Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection
Abstract Background We aimed to compare the effectiveness and complications of a novel piston technique versus the Ilizarov technique for the repair of bone defects after lower limb infection. Patients and methods We retrospectively reviewed 41 patients who had been treated at our department for low...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02844-1 |
| _version_ | 1828275048680521728 |
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| author | Jiafei Du Zifei Yin Pengfei Cheng Pei Han Hao Shen |
| author_facet | Jiafei Du Zifei Yin Pengfei Cheng Pei Han Hao Shen |
| author_sort | Jiafei Du |
| collection | DOAJ |
| description | Abstract Background We aimed to compare the effectiveness and complications of a novel piston technique versus the Ilizarov technique for the repair of bone defects after lower limb infection. Patients and methods We retrospectively reviewed 41 patients who had been treated at our department for lower extremity bone defects following osteomyelitis. There were 38 men and three women with a mean age of 43.41 (range, 12–69 years). The infected bone defects involved 36 tibias and five femurs. The piston technique (PT, group A) was used in 12 patients and the Ilizarov technique (IT, group B) in 29 patients. The mean follow-up period was 28.50 months (PT) and 29.90 months (IT). The modified Application of Methods of Illizarov (ASAMI) criteria was used to evaluate bone healing and functional recovery. Results Complete eradication of the infection and union of docking sites were accomplished in both groups. The mean external fixator index (EFI) was 42.32 days/cm in group A versus 58.85 days/cm in group B (p < 0.001). The bone outcomes were similar between groups A and B (p = 0.558) (excellent [9 vs. 19], good [3 vs.10]); group A showed better functional outcomes than group B (p < 0.05) (excellent [7 vs. 6], good [4 vs. 12], fair [0 vs. 10] and poor [1 vs. 1]). Pain was the most common complaint during follow-up, and group A had fewer cases of pin tract infection (1 vs. 6), adjacent joint stiffness (3 vs. 8), and delayed healing of the joint (0 vs. 3). Conclusions Satisfactory bone healing can be achieved by using both PT and IT, although PT demonstrated better functional results, lower EFI, and allowed early removal of the external fixation. We found that this novel piston technique can improve the comfort of patients, reduce the incidence of complications, and provide rapid and convenient rehabilitation. |
| first_indexed | 2024-04-13T06:43:55Z |
| format | Article |
| id | doaj.art-796419bb61fb499cbe32e37e27417f80 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-13T06:43:55Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-796419bb61fb499cbe32e37e27417f802022-12-22T02:57:39ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-12-011611810.1186/s13018-021-02844-1Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infectionJiafei Du0Zifei Yin1Pengfei Cheng2Pei Han3Hao Shen4Orthopaedic Department, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalJoint Department, Kunshan Hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese MedicineOrthopaedic Department, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalOrthopaedic Department, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalOrthopaedic Department, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalAbstract Background We aimed to compare the effectiveness and complications of a novel piston technique versus the Ilizarov technique for the repair of bone defects after lower limb infection. Patients and methods We retrospectively reviewed 41 patients who had been treated at our department for lower extremity bone defects following osteomyelitis. There were 38 men and three women with a mean age of 43.41 (range, 12–69 years). The infected bone defects involved 36 tibias and five femurs. The piston technique (PT, group A) was used in 12 patients and the Ilizarov technique (IT, group B) in 29 patients. The mean follow-up period was 28.50 months (PT) and 29.90 months (IT). The modified Application of Methods of Illizarov (ASAMI) criteria was used to evaluate bone healing and functional recovery. Results Complete eradication of the infection and union of docking sites were accomplished in both groups. The mean external fixator index (EFI) was 42.32 days/cm in group A versus 58.85 days/cm in group B (p < 0.001). The bone outcomes were similar between groups A and B (p = 0.558) (excellent [9 vs. 19], good [3 vs.10]); group A showed better functional outcomes than group B (p < 0.05) (excellent [7 vs. 6], good [4 vs. 12], fair [0 vs. 10] and poor [1 vs. 1]). Pain was the most common complaint during follow-up, and group A had fewer cases of pin tract infection (1 vs. 6), adjacent joint stiffness (3 vs. 8), and delayed healing of the joint (0 vs. 3). Conclusions Satisfactory bone healing can be achieved by using both PT and IT, although PT demonstrated better functional results, lower EFI, and allowed early removal of the external fixation. We found that this novel piston technique can improve the comfort of patients, reduce the incidence of complications, and provide rapid and convenient rehabilitation.https://doi.org/10.1186/s13018-021-02844-1Ilizarov techniquePiston techniqueMasqueletInduced membraneBone defectLower limb infection |
| spellingShingle | Jiafei Du Zifei Yin Pengfei Cheng Pei Han Hao Shen Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection Journal of Orthopaedic Surgery and Research Ilizarov technique Piston technique Masquelet Induced membrane Bone defect Lower limb infection |
| title | Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection |
| title_full | Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection |
| title_fullStr | Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection |
| title_full_unstemmed | Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection |
| title_short | Novel piston technique versus Ilizarov technique for the repair of bone defect after lower limb infection |
| title_sort | novel piston technique versus ilizarov technique for the repair of bone defect after lower limb infection |
| topic | Ilizarov technique Piston technique Masquelet Induced membrane Bone defect Lower limb infection |
| url | https://doi.org/10.1186/s13018-021-02844-1 |
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