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Ilizarov vs Orthofix
Ортопедия и травматология Отправлено Nicola Papapietro 24 Апрель 2006, 18:37
Dear Colleagues
our list seems to be much more interested in trauma than in orthopedic disease, and I know that most of problems we have to face in the whole world is of traumatic kind.
I tried to ask for some spine problems that I face every day, but I had very few or no answer at all in the past. I work in a new hospital with no ER (unfortunately only at the moment, soon we will have that, aaaargh!) and I'm very lucky because I face very few patients with trauma so I have few experiences in that.
I would like to ask you all why do you prefer the Ilizarov external fixator instead of the modern Orthofix that is for quite all purpose in trauma and in selected orthopedics problems. I have some experience in treating fractures but also ostheotomy for varus or valgus knee, for Salter-Harris type of lesion ot the ankle and I have obtained very good results. What is the reason, if one, to use the Ilizarov instead of the more technological kind of external fixators? I know that Ilizarov is superbe in controlling fragments in all 3 planes of the space but is a very big kind of device and I think there is little compliance by the patient. The Orthofix and many others are thin and well accepted by patients. It could be interesting to me to know your opinion.
Thank you very much
Dr. Nicola Papapietro MD
_______________________________________
Department of Orthopedics and Trauma Surgery
Bio-Campus University of Rome
Via E. Longoni 83 - 00191 Rome - Italy

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    Re: Ilizarov vs Orthofix
    Tommy Bacal 24 Апрель 2006, 20:04
    As a student of the ilizarov and orthofix devices I must say that their use is knowledge and experience based. Indeed. Ilizarov is better in 3 dimension control but tends to be more cumbersome. However, the patient's compliance is a result of his appreciation of his care giver. They approve of the ilizarov ex fix just as easily when given the proper explanation.
    Your choice of treatment should express your experience.

    Bacal tommy

    israel
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    • Re: Ilizarov vs Orthofix
      Отправитель: John Wood 24 Апрель 2006, 20:49
      Tommy the best of both worlds - the Taylor Spacial frame! Ilizarov in the 21st century
      John Wood
      London UK



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      • Re: Ilizarov vs Orthofix
        Отправитель: Tommy Bacal 25 Апрель 2006, 00:12
        I must confess ignorance. I will look it up

        Bacal tommy

        israel

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        • Re: Ilizarov vs Orthofix
          Отправитель: Tommy Bacal 25 Апрель 2006, 00:16
          Seen picture of taylor spatial frame. Sorry, no experience with this device, but looks interesting.

          As I said before, choice of treatment should express the care giver's knowhow.

          No human experiences without consent (lol)

          Bacal tommy

          israel


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          • Re: Ilizarov vs Orthofix
            Отправитель: Nicola Papapietro 25 Апрель 2006, 00:21
            I have just met (and had a very good dining with him and his girlfriend) Dror Paley from Baltimor at the last International Congress of the Mediterranean Orthopedic Surgeon (Ortho Mare Nostrum) at Tanger, Morocco. He showed us those incredible results obtained with the Taylor Spatial Frame in some really incredible cases of
            deformities of legs, femoral agenesia and limb lengthening. I have been really impressed. But I think that the Taylor is an "occuping space" and uncomfortable device, justified only in case of major deformities correction.
            The cost of Taylor spatial frame I suppose is equivalent to orthofix. I know now, from your answer, that Ilizarov is really cheap compared to orthofix or taylor.

            Nick

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            • Re: Ilizarov vs Orthofix
              Отправитель: Alexander Chelnokov 25 Апрель 2006, 01:08
              > incredible results obtained with the Taylor Spatial Frame in some
              > really incredible cases of deformities of legs, femoral agenesia and
              > limb lengthening. I have been really impressed.


              The deformities have been corrected successfully with the Ilizarov technique for about 50 years. Really ANY results achieved with TSF are reachable with the Ilizarov, and often with less cumbersome frame - but not vice versa. BTW a similar hexapod was developed for the Ilizarov set. You can find in outstanding D. Paley's book "Principles of deformity correction" many examples of using Ilizarov, TSF and other devices for same problems.

              > But I think that the Taylor is an "occuping space" and uncomfortable
              > device, justified only in case of major deformities correction.


              Despite it is really huge it is so attractive (especially for people without experience with Ilizarov) because it presents no brainer technique - just apply a frame, input distances to the software and have a "cheque" with tempo for every nut at the distraction rods.
              While with classic Ilizarov one must realize oneself what he plans to do, where is axis of rotation, where and how place hinges, spend time to frame reassemblies if all components of the deformity were not addressed simultaneously.
              Of course TSF is a real step to the future. Some day a computer will not only calculate correction, but recognize deformity, apply a frame and then control transformation. Surgeons will only worry about how to spend all the money :-)

              > The cost of Taylor spatial frame I suppose is equivalent to
              > orthofix. I know now, from your answer, that Ilizarov is really
              > cheap compared to orthofix or taylor.


              I am not sure - maybe in the price list of Smith & Nephew it is close to others. In our setting it is rather cheap. Simple materials, simple parts.

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        • Re: Ilizarov vs Orthofix
          Отправитель: Myles Clough 26 Апрель 2006, 00:43
          I've never used it but have seen the results and I think the concept is most intriguing. The disadvantage is the expense but US hospitals throw away these devices after use on one patient, so there must be a mechanism for distributing them to where they are needed.
          You apply the frame then take an Xray, measure the remaining deformities, angulation, translation, rotation and shortening etc. Then feed these parameters into a computer program (on line) and it returns the adjustments that must be made to each of the 6 expansion devices. I hope Smith and Nephew will forgive my copying the image from their page




          This is copied from http://ortho.smith-nephew.com/ca_en/Standard.asp?NodeId=2945 which has surprisingly little further information
          The literature on this device is quite extensive now. A PubMed search for "Taylor spatial frame" yields 15 articles 12 of which are on subject. The full URL is

          http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=PureSearch&db=pubmed&details_term=taylor%5BAll%20Fields%5D%20AND%20spatial%5BAll%20Fields%5D%20AND%20frame%5BAll%20Fields%5D

          Myles Clough mylesclough@shaw.ca
          Orthopaedic Surgeon, Kamloops, BC, Canada
          Clinical Instructor, University of British Columbia
          Editor, OWL (Orthopaedic Web Links) http://www.orthopaedicweblinks.com
          Orthogate Workshop Pages http://www.orthogate.com/clough/index.htm

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    Re: Ilizarov vs Orthofix
    Leonid Solomin 24 Апрель 2006, 20:07
    Dear Dr. Nicola Papapietro MD:
    If you:
    1. "have some experience in treating fractures but also ostheotomy for varus or valgus knee, for Salter-Harris type of lesion ot the ankle and I have obtained very good results"
    2. sure, that Orthofix is "more technological kind of external fixators", "The Orthofix and many others are thin and well accepted by patients",
    that it means, that you have no need to use Ilizarov frame for all these cases.
    It is possible, if you will start to treat patients with nonunions and false joints,
    multiplanar deformations, defects, etc., your attitude to Ilizarov device will be changed.

    Best regards,
    Leonid Solomin

    Leonid N.Solomin, MD, PhD
    Head of ExFix Department
    R.R.Vreden Russian Research Institute of Traumatology and Orthopedics
    8 Baykova Str., St.Petersburg, 195427, Russia
    [ Ответить ]

    Re: Ilizarov vs Orthofix
    Alexander Chelnokov 24 Апрель 2006, 21:22
    NP> fragments in all 3 planes of the space but is a very big kind of
    NP> device

    What about Taylor Spatial Frame?

    NP> and I think there is little compliance by the patient. The
    NP> Orthofix and many others are thin and well accepted by patients.

    If 1)it is available and 2)it is enough, Orthofix (and many other "prefabricated" frames) are quite acceptable. Ilizarov is not an external fixator but a set of multipurpose details for osteosynthesis according to the principles of Ilizarov. Using the set one may assembly any needed frame - circular, monolateral, hybrid, with
    hinges... Any bone or joint can be addressed. Because of its versatility Ilizarov system is dominating over any predefined construction.

    Many hospitals which already have Ilizarov sets just reuse them and feel lack of motivation to acquire another solution for a problem already solved with the existing equipment. Especially if instead of a single Orthofix frame one may obtain a truck of Ilizarov rings, bars, posts etc :-)
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    Re: Ilizarov vs Orthofix
    Jacob Odesky 25 Апрель 2006, 09:03
    Dear colleges! I would like to present a Hexapod Ilizarov external fixator.

    The Hexapod represents the kinematic mechanism that realizes the three dimensional movements by
    different lengths of the six distractors connected to the two platforms. It’s well known in technique
    and uses for imitation of flying and other machines.
    The system has been developed in Germany and first presented at the Ilizarov meeting in 1995 by Dr. K. Seide. It consists of six telescopic distractors of varying length from 105-235 mm, 6 y adaptors, a measuring stick and software. The Y adaptors can be utilized with all types of the Ilizarov rings. It is possible to place the adaptors freely along the rings as necessary. The connection between the Y adaptors and the distractors is through a universal ball and socket joints. The software is very simple to use and does not need any connection to the Internet. The base data needed includes the diameter of
    the upper and lower rings, the positions of the Y adaptors on each ring and the length of the
    distraction rods. After the input of this data into the computer, the program shows the initial
    position of center of the upper ring in relation to the lower. From this point, all adjustments are
    made with specific reference to the central point of the lower ring, since this ring remains in a static position. All adjustments can be in three planes. The CORA is entered in relation to the center of the distal ring and the desired correction entered into the computer.
    The software then makes the appropriate adjustments for deformity correction consistently for each plane according to the plan developed on the basis of the malalignment test along three axes with six degrees of freedom.
    The software displays a plan for correction detailing the steps according to the surgeons input of the number of days and steps desired. Beyond this, the software determines the final length of the distractors and the changes between the rings so that the progress and changes can be monitored to assure that the changes have occurred appropriately along the scheduled plan.
    There is no necessity to establish Hexapod in operation room, it application and removal is quick, taking only about fifteen minutes for each procedure, and is pain-free.
    After removal, it is possible to put it to the following patient, thus, having 3-4 Hexapod sets it is possible to treat consistently big number of patients. I, for example for a year having 2 sets, have applied them 21 times.
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    Re: Ilizarov vs Orthofix
    Odessky Jacob M.D. 27 Апрель 2006, 17:28
    Dear Nicola! I have asked us why we prefer the Ilizarov external fixator instead of the modern Orthofix that is for quite all purpose in trauma (according to you experience) and in selected orthopedics problems. What is the reason, if one, to use the Ilizarov instead of the more technological kind of external fixators?
    I▓ll try to answer this question very simply. I prefer Ilizarov▓s device because biomechanically, clinically and practically it▓s much better than Orthofix!
    I incur to tell greater - the Ilizarov Ex. Fix. augmented by Hexapod Set better not only Orthofix, but also the Taylor Spatial Frame.

    Кликните для загрузки файла 2005-09 (ס
    12KB (12366 bytes)

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    • Re: Ilizarov vs Orthofix
      Отправитель: John 14 Октябрь 2007, 21:21
      Hi,

      I have stumbled across this forum. I have had experience with Taylor Spatial Frame. As a matter of fact my tibia was severely damaged. Luckily I got one of these fixators fitted on. I think the ring fixators offer better mechanical conditions at fracture site of long bones. For other types of bones this might not be the case.

      I found very helpful the information provided on the www.bonefixator.com . Check out there the sections on bone healing, fractures, and fixation methods to get better understanding why and when to use external ring fixation.

      I hope this helps for people who are still looking at this forum.

      John


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    Re: Ilizarov vs Orthofix
    Popov Victor 01 Май 2006, 08:39
    Dear Colleague Nicola Papapietro. En 1985 j'apprenais deux mois chez Ilisarov avec l'orthopédiste de l'Italy Ferdinando del Prete. Je veux trouver Ferdinando del Prete. Popov Victor. Kazakstan. Karaganda. popov_cpl@mail.ru
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    • Re: Ilizarov vs Orthofix
      Отправитель: Nicola Papapietro 01 Май 2006, 20:43
      Cher Confrere

      ceci c'est l'addresse du docteur Del Prete. J ne connais pas lui, mais vous pouvez ecrire a lui. Ie n'ai pas l'e-mail ou le numero du telephone,
      seulement l'addresse postale:

      Dott. Ferdinando Del PreteVia S. Felice A Ema 35
      50125 Firenze

      Bonne chance

      A bien revoir

      Nicola Papapietro

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    Re: Ilizarov vs Orthofix
    john 26 Февраль 2010, 23:52
    Well both fixators can work. It all depends on the interfragentray motion and mechanical enviroment at the frature site. check out for more information http://www.bonefixator.com
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