Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results?
Introduction: Upper tibial nonunions (UTNUs) pose challenging difficulties such as soft-tissue scarring, infection, deformity, shortening, and small fragments with intra-articular extension. We present a retrospective analysis of probably the largest series of UTNUs using the Ilizarov techniques. Fa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Journal of Limb Lengthening & Reconstruction |
| Subjects: | |
| Online Access: | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2019;volume=5;issue=2;spage=71;epage=78;aulast=Chaudhary |
| _version_ | 1818551740418490368 |
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| author | Milind Madhav Chaudhary Monish Malhotra Umamahesh Neeli Kelvin Vaishnani Suman Banik Naeem Jagani |
| author_facet | Milind Madhav Chaudhary Monish Malhotra Umamahesh Neeli Kelvin Vaishnani Suman Banik Naeem Jagani |
| author_sort | Milind Madhav Chaudhary |
| collection | DOAJ |
| description | Introduction: Upper tibial nonunions (UTNUs) pose challenging difficulties such as soft-tissue scarring, infection, deformity, shortening, and small fragments with intra-articular extension. We present a retrospective analysis of probably the largest series of UTNUs using the Ilizarov techniques. Factors determining the outcome based on difficulty scores and NU scores were also assessed. Patients and Methods: Forty-one patients with UTNU (within 10 cm of joint line) were evaluated retrospectively. Fourteen were aseptic and 27 were septic. The mean NU distance was 5.6 cm from the knee joint. The Association for the Study and Application of Methods of Ilizarov (ASAMI) functional and bone scores were evaluated and compared with NU severity score (NUSS), NU level of difficulty score (NULODS), and infection severity score (ISS). External fixation duration (EFD) was compared to NUSS and NULODS to determine which is better in predicting the outcome. We also compared our results with the literature. Results: We achieved union in all except one. The mean EFD was 333 days. The mean regenerate lengthening was 8.6 cm. The ASAMI bone score was: excellent – 16, good – 22, fair – 2, poor – 1. The ASAMI functional score was: excellent – 16, good – 14, fair – 9, poor – 2, and failure – 0. We found a positive correlation between NUSS, NULODS, and ISS. EFD correlated better with overall NULODS and subset of NULODS gap score compared to NUSS and NUSS gap score, respectively. Conclusions: Ilizarov is an effective method to treat UTNU. It corrects the deformity, provides stable fixation, achieves union, and corrects limb length discrepancy. |
| first_indexed | 2024-12-12T09:03:55Z |
| format | Article |
| id | doaj.art-96f832a453364507b0a1390d0ccdb286 |
| institution | Directory Open Access Journal |
| issn | 2455-3719 2455-3719 |
| language | English |
| last_indexed | 2024-12-12T09:03:55Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Limb Lengthening & Reconstruction |
| spelling | doaj.art-96f832a453364507b0a1390d0ccdb2862022-12-22T00:29:45ZengWolters Kluwer Medknow PublicationsJournal of Limb Lengthening & Reconstruction2455-37192455-37192019-01-0152717810.4103/jllr.jllr_23_19Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results?Milind Madhav ChaudharyMonish MalhotraUmamahesh NeeliKelvin VaishnaniSuman BanikNaeem JaganiIntroduction: Upper tibial nonunions (UTNUs) pose challenging difficulties such as soft-tissue scarring, infection, deformity, shortening, and small fragments with intra-articular extension. We present a retrospective analysis of probably the largest series of UTNUs using the Ilizarov techniques. Factors determining the outcome based on difficulty scores and NU scores were also assessed. Patients and Methods: Forty-one patients with UTNU (within 10 cm of joint line) were evaluated retrospectively. Fourteen were aseptic and 27 were septic. The mean NU distance was 5.6 cm from the knee joint. The Association for the Study and Application of Methods of Ilizarov (ASAMI) functional and bone scores were evaluated and compared with NU severity score (NUSS), NU level of difficulty score (NULODS), and infection severity score (ISS). External fixation duration (EFD) was compared to NUSS and NULODS to determine which is better in predicting the outcome. We also compared our results with the literature. Results: We achieved union in all except one. The mean EFD was 333 days. The mean regenerate lengthening was 8.6 cm. The ASAMI bone score was: excellent – 16, good – 22, fair – 2, poor – 1. The ASAMI functional score was: excellent – 16, good – 14, fair – 9, poor – 2, and failure – 0. We found a positive correlation between NUSS, NULODS, and ISS. EFD correlated better with overall NULODS and subset of NULODS gap score compared to NUSS and NUSS gap score, respectively. Conclusions: Ilizarov is an effective method to treat UTNU. It corrects the deformity, provides stable fixation, achieves union, and corrects limb length discrepancy.http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2019;volume=5;issue=2;spage=71;epage=78;aulast=Chaudharyassociation for the study and application of methods of ilizarov scoredistal tibia lengtheningilizarovinfected nonunioninfection severity scorenonunion level of difficulty scorenonunion severity scoreupper tibial nonunion |
| spellingShingle | Milind Madhav Chaudhary Monish Malhotra Umamahesh Neeli Kelvin Vaishnani Suman Banik Naeem Jagani Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results? Journal of Limb Lengthening & Reconstruction association for the study and application of methods of ilizarov score distal tibia lengthening ilizarov infected nonunion infection severity score nonunion level of difficulty score nonunion severity score upper tibial nonunion |
| title | Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results? |
| title_full | Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results? |
| title_fullStr | Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results? |
| title_full_unstemmed | Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results? |
| title_short | Ilizarov techniques for upper tibial nonunions: How difficult is it to achieve excellent results? |
| title_sort | ilizarov techniques for upper tibial nonunions how difficult is it to achieve excellent results |
| topic | association for the study and application of methods of ilizarov score distal tibia lengthening ilizarov infected nonunion infection severity score nonunion level of difficulty score nonunion severity score upper tibial nonunion |
| url | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2019;volume=5;issue=2;spage=71;epage=78;aulast=Chaudhary |
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