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2015 ; 10
(11
): e0141973
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English Wikipedia
A Systematic Review and Meta-Analysis of Ilizarov Methods in the Treatment of
Infected Nonunion of Tibia and Femur
#MMPMID26529606
Yin P
; Ji Q
; Li T
; Li J
; Li Z
; Liu J
; Wang G
; Wang S
; Zhang L
; Mao Z
; Tang P
PLoS One
2015[]; 10
(11
): e0141973
PMID26529606
show ga
BACKGROUND: Infected nonunion of tibia and femur are common in clinical practice,
however, the treatment of these diseases has still been a challenge for
orthopaedic surgeons. Ilizarov methods can eradicate infection, compensate bone
defects and promote the bone union through progressive bone histogenesis. The
objective of this systematic review was to review current available studies
reporting on Ilizarov methods in the treatment of infected nonunion of tibia and
femur, and to perform meta-analysis of bone and functional results and
complications to evaluate the efficacy of Ilizarov methods. METHODS: A
comprehensive literature search was performed from the SCI, PubMed, Cochrane
Library; and Embase between January 1995 and August 2015. Some major data were
statistically analyzed using weighted means based on the sample size in each
study by SPSS 13.0, including number of patients, mean age, mean previous
surgical procedures, mean bone defects, mean length of follow-up, bone union,
complications per patient, external fixation time, and external fixation
index(EFI). Bone results (excellent, good, fair and poor rate), functional
results (excellent, good, fair and poor rate) and complications were analyzed by
Stata 9.0. FINDINGS: A total of 590 patients from 24 studies were included in
this systematic review. The average of bone union rate was 97.26% in all included
studies. The poor rate in bone results and functional results was 8% (95%CI,
0.04-0.12; I2 = 44.1%, P = 0.065) and 10% (95%CI, 0.05-0.14; I2 = 34.7%, P =
0.121) in patients with infected nonunion of tibia and femur treated by Ilizarov
methods. The rate of refracture, malunion, infectious recurrence, knee stiffness,
amputation, limb edema and peroneal nerve palsy was respectively 4%, 7%, 5%, 12%,
4%, 13% and 13%. CONCLUSIONS: Our systematic review showed that the patients with
infected nonunion of tibia and femur treated by Ilizarov methods had a low rate
of poor bone and functional results. Therefore, Ilizarov methods may be a good
choice for the treatment of infected nonunion of tibia and femur.