Fokin A A, Verbovetskiĭ L P, Fokin A A, Kulak A N
Vestn Khir Im I I Grek. 1990 Nov;145(11):15-20.
The method of treatment after Ilizarov was used in 28 patients with occlusion of lower extremity arteries, mainly of distal localization, with the III and IV degrees of ischemia. Osteotomy of mainly the tibial bone and distraction of the free osseous split was performed during 31-36 days. Two patients had fractures of the bone during operative interventions, after operation four patients had purulent complications or necrosis of the skin around the wire. The immediate positive result was noted in 20 patients. Their fate was followed-up in remote periods from 2 to 19 months, good results were observed in 18 patients. The use of the Ilizarov method was most justified in patients with the III and IV degrees of ischemia when other methods of treatment failed to give any effect and surgical reconstruction of the vessels is impossible. When treating patients with the IV degree, it is necessary to take into consideration the late appearance of revascularization and possibility of temporary deterioration. The use of the Ilizarov method foresees provision of the joint work of an angiosurgeon and a traumatologist-orthopedist.
对28例主要为远端闭塞、缺血程度为Ⅲ级和Ⅳ级的下肢动脉闭塞患者采用Ilizarov术后治疗方法。主要对胫骨进行截骨,并在31至36天内对游离骨劈开处进行牵张。2例患者在手术干预期间发生骨折,术后4例患者出现脓性并发症或钢丝周围皮肤坏死。20例患者取得了即时阳性结果。对他们进行了2至19个月的远期随访,18例患者效果良好。当其他治疗方法无效且无法进行血管外科重建时,Ilizarov方法在缺血程度为Ⅲ级和Ⅳ级的患者中使用最为合理。在治疗Ⅳ级患者时,有必要考虑血管再通的延迟出现和暂时恶化的可能性。使用Ilizarov方法需要血管外科医生和创伤骨科医生的联合协作。