BACKGROUND: The aim of this study was to assess the results of using the Ilizarov apparatus to transport bones in the treatment of benign bone tumors. METHODS: Seven patients (six males and one female) with benign bone tumors were treated by bone transport with an Ilizarov apparatus at our institution. Their mean age at surgery was 14.4 years (range, 4.8 to 36.9 years). The histological diagnoses were osteofibrous dysplasia (4), giant-cell tumor (1), intraosseous cavernous hemangioma (1), and aneurysmal bone cyst (1). Three radiological indices were used for evaluating the results: an external fixation index, a distraction index, and a maturation index. The bone and functional results were evaluated according to the Association for the Study and Application of the Method of Ilizarov classification. RESULTS: Five patients had bone union at the reconstructed site, one patient had a local recurrence, and the other had a nonunion at the docking site. The mean length of distraction was 7.3 cm (range, 5.1 to 12.1 cm). The mean external fixation index was 26.0 day/cm (range, 19.8 to 32.5 day/cm), the distraction index was 9.6 day/cm (range, 6.8 to 12.0 day/cm), and the maturation index was 14.9 day/cm (range, 8.0 to 22.5 day/cm). Ultimately, the bone and the functional results were rated excellent in six cases and good in one case. CONCLUSIONS: Bone transport using the Ilizarov apparatus is a good treatment option in patients with bone defects after the resection of an active or aggressive benign bone tumor.
Adolescent ; Adult ; Bone Neoplasms/*surgery ; Child ; Child, Preschool ; Female ; Humans ; Ilizarov Technique/*instrumentation ; Male ; Young Adult

Difficult femoral nonunion takes account of infective nonunion and aseptic gap nonunion. Limb length discrepancy and nonunion need to be tackled simultaneously. Conventionally Ilizarov ring fixator is in vogue but it has some limitations. To overcome these, monorail fixator is an effective alternative. Persistent good results can be obtained if we can get a perfect anatomical alignment and good regeneration.
External Fixators ; Femoral Fractures ; surgery ; Fracture Fixation ; instrumentation ; Fractures, Ununited ; surgery ; Humans ; Ilizarov Technique

OBJECTIVETo evaluate the clinical and functional outcomes of infected nonunion of the tibia by internal bone transport using the LRS mono-lateral external fixation.

METHODSFrom June 2003 to October 2005, twenty-eight patients who underwent internal bone transport for infected nonunion in the tibia were reviewed. Twenty-three cases were open fractures: grade IIIA, 5 cases; grade IIIB, 11 cases; grade IIIC, 7 cases. The other five cases were infected nonunion after internal fixation. The results were evaluated by the classification of the Association for the Study and Application of the Method of Ilizarove (ASAMI) which divided into bone and functional categories.

RESULTSMean follow-up was 16 months. All the cases got primary bone union, and infection was controlled. Bone results were 14 excellent, 9 good, 2 fair and 3 poor. And functional results were 10 excellent, 13 good, 2 fair and 3 poor. The mean length of time in healing for all patients were 9 months. The mean length of regenerate bone were 6.6 cm. The most common complication was pin infection, and 2 cases refractured at the docking site.

CONCLUSIONSTibial infected nonunion can be successfully treated using the internal bone transport technique.

Adolescent ; Adult ; Female ; Fractures, Ununited ; surgery ; Humans ; Ilizarov Technique ; instrumentation ; Male ; Middle Aged ; Retrospective Studies ; Tibial Fractures ; surgery ; Treatment Outcome

OBJECTIVETo shorten the time of external skeletal fixation on legs, and enhance quality of limb lengthening, avoid complications of shortening, bending, twisting and etc.

METHODSInsert pin transcortical to attack external skeletal fixation simultaneously, put un-reaming locked intramedullary nail (do not insert distal locked screw) into endosteum of lengthening bone. After the legs achieved predetermined length, insert distal locked screw and then remove external skeletal fixation, locked intramedullary nail, then maintain consolidation of rehabilitation.

RESULTSThe group lengthened legs for 412 cases. The range of lengthening was 3 to 18 cm. Mean length was 7.6 cm. The mean time for needed external skeletal fixation was 20 d/cm. The mean time of osteogenesis was 56 d/cm. For complications, there were 3 tibias ununion cases and 1 varus ankle. All cases were treated undergoing twice.

CONCLUSIONSThe method reduces the time for needed external skeletal fixation visibly, enhances the quality of limb lengthening remarkably, prevents complications of shortening new bone, deformity, bending and re-fracture which do not effect the healing time. This is a new choice of limb lengthening.

Adult ; Bone Lengthening ; instrumentation ; methods ; Bone Nails ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; instrumentation ; Humans ; Ilizarov Technique ; instrumentation ; Male ; Middle Aged ; Tibia ; surgery ; Treatment Outcome

PURPOSEIlizarov ring fixator and limb reconstruction system (LRS) fixators have been used in the management of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated. Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing. Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures. Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators.

METHODSThis prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, India and included 32 patients of compound tibial shaft fractures with or without infected nonunion. There were 26 males and 6 females and the average age was 40 years. Patients were randomly divided into two groups (n=16 for each): one underwent Ilizarov fixation and the other received LRS fixation. Cases were followed up for 3-24 months, 6 months on average from September 2012 to October 2014. Functional and radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators.

RESULTSUnion was achieved in all cases. Radiological outcome was found excellent in 68.75%, good in 18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators. Functional result was satis- factory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs. 31.25%.

CONCLUSIONIn our short-term assessment, LRS fixators show a better result than Ilizarov fixators in terms of fracture union and functional outcome with soft tissue care and limb length.

Adult ; Aged ; External Fixators ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Ilizarov Technique ; instrumentation ; Male ; Middle Aged ; Prospective Studies ; Tibial Fractures ; diagnostic imaging ; surgery ; Treatment Outcome

OBJECTIVE: To explore the efficacy of callus distraction performed by external fixtor in the reconstruction of bone defect and leg shortening of femur after osteomyelitis. METHODS: Nineteen child patients with bone defect and leg shortening after ostemomyelitis were treated by callus distraction with external fixator. The mean length of the bone defect was 1.3 cm. The mean leg-length discrepancy was 4.8 cm. RESULTS: All patients were followed up for 21-82 months. The bone lengthening area grew well, the length of callus distraction was 4.5-8.0 cm, and the mean radiographic consolidation index was 39.7 d/cm. According to the Paley's criteria, the healing effect of 14 cases was excellent, and that of the rest 5 cases was good. The functional recovery of 11 cases was excellent, and that of the rest 8 cases was good. CONCLUSION Callus distraction is a reliable method in the reconstruction of bone defect and leg shortening caused by ostemomyelitis.
Adolescent ; Bony Callus ; Child ; Chronic Disease ; Debridement ; adverse effects ; Female ; Femur ; Humans ; Ilizarov Technique ; Leg Length Inequality ; etiology ; surgery ; Male ; Osteogenesis, Distraction ; instrumentation ; methods ; Osteomyelitis ; complications ; surgery ; Retrospective Studies ; Treatment Outcome