Table 4.
Largest clinical studies published in 2015-2019 and their outcomes with distraction osteogenesis techniques
| Ref. | Number of patients | Fixation type / bone union rate | Problems requiring reoperations after frame removal or failures |
| Defects of tibia | |||
| Kinik et al[14], 2019, Turkey | 30 | Ilizarov/96.66% | 1 nonunion, 1 refracture of the regenerate, 1 late deformity of the regenerate |
| Fahad et al[15], 2019, Pakistan | 51 | Ilizarov/96% | 2 nonunions (1 amputation due to sepsis), 2 reinfections eradicated during main treatment |
| Thakeb et al[16], 2019, Egypt | 50 | Ilizarov/100% | |
| Catagni et al[17], 2019, Italy | 86 | Ilizarov/100% | 4 refractures |
| Wu et al[18], 2018, China | 40 | Ilizarov/100% | |
| Yilihamu et al[19], 2017, China | 129 | Ilizarov + Orthofix/100% | |
| McNally et al[20], 2017, United Kingdom | 79 | Ilizarov/86.1% | 2 refractures, recurrence of infection, 6 after-frame reoperations |
| El-Alfy et al[21], 2017, Egypt | 28 | Ilizarov/100% | |
| Meleppuram et al[22], 2016, India | 42 | Ilizarov/100% | |
| Abuomira et al[23], 2016, Italy | 55 | Ilizarov + Taylor spatial frame/89% | 1 osteitis, 2 bending of regenerate, 2 refractures of the docking site, 1 nonunion |
| Rohilla et al[24], 2016, India | 70 | Ilizarov vs rail fixator/77% vs 80% of primary union | The rail fixator was converted to a ring fixator in two patients, 2 after-frame refractures |
| Sadek et al[25], 2016, Egypt | 30 | Ilizarov vs two stage internal osteosynthesis | 1 nonunion in internal group |
| Bernstein et al[26], 2015, United States | 30 | Ilizarov/77% | - |
| Peng et al[27], 2015, China | 58 | Ilizarov/100% | 4 equinovarus deformities, 1 infection recurrence at the docking site |
| Defects due to acute fractures | |||
| van Niekerk et al[28], 2017, South Africa | 24 | Ilizarov/91.7% | 2 amputations, 1 persistent deep infection in a HIV-positive patient, mangled extremity |
| Salih et al[29], 2018, United Kingdom | 31 | Ilizarov/96% | 4 after-frame refractures, 2 regenerate deformities after frame, 1 stiff non-union |
| Fuermitz et al[30], 2016, Germany | 25 | Ilizarov or hybrid/92% | 2 amputations due to comorbidities |
| Azzam et al[31], 2016, Еgypt | 30 | Ilizarov/93.3% | 1 post-frame fracture |
| Thakeb et al[32], 2016, Egypt | 161 | Ilizarov | 1 failure |
| Ajmera et al[33], 2015, India | 30 | Monolateral/93% | 2 nonunions |
| Large-scale defects requiring tibilization of the fibula | |||
| Meselhy et al[34], 2018, Egypt | 141 | Ilizarov/100% | |
| Zaman et al[35], 2017, Pakistan | 121 | Ilizarov/100% | 1 supracondylar femoral fracture while removing frame |
| Defect of femur | |||
| Bakhsh et al[36], 2019, Pakistan | 50 | Ilizarov/98% | 2 nonunions, 1 refracture |
| Zhang et al[37], 2017, China | 41 | Monolateral/98% | 1 refracture, 5 cases of docking site nonunion |
| Mudiganty et al[38], 2017, India | 22 | Monolateral rail/97.5% | |
| Agrawal et al[39], 2016, India | 30 | Monorail/100% | 5 delayed union with autograft |
| Defects of femur and tibia | |||
| Ariyawatkul et al[40], 2019, Thailand | 171 | Ilizarov/94% | 1 nonunion |
| Lowenberg et al[41], 2015, United States | 127 | Ilizatov/96% | 3 amputations due to comorbidities |
| Yin et al[42], 2015, China | 110 | Ilizarov for tibia, monolateral for femur/100% | 2 after-frame refractures |
| Tumor- resection defects | |||
| Eralp et al[43], 2016 (Turkey, United States, Egypt) | 20 | Various types of external fixators/100% | 1 knee arthrodesis |
| Wang et al[44], 2019, China | 101 | Monolateral/90% | 1 amputation at long-term due to cancer relapse |
1
Smaller groups for rare conditions treated with the Ilizarov method (severely comminuted fractures, pan tibial defects, large periarticular defects). HIV: Human immunodeficiency virus.