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1.
Injury ; 51(11): 2574-2580, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32843147

RESUMO

INTRODUCTION: Supracondylar fracture malunion usually results in cubitus varus deformity. The long-standing unsightly deformity causes psychological stress to the child and his/her parents in addition to biomechanical disturbances and functional disorders in the affected elbow. The optimal timing of corrective osteotomy is not well-established in the literature. The present study aimed to report the results of early correction of cubitus varus deformity using a simple technique and to focus on the timing of early correction after supracondylar fracture malunion. PATIENTS AND METHODS: Thirty consecutive patients treated for recent cubitus varus deformity after malunited supracondylar fractures, in the period between January 2012 and August 2017, were retrospectively reviewed. All patients had early surgical correction of the deformity within one year after the initial injury. In patients who presented with maluniting supracondylar fracture, the fracture was splinted until union was achieved, then active exercises were encouraged until elbow ROM was regained. The deformity was then corrected with a lateral closing wedge (LCW) osteotomy and fixed with two lateral and one medial wire. RESULTS: All the osteotomies united. All the deformities were corrected. The humerus-elbow-wrist (HEW) angle significantly improved compared to the pre-operative values (p<0.001). All patients achieved satisfactory results at the final evaluation. Twenty-six patients (86.7%) achieved excellent results while four patients (13.3%) achieved good results. CONCLUSION: Early correction of cubitus varus deformity avoids the psychological stress of the long-standing unsightly deformity to the young child and his/her family. It also avoids the delayed biomechanical and functional disturbances to the affected elbow. The LCW osteotomy and the three-wires fixation technique are simple and effective to correct the deformity and maintain the correction.


Assuntos
Articulação do Cotovelo , Fraturas Mal-Unidas , Fraturas do Úmero , Deformidades Articulares Adquiridas , Criança , Pré-Escolar , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/cirurgia , Feminino , Fraturas Mal-Unidas/diagnóstico por imagem , Fraturas Mal-Unidas/cirurgia , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/cirurgia , Úmero , Deformidades Articulares Adquiridas/diagnóstico por imagem , Deformidades Articulares Adquiridas/etiologia , Deformidades Articulares Adquiridas/cirurgia , Masculino , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
2.
Musculoskelet Surg ; 96(2): 141-7, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22237840

RESUMO

Treatment of chronic hip instability in children and young adults is challenging. Proximal femoral osteotomy had been suggested to provide pelvic stability and improved abductor function. Total hip replacement after pelvic support osteotomy can be challenging due to altered anatomy due to angulation of the proximal femur in both frontal and sagittal planes. This is a 29-year-old woman who had total hip replacement after pelvic support osteotomy. The patient had pelvic support at the age of 14 years. Pelvic support osteotomy delayed the need for total hip replacement for 15 years. Preoperative planning for total hip replacement with model was used for proper understanding of the anatomy of the proximal femur. Revision of femoral component was necessary due to penetration of the proximal femur. In conclusion, total hip replacement after pelvic support osteotomy is a technically demanding procedure, and careful attention to surgical details is necessary for successful outcome.


Assuntos
Artroplastia de Quadril , Articulação do Quadril/cirurgia , Instabilidade Articular/cirurgia , Osteotomia , Adulto , Desenho Assistido por Computador , Feminino , Contratura de Quadril/etiologia , Contratura de Quadril/cirurgia , Humanos , Técnica de Ilizarov , Desigualdade de Membros Inferiores/etiologia , Desigualdade de Membros Inferiores/cirurgia , Locomoção , Modelos Anatômicos , Osteoartrite do Quadril/etiologia , Osteoartrite do Quadril/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Fatores de Tempo
3.
Injury ; 42(6): 580-6, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21530966

RESUMO

Bone regeneration obtained by distraction osteogenesis is influenced by a series of factors. These include factors that are related to the mechanical stability of the system of distraction (internal or external devices), and to factors directly depending on the biology of the bone tissue, such as the method of bone interruption (osteotomy), the delay and rhythm of distraction, the anatomical site of the osteotomy, and the histological characteristics of the bone requiring reconstruction. The stability of the system of bone fixation depends on the rigidity of the frame, the connexion of the apparatus to the bone (wires, pins) and the intrinsic stability of the segment (length and level of maturation of bone regenerate). The radiological characteristics of bone regeneration (hypo- or hypertrophy) lead to the adaptation of the rhythm of distraction. Following more than 28 years of experience of application of the Ilizarov method for bone reconstruction, the authors describe the technique of frame assembly and the methods of evaluation and treatment of the complications of new bone formation.


Assuntos
Regeneração Óssea/fisiologia , Técnica de Ilizarov , Osteogênese por Distração/métodos , Osteotomia/métodos , Fios Ortopédicos , Medicina Baseada em Evidências , Humanos , Técnica de Ilizarov/instrumentação , Técnica de Ilizarov/tendências , Osteogênese por Distração/instrumentação , Osteogênese por Distração/tendências , Osteotomia/instrumentação , Osteotomia/tendências
4.
Clin Orthop Relat Res ; 469(4): 1175-80, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20963528

RESUMO

BACKGROUND: Fibular hemimelia is partial or total aplasia of the fibula; it represents the most frequent congenital defect of the long bones. It usually is associated with other anomalies of the tibia, femur, and foot. QUESTIONS/PURPOSES: We reviewed 32 patients with Type III fibular hemimelia treated by successive lower limb lengthening and deformity correction using the Ilizarov method. We had three aims; first, to analyze complications, including the need for reoperation. The second was to assess knee and ankle function, specifically addressing knee ROM and stability and function of the foot and ankle. The third was assessment of overall patient satisfaction. PATIENTS AND METHODS: Thirty-two patients underwent 56 tibia lengthenings and 14 ipsilateral femoral lengthenings. Their mean age and mean functional leg-length discrepancy at initial treatment were 6.7 years and 6.2 cm, respectively. Activity level, pain, patient satisfaction with function, pain, and cosmesis, complications, and residual length discrepancy were assessed at the end of treatment. RESULTS: The mean number of surgeries was six per case. The healing index was 44.9 days/cm. Although complications were observed during 60 lengthenings (82%), the highly versatile system overcame most of them. Nearly equal limb length and a plantigrade foot were achieved by 16 patients. For two patients, a Syme's amputation was performed. The outcome was considered satisfactory in 17 patients (53%) and relatively good in eight patients (25%). CONCLUSIONS: The Ilizarov technique has satisfactory results for treatment of Type III congenital fibular hemimelia and can be considered a good alternative to amputation. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.


Assuntos
Amputação Cirúrgica , Ectromelia/cirurgia , Fíbula/cirurgia , Técnica de Ilizarov , Desigualdade de Membros Inferiores/cirurgia , Adolescente , Articulação do Tornozelo/fisiopatologia , Articulação do Tornozelo/cirurgia , Criança , Pré-Escolar , Ectromelia/classificação , Ectromelia/diagnóstico por imagem , Ectromelia/fisiopatologia , Feminino , Fíbula/anormalidades , Fíbula/diagnóstico por imagem , Humanos , Técnica de Ilizarov/efeitos adversos , Lactente , Recém-Nascido , Itália , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Desigualdade de Membros Inferiores/diagnóstico por imagem , Desigualdade de Membros Inferiores/fisiopatologia , Salvamento de Membro , Masculino , Satisfação do Paciente , Radiografia , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Reoperação , Estudos Retrospectivos , Tíbia/anormalidades , Tíbia/cirurgia , Fatores de Tempo , Resultado do Tratamento
5.
Injury ; 41(11): 1107-11, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20934700

RESUMO

We retrospectively review 84 cases of diaphyseal humeral fractures (24 type A, 38 type B, 22 type C of the AO/OTA classification) treated with external fixation (Hoffmann II frame) between 1995 and 2007. Six of these fractures were complicated with radial nerve palsy. Four cases were open fractures. All reductions were achieved closely or through minimal open approaches. All fractures achieved consolidation with an average of 95 days (range 58-140). The six radial nerve palsies had complete spontaneous recovery. According to the Constant score excellent shoulder function was recorded in 54.6% of the cases, good results in 25%, fair in 13.6% and poor in 6.8%. The elbow function according to the Mayo elbow performance index was excellent in 81.8% of cases, good in 13.6%, fair in 2.3%, and poor in 2.3%. We observed superficial pin tract infections in 12% of the patients. There was no cases of deep infection. External fixation of humeral diaphyseal fractures as recorded in this case series, represents a management option, which allows straightforward fracture reduction and adequate stability, with a short operative time, excellent consolidation rate and good functional results with no major complications secondary to this type of surgery.


Assuntos
Fixação de Fratura/métodos , Consolidação da Fratura/fisiologia , Fraturas do Úmero/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Diáfises/lesões , Diáfises/cirurgia , Fixadores Externos , Feminino , Humanos , Fraturas do Úmero/diagnóstico por imagem , Fraturas do Úmero/fisiopatologia , Masculino , Pessoa de Meia-Idade , Neuropatia Radial/etiologia , Radiografia , Remissão Espontânea , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
7.
J Trauma ; 63(5): 1043-53, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17993949

RESUMO

BACKGROUND: We intended to evaluate the technique of treatment of complex fractures of the tibial plateau using external circular fixation combined with limited internal fixation, and to evaluate the treatment outcomes. METHODS: From 1992 to 2002, we treated 59 patients (40 men, 19 women) ranging in age from 23 to 63 years with the external circular fixation. All the cases were classified preoperatively as Schatzker types V, VI/Orthopedic Trauma Association 41-C1.3, C2.3, C3.1, C3.3. Five fractures were open. Three different strategies of treatment were used: (1) the frame is confined to the tibia when the external fixation is stable enough to allow knee bending; (2) the frame is extended onto the distal femur, with the proximal tibial ring located at the level of the tibial plateau when the joint surface is severely unstable; and (3) the frame is extended onto the distal femur, with the proximal tibial ring located more distally, bypassing the fracture, when the skin and soft tissue are compromised and within the fracture there is no bone suitable to place wires and pins for the external fixation construct. RESULTS: The results were evaluated as excellent in 30 patients (50.85%), good in 27 patients (45.76%), fair in 1 patient (1.695%), and poor in another 1 (1.695%). The patients' satisfaction was significantly related with the functional results. CONCLUSIONS: Our hybrid Ilizarov method combined with minimal internal fixation enables excellent to good results in most cases of complex tibial plateau fractures.


Assuntos
Fixação de Fratura/métodos , Fraturas da Tíbia/terapia , Adulto , Pinos Ortopédicos , Fios Ortopédicos , Fixadores Externos , Feminino , Seguimentos , Fixação de Fratura/instrumentação , Humanos , Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Amplitude de Movimento Articular , Estudos Retrospectivos , Fraturas da Tíbia/classificação , Fraturas da Tíbia/reabilitação , Resultado do Tratamento
8.
Orthopedics ; 30(8): 608-11, 2007 08.
Artigo em Inglês | MEDLINE | ID: mdl-17727014

RESUMO

This article affirms the value of the application of the Ilizarov frame for gradual transport of the ipsilateral fibula to replace massive tibial bone loss following chronic refractory osteomyelitis.


Assuntos
Reabsorção Óssea/cirurgia , Transplante Ósseo/instrumentação , Fíbula/transplante , Técnica de Ilizarov , Osteomielite/cirurgia , Tíbia , Adulto , Reabsorção Óssea/etiologia , Doença Crônica , Feminino , Humanos , Osteomielite/complicações
9.
J Trauma ; 61(5): 1186-91, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17099527

RESUMO

BACKGROUND: The purpose of this study was to evaluate if there is a difference in the rates of infection between Ilizarov wires and half-pins and between half-pins with threads outside and inside the skin in circular fixators modified by Catagni and Cattaneo. METHODS: Between May and December 2004, 218 patients with circular Ilizarov fixators for various orthopaedic indications who visited our Ilizarov clinic were subjected to a one-time evaluation of half-pins and wires. RESULTS: A total of 1,093 half-pins were checked and 34 (3.11%) of these were infected (50% with threads outside and 50% with threads inside the skin). Among a total number of 951 wires (1,092 pin tracts) checked, 45 (4.73%) were infected. CONCLUSIONS: We conclude that the circular Ilizarov fixation with conical half-pins and wires has similar rate of infection compared with conventional Ilizarov circular fixator. Moreover, there is no difference in infection rates between pins with threads inside the skin as compared to those with threads outside the skin.


Assuntos
Pinos Ortopédicos/efeitos adversos , Fios Ortopédicos/efeitos adversos , Fixação de Fratura/efeitos adversos , Fraturas Ósseas/complicações , Infecção da Ferida Cirúrgica/epidemiologia , Adolescente , Adulto , Idoso , Antibioticoprofilaxia , Criança , Fixação de Fratura/instrumentação , Fixação de Fratura/métodos , Fraturas Ósseas/cirurgia , Humanos , Pessoa de Meia-Idade , Infecção da Ferida Cirúrgica/etiologia
10.
Clin Orthop Relat Res ; 448: 208-16, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16826118

RESUMO

UNLABELLED: Massive segmental tibial bone loss from trauma, tumor, or infection is a limb-threatening situation. It is a considerable surgical challenge, especially when associated with extensive skin and soft tissue damage. Amputation was the only solution in the past, but current limb-salvage options include contralateral or ipsilateral microvascularized or free-fibular transfer. However, these methods are not without risks and disadvantages. We report seven patients with massive tibial bone loss treated by gradual medial transport of the ipsilateral fibula using an Ilizarov traction apparatus with olive wires after proximal and distal fibular osteotomies. This method has the advantages of avoiding surgery on the contralateral limb while allowing early weightbearing because of the stability of the Ilizarov frame. Hypertrophy of the transported fibula accompanied by full weightbearing and satisfactory joint motion occurred in all patients. All patients were satisfied with the results, and none thought amputation would have been a better treatment. The minimum followup was 5 years. We think the Ilizarov frame for ipsilateral fibular gradual transport is a reasonable alternative for limb salvage in patients with massive tibial bone loss. LEVEL OF EVIDENCE: Therapeutic Study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.


Assuntos
Fíbula/transplante , Técnica de Ilizarov/instrumentação , Osteoporose/cirurgia , Manejo de Espécimes , Tíbia/cirurgia , Adulto , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico por imagem , Osteoporose/etiologia , Radiografia , Estudos Retrospectivos , Tíbia/diagnóstico por imagem , Tíbia/lesões , Fraturas da Tíbia/complicações , Fraturas da Tíbia/diagnóstico por imagem , Fraturas da Tíbia/cirurgia
11.
Knee Surg Sports Traumatol Arthrosc ; 13(7): 557-63, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15660273

RESUMO

Survival of osteosarcoma has greatly improved in the past few decades. Knee prosthesis is a well-recognized limb salvage procedure for osteosarcoma of the distal end of the femur. One drawback is that prostheses have a limited life and prosthetic failure with the inherent high rate of reoperations remains a serious long-term problem for former osteosarcoma patients. The segmental cement extraction system (SEG-CES) is a technique to remove cement in arthroplasty revision, based on a cement-bone interface with a lower strength compared to the old cement-new cement interface. We report the case of a 32-year-old former osteosarcoma patient in whom the SEG-CES was applied to remove a long-stemmed total knee cemented prosthesis. The prosthesis was placed 17 years before for a recurrent telangiectatic osteosarcoma of the left femur. Thirteen years after the prosthesis implantation, the patient complained of knee instability, pain, and complete failure of the extensor apparatus. The extraction of the prosthesis was performed using cylindrical batters of diameter corresponding to the diameter of the axle, two hammer extractors clamping the prosthesis components between two jaws. Extraction of the periprosthetic cement in the femoral and tibial components was done using the SEG-CES technique. The successful prosthesis removal performed in this patient allowed us to perform an external fixation with bone lengthening and reconstruction by the Ilizarov method.


Assuntos
Cimentos Ósseos , Técnica de Ilizarov , Prótese do Joelho , Osteólise/cirurgia , Osteossarcoma/cirurgia , Adulto , Cimentação , Feminino , Humanos , Prótese do Joelho/efeitos adversos , Procedimentos Ortopédicos/métodos , Osteólise/etiologia , Falha de Prótese , Implantação de Prótese , Infecções Relacionadas à Prótese/cirurgia
12.
J Shoulder Elbow Surg ; 12(5): 436-41, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14564263

RESUMO

Four patients with post-traumatic nonunion and shortening of the humeral diaphysis were treated with a hybrid advanced Ilizarov technique. The mean age of the patients was 32 years, and the mean total amount of humeral shortening was 6.63 cm. Three nonunions were atrophic and infected, and one was hypertrophic. All patients obtained union of the humeral fracture with resolution of infection at a mean external fixation time of 8 months. Restoration of normal humeral length was achieved in two patients, with a third having a residual discrepancy of 1 cm. The final patient, who had an infected nonunion with 11 cm of total humeral shortening, had a residual limb length discrepancy of 3 cm. All had improvement in shoulder and elbow motion after treatment. Superficial pin tract infections were seen in all patients, but all responded to pin-site care and oral antibiotics. Two patients had three refractures after removal of the fixator, two of which were treated by a second application of an Ilizarov frame and one by a cast. All patients had reduced pain and improved function at completion of the treatment. The Ilizarov method, though not a panacea for all humeral nonunions with extensive bone loss, does offer a viable salvage procedure in this unusual and often complex clinical problem.


Assuntos
Fraturas não Consolidadas/cirurgia , Fraturas do Úmero/cirurgia , Úmero/cirurgia , Técnica de Ilizarov , Adulto , Feminino , Fixação Interna de Fraturas , Fraturas não Consolidadas/complicações , Fraturas não Consolidadas/patologia , Humanos , Fraturas do Úmero/complicações , Fraturas do Úmero/patologia , Úmero/patologia , Masculino , Osteomielite/complicações , Infecções Estafilocócicas/complicações
13.
Clin Orthop Relat Res ; (410): 203-12, 2003 May.
Artigo em Inglês | MEDLINE | ID: mdl-12771832

RESUMO

Numerous salvage procedures have been proposed for the treatment of late sequelae of septic arthritis of the hip. Despite this, there are no reports in the literature discussing treatment with simultaneous hip reconstruction and femoral lengthening using the hybrid advanced Ilizarov method. The authors reviewed their experience with this technique, and present 15 patients treated between 1982 and 1997. The average age of the patients was 21.1 years and the average limb length discrepancy was 6.5 cm. All the hips were classified according to the classification of Choi et al. The time the external fixator was worn was 225.5 days and the average followup was 108 months. The results were classified based on pain relief, residual deformity, range of motion, Trendelenburg sign, and limb length discrepancy. Ten patients had a good or excellent result, three patients had a fair result, and only two patients had a poor result. Major complications included a common peroneal nerve palsy in one patient, loss of angulation of the proximal femoral osteotomy in two patients, and a mild knee subluxation in three patients all of whom responded to treatment. At the latest followup, 13 patients were satisfied with the treatment, all had returned to their previous occupations, and no patient had a total hip arthroplasty.


Assuntos
Artrite Infecciosa/complicações , Articulação do Quadril , Técnica de Ilizarov , Desigualdade de Membros Inferiores/etiologia , Desigualdade de Membros Inferiores/cirurgia , Adolescente , Adulto , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Satisfação do Paciente , Radiografia , Estudos Retrospectivos
16.
Rev. bras. ortop ; 32(8): 603-10, ago. 1997. ilus
Artigo em Português | LILACS | ID: lil-196862

RESUMO

A perda maciça de osso da tíbia depois de trauma ou da remoçäo de tumor representa problema imensurável. As técnicas reconstrutivas estäo associadas a morbidez do membro ou do local doador e frequentemente resultam em amputaçäo. Os autores apresentam outra técnica que usa a fíbula e o aparelho de Ilizarov. O aparelho de Ilizarov é fixado à tíbia remanescente, ocasionalmente incluindo fêmur distal ou pé e tornozelo. Uma corticotomia completa distal e proximal da fíbula foi acompanhada de distraçäo da fíbula ipsilateral para o defeito tibial. Enxerto ósseo foi adicionado ao local da falha óssea. Após a consolidaçäo o fixador foi substituído por gesso e finalmente por órtese. Esse procedimento foi realizado em 5 pacientes masculinos, de idade entre 13 e 53 anos, com perda maciça de osso tibial. Um paciente doi submetido a remoçäo de 2/3 da tíbia proximal por causa de um tumor; 3 pacientes, a reconstruçäo de tíbia após trauma agudo; e um paciente, a remoçäo de parte da tíbia por infecçäo crônica.Quatro pacientes obtiveram resultados de bom a excelente. Esses pacientes voltaram às atividades normais e até aos esportes. O tratamento näo foi eficaz em um paciente. A transferência da fíbula e a estabilizaçäo esquelética pelo aparelho de Ilizarov apresentam muitas vantagens sobre os métodos tradicionais de tratamento para perda óssea da tíbia após fratura ou remoçäo de tumor. A construçäo de aparelho de Ilizarov é estável e permite a possibilidade de carga. A fixaçäo interna é evitada. A tranferência horizontal é feita com procedimento cirúrgico menor. Näo há morbidade local e o paciente pode colocar carga constante no membro afetado


Assuntos
Humanos , Masculino , Adolescente , Adulto , Pessoa de Meia-Idade , Doenças Ósseas/cirurgia , Fraturas da Tíbia/cirurgia , Técnica de Ilizarov , Fíbula/cirurgia , Tíbia/lesões , Fixadores Externos , Transplante Ósseo/métodos
17.
Rev. bras. ortop ; 31(8): 613-9, ago. 1996. ilus
Artigo em Português | LILACS | ID: lil-212554

RESUMO

O fixador externo de Ilizarov combinado com locais de alongamento de dois níveis foi usado para tratar 26 pacientes com pseudartrose da tíbia; seis ainda estao em tratamento e 20 já o terminaram (15 homens e cinco mulheres), com média de idade de 31,3 anos (18-71). A média do período de acompanhamento foi de 35,5 meses (13-72). Catorze pacientes apresentavam infecçao, 19 casos eram conseqüentes a trauma e um devido a tumor ressecado previamente. Média de 1,85 operaçoes precedeu o tratamento "trifocal", o qual consistiu da ressecçao de osso inviável com corticotomias em dois diferentes sítios da tíbia. A maioria dos casos incluiu um segundo procedimento, chamado de revisao ou docking, o qual foi realizado quando as pontas do osso estavam aproximadas após o transporte ósseo suficiente. Enxerto ósseo córtico-esponjoso foi introduzido no local da pseudartrose em dois casos e em locais de alongamento em outros dois. Houve consolidaçao em 19 dos 20 casos. Uma paciente necessitou de amputaçao do pé devido a severa infecçao. Dezenove pacientes chegaram à equalizaçao ou apresentaram menos que 2cm de discrepância na perna. Média de 9,9cm (4-22) de alongamento ósseo total foi alcançada. Alongamento ósseo externo foi obtido em nove pacientes, em média de 3,37 cm (1-8cm). Três dos 14 (21 por cento) casos infectados continuaram a drenar mesmo depois que a consolidaçao foi conseguida. Outras complicaçoes incluíram um caso de refratura após remoçao do aparelho e outros três de desvio angular de poucos graus. Os resultados radiográficos foram excelentes em 14, bons em quatro, razoáveis em dois e precários em dois. Os resultados funcionais foram excelentes em 12, bons em seis, razoável em um e precário em um. O método de Ilizarov para o tratamento das pseudartroses tibiais proporciona resultados satisfatórios. O uso concomitante de alongamento em dois níveis melhora o resultado da correçao de falhas em ossos longos e das consolidaçoes prematuras, em relaçao a sítio de corticotomia simples. Este método oferece tratamento curto com menor quantidade de tecido a ser atravessado pela fixaçao enquanto nao aumenta a morbidade ou dificuldades técnicas do procedimento.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Alongamento Ósseo/métodos , Doenças Ósseas/cirurgia , Técnica de Ilizarov , Pseudoartrose/cirurgia , Tíbia/cirurgia , Seguimentos
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