Ilizarov Method: A Limb Salvage Device in a Child.
Ilizarov method is the best weapon for the treatment of the limb length discrepancy, especially in traumatic or congenital shortening of long bones. Post burn bony defect can be corrected by osteosynthesis. Here we treated a 7 years old boy, suffering from 33% electric burn affecting face, trunk, left upper limb & both lower limbs with loss of soft tissue of medial side of right leg along with dead and exposed of some segment (about 14cm) of Left tibia . Initially the patient was managed by plastic surgeons in the form of surgical toileting, wound debridement and wound coverage by split thickness skin graft. After about 6 weeks, we applied Ilizarov fixator on the affected limb and maintained it for 7 days to increase vascularity. As there was minimum bone in the proximal part, we did corticotomy at the distal end. After 7 days further, we started distal to proximal bone transport at a rate of 1mm per day. Staged excision of about 2.5 to 3cm dead bone was done, after transporting the same length of bone each time. In 5 such sittings, a total of 14cm bone was excised. Thus the burned portion was replaced by new bone; bony union was achieved after applying compression. Now the patient is able to walk individually, without any difficulty. So, we found that, Ilizarov method is a good option for the management of post burn bone loss. To our knowledge, such an application of the Ilizarov external fixation device in post burn bone loss has yet to be reported.
Dr ABM Golam Faruque, Associate Professor, National Institute of Traumatology & Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh.
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Faruque
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Mollah
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Siddiquee
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Bari
D002648:Child; D016267:External Fixators; D006801:Humans; D018889:Ilizarov Technique; D023821:Limb Salvage; D008297:Male; D013977:Tibia; D013978:Tibial Fractures / Q000601:surgery