genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/1028-4427-2024-30-2-255-262LRQNVUgenort-2963Research ArticleСЛУЧАЙ ИЗ ПРАКТИКИCASE REPORTЛечение контрактур сустава мягкотканного происхождения методом ИлизароваSoft-tissue origin joint contractures treated with the Ilizarov fixation methodYadkikarS. V.YadkikarS. V.

Shriniwas Vishnu Yadkikar — MS(ortho), Professor of Department, Orthopaedic Surgeon

Jaipur

Shriniwas Vishnu Yadkikar — MS(ortho), Professor of Department, Orthopaedic Surgeon

Jaipur

yadkikarpushkar@yahoo.co.inGroverR.GroverR.

Raman Grover — MDS (Oral and Maxillofacial Surgery), Associate Professor

Jaipur

Raman Grover — MDS (Oral and Maxillofacial Surgery), Associate Professor

Jaipur

ramangrov0211@gmail.comKaurP.KaurP.

Puneetpal Kaur — MD (Anaesthesia), Assistant Professor

Jaipur

Puneetpal Kaur — MD (Anaesthesia), Assistant Professor

Jaipur

Puneetpal.kaur@gamil.comYadkikarV. S.YadkikarV. S.

Vishnu Sitaram Yadkikar – MS(ortho), MS (Gen.Surgery), Consultant Orhthopedic Surgeon

Jaipur

Vishnu Sitaram Yadkikar — MS(ortho), MS (Gen.Surgery), Consultant Orhthopedic Surgeon

Jaipur

yadkikarpushkar@yahoo.co.inOjhaA.OjhaA.

Akanksha Ojha — DNB Anesthesia, Consultant Anaesthetist

Jaipur

Akanksha Ojha — DNB Anesthesia, Consultant Anaesthetist

Jaipur

akanshaojha@gmail.comJaipur National University Institute for Medical Sciences and Research CentreИндияJaipur National University Institute for Medical Sciences and Research CentreIndia202428042024302255262Copyright © Yadkikar S.V., Grover R., Kaur P., Yadkikar V., Ojha A., 20242024Yadkikar S.V., Grover R., Kaur P., Yadkikar V., Ojha A.Yadkikar S., Grover R., Kaur P., Yadkikar V., Ojha A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/2963Введение

Введение. Контрактуры мягких тканей суставов — распространенная ортопедическая проблема. Они могут иметь различную этиологию. Варианты лечения включают консервативные и хирургические методы. Такие контрактуры суставов постепенно становятся необратимыми, вызывая ухудшение повседневной деятельности. Метод Илизарова является хорошо зарекомендовавшим себя и проверенным временем методом лечения патологии костей. Однако возможно его использование и при лечении контрактур мягкотканного происхождения. Установлена его роль в неоостеогенезе и гистогенезе. Растяжение мягких тканей с помощью фиксатора выполняется в устойчивом медленном темпе, что обеспечивает гистонеогенез, позволяет избежать растяжения сосудисто-нервных структур и снижает вероятность рецидива.

Цель работы — определить эффективность метода Илизарова в лечении контрактур суставов мягкотканного происхождения; удовлетворить функциональные потребности пациентов; изучить осложнения метода Илизарова при лечении контрактур суставов мягкотканного происхождения.

Материалы и методы

Материалы и методы. Изучено 6 случаев контрактур суставов мягкотканного происхождения, развившихся вследствие туберкулеза, травматических повреждений, ожогов, укуса змеи в возрастной группе пациентов от 3 до 55 лет, пролеченных методом постепенной дистракции сустава по Илизарову в период от 22 января по 23 октября. В двух случаях наблюдалась тройная деформация колена, еще в двух — посттравматическая ригидность локтевого сустава, а также контрактура большого пальца стопы после ожога и вальгусная контрактура стопы после укуса змеи (по одному случаю). У всех пациентов наложение аппарата Илизарова выполняли трансартикулярно, а последующая постепенная дистракция сустава и мягких тканей осуществлялась с помощью шарнирно-стержневого дистрактора. Контрольное наблюдение во всех случаях осуществлялось в течение 1 года. После операции проводилась массивная физиотерапия.

Результаты

Результаты. Во всех случаях получен приемлемый функциональный результат без рецидива деформации. Все больные осуществляют самостоятельное передвижение.

Заключение

Заключение. Метод Илизарова может быть использован для лечения контрактур суставов, обусловленных травматической и нетравматической патологией.

Introduction Soft-tissue origin joint contractures are a common orthopedic problem. It could be due to various etiologies. Treatment options are available from conservative to surgical methods. These joint contractures slowly become irreversible causing impairment in activities of daily routine. The Ilizarov method is a well established and time-tested method used for management of bone pathologies, but its use in the management of soft-tissue origin contractures is also possible. It has an established role in neoosteogenesis and histogenesis. Fixator assisted soft-tissue stretching done at sustained slow pace leads to histoneogenesis that avoids stretching of neurovascular structures and reduces the possibility of recurrence.

Aims To determine usefulness of the Ilizarov method in management of joint contractures of soft tissue origin; to meet functional requirements of patients; to study complications of Ilizarov method in management joint contractures due to soft tissue origin.

Material and methods A total of 6 cases of soft-tissue origin joint contractures due to tuberculosis, post‑traumatic stiffness, post-burn contracture, deformity due to a snake bite in the age group from 3 to 55 years were treated with gradual distraction of joint with the Ilizarov method from January 22 to October 23. Two cases were of triple knee deformity, two were post-traumatic elbow stiffness, one was post-burn great toe contracture and one was post snake bite valgus foot contracture. All cases were operated with transarticular Ilizarov frame application and gradual distraction of joints and soft tissue with the help of hinge- and rod distractor assembly done. All cases completed follow up of 1 year. Aggressive physiotherapy was given postoperatively.

Results All cases obtained a reasonable functional outcome, with no recurrence of deformity. All patients walk independently.

Conclusion The Ilizarov method can be used for treating joint contractures due to traumatic and non‑traumatic pathologies.

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The authors declare that there are no conflicts of interest present.