medigraphic.com

2004, Number 1

<< Back Next >>

Rev Mex Ing Biomed 2004; 25 (1)

Design and Application of a Mechanical Distraction System for Knee Arthrodiastasis

Noriega ZD, Puerta HJPA, Hinojosa OM, Urriolagoitia CG, Hernández GLH

Language: Spanish
References: 25
Page: 44-51
PDF size: 795.89 Kb.


ABSTRACT

For orthopedic treatment of severe knee flexion contractures (exceeding 90º), external systems of mechanical distraction (ESMD) which separate (arthrodiastasis) the articular surfaces (AS), translate the tibia, and extend the knee, are used. The goal of this work was the design and manufacture of an ESMD for the orthopedic treatment of a first patient at the Instituto Nacional de Ortopedia, who had severe knee flexion contractures in his two knees due to poliomielitis sequels, because the systems used in Mexico are imported so they are very expensive for patients which come to the orthopedic public institutions. Two ESMD prototypes were manufactured, the first was placed on the left knee and an arthrodiastasis of 18 millimeters was achieved along 13 weeks; the extension was 175º applying skeletal traction (ST). The second prototype was placed on the right knee, and a tensor was designed to achieve a congruent AS separation (16 milli meters); the extension obtained was only 120º with ST along 12 weeks; then the ESMD was retired. Finally the two knees were fixed in extension.


REFERENCES

  1. Herzenberg JE, Davis JR, Paley D, Bhave A. Mechanical Distraction for Treatment of Severe Knee Flexion Contractures. Clin Orthop 1994; 301: 80-88, 1994.

  2. Oganesyan OV, Istomina IS, Kuzmin VI. Treatment of Equinocavovarus Deformity in Adults with the Use of a Hinged Distraction Apparatus. The Journal of Bone and Joint Surgery 1996; 78-A(4) 546-556, April 1996.

  3. Volkov MV, Oganesyan OV. Restoration of function in the knee and elbow with a hinge-distractor apparatus. J Bone Joint Surg 1975; 57A: 591-600, 1975.

  4. Wolfson N, Hearn TC, Thomason JJ, Armstrong PF. Force and stiffness changes during Ilizarov leg lengthening. Clin Orthop 1990; 250: 58-60.

  5. Damsin JP. Joint Contractures. In: Bianchi Maiocchi A, Aronson J. (eds.). Operative Principles of Ilizarov. Baltimore, Williams and Wilkins, 1981: 436-440.

  6. Cañadell J, Gonzalez F, Barrios RH, Amillo S. Arthrodiastasis for stiff hip in young patients. Int Orthop 1993; 17(4): 254-258.

  7. Econopouly DS, Perlman MD, Notari MA, Boiardo RA. The use of an ankle joint distractor in ankle arthroscopy. J Foot Surg 1992; 31(1): 96-99.

  8. Baro-Darias M, Mora-Zamarripa R, Álvarez-Alcover H, Reboso-Morales LE. Tratamiento inicial de las fracturas expuestas de tibia. Nuestra experiencia con el fijador externo LC. Rev Mex Ortho Traum 1998; 12(3): 210/213.

  9. EBI Medical Systems, 6 Upper Pond Road, Parsippany, NJ 07054. Folleto de información mecánica de los fijadores Ebifix. EBI data on file P/N 192177 12/95.

  10. Manufacturas Solco S.A. de C.V. (Calle Dos No. 29, Col. San Pedro de los Pinos, México D.F.). Folleto de distractores Biofix. 6 páginas. 1996.

  11. OrthoFix. Folletos de distractores y manuales de técnicas operatorias. 1996.

  12. Magdaleno-Ramírez FG, Molina-Zurita CM, Luna-Boza MA, Figueroa-Navarro M, Vidal-Colorado T. Diseño de un fijador para el manejo de diversas patologías fracturarias. Informe preliminar. Rev Mex Ortop Traum 1998; 12(3): 246-249.

  13. Servicio de Deformidades Neuromusculares. Expediente clínico No. 194,852–José González Calixto. 1997. Instituto Nacional de Ortopedia, México D.F.

  14. Cailliet R. Síndromes dolorosos-Rodilla. 3ª Edición. Editorial El Manual Moderno. México, 1994.

  15. Gardner E, Gray DJ, O’Rahilly R. Anatomía. Estudio por regiones del cuerpo humano. Primera Edición. Salvat Editores, España. 1967.

  16. Gray H. Anatomy of the human body. Twenty-ninth American Edition. Lea & Febiger. 1973.

  17. Insall JN, Windsor RE, Scott WN, Kelly MA, Aglietti P. Cirugía de la rodilla-Tomo 1. 2ª Edición. Editorial Médica Panamericana, Buenos Aires, Argentina, 1994.

  18. Seeley RR, Stephens TD, Tate P. Anatomy & Physiology. Second Edition. Mosby. St. Louis Missouri, USA. 1992.

  19. Blankevoort L, Huiskes R, De Lange A. Helical axes of passive knee joint motions. J Biomechanics 1990; 23(12): 1219-1229.

  20. Blankevoort L, Huiskes R. Validation of a three-dimensional model of the knee. J Biomechanics 1996; 29(7): 955-961.

  21. Hollister AM, Jatana S, Singh AK, Sullivan WW, Lupichuk AG. The axes of rotation of the knee. Clin Orthop 1993; 290: 259-268.

  22. Sathasivam S, Walker PS. A computer model with surface friction for the prediction of total knee kinematics. J Biomechanics 1997; 30(2): 177-184.

  23. Wilson DR, Feikes JD, O’ Connor JJ. Ligaments and articular contact guide passive knee flexion. Journal of Biomechanics 1998; 31: 1127-1136.

  24. Nordin M, Frankel VH. Basic biomechanics of the musculoskeletal system. Second Edition. Lea & Febiger, Penn. USA. 1989.

  25. Damián-Noriega Z. Diseño de un distractor externo para artrodiastasis de rodilla. Tesis de maestría en ciencias. Sección de Estudios de Postgrado e Investigación de la ESIME-IPN. 1999.




2020     |     www.medigraphic.com