Past, present and future. New techniques, latest developments in traumatology
Humans have long known the ability to manipulate and immobilize fractured limbs from outside the body. The oldest documented cases correspond to the discovery made in 1903, in excavations conducted by Professor G. Elliott Smith at the archaeological site of Naga- ed- Der, located north of the city of Luxor and correspond to limb immobilization splints.
In the Hippocratic Corpus Hipocraticum Cos ( 460-377 BC) referred to more elaborate systems of external fixation which permitted immobilize fractures. The current concept of External Fixation is cradled in the second half of the nineteenth century, after the appearance of anesthesia and before the discovery of antibiotics. Being in that then the most documented about military surgeons.
Be regarded as External Fixation immobilization of the various fragments of a fracture by insertion of nails through soft on each sides and turn nails joined together by any restraint system external plaster mechanical device, etc.… early designs not invaded the bone just relied on musculotendinous insertions were progressively more invasive to the present, in which the elements of skeletal fixation ( pins and wires ) pass through or are screwed bone directly.
The concepts of external fixation stiffness gave way to biologically closest to the natural process of healing of fractures concepts, neutralizing harmful forces and flattering modulating the healing process, Professor Juan Lazo Zibikowski (Sevilla ) collaborate in this regard between others, in the elaboration of the current concepts of bone repair.
External fixation is essential in the treatment of severe open fractures of the limbs, as well as a means of initial immobilization of fractures near the joints which can develop bad soft tissue, compromising internal assets with plates or intramedullary nails once you confirm the correct evolution of these soft tissue external fixation can be changed by an internal, all in the so-called “sequential treatment of fractures”, its use is vital also in initial care of multiple trauma, the&ldquo,&rdquo damage control;fast skeletal stabilization to prioritize on injuries that compromise the patient's life, essential in the stabilization of affects bones bony infections. It is a common tool to lengthen limbs.
Currently, the last few years is a powerful tool for your chance to bone regeneration and reconstruction of the skeletal system through the so-called“osteogenesis to distraction&rdquo ;, technique consists in making an surgically fracture once initiated the process repair of the fracture callus repairman go progressively stretching (similar to bony extensions ) at a rate of 1 mm per day, this leads to the spontaneous creation of a new bone presents exceptional physiological and morphological characteristics.
The new formed, bone“regenerated bone” has added a valuable therapeutic procedures in securities that reconstruction of large bone defects due to traumatic or diaphyseal bone resection techniques of tumor type used in the treatment of chronic bone infections, absence of consolidation of fractures or used osseous tumors.The regenerated bone, and whole bone undergoing treatment presents a hypervascularization, it is of great value because it increases the defense mechanisms against infections of the bone and allows better advent of antibiotics.The new bone rebuilt unlike the reconstructions made by other methods, has a tubular morphology as normal diaphyseal bone biomechanics from the point of view that form is the most lightweight and durable, it's the best.The method allows the correction of associated bony deformities, shortening, angular and rotational deformities.
In the process of bone transport for new bone, soft tissue related to the transported fragment also involved, this contributes to the solution of these soft loss at the time of trauma parts.It is an excellent method of reconstruction, superior to conventional, but as accurate these last extended periods of healing since it takes 2.4 months of treatment per centimeter rebuilt until final discharge to the problem solved.That is why all efforts now and in the foreseeable future will be directed to the reduction of periods of healing, adding internal stabilization bones undergo treatment or associating such treatment new biological and drugs products that accelerate the formation of new bone.These methods are currently used in Reconstructive Surgery of the Locomotor, the osteogenesis in distraction allows filling countless musculoskeletal pathologies and contribute to solve problems that arise during medical treatment surgical of our patients, all through the&ldquo, transportation bone” based on distraction osteogenesis.
The goal of SEFEx is to disseminate, teach and apply these techniques. The use of our external fixation allows the practice of a grateful osteoarticular reconstruction surgery.