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Tratamiento de las complicaciones vasculares tras aplicación del método de Ilizarov

Treatment of vascular complications after external fixation using the ilizarov method

R. GUARNIERO, E. TOLEDO DE AGUIAR y N. BOTTER MONTENEGRO Departamento de Cirugía Ortopédica. Hospital «das Clínicas». Universidad de Sao Paulo. Brasil.
Recepción:
06/11/2008
Aceptación:
06/11/2008
Publicación:
06/11/2008


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Resumen (ES)

From 1987 to 1991, 209 patients were operated on by the Ilizarov method in our institution. Among them, 3 patients presented vascular complications during the treatment. All were adults and have been treated for long bone pseudoarthrosis. The vascular lesion ocurred at the femoral superficial artery in one case, at the popliteal artery in other case, and at the posterior tibial artery in the third case. The clinical sign of vascular damage was bleeding through the cutaneous point of the Kirschnner transfixion wires in all cases. Arteriography was done in all cases but its interpretation was very difficult because of the presence of the external fixator. In the case of femoral artery, injury the external fixator was removed and a vascular by-pass was performed with an inverted graft of the saphenous vein. The same procedure was done in the case with a popliteal artery injury but without removal of the external fixator. The case with lesion of the posterior tibial artery was treated by arterial hgature. In all cases, outcome was satisfactory, allowing completion of the orthopaedic treatment.

Palabras clave (ES):

Arterial
Venosa
Osteotaxis
Secuela
Vascular
Ilizarov
Complicación
Fijación
Externa
Fijador
Externo
Circular

Resumen (EN)

From 1987 to 1991, 209 patients were operated on by the Ilizarov method in our institution. Among them, 3 patients presented vascular complications during the treatment. All were adults and have been treated for long bone pseudoarthrosis. The vascular lesion ocurred at the femoral superficial artery in one case, at the popliteal artery in other case, and at the posterior tibial artery in the third case. The clinical sign of vascular damage was bleeding through the cutaneous point of the Kirschnner transfixion wires in all cases. Arteriography was done in all cases but its interpretation was very difficult because of the presence of the external fixator. In the case of femoral artery, injury the external fixator was removed and a vascular by-pass was performed with an inverted graft of the saphenous vein. The same procedure was done in the case with a popliteal artery injury but without removal of the external fixator. The case with lesion of the posterior tibial artery was treated by arterial hgature. In all cases, outcome was satisfactory, allowing completion of the orthopaedic treatment.

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