de Pablos J, Cañadell J
Departamento de Cirugía Ortopédica y Traumatología, Universidad de Navarra, Pamplona.
Rev Med Univ Navarra. 1989 Apr-Jun;33(2):71-6.
Ilizarov's idea of treating large segmental bone defects (LSBD) by transporting bone along the length of the defect is to us extremely interesting. However, the circular external distractor employed, unlike monolateral frames in cumbersome, transfixing and difficult for both placement and postoperative management. A research project has been carried out at our experimental surgery laboratory to assess the reliability of monolateral frames in the treatment of LSBD following Ilizarov' idea. For this experiment we selected five 6 to 12 month-old dogs, five 6 month-old lambs and five 12 month-old lambs, the latter being skeletally mature. All animals were male. The experiment consisted in an attempo of reconstructing a LSBD of 4-5 cm of the animal's femoral diaphysis by means of Ilizarov' method but using monolateral devices. The evaluation of the results was made by X-rays, muscle and bone histology and measurement of the specimens. On the basis of the results obtained it is concluded that treatment of LSBD by the Ilizarov method can be successfully accomplished by using monolateral external fixator-distractors. The advantages of the monolateral frames include a marked minimization of some the most outstanding drawbacks of Ilizarov's circular device, while keeping the advantages of his original concept.
伊利扎洛夫通过沿骨缺损长度搬运骨来治疗大段骨缺损(LSBD)的理念,对我们来说极具吸引力。然而,所采用的环形外固定架与单侧框架不同,它操作繁琐、贯穿固定,放置和术后管理都很困难。我们的实验外科实验室开展了一项研究项目,以评估按照伊利扎洛夫理念使用单侧框架治疗LSBD的可靠性。在这个实验中,我们挑选了五只6至12个月大的狗、五只6个月大的羔羊和五只12个月大的羔羊(后者骨骼已成熟)。所有动物均为雄性。实验内容是尝试通过伊利扎洛夫方法、但使用单侧装置来重建动物股骨干4至5厘米的大段骨缺损。通过X射线、肌肉和骨骼组织学以及标本测量对结果进行评估。根据所获得的结果得出结论,使用单侧外固定牵开器通过伊利扎洛夫方法治疗大段骨缺损能够成功完成。单侧框架的优点包括,在保留其原始理念优点的同时,显著减少了伊利扎洛夫环形装置一些最突出的缺点。