Introducere. Tratamentul defectelor osoase prin metoda Ilizarov este de durată. Totuşi, in unitatea medicală
pacientul se află doar la etapele sângerânde şi dureroase ale tratamentului restul perioadei se petrece în condiţii
de ambulator. De aici, este evident că responsabilitatea pentru întreg tratamentul aparţine nu doar unui medic,
dar unui grup de persoane inclusiv pacientul sau/şi rudelor lui.
Scopul. Trecerea în revistă a erorilor depistate la tratamentul defectelor osului tibial prin metoda Ilizarov şi
evidenţierea posibilităţilor de rezolvare a lor.
Material şi metodă. Lucrarea este efectuată asupra 65 de cazuri clinice de tratament a defectelor circulare de tibie.
În cadrul lotului studiat au dominat bărbaţii cu 48 cazuri faţă de femei cu 14. Lungimea maximală a defectului
de os tibial recuperat a constituit 21 cm– minimală 5 cm. Erorile umane depistate de noi s-au înregistrat la etapa
de spitalizare şi de tratament ambulator. La etapa de spitalizare am constatat iniţierea egalizării lungimii gambei
in prezenţa fibulei consolidate cu scurtare–2;leziuni vasculare asociate osteotomiilor-4; trecerea cu broşele la
limita articulaţiilor învecinate osului–4;şi construirea incorectă a modulelor fixatorului extern–4.La etapa de
tratament ambulator ne-am întâlnit cu distracţii grăbite (urgentate)–3 şi tracţiune incorectă (pe un fragment
nefracturat al gambei)–3;
Rezultate. Toate erorile au dusa la complicaţii grave: scurtare de membru, segment doloros, rupere de broşe,
artrite reactive, instabilitate fixator, infecţii, defecte tegumentare, etc. Depăşirea lor a marit numărul intervenţiilor
chirurgicale per pacient.
Concluzii. Erorile umane depistate la tratamentul defectelor osului tibial prin metoda Ilizarov aparţin atât de
cadrul medical cât şi de persoanele tratate şi influenţează direct cheltuielile şi durata de tratament.
Introducere. The treatment of bone defects by Ilizarov method is lengthy. However, in the medical unit the
patient is at bleeding and painful stages of treatment, the remaining period is going on ambulatory. Hence,it
is obvious that the responsibility for the whole treatment belongs not just to doctor, but to a group of people
including patient and /or his relatives.
Purpose. To review the errors detected in the treatment of tibial bone defects by Ilizarov method and highlighting
the ways of solving them.
Material and methods. The paper reflects the analysis carried out on 65 clinical cases of treatment of circular tibial defects. The study group was dominated by men–48 cases, women being 14 cases. The maximum length
of recovered tibial bone defect was 21 cm, the minimal-5 cm. Human errors detected by us were recorded at
the stage of hospitalization and ambulatory treatment. At the stage of hospitalization we detect the beginning
of equalize of leg’s length in the presence of consolidated fibula with shortenin-2; vascular injury associated
osteotomies-4; brooches passage at limit of surrounding bone joints-4; incorrect building of external fixator
modules- 4.At ambulatory treatment stage we met rushed distractions (urged)-3 and incorrect traction (on a
non fractured fragment of the calf)–3.
Results. All errors led to serious complications: limb’s shortening, painful segment, brooches breaking, reactive
arthritis, fixator’s instability, infections, tissues defects etc. Overcoming them increased number of surgical
procedures per patient.
Conclusions. Human errors detected in the treatment of tibial bone defects by Ilizarov method belong to both,
the medical and the treated persons, and affect the costs and duration of patient's treatment.
