15-year experience of transosseous distraction osteosynthesis use for occlusion diseases of limb arteries

Abstract

The method of distraction osteosynthesis was used in 285 patients with arterial occlusions of upper and lower limbs, which occurred as a result of obliterating endarteritis and atherosclerosis and which were accompanied by chronic ischemia of tissues of II - IV Stage. Clinical, angiographic and instrumental methods showed, that surgical treatment of patients with occlusion diseases of limb arteries of distal type was accompanied by persistent compensation of ischemic disorders after formation of bone split, its transportation in the transverse direction with formation of a distraction regenerate, changed to mature bone tissue. Analysis of treatment outcomes revealed the best results in patients with endarteritis and ischemia of II Stage. Distraction osteosynthesis in these patients provided prolonged remission of the disease and opposite development of its symptoms. Compensation of vascular-and-trophic disorders was also noted in patients with ischemia of III - IV Stages. Ulceronecrotic foci, if not disappeared, separated and became suitable to perform necrectomy or economical amputation of distal limb parts. Positive result of treatment was noted in 236 patients (88,9%) and was maintained for three years in 86% of those observed. The method of distraction osteosynthesis is an effective means for compensation of chronic ischemia in non-constructable occlusions of limb arteries.