Metoda po Ilizarovu

master's thesis

• Title (english): Ilizarov method
• Author: Dominik Lončar
• Mentor: Domagoj Delimar (mentor)
• Committee member: Mislav Jelić (predsjednik povjerenstva)
• Committee member: Tomislav Đapić (član povjerenstva)
• Committee member: Domagoj Delimar (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Orthopedics); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Orthopedics

Abstract

Metoda po Ilizarovu je minimalno invazivna tehnika produljenja ekstremiteta. Osim za produljenje ekstremiteta metoda se koristi za liječenje prijeloma, pseudoartroza i korekciju deformiteta. Izmislio ju je Gavril Abramovič Ilizarov, sovjetski ortoped, 50-tih godina 20. stoljeća. Metoda se osniva na biološkim i mehaničkim principima distrakcijske osteogeneze i vanjskog fiksatora po Ilizarovu. Distrakcijska osteogeneza je mehanička indukcija nove kosti između koštanih površina koje se postupno razvlače. Očuvanje osteogenog potencijala endostealnih struktura i minimalna trauma periostalnim strukturama bitni su u koštanom cijeljenju. Metodom po Ilizarovu to se postiže kortikotomijom. Vanjski fiksator po Ilizarovu je specijalizirani oblik vanjskog fiksatora, cirkularnog oblika, modularan u konstrukciji. Tankim žicama se koštani segmenti stabiliziraju za okvir fiksatora. Postepenim zatezanjem i opuštanjem vijaka na okviru može se izvršiti kompresija ili distrakcija koštanih segmenata ovisno o indikaciji. U slučaju produživanja ekstremiteta takvo zatezanje vijaka mora se vršiti točno određenom brzinom. Preporuča se brzina od 1mm dnevno u intervalima od 6 sati. Veće ili manje brzine uzrokuju komplikacije. Iako se radi o minimalno invazivnom zahvatu, metoda nije bez komplikacija. Bol je česta, ali se može liječiti analgeticima. Potrebna je pažnja i svakodnevno čišćenje spoja između žica i kože kako bi se izbjegla infekcija. Metoda se preferira nad konvencionalnim opcijama kada postoji veliki rizik od infekcija, ili kada se unutarnji fiksatori ne mogu primijeniti.

Abstract (english)

The Ilizarov method is a minimal invasive technique for limb lengthening. Beside limb lengthening it is used for treating fractures, non-unions, and deformity corrections. It was invented by Gavril Abramovich Ilizarov, soviet surgeon, in the 50's. The method is based on biological and mechanical principles of distraction osteogenesis and Ilizarov external fixator. Distraction osteogenesis is a mechanical induction of new bone between bone surfaces which are gradually pulled apart. The preservation of osteogenic potential of endosteal structures and minimal trauma to periostal structures are valuable for bone healing. The Ilizarov method achieves this with corticotomy. Ilizarov external fixator is a specialized form of external fixator, circular shaped, modular in construction. With thin wires bone fragments are stabilized to the frame of fixator. By the means of gradual tightening and loosing of the screws on the frame, compression and distraction of bone fragments can be achieved, depending on the indication. In case of limb lengthening such tightening of the screws must be done with exact speed. Suggested speed is 1 mm per day with intervals of 6 hours. Higher or lesser speeds cause complications. Despite being an minimal invasive technique, the method is not without complications. Pain is common, but treatable with analgesics. Daily cleaning of wire insertion sites are necessary to prevent infections. This method is preferred over conventional options when there is high risk of infection, or internal fixators are unworkable.

• Keywords: metoda po Ilizarovu; distrakcijska osteogeneza; vanjski fiksator
• Keywords (english): Ilizarov method; distraction osteogenesis; external fixator
• Language: croatian
• URN:NBN: urn:nbn:hr:105:666143
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-04-03 11:10:56