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Journal of Long-Term Effects of Medical Implants

Publication de 4  numéros par an

ISSN Imprimer: 1050-6934

ISSN En ligne: 1940-4379

SJR: 0.184 SNIP: 0.485 CiteScore™:: 1.1 H-Index: 39

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Distraction over Nail Using Circular External Fixation for Septic Pseudarthrosis of the Tibia

Volume 22, Numéro 2, 2012, pp. 137-143
DOI: 10.1615/JLongTermEffMedImplants.v22.i2.40
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RÉSUMÉ

We present a report of nine patients (eight women and one man; mean age 37 years) from 2010 to 2012 with septic pseudarthrosis of the tibia treated with bone transport over an intramedullary nail using a circular external fixator. The mean follow-up was 15 months (range: 10−21 months). A twostage approach was used. At the first stage, removal of the primary osteosynthesis and extensive bone debridement to healthy, bleeding bone margins was performed. The bone defect was packed with antibiotic loaded cement beads, and stabilization of the tibia was done with a unilateral external fixator or with a long leg posterior splint. The mean size of bone defect was 4 cm (range: 3.5−5.5 cm). At the second stage, two consecutive negative wound cultures and normal values of blood cell count, C-reactive protein (CRP), and estimated sedimentation rate (ESR) were obtained. Then we reamed and locked the intramedullary nailing of the tibia, applied a circular external fixator, and performed percutaneous corticotomy of the tibia opposite the site of the bone defect. Bone distraction over the nail was initiated at the eighth postoperative day at a rate of 1 mm/day. At the last follow-up, union was achieved in all cases without recurrence of bone infection. All patients experienced excellent (n=3) or good (n=6) knee and ankle function, as well as complete return to their daily activities. Two patients experienced pin-tract infection, and one patient experienced anterior knee pain at the entry point of the nail.

CITÉ PAR
  1. Polyzois Vasilios D., Stathopoulos Ioannis P., Lampropoulou-Adamidou Kalliopi, Vasiliadis Elias S., Vlamis John, Pneumaticos Spiros G., Strategies for Managing Bone Defects of the Lower Extremity, Clinics in Podiatric Medicine and Surgery, 31, 4, 2014. Crossref

  2. Koutsostathis Stefanos D., Lepetsos Panagiotis, Polyzois Vasilios D., Pneumaticos Spyros G., Macheras George A., Combined use of Ilizarov external fixation and Papineau technique for septic pseudoarthrosis of the distal tibia in a patient with diabetes mellitus, Diabetic Foot & Ankle, 5, 1, 2014. Crossref

  3. Massobrio Marco, Pellicanò Giovanni, Sessa Pasquale, Farsetti Pasquale, Ancillary Usage of Hexapod External Fixators, in Hexapod External Fixator Systems, 2021. Crossref

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