Comparative Analysis of Distraction Osteogenesis with Ilizarov External Fixation Using Percutaneous Gigli Saw...

Distraction osteogenesis using the Ilizarov technique is a cornerstone in managing bone defects and limb length discrepancies. The choice of corticotomy method - multiple drill-hole or percutaneous Gigli saw osteotomy - affects regenerate quality, though no clear consensus exists on the superior technique.

This prospective observational study compared Gigli saw (n = 14) and multiple drill-hole (n = 20) corticotomy techniques in 34 skeletally mature patients undergoing Ilizarov-based tibial lengthening or bone transport. All surgeries were performed by a single surgeon, with a minimum 1-year follow-up. The Modified Healing Index (MHI) was the primary outcome, while consolidation time and postoperative pain (VAS score) were secondary measures.

The mean patient age was 36.97 ± 8.6 years, with road traffic accidents as the most common indication. Radiographs confirmed cortical formation in all cases. The mean consolidation time was 8.85 ± 2.9 months, and the overall MHI averaged 1.32 ± 0.17 months/cm. The drill-hole group showed a significantly lower MHI than the Gigli saw group (t = -2.733, P = 0.010), indicating superior bone regeneration.

Both techniques are effective, but the multiple drill-hole method demonstrated better healing and consolidation. Further multicentric randomized studies are needed to confirm these findings.