Strategies in Trauma and Limb Reconstruction

http://link.springer.com/journal/11751

List of Papers (Total 302)

A pseudo-iatrogenic case of medial clavicular fracture

Medial fractures are the least common type of clavicular fracture (2–10%). The patient is a 29-year-old gynaecology resident with hyper-laxity and sternoclavicular instability. The latter had been surgically stabilized with Dacron® tape, which eroded the bone causing an usura. Acute right shoulder pain occurred 10 years later. CT revealed medial clavicular stress fracture. After...

Safe corridors in external fixation: the lower leg (tibia, fibula, hindfoot and forefoot)

It is a prerequisite for surgeons using external fixation systems to be familiar with safe corridors for half pin or wire insertion. Several atlases of cross-sectional anatomy are available, mostly in print, to provide guidance [1, 2, 3]. This series of articles provides high-quality cross-sectional anatomical images together with guidance in locating safe corridors; the added...

Safety and reliability of external fixation for basicervical and intertrochanteric fractures in high-risk elderly patients

Forty elderly patients with basicervical and pertrochanteric fractures were managed with uniplanar AO external fixator under regional anaesthetic block of the femoral nerve and lateral cutaneous nerve of the thigh from April 2003 to March 2006. The mean age of the patients was 67.9 ± 5.5 years. External fixator application was performed under radiological control after closed...

The dynamic condylar screw in the management of subtrochanteric fractures: does judicious use of biological fixation enhance overall results?

Subtrochanteric fractures are fraught with certain anatomic, biologic and biomechanical challenges. Evolution of implants like the Gamma nail, fixed-angle nail plates, compression hip screws and dynamic hip screws with trochanteric stabilization plates underlines a persistent quest for a better implant. We studied the dynamic condylar screw DCS as an implant on a series of 30...

Corrective osteotomy after malunion of mid shaft fractures of the clavicle

Displaced mid shaft fractures of the clavicle result in some degree of shortening and rotation. These fractures often heal with some degree of malunion which can be symptomatic. The question arises as to whether surgical correction of the deformity will relieve the symptoms associated with the malunion. Ten patients with a symptomatic malunion of the clavicle were treated by...

Limb reconstruction surgery in China: an evaluation of its role in the largest developing nation

China is the “economic tiger” of the twenty-first century. Its new economic policies have overturned the outlook and futures of many industries in this nation, and parallel to this industrial progress have been strides in medicine. However a country steeped in a history of several millennia does not replace generations of experience nor knowledge in a few decades. The author...

The tantalum screw for treating femoral head necrosis: rationale and results

Femoral head necrosis (FHN) is a progressive pathology due to the failure of blood supply to the proximal femoral epiphysis, with consequent necrosis of the sub-chondral bone and collapse of the articular cartilage and loss of congruity between the head and the acetabulum. Borrowing the biological and mechanical principles from the vascularized fibular graft technique for the...

Monolateral external fixation for the progressive correction of neurological spastic knee flexion contracture in children

The purpose of this study was to report the results of the surgical treatment of spastic knee flexion contracture using tenotomy and progressive correction by external fixator–distractor devices. The study design involved a prospective observational study of 16 knees in nine patients with spastic flexion contracture greater than 30°. Treatment was indicated for both ambulatory...

Peri-acetabular external fixation for hip disease: an anatomical study

Hip distraction using cross joint articulated external fixation has been used by a number of orthopaedic centres for the treatment of osteoarthritis, chrondrolysis, and osteonecrosis, as an alternative to hip arthroplasty or arthrodesis in the adolescent and young adults . The hip, however, is problematic with respect to external fixation, as it lies deep, surrounded by powerful...

Biomechanics of the anterior cruciate ligament and implications for surgical reconstruction

Injury to the anterior cruciate ligament (ACL) is regarded as critical to the physiological kinematics of the femoral-tibial joint, its disruption eventually causing long-term functional impairment. Both the initial trauma and the pathologic motion pattern of the injured knee may result in primary degenerative lesions of the secondary stabilisers of the knee, each of which are...

Internal femoral osteosynthesis after external fixation in multiple-trauma patients

In this study the authors evaluate the results of internal synthesis of femoral fractures in polytraumatised patients initially treated by external fixation (EF). From January 2002 to December 2005, 39 femurs in 37 polytraumatised patients (average age 34.2 years, range 18-44) with closed fractures and an ISS>20 were initially treated with EF. There were three groups: Group A, 13...

Open reduction and corrective ulnar osteotomy for missed radial head dislocations in children

The treatment of chronic radial head dislocation remains controversial. Open reduction of the radial head in combination with correction of malalignment with ulnar osteotomy can be the key to a good surgical result. Between 2001 and 2006, 9 (6 female, 3 male, average age 8.4 (5-11) years) patients were treated surgically for chronic radial head dislocation by one surgeon. The...

Minimally invasive ankle arthrodesis with a retrograde locking nail after failed fusion

A retrograde nail with posterior-to-anterior (PA) locking into os calcis, talus and tibia was used to correct deformity and achieve fusion after failed fusion. A variety of methods have been published to achieve union of the ankle and subtalar joint in a failed fusion situation. We have studied a retrograde locking nail technique through a 2.5-cm incision in the non-weightbearing...

Correction of complex foot deformities using the V-osteotomy and the Ilizarov technique

Abstract Complex foot deformity is a multiplanar deformity with or without foot shortening. It also includes deformed feet with poor soft-tissue coverage, relapsed or neglected cases, and those with acompanying problems such as leg-length discrepancy, lower leg deformity, osteomyelitis and nonunions. Traditionally, correction of these deformities can be achieved by extensive soft...

Stability with unilateral external fixation in the tibia

Unilateral external fixation can be used in the provisional or definitive treatment of tibial fractures. A properly applied fixator allows bony and soft tissue stability, whereas an improperly applied fixator achieves neither and can be a hindrance. The principles for the successful application of monolateral external fixation, including the rationale for choosing this type of...

The “floating forearm” injury in a child: a case report

Abstract: The case of a eleven-year-old girl who had a fracture dislocation of the left elbow with entrapment of the ulnar nerve into the dislocated ulnar epicondyle anlage and unstable forearm fracture of the ipslateral upper extremity is described. This severe injury to the elbow and the ipsilateral forearm is termed “floating forearm” injury. The forearm was stabilized...

A life without pain: a case report

Congenital insensitivity to pain is a rare condition with an abnormality of interpretation of painful stimuli. This case report illustrates how a sequence of injuries after no or trivial trauma incapacitated a young boy. Especially the bilateral collapse and dislocation of the hip is an unusual sequela of this disorder.

The treatment of severely comminuted intra-articular fractures of the distal radius

Comminuted fractures of the distal end of the radius are caused by high-energy trauma and present as shear and impacted fractures of the articular surface of the distal radius with displacement of the fragments. The force of the impact and the position of the hand and carpal bone determine the pattern of articular fragmentation and their displacement and the amount and the extent...

Congenital pseudarthrosis of radius. A case report

We report a case of a 9 year old female child with congenital pseudarthrosis of the radius. She had a history of fractures of both bones of the left forearm after trivial trauma at the age of 7 years (2003) and 8 years (2004). On each occasion she was treated conservatively in a POP cast 4 weeks. She reported to us in January 2005 complaining of a gradually increasing deformity...

Editorial

Distal tibial metaphyseal fractures: the role of fibular fixation

Distal tibial extra-articular fractures are often a result of complex high-energy trauma, which commonly involves associated fibular fractures and soft tissue injury. The goal of tibial fixation is to maximise fracture stability without increasing soft tissue morbidity from surgical intervention. The role of adjunctive fibular fixation in distal tibial metaphyseal fractures has...

Salvage of a failed valgus osteotomy for non-union of an unstable pertrochanteric fracture

Salvage of a failed valgus osteotomy for nonunion of an unstable pertrochanteric fracture is reported. A valgus intertrochanteric osteotomy was performed for a failed sliding hip screw fixation of an unstable pertrochanteric fracture at another institution. Four months following osteotomy, the fracture was still un-united with two distal screws of the hip plate broken and a coxa...

Treatment of high-energy tibial plateau fractures

Treatment of high-energy fractures of the tibial plateau requires an inordinate degree of surgical effort in order to avoid complications. Fracture reduction can be a challenge to experienced hands and the soft tissue conditions are intolerant of careless dissection. In general, it is an oversimplification to use one technique of stabilisation for such a heterogenous group (even...

Efficacy of the A-V Impulse System versus cryotherapy in the reduction of postoperative oedema of the hand: a prospective randomised trial

In a prospective randomised trial, the effects of an intermittent compression hand pump vs. cryotherapy were compared on reduction of postoperative hand swelling and gain in finger movement after distal radius fractures. Although intermittent compression as a physical method for thromboprophylaxis and swelling reduction in orthopaedic and trauma patients of the lower leg are...