Related Experiment Video
Updated: Sep 15, 2026
Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
Published on: April 11, 2012
Management of childhood chronic tibial osteomyelitis with the Ilizarov method
Metin Kucukkaya1, Yavuz Kabukcuoglu, Mehmet Tezer
1First Department of Othopedic and Traumatology, Sisli Etfal Research and Training Hospital, Istanbul, Turkey. mkucukkaya@hotmail.com
Insights
The Ilizarov method, including sequestrectomy and antibiotics, effectively treats long bone defects from childhood osteomyelitis. This bifocal approach achieved excellent bone healing and function in seven pediatric patients without bone grafting.
Area of Science:
- Orthopedic Surgery
- Pediatric Osteology
- Infectious Disease Management
Background:
- Chronic hematogenous osteomyelitis in children can lead to significant long bone defects.
- The Ilizarov method is recognized for managing long bone defects, but its application in pediatric osteomyelitis is less documented.
- Childhood osteomyelitis presents unique challenges in bone reconstruction and infection control.
Purpose of the Study:
- To evaluate the efficacy of the Ilizarov method in treating long bone defects resulting from childhood chronic hematogenous osteomyelitis.
- To assess functional and radiological outcomes in pediatric patients undergoing Ilizarov treatment for tibial defects.
- To determine if bone grafting is necessary when using the Ilizarov method for infected pseudoarthrosis in children.
Main Methods:
- Seven pediatric patients with chronic hematogenous osteomyelitis of the tibia underwent treatment including sequestrectomy, debridement, antibiotic therapy, and bifocal Ilizarov fixation.
- Patients were classified as B1 infected pseudoarthrosis post-operatively according to Paley's criteria.
- Outcomes were assessed based on bone consolidation, healing index, need for bone grafting, and functional/radiological results at a mean follow-up of 4.6 years.
Main Results:
- Complete bone consolidation was achieved in all seven patients at the time of fixator extraction.
- The mean healing index was 32.3 days/cm, and no patients required bone grafting at the docking site.
- All patients demonstrated excellent functional and radiological results according to Paley's criteria at the final follow-up.
- The bifocal Ilizarov method proved effective in managing bone defects up to 12 cm.
Conclusions:
- The bifocal Ilizarov method, combined with sequestrectomy, debridement, and antibiotics, is a highly effective treatment for long bone defects caused by chronic hematogenous osteomyelitis in children.
- This treatment protocol leads to excellent bone healing and functional recovery without the need for bone grafting.
- The Ilizarov technique offers a superior alternative for managing complex bone defects in pediatric osteomyelitis cases.
Abstract:
The efficacy of the Ilizarov method in the management of the long bone defect is well established. There have been rare reports about the use of the Ilizarov method in the bone defect caused from childhood osteomyelitis. In this article, the authors present results of seven patients with childhood chronic hematogenous osteomyelitis of the tibia who were treated with the Ilizarov method. The treatment protocol also included sequestrectomy and debridement, appropriate antibiotic therapy, and bifocal treatment with the Ilizarov method. The mean age was 7.2 years old (range 6-8). After sequestrectomy and debridement, all cases were classified as B1 infected pseudoarthrosis according to Paley's criteria. All patients had active infection at the beginning of the treatment. The mean bone defect was 7.4 cm (range 3.5-12). Follow-up time was 4.6 years (range 2.7-5.8). At the time of fixator extraction, complete consolidation was obtained in all the patients. Healing index was 32.3 days/cm (range 28-44). Bone grafting was not required at the docking site in any of the patients. Functional and radiologic results were judged excellent according to Paley's criteria in all patients at the last follow-up. This study indicates that the bifocal method of the Ilizarov treatment is the best alternative for the bone defect caused by chronic hematogenous osteomyelitis in children.
More Related Videos
09:01Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
