Segmental Loss of Long Bones treated by Ilizarov Ring Fixation

Mubarak Basha, I (2007) Segmental Loss of Long Bones treated by Ilizarov Ring Fixation. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Bone loss management of long bones is a challenge to any orthopaedic surgeon. In many cases it may be associated with sepsis, shortening, deformity, non-union etc., and complicate the situation. In the past many techniques were used to manage this clinical problem and mostly ended in amputations. A breakthrough technique invented by Prof. Ilizarov using his unique ring fixator addresses all the above mentioned complications simultaneously. AIM: 1. To analyse the effect of distraction osteogenesis in cases of segmental bone loss due to Trauma, Tumors and Post Infective Sequealae. 2. To establish suitable protocols in the management of segmental bone loss using Ilizarov ring fixator. MATERIALS AND METHODS: This is a study to evaluate the patients with segmental loss of long bones managed by distraction osteogenesis using Ilizarov ring fixators at Government General Hospital Chennai for the period between August 2004 to October 2006. A total of 20 patients with segmental bone loss were included in this study. Males were 15 (14 yrs – 68 yrs) with a mean age of – 34.8 yrs. Females were 5 (12 yrs -53 yrs) with a mean age of 36 yrs. 14 patients have completed the treatment. Other 6 patients have completed the bone transport and waiting for consolidation and ring removal. The follow-up period ranged from 2 ½ months to 8 months. The etiology of bone defect was post traumatic bone loss in 13 cases, post tumour resection bone defect in 6 cases, and post infective sequealae in 1 case. 2 cases had initial treatment with ORIF, 1 with plate osteosynthesis (case no:11) and another with intramedullary interlocking nail (case no: 14) elsewhere and referred for bone loss management. RESULTS: The results were assessed according to Dror Paley’s assessment criteria listed below. The results were divided into bony and functional. For bony results 4 criteria were evaluated-union, infection, and deformity and leg length discrepancy. An excellent bony result was one with union without infection, deformity less than 7 degrees and length discrepancy less than 2.5 cm. A good result was union plus any two of the other. A fair result was union plus one of the other. The poor result was non-union of re-fracture or none of the others. CONCLUSION: In the present scenario, the available solutions for large segmental long bone defects with or without shortening are external fixations like Ilizarov ring fixator or the dynamic axial fixator system. Of these two, Ilizarov method is cheaper and provides better all around stability as compared to the unilateral frame of dynamic axial fixator system. • This can be used simultaneously for deformity correction and in conditions with poor skin with adherent scars on the deformed bone. • Bone grafting is not necessary in all the cases. • This system allows weight bearing during treatment period thus decreasing disuse osteoporosis and soft tissue dystrophy. • The size of bone defect is not a limitation for reconstruction by distraction osteogenesis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Segmental Loss ; Long Bones ; Ilizarov Ring Fixation.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 14 Sep 2017 01:56
Last Modified: 14 Sep 2017 01:56

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