Köpeklerin ekstremitelerinde İlizarov eksternal fiksatör uygulamaları üzerine klinik çalışmalar

İlizarov eksternal fiksatör uygulaması, antebrachium ve tibia'lannda ortopedik lezyonlar bulunan 30 olgu üzerinde gerçekleştirilmiş ve olguların iyileşme süreleri ile elde edilen bulgular klinik ve radyolojik olarak değerlendirilmiştir. Olguların büyük çoğunluğu 1-3 yaşlar arasında genç hayvanlardı. Lezyonlardan 17' si ossa cruris' te, 13' ü antebrachium' da lokalize olmuştu. Bu lezyonlann 23' ü kırık, 4' ü daha önce başka fiksasyon yöntemleriuygulanan olguların postoperatif döneminde gelişen kaynamama bozukluğu, 3' ü de büyüme plaklarının erken kapanmasına bağlı ekstremite deformasyonlan idi. Kırıkların 20' si açık, 3' ü kapalı kırık şeklindeydi. Büyüme plakların erken kapanmasına bağlı olarak; iki olguda radius kısalığı, radio-karpal eklemde subluksasyon, karpal valgus, dirsek ekleminde dejeneratif artritis ve radio-ulnar eklemde merdivenleşme saptandı. Bu olguların birine, radius' a kortikotomi, diğerine ise radius' a çift osteotomi ve ulna ostektomisi yapılarak, İlizarov eksternal fiksatörü uygulandı. Üçüncü olguda distal ulna büyüme plağında gecikmiş endrokondral ossifikasyon belirlendi. Bu olguya da radius osteotomisi ve ulna ostektomisi yapılarak İlizarov ekstemal fiksatörü uygulandı ve deformasyonun önemli oranda düzeldiği görüldü. Kaynamama bulunan 4 olgunun 3' ünde kompresyon monofokal osteosentez tekniği uygulanarak iyileşme sağlandı. Açık kırıklı 3 olguda, mevcut kemik kaybını önlemek için distraksiyon osteogenezis prensibi ile kemik kaydırma işlemi yapıldı. İki olguda tam, birinde sorunlu (kompresyon-distraksiyon uygulamasıyla) bir iyileşme sağlanabildi. İlizarov eksternal fiksatörü ile sağaltımı yapılan olguların büyük çoğunluğu operasyondan birkaç gün sonra ekstremitelerini kullanabiliyorlardı. Klinik seyirlerine göre, olguların çoğunda fiksatörler 8-11. haftalar içerisinde çıkartıldılar.

Clinical studies on İlizarov external fixator aplications in canine extremities

Application of İlizarov external fixator was carried out in 30 cases with orthopedic lesions in the antebrachium and tibia. Recovery periods and findings obtained from the cases were evaluated clinically and radiologically. Most of the cases were young animals between the ages of 1-3 years. Seventeen of the lesions were located in the ossa cruris and 13 were in the antebrachium. 23 of these lesions were fractures, 4 were non-unions which had developed in the post-operative period and 3 were limb deformities caused by premature closure of the growth plates. 20 of the fractures were open and 3 were closed. Radius shortness, radio-carpal subluxation, carpal valgus, degenerative arthritis andTncongruency in the elbow joint was seen in 2 cases due to premature closure of the growth plates. An Ilizarov external fixcator was applied to 2 of these cases of which a radial corticotomy was done in one, while a double osteotomy in the radius and an ulnar ostectomy was carried out in the other. İn the remaining case, delayed endochondral ossification was determined in the distal ulnar growth plate. Following radial osteotomy and ulnar ostectomy, an Ilizarov external fixator was applied to this case and the deformity was seen to improve significantly. Healing was achieved in 3 of the 4 cases with non-union by applying the compression monofocal osteosynthesis technique, tn cases with open fractures, in order to prevent bone loss, a bone shifting procedure was used under the principle of distraction osteogenesis. Complete recovery was achieved in 2 cases, while a complicated recovery (compression-distraction application) was seen in 1 case. Most of the cases which had been treated with an Ilizarov external fixator were able to use their extremity within days after the operation. According to their clinical development, the flxators were removed from the legs of the animals within 8-11 weeks in most of the cases.

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