Experimental and clinical justification of combined osteosynthesis for long bone defects (preliminary report)

Abstract

The motivation for researching combined technology of transosseus osteosynthesis and intramedullary nailing was need to reduce time of treatment, and improve the rehabilitation of patients with long bone defects. Defect-pseudoarthrosis with anatomical shortening of the bone was modeled in an experiment in five adult mongrel dogs. Then nailing, Ilizarov transosseous fixation and osteotomy in proximal metadiaphysis were carried out. Bone-transport was produced according to the traditional principles of academic Ilizarov. Radiological findings showed regenerate with zonal structure, bone sections of which were presented homogeneous shadows with a periosteal osteogenesis. After 30 days of distraction regenerate lost its zonal structure, and acquired a mechanical soundness. By this time also was detected consolidation of pseudarthrosis. We have experience of treatment of six patients with posttraumatic defects of the long bones, according to the described method. At the same time carried out transosseous osteosynthesis and nailing with locking in one bone fragment. The osteotomy was performed for following distraction. After necessary length of the bone was received, the opponent locking was carried out. And external fixation was removed. This technology has allowed not using Ilizarov in fixation period of the treatment.