• Journal of Korean Physical Therapy Science
• /
• v.1 no.2
• /
• pp.355-365
• /
• 1994

Ilizarov limb lengthening has been the new method to deal with a variety of orthopaedic problems. Ilizarov apparatus consists of stainless steel rings that surround the limb and are interconnected by threaded rods. Tensioned wires pierce the bone in the plane of each ring and are tightly attached to the ring. Ilizarov has reported distraction osteogenesis with the use of the typical fixator that allows functional loading. The purpose of this commentary is to introduce a four-stage rehabilitation protocol currently used by the authors in the physical therapy management of a post -limb lengthening. Each treament stage corresponds to a medical stage in the lengthening process. Treatment goals for each of the physical therapy treatment stage are presented to guide treatment planning. Two case examples are presented to illustrate the use of the management goals in treatment planning.

• The Journal of the Korean bone and joint tumor society
• /
• v.4 no.1
• /
• pp.53-58
• /
• 1998

Limb-salvage surgery has become more popular than amputation for the treatment of malignant bone tumor because no differences in local recurrence and the 5-year survival rate have been found. However for young patients with sarcoma, skeletal immaturity may be a contraindication to limb-salvage surgery due to the expected leg length discrepancy. If limb-sparing procedure should be impossible for skeletally immature patients, amputation has to be given first consideration. To minimize the functional difficulty from short amputation stump of above knee amputation, we performed lengthening of the amputation stump using ipsilateral tibia. One patient was lengthened 17cm using ipsilateral tibia and the other, 12cm. Two patients and their families were satisfied both clinically and psychologically.

• Journal of Yeungnam Medical Science
• /
• v.13 no.2
• /
• pp.182-191
• /
• 1996

• The Journal of the Korean bone and joint tumor society
• /
• v.12 no.2
• /
• pp.141-147
• /
• 2006

In 1996, a nine-year-old girl was treated with recycling autograft after wide resection of the distal femoral osteosarcoma. The leg lengthening and revision with growing tumor prosthesis were performed due to limb leg discrepancy and epiphyseal problem. However, deep infection developed after operation, and a temporary spacer with cement and Ender nail was inserted. After infection was controlled completely, the final leg lengthening was performed with mono-external fixator for limb length discrepancy (10 cm). Lastly, Tumor prosthesis was reinserted to preserve the joint function.

• The Journal of the Korean bone and joint tumor society
• /
• v.4 no.1
• /
• pp.22-29
• /
• 1998

A limb-sparing operation has a definitive role in the treatment of osteosarcoma in the lower extremity of skeletally-immature patients. After a limb-sparing operation, leg length discrepancy remains as a major disability that should be corrected. This study was designed to suggest methods of tumor resection and proper timing of leg length equalization in skeletally immature osteosarcoma patients. From September 1990 to January 1998, we reviewed eight osteosarcoma patients in an immature skeletal age. There were 4 males and 4 females, and their mean duration of follow-up was 50.37 months (range : 25 to 88 months). Mean skeletal age was 8 years (range : 8 months to 11 years). The patients were classified according to the methods of tumor resection ; intercalary resection in 1 case, transepiphyseal resection in 1, intra-articular resection in 5, and extra-articular resection in 1. The results were as follows ; 1. The leg lengthening was begun when a patient's leg length discrepancy reached 4-5cm. 2. The age of final lengthening with permanent reconstruction was 14 years in males and 12 years in females (about 2 years before skeletal maturity). 3. When reconstruction was performed with a temporary spacer, the site of lengthening Was in the soft tissue, not in bone, and then a permanant reconstruction was done. 4. Reconstruction with a biologic spacer to preserve the joint function was a reasonable method for equalization of leg length. In conclusion, the appropriate choice of reconstructive method and the age at which to correct the leg length discrepancy in a skeletally-immature osteosarcoma patients are important factors for maintaining leg length at full maturity.

• Korean Journal of Veterinary Research
• /
• v.42 no.3
• /
• pp.411-418
• /
• 2002

Thirty rabbits underwent femoral lengthening using monolateral external fixator to evaluate results and complications of limb lengthening. Twenty rabbits survived until consolidation of callus formed at the lengthening site after finishing lengthening. Ten rabbits were sacrificed during femoral lengthening because of complications. Survived 20 rabbits were classified to two groups according the amount of lengthening: group I (10% lengthening of the femoral length); group II (20% lengthening). There was no significant difference of consolidation time between two groups (p=0.25). Varus angulation at the lengthening site occurred in 60% of two groups and the amount of varus angulation in group II was larger than that of group I. Degenerative change of articular cartilage at the medial condyle of the distal femur was found in 30% of group II. Of sacrificed ten rabbits, 5 had pin loosenings with pull an of pins from the femur, 2 had fermoral fractures around the pin-tract site, and 3 had severe osteomyelitis of the femur around the pin-tract site.

• The Journal of the Korean bone and joint tumor society
• /
• v.11 no.2
• /
• pp.134-140
• /
• 2005

Purpose: We evaluated the effectiveness of temporary using the extendible external fixator (EF) for lengthening of soft tissue that contracture caused by tumor prosthesis removal in the treatment of complications after limb salvage surgery like deep infection and loosening. Materials and Methods: Five patients six cases were included who underwent extendible EF (Dyna-extor(r)). EF was applied after insertion of half pin to the proximal and distal bone of defect area. EF lengthening started at third day of post-operation, above 2-3 mm per day in the range of no neurological sign. Results: The treatment area was three in femur and two in tibia. Mean age when the time of EF apply was 22.2 years old (range 15-29), but its primary limb salvage operation had done in 13.4 years old (range 9-19), therefore mean times of interval between initial tumor prosthesis reconstruction and temporary EF apply was 8.8 years (range 3-14). One patient had EF for 150 days with 7.2 cm lengthening. Others 5 cases of 4 patients had EF for mean 37 days (range 25-50) and mean soft tissue lengthening was 5.8 cm. Three patients underwent re-insertion of tumor prosthesis and two patients underwent knee fusion as final operation and showed no evidence of infection through mean 22 months follow up period. Conclusion: Temporary using of extendible EF is an effective method for correction of leg shortening which occurred by soft tissue contracture in the complications of limb salvage operation or their treatment process, and it could be provide easily application of tumor prosthesis and knee fusion as final operation.

• Journal of Veterinary Clinics
• /
• v.34 no.4
• /
• pp.287-290
• /
• 2017

A 6-month-old, 4.1 kg female Dachshund dog presented with intermittent non-weight bearing lameness of the right thoracic limb. Radiographs revealed caudolateral luxation of the right radial head and a shortened right ulna compared to the contralateral limb. Bone lengthening by distraction of the ulna using the Ilizarov technique was performed following ulnar osteotomy. The rate of distraction was 1.5 mm per day, adjusted a total of 3 times daily for a total distraction distance of 10 mm. The Ilizarov fixator was removed four weeks after surgery. The patient showed knuckling due to radial nerve injury that occurred during limb-lengthening. Corrective osteotomy was performed using a plate and pin for the luxation and deformity of the right radial head. The luxation of the radial head was successfully reduced following surgery. However, the knuckling persisted after surgery. Rehabilitation for radial nerve injury was performed using heat therapy, massage, a passive range of motion exercises, water treadmill exercises, neuromuscular electrical stimulation, leash-walking, and acupuncture. 15 months after surgery, the patient showed satisfactory weight-bearing ambulation without recurrence of lameness. The use of the Ilizarov technique is a good surgical option for the treatment of a patient with congenital elbow luxation.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.2
• /
• pp.226-232
• /
• 1995

Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

• Proceedings of the KSME Conference
• /
• 2000.04a
• /
• pp.268-273
• /
• 2000

Velocity-dependent increase in tonic stretch reflexes is one of the prominent characteristics of spasticity. It is very important to evaluate spasticity objectively and quantitatively before and after treatment for physicians. An accurate quantitative biomechanical evaluation for the spasticity which is caused by the disorder of central nervous system is made in this study. A sudden leg dropper which is designed to generate objective testing environment at every trial gives very effective environment for the test. Kinematic data are archived by the 3-dimensional motion analysis system($Elite^{(R)}$, B.T.S., Italy). Kinematic data are angle and angular velocity of lower limb joints, and length and lengthening velocity of lower limb muscle. A program is also developed to analyze the kinematic data of lower limb, contraction and relaxation length of muscles, and dynamic EMG data at the same tim. To evaluate spasticity quantitatively, total 31 parameters extracted from goniogram, EMG and muscle model are analyzed. Statistical analysis are made for bilateral correlations for all parameters. The described instrumentation and parameters to make quantitative and objective evaluation of spasticity shows good results.