GRADUAL BONE LENGTHENING ON NON-UNION OF THE RIGHT DISTAL FEMUR WITH CRITICAL SIZED BONE DEFECT AND SHORTENING : A CASE REPORT
DOI:
https://doi.org/10.31004/prepotif.v8i3.36427Keywords:
Bone Lengthening, Critical Sized Bone Defect, Femur, Non-Union, ShorteningAbstract
Penanganan non-union merupakan tantangan bagi ahli bedah ortopedi. Kami menyajikan kasus non-union femur distal kanan dengan defek tulang berukuran kritis dan pemendekan yang dilakukan pemendekan akut dikombinasikan dengan pemanjangan tulang bertahap. Seorang wanita berusia 20 tahun datang ke pusat kami karena ketidakmampuan berjalan dan nyeri pada femur kanan. Dua tahun sebelumnya, ia ditabrak mobil dari sisi kanan saat mengendarai sepeda motor. Di rumah sakit, ia menjalani debridemen dan osteotomi. Satu tahun kemudian, ia menjalani pemanjangan tulang dengan fiksator eksternal rel. Pasien didiagnosis sebagai fraktur tertutup terabaikan pada femur distal kanan pasca osteogenesis distraksi dengan fiksator eksternal dan konversi ke plat femur distal dilakukan. Setelah satu tahun tindak lanjut, ada perbaikan klinis dan tanda kalus. Pasien dapat menahan beban sebagian dan tidak ada tanda infeksi pada luka. Beberapa keuntungan dari pemanjangan femur termasuk suplai darah subtrokanterik yang sangat baik dari anastomosis antara cabang-cabang pembuluh darah femoralis sirkumfleks medial dan lateral. Akibatnya, pembentukan regenerasi biasanya baik jika prinsip umum osteotom diikuti. Pada nonunion femoralis dengan defek tulang segmental, perawatan yang sering digunakan meliputi cangkok tulang autolog pedikel vaskular, teknik osteogenesis intramembran, dan osteogenesis distraksi Ilizarov. Untuk pasien dengan nonunion femoralis dengan defek tulang segmental besar, fiksasi eksternal monolateral dapat memberikan stabilitas yang efektif, meningkatkan kepatuhan, dan mengurangi komplikasi.References
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