Abstract
We studied the use of Ortho-SUV hexapod in the treatment of 15patients with lower limb false joints. All patients were at active working age – from 22 to 50years. In 12patients, the period from the moment of trauma was 1 to 3years, in 3patients – 3 to 6years. 5patients had femoral false joints, 10patients – shin false joints. In 98% of cases, the formation of false joints was caused by inadequate treatment of initial trauma. In 100% of cases, false joint localized at diaphyseal level and was accompanied with shortening of injured segment for 2.5±1.0cm in 13patients, and for 0.5 and 0.8cm in 2cases. We also registered recurvatum and valgus deformity in 5patients, recurvatum and varus deformity in 8patients, and antecurvatum and varus deformity in 2patients. Combined contracture in knee and ankle joint was found in 90% of patients. Using combined transosseous osteosynthesis along with Ortho-SUV hexapod allowed us to correct hip deformity for 35±10days and ankle deformity – for 20±5days on the average. When shortening of femoral bone for more than 5.0cm, the deformity was corrected in two stages. At the first stage, we reconstructed the length of a segment using methods of transosseous osteosynthesis at discrete-continuum distraction. At the second stage, we corrected deformity using Ortho-SUV hexapod within specified time limits. Duration of femoral and shin false joint consolidation was 194±16days. We registered inflammatory complications in the areas of transosseous elements contacting soft tissues in 3(0.2%)patients. These complications didn’t have an effect on the treatment results.
Highlights
We studied the use of Ortho-SUV hexapod in the treatment of 15 patients with lower limb false joints
In 98 % of cases, the formation of false joints was caused by inadequate treatment of initial trauma
In 100 % of cases, false joint localized at diaphyseal level and was accompanied with shortening of injured segment for 2.5 ± 1.0 cm in 13 patients, and for 0.5 and 0.8 cm in 2 cases
Summary
В клинике ФГБНУ «Иркутский научный центр хирургии и травматологии» при лечении ложных суставов нижней конечности новая медицинская технология [3, 6] применена в лечении 15 больных. На III уровне чрескостный стержень проводили на 9 часах под углом 90°, фиксировали в 3/4 кольцевой опоры. На VII уровне в направлении 2–8 проводили спицу d = 2,0 мм и на 9 часах проводили стержень под углом 90° к длинной оси дистального отломка. При локализации повреждения на уровне диафиза костей голени использовали чрескостные элементы (спицы d = 2,0 мм, стержни d = 6,0 мм), которые вводились по схеме: на I уровне большеберцовой кости проводили спицу в направлении 3–9, на II уровне на 2 часах под углом 90° к длинной оси проксимального отломка проводили чрескостный стержень. На III уровне проводили чрескостный стержень на 2 часах под углом 90°, фиксировали в кольцевой опоре. На VIII уровне большеберцовой кости проводили спицу в направлении 3–9, на VII уровне на 2 часах под углом 90° к длинной оси дистального отломка проводили чрескостный стержень. С целью стимуляции репаративного процесса на уровне ложного сустава выполняли продольную кортикотомию костных отломков
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