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Evaluation of the Treatment of Patients Subjected to Osteogenesis Induced by Tibia Bone Distraction / Avaliação do tratamento de pacientes submetidos a osteogênese por distração na tíbia
de Resende, Henrique Carvalho; Gomes, Diogo de Vasconcelos Sabido; Mota, Gabriel Milhomem da Silva.
  • de Resende, Henrique Carvalho; Núcleo de Ortopedia e Traumatologia. Belo Horizonte. BR
  • Gomes, Diogo de Vasconcelos Sabido; Hospital Maria Amélia Lins. Belo Horizonte. BR
  • Mota, Gabriel Milhomem da Silva; Hospital Maria Amélia Lins. Belo Horizonte. BR
Rev. bras. ortop ; 55(1): 75-81, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092674
ABSTRACT
Abstract Objectives To evaluate the management of tibial fractures resulting in bone loss (traumatic or infection-related) and the complications occurring during treatment with external fixator and immediately after apparatus removal. Methods Forty patients were selected from 2010 to 2017. The mean age of the patients was 33.02 years; 34 subjects were male and 6 were female. All patients had tibial bone regeneration, suffered trauma (mainly related to motorcycle accident) and were followed-up at an outpatient facility. Results Proximal tibial bones of up to 17 cm in length and distal tibial bones of up to 14 cm in length were obtained. The largest trifocal transport had the same length as the regenerated bone tissues, which was 14.5 cm. Regarding complications, 29 (72.5%) patients had infections in the pin and wire paths. There were 9 (22.5%) cases of de novo fracture, 6 of which were managed with the implantation of a new circular fixator, and 2 cases of infection of the regenerated bone. On average, patients were subjected to 4.72 procedures (ranging from 2-12), had the fixator for 20.75 months (ranging from 7-55 months), and stayed at the hospital for 53.7 days (ranging from 5-183 days), mainly because of soft-tissue complications, intravenous antibacterial therapy, and even social issues. Two (5%) patients presented symptomatic gonarthrosis, and two other patients had symptomatic ankle arthritis. Three of the patients showed lower limb discrepancy of 3.0, 3.7, and 5.0 cm. Conclusion Despite not being widely available, the Ilizarov method is useful for solving the majority of tibial bone losses, regardless of their etiology.
RESUMO
Resumo Objetivo Avaliar o tratamento das fraturas de tíbia que evoluíram com perda óssea (traumática ou secundária a infecção) e as complicações ocorridas durante o tratamento com fixador externo e no período imediatamente após sua retirada. Métodos Foram selecionados 40 pacientes tratados entre 2010 e 2017, com a idade média de 33,02 anos, sendo 34 do sexo masculino e 6 do sexo feminino. Todos os pacientes portavam regenerado ósseo da tíbia, foram vítimas de trauma (sobretudo motociclístico), e estavam em seguimento ambulatorial. Resultados Foram obtidos regenerados ósseos da tíbia proximal de até 17 cm e da tíbia distal de 14 cm. O maior transporte trifocal teve a soma do tamanho dos tecidos dos ossos regenerados, medindo 14,5 cm. Como complicações, 29 (72,5%) pacientes tiveram infecção no trajeto dos pinos e fios. Houve 9 (22,5%) casos de refratura, sendo 6 deles tratadas com novo fixador circular, e 2 infecções no osso regenerado. Os pacientes foram submetidos a uma média de 4,72 procedimentos cirúrgicos (2-12), portaram fixador por 20,75 meses (7-55 m.) e permaneceram internados por 53,7 dias (5-183) devido principalmente a complicações de partes moles, a antibioticoterapia intravenosa ou até mesmo a questões sociais. Dois (5%) pacientes apresentaram gonartrose sintomática e outros 2 artrite sintomática do tornozelo. Três apresentaram discrepância de membros inferiores de 3,0; 3,7; e 5,0 cm. Conclusão Apesar de não ser um método de tratamento amplamente disponível, o método de Ilizarov é útil para solucionar a maioria das falhas ósseas da tíbia, independente da sua etiologia.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Osteitis / Osteogenesis / Tibia / Bone and Bones / Bone Regeneration / External Fixators / Ilizarov Technique / Fractures, Bone Limits: Female / Humans / Male Language: English Journal: Rev. bras. ortop Journal subject: Orthopedics Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Maria Amélia Lins/BR / Núcleo de Ortopedia e Traumatologia/BR

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Full text: Available Index: LILACS (Americas) Main subject: Osteitis / Osteogenesis / Tibia / Bone and Bones / Bone Regeneration / External Fixators / Ilizarov Technique / Fractures, Bone Limits: Female / Humans / Male Language: English Journal: Rev. bras. ortop Journal subject: Orthopedics Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Hospital Maria Amélia Lins/BR / Núcleo de Ortopedia e Traumatologia/BR