Suksathien Yingyong, Suksathien Rachawan
Department of Orthopedic Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
J Med Assoc Thai. 2011 Oct;94(10):1224-9.
Fractures with related problems including intercalary bone defect, shortening, and malunion are still major problems in orthopedic practice. The Ilizalov's circular external fixator device has several advantages for bone reconstruction but also has certain drawbacks such as its bulkiness and complicated mounting. To maintain the advantages of Ilizalov's original concept and combine with the simplicity of monolateral frame, a new design multifunction dynamic external fixator system was developed to overcome the drawbacks.
To evaluate the clinical results and complications of a new design multifunction dynamic external fixator system for bone reconstructions.
Twenty patients requiring reconstructions between 2006 and 2009 participated in this study. The new design multifunction dynamic external fixators were used in 11 tibial and two femoral intercalary defects for bone transportation, three tibial and one femoral lengthening, and three tibial malunion correction (45, 60 and 75 degrees).
In bone transportation, new bone formation and union at the docking site were achieved in all patients. The mean new bone formation was 5.8 cm (range 3.5-14) in tibia and 4.3 cm (range 3.5-5) in femur. The mean healing index was 46.3 days/cm (range 42-60) in tibia and 93.9 days/cm (range 85.7-102) in femur. In bone lengthening, new bone formation and union were achieved in all patients. The mean amount of elongation was 3.5 cm (range 3-4) in tibia and 5 cm in femur. The mean healing index was 71.1 days/cm (range 68.6-76) in tibia and 73 days/cm in femur. In malunion correction, the mean correction time was 65 days (range 35-84) and the mean healing time was 187.3 days (range 154-212).
The new design multifunction dynamic external fixator system was successfully used for bone transportation, bone lengthening, and malunion correction with good results and low complications. It is simple, safe, and easy to use.
伴有诸如骨缺损、短缩和畸形愈合等相关问题的骨折仍是骨科临床实践中的主要难题。伊里扎洛夫环形外固定器在骨重建方面具有诸多优势,但也存在某些缺点,比如其体积庞大且安装复杂。为了保留伊里扎洛夫原始理念的优势并结合单侧框架的简易性,研发了一种新型多功能动态外固定器系统以克服这些缺点。
评估一种新型多功能动态外固定器系统用于骨重建的临床效果及并发症。
2006年至2009年间,20例需要进行骨重建的患者参与了本研究。新型多功能动态外固定器用于11例胫骨和2例股骨骨缺损的骨搬运、3例胫骨和1例股骨的延长以及3例胫骨畸形愈合的矫正(45度、60度和75度)。
在骨搬运中,所有患者对接部位均实现了新骨形成与愈合。胫骨新骨形成平均为5.8厘米(范围3.5 - 14厘米),股骨为4.3厘米(范围3.5 - 5厘米)。胫骨平均愈合指数为46.3天/厘米(范围42 - 60天/厘米),股骨为93.9天/厘米(范围85.7 - 102天/厘米)。在骨延长中,所有患者均实现了新骨形成与愈合。胫骨平均延长量为3.5厘米(范围3 - 4厘米),股骨为5厘米。胫骨平均愈合指数为71.1天/厘米(范围68.6 - 76天/厘米),股骨为73天/厘米。在畸形愈合矫正中,平均矫正时间为65天(范围35 - 84天),平均愈合时间为187.3天(范围154 - 212天)。
新型多功能动态外固定器系统成功用于骨搬运、骨延长和畸形愈合矫正,效果良好且并发症少。它操作简单、安全且易于使用。