Bezsmertnyi Yurii Oleksiiovych, Shevchuk Viktor Ivanovych, Branitsky Olexander Yuriyovych, Bezsmertnyi Olexander Yuriyovych
Scientific Department, Scientific and Research Institute of Rehabilitation of National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Orthop Res Rev. 2024 Oct 9;16:243-249. doi: 10.2147/ORR.S485430. eCollection 2024.
The creation of a functional tibial stump after combat injuries is sometimes too difficult. We describe a case of high amputation after a mine-blast injury. In this case, the tibia stump was too short (5 cm) and the fibula stump was too long (12 cm). There was a soft tissue reserve. The Ilizarov method was used to lengthen the tibia. The technique of the operation with exposure of the anterior medial ligament, its separation from the distal part of the bone, subperiosteal excision of the medial part of the patellar tendon from the tibia, oblique-frontal corticotomy of the tibia, which allowed to avoid undesirable complications during the distraction and to obtain a wide, strong regenerate, is described in detail. The alignment of the tibia lengths resulted in a highly functional stump with the possibility of full prosthetics. The proposed technique can be used in reconstructive operations on short stumps that require lengthening.
战伤后形成功能性胫骨残端有时非常困难。我们描述了一例地雷爆炸伤后高位截肢的病例。在此病例中，胫骨残端过短（5厘米），腓骨残端过长（12厘米）。存在软组织储备。采用伊里扎洛夫方法延长胫骨。详细描述了手术技术，包括显露前内侧韧带、将其与骨远端分离、从胫骨骨膜下切除髌腱内侧部分、胫骨斜向前皮质切开术，这有助于避免牵张过程中出现不良并发症并获得宽大、坚固的再生组织。胫骨长度的对齐形成了一个功能高度良好的残端，具备安装全假肢的可能性。所提出的技术可用于需要延长的短残端的重建手术。
