Features of Surgical Treatment of Posttraumatic Lower Limbs of Different Lengths in Adult Patients
https://doi.org/10.23934/2223-9022-2020-9-4-573-579
Abstract
Relevance. Different lengths of the lower extremities have a negative impact on the position of the pelvis and spine and lead to secondary deformities. To prevent these consequences, early surgical correction of the shortening is necessary.
Aim of study. Study of the features of post-traumatic shortening of the lower extremities, mechanisms of adaptation to this condition and, on the basis of this, optimization of surgical technique when performing reconstructive and restorative operations.
Material and methods. A total of 276 patients with posttraumatic shortening of the lower extremities were examined, 102 of whom were operated on. Comparative radiography of both legs was used to diagnose different lengths. The Ilizarov method was used as the main method of surgical correction.
Results. We studied the mechanisms of adaptation of patients to post-traumatic shortening of the hip and lower leg and optimized surgical technique. A method was developed for determining the optimal elongation value.
Conclusion. The most effective and least traumatic method is external osteosynthesis according to Ilizarov. Distraction in the apparatus allows the formation of a regenerate of the required shape and length and the elongation of exactly the amount that is optimal for a given patient.
About the Authors
A. A. Artemiev
Department of Traumatology and Orthopedics, Federal Scientific and Clinical Center for Specialized Types of Medical Aid and Medical Technologies of FMBA of Russia; Moscow State University of Food Production
Russian Federation
Russian Federation
Aleksandr A. Artemiev Doctor of Medical Sciences, Professor; Professor of the Department of Surgery of Injuries of the Medical Institute of Continuing Education
28 Orekhovy blvd., Moscow 115682, Russian Federation
11 Volokolamskoe Sh., Moscow 125080, Russian Federation
A. N. Ivashkin
Moscow State University of Food Production
Russian Federation
Russian Federation
Aleksandr N. Ivashkin Professor of the Department of Injury Surgery, Medical Institute of Continuing Education, Head of the Traumatology Department, GKB im. V.V. Vinogradov
11 Volokolamskoe Sh., Moscow 125080, Russian Federation
A. M. Kashoob
Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Ali M. Kashoob, postgraduate student of the Department of Traumatology and Orthopedics of the Medical Institute
6 Miklukho-Maklaya St., Moscow 117198, Russian Federation
Yu. S. Solovyov
Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Yuri S. Solovyov Applicant for the Department of Traumatology and Orthopedics of the Medical Institute
6 Miklukho-Maklaya St., Moscow 117198, Russian Federation
G. G. Gululyan
Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Gevorg G. Gululyan Applicant for the Department of Traumatology and Orthopedics of the Medical Institute
6 Miklukho-Maklaya St., Moscow 117198, Russian Federation
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Review
For citations:
Artemiev A.A., Ivashkin A.N., Kashoob A.M., Solovyov Yu.S., Gululyan G.G. Features of Surgical Treatment of Posttraumatic Lower Limbs of Different Lengths in Adult Patients. Russian Sklifosovsky Journal "Emergency Medical Care". 2020;9(4):573-579. https://doi.org/10.23934/2223-9022-2020-9-4-573-579
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