgical methods have been used for reconstruction after limb salvage surgery for pelvic tumours. We present a case of use of the Ilizarov technique as a second stage adjunct, for the improvement of function, after first stage tumour resection and arthrodesis. This technique is suitable for selected patients with tumour-free survival following the initial resection. Though not described before, our experience indicates it is an alternative to a mammoth one stage internal hemipelvectomy with reconstruction, that is often attempted even though there is a high risk of local recurrence and distant metastasis.
Subject(s)
Hemipelvectomy/rehabilitation , Ilizarov Technique , Adult , Humans , Male , Recovery of FunctionABSTRACT
Infection of the pubic symphysis after delivery is rare, and probably occurs through a small vaginal laceration and is usually silent in the early phase: as the disease progresses, bone infection, sequestra formation and septicemia man occur. This report presents one case of staphylococcal osteomyelitis of the symphysis in a twenty five years old woman, with onset of symptoms 2 months after delivery. Staphylococcus Aureus was collected from pus and blood. Bone sequestra and a large abscess extending in the rectus abdominis fascia were present. Drainage and curettage resolved infection, but sourapubic pain persisted because of symphysis disjunction, and was treated by external pelvic fixation.
