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Distraction histogenesis for hypertrophic nonunion of the tibia with deformity and shortening

  • Mahmoud A. El-RosasyEmail author
Original Article

Abstract

The results of distraction histogenesis using Ilizarov techniques for 18 consecutive patients were evaluated. There were 13 male and 5 female patients. Their ages ranged from 11 to 74 years (average 36.8 years). All patients presented with established hypertrophic nonunion of the tibia, associated deformity ≥15° and leg shortening. There were no cases of active infection at the time of our treatment. The procedure included fibular osteotomy, application of a pre-constructed Ilizarov frame. Controlled distraction was done until complete deformity correction and equalization of leg length. Weight bearing was allowed during treatment. All patients (100%) had their nonunions consolidated with deformity correction and restoration of the normal mechanical axis of the limb. The leg length discrepancy was corrected in all cases. The follow up ranged from 29 to 50 months (average 37.2 month) after fixator removal. Distraction histogenesis, using Ilizarov techniques, is a reliable method for consolidation of hypertrophic nonunion, deformity correction and equalization of leg length all in one procedure through minimal surgical interference.

Keywords

Distraction histogenesis Tibia Nonunion Deformity Ilizarov 

Technique d’Ilizarov pour pseudarthose hypertrophique du tibia avec déformation et raccourcissement

Résumé

Les résultats de l’histogenèse osseuse par la technique de distraction selon Ilizarov a été évaluée chez 18 patients consécutifs (13 hommes et 5 femmes). L’âge était compris entre 11 et 74 ans (âge moyen 36,8 ans). Tous les patients étaient porteurs d’une pseudartrhrose hypertrophique du tibia avec angulation supérieure à 15° et raccourcissement de la jambe. Il n’y avait pas d’infection active au moment de notre traitement. Le protocole comportait une ostéotomie du péroné (fibula) et la mise en place d ‘un cadre d’Ilizarov assemblé préalablement. La distraction a été effectuée jusqu’à correction complète de l’angulation vicieuse et rétablissement de la bonne longueur. L’appui était autorisé pendant le traitement. Tous les patients (100 % = ont vu consolider leur pseudarthrose avec correction de l’angulation et rétablissement de l’axe du tibia. Tous les patients ont récupéré l’égalité de longueur de leurs jambes. Le recul allait de 29 à 50 mois (recul moyen 37,2 mois) après ablation du fixateur externe. La régénération osseuse par la technique d’Ilizarov est une méthode fiable pour la consolidation des pseudarthroses hypertrophiques, pour la correction des angulations vicieuses et pour rendre l’égalité de longueur, le tout grâce à un seul gestee avec peu d’agressivité chirurgicale.

Mots clés

Ostéogenèse par distraction Tibia Pseudarthrose Cals vicieux Ilizarov 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery and Traumatology, Faculty of MedicineUniversity of TantaTantaEgypt
  2. 2.Al-Adwani HospitalTaifKingdom Saudia Arabia

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