• Title/Summary/Keyword: Ilizarov technique

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Limb-Salvage Surgery using Ilizarov Technique - Report of 2 cases - (Ilizarov술식을 이용한 사지 구제술 - 2례 보고 -)

  • Cho, Duck-Yun;Koh, Eun-Sung;Lee, Ji-Sup
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.226-232
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    • 1995
  • Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

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Treatment for Severe Deformed Foot with Ilizarov Technique(2 cases) (Ilizarov 술식을 이용한 심한 족부 변형의 치료)

  • Park, Yong-Wook;Lee, Chang-Ju;Chung, Yung-Khee;Yoo, Jung-Han;Park, Ju-Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.42-47
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    • 1998
  • The conventional surgical treatment for deformed foot has always consisted of massive soft tissue releases combined with varying methods of osteotomies and fusions to plantigrade functional foot. But, the resulting feet have often been foreshortened, stiff, and nothing more than a cosmetically acceptable but functionally poor foot. Now the techniques of distraction histogenesis has been given a new tool to apply to the complex foot deformity. We have recently experienced two cases of severe deformed feet and treated with Ilizarov technique. One patient had postcompartmental severe rigid equinocavovarus foot. And the other had traumatic severe rigid metatarsus abductus. The follow up periods were 14 and 28 months respectively. The feet were aesthetically pleasing. So, we believed that the Jlizarov technique is an excellent treating method for severe deformed foot.

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Treatment of Congenital Elbow Luxation using the Ilizarov Technique of Distraction Osteogenesis in a Dog

  • Kim, Byung-ju;Han, Kyung-Jin;Hong, Young-chae;Park, Ji-young;Jeong, Seong-Mok;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.34 no.4
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    • pp.287-290
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    • 2017
  • A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

Efficacy of Ilizarov External Fixation and Autologous Bone Grafting for Performing Arthrodesis on the Ankle Arthropathy with Risk Factors (불유합의 위험 인자를 가진 족관절 병변에 시행한 족관절 유합술로서 Ilizarov 외고정 기구 장착술 및 자가골 이식술의 유용성)

  • Lee, Yong-Sik;Nam, Il-Hyun;Lee, Tae-Hun;Ahn, Gil-Yeong;Lee, Yeong-Hyeon;Lee, Hee-Hyung;Hwang, Sung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.4
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    • pp.189-195
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    • 2019
  • Purpose: The aim of this study is to evaluate if the Ilizarov external fixation procedure with axial compression can help to obtain fusion across the ankle joint in patients with a high risk of nonunion. Materials and Methods: From January 2006 to December 2015, the study reviewed 17 patients who underwent ankle arthropathy with a high risk of nonunion and who underwent ankle fusion using the Ilizarov external fixator with axial compression and auto bone grafting. After the lateral surface of the ankle joint was exposed through a lateral trans-fibular approach, massive removal of the articular cartilage and excision of any loose or avascular bone were done. With the cortical bone harvested from the pelvis as corticocancellous bone blocks, we inserted the two cortical blocks longitudinally into the anterior and posterior part of the free ankle space from lateral to medial to make the rectangular chamber to fill the cancellous bones. After the Ilizarov external fixator was equipped, we tightened the frame by 5 mm to compress the bone graft space. We accessed the American Orthopaedic Foot and Ankle Society (AOFAS) AnkleHindfoot score both preoperatively and postoperatively. Results: The average age at the time of operation was 63.4 years (range, 47~78 years). The mean frame time was 17.4 weeks (range, 15~23 weeks). The average follow-up period was 3.7 years (range, 2~6 years). Osseous fusion was obtained in 15 patients (88.2%). There were two stable pseudarthroses among the rheumatoid arthritis patients, and we continued their follow-up. The mean AOFAS AnkleHindfoot score improved from 48.5 to 73.7 points. Conclusion: Ankle arthrodesis using the Ilizarov external fixation with axial compression and auto bone grafting on the ankle arthropathy that had difficult conditions to achieve union is considered one of the useful methods with a correspondingly low incidence of complications.

HISTOLOGICAL CHANGES IN THE ELONGATED BONE AFFECTED BY OSTEODISTRACTION OF THE MANDIBLE IN THE DOG (성견 하악골 절단 후 기계적 골 견인에 의해 형성된 골 신장부에 대한 시기별 조직학적 변화)

  • Baek, Sun-Ho;Ahn, Byoung-Keun;Park, Young-Ju;Park, Hee-Geon;Park, Jun-Woo;Rhee, Gun-Joo;Lee, Yong-Chan;Cho, Byoung-Ouck
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.5
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    • pp.404-416
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    • 2001
  • Purpose : Traditionally, the treatement of choice has been a bone grafting procedure to increase the length of bone in case of actual length discrepancy. But, bone grafting procedure has many disadvantages, for example, graft resorption, donor site morbidity, and so on. So, many trials have been performed to avert the use of autogenous bone graft via introducing new materials or methods. And, one of those trials has been realized by the development of a technique inducing bone lengthening by osteotomy (or corticotomy) and slow gradual distraction of the osteotomized segments. This new technique of bone lengthening dates back to the early 20th century. But, the majority of information concerning the biology of new bone formation during bone lengthening and technical details of the procedure were produced by extensive clinical and experimental studies performed by Ilizarov, a Russian surgeon. According to Ilizarov, with adequate blood supply, preservation of periosteum, rigid fixation of the osteotomized segments, and proper rate and rhythm of distraction, intramembranous bone rapidly develops within the distraction gap in the limb lengthening procedure. In the limb lengthening, many orthopedic surgeons try to observe the biologic and clinical principles recommended by Ilizarov. In the oral and maxillofacial region, however, not a few studies must be performed to apply this surgical technique in the clinical cases. Besides, the mechanism of bone formation in the distraction gap is not clear, yet. The purpose of this experiment was to scrutinize serially the histological changes in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. In addition, it was performed to confirm the presence of specific region(s) which was important in the bone formation in the gap through the observation of the expression pattern of osteocalcin and osteonectin with the immunohistochemical examination. Materials and Methods : The experimental and control specimens were obtained from seven adult male mongrel dogs weighing over 20kg. The distractors were custom-made linear extraoral devices and bicortical fixation screws were 2.3mm in diameter, 50mm in total length, 15mm in screw length. The distractors were devised to produce a linear gap of 0.75mm between two bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side of each animal was corticotomized perpendicular to the occlusal plane and then two bony segments were separated completely by careful manipulation of the segments with bone forceps. The left side of each animal was left intact. This side was served as control. At sixth day after osteotomy and fixation of the segments were performed, distraction of the segments was commenced with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were euthanized at the 16th. 29th, and 44th day after the osteotomy. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with H&E. The prepared specimens were examined under the light microscope. And, immunohistochemical examinations using anti-osteocalcin antibody (OC1, Biodesign, USA) and anti-osteonectin antibody (Haematologic Technologies Inc., Essex, VT) to locate the expressions of osteocalcin and osteonectin, respectively, were performed. Results : 1. New bone was observed already at the 16th. day after osteotomy. This suggests that new bone formation in osteodistraction was commenced at an early stage of the regenerative process. But, radiologically and microscopically, bony union was not completed in the distraction gap at the 44th. day after osteotomy. Therefore, rigid fixation must be maintained between the bony fragments till the complete bony union is confirmed clinically rather than one month or so after the completion of distraction.

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Management of an Open Comminuted Fracture of the Metacarpus using Circular External Skeletal Fixation in a Korean Water Deer (Hydropotes inermis argyopus) (고라니에서 발생한 손허리뼈 개방 복합골절의 원형 외부골격고정법 적용)

  • Heo, Su-Young;Jeong, Seongmok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.359-362
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    • 2015
  • A Korean water deer was rescued after being hit by a motor vehicle. Clinical and radiographic examination revealed a grade III open fracture of the right metacarpus with severe soft tissue injury. The water deer underwent closed reduction of the fracture, which was stabilized by the application of the Ilizarov method of 4-ring circular external skeletal fixation (CESF) as a minimally invasive technique. The water deer was successfully released into the wild. CESF was advantageous for the stabilization of open comminuted fracture and the management of a severely contaminated wound in a Korean water deer. CESF can be used successfully in wild deer with good tolerance and minimal complications.

VERTICAL DISTRACTION OF ALVEOLAR BONE FOR PLACEMENT OF DENTAL IMPLANT (치과 임플란트 식립을 위한 치조골의 수직적 신장술)

  • Oh, Jung-Hwan;Lazar, Frank;Zoeller, Joachim E.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.4
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    • pp.326-329
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    • 2002
  • Adequate alveolar bone height and width are required for the successful placement of dental implants. Conventional therapeutic regimens for alveolar atrophy are bone grafts or augmentation using allografts and membrane (GBR). Conventional graft techniques have some limitations and complications such as infection, soft tissue problem and high resorption rate. Recently, distraction osteogenesis of alveolar bone is considered as a new alternative for ridge augmentation. Distraction osteogenesis was originally defined and popularized by Ilizarov for lengthening of long bone. Some clinicians have tried to apply distraction osteogenesis in treatment of maxillofacial discrepancies. It was also used to augment alveolar bone. Cologne study group successfully applied the technique for augmentation of alveolar bone and designed several miniplate-distractor systems fabricated by Martin Medizintechnik GmbH in Germany. Vertical distraction of alveolar bone was successfully completed in 104 patients with miniplate-distractor systems. The mean distance of distraction was 10.2mm (range: 6-15 mm) and the mean length of segment was 45 mm (range: 6-127 mm). 162 dental implants in 54 patients were placed immediately or 4 weeks later after removal of the distractor. The results of our study show that vertical distraction of alveolar bone is an effective and reliable technique to restore alveolar atrophy and alveolar vertical defect caused by trauma or tumor.