The combined use of the Ilizarov method and microsurgical techniques for limb salvage.
The purpose of this article is to review clinical outcomes and propose a new classification scheme for combined use of Ilizarov Method with free tissue transfer for limb salvage. This is an Institutional Review Board-approved retrospective review of 62 patients treated with free tissue transfer and Ilizarov method over the past 15 years at a single institution. The surgical management of these patients is classified into 4 distinct approaches. The mean age was 37 years with the most common injury being Gustillo IIIB tibial fractures (61%). Eighty-seven percent of patients had failed prior fixation and 63% had osteomyelitis with a draining wound. The overall flap survival rate was 97%. The mean duration of Ilizarov fixation was 6.9 months with a mean limb length correction of 3 cm. The overall rate of primary bony union was 74%. With a mean follow-up of 42 months, the combined techniques resulted in limb salvage for 84% of cases. Failure of primary bony union was the only predictor of limb amputation. This multidisciplinary approach to limb salvage combines reconstructive microsurgery and the Ilizarov method.
Hollenbeck
Scott T
ST
Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Woo
Shoshana
S
Ong
Siang
S
Fitch
Robert D
RD
Erdmann
Detlev
D
Levin
L Scott
LS
D000293:Adolescent; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000601:surgery; D001859:Bone Neoplasms / Q000601:surgery; D005260:Female; D005360:Fibula / Q000293:injuries / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique / Q000009:adverse effects; D007866:Leg; D007870:Leg Length Inequality / Q000209:etiology / Q000601:surgery; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery; D012516:Osteosarcoma / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000601:surgery; D055815:Young Adult