Early Postoperative Weight Bearing Following the Reconstruction of Traumatic Complex Tibial Bone Defects by Vascularized Free Fibula and Ilizarov External Fixator: A Case Series.

Autor:	Elgouhary A; Department of Orthopedics and Traumatology, Rashid Hospital, Dubai, ARE., Sanad MA; Department of Orthopedics and Traumatology, Sheikh Khalifa Medical City, Abu Dhabi, ARE., Elgammal AI; Department of Orthopedics and Traumatology, Rashid Hospital, Dubai, ARE., Elsayed A; Department of Orthopedics and Traumatology, Rashid Hospital, Dubai, ARE., Dodakundi C; Department of Hand and Microsurgery, Rashid Hospital, Dubai, ARE., Alawadi KA; Department of Hand and Microsurgery, Rashid Hospital, Dubai, ARE., Badawi HA; Department of Hand and Microsurgery, Rashid Hospital, Dubai, ARE.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Nov 22; Vol. 16 (11), pp. e74207. Date of Electronic Publication: 2024 Nov 22 (Print Publication: 2024).
DOI:	10.7759/cureus.74207
Abstrakt:	Objective: Post-traumatic tibial bone defects represent a significant challenge to orthopedic surgeons. Various reconstructive methods are available based on associated local soft tissue injury and defect size. Free vascularized fibular graft represents a major successful technique; combined with a rigid Ilizarov external fixator, it allows safe, immediate postoperative weight bearing. In this article, we describe a series of six patients managed according to the previously presented plan, achieving satisfactory results. Methods: A series of six patients, all males with an average age of 33.3 years, underwent reconstruction for post-traumatic complex tibial bony defects using contralateral free vascularized fibular grafts and Ilizarov external fixation. Initially, all patients underwent multiple sessions of debridement and a simple pin-to-bar external fixator. The bony defect averaged 15 cm, and the average harvested length of the fibula used for reconstruction was 22.1 cm. All patients started immediate total weight bearing postoperatively, with a mean time of 17 days after bony union Ilizarov was replaced with minimally invasive plate osteosynthesis (MIPO) in all patients, and continued full weight bearing (FWB). Results: During the follow-up period, averaging 19.3 months, all patients achieved bony union with a mean time of 3.75 months. Patients spent an average of 6.4 months in the Ilizarov frame before it was replaced with MIPO; graft hypertrophy occurred in all patients, averaging 52.6%. Conclusion: The combined use of a vascularized fibular bone graft and an Ilizarov frame proves to be a successful and safe approach for immediate postoperative FWB. This yields comparable outcomes in terms of union and function. Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Review Board (IRB) of the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) issued approval MBRU IRB-2023-371. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Elgouhary et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu