Strategies in Trauma and Limb Reconstruction

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

List of Papers (Total 302)

Conversion of external fixation to internal fixation in a non-acute, reconstructive setting: a case series

The aim of the study is to determine the outcomes in patients who underwent conversion from an external fixator to an internal fixation device. This is a retrospective review of 18 patients (24 limbs) who underwent conversion from external to internal fixation. The patients had external fixators applied for traumatic bone defects or congenital deformities. Conversion to internal...

A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint

The aim of this study was to assess the effect of conservative versus operative treatment for unstable palmar plate disruption in the proximal interphalangeal (PIP) joint of the fingers with respect to preservation of joint stability, mobility, and pain. The study was conducted as a prospective study in which 83 patients were randomly assigned into 2 groups: (1) conservative...

The sequelae of a missed Essex-Lopresti lesion

Radial head fractures are the most common type of elbow fracture in adults. Unrecognised disruption of the intraosseous membrane at the time of injury can lead to severe wrist pain from proximal radial migration especially if the radial head is excised. In this case, despite anatomical reduction and internal fixation of the radial head fracture, longitudinal forearm instability...

Cortical tibial osteoperiosteal flap technique to achieve bony bridge in transtibial amputation: experience in nine adult patients

Amputation, especially of the lower limbs, is a surgical procedure that gives excellent results when conducted under the appropriate conditions. In 1949 Ertl developed a technique for transtibial osteomyoplastic amputation which restored the intraosseous pressure through canal obliteration and expanded the area of terminal support through a bony bridge between the fibula and...

Open management of neglected inferior dislocation of the shoulder with proximal humeral fracture in an adolescent

Neglected dislocation of the shoulder is a rare condition with some cases of anterior and posterior dislocation being reported. We report a case with a fracture dislocation of the proximal humerus with the dislocated head lying inferior to the glenoid. We also report on the surgical management of a case with this extremely rare condition which required shortening of the distal...

Distal tibial hypertrophic nonunion with deformity: treatment by fixator-assisted acute deformity correction and LCP fixation

Distal tibial hypertrophic nonunion with angular deformity has been successfully treated by circular external fixator. The inconvenience of the bulky external fixator and frequent pin tract infection would not be accepted in certain cases. This study included thirteen patients (mean age 39 years) with angular deformity of the distal dia-/metaphyseal tibial shaft. Five patients...

The Essex-Lopresti lesion

The Essex-Lopresti lesion represents a severe injury of the forearm unit. In the 1940s, it’s pathology and consequences have already been mentioned by several authors. Over the course of time, the pathophysiology of the lesion was displayed in more detail. Therefore, an intensive analysis of the involved anatomic structures was done. The interosseous membrane was shown to play a...

Correlation between pattern and mechanism of injury of free fall

To define the pattern of injury and aetiology of death of patients who have sustained major trauma due to high fall and its relationship with the mechanism of free fall. A total of 188 consecutive patients who sustained a high fall were included after the TRAUMASUR database was retrospectively reviewed. Demographic characteristics, severity scores, injury type, aetiology of high...

Flexible stabilization of the distal tibiofibular syndesmosis: clinical and biomechanical considerations: a review of the literature

Syndesmotic rupture is present in 10 % of ankle fractures and must be recognized and treated to prevent late complications. The method of fixation is classically rigid fixation with one or two screws. Knowledge of the biomechanics of the syndesmosis has led to the development of new dynamic implants to restore physiologic motion during walking. One of these implants is the suture...

Does the use of an intramedullary nail alter the duration of external fixation and rate of consolidation in tibial lengthening procedures? A systematic review

We performed this systematic review to evaluate tibial lengthening procedures with the use of an intramedullary nail. We investigated the hypothesis that lengthening over a nail can reduce the time spent in an external fixator and increase the rate of consolidation thereby reducing the risk of complications and improving patient satisfaction. We conducted a comprehensive...

Dual lag screw cephalomedullary nail versus the classic sliding hip screw for the stabilization of intertrochanteric fractures. A prospective randomized study

This study is a randomized prospective study comparing two fracture fixation implants, the extramedullary sliding hip screw (SHS) and the dual lag screw cephalomedullary nail, in the treatment of intertrochanteric femoral fractures in the elderly. One hundred and sixty-five patients with low-energy intertrochanteric fractures, classified as AO/OTA 31A, were prospectively included...

Tibial plateau fractures: compared outcomes between ARIF and ORIF

The purpose of this study is to compare arthroscopic assisted reduction internal fixation (ARIF) treatment with open reduction internal fixation (ORIF) treatment in patients with tibial plateau fractures. We studied 100 patients with tibial plateau fractures (54 men and 46 women) examined by X-rays and CT scans, divided into 2 groups. Group A with associated meniscus tear was...

Limb lengthening in congenital posteromedial bow of the tibia

Congenital posteromedial bowing of the tibia (PMBT) is a rare condition affecting one lower limb. The bowing of the tibia usually resolves; however, there is associated limb length discrepancy (LLD), which often persists and can cause functional deficits. Advances in limb lengthening techniques allow this issue to be addressed, often with concomitant angular deformity correction...

Beware the painful nerve palsy; neurostenalgia, a diagnosis not to be missed

We present a case of painful radial nerve palsy following application of a humeral lengthening frame. At re-operation, the radial nerve was found to be compressed against a distal pin. This was re-sited providing immediate pain relief and a gradual resolution of the radial nerve palsy. Pain in association with a nerve palsy should alert the clinician to the possibility of nerve...

The diagnosis and treatment of deltoid ligament lesions in supination–external rotation ankle fractures: a review

The supination–external rotation or Weber B type fracture exists as a stable and an unstable type. The unstable type has a medial malleolus fracture or deltoid ligament lesion in addition to a fibular fracture. The consensus is the unstable type and best treated by open reduction and internal fixation. The diagnostic process for a medial ligament lesion has been well investigated...

Management of the mangled extremity

The management of a mangled extremity continues to be a matter of debate. With modern advances in trauma resuscitation, microvascular tissue transfer, and fracture fixation, severe traumatic extremity injuries that would historically have been amputated are often salvaged. Even if preserving a mangled limb is a technical possibility, the question is often raised whether the end...

The treatment of high tibial osteotomy non-union with the Ilizarov external fixator

To evaluate the results of the Ilizarov external fixator in the treatment of non-union post–high tibial osteotomy (HTO). Five non-unions, in four patients, following HTO were treated by Ilizarov fixation. Clinical outcome was assessed pre- and post-operatively by the Knee Society Clinical Rating System (KSCRS). Radiological analysis assessed bone healing pre- and post-operatively...

Spontaneous scapular spine fracture related to rotator cuff pathology: a report of two cases

Spontaneous fractures of the scapula are rare, especially those involving the scapular spine. There are only a few case reports addressing this topic. Two cases are presented of spontaneous scapular spine fractures in patients with cuff-tear arthropathy. Treatment was conservative, resulting in a stiff shoulder in both patients. The combination of oral steroids and cuff-tear...

Abductor pollicis longus tendon division with swan neck thumb deformity

Swan neck thumb deformity can be caused by osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, tendon transfers and paralytic diseases. Abductor pollicis longus is one of the major stabilizing tendon of the carpometacarpal joint of thumb. To the best of our knowledge, swan neck thumb deformity owing to division of abductor pollicis longus tendon is rare. In this...

Preliminary results of cannulated screw fixation for isolated pubic ramus fractures

Isolated pubic ramus fractures are common fractures in the elderly, and treatment is typically non-operative. Up to 35 % of patients have a prolonged hospital stay due to pain. A small number of these patients do not respond to standard (non-operative) treatment. We retrospectively reviewed six patients with isolated pubic ramus fractures and persistent pain who were treated with...

Prevention and management of external fixator pin track sepsis

Pin track-associated complications are almost universal findings with the use of external fixation. These complications are catastrophic if it leads to the failure of the bone–pin interface and could lead to pin loosening, fracture non-union and chronic osteomyelitis. Strategies proposed for the prevention and management of pin track complications are diverse and constantly...

Bilateral Galeazzi fracture-dislocations: a case report of early rehabilitation

A 24-year-old man had bilateral Galeazzi fracture-dislocations due to a motorcycle accident. The right radius fracture was a simple fracture and was fixed with a limited contact dynamic compression plate. The left radius fracture was a comminuted fracture and was fixed with a long locking compression plate in the bridging plate fashion while maintaining reduction with a temporary...

Outcomes and complications of fibular head resection

The fibular head is often used as donor graft material for reconstruction of defects of the distal radius. However little is known on the safety of such a procedure. This report describes the long-term donor-site morbidity following the procedure. Fourteen patients who underwent simple or marginal resections of the proximal fibula between 1990 and 2007 were reviewed. Subjective...

Proximal tibial osteotomies for the medial compartment arthrosis of the knee: a historical journey

Several proximal tibial osteotomy techniques for the medial compartment arthrosis of the knee are described and traced in their development. These techniques are of the closed wedge, dome and open wedge types. We detail the differences in planning and surgery as well the need for different fixation devices. This historical and technical description will benefit those surgeons...

An aggressive aneurysmal bone cyst of the proximal humerus and related complications in a pediatric patient

Clinical behavior of aneurysmal bone cyst (ABC) in younger patients can be more aggressive than that in older children and adults. Angular deformity and shortening can occur due to growth plate destruction or tumor resection. A 11-year-old boy who had been operated twice in another center for an ABC located in the left proximal humerus presented to the author’s institution with...