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Limb lengthening methods extend the length of bones (height) in disproportionately short limbs, either by the administration of growth stimulators or surgery (distraction osteogenesis). Active natural growth in humans ends in the majority of cases before 20 years of age and can, in some cases, leave disproportionately short limbs. Significant results are possible only by artificially lengthening lower extremity bone length with various construction devices (). Surgical methods may be grouped into three main categories: * external methods; * internal (intraosseal) methods; and * combined (mixed) methods. All methods generally feature: # Bone dissection (artificial fracture). This is the location where additional length can be added. # Artificial regeneration process, prolonged by distraction (gradual bone part separation at an average speed of 1 mm a day). The 'young' bone is stretched to a planned length, and is totally formed (ossified) only after distraction is terminated. # muscle and tendon stretching (various methods change the stretching conditions). General requirements for all methods: # Stiff, solid bone fragment fixation until the moment of complete bone co-ossification («device-bone» complex). # Gradual distraction (lengthening). In other words, creating favorable conditions for 'young bone' regeneration that takes place between stretching bone fragments. # Sparing environment for muscles and joints during stretching and regeneration. == External methods == Characteristic features of external methods are: * external constructions (outside the body) * power clusters (for distraction activation) situated on the external construction * bone fixation (creation of a common «device-bone complex») with spokes (rods) that run through the leg segment. The spoke (rod) ends are fixed in the external device * distraction due to the separation of external device elements (increases the distance between spokes, which fixates various bone zones) Starting in the 1960s, external compression-distraction devices gained popularity to achieve transosseous compression-distraction osteosynthesis in shin and hip lengthening. This approach was the result of device construction changes and more progressive surgical intervention methods. Three were three common methods, involving the use of Volkov-Oganesyan 〔Volkov M. V. Treatment of joints and bones damages by author devices/ М. V. Volkov, О. V. Oganesyan. – Tashkent : Medicine, (1978), P. 203〕〔Ryabzev S. L. Lower extremities lengthening in adults with simultaneous restoration of adjacent joints function by Volkov-Oganesyan devices / S. L. Ryabzev // Form and function restoration in damaged joints by Volkov-Oganesyan devices: CYTO Works Collection. – М. : CYTO Publishing House, (1982), P. 100–102〕 (Fig. 1.1), Gudushauri〔Gudushauri О. N. Device for reposition and fixation of long tubular bones in fractures and bones lengthening/ О. N. Gudushauri // Orthopedics, traumatology and prosthetics– (1958). – # 3, P. 53–56〕 (Fig. 1.2), and Ilizarov (Fig. 1.3) devices. The Ilizarov method developed by G.A. Ilizarov became widespread in many countries.〔Popova L. А. G/A/Ilizarov method evolution in traumatology and orthopaedics / L. А. Popova // Orthoped genius – (2006). # 4, P. 10–19〕〔Ilizarov G. А. Clinical possibilities of transosteous osteosynthesis method (basic practical directions)/ Ilizarov G. А., Popova L. А., Shevzov V. I. // Russian Federation Health Care. – (1986) # 9, P. 5–10〕〔Ilizarov G. А. Clinical and theoretical aspects of compression and distraction osteosynthesis/ G. А. Ilizarov // In the book: Theoretical and practical aspects of transosteous compression and distraction osteosynthesis. – Kurgan: Kurgan Publishers. NIIEKoT, (1976), P. 14–25〕 The Ilizarov device (see Fig. 1.3) involves an external ring clamp consisting of split rings with the fixation possibility of bars, spikes or rods. The composition of the device may vary (Fig. 1.4, Fig. 1.5) depending on the particular clinical task.〔Blachier D. Allongements progressifs du temur selon la technique de Wagner. A propos de 48 cas / D. Blachier, L. Trevonx // Rev. Chir. Orthop. – (1986),Vol. 72., P. 495–499〕〔Wagner H. Surgical lengthening or shortening of femur and tibia / H. Wagner // Progress in Orthopaedic Surg. (1977), Vol. 1., P. 71〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Limb lengthening methods」の詳細全文を読む スポンサード リンク
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