OPTIMIZATION OF OPERATIVE TECHNIQUES FOR LOWER LIMB LENGTHENING

Abstract

The most widely used devices for lengthening are A.I. Bliskunova and G.A. Ilizarov. The negative aspects of these methods include the length of time the bulky apparatus is placed on the limb being lengthened, secondary displacement, the development of pin osteomyelitis, contractures of adjacent joints, the high-tech and high cost of implants and instruments, and the requirements for highly qualified orthopedic surgeons. We have developed and introduced into clinical practice a method of combined lengthening of the long bones of the lower limb (invention patent KR No. 140 dated 08/19/2011, certificates for rationalization proposals No. 41/12 dated November 30, 2012, No. 45/12 dated 12/04. 2012). The technique is based on a combination of two methods of fixation and distraction of bone fragments: a transosseous extrafocal osteosynthesis device and external osteosynthesis. In the conditions of the City Clinical Emergency Hospital in Bishkek, this technique was applied to 49 patients; the average age was 23.8 years. The combination of extrafocal osteosynthesis (Ilizarov apparatus) and a bone plate of an original design made it possible to improve the final results of lengthening. The number of complications encountered when using traditional methods has also decreased (wire osteomyelitis, mixing of bone fragments, the formation of weak bone regenerate, pseudarthrosis, desmo- and myogenic contractures).