Simultaneous Joint Arthrodesis and Bone Lengthening by the Ilizarov Method (A Case Report)

Year 2008, Volume: 25 Issue: 3, 102 - 106, 29.12.2009

Ahmet Pıskın Yilmaz Tomak Leman Tomak Ahmet Baydın

Abstract

Large osteoarticular defects of the extremities are challenge cases in orthopaedic surgery. Although there are several conventional treatment options for this kind of skeletal defects, the rate of success is low. We report the case of a 48-year-old patient in whom a large osteoarticular defect including the whole distal tibia, distal fibula and talar dome of the right leg, due to a gunshot injury, was treated with tibial lengthening and tibiotalar fusion by the Ilizarov method. Selected treatment was not just a simultaneous arthrodesis and limb lengthening procedure. Whole distal tibia and ankle region was simultaneously reconstructed using tibiotalar fusion and proximal tibial lengthening. The Ilizarov method is the most important alternative for the orthopaedic surgeon in the reconstruction of large osteoarticular defects of the skeleton.
Key words: Osteoarticular defect, bone transport, tibiotalar fusion, the Ilizarov method, ankle


İlizarov Metodu ile Eş Zamanlı Artroez ve Kemik Uzatılması
Ekstremitelerin büyük osteoartiküler defektleri ortopedik cerrahinin oldukça güç olgularındandır. İskelet sisteminin bu tür defektleri için çeşitli geleneksel tedavi yöntemleri olsa da, başarı oranı düşüktür. Ateşli silah yaralanmasına bağlı tüm distal tibia, distal fibula ve talus kubbesini içeren büyük bir osteoartiküler defekte sahip olan 48 yaşındaki hastanın İlizarov yöntemiyle tibial uzatma ve tibiotalar füzyon ile tedavisini rapor ediyoruz. Seçilen tedavi yöntemi sadece eş zamanlı yapılmış bir artrodez ve ekstremite uzatma işlemi değildi. Bütün sağ distal tibia ve ayak bileği bölgesi tibiotalar füzyon ve proksimal tibial uzatma yapılarak rekonstrükte edildi. İlizarov yöntemi iskelet sisteminin büyük osteoartiküler defektlerinin rekonstrüksiyonunda ortopedik cerrah için en önemli alternatiftir.
Anahtar kelimeler: Osteoartiküler defekt, kemik transportu, tibiotalar füzyon, ayak bileği

Keywords

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References

• Carrington NC, Smith RM, Knight SL, Matthews SJE (2000) Ilizarov bone transport over a primary tibial nail and free flap: a new technique for treating Gustilo grade 3b fractures with large segmental defects. Injury 31: 112–115.
• Cierny G, Zorn KE (1994) Segmental tibial defects. Comparing conventional and Ilizarov methodologies. Clin Orthop 301: 118-123.
• Green SA (1994) Skeletal defects. A comparison of bone grafting and bone transport for segmental skeletal defects. Clin Orthop 301: 111–117.
• Marsh JL, Prokuski L, Biermann JS (1994) Chronic infected tibial nonunions with bone loss. Conventional techniques versus bone transport. Clin Orthop 301: 139–146.
• Kitson J, Eyres KS (2002) Simultaneous leg lengthening and knee arthrodesis using an external ring fixator-a case report. Acta Orthop Scand 73: 712–714.
• Manzotti A, Pullen C, Guerreschi F, Catagni MA (2002) Knee arthrodesis and limb lengthening in the treatment of infected total knee arthroplasty: case report. J Traum 52: 359–363.
• Uehara K, Tsuchiya H, Kabata T, Sakurakichi K, Shimozaki E, Tomita K (2001) Ankle arthrodesis and tibial lengthening for congenital sensory neurophaty with anhidrosis. J Orthop Sci 6: 430–434.