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Ilizarov’s method: a solution for infected bone loss

  • K. FabryEmail author
  • J. Lammens
  • P. Delhey
  • J. Stuyck
  • U. Z. Pellenberg
Original Article

Abstract

We report the results of 22 infected nonunions treated by radical resection and bone transport technique according to Ilizarov with a minimal follow-up period of 2 years. This series involves four fractures of the femur diaphysis, ten at tibial level, four defects of the knee and four of the upper limb. The mean length of the bone defect was 7.7 cm. The mean time from the transport procedure to frame removal was 14.5 months. In 15 cases the docking site was reviewed to refresh the bone ends at the end of the transport procedure, of which eight had a bone graft performed. Five refractures were noticed at the docking site in the nonrevised group and one in the other group. Two of them were treated conservatively and four with a new external fixator. Consolidation was achieved in all but two nonunions at the knee level, which means a succesrate of 91%. The infection could be eradicated in all 22 patients. A revision of the docking site at the end of the bone transport procedure with or without bone grafting is recommended.

Keywords

Infected bone loss Ilizarov Bone transport Refracture Revision of docking site 

La méthode d’Ilizarov, une solution pour les pertes osseuses septiques

Résumé

Nous rapportons les résultats de 22 pseudarthroses traitées par résection radicale et technique d’Ilizarov de transport osseux par ostéogenèse avec un recul minimal de deux ans. Cette série comprend quatre fractures de la diaphyse fémorale, dix du tibia, quatre défects du genou et quatre du membre supérieur. La dimension moyenne du défect osseux était de 7,7 cm. La durée moyenne à partir de l’ostéogenèse jusqu’à l’ablation du fixateur d’Ilizarov était de 14.5 mois. Dans 15 cas, la zone réceptrice a été révisée pour aviver les surfaces osseuses à la fin de la période de transport osseux et huit de ces cas bénéficièrent à ce stade d’une greffe osseuse. Cinq refractures furent notées dans le groupe de cas non révisés et seulement une dans le groupe des cas révisés. Deux de ces fractures itératives furent traitées de façon conservatoire et quatre avec un nouveau fixateur externe. La consolidation fut acquise dans tous les cas sauf deux cas de pseudarthroses du genou, ce qui nous donne un taux de succès de 91 %. L’infection put être éradiquée chez tous les patients. Une révision de la zone receveuse à la fin du transport osseux avec ou sans greffe osseuse est recommandée.

Mots clés

pertes osseuses infectées Ilizarov transport osseux refracture révision de l’os receveur 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • K. Fabry
    • 1
    • 2
    Email author
  • J. Lammens
    • 1
  • P. Delhey
    • 1
  • J. Stuyck
    • 1
  • U. Z. Pellenberg
    • 2
  1. 1.The university hospital LeuvenLeuvenBelgium
  2. 2.Department of Orthopaedic SurgeryLubbeek, PellenbergBelgium

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