Novosti
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Year 2012 Vol. 20 No 4
TRAUMATOLOGY AND ORTHOPEDICS
A.A. LERNER, M.V. FOMENKO
TEMPORARY ACUTE BONE SHORTENING AND ANGULAR DEFORMATION – MODULAR STRATEGY IN TREATMENT OF SEVERE COMBINED TRAUMA OF THE LIMBS
Medical Center “Ziv”, Safed,
Israel
Objectives. To study long-term results of patients treatment with severe combined trauma of the limbs using the method of external stabilization with temporary acute bone shortening and angular deformation of the damaged segments.
Methods. Treatment results were analyzed in 12 patients, who underwent temporary acute bone shortening and external stabilization of the injured limb. Gradual elongation of the bones by the G.A. Ilizarov method was further performed to restore the length of the injured limb. While treating four patients with significant one-sided defects of the soft tissues at the acute period, temporary angular deformation of the injured segments was performed in addition to shortening to cover the fracture place without excessive resection of bone fragments ends.
Results. Complete healing of the wounds and fractures’ adnation were achieved in all 12 patients. The superficial posttraumatic wound infection without bone tissue involvement was observed in 5 of them. There were no cases of deep and chronic infection. The applied technique permitted to reveal the given advantages. Demand for free and local transplants decreases thus additional trauma and possible complications from the donor wound are excluded. The time of the operative intervention is shortened that is particularly important for patients with multiple and combined traumas. A good possibility is proposed to restore defects in the severe combined cases of injuring bones and soft tissue during one and the same operative intervention. One may perform the primary surgical treatment of a wound maximally radical that further decreases the possibility of the necrotic and purulent-septic complications development. The application of the three-dimensional external fixer of G.A. Ilizarov provides a possibility of early functional load.
Conclusion. Temporary acute bone shortening of the limb using the external bone fixation technique accompanied by further gradual restoring of the length of the injured segment by the G.A. Ilizarov method is one of effective ways to treat compound fractures with severe tissue damages. It is advisable to use this method to restore the limbs after the extensive compound high-energy fractures with extensive injuries and defects of soft tissues.
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13100, ISRAEL, SAFED MEDICAL CENTER “ZIV”,Orthopedics department
å-mail: alex_lerner@yahoo.com
Lerner Aleksandr Aronovich
Lerner A.A., Senior Lecturer of the Medical Faculty of Bar-Ilan University, Director of the Orthopedics Department, Medical Center “ZIV”, SAFED
Fomenko M.V., Candidate of Medical Sciences, Physician of the Orthopedics Department, Medical Center “ZIV”, SAFED
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