Sala Francesco, Talamonti Tazio, Agus Maria Alice
Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, Paolo Giovio 45, 20144 Milan, Italy.
Musculoskelet Surg. 2011 Aug;95(2):151-5. doi: 10.1007/s12306-011-0116-9. Epub 2011 Mar 23.
Treatment of segmental tibial bone defects after high-energy trauma or atrophic nonunion resection is challenging. In the last two decades, distraction osteogenesis Ilizarov bone transport has become a gold standard for the treatment of segmental tibial bone defects and lengthening in spite of the fact that frequent frame modifications and the need for sequential correction of deformities during bone transport are the main limitations of the device itself. The Taylor Spatial Frame applies the concept of the Stewart platform to the standard Ilizarov frame while applying the same principles of distraction osteogenesis postulated by Ilizarov. We report the case of a patient with two problems we could treat simultaneously: an ankle equinus contracture (a consequence of limb leg discrepancy) and infected tibial nonunion and soft-tissue damage complication after plating in a 41A3 type II Gustilo fracture of the left leg.
治疗高能创伤或萎缩性骨不连切除术后的节段性胫骨骨缺损具有挑战性。在过去二十年中,尽管频繁调整外固定架以及在骨搬运过程中需要对畸形进行逐步矫正,这些都是该设备本身的主要局限性,但牵引成骨Ilizarov骨搬运术已成为治疗节段性胫骨骨缺损和肢体延长的金标准。泰勒空间外固定架将斯图尔特平台的概念应用于标准的Ilizarov外固定架,同时应用Ilizarov提出的相同牵引成骨原理。我们报告了一例患者,存在两个可同时治疗的问题:踝关节马蹄足挛缩(肢体长度差异的结果)以及左侧41A3型II度 Gustilo 骨折钢板固定术后的感染性胫骨骨不连和软组织损伤并发症。