scholarly journals Reconstructive procedures on lower extremities using Mitkovic external fixation system

2005 ◽  
Vol 52 (2) ◽  
pp. 117-119 ◽  
Author(s):  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Z. Golubovic ◽  
D. Mladenovic ◽  
S. Milenkovic ◽  
...  
Keyword(s):  
External Fixation ◽  
Low Cost ◽  
Deformity Correction ◽  
Lower Extremities ◽  
Limb Lengthening ◽  
Bone Transport ◽  
Invasive Technique ◽  
Angular Deformity ◽  
Reconstructive Procedures ◽  
Fixation System

The results of limb lengthening, correction of limb deformities and solving of bone loss, by the use of Mitkovic external fixation system and minimally invasive technique on the series of 96 operations in 89 patients are shown. Only lower extremities were included in this series. The advantages of this external fixation system in comparison to other systems are pointed out. The main advantages are the optimal biomechanical conditions including unilateral but 3-dimensional frame, which provides conditions very similar to natural biomechanical features of the human long bones, simplicity of application and low cost. The received result was excellent or very good in 98.4%. Maximal limb lengthening was 18 cm (at the same time in the femur and the tibia). Angular deformity correction is extremely simplified with minimized possibility of complications. The frame for bone transport is very simple. It can be concluded that presented methods are suitable for routine use.

scholarly journals Correction of Complex Lower Limb Deformities by the Ilizarov Technique: An Audit of Complications

2000 ◽  
Vol 8 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Jean-Claude Theis ◽  
H Simpson ◽  
J Kenwright
Keyword(s):  
Lower Limb ◽  
Deformity Correction ◽  
Limb Lengthening ◽  
Bone Transport ◽  
Angular Deformity ◽  
Ilizarov Technique ◽  
Leg Lengthening ◽  
Limb Deformities ◽  
Lower Limb Reconstruction ◽  
Tract Infections

This is an audit of complications resulting from correction of complex lower limb deformities by the Ilizarov technique. 33 patients (40 bone segments) were reviewed and divided into 4 groups according to the type of surgery carried out: limb lengthening and/or correction of deformity, bone or joint stabilisation, treatment of nonunion or bone defect, angular and/or rotation correction. Most minor complications were fixator specific. Pin tract infections were almost universal but responded well to oral antibiotics and rarely resulted in osteomyelitis. Major complications were procedure specific and more common in those patients who underwent leg lengthening, treatment for nonunion and bone transport. There was also a high incidence of nerve injury as a result of acute angular deformity correction. Despite the high complication rate the Ilizarov technique remains an effective tool for complex lower limb reconstruction surgery.

scholarly journals Treatment options for infected bone defects in the lower extremities: free vascularized fibular graft or Ilizarov bone transport?

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Gao-hong Ren ◽  
Runguang Li ◽  
Yanjun Hu ◽  
Yirong Chen ◽  
Chaojie Chen ◽  
...  
Keyword(s):  
External Fixation ◽  
Lower Extremities ◽  
Bone Defects ◽  
Bone Transport ◽  
Fixation Time ◽  
Fibular Graft ◽  
Treatment Groups ◽  
Free Vascularized Fibular Graft ◽  
Ilizarov Bone Transport ◽  
The Times

Abstract Objective The objective was to explore the relative indications of free vascularized fibular graft (FVFG) and Ilizarov bone transport (IBT) in the treatment of infected bone defects of lower extremities via comparative analysis on the clinical characteristics and efficacies. Methods The clinical data of 66 cases with post-traumatic infected bone defects of the lower extremities who underwent FVFG (n = 23) or IBT (n = 43) from July 2014 to June 2018 were retrieved and retrospectively analyzed. Clinical characteristics, operation time, and intraoperative blood loss were statistically compared between two groups. Specifically, the clinical efficacies of two methods were statistically evaluated according to the external fixation time/index, recurrence rate of deep infection, incidence of complications, the times of reoperation, and final functional score of the affected extremities. Results Gender, age, cause of injury, Gustilo grade of initial injury, proportion of complicated injuries in other parts of the affected extremities, and numbers of femoral/tibial defect cases did not differ significantly between treatment groups, while infection site distribution after debridement (shaft/metaphysis) differed moderately, with metaphysis infection little more frequent in the FVFG group (P = 0.068). Femoral/tibial defect length was longer in the FVFG group (9.96 ± 2.27 vs. 8.74 ± 2.52 cm, P = 0.014). More patients in the FVFG group presented with moderate or complex wounds with soft-tissue defects. FVFG treatment required a longer surgical time (6.60 ± 1.34 vs. 3.12 ± 0.99 h) and resulted in greater intraoperative blood loss (873.91 ± 183.94 vs. 386.08 ± 131.98 ml; both P < 0.05) than the IBT group, while average follow-up time, recurrence rate of postoperative osteomyelitis, degree of bony union, and final functional scores did not differ between treatment groups. However, FVFG required a shorter external fixation time (7.04 ± 1.72 vs. 13.16 ± 2.92 months), yielded a lower external fixation index (0.73 ± 0.28 vs. 1.55 ± 0.28), and resulted in a lower incidence of postoperative complications (0.87 ± 0.76 vs. 2.21±1.78, times/case, P < 0.05). The times of reoperation in the two groups did not differ (0.78 ± 0.60 vs. 0.98 ± 0.99 times/case, P = 0.615). Conclusion Both FVFG and IBT are effective methods for repairing and reconstructing infected bone defects of the lower extremities, with unique advantages and limitations. Generally, FVFG is recommended for patients with soft tissue defects, bone defects adjacent to joints, large bone defects (particularly monocortical defects), and those who can tolerate microsurgery.

scholarly journals Functional state of blood circulation and neuromuscular system of the lower limb of patients with congenital pseudarthrosis of the tibia after consolidation of the nonunion

2015 ◽  
Vol 3 (4) ◽  
pp. 6-11
Author(s):  
Aleksander Pavlovich Pozdeev ◽  
Ekaterina Anatolievna Zakharyan ◽  
Timur Faizovich Zubairov ◽  
Igor Evgenievich Nikityuk
Keyword(s):  
Functional State ◽  
Blood Circulation ◽  
Deformity Correction ◽  
Lower Extremities ◽  
Limb Lengthening ◽  
Lower Limbs ◽  
Neuromuscular System ◽  
Non Union ◽  
Congenital Pseudarthrosis ◽  
Consolidation Material

The aim of this study was to evaluate the clinical and functional state of the neuromuscular system and the blood supply to the lower limbs of children with congenital pseudarthrosis of the tibia (CPT) after consolidation. Material and Methods. A total of 100 patients with CPT were analyzed. We performed a clinical examination of patients, panoramic X-ray of the lower extremities, electroneuromyogram, and reovasography. Results and Conclusions. The primary complaints of patients with CPT after the consolidation of the non-union were lameness, deformations of lower extremities, and pain in the local joints. The electromyoneuromyogram data of the lower limbs of patients with CPT exhibited a decrease of the contractility of the muscles of the lower limbs, and neuropathy of the peroneal nerves of both lower limbs. The reovasography data of the lower limbs of patients with CPT displayed improvement in blood circulation in the lower extremities after the consolidation of the tibia. These data promote the current methods of treatment of patients with CPT; however, the temperature, degree of limb lengthening, and deformity correction should be considered in the future.

scholarly journals Bone and Joint Reconstruction Using Ilizarov Circular External Fixation Device

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Nazri Bin Mohd Yusof ◽  
Ahmad Fadzly Sulong
Keyword(s):  
External Fixation ◽  
Fracture Fixation ◽  
Deformity Correction ◽  
Medical Problem ◽  
Bone Transport ◽  
Flexion Contracture ◽  
Fixation Device ◽  
Non Union ◽  
Joint Reconstruction ◽  
External Fixation Device

Introduction: Ilizarov circular external fixation device is a versatile external fixation device which can be used for bone and joint reconstruction such as fracture fixation, bone transport, lengthening, shortening, and correction of deformity and contracture. It is a complex procedure and requires patients understanding, motivation, pin site care and rehabilitation to ensure successful treatment and avoiding complication. The aim of this study was to review cases of bone and joint reconstruction using Ilizarov external fixation device. Materials and Methods: From 2006 till 2018, 59 patients with the mean age of 34.8 (10-69) years old underwent these procedures. There were 49 tibias, three femurs, one humerus, three elbows, two knees and one ankle reconstruction. 18 open fractures, 16 non- union, seven tibial plateau fractures, 10 implant related infections, one valgus mal-union and one shortening. There were also 4 dislocations and two flexion contracture. The procedure that were done include 31 bone transport, 18 fracture fixation, three joint reduction, two correction of flexion contracture, two shortening of tibia and one each for lengthening, deformity correction and arthrodesis. Results: Forty seven (80%) patients achieved the objective of operation: 41 fractures united, three joints were reduced, two achieved knee extension and one deformity corrected. Five developed non-union, of which two not compliant to treatment, two had failed bone transport and one died during the treatment due to medical problem not related to the Ilizarov fixation. Conclusion: Ilizarov circular external fixation is an effective device for joint and bone reconstruction in majority of patients.

The role of external fixation in paediatric limb lengthening and deformity correction

Injury ◽  
2019 ◽  
Vol 50 ◽  
pp. S18-S23
Author(s):  
Peter R. Calder ◽  
Martina Faimali ◽  
W. David Goodier
Keyword(s):  
External Fixation ◽  
Deformity Correction ◽  
Limb Lengthening

scholarly journals UNILATERAL 3D EXTERNAL FIXATION IN SERBIAN TRAUMATOLOGY AND ORTHOPAEDICS

2021 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milan Mitkovic ◽  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Vojislav Bumbasirevic
Keyword(s):  
External Fixation ◽  
Femoral Fractures ◽  
Limb Lengthening ◽  
Fixation Method ◽  
External Fixators ◽  
Biomechanical Stability ◽  
Post Traumatic ◽  
The Republic ◽  
Practice Methods ◽  
Fixation System

Objective Although it may have been criticized and questioned by numerous authors, external fixation holds its place in modern orthopaedics and traumatology. The aim of this paper is to show the applicability of the unilateral 3D external fixation in everyday practice. Methods For external fixation of the bones, we used unilateral 3D external fixators according to Mitkovic. Results In the Republic of Serbia, the Mitkovic unilateral 3D external fixation system has been used in over 30,000 cases. The indication field of applicability of this method is wide. External fixation method was mostly used for the treatment of open and closed tibial fractures at all levels, in open femoral fractures as a part of the “staging” protocol and in fractures of the upper limbs. We used external fixation for the treatment of nonunions, malunions, in the treatment of osteitis, septic pseudoarthrosis, angular knee deformities, post-traumatic deformities, for limb lengthening and in replantation surgery. Conclusion The unilateral external fixator enables 3D biomechanical stability and is suitable for use in everyday traumatology and orthopaedics practice.

scholarly journals Development of an easy-to-assemble external fixation system for bone transport

DYNA ◽  
2019 ◽  
Vol 86 (208) ◽  
pp. 53-59
Author(s):  
Fernando Casanova Garcia ◽  
Andres Carrera Pinzon ◽  
Arlex Leyton ◽  
Andres Machado Caicedo ◽  
Jose Jaime GarcIa Alvarez
Keyword(s):  
Carbon Fiber ◽  
External Fixation ◽  
Bone Transport ◽  
Lateral Bending ◽  
Bone Distraction ◽  
Torsional Load ◽  
Bone Elongation ◽  
Fixation System

We developed a monolateral external fixation system for bone elongation easier to assemble than commercial systems since the clamps can be laterally assembled to the rail in contrast to the commercial systems where the clamps can only be assembled from the ends. The system is formed by clamps, screws, and a rail. The rail is composed of two carbon fiber circular rods of ½” diameter and 42-cm length. The clamps can slide with respect to the rail to allow bone distraction or may be fixed to the rail by using a wedge and a screw. The prototype was mechanically evaluated under the ASTM F1541 standard. The stiffness in axial, Medio Lateral bending (ML), Antero Posterior bending (AP), and flexo-torsional load were 117 N/mm, 46 N/mm, 8.7 N/mm, and 5.8 N-mm/°, respectively, which are on the range of stiffness of commercial systems. 

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