Shortness Reasons :
Tqdrnsph occurrence of one of the parties in the palace when the general public to 10%, bringing the palace to 1 -1.5 cm.
1 - congenital malformations and diseases (birth defects) with palaces upper and lower limbs
2 - Traffic accidents
This is a very common and caused a crush in the bones and short, non-coalescence of a large number of people.
3 - infections
That follow open fractures lead to the breakdown in the bones, and the death of the bone or bone mass and the occurrence of the palace with a gap in the fracture, and is often accompanied by a hardening of the detailed Oalichohat.
4 - Center crashes Alnmoand children
Because of the growth plate injury at the end of long bones, due to a fracture or inflammation.
5 - nerve diseases such as cerebral palsy may lead to the palace of real bone.
The effects of inequality in the parties:
Qasralparty upper may not create significant problems, and the difference is not noticeable if it does not exceed 15%.
Palace in the lower limb over excessive force on the joints with pregnancy weight can lead to
Irregularity in walking.
Milan in the basin.
Deviation of the spine.
Pain in the back early.
Friction in the hip and knee.
Psychological effects of the palace.
Methods of assessing the palace:
1 - clinical evaluation:
Primitive way old and inaccurate, especially when the difference in length is simple.
Conduct thorough clinical examination of the joints of the Note contractions and distortions with a note of instability in the joints.
2 - Measure the height using tomography:
Is a way very accurate when taking measurements accurately.
Stages of lengthening the bone:
Lengthen the parties are in three phases:
A) an incision in the bone through the skin: like broken and wait 5 to 10 days after surgery, and this allows the start of the mechanisms of healing incision.
B) phase radius: 1 mm are lengthening daily until the desired length is achieved.
C) hardening of the bone that has been lengthen, this stage may take twice the lengthening phase.
Biologically limb lengthening:
Depending on the law of stress and tension, which he described as a law Ilizarov biologist in the lengthening.
It states that when exposed tissues and blood vessels of the lengthening after making an incision in the bone, it causes the bone tissue and new.
This theory came after Ilizarov conducted a series of experiments on animals that have clearly demonstrated a new mechanism to form bone tissue and the factors necessary for the formation and maturation properly.
The necessary ingredients for the success of the radius:
1 - Use an external device is installed in the bone by screws or wires.
2 - an incision bone without harming surrounding tissue.
3 - lengthening the amount that needs to be done that is currently only 1 mm per day.
Practice should be about ¼ mm each time does not exceed 1 mm per day.
If weak bone formation rate should be reduced to ¼ mm twice a day, and if a large bone formation rate should be increased to ½ mm three times a day for a few days.
4 - keep detailed movement and function of the parties:
Allowing the patient to walk and maintain its functions preserves and promotes blood circulation in the limbs.
This is crucial for the formation of new bone.
For walking and exercise should be 5 to 6 hours a day.
What are the factors that hinder the lengthening
1 - smoking impedes blood flow and the formation of new bone
2 - lack of movement
3 - a disorder of the hormones
4 - in the structure of the bone disease
Methods used to correct short lower limbs:
An increase in the length of the shoe heel.
To stop the growth in the party sense and are conducting in children before the completion of the growth phase, provided that they are long-stature.
Shorten the long man and turn him in this case the presence of a suitable length.
Lengthening of the bone.
Surgical methods for lengthening
1 - Using the Ilizarov device:
It consists of several circular rings fastened to the bone by a valuable metal wires or screws jagged private.
What are the problems in the conduct of lengthening by Ilizarov device?
The patient's need to make frequent visits to the clinic for care Baloseach and nails.
Difficulty dressing the existence of the device. Inflammation of the metal wire.
Stiffness in the joints around the device. Can be conducted using a long way Ilizarov hand or by machine Automatically running computer and this is very expensive.
2 - the Italian way:
Using a device installed Orthofix bone where this device is installed on the outer surface of the bone using screws and serrated advantage:
Easily dealt with by the patient and the doctor.
Avoid problems caused by the use of Ilizarov device.
3 - Use the screw myeloid dynamic:
This method is the implantation of a special nail within the bone marrow and install from the parties and this is usually used if the palace was less than 8 cm, so stop lengthening alone and this device depends on the rotation of the man inside and outside of a 30 degree angle.
Disadvantages screw myeloid:
1 - difficult to control the speed of lengthening as you need to a few degrees of rotation.
2 - the patient is unable to walk and spend time each mobile crane on the chair.
3 - high financial cost.
4 - used on a limited scale in the world.
What are the situations that you can not use them this way?
Children.
If the palace was more than 8 cm.
Deviation in greatness to be Ttoelha.
The inability of the patient to cope with the device as required.
A type of screw-called cerebrospinal nail Albeza Albizzia telescopic nail and after rotation leg called Voice refers to the speed lengthening, and this feature can screw it to the patient to walk with crutches, and disadvantages of very high financial cost and is used on a limited scale in the world
4 - Use a screw inside the spinal bone with Sticky bone from the outside:
Where they are first planted screw myeloid then an incision in the bone and then put the outer bone Sticky Orthofix (lengthening device), and the advantage of this method that can remove a lengthening at an early stage so that a patient who is to lengthen the length of 5 cm device is removed after two months.
5 - Use screw myeloid smart: The Fitbone nail
So that the process is controlled by lengthening a small computer, but that this method is very expensive and are not recommended for use not being used in all cases Palace bones.
Features screw Smartphone:
1. Mild pain.
2. Mild scars.
3. No need to take care of screws.
4. The patient can practice moving the joints after surgery.
Disadvantages screw Smartphone:
1 - the patient can not walk and is serving a mobile crane on the chair.
2 - The process of lengthening using an external device called an accurate control unit via the Cape of alert for a future connection that is under the skin, and the patient puts the headset in the alarm even hear the sound of clicks lengthening.
3 - very high financial cost.
6 - Use your palate Taylor:
It is a device-like device Ilizarov but it works by computer and method of elongating a very expensive when you use it.
This device consists of two rods connected by 6 animated feature of this device is that it can be amended deviations in several directions Bjahh to a special computer system to enter the data required for the degree and direction of distortions.
Complications of bone lengthening:
Bone lengthening process is laborious way by many of the complications, but most can be avoided and control it by close monitoring and continuous monitoring of the patient after the procedure, and these complications:
1 - pain and harassment of the process is usually a place for several days, and hide with the fait accompli and usually the patient is given a sedative that do not affect the growth of the bone.
2 - inflammation around the screws or metal wire, and this is very common in all operations but lengthening follow-up and keep the parts with wire clean about what can overcome this problem.
3 - Problems osteogenesis in the lengthening
Sometimes there is a weakness of the bone, and this is due to the instability of the external device or there is a lack of essential nutrients or the presence of hormonal disorder or increase the speed of lengthening.
Second, there could be an increase bone formation and tackle on quickly in the boom, and this may need to re-work an incision in the bone again.
It complications region lengthening it breaks after removing device lengthening.
4 - deviation in the bone
This is caused by severe muscle forces acting on bone flexion, and this is a very common operations in lengthening, you have this problem in any stage of the boom and can notice even after several months, the patient may need to undergo surgery to modify flexing.
5 - problems related to nerves
Can be exposed nerves to tighten plus or nerve injury by wire to dissuade planted and then Eshkoy disease from lack of sensation in a specific area in the foot if the cause tensile overload time can be minimized by lengthening periods.
6 - joint problems
Usually located every bone in parties between joints and at lengthening the greatness gets stiff in one of these joints and the best solution in these cases is to perform physical therapy for an hour to two hours a day and there are cases, especially children if they have a palace congenital vulnerable to displacement or dislocated joint during the period lengthening and the erosion of these complications can be carefully studied before and after the operation and review the patient on an ongoing basis.
7 - frustration and mental disorder
Affects some patients as a result of the device a long time.
When we do not conduct lengthening despite the existence of a palace in the lower limb?
Instability of the joint around the boom.
Disorder in sensation and movement in the short end (sensory paralysis and muscle).
When the patient's mental disorder.
Non-cooperative patients
In a medical site by Freeh Back Abu Hassan
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