tailieunhanh - báo cáo hóa học:" The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases | Bumbasirevic et al. Journal of Orthopaedic Surgery and Research 2011 6 57 http content 6 1 57 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH RESEARCH ARTICLE Open Access The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft a study of 18 cases Marko Bumbasirevic1 Slavko Tomic2 Aleksandar Lesic1 Vesna Bumbasirevic1 Zoran Rakocevic1 and Henry D Atkinson3 Abstract Objectives Evaluating the safety and efficacy of the Ilizarov fine-wire compression distraction technique in the treatment of scaphoid nonunion SNU without the use of bone graft. Design A retrospective review of 18 consecutive patients in one centre. Patients and Methods 18 patients 17 males 1 female with a mean SNU duration of months. Patients with carpal instability humpback deformity carpal collapse avascular necrosis or marked degenerative change were excluded. Following frame application the treatment consisted of three stages the frame was distracted 1 mm per day until radiographs showed a 2-3 mm opening at the SNU site mean 10 days the SNU site was then compressed for 5 days at a rate of 1 mm per day with the wrist in 15 degrees of flexion and 15 degrees of radial deviation the third stage involved immobilization with the Ilizarov fixator for 6 weeks. The technique is detailed herein. Results Radiographic CT and clinical bony union was achieved in all 18 patients after a mean of 89 days 70-130 days . Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months 24-72 months with good excellent results in 14 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections which resolved with oral antibiotics. Conclusions In these selected patients this technique safely achieved bony union without the need to open the SNU site and without the use of bone graft. Keywords Scaphoid nonunion Ilizarov circular frame without bone graft .