LIMB LENGTHENING: METODE ILIZAROV DAN WAGNER

Safrizal Rahman

Abstract


Abstrak. Limb lenghthening adalah teknik pemanjangan tulang melalui metode pembedahan khusus yang memiliki prinsip bahwa tulang dan jaringan lunak dapat melakukan regenerasi jika diberikan tekanan (tarikan) secara simultan. Law of tension stress merupakan dasar dari proses limb lengthening, yang mana jika jaringan tubuh yang berfungsi normal dan mempunyai sistem perdarahan yang baik, apabila diberikan tarikan (tegangan) maka jaringan tersebut akan mengalami proses neohistogenesis, yang mana pada tulang yang diberi distraksi disebut osteogenesis. Terdapat beberapa penyebab terjadinya pemendekan ektremitas yaitu berupa kelainan kongenital, trauma, infeksi, kelainan neurologis dan iatrogenik. Prosedur limb lengthening terbagi kedalam 3 fase utama yaitu fase laten, fase distraksi, dan fase konsolidasi. Metode Ilizarov dan Wagner merupakan metode limb lengthening yang menggunakan eksternal fiksasi. Perbedaan kedua jenis metode tersebut adalah dari jenis aparatur yang digunakan untuk melakukan distraksi, yang mana pada metode Ilizarov menggunakan cincin sirkular yang mengelilingi anggota gerak (multiaksial) sedangkan metode Wagner menggunakan distraksi pada satu sisi ekstremitas (uniaksial). Penambahan panjang perhari metode Ilizarov adalah 1 mm dan metode Wagner 1,5 mm. Dalam penerapanya, metode Ilizarov lebih sulit dipasang namun memiliki insidensi komplikasi mayor yang lebih rendah dibandingkan metode Wagner.

(JKS 2016; 1: 26-33)

Kata Kunci: Limb lengthening, ilizarov, wagner

Abstract. Limb lengthening is a technique of lengthening the bone through a special surgical method which has a principle that bone and soft tissue can regenerate if given the pressure (tension) simultaneously. Law of tension stress is the basis of the process of limb lengthening, which if tissues have normal function and good vascularisation given the distraction, the tissue will undergo a neohistogenesis process, in which the bone by distraction called osteogenesis. There are several causes of shortening of extremity in the form of congenital abnormalities, trauma, infection, neurological disorders and iatrogenic. Limb lengthening procedures are divided into three main phases, namely the latent phase, distraction phase, and consolidation phase.Wagner and Ilizarov method is a method of limb lengthening which use external fixation. Differences in the two types of methods are of the type of apparatus used to perform distraction, which the Ilizarov method using a circular ring surrounding a limb (multiaxial) while Wagner method using distraction on one side of the limb (uniaxial). The elongated of Ilizarov method is 1 mm per day and 1.5 mm per day for Wagner method. In applicability, Ilizarov method is more difficult to perform but by use this method, the incidence of major complications is lower than Wagner method.

(JKS 2016; 1: 26-33)

Key words: Limb lengthening, ilizarov, wagner

Keywords


Limb lengthening, ilizarov, wagner; Limb lengthening, ilizarov, wagner

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References


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