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Sherif Galal
: Developmental coxa vara (DCV) develops during early childhood between the age of independent walking and 6 years. The deformity includes a decrease in the neck-shaft angle and femoral retroversion. Recently, good results have been reported using external fixator systems for the correction of proximal femoral deformities secondary to slipped capital femoral epiphysis, Perthes' disease in children, and percutaneous proximal femoral osteotomy for coxa vara. This preliminary study was performed to evaluate the results of percutaneous subtrochanteric osteotomy in restoring the normal alignment and orientation (radiographic outcome), thereby restoring the normal mechanics of the hip joint, overcoming shortening of the limb, and re-establishing the length-tension relationship of the abductor muscles (functional outcome)...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
Lei Zhai, Xin-Long Ma, Chuan Jiang, Bo Zhang, Shui-Tao Liu, Geng-Yan Xing
BACKGROUND: Currently, the available treatments for long bone nonunion (LBN) are removing of focus of infection, bone marrow transplantation as well as Ilizarov methods etc. Due to a high percentage of failures, the treatments are complex and debated. To develop an effective method for the treatment of LBN, we explored the use of human autologous bone mesenchymal stems cells (hBMSCs) along with extracorporeal shock wave therapy (ESWT). MATERIALS AND METHODS: Sixty three patients of LBN were subjected to ESWT treatment and were divided into hBMSCs transplantation group (Group A, 32 cases) and simple ESWT treatment group (Group B, 31 cases)...
September 2016: Indian Journal of Orthopaedics
R Rohilla, J Wadhwani, A Devgan, R Singh, M Khanna
AIMS: This is a prospective randomised study which compares the radiological and functional outcomes of ring and rail fixators in patients with an infected gap (> 3 cm) nonunion of the tibia. PATIENTS AND METHODS: Between May 2008 and February 2013, 70 patients were treated at our Institute for a posttraumatic osseocutaneous defect of the tibia measuring at least 3 cm. These were randomised into two groups of 35 patients using the lottery method. Group I patients were treated with a ring fixator and group II patients with a rail fixator...
October 2016: Bone & Joint Journal
Nader S Alkenani, Mariam A Alosfoor, Abdulaziz K Al-Araifi, Hala A Alnuaim
INTRODUCTION: This is a case report of extreme lengthening of the tibia of about 14.5cm using bone transport technique following road traffic accident trauma to the lower limbs. The management of the subsequent massive skeletal defects was challenging to orthopedic surgeons. Based on reported cases, the highest tibial lengthening was 22cm using bifocal transport, while the highest unifocal tibial lengthening reached 14.5cm. CASE PRESENTATION: A 20-year-old male driver was brought to the emergency department after a road traffic accident...
September 3, 2016: International Journal of Surgery Case Reports
W Z Meng, Y J Guo, Z K Liu, Y F Li, G Z Wang
Objective: To investigate the influencing factors for trauma-induced tibial infection in underground coal mine. Methods: A retrospective analysis was performed for the clinical data of 1 090 patients with tibial fracture complicated by bone infection who were injured in underground coal mine and admitted to our hospital from January 1995 to August 2015, including the type of trauma, injured parts, severity, and treatment outcome. The association between risk factors and infection was analyzed. Results: Among the 1 090 patients, 357 had the clinical manifestations of acute and chronic bone infection, 219 had red and swollen legs with heat pain, and 138 experienced skin necrosis, rupture, and discharge of pus...
July 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Ibrahim Elsayed Abdellatif Abuomira, Francesco Sala, Yasser Elbatrawy, Giovanni Lovisetti, Salvatore Alati, Dario Capitani
This retrospective review assesses 55 tibial nonunions with bone loss to compare union achieved with combined Ilizarov and Taylor spatial frames (I-TSF) versus a conventional circular frame with the standard Ilizarov procedure. Seventeen (31 %) of the 55 nonunions were infected. Thirty patients treated with I-TSF were compared with 25 patients treated with a conventional circular frame. In the I-TSF group, an average of 7.6 cm of bone was resected and the lengthening index (treatment time in months divided by lengthening amount in centimeters) was 1...
September 22, 2016: Strategies in Trauma and Limb Reconstruction
Louis V DeFazio, Guido A LaPorta
INTRODUCTION AND OBJECTIVES: Calcaneal fractures are a serious injury with significant associated morbidity. Bilateral calcaneal fractures complicate issues even further, due to the physical disability that the patient is left with. One of the major issues with any calcaneal fracture is the risk of soft tissue compromise caused by the traumatic nature of the injury. A percutaneous approach allows the soft tissue envelope to remain viable, while still fixating the fractures. The purpose of this presentation is to highlight the use of percutaneous repair, the role of external fixation in calcaneal fractures, and lastly discuss the outcome for this particular patient...
September 2016: Journal of the American Podiatric Medical Association
M G Faruque, M U Mollah, T H Siddiquee, S Bari
Ilizarov method is the best weapon for the treatment of the limb length discrepancy, especially in traumatic or congenital shortening of long bones. Post burn bony defect can be corrected by osteosynthesis. Here we treated a 7 years old boy, suffering from 33% electric burn affecting face, trunk, left upper limb & both lower limbs with loss of soft tissue of medial side of right leg along with dead and exposed of some segment (about 14cm) of Left tibia . Initially the patient was managed by plastic surgeons in the form of surgical toileting, wound debridement and wound coverage by split thickness skin graft...
July 2016: Mymensingh Medical Journal: MMJ
L T Donnan, B Gomes, A Donnan, C Harris, I Torode, C Heidt
AIMS: We wished to examine the effectiveness of tibial lengthening using a two ring Ilizarov frame in skeletally immature patients. This is a potentially biomechanically unstable construct which risks the loss of axial control. PATIENTS AND METHODS: We retrospectively reviewed a consecutive series of 24 boys and 26 girls, with a mean age of 8.6 years (4 to 14), who underwent 52 tibial lengthening procedures with a mean follow-up of 4.3 years (4.0 to 16.9). Tibial alignment was measured before and after treatment using joint orientation lines from the knee and a calculation of the oblique plane axis...
September 2016: Bone & Joint Journal
Pieter Reynders-Frederix, Cristina Reynders-Frederix, Muhammad Wajid
BACKGROUND: Young patients with a acquired dislocation of the hip with concomitant shortening of the lower limb is a difficult diagnostic problem with few definite treatment options. METHODS: We used the technique, originally described by Ilizarov, with a double femur osteotomy and lengthening the femur. Lengthening was done with a sub muscular placed on-lay femur distraction rod. Distraction of the rod was done by fluid mechanics. After lengthening, the distraction was secured by a parked plate by locking the distal part of the plate...
2016: Open Orthopaedics Journal
O Borens, N Helmy
BACKGROUND: Infections after osteosynthesis are a feared complication of the surgical treatment of fractures and should be dealt with by a multidisciplinary team. In addition to the surgeon, also included in this multidisciplinary team are a specialist for infectious diseases, a microbiologist, a radiologist and often a plastic surgeon. This review article describes the current knowledge on the pathogenesis, diagnostics, classification and treatment. The aim is to demonstrate some basic rules in the treatment of infections associated with implants and to show potential therpeutic approaches...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
ZhanJun Yan, YouDong Pan, ShiHui Wang, MaoHua Cheng, HongMei Kong, ChunGuang Sun, Kai Hu, TongLei Chen, QiRong Dong, JianFeng Chen
STUDY DESIGN: A 3-level rat tail caudal intervertebral disc (IVD) degeneration (IVDD) model was established to study effects of static compression on extracellular matrix (ECM) remodeling and integrin signaling in IVDs during IVDD. OBJECTIVE: To investigate the effect of compression force on ECM remodeling and integrin signaling in IVDs during IVDD SUMMARY OF BACKGROUND DATA.: Integrins sense mechanical environment alteration via binding to ECM ligands and trigger intracellular signaling for pathological ECM remodeling during IVDD...
August 19, 2016: Spine
P Guerreschi, A Wolber, Y Bennis, M Vinchon, V Martinot-Duquennoy
Distraction osteogenesis, initially developed by Ilizarov for limb, is the tissular extension caused by the progressive space of the osseous pieces following an osteotomy. Distraction is osteogenesic and histogenic. Twenty-five years ago, at the instigation of McCarthy, this technique was used to handle the craniofacial malformations in the various floors of the face : mandibular, mediofacial and cranial. The most wide-spread protocols respect a latency period from 0 to 7 days, a rhythm of distraction from 1 to 2mm a day in 2 at 4 times and a period of consolidation from 4 to 8 weeks...
October 2016: Annales de Chirurgie Plastique et Esthétique
Andre J Keenan, O J F Keenan, C Tubb, A M Wood, T Rowlands, S E Christensen
Large tibial defects present a challenging scenario for the orthopaedic surgeon, particularly in the paediatric patient. Most management options, such as the vascularised fibular graft or Ilizarov technique, require microsurgical techniques or specialist equipment. In an austere environment, acute shortening or limb amputation may be most appropriate. However, limb salvage may be achieved by ipsilateral fibular transfer. In a one-stage operation, the fibular graft is harvested and either placed in the tibial defect in an intramedullary position or secured to the tibia with screws...
July 22, 2016: Journal of the Royal Army Medical Corps
Ahmed Fathy Sadek, Mohammed A Laklok, Ezzat H Fouly, Mohamed Elshafie
INTRODUCTION: Infected nonunion of the tibial diaphysis poses one of the most challenging scenarios. There is no clear cut guidelines for cases of infected diaphyseal nonunion with bony defects of ≤6 cm. MATERIALS AND METHODS: A retrospective comparative study was conducted on 30 patients who sustained resistant infected tibial diaphyseal nonunion with bony defect of ≤6 cm. The 30 patients were the sum of two groups; group I (16 patients, mean age 33.6 years) which included all patients, who underwent two stage reconstructions, and Group II patients (14 patients, mean age 29...
September 2016: Archives of Orthopaedic and Trauma Surgery
Takahiro Niikura, Sang Yang Lee, Takashi Iwakura, Masahiro Kurosaka
BACKGROUND: The Masquelet technique is a relatively new option in the management of bone defects. It consists of 2-stage surgery. At first surgery, a cement spacer is placed to fill the bone defect. After a waiting period of 6-8 weeks, a pseudo-synovial membrane is formed around the cement. The induced membrane is rich in vascularity and osteogenic activity. At second surgery, the cement is replaced with an autologous bone graft and the graft is packed in the membrane. To harvest large quantities of bone graft, the reamer irrigator aspirator (RIA) is utilized...
August 2016: Journal of Orthopaedic Trauma
Koji Nozaka, Yoichi Shimada, Naohisa Miyakoshi, Shin Yamada, Michio Hongo, Hiroyuki Nagasawa, Yuji Kasukawa, Hidetomo Saito, Hiroaki Kijima, Hiroyuki Tsuchie
BACKGROUND: It is an advantage for orthopaedic surgeons to remove an Ilizarov external fixator as early as possible after surgery. Although both teriparatide and low-intensity pulsed ultrasound (LIPUS) have been found to accelerate fracture-healing processes, the effect of the combination of teriparatide and LIPUS in clinical bone fracture management remains unclear. SUBJECTS: From among 721 patients with a lower limb fracture on admission to our department who underwent surgical treatment for a lower limb fracture with an Ilizarov external fixator, 38 patients over 60-year-old were investigated...
August 2016: Journal of Orthopaedic Trauma
Alexander V Gubin, Dmitry Y Borzunov, Larisa O Marchenkova, Tatiana A Malkova, Irina L Smirnova
Methodological solutions of Prof. G.A. Ilizarov are the core stone of the contemporary bone lengthening and reconstruction surgery. They have been acknowledged in the orthopaedic world as one of the greatest contributions to treating bone pathologies. The Ilizarov method of transosseous compression-distraction osteosynthesis has been widely used for managing bone non-union and defects, bone infection, congenital and posttraumatic limb length discrepancies, hand and foot disorders. The optimal conditions for implementing distraction and compression osteogenesis were proven by numerous experimental studies that Prof...
July 18, 2016: Strategies in Trauma and Limb Reconstruction
Raju Vaishya, Amit Kumar Agarwal, Nishint Gupta, Vipul Vijay
OBJECTIVE: Non-union after intramedullary nail fixation of femur shaft fractures is although infrequent but a challenging condition to treat. The treatment options available to deal with such a situation include exchange nailing, removal of nail and re-osteosynthesis with plating, or Ilizarov fixation. We believe that rotational instability, in the presence of a nail, is one of the main reasons for most of the non-union. We present our experience of plate augmentation leaving the nail in situ for non-union of femoral shaft fracture...
December 2016: Journal of Orthopaedics
Xin He, Hui-Lin Zhang, Yong-Cheng Hu
Under the effective chemotherapy protocol, physeal distraction could be used as an effective limb salvage in the growing children with lower-limb malignant metaphyseal bone tumours and could actively prevent leg length discrepancy or malalignment that profoundly affects function. In this paper, we report a 7-year-old boy with right distal tibial osteosarcoma but not yet invaded the epiphysis, which underwent surgical treatment after effective chemotherapy. The surgical procedure included two phases: epiphysiolysis (physeal distraction) and en-bloc resection of tumor and distraction osteogenesis...
May 2016: Orthopaedic Surgery
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