Ilizarov’s method is a compound system
consisting of rings and wires, in order to fix the bone.
PHILOSOPHY
OF EXTREMITY LENGHTENING AND RECONSTRUCTION
Extremity lenghtening and reconstruction techniques are
used to replace bone defects and to lenghten or to correct deformities. These
interventions can be applicated in congenital pathologies, bone defects, post traumatic
extremity lenght discrepancies. It can be used for children, and adults till the age of 70
as well. The procedure of extremity lenghtening and deformity correction is based on the
principle of distraction osteogenesis, which opens a new era , breaking the strict belief
that bones cannot be lenghtened. Extremity lenghtening is performed by an osteotomy and
gradual lenghtening, while the created gap is filled with new bone (Osteogenesis). In this
way , bone can be lenghtened by % 15-100 of its original length.
The University of Istanbul, Istanbul
Medical Faculty, Department of Orthopaedic Surgery and Traumatology, performed the
extremity lenghtening and deformity correction, by using monolateral and circular external
fixators. In this way, patients who seemed inoperable before, are actually treated in our
hospital.
EXTREMITY
LENGHTENING
The Clinical team of our department, consists of experienced orthopaedic surgeons and
residents in extremity lenghtening and deformity correction;physiotherapists, nurses and
other qualified staff. We also do perform clinical and basic science researchs, in order
to develope surgical techniques and to evaluate biological principles of extremity
lenghtening.
METHOD
OF EXTREMITY LENGHTENING AND RECONSTRUCTION
STEP 1
The patient will be firstly physically examined at our
clinic which is followed by a radiologic picture collection of the case. The method of
surgical therapy will be determined following the discussion and agreement on the
possibilities, with the patient himself and the surgical team.EKSTREMİTE UZATMA VE
REKONSTRÜKSİYON METODU
11 cm short (before surgery)
STEP 2 :
SURGERY
A frame is prepared for every patient, preoperatively.
This frame will be fixed to the bone, by using pins and wires. The operation is performed
thru a couple of mini incisions. The osteotomy is performed by respecting the surrounding
soft-tissues.
STEP 3 :
POSTOPERATIVE THERAPY AND REHABILITATION
Lenghtening usually begins after the first week after
the operation, by distracting one milimeter every day. The patients are in generally
hospitalized for three to seven days; more complicated cases, may stay for longer periods.
Rehabilitation starts at the first or the second postoperative day. The aim of the
physical therapy is to protect the joint range of motion and to keep the muscle tension.
Standing up and bipedal gait with weight bearing begins a couple of days after the
operation.
The physical therapy program is of great concern during the follow-up. Complicated cases
can be rehabilitated, while hospitalized. All patients are permanently encouraged to
continue, their daily routine activities. Walking and washing ( by using disinfectant
soaps) is allowed.
STEP 4 :
HARDENING OF THE BONE
(OSSIFICATION)
After the planned size lenghtening is reached, the frame will not be manipulated anymore.
After the new bone reaches his required strenght, the frame will be removed from the
patient, under local or general anesthesia. The new formed bone is protected by a cast or
a plastic brace, for one or two additional months.
Stage of bone hardening
|
After bone hardening
(11 cm lngthening achieved). |
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| Before |
 |
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| After |
FOLLOW
- UP :
The follow-up period depends on the patients characteristics. The
control examinations are performed every two or three weeks.
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