Bridging bone gaps with the Ilizarov technique. Biologic principles.
For the treatment of bone gaps of less than 4 cm, cancellous autografting remains the treatment of choice. But for gaps exceeding 4 cm, the distraction osteogenesis is a viable option. The following conditions should be satisfied: (1) patient selection; (2) stable fixation; (3) osteotomy by corticotomy; (4) 7- to 14-day latency period before initiating distraction; and (5) a controlled rate and rhythm of distraction of 1 mm per day (0.25 mm, four times a day). This type of treatment leaves the pathologic focus alone, and bone healing occurs on the healthy bone. The quality of bone regenerate may be improved by a motorized unit and by better soft-tissue coverage using early grafts and flaps. Interface healing is probably improved by cancellous grafting and internal fixation after the transport period, thus decreasing the fixator time.
Alonso
J E
JE
Department of Surgery, University of Alabama, Birmingham.
Regazzoni
P
P
D001852:Bone Lengthening / Q000009:adverse effects / Q000379:methods*; D016267:External Fixators; D006801:Humans; D010027:Osteotomy / Q000379:methods; D013978:Tibial Fractures / Q000628:therapy*; D014458:Ulna Fractures / Q000628:therapy*