Treatment of Bone Loss using Ilizarov Fixation after Resection of Benign Tumor in the Long Bone

Sung Taek Jung; Seong Beom Cho; Jin Ho Lee

doi:10.4055/jkoa.2007.42.4.426

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Jung, Cho, and Lee: Treatment of Bone Loss using Ilizarov Fixation after Resection of Benign Tumor in the Long Bone

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2007; 42(4): 426-132.

Published online: 31 August 2007

DOI: https://doi.org/10.4055/jkoa.2007.42.4.426

Treatment of Bone Loss using Ilizarov Fixation after Resection of Benign Tumor in the Long Bone

Sung Taek Jung, M.D., Seong Beom Cho, M.D., Jin Ho Lee, M.D.

Department of Orthopaedic Surgery, Chonnam National University Hospital, Gwangju, Korea.

Address reprint requests to Seong Beom Cho, M.D. Department of Orthopaedic Surgery, Chonnam National University Hospital, 8, Hak 1-dong, Dong-gu, Gwangju 501-757, Korea. Tel: +82.62-227-1640, Fax: +82.62-225-7794, madkid@dreamwiz.com

Abstract

Purpose

This study analyzed the results of treatment of bone loss using Ilizarov fixation after resection of benign tumor in the long bone radiologically and clinically.

Materials and Methods

Initial diagnoses were 5 osteofibrous dysplasia, 1 aneurysmal bone cyst and 1 giant cell tumor. Three indices were used to evaluate the results; percentage transport, healing index and percentage increase. The function of the affected limb was assessed according to Ennecking rating. And we assessed the radiological and functional results according to A.S.A.M.I.'s classification.

Results

Percentage transport averaged 75% (range: 29-144), healing index averaged 64.5 day/cm (range: 34.8-108.6) and the percentage increase averaged 13% (range: 11-20). In Enneking rating, there were 6 cases that were classified as being better than good. In A.S.A.M.I.'s classification, there were 6 good cases, and 1 fair case each in the bone result and functional result, respectively.

Conclusion

Ilizarov technique is a reconstruction method using living bone. It is safe and effective for the treatment of bone loss after the resection of a benign tumor in the long bone.

Keywords: Benign bone tumor, Bone defect, Ilizarov

Figures and Tables

Fig. 1

(A) Radiographs of a 12-year-old male patient show an osteolytic lesion of left tibial shaft. (B) Coronal and sagittal images of computed tomograph show the same lesions. (C) We performed resection of the lesion and applied Ilizarov fixator. Pathologic diagnosis was osteofibrous dysplasia. (D) Radiographs of at 5 months postoperative show nonunion of docking site. (E) We performed a fibular strut bone graft at docking site. (F) Radiographs from the last follow-up show a healed bone lesion.

Fig. 2

(A) Radiographs of a 14-year-old male patient show an osteolytic lesion of the shaft of the right tibia. (B) We resected the lesion and inserted calcium sulfate into the bone defect and applied Ilizarov fixator. We simutaneously performed corticotomy at the proximal metaphysis. Radiographs at 1 month postoperative showed that the proximal fragment was transported distally. (C) Radiographs from the last follow-up show healed bone lesion.

Fig. 3

(A) Radiographs of a 15-year-old female patient show a pathologic fracture of the right distal femur. (B) We performed resecting of the lesion and applied Ilizarov fixator. (C) Radiographs at 2 months postoperative show lengthening of the corticotomy site. (D) Radiographs from the last follow-up show a healed bone lesion.

Fig. 4

(A) The image shows the pathologic fracture due to fibrous dysplasia of the diaphysis. (B) We resected the lesion and applied Ilizarov fixator. (C) We performed gradual lengthening at the proximal metaphysis. (D) Radiographs at the last follow-up show a healed bone lesion.

Fig. 5

(A) Radiographs of a 4-year-old male patient show an osteolytic lesion of the right tibial diaphysis. (B) We performed resecting of the lesion and applied Ilizarov fixator. (C) Radiographs at 12 months postoperative show lengthening of the corticotomy site. (D) Radiographs at the last follow-up show a healed bone lesion.

Fig. 6

(A) Radiographs of a 36-year-old male patient show an osteolytic lesion of the left dital femur. (B) We resected the lesion and applied Ilizarov fixator. (C) Radiographs at 9 months postoperative show lengthening of the corticotomy site. (D) Radiographs at 2 years postoperative show a healed bone lesion.

Fig. 7

(A) Radiographs of a 10-year-old male patient show an osteolytic lesion of the shaft of the right tibia. (B) We resected the lesion and inserted calcium sulfate and a fibular strut bone graft at the bone defect. (C) The image shows union processing at the graft site. (D) Radiographs at the last follow-up show a healed bone lesion.

Table 1

Summary of Treated Patients

^*No., Number; ^†M, Male; ^‡F, Female; ^§OFD, Osteofibrous dysplasia; ^∥ABC, Aneurysmal bone tumor; ^¶GCT, Giant cell tumor.

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