Review : Prevention and Management of Complications of the Ilizarov Treatment Method

Abstract

Serious orthopaedic conditions such as nonunions and pilon, calcaneal, and Lisfranc fractures, as well as leg lengthening, correction of angular deformities, resection of osteomyelitis, and bone transfer, can be treated successfully with the Ilizarov system. However, complications such as contractures, loss of range of motion, neurologic deficits, articular damage, contractures, and pin track infections can occur. This article describes the costs of limb salvage with the Ilizarov system compared with amputation as well as possible complications and their prevention; it also provides a treatment protocol.

Keywords

Ilizarov pin track external fixator femoral lengthening limb salvage postoperative complications

References

Parihar M. Ilizarov method: physiotherapy. In Wheeless' Textbook of Orthopaedics . Available at: www.wheelessonline.com .

Olney BW , Jayaraman G. Joint reaction force during femoral lengthening. Clin Orthop Relat Res. 1994;301:64-67.

Stanitski DF The effect of limb lengthening on articular cartilage. Clin Orthop Relat Res. 1994;301:68-72.

Rogers LC , Bevilaqua NJ , Frykberg FG , Armstrong DA Predictors of postoperative complications of Ilizarov external ring fixators in the foot and ankle. J Foot Ankle Surg. 2007;46:372-375.

Temple J. , Santy J. Summary. Available at: www.Cochrane.org/reviews/en/ab004551.html-16k.

W-Dahl A. , Toksvig-Larsen S. , Lindstrand A. No difference between daily and weekly pin site care. Acta Orthop Scand. 2003;74:704-708.

Ziran BH , Smith WR , Anglen JO , Tornetta P.III External fixation: how to make it work. J Bone Joint Surg Am. 2007;89:1620-1632.

Checketts R. , Otterbarn M. , Maceachern G. Pin track infection: definition, incidence, and prevention. Int J Orthop Trauma I Suppl. 1993;13:16-18.

Herzenberg JE , Scheufele LL , Paley D. , Bechtel R. , Tepper S. Knee range of motion in isolated femoral lengthening . Clin Orthop Relat Res. 1994;301:49-54.

10.

Barker KL , Lamb SE , Simpson AHR. Functional recovery in patients with nonunion treated with the Ilizarov technique . J Bone Joint Surg Br. 2004;86:81-85.

11.

Maini L. , Chadha M. , Vihwanat J. , Kapoor S. , Mehtani A. The Ilizarov method in infected nonunion of fractures. Injury . 2000;31:509-517.

12.

Lerner KK , Esterhai JL Jr , Polomano RC , Cheatle MD , Heppenstall BR Functional outcome after treatment of lower extremity non-union. Clin Orthop Relat Res. 1993;295:38-36.

13.

Georgiadis GM , Behrens FF , Joyce MJ , Earle AS , Simmons AL Open tibial fractures with severe soft tissue loss: limb salvage compared with below knee amputation . J Bone Joint Surg Am. 1993;75:1431-1441.

14.

Toh CL , Jupiter JB The infected nonunion of the tibia. Clin Orthop Relat Res . 1995;315:176-191.

15.

Patel S. , Montgomery R. Management of complex tibial and femoral nonunions using the Ilizarov technique and its cost implications. J Bone Joint Surg Br . 2006;88:926-932.

16.

Williams MO Long-term cost comparison of major limb salvage using the Ilizarov method versus amputation. Clin Orthop Relat Res. 1994;301:156-158.

17.

MacKenzie EJ , Snow Jones A. , Bosse MJ , et al. Health-care costs associated with amputation or reconstruction of a limb-threatening injury . J Bone Joint Surg Am. 2007;89:1685-1692.