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Hong-Fei Shi, Jin Xiong, Yi-Xin Chen, Jun-Fei Wang, Xu-Sheng Qiu, Jie Huang, Xue-Yang Gui, Si-Yuan Wen, Yin-He Wang
BACKGROUND: The optimal method for the reduction and fixation of posterior malleolar fracture (PMF) remains inconclusive. Currently, both of the indirect and direct reduction techniques are widely used. We aimed to compare the reduction quality and clinical outcome of posterior malleolar fracture managed with the direct reduction technique through posterolateral approach or the indirect reduction technique using ligamentotaxis. METHODS: Patients with a PMF involving over 25% of the articular surface were recruited and assigned to the direct reduction (DR) group or the indirect reduction (IR) group...
March 14, 2017: BMC Musculoskeletal Disorders
Anto Jose, Shishir Murugharaj Suranigi, Pascal Noel Deniese, Abey Thomas Babu, Kanagasabai Rengasamy, Syed Najimudeen
INTRODUCTION: Fracture of the distal end of radius represents the most common fracture of the upper extremity accounting for 16-20% of all fractures. Plating is now emerging as the gold standard for management of distal radius fractures due to increased rate of complications such as malunion, subluxation/dislocation of distal radio-ulnar joint or late collapse of fracture. Procedures such as closed reduction and cast immobilization, ligamentotaxis with external fixator and percutaneous pin fixation are no longer acceptable...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
Michael Kreinest, Dorothee Schmahl, Paul A Grützner, Stefan Matschke
BACKGROUND: Around 5% of all trauma patients suffer from spinal trauma. Spinal fractures are mainly located in the thoracic and lumbar spine. For multisegmental vertebral fractures categorized as instable, combined dorsal instrumentation and ventral stabilization is recommended. Numerous vertebral body replacement systems are available for ventral stabilization. OBJECTIVES: The aim of the current study was to analyze radiological results following the implantation of a hydraulic expandable vertebral body replacement and the evaluation of patients' outcome three years after implantation...
March 3, 2017: Der Unfallchirurg
Mark Henry
The more common dorsal fracture subluxations at the base of the middle phalanx have an intact dorsal buttress of articular surface in continuity with the shaft. Capitalizing on this foundation, various fixation methods have met with relatively equivalent success including Kirschner wires, screws only, nonlocking plate and screws, and external fixation. Pilon fractures are complete articular fractures, where the comminuted articular fragments lack any structural connection to the more distal shaft of the middle phalanx, and have largely relied upon external fixation traction systems...
March 2017: Techniques in Hand & Upper Extremity Surgery
N Tartaglia, G Vicenti, M Carrozzo, A Abate, F Rifino, G Picca, G Solarino, B Moretti
INTRODUCTION: The treatment for humeral diaphyseal fractures is still controversial. The purpose of this study was to evaluate the clinical and radiographic outcomes of treating humeral distal third diaphyseal fractures by using external fixation technique. MATERIALS AND METHODS: We retrospectively review 65 cases of diaphyseal humeral fractures (31 type A, 23 type B and 11 type C of the AO/OTA classification) treated with external fixation (Orthofix FAD small) between 2008 and 2013...
December 2016: Musculoskeletal Surgery
M Rongières
The use of external fixation or internal plating to bridge communitive fractures of the distal radius is discussed based on a review of prospective and meta-analysis studies. Distraction by an external fixator is not advised (ligamentotaxis) because of the high incidence of complex regional pain syndrome and the destabilization of bone and ligaments surrounding the intra-articular fracture site. The external fixator must be used as a neutralization device and supplemented with K-wire or volar plate fixation...
December 2016: Hand Surgery and Rehabilitation
Vito N Galante, Giovanni Vicenti, Gianfranco Corina, Claudio Mori, Antonella Abate, Girolamo Picca, Vito Conserva, Domenico Speciale, Lorenzo Scialpi, Nicola Tartaglia, Vincenzo Caiaffa, Biagio Moretti
OBJECTIVES: To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. DESIGN: Retrospective, multicentre study. PATIENTS/PARTICIPANTS: Adult patients with tibial pilon fractures treated with hybrid external fixation. INTERVENTION: Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. MAIN OUTCOME MEASUREMENTS: Fracture union, complications, functional outcome (Mazur Ankle Score)...
October 2016: Injury
Jonathan P Ng, Derek T Cawley, Suzanne M Beecher, Joseph F Baker, John P McCabe
BACKGROUND: Standard positioning for percutaneous balloon kyphoplasty requires placing a patient prone with supports under the iliac crests and upper thorax. The authors believe that hip hyperextension maximises pelvic anteversion creating anterior longitudinal ligamentotaxis, thus facilitating restoration of vertebral height. METHODS: Radiographic imaging including pre-operative, post-positioning, post balloon tamp inflation and post-operative lateral radiographs were analysed for anterior and posterior column height, wedge angle of the affected vertebra and 3-level Cobb angle in patients with recent fractures of T11-L1...
2016: International Journal of Spine Surgery
Xiao-Bin Wang, Guo-Hua Lü, Jing Li, Bing Wang, Chang Lu, Kevin Phan
STUDY DESIGN: A retrospective clinical study. OBJECTIVE: To determine the imaging features that can be used to predict failure of reduction of a retropulsed fracture fragment by posterior ligamentotaxis in thoracolumbar burst fractures. SUMMARY OF BACKGROUND DATA: Posterior instrumentation and distraction with ligamentotaxis has been successfully used to shift retropulsed fragments anteriorly in thoracolumbar burst fractures. However, posterior longitudinal ligament rupture can lead to treatment failure...
June 3, 2016: Clinical Spine Surgery
Hiroyuki Aono, Hidekazu Tobimatsu, Kenta Ariga, Masayuki Kuroda, Yukitaka Nagamoto, Shota Takenaka, Masayuki Furuya, Motoki Iwasaki
BACKGROUND: Short-segment posterior spinal instrumentation for thoracolumbar burst fracture provides superior correction of kyphosis by an indirect reduction technique, but it has a high failure rate. We investigated the clinical and radiological results of temporary short-segment pedicle screw fixation without augmentation performed for thoracolumbar burst fractures with the goal of avoiding treatment failure by waiting to see if anterior reconstruction was necessary. METHODS: We studied 27 consecutive patients with thoracolumbar burst fracture who underwent short-segment posterior instrumentation using ligamentotaxis with Schanz screws and without augmentation...
June 2016: Injury
Ashish-Kumar Gupta, Rahul Sapra, Rakesh Kumar, Som-Prakash Gupta, Devwart Kaushik, Sahil Gaba, Mahesh Chand Bansal, Ratan Lal Dayma
PURPOSE: The treatment of high-energy tibial condylar fractures which are associated with severe soft tissue injuries remains contentious and challenging. In this study, we assessed the results of Joshi's external stabilization system (JESS) by using the principle of ligamentotaxis and percutaneous screw fixation for managing high-energy tibial condylar fractures associated with severe soft tissue injuries. METHODS: Between June 2008 and June 2010, 25 consecutive patients who were 17e71 years (mean, 39...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Vamshi Krishna Chilakamary, Maheshwar Lakkireddy, Kiran Kumar Koppolu, Shivaprasad Rapur
BACKGROUND: Distal radius fractures are the commonest fractures occurring in the upper extremity, accounting for 15-20% of patients treated in emergency department. Although distal radial fractures were described 200 years ago, they still remain as unsolved fractures with no clear guidelines. It is often reported that anatomical reduction has a bearing on the functional outcome. AIM: To study the management of distal end radius fracture by utilizing the principle of ligamentotaxis where in the reduction obtained by closed means is maintained by external fixator till solid bony union occurs...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
P Pélissier, F Gobel, H Choughri, J-M Alet
Ligamentotaxis is now a well-established treatment method for proximal interphalangeal (PIP) joint fractures. Despite satisfactory results, the technique is considered complex and the devices cumbersome. The aim of this study was to evaluate a miniaturized dynamic external fixator (Ligamentotaxor(®)) for the management of these fractures. Eighty-six patients with 88 fractures of the PIP joint were treated at 10 European hand surgery centers. The device was applied within eight days of the injury and was removed 40-45 days after the injury...
October 2015: Chirurgie de la Main
R J MacFarlane, S Gillespie, F Cashin, A Mahmood, G Cheung, D J Brown
Complex fracture subluxations of the proximal interphalangeal joint are often difficult to treat and their outcome variable. A number of methods for treatment of these injuries have been described. We have used a ligamentotaxis device (Ligamentotaxor, Arex, Palaiseau Cedex, France) since 2008. We performed 28 operations in 28 patients with complex proximal interphalangeal joint injuries over a 3-year period. Patients followed a standardized postoperative rehabilitation regime, including fixator adjustment as necessary...
October 2015: Journal of Hand Surgery, European Volume
Olga D Savvidou, Michael Beltsios, Vasileios I Sakellariou, Panayiotis J Papagelopoulos
UNLABELLED: Background The purpose of this study was to review clinical and radiographic outcomes of perilunate dislocations (PLDs) and fracture-dislocations (PLFDs) treated with external fixation and Kirschner wires (K-wires). Materials and Methods Twenty patients (18 males and 2 females) with a mean age of 38 years (range 18-59) with an acute PLD or PLFD were treated with external fixator and K-wires. There were 12 PLDs and seven transscaphoid and one transstyloid PLFDs. The median time from trauma to operation was 8 hours (range 2-12 hours)...
May 2015: Journal of Wrist Surgery
Michael Neil Woodall, Basheer Shakir, Adam Smitherman, Haroon Choudhri
PURPOSE: The lateral transpsoas interbody fusion (LTIF) is an increasingly popular minimally invasive technique for lumbar interbody fusion. Although a posterior approach to the lumbar spine has traditionally been favored for the treatment of canal stenosis and neural foraminal stenosis, a growing body of evidence suggests that indirect decompression of the spinal canal and neural foramen can be achieved using a lateral transpsoas approach to the lumbar spine. We present 2 cases that may suggest a role for spontaneous electromyography (s-EMG) monitoring in assessing the adequacy of decompression during LTIF...
2013: International Journal of Spine Surgery
F Lavini, C Dall'Oca, S Mezzari, T Maluta, E Luminari, F Perusi, E Vecchini, B Magnan
Fractures that involve the distal area of the tibia are associated with a high percentage of complications. Soft tissue oedema, swelling, blisters, skin abrasions and open wounds could compromise the outcome of these lesions. The waiting time before surgery with ORIF is mostly due to soft tissue conditions. Early application of a simple joint-spanning external fixator would achieve the initial goal of stability and the respect of soft tissue, thereby decreasing the time necessary for definitive treatment. A total of 40 consecutive patients (22 male and 18 female) with a mean age of 52 years (range 17-82 years) with distal tibial fracture treated between January 2010 and January 2013 were evaluated...
December 2014: Injury
Xiao-Bin Wang, Guo-Hua Lü, Jing Li, Bing Wang, Chang Lu, Kevin Phan
STUDY DESIGN: A retrospective clinical study. OBJECTIVE: To determine the imaging features that can be used to predict failure of reduction of a retropulsed fracture fragment by posterior ligamentotaxis in thoracolumbar burst fractures. SUMMARY OF BACKGROUND DATA: Posterior instrumentation and distraction with ligamentotaxis has been successfully used to shift retropulsed fragments anteriorly in thoracolumbar burst fractures. However, posterior longitudinal ligament rupture can lead to treatment failure...
October 28, 2014: Journal of Spinal Disorders & Techniques
Olga D Savvidou, Michael Beltsios, Vasileios I Sakellariou, Andreas F Mavrogenis, Michael Christodoulou, Panayiotis J Papagelopoulos
The purpose of this study was to review clinical and radiographic outcomes of perilunate dislocations and fracture dislocations treated with external fixation and K-wire fixation. Twenty patients (18 males and two females) with a mean age of 38 years (range 18-59) who had an acute dorsal perilunate dislocation or fracture dislocation were treated with the use of wrist external fixator and K-wires. The injuries included 12 perilunate dislocations, seven trans-scaphoid perilunate fracture dislocations, and one trans-styloid perilunate fracture dislocation...
November 2014: Strategies in Trauma and Limb Reconstruction
Frédéric Lebailly, Ahmed Zemirline, Sybille Facca, Stéphanie Gouzou, Philippe Liverneaux
The volar Henry approach is becoming the gold standard for distal radius fracture fixation. It decreases the incidence of nonunion, limits complications especially complex regional pain syndrome (CRPS) type I, and allows early mobilization of the wrist. Nonetheless, it has some disadvantages such as the size of the incision, which is not esthetically pleasing, and the loss of ligamentotaxis. This is why some authors have developed a mini-invasive approach. The aim of this work was to evaluate the feasibility of the anterior mini-invasive approach of 15 mm in a clinical series of 144 cases of distal radius fracture...
August 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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