Ilizarov technique in the management of bilateral tibia nonunion in an adult with osteogenesis imperfecta

Abstract

The purpose of this study is to present our surgical strategy and describe the advantages and outcomes of the Ilizarov method in the treatment of bilateral tibia nonunion in an adult with OI. The major of bone fracture fixation drawback is the difficult placement of nails due to abnormal bony anatomy, non-linear and imperforate canals, marked bowing and unusually short limbs. A female adult aged 18yo with bilateral tibia nonunion affected with OI type V was treated with the Ilizarov method. The tibia was in varus (15° at left, 14° at right) and recurvatum (18° on left, 27° on right). Surgical technic was same for both tibia in one-time procedure and it's compounded: primary fibula osteotomy, tibia and osteotomy taking out interfragmentary fibrosis, reduction and fixation by Ilizarov frame. Full weight-bearing was allowed at 3 months. The complications that occurred were minors. Bone's consolidation was obtained at 5 months and the frames were removed at 6 months in the office without anesthesia. At the follow-up visit 5 months after removal, the ASAMI functional and radiological score was excellent on the left side and good on the right side. The use of the Ilizarov method for treating a tibia bilateral nonunion in an adult patient with moderate OI provides good stability. This technic ensures early weight full bearing, above joint motion, recovery functional necessary to bone tissue regeneration normal. This is an alternative to avoid difficulties and complications due to internal fixation in deformities correction in adults with acquired bone-weakening conditions.