Abstract:
BACKGROUND:Thromboangiitis obliterans (TAO), also known as Buerger disease, is characterized by thrombosis in medium-sized arteries and veins along with a marked inflammatory response. TAO can be managed by using the principle of distraction osteogenesis to induce neoangiogenesis. We report thirty patients of TAO in the age-group of 20-50 years were treated with the Ilizarov method. MATERIALS AND METHODS:Patients with severe rest pain (n=30), absent distal pulsation (n=30) and ulcer (n=6) and/or gangrene of the toes (n=4), who had failed the conservative pharmacological modalities of treatment were included. A lateral tibial corticotomy was performed and distraction applied by use of olive wire. A two-ring frame was used for all cases. RESULTS:Of the 30 cases, 25 patients became pain free while 1 had partial relief of pain. The four patients worsened on treatment and developed frank infection were amputed. The average distraction was 1.8±0.3 mm (range: 1.5-2.2 cm). The mean consolidation period was 98±11 days, after which the fixator was removed. The total duration of treatment was 122±23 days. There were two cases of osteomyelitis in our series; both healed after debridement and both patients had good result, with relief of pain. The ulcers started healing by 4-6 weeks. CONCLUSION:The principle of the distraction osteogenesis including neoangiogenesis can be used for treatment of TAO and has an acceptable complication rate.
journal_name
Indian J Orthopjournal_title
Indian journal of orthopaedicsauthors
Kulkarni S,Kulkarni G,Shyam AK,Kulkarni M,Kulkarni R,Kulkarni Vdoi
10.4103/0019-5413.83954subject
Has Abstractpub_date
2011-09-01 00:00:00pages
459-64issue
5eissn
0019-5413issn
1998-3727pii
IJOrtho-45-459journal_volume
45pub_type
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