Systematic review on Ilizarov technique in the management of congenital radial club hand
Emad Ibrahim shakhloul;
Abstract
Radial longitudinal deficiency (RLD) is a congenital deformity of the upper extremity that can manifest as hypo plasia of the limb or limb segment, dysplasia of a bone segment, or absence of the radius (either partial or complete). On appearance, upper extremity shortening and angular deformity usually are obvious. It is important to note that RLD also may be associated with other body system abnormalities, some of which can be fatal.
The goal of treatment is to provide the most functional extremity possible. This will first require a complete assessment of the child to check for possible associated conditions, followed by a treatment plan that may take a long time to achieve.
The treatment range from non operative, splinting and operative that include centralization, radialization and corrective osteotomies and lengthening by ilizarov apparatus.
Circular external fixator (ilizarov) is used for gradual distraction of bone and soft tissue. In early childhood pre-centralization soft tissue distraction by ilizarov then centralization is preferable. In elderly children centralization then gradual distraction and lengthening of ulnar shortening with correction of deformity by ilizarov has a good results. The use of ilizarov achieve ulnar lengthening without need of bone graft. Ilizarov can length, correct deformity of forearm, and centralize the ulna to carpus in multi-axial direction by use of poly-axial hinges and spanning the wrist, so it has many advantages over other fixator or methods.
Pre-operative soft tissue distraction for radial deficiency is indicated in late presenting or neglected patients or cases with severe, irreducible wrist angulation and displacement.
Dramatic correction is possible using ilizarov fixator distractors. Although minor complications are common, they diminish with experience. Using this technique, the surgeon avoids skeletal shortening and strain on the nerves and vessels at the time of centralization.
The goal of treatment is to provide the most functional extremity possible. This will first require a complete assessment of the child to check for possible associated conditions, followed by a treatment plan that may take a long time to achieve.
The treatment range from non operative, splinting and operative that include centralization, radialization and corrective osteotomies and lengthening by ilizarov apparatus.
Circular external fixator (ilizarov) is used for gradual distraction of bone and soft tissue. In early childhood pre-centralization soft tissue distraction by ilizarov then centralization is preferable. In elderly children centralization then gradual distraction and lengthening of ulnar shortening with correction of deformity by ilizarov has a good results. The use of ilizarov achieve ulnar lengthening without need of bone graft. Ilizarov can length, correct deformity of forearm, and centralize the ulna to carpus in multi-axial direction by use of poly-axial hinges and spanning the wrist, so it has many advantages over other fixator or methods.
Pre-operative soft tissue distraction for radial deficiency is indicated in late presenting or neglected patients or cases with severe, irreducible wrist angulation and displacement.
Dramatic correction is possible using ilizarov fixator distractors. Although minor complications are common, they diminish with experience. Using this technique, the surgeon avoids skeletal shortening and strain on the nerves and vessels at the time of centralization.
Other data
| Title | Systematic review on Ilizarov technique in the management of congenital radial club hand | Other Titles | دراسة منهجية عن تصليح اعوجاج اليد الكعبري الخلقي بواسطة الإليزاروف | Authors | Emad Ibrahim shakhloul | Issue Date | 2015 |
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