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Role of the Ilizarov non-free bone plasty in the management of long bone defects and nonunion: Problems solved and unsolved 被引量:14
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作者 Dmitry Y Borzunov Sergei N Kolchin Tatiana A Malkova 《World Journal of Orthopedics》 2020年第6期304-318,共15页
BACKGROUND Ilizarov non-free bone plasty is a method of distraction osteogenesis using the Ilizarov apparatus for external fixation which originated in Russia and was disseminated across the world. It has been used in... BACKGROUND Ilizarov non-free bone plasty is a method of distraction osteogenesis using the Ilizarov apparatus for external fixation which originated in Russia and was disseminated across the world. It has been used in long bone defect and nonunion management along with free vascularized grafting and induced membrane technique. However, the shortcomings and problems of these methods still remain the issues which restrict their overall use.AIM To study the recent available literature on the role of Ilizarov non-free bone plasty in long bone defect and nonunion management, its problems and the solutions to these problems in order to achieve better treatment outcomes.METHODS Three databases(Pub Med, Scopus, and Web of Science) were searched for literature sources on distraction osteogenesis, free vascularized grafting and induced membrane technique used in long bone defect and nonunion treatment within a five-year period(2015-2019). Full-text clinical articles in the English language were selected for analysis only if they contained treatment results,complications and described large patient samples(not less than ten cases for congenital, post-tumor resection cases or rare conditions, and more than 20 cases for the rest). Case reports were excluded.RESULTS Fifty full-text articles and reviews on distraction osteogenesis were chosen.Thirty-five clinical studies containing large series of patients treated with this method and problems with its outcome were analyzed. It was found that distraction osteogenesis techniques provide treatment for segmental bone defects and nonunion of the lower extremity in many clinical situations, especially in complex problems. The Ilizarov techniques treat the triad of problems simultaneously(bone loss, soft-tissue loss and infection). Management of tibial defects mostly utilizes the Ilizarov circular fixator. Monolateral fixators are preferable in the femur. The use of a ring fixator is recommended in patients with an infected tibial bone gap of more than 6 cm. High rates of successful treatment were reported by the authors that ranged from 77% to 100% and depended on the pathology and the type of Ilizarov technique used. Hybrid fixation and autogenous grafting are the most applicable solutions to avoid after-frame regenerate fracture or deformity and docking site nonunion.CONCLUSION The role of Ilizarov non-free bone plasty has not lost its significance in the treatment of segmental bone defects despite the shortcomings and treatment problems encountered. 展开更多
关键词 Bone defect Ilizarov method Distraction osteogenesis Bone transport Bone nonunion free vascularized grafts Induced membrane technique complication
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FREE GRAFT TWO-STAGE URETHROPLASTY FOR HYPOSPADIAS REPAIR
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作者 Zhong-jinYue Ling-junZuo Jia-jiWang Gan-pingZhong Jian-mingDuan Zhi-pingWang Da-shanQin 《Chinese Medical Sciences Journal》 CAS CSCD 2005年第2期119-122, ,共4页
Objective To evaluate the effectiveness of free graft transplantation two-stage urethroplasty for hypospadias repair. Methods Fifty-eight cases with different types of hypospadias including 10 subcoronal, 36 penile sh... Objective To evaluate the effectiveness of free graft transplantation two-stage urethroplasty for hypospadias repair. Methods Fifty-eight cases with different types of hypospadias including 10 subcoronal, 36 penile shaft, 9 scrotal, and 3 perineal were treated with free full-thickness skin graft or (and) buccal mucosal graft transplantation two-stage urethroplasty. Of 58 cases, 45 were new cases, 13 had history of previous failed surgeries. Operative procedure included two stages: the first stage is to correct penile curvature (chordee), prepare transplanting bed, harvest and prepare full-thickness skin graft, buccal mucosal graft, and perform graft transplantation. The second stage is to complete urethroplasty and glanuloplasty. Results After the first stage operation, 56 of 58 cases (96.6%) were successful with grafts healing well, another 2 foreskin grafts got gangrened. After the second stage operation on 56 cases, 5 cases failed with newly formed urethras opened due to infection, 8 cases had fistulas, 43 (76.8%) cases healed well. Conclusions Free graft transplantation two-stage urethroplasty for hypospadias repair is a kind of effective treatment with broad indication, comparatively high success rate, less complications and good cosmatic results, indicative of various types of hypospadias repair. 展开更多
关键词 HYPOSPADIAS two-stage operation free graft transplantation
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Comparison of anatomical and functional outcomes of different surgical techniques in myopic macular hole without retinal detachment 被引量:1
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作者 Merve Ozbek Sehnaz Ozcaliskan +1 位作者 Cengiz Alagoz Ozgur Artunay 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2023年第10期1651-1656,共6页
AIM:To define the anatomic and functional outcomes of pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole... AIM:To define the anatomic and functional outcomes of pars plana vitrectomy(PPV)with internal limiting membrane(ILM)peeling,inverted ILM flap and free ILM patch graft technique for the treatment of myopic macular hole(MH)without retinal detachment.METHODS:Sixty-four eyes of 64 patients who underwent PPV for myopic MH were included.Group 1 consists of patients underwent ILM peeling(n=26),and Groups 2 and 3 consists of patient underwent free ILM patch graft(n=20)and inverted ILM flap procedure(n=18)respectively.Outcomes following surgery were MH closure and best corrected visual acuity(BCVA)in logMAR at 6mo.RESULTS:Closure of MH was obtained in 20 eyes(76.9%)of the Group 1,in 16 eyes(80%)of the Group 2 and in 16 eyes(88.9%)of the Group 3.The mean preoperative and postoperative BCVA was 1.60±0.53 logMAR and 1.27±0.58 logMAR,respectively(P<0.05).There was no significant difference in the postoperative BCVA and anatomical closure rates in the three groups.Although the anatomical closure rate did not differ significantly in the groups,closure of MH tended to be better in the inverted ILM flap technique group at 6mo.CONCLUSION:Different surgical techniques may provide favorable visual and anatomical results for myopic MH surgery.ILM flap techniques offer higher closure rates compared to ILM peeling technique.However,in terms of visual outcomes,the study reveals no difference in three surgical techniques. 展开更多
关键词 free internal limiting membrane patch graft inverted internal limiting membrane flap myopic macular hole internal limiting membrane peeling
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Free vascularized fibular grafting for treatment of old femoral neck fractures 被引量:7
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作者 ZHANGChang-qing WANGKun-zheng +6 位作者 ZENGBing-fang XUZheng-yu LIHong-shuai JINDong-xu SHAOLei SONGWen-qi XUShu-ping 《Chinese Medical Journal》 SCIE CAS CSCD 2005年第9期786-789,共4页
The internal fixation failure for treatment of femoral neck fracture is mainly due to improper fixation, loss of fixation stability and premature ambulation. Bone nonunion and avascular osteonecrosis of the femoral he... The internal fixation failure for treatment of femoral neck fracture is mainly due to improper fixation, loss of fixation stability and premature ambulation. Bone nonunion and avascular osteonecrosis of the femoral head caused by the internal fixation failure for femoral neck fracture are always the complex topics in orthopedics. With regard to patients who sustain these complications, total hip arthroplasty is a proper choice for elderly patients, but is not acceptable by young patients. We report nine patients with the failure of internal fixation for femoral neck fracture who were treated with free vascularized fibular grafting and internal fixation with cannulated screw from November 2001 to October 2003. All of them achieved good results. 展开更多
关键词 femoral neck fracture bone nonunion OSTEONECROSIS femoral head free vascularized fibular grafting
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Study on Different Types of Skin Flap Transplantation to Repair Forefoot Damaged Injury 被引量:1
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作者 Jian-yun XU Xin-lei YANG +1 位作者 Bao-kai CAI Jin-hu LI 《Chinese Journal of Plastic and Reconstructive Surgery》 2019年第4期36-40,共5页
Objective To investigate the clinical effect of different types of skin flap transplantation in repairing forefoot lesion.Methods From January 2016 to June 2019,62 patients with forefoot damage were selected and their... Objective To investigate the clinical effect of different types of skin flap transplantation in repairing forefoot lesion.Methods From January 2016 to June 2019,62 patients with forefoot damage were selected and their clinical data were retrospectively analyzed.All the selected patients received skin flap transplantation and repair,of which 26 patients received free myocutaneous flap transplantation and repair,and were treated as group A.The other 36 patients underwent retrograde foot flap transplantation and repair.They were taken as group B,and the clinical treatment methods and curative effects were summarized.Results Among the 26 patients in group A,the skin flaps of 21 patients survived completely,while those of the other 5 patients showed partial necrosis at the edge of the skin flaps.They were treated with free skin grafting and healed after regular dressing change.All the skin flaps survived.Follow-up for at least 6 months showed that 11 patients had mild claudication and skin flap sensation was slightly poor.Among the 36 patients in group B,only 2 cases suffered from distal partial necrosis after the operation,which was caused by large tension after dorsum pedis flap transplantation.After systematic treatment and regular dressing change by doctors,the flaps of 2 patients healed.In addition,venous reflux disorder occurred in 3 patients with medial saphenous nerve nutrient vessel flap of the foot,which was related to swelling factors.The flaps of other patients survived,healed well and did not show infection symptoms.Conclusion According to the actual condition of patients with forefoot damage,the flap repair method is formulated,which has good short-term and long-term therapeutic effects and plays an important role in repairing forefoot damage. 展开更多
关键词 Skin flap transplantation forefoot lesion Flap necrosis free skin grafting
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EXPERIMENTAL STUDY OF NERVE GRAFT WITH VASCULAR IMPLANTATION
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作者 丁海明 韩西城 +2 位作者 吕厚山 姜保国 冯传汉 《Chinese Medical Sciences Journal》 CAS CSCD 1999年第1期61-63,共3页
Objective To study the performance of free nerve graft with vascular implantation Material and method Three groups of rats were used A 10 mm nerve defect was made in the sciat... Objective To study the performance of free nerve graft with vascular implantation Material and method Three groups of rats were used A 10 mm nerve defect was made in the sciatic nerve It was repaired respectively with vascularised nerve graft(VNG), free nerve graft with vascular implantation(NGV) or free nerve graft(NG) Before 30 days the revascularisation of the nerve graft was assessed;at 2 to 3 month regeneration of nerve was evaluated Histochemical staining, vascular morphology and electrophysiological examination were undertaken Result and conclusion The number of regenerated blood vessels in VNG and NGV was significantly increased than that in NG before 30 days The ratio of regenerated nerve fiber area and conduction velocity in the first two groups were much better than those in NG at 2 to 3 months 展开更多
关键词 free nerve graft vascular implantation sciatic nerve
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Modified Masquelet technique in children
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作者 Ravi Mittal Siddharth Jain 《Chinese Journal of Traumatology》 CAS CSCD 2022年第6期389-391,共3页
Masquelet technique is one of the modalities for the treatment of long bone defect.Using cancellous bone graft to fill the bone defect is always a concern in children due to the small size of their iliac crest and ope... Masquelet technique is one of the modalities for the treatment of long bone defect.Using cancellous bone graft to fill the bone defect is always a concern in children due to the small size of their iliac crest and open growth plate.We reported a case of 13-year-old male who presented with gap non-union of middle third of tibia.We applied a modified Masquelet technique by using only the cortical fibular graft instead of cancellous bone to fill the space surrounded by induced membrane.Fibula was used as a nonvascularized strut graft and matched stick graft to achieve complete union.We concluded that nonvascularized fibula grafting is an easy and effective option to fill the bone defect in children in the second stage of Masquelet technique. 展开更多
关键词 Masquelet technique Induced membrane CHILDREN Gap non-union free fibula graft
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