Primena aparata prema Ilizarovu za spasavanje noge u lečenju masivnih defekata butne kosti nakon neuspešne tumorske artroplastike

  • Aleksandar Radunović Vojnomedicinska akademija
  • Milimir Košutić Clinic for Orthopedic Surgery and Traumatology, Military Medical Academy, Belgrade, Serbia
  • Maja Vulović Department of Anatomy and Forensic Medicine,Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Boško Milev Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Nataša Janjušević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Anita Ivošević Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  • Vladimir Krulj Department of Orthopedics, Medical Center, Ćuprija, Serbia
DOI: https://doi.org/10.2298/VSP150419039R
Ključne reči: sarcoma, ewing||, ||sarkom, juingov, femur||, ||femur, infection||, ||infekcija, fractures, bone||, ||prelomi, ilizarov technique||, ||metod ilizarova, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Hirurško zbrinjavanje velikih defekata kostiju stavlja hirurga u veliko iskušenje u pogledu procene mogućnosti spasavanja ekstremiteta kao i primene adekvatne metode kojom će to učiniti. Izbor metoda je dodatno ograničen kod postojanja infekcije na mestu defekta. Prikaz bolesnika. Kod bolesnice zbog Ewing-ovog sarkoma učinjena je resekcija tumora i implantacija tumorske endoproteze Kotz. Posle pet godina javili su se znaci infekcije niskog intenzitetom. Nakon 12 godina, bolesnica je pri padu zadobila periprotetski prelom kada je odstranjena endoproteza, učinjena hirurška obrada i postavljen aparat prema Ilizarovu koji je, uz menjanje konstrukcije i dodatne operacije, nosila do potpune nadoknade defekta i postizanja artrodeze kolena. Zaključak. Aparat prema Ilizarovu pruža velike mogućnosti nadoknade defekta prirodnom kosti koja ima superiorne biomehaničke karakteristike u odnosu na implantat. Najčešća komplikacija ove metode je produženi period nošenja, što zahteva dobru selekciju i pripremu bolesnika, kao i veliku veštinu hirurga.

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Objavljeno
2017/03/03
Broj časopisa
Vol. 73 Br. 8 (2016)
Rubrika
Prikaz bolesnika