Role of the Ilizarov External Ring Fixator in Gap Non-Union and Bone Loss Management
DOI:
https://doi.org/10.53350/pjmhs02025194.7Keywords:
Ilizarov, Management, Complications, Bone defects, Fixator.Abstract
Background: Several surgical techniques are available to address segmental long-bone defects. Each technique has its own advantages and limitations. The Ilizarov bone plasty is a vital method for infected nonunion and compensating bone loss which has gained widespread popularity within the last few decades.
Objective: To determine the role of the Ilizarov external ring fixator in gap non-union and bone loss management.
Study Design: Observational study
Place and Duration of Study: Department of Orthopaedics Unit-1, Chandka Medical College, SMBBU, Larkana from 1st October 2023 to 30th September 2024.
Methodology: Sixty patients suffering from extensive tibial defects of more than ten centimetres were enrolled. The patients requiring bone gap union and bone loss management were included.
Results: There were 43 males and 17 females with mean age 20.8±11.2. The mean bone defect value was 13.2±0.9 and anatomical shortening was 6.5± 0.8cm. The mean restoration of lower leg length was significantly higher as 88.8 ± 2.5%. The complications associated with the Ilizarov external ring fixator included highest presentation of skin inflammation up to 23.8% followed by recurrence of equinus in 18.3% and ankle stiffness presented in 11.6%.
Conclusion: The Ilizarov external ring fixator has an efficient role in gap non-union and bone loss management.
References
Guerado E, Caso E. Challenges of bone tissue engineering in orthopaedic patients. World J Orthop 2017;8:87-98.
Wen G, Zhou R, Wang Y, Lu S, Chai Y, Yang H. Management of post-traumatic long bone defects: a comparative study based on long-term results. Injury 2019;50:2070-74.
Goldstein RY, Jordan CJ, McLaurin TM, Grant A. The evolution of the Ilizarov technique: part 2: the principles of distraction osteosynthesis. Bull Hosp Jt Dis 2013; 1:96-103.
Birch JG. A brief history of limb lengthening. J Pediatr Orthop 2017;37(Suppl 2):S1-8.
Borzunov DY, Chevardin AV. Ilizarov non-free bone plasty for extensive tibial defects. Int Orthop 2013;37:709-14.
Taylor GI, Corlett RJ, Ashton MW. The Evolution of Free Vascularized Bone Transfer: A 40-year experience. Plast Reconstr Surg 2016;137:1292-1305.
Masquelet AC. Induced Membrane Technique: Pearls and Pitfalls. J Orthop Trauma 2017;31 Suppl 5:S36-8.
Borzunov DY, Kolchin SN, Malkova TA. Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved. World J Orthop 2020;11(6):304-18.
Locker PH, Arthur J, Edmiston T, Puri R, Levine BR. Management of bone defects in orthopedic trauma. Bull Hosp Jt Dis 2018; 76: 278-84.
Toogood P, Miclau T. Critical-sized bone defects: sequence and planning. J Orthop Trauma 2017;31 Suppl 5:S23-6.
Chalak A, Singh S, Shetty S, Kale S, Singh P, Ghodke A. A Novel technique of three-ring Ilizarov fixator frame in gap non-union of tibia. J Clin Orthop Trauma 2021;23:101639.
Pati S, Montgomery R. Management of complex tibial and femoral nonunion using the Ilizarov technique, and its cost implications. JBJS [B] 2006; 88(7): 928-32.
Farmanullah, Khan MS, Awais SM. Evaluation of management of tibial non-union defect with Ilizarov fixator. JAyub Med Coll Abbottabad 2007; 19(3): 34-6.
Baruah R.K., Kumar S. Ilizarov strategies in the management of nonunions and difficult fractures of the femur. J Limb Lengthening Reconstruct 2019; 5(2): 79-87.
Yin P, Zhang Q, Mao Z, Li T, Zhang L, Tang P. The treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator and a systematic review of infected tibial nonunion treated by Ilizarov methods. Acta Orthop Belg 2014; 80(3): 426-35.
Fang H, Liu F, Sun C, Pang P. Impact of wound closure on fibular donor-site morbidity: a meta-analysis. BMC Surg 2019;19:81.
Cano-Luís P, Andrés-Cano P, Ricón-Recarey FJ, Giráldez-Sánchez MA. Treatment of posttraumatic bone defects of the forearm with vascularized fibular grafts. Follow up after fourteen years. Injury 2018;49 Suppl 2:S27-35.
Emori M, Kaya M, Irifune H, Takahashi N, Shimizu J, Mizushima E, et al. Vascularised fibular grafts for reconstruction of extremity bone defects after resection of bone and soft-tissue tumours: a single institutional study of 49 patients. Bone Joint J 2017;99-B:1237-43.
Borzunov DY, Gorbach EN, Mokhovikov DS, Kolchin SN. Combined bone plasty interventions for rehabilitation of patients with congenital pseudarthrosis of the tibia. Genij Ortopedii 2019;25(3):304-11.
Raven TF, Moghaddam A, Ermisch C, Westhauser F, Heller R, Bruckner T, et al. Use of Masquelet technique in treatment of septic and atrophic fracture nonunion. Injury 2019;50 Suppl 3:40-54.
Tong K, Zhong Z, Peng Y, Lin C, Cao S, Yang Y, et al. Masquelet technique versus Ilizarov bone transport for reconstruction of lower extremity bone defects following posttraumatic osteomyelitis. Injury 2017;48:1616-22.
Downloads
How to Cite
Issue
Section
License
Copyright (c) 2025 MUHAMMAD ZAIB TUNIO, FRAZ NOOR, MUHAMMAD ISHAQ, ABDUL SAMAD QURESHI, ZAIN-UL-ABIDEEN,WAZIR AHMED

This work is licensed under a Creative Commons Attribution 4.0 International License.
