OSTEOGENESIS DISTRACTION USING COMBINED PLATE AND ILIZAROF FIXATOR IN THE TREATMENT OF BONE DEFECT: A CASE REPORT

Misbahuddin Misbahuddin, Ismail Mariyanto

DOI: https://doi.org/10.23917/biomedika.v11i2.8598

Abstract

Distraksi osteogenesis dan pemanjangan tulang telah digunakan untuk merekonstruksi hilangnya tulang dengan memungkinkan tulang baru terbentuk pada celah. Pada penelitian sebelumnya, pemanjangan tulang yang dipandu pelat telah berhasil mengobati hilangnya  tulang pada tulang paha, tibia, dan mandibula. Penelitian ini melaporkan sebuah kasus fraktur tibia dengan kehilangan tulang kominutif yang diobati dengan fiksasi pelat dan pemanjangan tulang dengan fiksator cincin Ilizarov. Pada saat pengaitan, ketika segmen pemanjangan dikompresi dengan fragmen tulang, fragmen tulang difiksasi dengan sekrup locking dan non-locking tambahan melalui pelat. Panjang defek tulang adalah 7 cm. Indeks pemanjangan atau fiksasi eksternal adalah 12,7 hari / cm. Pada kasus ini tidak ada pemendekan yang terjadi. Indeks konsolidasi radiografi rata-rata adalah 37 hari / cm. Kasus ini  mencapai regenerasi segmen tulang yang bebas infeksi dan hasil fungsional yang memuaskan. Teknik ini mengurangi durasi fiksasi eksternal selama fase konsolidasi, memungkinkan koreksi panjangtulang, dan penyelarasan dan waktu rehabilitasi yang lebih singkat.\

Kata kunci: Defek Tulang, Transportasi Tulang, Osteogenesis Gangguan, Teknik Ilizarov, Osteogenesis Lempeng Tulang


Osteogenesis distraction and bone transport has been used to reconstruct bone loss defect by allowing new bone to form in the gap. In previous studies, plate-guided bone transport has been successfully to treat bone loss defect in the femur, tibia, and mandible. This study reports a case of fracture of tibia with comminutive bone loss treated with plate fixation and bone transport with Ilizarov ring fixator. At the time of docking, when the transport segment is compressed with bone fragment, the bone fragment is fixed with additional locking or nonlocking screws through the plate. The bone defect size was 7 cm. The lengthening/external fixation index was 12.7 days/cm. In this case there were no shortening that  present. The average radiographic consolidation index was 37 days/cm. This case achieved infection-free bone segment regeneration and satisfactorily functional outcome. This technique reduces the duration of external fixation during the consolidation phase, allows correction of length and alignment and provides earlier rehabilitation.

Keywords: Bone Defect, Bone Transport, Distraction Osteogenesis, Ilizarov Technique, Bone Plate Osteogenesis


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