Reconstruction of the hip stump

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Combat injuries often result in extensive soft tissue damage, complicating the formation of functional limb stumps.
• Long femoral stumps can lead to complications like skin breakdown and prosthetic intolerance due to mismatched weight-bearing surfaces.

Purpose of the Study:

• To describe a novel method for reconstructing a femoral stump in a combat injury patient.
• To address challenges in prosthetic fitting caused by scarring and inadequate stump morphology.

Main Methods:

• Ilizarov compression-distraction osteosynthesis for femoral stump reconstruction.
• Distraction osteogenesis to expand the distal femoral stump.
• Radiographic assessment and GaitRite system gait analysis before and after treatment.

Main Results:

• The Ilizarov apparatus successfully created a mushroom-shaped femoral stump with a twofold larger bearing surface.
• Reduced load per unit area and improved pressure distribution within the prosthetic socket.
• Enhanced load-bearing capacity and reduced soft tissue trauma.

Conclusions:

• Distraction osteogenesis is an effective method for enlarging distal femoral stumps, creating a stable weight-bearing platform.
• This technique improves prosthetic fit, reduces complications, and enhances functional outcomes for patients with combat-related amputations.
• The method offers a significant advancement in limb stump reconstruction, particularly for challenging cases with extensive scarring.