Dissertation > Excellent graduate degree dissertation topics show

Study on Ilizarov Distraction Technique for Limb Lengthening and Bone Transport

Author: LanXia
Tutor: TangPeiFu
School:
Course: Orthopaedic Surgery
Keywords: Distraction osteogenesis limb lengthening bone transport externalfixators osteotomy
CLC: R687.3
Type: PhD thesis
Year: 2013
Downloads: 84
Quote: 0
Read: Download Dissertation

Abstract


Purpose The aim of this study was to explore the clinical effects of Ilizarovdistraction technique for bilateral leg lengthening and long bone defect.Methods In the first part, we performed a retrospective study of520patients who hadbilateral shortening deformity treated with Ilizarov methods between June1995andJune2011. To explore the clinical effects of the modified Ilizarov apparatus for leglengthening, combined external fixation and nail technique and longitudinal S-osteotomy for leg lengthening. In the second part, we performed a retrospective study of115patients who had bone defects treated by Ilizarov bone transport. To explore theclinical effects of segmental bone trasport(SBT) and compression distraction(CD).Theconsolidation index(CI) were calculated and complications were recorded according toPaley’s classification criteria. And leg lengthening database and bone defect databasewere established with SPSS16.0software.Analysis was performed based on the twodatabase. Frequency and descriptive analysis were performed for all the variables.Descriptive grade analysis were performed for age, the length of leg lengtheing andbone defect. In the leg lengthening database, multiple linear regression was used toanalyze the factors that may affect the bone regerationa and consolidation. In the leglengthening database, S-osteotomy, transverse osteotomy and bifocal osteotomy wereapplied, and lengthening by external fixator, lenthening over a nail, and lengthening andthen nailing(LATN) were aplied. The mean CI between the three ostotomy methods, andthe mean CI and external fixation index(EFI) between three fixation methods werecompared and anlysed with one–factor analysis of variance. Ordinal contingency wasused to analyse the rates of ankle flexion contracture of the diffenrent lengthening grades and Chi-square test was used to compare the diffenrence. In the bone defectdatabase,the length of bone defect and limb shortening of femur,tibia,radius and ulnarwere analysed.The Catagni classification for bone defect was used and analysed.Chi-square test was used to compare and analyse the pin-tract infection rates of thedifferent bone.Results The patients with leg lengthened were followed for a mean of2.5years(1-4).The mean final gain length of leg was8.15±2.05cm(2.5-21.1). The mean CI was73.89±12.06d/cm(35-95.6). The CI of S-osteotomy was significantly lower than thetransverse osteotomy and bifocal osteotomy. The EFI of lengthening by combinedexternal fixator and nailing was significantly lower than lengthening by external fixator.The CI of LATN was significantly lower than the other two fixation methods.Therewere two obstacles of ankle flexion contracture(2/520,0.38%).The patients with bonedefect were followed for a mean of2years(1-3). The mean bone defect was7.02±2.22cm(3-18).The mean limb shortening was2.42±1.50cm(1-5). Bone defect healed inall patients and the mean healing time was15.3±2.52(7-23)months. Infection wascontrolled in69patients with infected nounion and no recurrence occurred duringfollow-up.18patients had bone defect complicated with limb shortening (Catagni B3)and only3patients had residual limb discrepancy (1cm,0.5cm,1.5cm).Conclusions1. The modified apparatus for leg lengthening can effectively preventankle flexion contracture during leg lengthening.2. Combined external fixation andnailing can provide internal fixation for the newly bone and reduce axial deviation andrefracture after fixator removal. The time for external fixation was also significantlyreduced than lengthening by external fixator.3. S-osteotomy can promote boneregeneration and consolidation.4. Both segmental bone trasport and compressiondistraction are effective methods for various kinds of bone defects. The limb shorteningand other complicated deformity can be corrected simultaneously.5. Combined segmental bone transport with lesions removal for infective bone defect can controlinfection effectively and the recurrence was rare.

Related Dissertations

  1. Single-segment Transpedicular Vertebral Osteotomyon the Top of Kyphosis Combined with Screw Internal Fixationfor Correction of Thoracolumbar Spine Kyphosis in Ankylosing Spondylitis,R687.3
  2. Clinical Analysis of the Complications Following Correction of Prominent Mandibular Angle,R622
  3. Clinical Analysis above the Changes of the Occlusion Through Rigid Internal Fixation after the Mandibular Osteotomy of Tongue Carcinoma,R739.86
  4. Application of De-rotation Osteotomy of Ulnar and Radial Bone in the Treatment of Obstetric Brachial Plexus Palsy,R726.8
  5. A Comparative Study of the Treatment of Complicated Fracture of Talar Neck by the Fibular Osteotomy and Non-osteotomy Approach,R687.3
  6. The Clinical Research of Total Hip Arthroplasty for Congenital Hip Dysplasia in Adults,R687.3
  7. The Effect of Subtrochanteric Varus Osteotomy to Vascularization and Endochondral Ossification of the Femoral Head in Rabbit Model of Perthes’ Disease,R687.3
  8. The Acute Effect of Spinal Cord Shortening on Function and Blood Flow in Rabbit Undergoing the Lumbar Body Posterior Vertebrectomy,R687.3
  9. Analysis of the Therapeutic Effect of Two Procedures in the Treatment of Obsolete Monteggia Fractures in Children,R726.8
  10. A Correlation Analysis: Effect of Thoracolumbar Kyphosis by Osteotomy and Orthomorphia and Lumbar Lordosis,R687.3
  11. 3D virtual the osteotomy surgery simulation and measurement algorithms,TP391.9
  12. Mandibular Deformity Three-dimensional Reconstruction and Simulation of Surgery,R782
  13. Dorsum narrow osteotomy clinical and basic research related,R622
  14. Correlative Study of Transfer Metatarsalgia of Hallux Valgus After Distal Osteotomy of the First Metatarsal,R687.3
  15. Operation for Developmental Dislocation of the Hip,R684
  16. Osteotomy ankle ankle two traumatic arthritis Efficacy,R687.3
  17. The Application of Three-dimensional CT in Preoperation and Postoperation of Developmental Dysplasia of the Hip,R816.8
  18. Transverse osteotomy on the condylar neck and mandibular condylar growth in rats,R782.4
  19. Number of Virtual Technology in the Hallux Valgus Foot Orthotics Surgery,R687.3
  20. The Intervention to Tibial Delayed Union and Nonunion of Open Tibial Fracture after External Fixation,R687.3
  21. Biomechanical Causes Analysis and Precaution of Intraoperative Periprosthetic Fracture of the Femur in Total Hip Replacement with the Collum Femoris Preserving Prosthesis,R687.3

CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
© 2012 www.DissertationTopic.Net  Mobile