{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:58:56Z","timestamp":1790791136133,"version":"4.1.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JOIO"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1007\/s43465-025-01685-y","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:20:24Z","timestamp":1768206024000},"page":"2588-2598","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced Bone Healing in Tibial Osteogenesis Using the Distraction Holiday Protocol in Ilizarov Fixation"],"prefix":"10.1007","volume":"60","author":[{"given":"Pappu","family":"Rajasekhar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4305-1022","authenticated-orcid":false,"given":"Tarun","family":"Jayakumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praharsha","family":"Mulpur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev Reddy","family":"Kikkuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. V. Gurava","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"3","key":"1685_CR1","doi-asserted-by":"publisher","first-page":"144","DOI":"10.5435\/00124635-200405000-00002","volume":"12","author":"JG Birch","year":"2004","unstructured":"Birch, J. G., & Samchukov, M. L. (2004). Use of the Ilizarov method to correct lower limb deformities in children and adolescents. Journal of the American Academy of Orthopaedic Surgeons, 12(3), 144\u2013154. https:\/\/doi.org\/10.5435\/00124635-200405000-00002","journal-title":"Journal of the American Academy of Orthopaedic Surgeons"},{"issue":"1","key":"1685_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/s10195-019-0527-1","volume":"20","author":"K Aktuglu","year":"2019","unstructured":"Aktuglu, K., Erol, K., & Vahabi, A. (2019). Ilizarov bone transport and treatment of critical-sized tibial bone defects: A narrative review. Journal of Orthopaedics and Traumatology, 20(1), Article 22. https:\/\/doi.org\/10.1186\/s10195-019-0527-1","journal-title":"Journal of Orthopaedics and Traumatology"},{"issue":"Suppl 1","key":"1685_CR3","doi-asserted-by":"publisher","first-page":"S7","DOI":"10.1097\/BOT.0000000000001115","volume":"32","author":"A Nauth","year":"2018","unstructured":"Nauth, A., Schemitsch, E., Norris, B., Nollin, Z., & Watson, J. T. (2018). Critical-size bone defects: Is there a consensus for diagnosis and treatment? Journal of Orthopaedic Trauma, 32(Suppl 1), S7\u2013S11. https:\/\/doi.org\/10.1097\/BOT.0000000000001115","journal-title":"Journal of Orthopaedic Trauma"},{"issue":"6","key":"1685_CR4","doi-asserted-by":"publisher","first-page":"3225","DOI":"10.1007\/s00590-024-04050-1","volume":"34","author":"S-TJ Tsang","year":"2024","unstructured":"Tsang, S.-T.J., van Rensburg, A. J., van Heerden, J., Epstein, G. Z., Venter, R., & Ferreira, N. (2024). The management of critical bone defects: Outcomes of a systematic approach. European Journal of Orthopaedic Surgery & Traumatology, 34(6), 3225\u20133231. https:\/\/doi.org\/10.1007\/s00590-024-04050-1","journal-title":"European Journal of Orthopaedic Surgery & Traumatology"},{"key":"1685_CR5","doi-asserted-by":"publisher","DOI":"10.1016\/j.medntd.2021.100077","volume":"11","author":"R Fu","year":"2021","unstructured":"Fu, R., Feng, Y., Liu, Y., & Yang, H. (2021). Mechanical regulation of bone regeneration during distraction osteogenesis. Medicine in Novel Technology and Devices, 11, Article 100077. https:\/\/doi.org\/10.1016\/j.medntd.2021.100077","journal-title":"Medicine in Novel Technology and Devices"},{"issue":"6","key":"1685_CR6","doi-asserted-by":"publisher","first-page":"591","DOI":"10.5604\/15093492.1091515","volume":"15","author":"P Koczewski","year":"2013","unstructured":"Koczewski, P., & Shadi, M. (2013). Factors influencing bone regenerate healing in distraction osteogenesis. Ortopedia, Traumatologia, Rehabilitacja, 15(6), 591\u2013599. https:\/\/doi.org\/10.5604\/15093492.1091515","journal-title":"Ortopedia, Traumatologia, Rehabilitacja"},{"key":"1685_CR7","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1097\/00003086-199602000-00036","volume":"323","author":"B Fink","year":"1996","unstructured":"Fink, B., Krieger, M., Strauss, J. M., Opheys, C., Menkhaus, S., Fischer, J., et al. (1996). Osteoneogenesis and its influencing factors during treatment with the Ilizarov method. Clinical Orthopaedics and Related Research, 323, 261\u2013272. https:\/\/doi.org\/10.1097\/00003086-199602000-00036","journal-title":"Clinical Orthopaedics and Related Research"},{"issue":"Suppl 2","key":"1685_CR8","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.injury.2014.04.002","volume":"45","author":"DJ Hak","year":"2014","unstructured":"Hak, D. J., Fitzpatrick, D., Bishop, J. A., Marsh, J. L., Tilp, S., Schnettler, R., et al. (2014). Delayed union and nonunions: Epidemiology, clinical issues, and financial aspects. Injury, 45(Suppl 2), S3-7. https:\/\/doi.org\/10.1016\/j.injury.2014.04.002","journal-title":"Injury"},{"key":"1685_CR9","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.jot.2017.04.002","volume":"10","author":"E Gibon","year":"2017","unstructured":"Gibon, E., Lu, L. Y., Nathan, K., & Goodman, S. B. (2017). Inflammation, ageing, and bone regeneration. Journal of Orthopaedic Translation, 10, 28\u201335. https:\/\/doi.org\/10.1016\/j.jot.2017.04.002","journal-title":"Journal of Orthopaedic Translation"},{"key":"1685_CR10","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1097\/00003086-199404000-00021","volume":"301","author":"TM Ganey","year":"1994","unstructured":"Ganey, T. M., Klotch, D. W., Sasse, J., Ogden, J. A., & Garcia, T. (1994). Basement membrane of blood vessels during distraction osteogenesis. Clinical Orthopaedics and Related Research, 301, 132\u2013138.","journal-title":"Clinical Orthopaedics and Related Research"},{"issue":"1","key":"1685_CR11","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1055\/s-0043-1776021","volume":"59","author":"GS Cardoso","year":"2024","unstructured":"Cardoso, G. S., & Amorim, R. (2024). Bone regenerate evaluation methods. Revista Brasileira de Ortopedia, 59(1), e1\u2013e9. https:\/\/doi.org\/10.1055\/s-0043-1776021","journal-title":"Revista Brasileira de Ortopedia"},{"issue":"8","key":"1685_CR12","doi-asserted-by":"publisher","first-page":"2425","DOI":"10.1016\/j.injury.2019.12.025","volume":"52","author":"H Kinik","year":"2021","unstructured":"Kinik, H., & Kalem, M. (2021). Ilizarov segmental bone transport of infected tibial nonunions requiring extensive debridement with an average distraction length of 9,5 centimetres. Is it safe? Injury, 52(8), 2425\u20132433. https:\/\/doi.org\/10.1016\/j.injury.2019.12.025","journal-title":"Injury"},{"issue":"2","key":"1685_CR13","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/01.TA.0000057234.48501.30","volume":"56","author":"AO Mekhail","year":"2004","unstructured":"Mekhail, A. O., Abraham, E., Gruber, B., & Gonzalez, M. (2004). Bone transport in the management of posttraumatic bone defects in the lower extremity: The journal of trauma: injury. Infection, and Critical Care, 56(2), 368\u2013378. https:\/\/doi.org\/10.1097\/01.TA.0000057234.48501.30","journal-title":"Infection, and Critical Care"},{"issue":"3","key":"1685_CR14","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1007\/s11751-009-0070-3","volume":"4","author":"NWL Schep","year":"2009","unstructured":"Schep, N. W. L., Van Lieshout, E. M. M., Patka, P., & Vogels, L. M. M. (2009). Long-term functional and quality of live assessment following post-traumatic distraction osteogenesis of the lower limb. Strategies in Trauma and Limb Reconstruction, 4(3), 107\u2013112. https:\/\/doi.org\/10.1007\/s11751-009-0070-3","journal-title":"Strategies in Trauma and Limb Reconstruction"},{"issue":"Suppl 2","key":"1685_CR15","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.jcot.2016.02.016","volume":"7","author":"R Rohilla","year":"2016","unstructured":"Rohilla, R., Siwach, K., Devgan, A., Singh, R., Wadhwani, J., & Ahmed, N. (2016). Outcome of distraction osteogenesis by ring fixator in infected, large bone defects of tibia. Journal of Clinical Orthopaedics and Trauma, 7(Suppl 2), 201\u2013209. https:\/\/doi.org\/10.1016\/j.jcot.2016.02.016","journal-title":"Journal of Clinical Orthopaedics and Trauma"},{"issue":"7","key":"1685_CR16","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1007\/s00264-013-2254-1","volume":"38","author":"KH Salem","year":"2014","unstructured":"Salem, K. H., & Schmelz, A. (2014). Low-intensity pulsed ultrasound shortens the treatment time in tibial distraction osteogenesis. International Orthopaedics, 38(7), 1477\u20131482. https:\/\/doi.org\/10.1007\/s00264-013-2254-1","journal-title":"International Orthopaedics"},{"issue":"5","key":"1685_CR17","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1097\/TA.0b013e31821912b2","volume":"71","author":"M Dudda","year":"2011","unstructured":"Dudda, M., Hauser, J., Muhr, G., & Esenwein, S. A. (2011). Low-intensity pulsed ultrasound as a useful adjuvant during distraction osteogenesis: A prospective, randomized controlled trial. Journal of Trauma-Injury Infection and Critical Care, 71(5), 1376\u20131380. https:\/\/doi.org\/10.1097\/TA.0b013e31821912b2","journal-title":"Journal of Trauma-Injury Infection and Critical Care"},{"issue":"2","key":"1685_CR18","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s00264-004-0625-3","volume":"29","author":"H El-Mowafi","year":"2005","unstructured":"El-Mowafi, H., & Mohsen, M. (2005). The effect of low-intensity pulsed ultrasound on callus maturation in tibial distraction osteogenesis. International Orthopaedics, 29(2), 121\u2013124. https:\/\/doi.org\/10.1007\/s00264-004-0625-3","journal-title":"International Orthopaedics"},{"issue":"1","key":"1685_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03894-y","volume":"22","author":"Y-Q Xu","year":"2021","unstructured":"Xu, Y.-Q., Fan, X.-Y., He, X.-Q., & Wen, H.-J. (2021). Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: Experience from 31 cases. BMC Musculoskeletal Disorders, 22(1), Article 34. https:\/\/doi.org\/10.1186\/s12891-020-03894-y","journal-title":"BMC Musculoskeletal Disorders"},{"issue":"5","key":"1685_CR20","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1007\/s00264-017-3684-y","volume":"42","author":"Y Zhang","year":"2018","unstructured":"Zhang, Y., Wang, Y., Di, J., & Peng, A. (2018). Double-level bone transport for large post-traumatic tibial bone defects: A single centre experience of sixteen cases. International Orthopaedics, 42(5), 1157\u20131164. https:\/\/doi.org\/10.1007\/s00264-017-3684-y","journal-title":"International Orthopaedics"},{"issue":"2","key":"1685_CR21","doi-asserted-by":"publisher","first-page":"106","DOI":"10.5005\/jp-journals-10080-1466","volume":"15","author":"N Ferreira","year":"2020","unstructured":"Ferreira, N., & Tanwar, Y. S. (2020). Systematic approach to the management of post-traumatic segmental diaphyseal long bone defects: Treatment algorithm and comprehensive classification system. Strategies in Trauma and Limb Reconstruction, 15(2), 106\u2013116. https:\/\/doi.org\/10.5005\/jp-journals-10080-1466","journal-title":"Strategies in Trauma and Limb Reconstruction"},{"issue":"12","key":"1685_CR22","doi-asserted-by":"publisher","first-page":"2955","DOI":"10.1007\/s11999-008-0514-y","volume":"466","author":"N Saran","year":"2008","unstructured":"Saran, N., & Hamdy, R. C. (2008). DEXA as a predictor of fixator removal in distraction osteogenesis. Clinical Orthopaedics & Related Research, 466(12), 2955\u20132961. https:\/\/doi.org\/10.1007\/s11999-008-0514-y","journal-title":"Clinical Orthopaedics & Related Research"},{"issue":"2","key":"1685_CR23","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/01241398-198703000-00002","volume":"7","author":"G De Bastiani","year":"1987","unstructured":"De Bastiani, G., Aldegheri, R., Renzi-Brivio, L., & Trivella, G. (1987). Limb lengthening by callus distraction (callotasis). Journal of Pediatric Orthopedics, 7(2), 129\u2013134. https:\/\/doi.org\/10.1097\/01241398-198703000-00002","journal-title":"Journal of Pediatric Orthopedics"},{"issue":"1","key":"1685_CR24","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-06034-w","volume":"23","author":"Q Liu","year":"2022","unstructured":"Liu, Q., Liu, Z., Guo, H., Wang, M., Liang, J., & Zhang, Y. (2022). A comparative study of bone union and nonunion during distraction osteogenesis. BMC Musculoskeletal Disorders, 23(1), Article 1053. https:\/\/doi.org\/10.1186\/s12891-022-06034-w","journal-title":"BMC Musculoskeletal Disorders"},{"issue":"7","key":"1685_CR25","doi-asserted-by":"publisher","first-page":"2084","DOI":"10.18203\/2320-6012.ijrms20212530","volume":"9","author":"IW Subawa","year":"2021","unstructured":"Subawa, I. W., Astawa, P., Razunip, P., Putra, A. A. G. D. M., Putra, G. M., Arnaya, A. K., et al. (2021). Efficacy of trifocal versus bifocal bone transport on large tibial bone defect: A systematic review and meta-analysis. International Journal of Research in Medical Sciences, 9(7), 2084. https:\/\/doi.org\/10.18203\/2320-6012.ijrms20212530","journal-title":"International Journal of Research in Medical Sciences"},{"key":"1685_CR26","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.858240","volume":"9","author":"A Abulaiti","year":"2022","unstructured":"Abulaiti, A., Liu, Y., Cai, F., Liu, K., Abula, A., Maimaiti, X., et al. (2022). Bone defects in Tibia managed by the bifocal vs. trifocal bone transport technique: A retrospective comparative study. Frontiers in Surgery, 9, Article 858240. https:\/\/doi.org\/10.3389\/fsurg.2022.858240","journal-title":"Frontiers in Surgery"},{"issue":"6","key":"1685_CR27","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.injury.2011.04.004","volume":"42","author":"MA Catagni","year":"2011","unstructured":"Catagni, M. A., Guerreschi, F., & Lovisetti, L. (2011). Distraction osteogenesis for bone repair in the 21st century: Lessons learned. Injury, 42(6), 580\u2013586. https:\/\/doi.org\/10.1016\/j.injury.2011.04.004","journal-title":"Injury"},{"issue":"3","key":"1685_CR28","doi-asserted-by":"publisher","first-page":"306","DOI":"10.3109\/17453679809000936","volume":"69","author":"K Mamada","year":"1998","unstructured":"Mamada, K., Nakamura, K., Matsushita, T., Okazaki, H., Shiro, R., Ou, W., et al. (1998). The diameter of callus in leg lengthening 28 tibial lengthenings in 14 patients with achondroplasia. Acta Orthopaedica Scandinavica, 69(3), 306\u2013310. https:\/\/doi.org\/10.3109\/17453679809000936","journal-title":"Acta Orthopaedica Scandinavica"},{"issue":"8","key":"1685_CR29","doi-asserted-by":"publisher","first-page":"2880","DOI":"10.1016\/j.injury.2022.06.006","volume":"53","author":"M Yushan","year":"2022","unstructured":"Yushan, M., Abulaiti, A., Maimaiti, X., Hamiti, Y., & Yusufu, A. (2022). Tetrafocal (three osteotomies) and pentafocal (four osteotomies) bone transport using Ilizarov technique in the treatment of distal tibial defect-preliminary outcomes of 12 cases and a description of the surgical technique. Injury, 53(8), 2880\u20132887. https:\/\/doi.org\/10.1016\/j.injury.2022.06.006","journal-title":"Injury"},{"issue":"4","key":"1685_CR30","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s12570-015-0330-2","volume":"6","author":"M El-Sayed","year":"2015","unstructured":"El-Sayed, M., Correll, J., Hosny, G. A., Hegazy, M., Abdelatif, N. M. N., Badawy, I., et al. (2015). Bone regenerate complications during lengthening: Incidence, predisposing factors, and treatment. European Orthopaedics and Traumatology, 6(4), 445\u2013449. https:\/\/doi.org\/10.1007\/s12570-015-0330-2","journal-title":"European Orthopaedics and Traumatology"},{"issue":"2","key":"1685_CR31","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1111\/os.12374","volume":"10","author":"P Tirawanish","year":"2018","unstructured":"Tirawanish, P., & Eamsobhana, P. (2018). Prediction of callus subsidence in distraction osteogenesis using callus formation scoring system: Preliminary study: Prediction of callus subsidence. Orthopaedic Surgery, 10(2), 121\u2013127. https:\/\/doi.org\/10.1111\/os.12374","journal-title":"Orthopaedic Surgery"},{"issue":"1","key":"1685_CR32","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-66","volume":"9","author":"R Dimitriou","year":"2011","unstructured":"Dimitriou, R., Jones, E., McGonagle, D., & Giannoudis, P. V. (2011). Bone regeneration: Current concepts and future directions. BMC Medicine, 9(1), Article 66. https:\/\/doi.org\/10.1186\/1741-7015-9-66","journal-title":"BMC Medicine"}],"container-title":["Indian Journal of Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43465-025-01685-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s43465-025-01685-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s43465-025-01685-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:38:35Z","timestamp":1790789915000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s43465-025-01685-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["1685"],"URL":"https:\/\/doi.org\/10.1007\/s43465-025-01685-y","relation":{},"ISSN":["0019-5413","1998-3727"],"issn-type":[{"value":"0019-5413","type":"print"},{"value":"1998-3727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"assertion":[{"value":"8 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent to publish was obtained from all individual participants included in the study.","order":2,"name":"Ethics","label":"Consent to Publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Obtained. Approved by the Institutional Ethical Committee (SIEC\/2023\/515).","order":3,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent to participate was obtained from all individual participants included in the study.","order":4,"name":"Ethics","label":"Human Ethics and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}}]}}