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Evaluation of the Treatment of Patients Subjected to Osteogenesis Induced by Tibia Bone Distraction[∗]Article in several languages: português | English
11 May 2018
27 November 2018
28 February 2020 (online)
Objectives To evaluate the management of tibial fractures resulting in bone loss (traumatic or infection-related) and the complications occurring during treatment with external fixator and immediately after apparatus removal.
Methods Forty patients were selected from 2010 to 2017. The mean age of the patients was 33.02 years; 34 subjects were male and 6 were female. All patients had tibial bone regeneration, suffered trauma (mainly related to motorcycle accident) and were followed-up at an outpatient facility.
Results Proximal tibial bones of up to 17 cm in length and distal tibial bones of up to 14 cm in length were obtained. The largest trifocal transport had the same length as the regenerated bone tissues, which was 14.5 cm. Regarding complications, 29 (72.5%) patients had infections in the pin and wire paths. There were 9 (22.5%) cases of de novo fracture, 6 of which were managed with the implantation of a new circular fixator, and 2 cases of infection of the regenerated bone. On average, patients were subjected to 4.72 procedures (ranging from 2–12), had the fixator for 20.75 months (ranging from 7–55 months), and stayed at the hospital for 53.7 days (ranging from 5–183 days), mainly because of soft-tissue complications, intravenous antibacterial therapy, and even social issues. Two (5%) patients presented symptomatic gonarthrosis, and two other patients had symptomatic ankle arthritis. Three of the patients showed lower limb discrepancy of 3.0, 3.7, and 5.0 cm.
Conclusion Despite not being widely available, the Ilizarov method is useful for solving the majority of tibial bone losses, regardless of their etiology.
∗ Work performed at Hospital Maria Amélia Lins (HMAL), Belo Horizonte, MG, Brazil.
- 1 Silva WN, Martins LH, Coutinho EC. Transporte ósseo da tíbia com o método de Ilizarov nos casos de pseudartrose com falha óssea. Rev Bras Ortop 1998; 33 (10) 805-810
- 2 Tuffi GJ, Franco Filho N, Sbruzzi FC. Tratamento das infecções ósseas pelo método de Ilizarov usando o transporte ósseo e/ou a osteossíntese monofocal. Rev Bras Ortop 1997; 32 (08) 583-590
- 3 Catagni MA, Guerreschi F, Lovisetti L, Camagni M. Ricostruzioni diafisarie con apparato di Ilizarov. GIOT 2005; 31 (Suppl. 02) 464-469
- 4 Papineau LJ, Alfageme A, Dalcourt JP, Pilon L. Chronic osteomyelitis: open excision and grafting after saucerization (author's transl). Int Orthop 1979; 3 (03) 165-176
- 5 Neves J, Carvalho M, Araújo A. , et al. Método de Papineau uma opção válida no tratamento da osteomielite e/ou pseudartrose infetada. Rev Port Ortop Traumatol 2014; 22 (04) 431-438
- 6 Masquelet AC. Muscle reconstruction in reconstructive surgery: soft tissue repair and long bone reconstruction. Langenbecks Arch Surg 2003; 388 (05) 344-346
- 7 Durigan Junior A, Batista LC. Corticotomia. Rev Bras Ortop 1997; 32 (08) 623-629
- 8 Li R, Saleh M, Yang L, Coulton L. Radiographic classification of osteogenesis during bone distraction. J Orthop Res 2006; 24 (03) 339-347
- 9 Iacobellis C, Berizzi A, Aldegheri R. Bone transport using the Ilizarov method: a review of complications in 100 consecutive cases. Strateg Trauma Limb Reconstr 2010; 5 (01) 17-22
- 10 Mercadante MT, Santin RAL. Tratamento da pseudartrose da tíbia com falha óssea pelo método de Ilizarov. Rev Bras Ortop 1997; 32 (08) 591-599
- 11 Mercadante MT, Santin RAL, Ferreira RC. Análise crítica das técnicas cirúrgicas para artrodese do tornozelo. Rev Bras Ortop 2000; 35 (06) 187-193
- 12 Catagni MA, Felici JVN. Alongamento de dois níveis e o método de Ilizarov (trifocal) no tratamento da pseudartrose tibial com perda óssea. Rev Bras Ortop 1996; 31 (08) 613-619
- 13 Patzakis MJ, Wilkins J. Factors influencing infection rate in open fracture wounds. Clin Orthop Relat Res 1989; (243) 36-40