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首页> 外文期刊>Strategies in trauma and limb reconstruction. >Pelvic Support Hip Reconstruction with Internal Devices: An Alternative to Ilizarov Hip Reconstruction
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Pelvic Support Hip Reconstruction with Internal Devices: An Alternative to Ilizarov Hip Reconstruction

机译:骨盆支撑髋关节重建与内部设备:Ilizarov Hip重建的替代方案

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Aim and objective:Ilizarov hip reconstruction (IHR) is a traditional method of salvaging chronic adolescent problem hips but faces practical issues from external fixators leading to reduced compliance. We present the same reconstruction procedure using only internal devices with a modification in the technique and review early results.Materials and methods:We retrospectively evaluated eight patients between 2014 and 2017 with chronic painful hips treated by two-stage reconstruction; stage I included femoral head resection and pelvic support osteotomy using double plating, whereas stage II comprised distal femoral osteotomy avoiding varus followed by the insertion of a retrograde magnetic nail for postoperative lengthening. Patients continued physiotherapy postoperatively while protecting from early weight-bearing.Results:At a mean follow-up of 19 months (range, 6-36), all osteotomies healed with a bone healing index of 47 days/cm (range, 30-72). Pain improved from 8.3 (range, 7-9) to 2 (range, 0-6) while the limb length discrepancy got corrected from 4.3 cm (range, 3-5) to 1.4 cm (range, 0-2.5) at the final follow-up. Trendelenburg sign was eliminated in three patients and delayed in five patients. No examples of infection or permanent knee stiffness were noted. One patient had plate breakage due to mechanical fall, and another patient had 35 mm of lateral mechanical axis deviation (MAD) requiring corrective osteotomy.Conclusion:Pelvic support hip reconstruction with exclusive internal devices is a technique in evolution with encouraging early results. It avoids common complications of external fixators and facilitates quick rehabilitation of joints. Refraining from distal varus can effectively eliminate Trendelenburg gait, although with some degree of lateral MAD. Unlike external fixation where there is a possibility of gradual correction, this staged procedure of internal fixation is technically demanding with a learning curve.Clinical significance:Pelvic support hip reconstruction performed by internal implants is a viable alternative to Ilizarov hip reconstruction with potential benefits.How to cite this article:Metikala S, Kurian BT, Madan SS, et al. Pelvic Support Hip Reconstruction with Internal Devices: An Alternative to Ilizarov Hip Reconstruction. Strategies Trauma Limb Reconstr 2020;15(1):34-40.Copyright ? 2020; Jaypee Brothers Medical Publishers (P) Ltd.
机译:目的和目标:Ilizarov Hip重建(IHR)是一种传统的拯救慢性青少年问题臀部的方法,但面临外部固定器的实际问题,导致遵守减少。我们仅使用内部设备介绍了相同的重建程序,并在技术中进行了修改,并查看早期结果。材料和方法:我们回顾性评估了2014年至2017年间的八患者,两级重建治疗慢性痛苦的髋骨;阶段我包括使用双电镀的股骨头切除和盆腔壳体骨质型,而第II阶段包括远端股骨骨质图术避免Varus,然后插入逆行磁钉以进行术后延长。患者在术后持续物理治疗,同时免受早期减肥保护。结果:在19个月的平均随访(范围,6-36),所有截骨术治疗47天/厘米(范围,30-72 )。疼痛从8.3(范围,7-9)到2(范围,0-6),而LIMB长度差异在最终的4.3厘米(范围为3-5)至1.4cm(范围,0-2.5)中得到校正跟进。 Trendelenburg标志在三名患者中被淘汰并延迟了五名患者。没有注意到感染或永久性膝僵硬度的例子。一名患者由于机械跌落而具有纸张破损,另一位患者具有35毫米的横向机械轴偏差(MAD),需要矫正截骨术。结论:具有独家内部设备的骨盆支撑髋关节重建是一种令人鼓舞的早期结果的技术。它避免了外部固定器的常见并发症,并有助于快速恢复关节。避免远端瓦鲁斯可以有效地消除Trendelenburg步态,尽管有一定程度的侧面疯狂。与外部固定有可能逐渐校正的外部固定,该内部固定的分阶段过程在技术上要求学习曲线。临床意义:内植入物进行的骨盆支撑髋关节重建是Ilizarov Hip重建具有潜在益处的可行替代品。如何为了引用这篇文章:Madan Bt,Madan Ss等,梅里安娜S,Kuriana Ss,等。骨盆支撑髋关节重建与内部设备:Ilizarov HIP重建的替代品。策略创伤肢体recolstr 2020; 15(1):34-40.copyright? 2020; Jaypee Brothers Medical Publishers(P)有限公司

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