CLINICAL OBSERVATION OF IMPROVING AXIAL OFFSET BY USING Ilizarov BONE TRANSPORT TECHNOLOGY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 WANGJingshuang , HUSibin , MAJie , CUILukuan

No. 3 Department of Orthopedics, Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou Hebei, 061001, P. R. China;

Corresponding?author：

WANGJingshuang, Email: jingshuang1979@sohu.com

Keywords：

Ilizarov technique; Bone transport; Axial offset

DOI：

10.7507/1002-1892.20160110

Video：

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Objective To explore the effectiveness of Ilizarov technique in improving bone transport axial offset. Methods Between January 2010 and December 2014, 14 patients with tibial fracture were treated by using Ilizarov technique. Of 14 cases, 11 were male and 3 were female, aged 18-70 years (mean, 38.8 years); there were 10 cases of infective bone defect and 4 cases of non-infective bone defect. According to Paley typing, 7 cases were rated as type B1(bone defect without shortening) and 7 cases as type B3(bone defect with shortening). The injury to operation time was 1 to 72 months (mean, 11.9 months). Ilizarov fixation was used for type architecture and adjusting fixed bone removal of half the distance between the needle and the ring, changing the auadrilateral edges, adjusting the convolution relationship between the bone removal section and bone segment involution, and adjusting the two force lines of bone segment involution end so as to make the limb lines of force satisfactory. Results The patients were followed up 9-31 months (mean, 19.1 months). Four cases achieved natural bone healing at last follow-up, bone healing was obtained in 10 cases after bone graft. At 1 week after operation, X-ray films showed angulation in the coronal plane in 10 cases (3-12°, 4.9° on average) and in the sagittal plane in 9 cases (2-12°, 3.8° on average); axial offset was observed in 6 cases (43%), which was corrected in 5 cases except 1 case. At last followup, angulation in the coronal plane was observed in 5 cases (2-4°, 2.6° on average), angulation in the sagittal plane in 6 cases (2-6°, 4.1° on average), and axial offset in 1 case (7%), which were significantly improved when compared with ones at 1 week. According to Paley evaluation criteria, the osseous results were excellent in 12 cases and good in 2 cases; the functional results were excellent in 12 cases and good in 2 cases at last follow-up. Conclusion Axial offset in the Ilizarov bone transport relatively common. By adjusting fixed bone removal of half the distance between the needle and the ring, the axial offset can be improved.

Citation： WANGJingshuang, HUSibin, MAJie, CUILukuan. CLINICAL OBSERVATION OF IMPROVING AXIAL OFFSET BY USING Ilizarov BONE TRANSPORT TECHNOLOGY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 546-550. doi: 10.7507/1002-1892.20160110 Copy

1.	?Liu T, Zhang X, Li Z, et al. Management of combined bone defect and limb-length discrepancy after tibial chronic osteomyelitis. Orthopedics, 2011, 34(8):e363-367.
2.	郭保逢, 秦泗河, 任龍喜. 牽拉成骨技術治療慢性骨髓炎. 中華骨科雜志, 2012, 32(3):283-285.
3.	Sen C, Eralp L, Gunes T, et al. An alternative method for the treatment of nonunion of the tibia with bone loss. J Bone Joint Surg (Br), 2006, 88(6):783-789.
4.	Paley D, Catagni MA, Argnani F, et al. Ilizarov treament oftibial nonunions with bone loss. Clin Orthop Relat Res, 1989, (241):146-165.
5.	La Russa V, Skallerud B, Klaksvik J, et al. Reduction in wire tension caused by wire clamping and wire tensioner removal:an experimental Ilizarov frame study. Proc Inst Mech Eng H, 2011, 225(3):220-227.
6.	Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res, 1990, (250):81-104.
7.	Paley D. 矯形外科原則. 陳堅, 譯. 北京:中國醫藥科技出版社, 2005:175-183.
8.	El-Rosasy MA. Acute shortening and re-lengthing in the management of bone and soft-tissure loss in complicated fractures of the tibia. J Bone Joint Surg (Br), 2007, 89(1):80-88.
9.	El-Alfy B, El-Mowafi H, El-Moghazy N. Distraction oseogenesis in management of composite bone and soft-tissure defects. Int Orthop, 2010, 34(1):115-118.
10.	Khaleel A, Pool BD. Bone transport. Curr Orthop, 2001, 15(3):229-237.
11.	Lacobellis C, Berizzi A, Aldegheri R. Bone transport using the Ilizarov method:a review of complictions in 100 consecutive cases. Strategies Trauma Limb Reconstr, 2010, 5(1):17-22.
12.	Paley D, Maar DC. Ilizarov bone transport treatment for tibial defects. J Orthop Trauma, 2000, 14(2):76-85.
13.	Dendrinos GK, Kontos S, Lyritsis E. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg (Am), 1995, 77(6):835-846.
14.	魏星, 王虎, 莊巖, 等. 一期節段性清創骨搬運技術治療脛骨感染性骨不連. 中華創傷骨科雜志, 2015, 17(10):838-844.
15.	徐永清, 朱躍良, 范新宇, 等. 二處截骨骨搬運治療脛骨干大段感染性骨缺損合并軟組織缺損的再認識. 中華創傷骨科雜志, 2015, 17(10):850-853.
16.	柴明祥, 臧建成, 吳天昊, 等. 脛骨骨搬運后對合端不愈合的原因與治療. 中華創傷骨科雜志, 2014, 15(10):840-844.
17.	秦泗河, 李剛. Ilizarov 技術骨科應用進展. 北京:人民軍醫出版社, 2014:359-360.
18.	殷渠東, 孫振東, 顧三軍, 等. 骨搬運與骨短縮-延長治療脛骨骨缺損合并軟組織缺損的療效比較. 中國修復重建外科雜志, 2014, 28(7):818-822.

1. ?Liu T, Zhang X, Li Z, et al. Management of combined bone defect and limb-length discrepancy after tibial chronic osteomyelitis. Orthopedics, 2011, 34(8):e363-367.
2. 郭保逢, 秦泗河, 任龍喜. 牽拉成骨技術治療慢性骨髓炎. 中華骨科雜志, 2012, 32(3):283-285.
3. Sen C, Eralp L, Gunes T, et al. An alternative method for the treatment of nonunion of the tibia with bone loss. J Bone Joint Surg (Br), 2006, 88(6):783-789.
4. Paley D, Catagni MA, Argnani F, et al. Ilizarov treament oftibial nonunions with bone loss. Clin Orthop Relat Res, 1989, (241):146-165.
5. La Russa V, Skallerud B, Klaksvik J, et al. Reduction in wire tension caused by wire clamping and wire tensioner removal:an experimental Ilizarov frame study. Proc Inst Mech Eng H, 2011, 225(3):220-227.
6. Paley D. Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res, 1990, (250):81-104.
7. Paley D. 矯形外科原則. 陳堅, 譯. 北京:中國醫藥科技出版社, 2005:175-183.
8. El-Rosasy MA. Acute shortening and re-lengthing in the management of bone and soft-tissure loss in complicated fractures of the tibia. J Bone Joint Surg (Br), 2007, 89(1):80-88.
9. El-Alfy B, El-Mowafi H, El-Moghazy N. Distraction oseogenesis in management of composite bone and soft-tissure defects. Int Orthop, 2010, 34(1):115-118.
10. Khaleel A, Pool BD. Bone transport. Curr Orthop, 2001, 15(3):229-237.
11. Lacobellis C, Berizzi A, Aldegheri R. Bone transport using the Ilizarov method:a review of complictions in 100 consecutive cases. Strategies Trauma Limb Reconstr, 2010, 5(1):17-22.
12. Paley D, Maar DC. Ilizarov bone transport treatment for tibial defects. J Orthop Trauma, 2000, 14(2):76-85.
13. Dendrinos GK, Kontos S, Lyritsis E. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg (Am), 1995, 77(6):835-846.
14. 魏星, 王虎, 莊巖, 等. 一期節段性清創骨搬運技術治療脛骨感染性骨不連. 中華創傷骨科雜志, 2015, 17(10):838-844.
15. 徐永清, 朱躍良, 范新宇, 等. 二處截骨骨搬運治療脛骨干大段感染性骨缺損合并軟組織缺損的再認識. 中華創傷骨科雜志, 2015, 17(10):850-853.
16. 柴明祥, 臧建成, 吳天昊, 等. 脛骨骨搬運后對合端不愈合的原因與治療. 中華創傷骨科雜志, 2014, 15(10):840-844.
17. 秦泗河, 李剛. Ilizarov 技術骨科應用進展. 北京:人民軍醫出版社, 2014:359-360.
18. 殷渠東, 孫振東, 顧三軍, 等. 骨搬運與骨短縮-延長治療脛骨骨缺損合并軟組織缺損的療效比較. 中國修復重建外科雜志, 2014, 28(7):818-822.

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