Abstract
In tibial pseudoarthrosis, segmental bone transport with Ilizarov external fixator is being widely applicated all around the world, with encouraging successful outcomes. As the treatment with this technique requires a long period of time, the surgeon may face many problems which may negatively affect the final outcome. Pin tract infection, early or delayed consolidation, axial deviation and translation at the target area, skin inversion, rupture of the bone by the wires and joint contractures or stiffness form the main and common clinical problems. The rate of failure and complications with Ilizarov method used for diaphysial bone defects are so rare when precise technical details are carried out. With other treatment modalities, it is usually too difficult to obtain union synchronously with infection eradication. Thus, the Ilizarov technique presents successful outcomes against some complications mentioned above. Segmental bone transport is a surgical technique in which some of the problems can never be prevented. However, close patient follow up and always keeping the problems in mind make early diagnosis possible. With the early recognition of problems, successful treatment and increased overall outcome can be expected.
Résumé
Dans le traitement des pseudarthroses du tibia, le transfert osseux grâce au fixateur externe d’Ilizarov est largement utilisé dans le monde entier avec des succès encourageants. A cause de la longueur du traitement, le chirurgien doit faire face à de nombreux problèmes qui risquent d’affecter le résultat final. L’infection des broches, la consolidation trop précoce ou au contraire retardée, la déviation axiale ou la translation dans la zone cible, l’invagination cutanée, la fracture osseuse par la rétraction articulaire ou la raideur sont les problèmes les plus courants et les plus importants. Le taux de complications pour la méthode d’Ilizarov appliquée aux défects diaphysaires est en fait rare lorsque la technique est utilisée de façon précise dans ses moindres détails. Avec d’autres méthodes il est souvent difficile d’obtenir la consolidation osseuse de façon synchrone avec l’éradication de l’infection. La technique d’Ilizarov permet des succès malgré les complications citées plus haut. Le transfert osseux segmentaire est une technique chirurgicale dans laquelle il n’est jamais possible de prévenir toute complication. Mais, le suivi rapproché des patients et le fait d’avoir continuellement ces problèmes à l’esprit, permet le diagnostic précoce de ces complications. Grâce à cette reconnaissance précoce des problèmes, on est en droit d’espérer un résultat favorable malgré tout.
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Cirpar, M., Cetik, O., Uslu, M. et al. Common complications of segmental bone transport with Ilizarov technique in defective tibia pseudoarthrosis: a review. Eur J Orthop Surg Traumatol 16, 380–385 (2006). https://doi.org/10.1007/s00590-006-0089-9
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DOI: https://doi.org/10.1007/s00590-006-0089-9