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External fixation

Eugene T H Ek, Sophia K Paul, Robert N Hotchkiss
BACKGROUND: The role of elbow contracture release in the very young is unclear, with existing studies reporting conflicting results. This study evaluated the long-term results after open elbow contracture release in patients aged younger than 18 years. METHODS: Between 1994 and 2012, 32 patients underwent open elbow contracture release at a mean age of 13.8 years (range, 5-18 years), and their outcomes were reviewed. The primary cause was traumatic in 30 patients (4 radial head/neck fractures, 5 intra-articular distal humeral fractures, 11 extra-articular distal humeral fractures, 10 complex fracture-dislocations), and the mean time from the index injury to contracture release was 16...
October 14, 2016: Journal of Shoulder and Elbow Surgery
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
Chul Hyun Park, Oog Jin Shon, Gi Beom Kim
BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Rohan A Ramasubbu, Benjamin M Ramasubbu
BACKGROUND: Management of open tibial fractures is well documented in adults, with existing protocols outlining detailed treatment strategies. No clear guidelines exist for children. Surgical stabilization of tibial fractures in the pediatric population requires implants that do not disrupt the open epiphyses (growth plate). Both elastic stable intramedullary nails and external fixation can be used. The objective of this study was to identify the optimal method of surgical stabilization in the treatment of open tibial fractures in children...
September 2016: Indian Journal of Orthopaedics
Martin Sack, Stefanie Zehl, Alexander Otti, Claas Lahmann, Peter Henningsen, Johannes Kruse, Markus Stingl
BACKGROUND: Currently, there is controversy on the possible benefits of dual-attention tasks during eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD). METHODS: A total of 139 consecutive patients (including 85 females) suffering from PTSD were allocated randomly among 3 different treatment conditions: exposure with eyes moving while fixating on the therapist's moving hand (EM), exposure with eyes fixating on the therapist's nonmoving hand (EF), and exposure without explicit visual focus of attention as control condition (EC)...
October 15, 2016: Psychotherapy and Psychosomatics
Alexios Dimitrios Iliadis, Parag Kumar Jaiswal, Jay Meswania, Gordon Blunn, David Goodier, Peter Calder
A mechanical study investigating the use of two different methods (grub and bolt screws) to secure external fixation half pins to circular frames. A four part experiment: (1) Grub and bolt screws were used to secure half pins in Taylor Spatial frames. Loosening torques were measured using a calibrated torque wrench. (2) Using universal testing machine (UTM), axial loading was applied to establish thresholds for loosening in grub and bolt screw constructs. (3) We established the application torque to produce failure at the head-driver interface using these two methods...
October 13, 2016: Strategies in Trauma and Limb Reconstruction
Augusta Whitney Kluk, Tina Zhang, Joseph P Russell, Hyunchul Kim, Adam H Hsieh, Robert V O'Toole
Orthopedic dogma states that external fixator stiffness is improved by placing 1 pin close to the fracture and 1 as distant as possible ("near-far"). This fixator construct is thought to be less expensive than placing pins a shorter distance apart and using "pin-bar" clamps that attach pins to outriggers. The authors therefore hypothesized that the near-far construct is stiffer and less expensive. They compared mechanical stiffness and costs of near-far and pin-bar constructs commonly used for temporary external fixation of femoral shaft fractures...
October 13, 2016: Orthopedics
Ratika Parkash, Bernard Thibault, Iqwal Mangat, Benoit Coutu, Matthew Bennett, Jeffrey Healey, Atul Verma, Francois Philippon, Roopinder Sandhu, Douglas Cameron, Felix Ayala-Paredes, Laurence Sterns, Vidal Essebag, Teresa Kus, Pablo Nery, Elizabeth Stephenson, Raymond Yee, Derek Exner, Satish Toal, David Birnie, George Wells, Andrew Krahn
BACKGROUND: The Riata lead under advisory has posed a unique clinical scenario where inside-out abrasion results in externalization of conductor cables, with a higher risk of electrical failure. We developed a comprehensive registry to assist with clinical management of this lead. METHODS AND RESULTS: This Canadian registry reports the findings of 3763 (74.2% of all Riata leads in Canada) Riata leads under advisory, with a mean follow-up time of 8.9±1.5 years. The overall electrical failure rate was 5...
October 2016: Circulation. Arrhythmia and Electrophysiology
Benhua Xu, Xiaoliang Tang, Ji'an Zhou, Wanmin Chen, Haile Liu, Zhenghua Ju, Weisheng Liu
A functional amide-type pincer ligand was designed and synthesized, which could effectively capture Tb(3+) ions to form a phosphorescence complex-based chemosensor Tb-1. The chemosensor could further coordinate with Pb(2+) ions and display a turn-on phosphorescence response. This sensing process was analyzed in detail by steady-state luminescence spectroscopy, time-resolved luminescence spectroscopy, electron microscopy and dynamic light scattering, which suggest that the formation of Pb(2+)-induced hydroxide nanoclusters can adjust the optical signal of the external luminescence compound by embedment and fixation of Tb(3+) complexes...
September 16, 2016: Dalton Transactions: An International Journal of Inorganic Chemistry
Pokket Sirisreetreerux, Kathy M Lue, Thammasin Ingviya, Daniel A Friedlander, Heather N Di Carlo, Paul D Sponseller, John P Gearhart
PURPOSE: A successful primary bladder exstrophy closure provides the best opportunity for patients to achieve a functional closure and urinary continence regardless of the method of repair. Use of osteotomy during initial closure has significantly improved success rates, however failures can still occur. This study aimed to identify factors that contribute to a failed primary exstrophy closure with osteotomy. MATERIALS AND METHODS: A prospectively-maintained institutional database was reviewed for classic bladder exstrophy patients who were primarily closed with osteotomy at our institution or referred after primary closure from 1990 to 2015...
October 5, 2016: Journal of Urology
C Holwein, S Hinterwimmer, H O Mayr, L Lämmle, P U Brucker, E O Münch, A B Imhoff
BACKGROUND: This study evaluates sports ability, rotational laxity and potential growth changes in children after transphyseal ACL reconstruction with metaphyseal fixation technique, considering physis biology by placing drill holes vertically in the femoral anatomic origin in order to reduce volumetric injury to the physis. METHODS: In this retrospective trial of 42 patients data were collected. Thirty-seven were reviewed measuring rotational laxity and anteroposterior tibial translation using the Laxitester (ORTEMA Sport Protection, Markgroeningen, Germany) and the KT1000...
October 4, 2016: Knee
Sei Yano, Yasuchika Aoki, Atsuya Watanabe, Takayuki Nakajima, Makoto Takazawa, Hiroyuki Hirasawa, Kazuhisa Takahashi, Koichi Nakagawa, Arata Nakajima, Hiroshi Takahashi, Sumihisa Orita, Yawara Eguchi, Takane Suzuki, Seiji Ohtori
Pelvic ring fractures are defined as life-threatening injuries that can be treated surgically with external or internal fixation. The authors report on an 81-year-old woman with an unstable pelvic fracture accompanying multiple traumas that was successfully treated with a less invasive procedure. The patient was injured in a traffic accident and sustained a total of 20 fractures, including pelvic ring, bilateral rib, and lumbar transverse processes fractures, and multiple fractures of both upper and lower extremities...
October 7, 2016: Journal of Neurosurgery. Spine
Simone Donati, Simona Maria Caprani, Francesco Semeraro, Riccardo Vinciguerra, Gianni Virgili, Francesco Testa, Francesca Simonelli, Claudio Azzolini
PURPOSE: To analyze functional and morphological findings after surgery for idiopathic epiretinal macular membrane (IEMM). MATERIALS AND METHODS: Twenty eyes of 20 patients affected by IEMM underwent 23-Gauge surgery. Morphological and functional examinations were assessed at baseline and at 30, 90, and 180 days after surgery. SD-OCT evaluated foveal morphology and thickness, photoreceptor inner/outer segment junction, and external limiting membrane. Functional assessment evaluated visual acuity, retinal sensitivity, and fixation patterns...
August 10, 2016: Seminars in Ophthalmology
Amanda T Whitaker, Carley Vuillermin
The pediatric lower extremity has well known growth patterns. When deformities or growth disturbances occur, there are several methods to measure and predict the resulting discrepancy, including the Green-Anderson, Moseley, and Multiplier methods. Many techniques exist to correct leg length discrepancy and deformity such and temporary epiphysiodesis, permanent epiphysiodesis, external fixators, and internal lengthening devices. All of these methods have numerous complications and limitations; however, with careful planning and patient selection, length and alignment can be improved with high patient satisfaction...
October 5, 2016: Current Reviews in Musculoskeletal Medicine
Lisa K Schroder, Erich M Gauger, Jeffrey A Gilbertson, Peter A Cole
BACKGROUND: This study's purpose was to assess patient-based functional outcomes following open reduction and internal fixation (ORIF) of displaced scapular body and glenoid neck fractures. This series represents a 9-year experience at a level-I trauma center and referral destination for this injury. METHODS: A database was established to record surgical and functional outcomes of scapular fractures treated with ORIF. For this report, the cases of all patients who had a glenoid neck or scapular body fracture (AO/OTA 14-A3 or 14-C1) without intra-articular involvement were reviewed...
October 5, 2016: Journal of Bone and Joint Surgery. American Volume
James Richman, Adam Cota, Steven Weinfeld
BACKGROUND: Surgical strategies to address deformities of the ankle and hindfoot in patients with Charcot arthropathy include the use of retrograde intramedullary nails and ring fixators. The literature has not shown superiority of one technique over the other. This study presents a single surgeon's case series of Charcot arthropathy patients treated with either a ring fixator or retrograde intramedullary nail to achieve tibiotalocalcaneal arthrodesis. METHODS: We performed a retrospective analysis of 27 consecutive patients with Charcot arthropathy who underwent a tibiotalocalcaneal arthrodesis using either a retrograde intramedullary (IM) nail (n = 16 patients) or a ring fixator (RF) (n = 11 patients) by a single surgeon...
October 2, 2016: Foot & Ankle International
Peter A Turner, John M Baker, Timothy J Griffis, Rodney T Venterea
Nitrous oxide (NO), produced primarily in agricultural soils, is a potent greenhouse gas and is the dominant ozone-depleting substance. Efforts to reduce NO emissions are underway, but mitigation results have been inconsistent. The leguminous perennial kura clover ( M. Bieb.) (KC) can grow side-by-side with cash crops in rotational corn ( L.)-soybean ( L.) systems. With biological nitrogen fixation, KC provides land managers an opportunity to reduce external fertilizer inputs, which may diminish problematic NO emissions...
September 2016: Journal of Environmental Quality
M Laubscher, C Mitchell, A Timms, D Goodier, P Calder
AIMS: Patients undergoing femoral lengthening by external fixation tolerate treatment less well when compared to tibial lengthening. Lengthening of the femur with an intramedullary device may have advantages. PATIENTS AND METHODS: We reviewed all cases of simple femoral lengthening performed at our unit from 2009 to 2014. Cases of nonunions, concurrent deformities, congenital limb deficiencies and lengthening with an unstable hip were excluded, leaving 33 cases (in 22 patients; 11 patients had bilateral procedures) for review...
October 2016: Bone & Joint Journal
Luca Dalla Paola, Anna Carone, Giulio Boscarino, Giuseppe Scavone, Lucian Vasilache
Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator...
September 29, 2016: International Journal of Lower Extremity Wounds
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
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