Bone transport using the Ilizarov method: a review of complications in 100 consecutive cases

Claudio Iacobellis, Antonio Berizzi, Roberto Aldegheri, Claudio Iacobellis, Antonio Berizzi, Roberto Aldegheri

Abstract

We present the results of treatment of 100 patients (72 men, 28 women) by the Ilizarov method of bone transport using circular (55) and monolateral external fixators (45). A total of 26 femurs (18 monolateral, 8 circular) and 74 tibias (49 circular, 25 monolateral) was examined. There were no significant differences between the circular fixator and the monolateral fixator with regard to treatment time, complications in the treated bone segments or compliance with the presence of the fixator. The main complications (pseudoarthrosis at bone contact points after transport, insufficient ossification of lengthened bone, knee stiffness) were resolved with further treatment for all patients with the exception of one case which continued with repeated infections. The circular fixator allows for deformity corrections during bone transport but the monolateral fixator is tolerated better by patients, especially in those with femoral defects.

Keywords: Bone transport; Distraction osteogenesis; External fixator.

Figures

Fig. 1
Fig. 1
G.M., man, aged 19. a, b Exposed fracture with bone gap, treated urgently with monolateral fixator. c, d Check-up 5 months after resection and transport. e, f Check-up after second surgical examination of bone ends at point of contact. g, h Check-up 4 years later
Fig. 2
Fig. 2
V.O., man, aged 59. a Bone transport (descending technique) in previous proximal tibial closed fracture and distal exposed fracture with loss of bone. b, c Check-up after second surgical examination of bone ends at point of contact. d, e Check-up 9 months, immediately after removal of fixator. f, g Check-up 2 years after removal of fixator
Fig. 3
Fig. 3
N.A., man, aged 11. a–c Osteomyelitis secondary upon previous operations. d Check-up after resection, application of monolateral fixator and osteotomy for transport. e, f Check-up 8 months, immediately after removal of fixator. g, h Check-up 2 years after removal of fixator
Fig. 4
Fig. 4
C.A., man, aged 28. a, b Osteomyelitis after exposed fracture with bone gap, treated with external fixator and later osteosynthesis. c, d Check-up 7 months after transport. e, f Pseudoarthrosis at point of contact, 1 year after initial transport. g, h Check-up 3 years after nailing
Fig. 5
Fig. 5
F.L., man, aged 32. a, b Arteriography in an exposed tibial fracture with loss of bone. c, d Arteriography 3 months after transport shows improved vascularization of foot

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