[Treatment of Congenital Deformities of the Forearm by Ilizarov's Distraction Method.].
The authors describe two cases of distraction of the bones of the forearm, using Ilizarov's distraction method. In the first case the author treated a patient with aplasia of the 1st metacarpal bone, a hypoplastic thumb on a dermal stalk and a hypoplastic radius on the right. After operations which were not effective (extension of the dermal stalk of the hypoplastic thumb by a Z-plasty, correction of the position of the hand by means of an osseo-cartilaginous transplant) and after pollicization of the index finger they decided for distraction of the radius by means of an original compressive-distraction apparatus. Within one year they achieved a prolongation of 10 cm in a 20-year-old female patient. The predistraction stage lasted 39 weeks and the stage of active rehabilitation without the apparatus 6 months. The authors achieved a correct position of the hand, functional restoration and better appearance of the right upper extremity. In the second case, a 25-year-old female patient, the left hand was adequately developed, there was hypoplasia of the radius (only the distal quarter of the radius was developed) and the ulna was bent in a radial direction. In this patient they achieved a correct position of the hand within 18 weeks, straightening of the bent ulna and its prolongation by 4 cm in 4 weeks. The stage of spontaneous osteogenesis of the newly formed bone took 8 weeks and the stage of active rehabilitation 3 months. They achieved a correct position of the hand, they improved the hand grip and aesthetic appearance. Both patients were satisfied with the results. Key words: club hand, distraction of the radius and ulna, Ilizarov's method.
Guzanin
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Klinika plastickej a rekonstrukcnej chirurgie Lekárskej fakulty UPJS, Kosice.