School of Podiatric Medicine - Medical Student Research
Document Type
Poster
Publication Date
2025
Abstract
This review examines current literature regarding the viability of reused/reprocessed Ilizarov External Fixation (IEF) – with the end-goal of improving surgical options for complex limb pathologies in austere environments. We hypothesize this review will find no statistically significant difference between clinical outcomes of reused vs. new IEFs
IEF is an important but costly modality for complex limb pathologies, such as trauma, deformity, and nonunion (Chironga et al., 2023). Though effective, the cost of IEF is exacerbated by its single-use deployment (Chironga et al., 2023). A proposed cost-control measure is IEF reuse/reprocessing via (1) antiseptic pre-treatment, (2) structural stability assessment, (3) autoclave sterilization (Mahapatra et al., 2017)
Investigators reviewed searched current literature published in PubMed, Cochrane, Web of Science, and Google Scholar for candidate articles for search terms “External Fixator Frame” and “Reuse.” applied in these databases for retrieval and reproducibility purposes. Search strategy: Parameters were set for articles that would be included in the study and documented using a PRISMA flow chart. Candidate articles were screened by both reviewers using exclusion criteria included: duplicates, paper not available in English, paper does not meet search term definitions, full definitions, full text not available, published before 2004, not being original research, and full text not available. Papers were included if they passed screening by both reviewers.
Systematic searching yielded 59 results. No pertinent papers on reprocessed IEF were identified. While many papers concern external fixation, they did not state if the fixation was IEF. Some papers did not compare reused vs. single-use external fixation, and one paper covered veterinary subjects only. Commonly referenced papers concerning IEF include:
• Kummer et al, 1992 – no access to full text at time of review
• Chironga et al, 2023 – does not directly compare reused vs. single-use IEF
• Mahapatra et al, 2017 – does not directly state reprocessed frame type
This review shows no studies have compared reused vs. single-use IEF.
This review found that there are no papers directly comparing reprocessed Ilizarov Frames and single use Ilizarov Frames. No reported patient outcomes were found in reprocessed Ilizarov type frames specifically. Chironga (2023) found that cost saving of Ilizarov frames are 63%, but did not record patient outcomes. Access to the Kummer (1992) paper was obtained after the systematic searching was completed, and stated that IEF rings were structurally intact after initial use, though other components (wires, bolts) suffered from wear. Beck (2006) argued against reprocessing, noting unpredictable frame behavior with initial application and break-in period; this is expanded on by the Mahapatra (2017) paper which found increased complications in reprocessed vs single use, but no differences between frames reprocessed one time vs. two times. Though our review found no specific articles directly comparing new vs reprocessed, articles of interest maintained that cost savings with reprocessed IEFs was possible in an ethical and efficacious manner per measured patient outcomes and material evaluation in austere environments
Recommended Citation
Hughes, James; Obias, Nicholas; Prins, Dustin; and Killeen, Amanda, "New vs. Reprocessed: A Scoping Review on Ilizarov Frame Reuse" (2025). School of Podiatric Medicine - Medical Student Research. 10.
https://scholarworks.utrgv.edu/sopm_mspub/10
Works Cited
