Strategies in Trauma and Limb Reconstruction

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

List of Papers (Total 289)

Efficacy of a compliant semicircular Ilizarov pin fixator module for treating infected nonunion of the femoral diaphysis

Percutaneous transosseous Ilizarov wiring, whilst preferred in the tibia because of its unique properties, carries a high risk of complications in the femur. The aim of this work was to evaluate the efficacy of a more patient-friendly semicircular pin external fixator module built up from parts of the Ilizarov fixator components and its use in managing diaphyseal femoral nonunions. ...

Complex reconstruction after wide excision of juvenile aponeurotic fibromatoses of upper one-third of leg

Juvenile musculoaponeurotic fibromatoses are benign tumors which arise from musculoaponeurotic stromal cells. They rarely occur in lower extremity and more rarely in children. They are locally invasive tumors with a high incidence of recurrence after surgery. Hence, wide local excision is the treatment of choice for such tumors. However, complex reconstruction is often required to ...

Nailing treatment in bone transport complications

A series of cases of reamed intramedullary nailings carried out after complications in regenerated bone and docking site had occurred in bone transport is presented here. Nine patients (femur = 5; tibia = 4) had treatment with resection after open fractures or infection and underwent bone transport. The mean length of regenerated bone was 9.5 cm (range 6–18 cm). After bone ...

Reviewers 2013

Results in treatment of distal femur fractures using polyaxial locking plate

Indications and techniques of locked plate fixation for the treatment of challenging fractures continue to evolve. As design variant of classic locked plates, the polyaxial locked plate has the ability to alter the screw angle and thereby, enhance fracture fixation. The aim of this observational study was to evaluate clinical and radiographic results in 89 patients with 90 ...

Bicondylar tibial plateau fractures treated with fine-wire circular external fixation

Bicondylar tibial plateau fractures are serious injuries to a major weight-bearing joint. These injuries are often associated with severe soft tissue injuries that complicate surgical management. We reviewed 54 consecutive patients who sustained bicondylar tibial plateau fractures that were treated with limited open reduction and cannulated screw fixation combined with fine-wire ...

Patient-reported outcomes following treatment of tibial non-union with circular frames

The management of tibial non-union is challenging with protracted, often arduous, treatments. The purpose of this study was to assess patient-reported outcomes following treatment of tibial non-union in circular external fixators. Twenty-one patients with tibial non-unions who successfully completed treatment at a mean of 10.1 months (range 6–20) in a circular external fixator were ...

Can the material properties of regenerate bone be predicted with non-invasive methods of assessment? Exploring the correlation between dual X-ray absorptiometry and compression testing to failure in an animal model of distraction osteogenesis

Evaluation of the material properties of regenerate bone is of fundamental importance to a successful outcome following distraction osteogenesis using an external fixator. Plain radiographs are in widespread use for assessment of alignment and the distraction gap but are unable to detect bone formation in the early stages of distraction osteogenesis and do not quantify accurately ...

Success of torsional correction surgery after failed surgeries for patellofemoral pain and instability

Torsional deformities of the femur and/or tibia often go unrecognized in adolescents and adults who present with anterior knee pain, and patellar maltracking or instability. While open and arthroscopic surgical techniques have evolved to address these problems, unrecognized torsion may compromise the outcomes of these procedures. We collected a group of 16 consecutive patients (23 ...

Percutaneous cerclage wiring for the surgical treatment of displaced patella fractures

The patella plays an important role in the knee joint extension, and a patella fracture requires surgical treatment when it is accompanied by displacement of bone fragments and a joint surface gap. In patella fractures, there is disruption of the soft tissue structures that support the knee extension mechanism. We use a method of percutaneous cerclage wiring to fix the patella and ...

Guided growth of the trochanteric apophysis combined with soft tissue release for Legg–Calve–Perthes disease

During the initial fragmentation stage of Perthes disease, the principle focus is to achieve containment of the femoral head within the acetabulum. Whether by bracing, abduction casts, femoral and/or pelvic osteotomy, the goals are to maximize the range of hip motion and to avoid incongruity, hoping to avert subsequent femoro-acetabular impingement or hinge abduction. A more subtle ...

Epiphysiodesis for limb length discrepancy: a comparison of two methods

A retrospective review of 42 patients from 1999 to 2008 with at least 1-year follow-up was performed. The type and location of epiphysiodesis, average operative time and hospital stay, complications, timing and the final limb length discrepancy (LLD) were recorded. Computer tomography scanograms and mechanical axis view with grids were done to assess LLD. Twenty-six patients ...

Correction osteotomy of distal radius malunion stabilised with dorsal locking plates without grafting

The purpose of this study was to evaluate the results of our correction osteotomies of distal radial malunions without a bone graft. Eleven consecutive patients (mean age 52 years, range 18–71) were treated. A dorsal approach was utilised to perform an opening-wedge osteotomy which then was stabilised with two dorsal columnar plates without filling the osteotomy gap. All patients ...

Local perforator island flaps in post-traumatic reconstruction of middle third of the leg

Perforator flaps have been introduced for coverage of local and distant defects. Various designs of this flap are possible, but their role in the setting of trauma is debated. We report that it is possible to raise these flaps in cases of post-traumatic lower limb reconstruction with good results. Consideration must be given to the type of movement that is planned vis-a-vis the ...

Arthroscopically assisted reduction and internal fixation of a femoral anterior cruciate ligament osteochondral avulsion fracture in a 14-year-old girl via transphyseal inside-out technique

Femoral avulsion fracture of the anterior cruciate ligament (ACL) in children and adolescents is rare, and its arthroscopic treatment is even more so. A femoral avulsion fracture of the ACL of a 14-year-old girl was arthroscopically reduced and fixed by a Kirschner wire (K-wire) via an inside-out technique. A 1.4-mm K-wire was drilled inside-out into the osseous defect of the ...

Lumbar plexus injury in an anterior fracture dislocation of sacroiliac joint: a case report and review of literature

Displaced unstable pelvic fractures are commonly associated with disruption of the osteoarticular junction of the sacroiliac joint. Posterior sacroiliac dislocation are commonly reported but there are only few reports the anterior type of sacroiliac dislocation where the iliac bone fractures and displaces anterior to sacrum, often in combination with fractures of pubic rami and ...

Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture

Fibrous dysplasia (FD) is a rare bone disorder in which normal medullary bone is replaced by fibro-osseous tissue. It typically presents in childhood with pain, skeletal deformities, gait abnormalities and occasionally, fatigue fractures. The management of FD remains a challenge. Surgical procedures have been developed to provide symptom relief, correct skeletal deformity and offer ...

Cytotoxic agents are detrimental to bone formed by distraction osteogenesis

Distraction osteogenesis can be used to replace segmental bone loss when treating malignant bone tumors in children and adolescents. These patients often receive cytotoxic chemotherapy as part of their treatment regimen. The effect of cytotoxic drugs on the cellular processes during distraction osteogenesis and the structural and mechanical properties of regenerate bone is unknown. ...

Antibiotic-impregnated cement spacer as a definitive treatment for post-arthroscopy shoulder destructive osteomyelitis: case report and review of literature

Arthroscopic revision of rotator cuff lesions is an increasingly popular procedure with a relatively safe profile. However, associated deep articular infection has been described, with potentially destructive joint sequelae. When occurring, it poses the double challenge of eradicating the infectious agent while preserving the articulation and its function. Experience remains scarce ...

Valgus osteotomy by external fixation for treatment for developmental coxa vara

Valgus subtrochanteric osteotomy is the standard surgical treatment for coxa vara. Nevertheless, there is no consensus on the method of fixation and osteotomy technique. There are some reports on employing rigid internal fixation methods that preclude the need of postoperative immobilization. This is a technical description of a valgus osteotomy performed using external fixation ...

Cost implications of the physiotherapy management of complex tibial fractures treated with circular frames

Seventy-three consecutive patients with complex tibial fractures treated with an Ilizarov frame or Taylor Spatial Frame received physiotherapy between April 2008 and April 2010. Data were collected prospectively, and physiotherapy input was recorded (in minutes) for the patients identified. This included treatment received as an inpatient as well as an outpatient. The data were ...

Outcome after modified Putti-Platt procedure for recurrent traumatic anterior shoulder dislocations

Most recent studies on procedures for stabilizing the glenohumeral joint focus on arthroscopic techniques. A relatively simple open procedure is the modified Putti-Platt procedure. The aim of these retrospective case series was to evaluate the functional outcome, patient satisfaction, and quality of life of patients who underwent this procedure. After a median follow-up time of 4.7 ...

Proximal humeral reconstruction using nail cement spacer in primary and metastatic tumours of proximal humerus

Limb salvage surgery for malignant tumours of proximal humerus is an operative challenge, where the surgeon has to preserve elbow and hand functions and retain shoulder stability with as much function as possible. We treated 14 consecutive patients with primary malignant or isolated metastasis of proximal humerus with surgical resection and reconstruction by nail cement spacer. ...

Operative treatment and outcome of unstable distal radial fractures using a palmar T-miniplate at a non-specialized institution

Treatment options for displaced distal radial fractures are still a controversial topic of discussion. Although good results for the palmar plating of high-volume centers have been published, evidence of its successful use in smaller institutions is still lacking. We report the clinical and radiological results of the treatment for 84 distal radial fractures with a single 2.4-mm ...

Operative treatment for femoral shaft nonunions, a systematic review of the literature

The objective of this article is to systematically review the currently available literature to formulate evidence-based guidelines for the treatment of femoral shaft nonunions for clinical practice and to establish recommendations for future research. Articles from PubMed/MEDLINE, Cochrane Clinical Trial Register, and EMBASE, that presented data concerning treatment of nonunions ...