Preview

Science and Innovations

Advanced search

The choice of methods for fixing bone fragments in autoplasty of long tubular bone defects

https://doi.org/10.29235/1818-9857-2021-3-72-79

Abstract

The aim of the study was to analyze the effect of different methods of fixing bone fragments after transplantation of the fibula into a large defect of long tubular bones on the results of treatment. The study included 10 patients (group 1) with major tibia defects in whom the method of postoperative fixation of the segment of the operated limb allowed to give an early mechanical load on the graft itself and 10 patients (group 2) where the impact of mechanical load on the graft was excluded due to its transplantation into the hummers defect (6 cases) or minimized when replacing the tibia defect (4 cases). The degree of graft hypertrophy, the rate of its fusion with the recipient bed, and the number of postoperative complications under different conditions of mechanical stimulation of the fibula graft were studied. The rate of fusion of the graft with the recipient bed in both groups of patients was the same, but the incidence of complete stress fractures of the fibula graft in the second group was three times higher than in the first and was 30%, against the background of a slight degree of graft hypertrophy (from 19% to 45%). The use of the Ilizarov device for fixing fragments of the post-resection bone bed and graft in a stable and dynamic mode allows to give an early postoperative load on the lower limb, stimulates the rate of graft hypertrophy and reduces the likelihood of developing complete stress fractures.

About the Authors

D. Podgaysky
Минская областная клиническая больница
Belarus


V. Podgaysky
БелМАПО
Belarus


Y. Ladutko
БелМАПО
Belarus


O. Kezlya
БелМАПО
Belarus


A. Pekar
Минская областная клиническая больница
Belarus


A. Selitsky
БелМАПО
Belarus


References

1. Ручкина И. В., Осипова Е. В., Дьячков. А. Н. Рентгеноденситометрические особенности формирования реге- нерата в костном дефекте, изолированном от мягких тканей резорбируемым материалом (экспериментальное исследование) // Гений Ортопедии. №4. 2003. С. 35.

2. Gugala Z., Lindsey R.W., Gogolewski S. New approaches in the treatment of critical-size segmental defects in long bones // Macromolecular Symposia. 2007. P. 253, 147–161.

3. Houdek M.T., Bayne C.O., Bishop, Allen Thorp Shin, Alexander Yong-Shik. The outcome and complications of vascularised fibular grafts. // The bone & joint journal. 2017. Vol. 99-B, №1. РР. 134–138.

4. Falder S., Sinclair J.S., Rogers C.A., GTownsend P.L.. Long-term behaviour of the free vascularised fibula following reconstruction of large bony defects // British Journal of Plastic Surgery. Vol. 56–6. PP. 571–584.

5. Zelenski N., Brigman B.E, Levin LS, Erdmann D., Eward W.C. The vascularized fibular graft in the pediatric upper extremity: a durable, biological solution to large oncologic defects // Sarcoma. 2013.

6. Родоманова Л. А. Возможности реконструктивной микрохирургии в раннем лечении больных с обширны- ми посттравматическими дефектами конечностей: дис. д. м.н. – СПб. 2010.

7. Тихилов Р. М., Кочиш А. Ю., Родоманова Л. А., Разоренов В. Л., Козлов И. В. Современные тенденции пластики лоскутами с осевым типом кровоснабжения на нижней конечности // Вестник травматологии и ортопедии им. Н. Н. Приорова. 2007. №2. С. 71–75.

8. Keating J.F., Simpson A.H., Robinson C.M. The management of fractures with bone loss // J Bone Joint Surg Br. 2005. 87(2). P. 142.

9. De Boer H. H., Wood M. B. Bone changes in a vascular fibular graft // Journal of Bone and Joint Surgery. UK. 1989. №71(3). P. 374–378.

10. De Boer H. H. Vascularized fibular transfer // Thesis, Leiden. The Netherlands. 1988.

11. Woo SLY, Kuei S. C., Amiel D. et al. The effect of prolonged physical training on the properties of long bone: a study of Wolff's law // J Bone Joint Surg. 1981. №63-A. P. 780–787.

12. Jones H.H., Priest J.D., Hayes W.C., Tichenor C.C., Nagel D.A. // Humeral hypertrophy in response to exercise // J. Bone Joint Surg. 1977. №59-A. P. 204–208.

13. Mizumoto S., Tamai S., Goshima J. et al. Experimental study of vascularized tibiofibular graft in inbred rats: a preliminary report // J Reconstr Microsurg. 1986. №3. P. 1–9.

14. Bos K.E., Besselaar P. P., Eijken L. W., Raaymakers, ELFB // Failure of hypertrophy in revascularized fibula grafts due to stress protection // Microsurgery. 1996. №17. P 366–370.

15. Huang W. C. How does the age factor influence the hypertrophy of vascularized bone grafts? An experimental study // J Nara Med Assoc. 1988. №39. P 756–772.

16. Lee K. S., Chung H. K., Kim K. H. Vascularized osteocutaneous fibular transfer to the tibia // Int Orthop (SICOT). 1991. №15. P. 199–203.


Review

For citations:


Podgaysky D., Podgaysky V., Ladutko Y., Kezlya O., Pekar A., Selitsky A. The choice of methods for fixing bone fragments in autoplasty of long tubular bone defects. Science and Innovations. 2021;(3):72-79. (In Russ.) https://doi.org/10.29235/1818-9857-2021-3-72-79

Views: 70


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1818-9857 (Print)
ISSN 2412-9372 (Online)