Kątowa deformacja kończyny skorygowana dynamiczną osteotomią korekcyjną – opis przypadku

Treatment of angular limb deformity

Treatment of growth deformities depends on the age of the patient, the remaining growth capacity and on the localisation of the injury. The treatment goal for very young patients with damage to one growth plate of paired bones (radius/ulna) must be reducing the amaount of angular deformity that will result in the future with continuous growth and reducing the severity of growth discrepance consequences to the adjacent joints.

The first goal is reached by ulna ostectomy in order to reduce further growth deformity (Fig. 3).

The second goal can only be reached by corrective osteotomy of the radius and lengthening of the radius. Corrective osteotomy can be done acutely by open or closed wedge osteotomy and stabilisation with plates and screws, lineal or circular fixators (Fig. 4). This does not allow to further lengthen the bone and is only reasonable in nearly mature animals.

Lengthening of a long bone after osteotomy can be attained by the principle of distraction osteogenesis. Distraction osteogenesis describes the induction of new bone formation in a bone gap that occurs when two stabilized bone segments are gradually and controlled separated in their long axis. Distraction osteogenesis is a special form of the inherent capacity of bone to repair and remodel according to mechanical forces and strains to which it is exposed (Fig. 5, 6, 7).

Circular external skeletal fiaxators are excellent devices to provide adequate stability to neutralize bending, torsional and shear forces during distraction while maintaining minimal axial elasticity to allow axial micromotion to enhance bone formation. Circular external fixators use fine wires (1.0-1.6 mm) that are tensione...