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This system helps provide a structural support to the limb and holds the broken bone fragments together so healing can take place over a period of time. It may be necessary to have this frame on your limb for a number of months. Twenty-six cases were treated with monofocal distraction, 19 with monofocal compression, 16 with bifocal compression/distraction, and 18 with bone transport. Main Outcome Measurements: Beris AE, Lykissas MG, Sioros V, Mavrodontidis AN, Korompilias AV. Femoral periprosthetic fracture in osteoporotic bone after a total knee replacement:treatment with Ilizarov external fixation. J Arthroplast. 2010;25(7):1168.e9–12. There are many ways you can retain your independence in the kitchen. Your Occupational Therapist will discuss these with you during your assessment. loose wires or pins on your frame. Do not try any modifications yourself or let anyone else do this.
The Ilizarov fixator provides efficient treatment for some of the most baffling conditions in orthopedic practice such as gap and infected nonunion of the tibia (14). Tibial non-unions are challenging to treat and are further complicated by bone loss 15 and infection. 16 The Ilizarov technique of distraction histogenesis allows removal of infected bone segments, stabilization, better chances of consolidation, and maintenance of limb length as well. It also allows joint function and thereby it is encouraged and started within few days of frame application. 17 The Ilizarov frame's adaptability to axial loading and resistance to torsional and bending forces further helps in achieving a limb that has fewer deformities and normal strength and range of motion. 1 , 2All patients are at risk of having skin infections around the entry points of the wires and pins, if this occurs it is treated with a short course of antibiotics. Occasionally patients have to take a longer course of antibiotics, sometimes for the duration of their frame treatment. Very rarely the infection can affect the bone or joint; this is called osteomyelitis or septic arthritis. This often requires further surgery and a long course of antibiotics which are usually administered intravenously (into a vein). Step your frame leg first then weight bear down through your arms and step your non-operated leg in to meet it then repeat. The Limb Reconstruction Team consists of consultant orthopaedic surgeons, frame specialist nurse and specialist physiotherapist. What is a frame? Do not drive a car or apply ointments or creams to the limb that has the frame on unless instructed by your doctor or nurse. Taking care of your frame Ilizarov taught that, “infection burns in the flame of regeneration.” In our series, infection was eradicated in all 60 of the cases involving distraction, but this may be due to better removal of the infected tissue with a larger resection gap compared with the monofocal compression group. Reliable clearance of infection in the bifocal group offers a significant advantage, allowing safer bone grafting and internal fixation if union is not secured by the Ilizarov method alone.
Littlewood, Rebecca. "The Benefits and Risks of the Ilizarov Technique for Limb Reconstruction" (PDF). Oxford University Hospitals . Retrieved April 15, 2023. To prevent postoperative complications, pin/wire-insertion technique is more important than any pin/wire-care protocol: A frame is a special form of scaffolding (external frame) that can hold and control your bone to aid repair. Sometimes this is referred to as an Ilizarov frame, cage or a circular frame, because of the rings that go round the leg.The management of infected nonunion of the tibia is challenging, particularly with segmental bone loss, multiple draining sinuses, poor soft tissue cover, osteopenia, adjacent joint stiffness, limb deformity, or multidrug-resistant polymicrobial infection. 1,2 Permanent functional deficits, prolonged recovery times, and even amputation can result. 3 Despite acceptance of open fracture management guidelines, advances in implant design, and less traumatic surgical techniques, infection is still common after open fracture (9.3%–18%). 4–8 Studies have demonstrated financial costs to be 2 to 3 times higher for infected fractures compared with cases uncomplicated by infection. 9,10 On the day of the operation, you will need to shower or be washed with an antiseptic wash and dressed in a theatre gown. Ankle joint presents with numerous difficulties as the amount of cases with joint destruction after complicated fractures are on the rise [ 10, 13, 14]. Incidence of chronic infections, bone defects, limb length discrepancy, soft-tissue loss, and joint abnormalities are quite challenging and difficult to treat [ 13, 14]. Amputation may present as the last resort for patients with failed arthrodesis, and therefore, fusion procedures should be thoroughly evaluated to prevent inadequate results.
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Can there be any complications or risks?
Velazquez RJ, Bell DF, Armstrong PF, Babyn P, Tibshirani R. Complications of use of the Ilizarov technique in the correction of limb deformities in children. J Bone Joint Surg Am. 1993;75(8):1148–56. Vidyadhara S, Rao SK. Ilizarov treatment of complex tibial pilon fractures. Int Orthop. 2006;30(2):113–7. The Ilizarov device is a flexible external fixator that permits dynamic and multidirectional stresses to be applied. The ability to alter the alignment of the hindfoot and forefoot after the surgery by repositioning the frame as required is a distinct benefit of the Ilizarov technique, allowing for the rectification of intraoperative errors or early postoperative loss of position. These advantages significantly improve the outcome of the surgery and are quite helpful in thecorrection of malalignment, providing animproved level of activity, and pain management.
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