- Limb lengthening: only in case of emergency
- Osteosynthesis method GA Ilizarov
Types and causes of limb shortening
Shortening of the limbs can be of three types: true, relative and total.
The real change leg length - a shortening of the length of an individual segment of a limb (thigh, shoulder, leg and so on) This change could be due to the destruction of articular ends of the long bones (epiphysis), improper seam fractures and other - shortened the bone and the surrounding soft tissue . The relative change in the length of the limbs occurs in sprains
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. Total shortening - a reduction in the total length of the course includes a real, relative and apparent (at constant bending limbs). Shortening of a limb - it is always a consequence of a disease or injury.
They can be shortened and the two limbs - is more common in congenital deformities and hereditary diseases. Finally, a man with a proportional addition may be a slight increase, which does not suit him and is responsible for a variety of stressful situations.
How can lengthen limbs
Enlarge growth is possible only in an age when the body has not yet formed, and closed zones of bone growth. They are closed at different times, someone at 14, but someone in the 20. After this growth can be increased only by surgery. The indications for the extension of one limb shortening is it not less than 3 75 cm, as less shortening can be offset by the special orthopedic shoes
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With significant shortening can be performed sequentially lengthening the femur and tibia (with shortening of more than 10 cm). Nowadays, the most common two types of operations for limb lengthening - dissection of bone followed by the imposition of various external fixation devices (for example, by Ilizarov, Volkov-Oganesyan Gudushauri and others), or with the imposition of a compact device that is fully implanted in the bone (method A .I.Bliskunova).
The compression-distraction osteosynthesis method GA Ilizarov
This technique was developed by GA Ilizarov in the 50s of the last century for the treatment of fractures. Later it was used for limb lengthening. The operation consists in that the incised bone (femur or tibia), and then it establishes a special apparatus, whereby the bone fragments are in a fixed state. After 10-12 days after the operation start lengthening bones. When the screw several times a day, the distance between the bone fragments mildly (mm fraction) increases. The day such increase should not exceed 1 mm, otherwise the bones grow together. But too slowly increase the distance it is impossible - bones can grow together too quickly. Thus, an increase in limb 6 cm it will require about 60-70 days. Walking on crutches, the patient is allowed to have a few days after surgery.
Once the foot is stretched to the desired length, a period of fixation - certainly fix it until full recovery (about 3 more months). Gradually, the patient is allowed to increase the burden on the feet, and by the mid-term fix, they can walk without crutches. At the same time in this period is assigned to therapeutic exercises to restore muscle function.
With such an operation can increase the length of the thigh 10 cm, shin - 6 cm.
When using external fixation devices may experience the following complications:
- Injury of blood vessels and nerves, which can result in bleeding or be broken innervation of the limbs;
- as the needles pass through the Ilizarov limb tissue and come out through the holes in the skin into the bone and soft tissue infection can penetrate; In some cases (especially if the patient has impaired immunity) it negates all efforts to carry out the operation;
- breaking the individual spokes or other elements of the Ilizarov fixator may require re-operation;
- sometimes in the treatment of pain there is significant.
Osteosynthesis followed by the imposition of the device AI Bliskunova
A new trend in orthopedics has become the method of Professor A. Bliskunova, he developed about 20 years ago. To lengthen limbs Bliskunov proposed use of compact devices that are fully implanted into the bone. These devices have a special device - a ratchet, which operates under the control of the patient. For the implantation of the device was developed by a special technology and equipment.
Bliskunova method allows to increase the height of a man on a 5-20 cm. The absence of external hardware, stable fixation, complete autonomy allow the patient to a week after surgery to walk, take a shower, bath, swim in the pool, doing gymnastics.
If the extension of the legs is not vital, it is worth considering whether to make this a painful and not always a safe operation.