{"id":6892,"date":"2021-08-23T21:58:38","date_gmt":"2021-08-23T14:58:38","guid":{"rendered":"https:\/\/cms.drdoan.vn\/?p=6892"},"modified":"2021-08-23T21:58:38","modified_gmt":"2021-08-23T14:58:38","slug":"factors-that-affect-the-leg-lengthening-process","status":"publish","type":"post","link":"https:\/\/cms.drdoan.vn\/en\/factors-that-affect-the-leg-lengthening-process\/","title":{"rendered":"Factors that affect the leg lengthening process"},"content":{"rendered":"

In order for the bone healing process to be eventful, we must follow 4 basic principles:<\/p>\n

Fully protect the osteoblasts during the procedure<\/strong><\/p>\n

The osteotomy technique has huge impacts on the quality of the newly-formed bone in the cavity. When performing osteotomy, it is important to preserve the osteoblasts. Osteoblasts consists of periosteum and bone marrow. Periosteum is integral to the filling of cavity and its ability to form new bone is five times faster than of the bone marrow. Therefore, when performing osteotomy using any method (carving, sawing, drilling, etc.), the doctor must commit to fully protect the osteoblasts.<\/p>\n

Set suitable stretching rate and pace<\/strong><\/p>\n

The optimal stretching rate for the healing process should be 1mm per day, equally divided to 3-4 times a day. However, the stretching rate should be reduced when the stretched cavity at the diaphysis or at the bone position in general is malnourished, when the soft tissue are poor or when the patient is an elderly.<\/p>\n

If the osteogenesis process is bad, the stretching rate should be reduced, or the stretching process should be halted entirely to help improve the osteogenesis process. A suitable stretching rate can also preserve blood supply to the osteoblasts. In the clinical perspective, the waiting period is usually between 7 and 10 days, depending on factors such as age, position of the cut, osteotomy technique, quality of the bone, soft tissue status, etc. The waiting period should be long if the osteogenesis process is bad and vice versa.<\/p>\n

Fix the cavity<\/strong><\/p>\n

The firrm fixation of the external fixator is an important factor in the bone healing process. The external fixator should be firm to fix the cavity and only allow the cavity to be elastic along the vertical axis of the bone. If the fixator is not firm, the bone healing process will be slow or it may lead to nonunion. The Ilizarov fixator uses Kirschner nails with diameters ranging from 1.4 to 2 mm that allow not only the cavity to be fixed, but also the cavity to be elastic which stimulates the osteoblasts to have a better growth than from a stiff external fixator.<\/p>\n

Exercise the joints and do compression exercises for the limb as soon as possible<\/p>\n

Exercising the joints and doing compression exercises for the limb as soon as possible can help prevent amyotrophic diseases, improve muscular strength, prevent joint stiffness as well as improve blood supply to the cavity. Doing compression exercises as soon as possible stimulates the osteogenesis process in the leg lengthening procedure.<\/p>\n

\u00a0\"\"<\/strong><\/p>\n

A patient that is exercising the joints and doing compression exercises for both legs after the surgery.<\/p>\n

\u0110\u1ec3 qu\u00e1 tr\u00ecnh li\u1ec1n x\u01b0\u01a1ng di\u1ec5n ra thu\u1eadn l\u1ee3i khi k\u00e9o d\u00e0i ch\u00e2n th\u00ec ph\u1ea3i tu\u00e2n theo 4 nguy\u00ean t\u1eafc c\u01a1 b\u1ea3n:<\/p>\n

B\u1ea3o v\u1ec7 t\u1ed1i \u0111a c\u00e1c m\u00f4 sinh x\u01b0\u01a1ng khi ph\u1eabu thu\u1eadt<\/strong><\/p>\n

K\u1ef9 thu\u1eadt c\u1eaft x\u01b0\u01a1ng \u1ea3nh h\u01b0\u1edfng r\u1ea5t l\u1edbn \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng m\u1edbi \u0111\u01b0\u1ee3c t\u1ea1o ra t\u1ea1i \u1ed5 c\u0103ng d\u00e3n m\u00e0 \u0111i\u1ec3m quan tr\u1ecdng khi c\u1eaft x\u01b0\u01a1ng ph\u1ea3i gi\u1eef \u0111\u01b0\u1ee3c c\u00e1c m\u00f4 sinh x\u01b0\u01a1ng. M\u00f4 sinh x\u01b0\u01a1ng bao g\u1ed3m c\u1ed1t m\u1ea1c v\u00e0 t\u1ee7y x\u01b0\u01a1ng. C\u1ed1t m\u1ea1c c\u00f3 vai tr\u00f2 quy\u1ebft \u0111\u1ecbnh \u0111\u1ed1i v\u1edbi vi\u1ec7c h\u00ecnh th\u00e0nh can x\u01b0\u01a1ng v\u00e0 kh\u1ea3 n\u0103ng t\u1ea1o x\u01b0\u01a1ng m\u1edbi g\u1ea5p 5 l\u1ea7n so v\u1edbi t\u1ee7y x\u01b0\u01a1ng. Ch\u00ednh v\u00ec v\u1eady, khi c\u1eaft x\u01b0\u01a1ng b\u1eb1ng b\u1ea5t k\u1ef3 ph\u01b0\u01a1ng ph\u00e1p n\u00e0o (\u0111\u1ee5c, c\u01b0a, khoan..) th\u00ec b\u00e1c s\u0129 ph\u1ea3i b\u1ea3o t\u1ed3n \u0111\u01b0\u1ee3c t\u1ed1i \u0111a c\u1ed1t m\u1ea1c.<\/p>\n

T\u1ed1c \u0111\u1ed9 v\u00e0 nh\u1ecbp \u0111i\u1ec7u c\u0103ng d\u00e3n ph\u00f9 h\u1ee3p<\/strong><\/p>\n

T\u1ed1c \u0111\u1ed9 c\u0103ng d\u00e3n t\u1ed1i \u01b0u cho qu\u00e1 tr\u00ecnh li\u1ec1n x\u01b0\u01a1ng l\u00e0 1mm\/ng\u00e0y, chia \u0111\u1ec1u 3-4 l\u1ea7n\/ng\u00e0y. Tuy v\u1eady, t\u1ed1c \u0111\u1ed9 c\u0103ng d\u00e3n c\u1ea7n gi\u1ea3m khi \u1ed5 c\u0103ng d\u00e3n \u1edf th\u00e2n x\u01b0\u01a1ng ho\u1eb7c \u1edf v\u1ecb tr\u00ed x\u01b0\u01a1ng \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng k\u00e9m, ho\u1eb7c khi ph\u1ea7n m\u1ec1m x\u1ea5u, ho\u1eb7c \u1edf ng\u01b0\u1eddi cao tu\u1ed5i.<\/p>\n

N\u1ebfu qu\u00e1 tr\u00ecnh t\u1ea1o x\u01b0\u01a1ng k\u00e9m th\u00ec n\u00ean gi\u1ea3m t\u1ed1c \u0111\u1ed9 c\u0103ng d\u00e3n, th\u1eadm ch\u00ed t\u1ea1m ng\u01b0ng c\u0103ng d\u00e3n \u0111\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n qu\u00e1 tr\u00ecnh t\u1ea1o x\u01b0\u01a1ng. T\u1ed1c \u0111\u1ed9 c\u0103ng d\u00e3n ph\u00f9 h\u1ee3p c\u0169ng b\u1ea3o t\u1ed3n s\u1ef1 c\u1ea5p m\u00e1u cho c\u00e1c m\u00f4 sinh x\u01b0\u01a1ng. Tr\u00ean l\u00e2m s\u00e0ng, th\u1eddi gian ch\u1edd \u0111\u1ee3i th\u01b0\u1eddng t\u1eeb 7-10 ng\u00e0y, ph\u1ee5 thu\u1ed9c v\u00e0o: tu\u1ed5i, v\u1ecb tr\u00ed c\u1eaft x\u01b0\u01a1ng, k\u1ef9 thu\u1eadt c\u1eaft x\u01b0\u01a1ng, ch\u1ea5t l\u01b0\u1ee3ng x\u01b0\u01a1ng, t\u00ecnh tr\u1ea1ng ph\u1ea7n m\u1ec1m\u2026Th\u1eddi gian ch\u1edd \u0111\u1ee3i d\u00e0i khi nghi ng\u1edd qu\u00e1 tr\u00ecnh t\u1ea1o x\u01b0\u01a1ng di\u1ec5n bi\u1ebfn k\u00e9m v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n

C\u1ed1 \u0111\u1ecbnh \u1ed5 c\u0103ng d\u00e3n<\/strong><\/p>\n

Vi\u1ec7c c\u1ed1 \u0111\u1ecbnh v\u1eefng c\u1ee7a khung c\u1ed1 \u0111\u1ecbnh ngo\u00e0i l\u00e0 y\u1ebfu t\u1ed1 r\u1ea5t quan tr\u1ecdng cho qu\u00e1 tr\u00ecnh li\u1ec1n x\u01b0\u01a1ng. Khung c\u1ed1 \u0111\u1ecbnh ngo\u00e0i ph\u1ea3i \u0111\u1ee7 v\u1eefng \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh \u1ed5 c\u0103ng d\u00e3n v\u00e0 ch\u1ec9 cho ph\u00e9p \u1ed5 c\u0103ng d\u00e3n \u0111\u00e0n h\u1ed3i theo tr\u1ee5c d\u1ecdc c\u1ee7a x\u01b0\u01a1ng. N\u1ebfu khung c\u1ed1 \u0111\u1ecbnh ngo\u00e0i kh\u00f4ng v\u1eefng th\u00ec s\u1ebd d\u1eabn \u0111\u1ebfn li\u1ec1n x\u01b0\u01a1ng k\u00e9m ho\u1eb7c kh\u00f4ng li\u1ec1n x\u01b0\u01a1ng. Khung Ilizarov s\u1eed d\u1ee5ng c\u00e1c \u0111inh Kirschner c\u00f3 \u0111\u01b0\u1eddng k\u00ednh t\u1eeb 1,4 \u0111\u1ebfn 2 mm cho ph\u00e9p v\u1eeba c\u1ed1 \u0111\u1ecbnh v\u1eefng \u1ed5 c\u0103ng d\u00e3n, v\u1eeba cho ph\u00e9p \u0111\u00e0n h\u1ed3i t\u1ea1i \u1ed5 c\u0103ng d\u00e3n, k\u00edch th\u00edch m\u00f4 sinh x\u01b0\u01a1ng ph\u00e1t tri\u1ec3n t\u1ed1t h\u01a1n m\u1ed9t khung c\u1ed1 \u0111\u1ecbnh ngo\u00e0i c\u1ee9ng nh\u1eafc.<\/p>\n

T\u1eadp v\u1eadn \u0111\u1ed9ng c\u00e1c kh\u1edbp v\u00e0 t\u00ec n\u00e9n s\u1edbm tr\u00ean chi m\u1ed5<\/strong><\/p>\n

T\u1eadp v\u1eadn \u0111\u1ed9ng c\u00e1c kh\u1edbp v\u00e0 t\u00ec n\u00e9n tr\u00ean s\u1edbm ch\u00e2n m\u1ed5 s\u1edbm, c\u00f3 t\u00e1c d\u1ee5ng ch\u1ed1ng teo c\u01a1, t\u0103ng c\u01b0\u1eddng s\u1ee9c c\u01a1, \u00a0ch\u1ed1ng c\u1ee9ng kh\u1edbp, \u0111\u1ed3ng th\u1eddi t\u0103ng c\u01b0\u1eddng m\u00e1u \u0111\u1ebfn nu\u00f4i d\u01b0\u1ee1ng \u1ed5 can x\u01b0\u01a1ng. T\u1eadp t\u00ec n\u00e9n s\u1edbm k\u00edch th\u00edch qu\u00e1 tr\u00ecnh t\u1ea1o x\u01b0\u01a1ng trong k\u00e9o d\u00e0i ch\u00e2n.<\/p>\n

\u00a0\"\"<\/strong><\/p>\n

B\u1ec7nh nh\u00e2n t\u1eadp v\u1eadn \u0111\u1ed9ng c\u00e1c kh\u1edbp v\u00e0 t\u00ec n\u00e9n tr\u00ean 2 ch\u00e2n sau m\u1ed5<\/p>\n","protected":false},"excerpt":{"rendered":"

In order for the bone healing process to be eventful, we must follow 4 basic principles: Fully protect the osteoblasts during the procedure The osteotomy technique has huge impacts on the quality of the newly-formed bone in the cavity. When performing osteotomy, it is important to preserve the osteoblasts. Osteoblasts consists of periosteum and bone […]<\/p>\n","protected":false},"author":1,"featured_media":6895,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[72],"tags":[],"_links":{"self":[{"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/posts\/6892"}],"collection":[{"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/comments?post=6892"}],"version-history":[{"count":2,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/posts\/6892\/revisions"}],"predecessor-version":[{"id":6897,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/posts\/6892\/revisions\/6897"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/media\/6895"}],"wp:attachment":[{"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/media?parent=6892"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/categories?post=6892"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cms.drdoan.vn\/en\/wp-json\/wp\/v2\/tags?post=6892"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}