Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis
Abstract Introduction This study compared surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia. Material and methods In a retrospective comparative study, 75 patients were treated with the Ilizarov technique for aseptic posttrau...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01697-4 |
| _version_ | 1828153451056463872 |
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| author | Łukasz Szelerski Sławomir Żarek Radosław Górski Karol Mochocki Ryszard Górski Piotr Morasiewicz Paweł Małdyk |
| author_facet | Łukasz Szelerski Sławomir Żarek Radosław Górski Karol Mochocki Ryszard Górski Piotr Morasiewicz Paweł Małdyk |
| author_sort | Łukasz Szelerski |
| collection | DOAJ |
| description | Abstract Introduction This study compared surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia. Material and methods In a retrospective comparative study, 75 patients were treated with the Ilizarov technique for aseptic posttraumatic pseudarthrosis of the tibia in the period 2000–2016. We compared them with the 51 patients from the control group, treated for tibial bone union disturbances using internal osteosynthesis methods, i.e., internal-fixation plates and intramedullary nails. The study groups were compared in terms of the rates of union, time to union, and the baseline-to-postoperative difference in lower leg deformity. Results Union rate in the Ilizarov group was 100% and the control group was 51.92% (p < 0.001). The median time to union suggests that patients from the Ilizarov group needed a shorter time to achieve bone union (203.00 days vs. 271.00 days) (p = 0.091). The effect size in the Ilizarov group was larger both in terms of reducing both limb deformity and shortening (it is worth noting, however, that the Ilizarov treatment was used in patients with higher baseline values of both these parameters). We observed no significant difference in terms of time to union between the group of patients with at least one risk factor for disturbance in fracture healing and the group with no risk factors. The following risk factors were considered: diabetes mellitus, corticosteroid therapy, smoking, alcohol dependence, and advanced lower-extremity vascular disease (p = 0.827). Discussion Our study demonstrated a high effectiveness of the Ilizarov method in the treatment of aseptic posttraumatic pseudarthroses of the tibia. The Ilizarov method seems to be worth considering in all cases where either the patient or the nature of injury is associated with additional risk factors and whenever there is a need for leg deformity correction or leg elongation. |
| first_indexed | 2024-04-11T22:26:19Z |
| format | Article |
| id | doaj.art-238f34f07d38437a81984e4e715c629d |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:26:19Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-238f34f07d38437a81984e4e715c629d2022-12-22T03:59:39ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-05-0115111110.1186/s13018-020-01697-4Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysisŁukasz Szelerski0Sławomir Żarek1Radosław Górski2Karol Mochocki3Ryszard Górski4Piotr Morasiewicz5Paweł Małdyk6Department of Orthopedics and Musculoskeletal Traumatology, Medical University of WarsawDepartment of Orthopedics and Musculoskeletal Traumatology, Medical University of WarsawDepartment of Orthopedics and Musculoskeletal Traumatology, Medical University of WarsawDepartment of Orthopedics and Musculoskeletal Traumatology, Medical University of WarsawDepartment of Orthopedics and Musculoskeletal Traumatology, Medical University of WarsawDepartment and Clinic of Orthopaedic and Traumatologic Surgery, Wroclaw Medical UniversityDepartment of Orthopedics and Musculoskeletal Traumatology, Medical University of WarsawAbstract Introduction This study compared surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia. Material and methods In a retrospective comparative study, 75 patients were treated with the Ilizarov technique for aseptic posttraumatic pseudarthrosis of the tibia in the period 2000–2016. We compared them with the 51 patients from the control group, treated for tibial bone union disturbances using internal osteosynthesis methods, i.e., internal-fixation plates and intramedullary nails. The study groups were compared in terms of the rates of union, time to union, and the baseline-to-postoperative difference in lower leg deformity. Results Union rate in the Ilizarov group was 100% and the control group was 51.92% (p < 0.001). The median time to union suggests that patients from the Ilizarov group needed a shorter time to achieve bone union (203.00 days vs. 271.00 days) (p = 0.091). The effect size in the Ilizarov group was larger both in terms of reducing both limb deformity and shortening (it is worth noting, however, that the Ilizarov treatment was used in patients with higher baseline values of both these parameters). We observed no significant difference in terms of time to union between the group of patients with at least one risk factor for disturbance in fracture healing and the group with no risk factors. The following risk factors were considered: diabetes mellitus, corticosteroid therapy, smoking, alcohol dependence, and advanced lower-extremity vascular disease (p = 0.827). Discussion Our study demonstrated a high effectiveness of the Ilizarov method in the treatment of aseptic posttraumatic pseudarthroses of the tibia. The Ilizarov method seems to be worth considering in all cases where either the patient or the nature of injury is associated with additional risk factors and whenever there is a need for leg deformity correction or leg elongation.http://link.springer.com/article/10.1186/s13018-020-01697-4Ilizarov methodAseptic pseudarthrosisTibial nonunionExternal fixator |
| spellingShingle | Łukasz Szelerski Sławomir Żarek Radosław Górski Karol Mochocki Ryszard Górski Piotr Morasiewicz Paweł Małdyk Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis Journal of Orthopaedic Surgery and Research Ilizarov method Aseptic pseudarthrosis Tibial nonunion External fixator |
| title | Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis |
| title_full | Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis |
| title_fullStr | Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis |
| title_full_unstemmed | Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis |
| title_short | Surgical treatment outcomes of the Ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia—a retrospective comparative analysis |
| title_sort | surgical treatment outcomes of the ilizarov and internal osteosynthesis methods in posttraumatic pseudarthrosis of the tibia a retrospective comparative analysis |
| topic | Ilizarov method Aseptic pseudarthrosis Tibial nonunion External fixator |
| url | http://link.springer.com/article/10.1186/s13018-020-01697-4 |
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