The application of llizarov technique in the treatment of comminuted distal tibia fractures

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Acta Facultatis Medicae Naissensis Pub Date : 2023-01-01 DOI:10.5937/afmnai40-41694
Ivica Lalić, Vladimir Harhaji, Oliver Dulić, Mile Bjelobrk, Nataša Janjić, Nensi Lalić, Marko Bojović, Marko Mladenović
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Abstract

Introduction. High-energy distal tibia fractures are characterized by great comminution and extensive lesions of the surrounding soft tissues. The risk of developing complications during treatment is high. The application of the Ilizarov's technique reduces the risk of complications significantly, and provides good final treatment results. Methods. In our prospective observational study 41 patients were included. Clinical characteristics were evaluated by Gustillo-Anderson, Checketts-Otterburns and AO/OTA classification. The ASAMI protocol was used to assess bone union. Functional treatment results were represented using the modified Karlström-Ollerud scoring system. Analysis and monitoring time (follow up) was 18 months. Results. Using radiographic and clinical parameters, we recorded complete healing in all fractures. In the group of 43B intra-articular fractures, circular fixator was removed after 16 weeks (range 13 -31), while in the 43C fracture type group, it was removed after 18 weeks (range 13 -29). The ASAMI evaluation of bone healing showed 31 (75%) excellent, 76 (15%) good, 3 (8%) satisfactory, and 1 (2%) poor result. Functional recovery results obtained after 6 months showed the mean value of 24.7 using the modified Karlström-Ollerud scoring system in three follow-up periods, which represents recovery. The results present 12 months after surgery showed the mean value of 27.6, representing satisfactory recovery, while during the last parameter measurement performed after 18 months, the value was 29.5, which indicates good functional recovery. Conclusion. Transosseous osteosynthesis Ilizarov treatment applied in closed and open comminuted distal tibia fractures showed good final bone and functional results with minimal complications, and contributed to better patient's quality of life.
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利扎罗夫技术在胫骨远端粉碎性骨折治疗中的应用
介绍。高能胫骨远端骨折的特点是严重粉碎和周围软组织的广泛病变。在治疗期间发生并发症的风险很高。Ilizarov技术的应用显著降低了并发症的风险,并提供了良好的最终治疗效果。方法。在我们的前瞻性观察性研究中,纳入了41例患者。采用Gustillo-Anderson、Checketts-Otterburns和AO/OTA分类评估临床特征。采用ASAMI方案评估骨愈合。功能治疗结果用改进的Karlström-Ollerud评分系统表示。分析监测时间(随访)为18个月。结果。通过影像学和临床参数,我们记录了所有骨折的完全愈合。43B型关节内骨折组16周(范围13 -31)取出圆形固定器,43C型骨折组18周(范围13 -29)取出圆形固定器。ASAMI对骨愈合的评价结果为:优31例(75%),良76例(15%),满意3例(8%),差1例(2%)。6个月后的功能恢复结果,采用改进的Karlström-Ollerud评分系统,三个随访期的平均值为24.7,代表恢复。术后12个月的平均值为27.6,恢复满意,18个月后的最后一次参数测量值为29.5,功能恢复良好。结论。经骨Ilizarov治疗闭合和开放粉碎性胫骨远端骨折的最终骨和功能效果良好,并发症最少,并有助于提高患者的生活质量。
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来源期刊
Acta Facultatis Medicae Naissensis
Acta Facultatis Medicae Naissensis MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
0.00%
发文量
13
审稿时长
12 weeks
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