Transosseous osteosynthesis in post-resection defects of the hand tubular bones - 04/12/15
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Résumé |
Introduction |
From 3.5 to 5.2% of clinical observation in the structure of general hand pathology account for tumor and tumor-like injuries. The fact that forming post-resection defects are small in absolute values (cm) but make up to 100% of bone loss.
Materials and methods |
We have an experience of 41 patients management aged from 11 to 63years. Prior to admission to Russian Ilizarov Center all patients underwent conservative treatment only. We defined 34 cases of enchondroma, 1 ecchodroma, 2 cases of aneurismal bone cyst, 1 osteoblastoclastoma, 1 osteoma and 2 cases of multiple chondromatosis of the hand tubula bones. In 11 cases, the pathological process was complicated by the fracture in the destruction focus. We produced the following types of resection: intraosseous resection - 31 case, Segmental resection - 6 cases, Segmental resection of the tubular bone with the adjacent join - 4 cases. We used the following implants: Fragment of tibial compact layer - 26 cases, Fragment of iliac crest - 4 cases, Fragment of radial metaphysis - 1 case, Bone plastic material Collapan - 10 cases. Affected bone, graft and phalanx adjacent to involved metaphysis were fixed by Ilizarov mini-fixator. This frame assembly allowed us to produce gradual compression between the implant and bed by transporting the mini-fixator junctions. This frame assembly allowed us to perform adequate fixation of auto-graft and gradual compression at the docking site.
Results |
Fixation with the frame on took from 44 to 108 (65.6±14.9) days in intraosseos resection, in the segmented one it lasted from 62 to 113 (87.6±12.5) days. After frame and wires removal bone healing and full (100%) filling in the post-resection defect of tubular bone was achieved in all patients.
When we evaluated the treatment outcomes of all patients, we noted good results in 30 cases and satisfactory ones in 11 observations. There were no poor results.
Discussion |
Ilizarov mini-fixator application provides required stiffness and control over the bone fragments and graft fixation. The creation and support of gradual compression at the fragment docking site provide healing of the pathological fracture and auto-graft to the hosting bed.
Conclusion |
Design peculiarities of Ilizarov mini-fixator allows creating optimal conditions for guided and controllable bone tissue regeneration in the patients with post-resection defects of the hand tubular bones.
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Vol 34 - N° 6
P. 381-382 - décembre 2015 Retour au numéro
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