MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Strategies in Trauma and Limb Reconstruction' source. Thu, 09 Feb 2012 00:02:42 +0100 http://www.medworm.com/index.php?rid=5639821&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2410875m6266567p%2F We report a case of a 30-year old male, who presented with a right distal radius intra-articular fracture complicated by compartment syndrome. He was treated with fasciotomies and fracture fixation with a 3.5 mm LCP (Synthes™), followed 7 days later by skin graft. Repeat radiographs 8 weeks later showed a break across the plate at the level of an unfilled screw hole over the fracture. He underwent exchange plating with a 2.4 mm LCP Distal Radius Plate (Synthes™). This revision was complicated by an infected wound dehiscence 2 weeks later requiring multiple procedures. Radiographs at 20 weeks showed broken distal screws. A second revision was performed. At 12 months, the fracture had healed clinically and radiologically, but the three distal screws... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5639821 Wed, 25 Jan 2012 18:11:46 +0100 5639821 http://www.medworm.com/index.php?rid=5573394&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp2w3m2180786n118%2F We describe a case of an 8-year-old girl with an unilateral congenital radial head dislocation with a progressive cubitus valgus of 35°, caused by a prematurely closing physis of the lateral humeral condyle. This might be caused by an increased pressure on the lateral physis by the anteriorly dislocated radial head. As no complaints or limitations were present, treatment was non-operative with clinical observation, with satisfactory results after a follow-up of 18 months. A concomitant progressive cubitus valgus can be present in patients with a congenital radial head dislocation. Non-operative treatment can provide satisfactory results. Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.1007/s11751-011-0126-zAuthors Laurens Kaas, Department of Orthopaedic Su... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5573394 Thu, 05 Jan 2012 17:06:16 +0100 5573394 http://www.medworm.com/index.php?rid=5450803&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4567v8122823757m%2F Abstract  Forearm nonunions are uncommon but severely disabling and challenging to treat. Multiple factors have been associated with the establishment of forearm nonunions such as fracture location and complexity, patient characteristics and surgical technique. Treatment of diaphyseal forearm nonunions differs from that of other type of diaphyseal nonunions because of the intimate relationship between the radius and ulna and their reciprocal movement. There is a wide variation of surgical techniques, and the optimal choice of management remains subject to debate. In this review, we aim to summarize the available evidence in the literature on forearm nonunions and combine it with practical recommendations based on our clinical experience to help guide the management of this ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5450803 Wed, 23 Nov 2011 17:42:17 +0100 5450803 http://www.medworm.com/index.php?rid=5433460&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F066q353155101725%2F We present an 11-year-old girl, who underwent two-stage limb lengthening with a circular fixator, for a previously treated pseudoarthrosis of the tibia. During the lengthening plan, a concave defect was noted on one side of the regenerate, which was found to be due to extrinsic compression by a pseudoaneurysm. Normal regenerate formation was seen after selective embolisation of the pseudoaneurysm. This concave appearance on one side of the regenerate has previously been described secondary to a difference in stability on the two sides of the osteotomy, when a monolateral fixator is used, but not due to extrinsic compression by a pseudoaneurysm. The authors propose that this radiographic appearance of “asymmetrical scalloping” on one side of the regenerate may represent a radiolog... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5433460 Fri, 18 Nov 2011 06:57:51 +0100 5433460 http://www.medworm.com/index.php?rid=5411391&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp04l02435433u437%2F Abstract  The present retrospective study aims to evaluate the outcome in 41 patients of femoral shaft fractures, who had closed intramedullary nailing in lateral decubitus position without fracture table or image intensifier. Mean age was 33.2 (range, 18–70) years. The cannulated reamer in proximal fragment (as intramedullary joystick) and Schanz screw in the distal fragment (as percutaneous joystick) were simultaneously used to assist closed reduction of the fracture without the use of image intensifier. Closed reduction was successful in 38 patients. Open reduction was required in 3 patients. Schanz screw was used for closed reduction in 12 patients. Average number of intra-operative radiographic exposures was 4.4. Two patients had exchange nailing using large diameter... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5411391 Sat, 12 Nov 2011 16:53:38 +0100 5411391 http://www.medworm.com/index.php?rid=5411392&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc841gg3624125383%2F This study demonstrates that in selected patients the TSF provides a viable treatment option for performing HTO in medial compartment OA with varus deformity. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11751-011-0123-2Authors P. M. Robinson, Limb Reconstruction Unit, Department of Orthopaedics, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, Greater Manchester M6 8HD, UKM. C. Papanna, Limb Reconstruction Unit, Department of Orthopaedics, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, Greater Manchester M6 8HD, UKB. V. Somanchi, Limb Reconstruction Unit, Department of Orthopaedics, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford, Greater Manchester M6 8HD, UKS. A. Khan, Limb Reconstruction Unit, De... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5411392 Wed, 09 Nov 2011 17:55:03 +0100 5411392 http://www.medworm.com/index.php?rid=5390807&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7u3p366040774163%2F This study proposes a comparison between two percutaneous techniques of subcutaneous Achilles tendon rupture by evaluating the risk of lesion developing, the morbidity of the surgical technique adopted and the effectiveness of each technique. Sixty patients were operated at Padua Orthopaedic Clinic by using the two different procedures: (1) Ma and Griffith in 30 cases and (2) Tenolig in 30 cases. Risk of rupture developing has been evaluated in relation to sex, age, side, kind of trauma, work and presence of preoperative risk factors. The Morbidity of surgical technique has been evaluated in with respect to surgical time, hospital permanence, immobilization, active nonweight-bearing mobilization, assisted weight bearing until the full one, number of early and late complications befor... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5390807 Mon, 07 Nov 2011 17:12:29 +0100 5390807 http://www.medworm.com/index.php?rid=5212445&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd06lun031291m87v%2F Abstract  To report a proximal femoral osteotomy with retention of bone ledges in a reciprocal position to increase bone contact and stability. The method was applied to 5 patients over a 3-year period. All patients had coxa vara. The average length gained was 1.5 cm, and the average neck shaft angle improvement was 30°. The Harris hip score improved from an average of 63 to 82. The reciprocal ledge osteotomy is technically less demanding and also allows conversion of normal shear forces around the upper femur to stabilizing forces. This method allows easier use of the DHS implant as potential rotation about the axis of the screw is negated by the ledges and the dynamic forces. Content Type Journal ArticleCategory Technical ReportPages 1-4DOI 10.1007/s11751-011-01... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5212445 Fri, 09 Sep 2011 05:49:32 +0100 5212445 http://www.medworm.com/index.php?rid=5164909&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fahu6685287438273%2F Abstract  Pyoderma gangrenosum is a rare autoinflammatory syndrome manifested by skin lesions eventually creating ulcers. Surgical management can lead to scarring and contracture at the site of the lesion due to the pathergy phenomenon. A 43-year-old woman presented with a 5-year history of severe equinovarus deformity due to chronic pyoderma gangrenosum on her posteromedial ankle. She underwent a staged fusion. A gradual “closed” correction was performed in a Taylor spatial frame for 8 weeks in order to obviate the need for a surgical release in the area of the ulcer. She was ambulatory and full weight-bearing within 4 weeks of her frame removal. She maintained her correction with an accommodative foot orthosis until she had an uneventful tibiotalar calcaneal ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5164909 Tue, 23 Aug 2011 15:53:27 +0100 5164909 http://www.medworm.com/index.php?rid=5164910&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9170h3mx63x5881p%2F Abstract  Necrotizing fasciitis is a rapidly progressive infection and is a necrosis of the fascia and surrounding tissues. Despite recent advances in its management, outcomes have not improved and mortality rate is still high. Between September 2007 and August 2009, we prospectively studied twenty-four histopathologically proven necrotizing fasciitis patients to assess the prognostic factors that indicate the outcome. Mortality rate was 20.8%. Twelve patients (50%) improved, while seven patients (29.2%) were complicated by limb loss. Mortality rates related to upper and lower limb involvement were similar (20% vs. 22.2%). The rates of gangrene and amputation in patients with diabetes mellitus were significantly higher than other comorbidities. Patients with gram-positive i... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5164910 Tue, 23 Aug 2011 15:53:25 +0100 5164910 http://www.medworm.com/index.php?rid=5099402&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F85873m0813k11740%2F In conclusion, the Ilizarov method allows simultaneous progressive correction of all components of severe foot deformities associated with limb-lengthening discrepancy with minimal surgery, reducing risks of cutaneous or neurovascular complications and avoiding important shortening of the foot. Content Type Journal ArticlePages 1-14DOI 10.1007/s11751-011-0111-6Authors Alexander Kirienko, Università degli Studi di Milano, Milan, ItalyAndrea Peccati, Università degli Studi di Milano, Milan, ItalyIbrahim Abdellatif, Istituto Clinico Humanitas, Rozzano, ItalyYasser Elbatrawy, Alzahraa University Hospital, Cairo, EgyptZayed Mahmoud A. Mostaf, Alzahraa University Hospital, Cairo, EgyptValentina Necci, Università degli Studi di Roma “La Sapienza”, Rome, Italy Journal Strat... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5099402 Tue, 02 Aug 2011 06:18:31 +0100 5099402 http://www.medworm.com/index.php?rid=5072431&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff4837708jp7p654n%2F Abstract  Despite modern reconstruction techniques and replantation, the preservation of a severely traumatised limb, or even a limb affected by a congenital malformation, usually gives poorer functional results compared with amputation and prosthetisation. The aim of this study was to describe a hind foot (including the calcaneum and fat pad) sensate flap with a surface that allows full terminal weight bearing in transtibial amputations in adults. Between June 2007 and September 2008, eight patients underwent leg amputations with a sensate composite calcaneal flap reconstruction of the stump. Patients consisted of four men and four women with a mean age of 46.5 (26–66) years. All amputations were unilateral. The mean follow-up was 28.3 (25–42) months. There were no com... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5072431 Mon, 25 Jul 2011 15:47:33 +0100 5072431 http://www.medworm.com/index.php?rid=5058624&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe6802066228267l1%2F Abstract  The aim of our study was to review the literature looking for the up to date information regarding these controversial topics. An electronic literature search was performed using the Medline/PubMed database. A closed reduction attempt should always be done first. It is more important to engage both columns as well as divergence of the pins no matter whatever configuration is applied. Time to surgery seems to be not an important factor to increase the risk of complications as well as open reduction rate. Usually neurological injuries present a spontaneous recovery. If there is absent pulse, we should follow the algorithm associated with the perfusion of the hand. Content Type Journal ArticlePages 1-8DOI 10.1007/s11751-011-0114-3Authors Juan Pretell-Mazzini, O... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058624 Fri, 22 Jul 2011 16:57:41 +0100 5058624 http://www.medworm.com/index.php?rid=5058626&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5443605386743j88%2F We reported 5 adolescent patients, 2 men and 3 women, treated from 2000 to 2009, associated with average pelvic imbalance of 3.2 cm (2.5–4.5 cm) without other associated congenital anomalies. Patients classified as Vergara (Acta Ortop Mex 19:6–12, 2005) type IB unilateral partial agenesis of the sacrum, asymmetry of the pelvic ring there’s a torac-pelvic cifoscoliotic deformity. Mean age was 12.2 years-old (range from 8.2 to 13.7). The mean follow-up was 7.2 years (from 2 to 8). The consolidation process of the osteotomy site was in an average of 6.4 (5–8.7 weeks) (P = 0.036). None of the patients presented family medical history of diabetes on their mothers. None residual femoral nerve palsy. The procedure offers postural correction at the l... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058626 Fri, 22 Jul 2011 16:57:40 +0100 5058626 http://www.medworm.com/index.php?rid=5058625&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd44151465n531pn1%2F Abstract  Fixed knee flexion deformity can present as an insidious and significant problem in diverse etiologies, most commonly in cerebral palsy. Traditional surgical intervention has included posterior capsulotomy and supracondylar femoral osteotomy, both of which carry significant associated morbidity and risks. In the skeletally immature patient, guided growth may be used to correct or substantially diminish the deformity. We are presenting our early experience encompassing four subjects who completed instrumented gait analysis both prior to and after distal femoral anterior guided growth (hemiepiphysiodesis). Changes in gait and function resulting from surgery in each individual are reported. Outcomes indicate improved knee range of motion and alleviation of crouch at ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058625 Fri, 22 Jul 2011 16:57:40 +0100 5058625 http://www.medworm.com/index.php?rid=5058627&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffw70654407504512%2F Abstract  The surgical management of ipsilateral fractures of the femoral neck and shaft presents a difficult and challenging problem for the orthopaedic surgeon. The purpose of the present study was to report the mid-term results and complications in a series of patients who sustained ipsilateral femoral neck and shaft fractures and treated in our trauma department with a single reconstruction nail for both fractures. Eleven patients were included in the study with an average age of 46.4 years. The mean follow-up was 47 months (range, 15–75 months). There were no cases of a missed diagnosis at initial presentation. The mean time to union was 4.5 months for the neck fracture and 8.2 months for the shaft. There were no cases of avascular necrosis o... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058627 Thu, 21 Jul 2011 18:06:40 +0100 5058627 http://www.medworm.com/index.php?rid=5058628&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhw74p142rt465380%2F We present a case of a 56-year-old man with a GCT of the distal ulna treated successfully with an en-bloc resection of the distal ulna with reconstruction using radioulnar joint prosthesis. Although the experience with this type of treatment is limited, implantation of a metallic prosthesis to replace the distal part of the ulna can also be considered as a salvage procedure for the treatment of this difficult pathology. Content Type Journal ArticlePages 1-4DOI 10.1007/s11751-011-0113-4Authors Isidre Gracia, Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, SpainIgnacio R. Proubasta, Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, SpainLaura Trullols, Orthopaedic Department, Hospital Santa Cruz Y San Pablo, Barcelona, SpainAna Peiró, Orthopae... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058628 Wed, 20 Jul 2011 12:27:45 +0100 5058628 http://www.medworm.com/index.php?rid=5058629&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg55k7531m1220025%2F We report the results of fifteen cases of Sprengel’s deformity treated surgically by initial subperiosteal resection of the middle third of the clavicle in conjunction with surgical release of all attachments of the scapula to the spine, excision of any omovertebral bone and resection of prominent supraspinous process of scapula. The patients included ten female and three male patients (age range at the time of operation, 3.3–10 years; mean: 6.11 years). The deformity involved the left shoulder in eight patients, the right shoulder in three and two were bilateral. All patients were followed for an average of 5.9 years (range 4–11 years). Preoperatively, the arc of total abduction (glenohumeral and scapulothoracic) ranged from 80 to 140°, and the average was... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058629 Tue, 19 Jul 2011 23:22:54 +0100 5058629 http://www.medworm.com/index.php?rid=5058630&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F030127u246013287%2F Abstract  We illustrate a rare complex dislocation of the elbow involving a posterior ulno-humeral dislocation associated with open diaphyseal fracture of the ulna, radial shaft fracture, Type 1 coronoid fracture and neuropraxia of the deep branch of the radial nerve. The isolated ulno-humeral dislocation without radio-capitellar involvement, and ulnar diaphyseal fracture, makes this “reverse Monteggia” type of injury pattern very unique. This patient was managed with an initial reduction of his ulno-humeral joint and stabilization of his radius and ulna fractures. He underwent a delayed medial collateral ligament reconstruction a few days later. His fractures went on to unite fully, his elbow joint remained stable, and he achieved good range of motion of his elbow. ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=5058630 Tue, 19 Jul 2011 23:22:53 +0100 5058630 http://www.medworm.com/index.php?rid=4834672&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa121410j2411g286%2F We present the 25 years follow-up of one patient with a literature review of alternative present day treatment options. The patient maintained community ambulant status despite developing late stage osteoarthritis. Although this procedure is performed rarely, it remains an alternative to the more sophisticated treatment options making it a useful method in centres with limited facilities and expertise. Content Type Journal ArticlePages 1-4DOI 10.1007/s11751-011-0108-1Authors Syed Kamran Ahmed, Division of Hand and Foot Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, University of Hong Kong, 102, Pok Fu Lam Road, Pokfulam, Hong KongBoris Kwok Keung Fung, Division of Hand and Foot Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hosp... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4834672 Mon, 16 May 2011 15:48:11 +0100 4834672 http://www.medworm.com/index.php?rid=4727991&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc118585pq642q806%2F We report one such case of osteosarcoma of the tibia treated initially with wide resection of the tumour and intercalary fibular strut grafting using plate and screws. The operation was complicated by a non-union at the proximal tibio-fibular autograft junction. This leads to a multiplanar deformity with severe procurvatum at the proximal tibio-fibular graft junction, which was successfully treated by callotasis using an Ilizarov fixator. Appropriate consent was obtained from the patient and parents to publish this case report. Content Type Journal ArticlePages 1-5DOI 10.1007/s11751-011-0106-3Authors Yasser Elbatrawy, Elzahra’a University Hospital, Azhar University, Cairo, 11884 EgyptGiby C. Philips, Welcare Hospital, Cochin, 682019 Kerala, India Journal Strategies in ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4727991 Tue, 12 Apr 2011 06:52:14 +0100 4727991 http://www.medworm.com/index.php?rid=4688652&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F482v3u7n7187j025%2F The objective of this article is to review the literature concerning the results of osteotomies for correcting fibular malunions and to formulate recommendations for clinical practice. Based on available literature, corrective osteotomies for fibular malunion have good or excellent results in more than 75% of the patients. Reconstructive fibular osteotomy has been recommended to avoid or postpone sequela of posttraumatic degeneration, an ankle arthrodesis or supramalleolar osteotomy. The development of degenerative changes is not fully predictable; therefore, it is advisable to reconstruct a fibular malunion soon after the diagnosis is made and in presence of a good ankle function. Recommendations were made for future research because of the low level of evidence of available literat... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4688652 Wed, 06 Apr 2011 06:43:00 +0100 4688652 http://www.medworm.com/index.php?rid=4537648&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy22mj7082975u227%2F Abstract  For evaluating pelvic support osteotomy as a salvage procedure in managing neglected hip problems in adolescents and young adults, PSO was performed for 20 hips in 20 patients (5 men and 15 women). The mean age was 21.5 years. The etiology was neglected developmental dysplasia of the hip in 9 patients, post-septic hip sequelae in 9 patients, and paralytic dislocation due to poliomyelitis in 2 patients. All patients were treated by two osteotomies: a proximal femoral osteotomy to support the pelvis and correct the flexion and rotational deformities of the hip and a distal varization and lengthening osteotomy. Final clinical evaluation was done 6 months after frame removal. The mean external fixation time was 6.4. Lengthening and mechanical axis parallelis... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4537648 Mon, 28 Feb 2011 16:48:58 +0100 4537648 http://www.medworm.com/index.php?rid=4467216&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb7821172u4817172%2F Abstract  High-energy tibial plateau fractures associated with severe soft tissue injury are difficult to manage. The risk of wound complications following open reduction and internal fixation is notably high owing to extensive soft tissue dissection. Alternatively, application of hybrid external fixator minimizes soft tissue dissection and provides adequate fracture stabilization to allow early range of motion and correction of any mal-alignment. With this technique, soft tissue complications particularly surgical site infections are expected to be significantly reduced. This prospective study aims to determine the effectiveness of a modified hybrid external fixator in the management of high-energy tibial plateau fractures. Thirty-three patients with high-energy Schatzker ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4467216 Thu, 10 Feb 2011 19:59:17 +0100 4467216 http://www.medworm.com/index.php?rid=4467217&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft37p6lv4h2122227%2F Abstract  The amount of weight bearing and the force transmission to the frame have an important influence on the results of treatment with an Ilizarov external fixator. The frame provides beneficial interfragmentary movements and compressive loads at the fracture site through elastic wires. Mobilisation can be achieved by applying a weight-bearing platform at the distal end of the fixator. The effect on the interfragmentary movements and the compressive loads in indirect and direct loading were analysed in this study using a composite tibia bone model. Displacement transducers were attached to measure the interfragmentary movements and to detect relative movements of the bone fragments and movements between the rings. The compressive loads in the osteotomy were measured wi... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4467217 Thu, 10 Feb 2011 19:59:16 +0100 4467217 http://www.medworm.com/index.php?rid=4402160&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5h042245g6362v04%2F Abstract  Between 2002 and 2007, fifty elderly patients with displaced femoral neck fractures were treated with hip replacement at Emergency Hospital, Mansoura University. Patients were randomly selected, 25 patients had either cemented or cementless bipolar prosthesis, and another 25 patients had either cemented or cementless fixed-head prosthesis. There were 34 women and 16 men with an average age of 63.5 years (range between 55 and 72 years). All patients were followed up both clinically and radiologically for an average 4.4 years (range between 2 and 6 years). At the final follow-up, the average Harris hip score among the bipolar group was 92 points (range between 72 and 97 points), while the fixed-head group was 84 points (range between 65 and 95 poi... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4402160 Fri, 21 Jan 2011 20:32:13 +0100 4402160 http://www.medworm.com/index.php?rid=4365482&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm764631520q0511k%2F Abstract  We studied 140 patients with femoral neck fractures treated from January 1999 to December 2006. There were 68 men and 72 women with a mean age of 72 years (range 60–80 years). Seventy patients were treated with closed reduction and internal fixation (group A), and 70 patients with hip arthroplasty (group B). The duration of surgery, length of hospitalization, complications, postoperative Harris hip score, and need for reoperation were recorded. Group B had significantly higher blood loss, increased surgical time and length of hospitalization compared to group A patients. The Harris hip score was significantly higher in group B at the 3, 6, and 12-month follow-up evaluations; however, the differences were no longer significant at the 24-month evaluation... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4365482 Sat, 15 Jan 2011 01:06:42 +0100 4365482 http://www.medworm.com/index.php?rid=4365481&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm824885639312u52%2F We present a technique using LARS ligament for the reconstruction of a chronic patella tendon rupture in a low-demand patient. The result after 1-year follow-up was deemed successful. Content Type Journal ArticlePages 1-3DOI 10.1007/s11751-010-0101-0Authors Soulat Naim, University Hospital North Staffordshire, Stoke on Trent, UKNikolaos Gougoulias, University Hospital North Staffordshire, Stoke on Trent, UKDavid Griffiths, University Hospital North Staffordshire, Stoke on Trent, UK Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4365481 Sat, 15 Jan 2011 01:06:42 +0100 4365481 http://www.medworm.com/index.php?rid=4365483&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5648n4x522q34971%2F We present a complex pattern of floating injury, occurring in the same limb 3 years after a floating elbow lesion, which included supracondylar fracture of the humerus and associated ipsilateral midshaft fracture of forearm bones. Satisfactory outcomes were finally obtained. This clinical case illustrates the importance of carefully assessing floating elbow injuries when they occur to optimize the surgical strategies and the adequate timing of the treatment. A comprehensive literature review of the floating elbow injuries is here reported. Content Type Journal ArticlePages 1-5DOI 10.1007/s11751-011-0102-7Authors Olimpio Galasso, Department of Orthopaedic and Trauma Surgery, School of Medicine, Magna Græcia University, Campus S. Venuta—V.le Europa, 88100 Germaneto, Catan... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4365483 Sat, 15 Jan 2011 01:06:41 +0100 4365483 http://www.medworm.com/index.php?rid=4141645&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm1v5787033j75621%2F Abstract  Lengthening the femur with an external fixator is commonly practised for a wide variety of pathologies. This technical report includes tips derived from observation and experience in a busy limb reconstruction unit. It focuses on the use of a rail fixator, although some of the descriptions are applicable to lengthening by circular fixators. Content Type Journal ArticleDOI 10.1007/s11751-010-0098-4Authors Selvadurai Nayagam, Consultant in Orthopaedic Surgery, Royal Liverpool Children’s and Royal Liverpool University Hospital, Liverpool, UK Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4141645 Wed, 03 Nov 2010 17:12:33 +0100 4141645 http://www.medworm.com/index.php?rid=4026409&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F74466156x116778j%2F We present a series of 9 relapsed club feet treated with closed gradual distraction using this scoring method. Content Type Journal ArticleDOI 10.1007/s11751-010-0097-5Authors Said Saghieh, Surgery Department, American University of Beirut, AUB_Medical Center, Cairo street, Beirut, LebanonAbdo Bashoura, Surgery Department, American University of Beirut, AUB_Medical Center, Cairo street, Beirut, LebanonGhina Berjawi, Diagnostic Radiology Department, American University of Beirut, Beirut, LebanonNadim Afeiche, Surgery Department, American University of Beirut, AUB_Medical Center, Cairo street, Beirut, LebanonRayan Elkattah, Diagnostic Radiology Department, American University of Beirut, Beirut, Lebanon Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Pr... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4026409 Fri, 01 Oct 2010 07:02:27 +0100 4026409 http://www.medworm.com/index.php?rid=4020368&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkk005116323442mp%2F We report the first use of an Orthofix Gottfried Percutaneous Compression Plate (PC.C.P.) (Orthofix, Guilford, UK) to treat a non-union of an intra-capsular fractured neck of femur. We recommend this, in combination with autologous bone grafting, via a mini hip modification of the Smith–Petersen approach. Content Type Journal ArticleDOI 10.1007/s11751-010-0096-6Authors P. Mukherjee, Orthopaedic Surgery, Rotherham General Hospital, Rotherham, S60 2UD UKM. J. Ashworth, Trauma and Orthopaedics, Torbay Hospital, Torquay, Devon TQ2 7AA, UK Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4020368 Tue, 28 Sep 2010 19:07:06 +0100 4020368 http://www.medworm.com/index.php?rid=4020367&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fug7kp33j100221h3%2F Abstract  From October 2005 to August 2007, we operated on six patients who had femoral non-unions and performed interlocked intramedullary nailing without X-ray guidance or a targeting device. There were three fractures of the distal femur, two fractures of the mid-shaft and one of the proximal femur. Fatigue failure of a non-interlocked Kuntscher nail and one nail migration were the presenting features in two patients. The presence of sclerosis of the bone ends in four cases and a need for cancellous bone grafts at the site of non-union in all patients made wide dissection and open reduction unavoidable. There was a limb length discrepancy in all patients before surgical intervention. Partial weight bearing was commenced at 6 weeks post-operation. There was no case o... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=4020367 Tue, 28 Sep 2010 19:07:06 +0100 4020367 http://www.medworm.com/index.php?rid=3990447&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa62ktk1052060l77%2F We present a case with a large composite tissue loss that was reconstructed with cross-leg free transfer of a combined latissimus dorsi and serratus anterior muscle flap. This case indicates that this large muscle flap can survive with the cross-leg free flap method and this technique may be a viable alternative for large lower extremity defects that have no reliable recipient artery. Content Type Journal ArticleDOI 10.1007/s11751-010-0094-8Authors Gursel Turgut, Department of Plastic Reconstructive Surgery, Sisli Etfal Research Hospital, Istanbul, TurkeyMahmut Ulvi Kayalı, Department of Plastic Reconstructive Surgery, Sisli Etfal Research Hospital, Istanbul, TurkeyÖzkan Köse, Orthopedics and Traumatology Clinic, Diyarbakır State Hospital, Diyarbakır, TurkeyLütfü Baş, Dep... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3990447 Sat, 18 Sep 2010 05:53:11 +0100 3990447 http://www.medworm.com/index.php?rid=3934187&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7l2372398t07v8m7%2F Abstract  The aim of this study was to present the results of non-vascularized fibular graft for reconstruction of bone defects after en block resection of giant aneurysmal bone cyst (ABC) of the extremities. Between 1998 and 2006, three patients, aged 6, 8 and 23 years, with giant aneurysmal bone cysts were treated. The cysts were located in the humerus, proximal femur and metatarsal. All patients were given en bloc resection of the cyst followed by non-vascularized fibular bone graft, with the graft length ranging from 6 to 18 cm. All patients needed supplementary fixation with a single Kirschner wire or plate and screws. At the final follow-up, bony union was achieved in each case, and there was no recurrence, limitation of range of motion or disability. In add... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3934187 Fri, 03 Sep 2010 16:50:35 +0100 3934187 http://www.medworm.com/index.php?rid=3811019&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft5825u7101704773%2F We present the treatment and follow-up of this case. In addition, the literature on scaphoid dislocation and its treatment is reviewed. We emphasize the need to reconstruct the carpal alignment and scapho-lunate linkage. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-010-0092-xAuthors Matthijs P. Somford, AMC Hospital Department of Orthopaedic Surgery Meibergdreef 9 1105 AZ Amsterdam The NetherlandsMaarten F. A. M. Sturm, Amphia Hospital Department of Radiology Breda The NetherlandsJos P. A. M. Vroemen, Amphia Hospital Department of General Surgery Molengracht 21 4818 CK Breda The Netherlands Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3811019 Fri, 30 Jul 2010 17:22:29 +0100 3811019 http://www.medworm.com/index.php?rid=3774625&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp827849802625005%2F Abstract  Supracondylar fracture of the humerus is the second most common fracture in children (16.6%) and the most common elbow fracture. These fractures are classified using the modified Gartland classification. Type III and type IV are considered to be totally displaced. A totally displaced fracture is one of the most difficult fractures to manage and may lead to proceeding to open procedures to achieve acceptable reductions. Many surgeons are concerned about its outcome compared to closed procedures. We therefore performed a systematic review of the literature to investigate the existing evidence regarding functional and radiological outcomes as well as postsurgical complications of primary open compared to primary closed reduction. Content Type Journal ArticleCateg... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3774625 Fri, 16 Jul 2010 17:02:14 +0100 3774625 http://www.medworm.com/index.php?rid=3728287&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm852047u86j86576%2F We present an expanded latissimus dorsi musculocutaneus (LDMC) flap to treat circumferential upper extremity defects via resurfacing and “spiral reconstruction” in 5 patients during a 17-year period. Five patients with different indications for tissue expansion from burns to congenital hairy nevi were operated. The expansion was done in a longitudinal direction, and a rectangular tissue expander (TE) was inserted under the LD muscle to expand the flap in a longitudinal direction thereby forming a “long” flap rather than a “wide” one. After excising the circumferential lesion, the expanded “elongated” flap was wrapped spirally around the extremity to cover the defect; the donor site was closed as usual. The 5 patients we treated via LDMC flaps in a spiral fashion were ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3728287 Fri, 02 Jul 2010 19:51:08 +0100 3728287 http://www.medworm.com/index.php?rid=3583661&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu0w500k268278753%2F This study included 12 limbs in 8 patients (mean age 9 years), all were classified as stage V or VI according to the Langenskiold classification. All osteotomies healed completely in all patients. The mean time in the frame was 23 weeks. The mean preoperative femoral shaft-tibial shaft angle was 36° of varus. This improved to 5° of varus. The mean preoperative femoral condyle-tibial shaft angle was 58°. This improved to 84°. The mean preoperative angle of depressed medial tibial plateau was 63°. This improved to 8°. All patients were maintaining full extension of the knee at the final follow-up, and all patients noticed a significant improvement in their gait pattern. We believe that this technique is safer and less invasive compared to traditional and even newly desc... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3583661 Wed, 19 May 2010 18:02:20 +0100 3583661 http://www.medworm.com/index.php?rid=3583662&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpw78k82qm7726721%2F We report a case of hypertrophic nonunion of the ulna in a child who was treated surgically using an elastic stable intramedullary nail (ESIN) without bone grafting. The nonunion healed 4 months after surgery. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-010-0089-5Authors Abdul Halim Abd Rashid, Universiti Kebangsaan Malaysia Department of Orthopaedics and Traumatology, Faculty of Medicine Jalan Yaacob Latif 56000 Kuala Lumpur MalaysiaSharaf Ibrahim, Universiti Kebangsaan Malaysia Department of Orthopaedics and Traumatology, Faculty of Medicine Jalan Yaacob Latif 56000 Kuala Lumpur Malaysia Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3583662 Wed, 19 May 2010 10:58:14 +0100 3583662 http://www.medworm.com/index.php?rid=3562317&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn7777276020r3760%2F This study reports patient and fracture characteristics of these injuries. We also determined potential skating-related risk factors. All patients who sustained a distal radius fracture during natural ice skating between January 3 and January 12, 2009 were included. Patient and fracture characteristics, treatment, validated outcome (Quick DASH) at 3 months after injury were determined. Natural ice skating accounted for a 5.5-fold increase of distal radius fractures (92 fractures) compared to a similar time period without natural ice skating in 2008. Fracture types were AO-type A, n = 50, type B, n = 11 and type C, n = 31. Twenty-eight patients were casted without reduction. Fifty-four patients underwent at least one reduction before casting. The non... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3562317 Wed, 12 May 2010 07:01:28 +0100 3562317 http://www.medworm.com/index.php?rid=3478673&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq038w711716q6411%2F Abstract  Infections of a total joint replacement (TJR) of the shoulder are rare complications. After revision surgery, the incidence rises dramatically. If infection occurs, it leads to a loss of function and may be devastating to the joint. Treatment options range from single- to multiple-staged revision programs, permanent resection arthroplasty or exarticulation. In this case, a reversed shoulder endoprosthesis, which was implanted after multiple revisions of a TJR due to a posttraumatic omarthrosis and rotator cuff insufficiency, got infected. A hybrid-spacer, made of a humeral nail and a custom-made PMMA spacer forming the humeral head, was used during the revision program. After two operations, clinical and paraclinical signs turned back to normal. The patient felt w... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3478673 Tue, 13 Apr 2010 18:21:00 +0100 3478673 http://www.medworm.com/index.php?rid=3401393&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg216hw5rm7740874%2F Abstract  Depending upon initial treatment, between 2 and 30% of patients with a displaced intra-articular calcaneal fracture require a secondary arthrodesis. The aim of this study was to investigate the effect of subtalar versus triple arthrodesis on functional outcome. A total of 33 patients with 37 secondary arthrodeses (17 subtalar and 20 triple) with a median follow-up of 116 months were asked to complete questionnaires regarding disease-specific functional outcome (Maryland Foot Score, MFS), quality of life (SF-36) and overall satisfaction with the treatment (Visual Analogue Scale, VAS). Patient groups were comparable considering median age at fracture, initial treatment (conservative or operative), time to arthrodesis, median follow-up, and post-arthrodesis radi... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3401393 Tue, 23 Mar 2010 07:56:37 +0100 3401393 http://www.medworm.com/index.php?rid=3361214&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr4593n3x34940936%2F Abstract  We evaluated the morphological features of the newly formed tissue in an experimental model of tibial callotasis lengthening on 24 lambs, aged from 2 to 3 months at the time of operation. A unilateral external fixator prototype Monotube Triax® (Stryker Howmedica Osteonics, New Jersey) was applied to the left tibia. A percutaneous osteotomy was performed in a minimally traumatic manner using a chisel. Lengthening was started 7 days after surgery and was continued to 30 mm. The 24 animals were randomly divided into three groups of 8 animals each: in Group 1, lengthening took place at a rate of 1 mm/day for 30 days; in Group 2, at a rate of 2 mm/day for 15 days; in Group 3, at a rate of 3 mm/day for 10 days. In each group, ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3361214 Thu, 11 Mar 2010 02:49:11 +0100 3361214 http://www.medworm.com/index.php?rid=3356733&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4l8w721191710460%2F Abstract  Sixteen patients underwent minimally invasive subtalar arthrodesis through a mini-invasive approach with posterior iliac graft between 2004 and 2006. No hardware was used to transfix the arthrodesis and partial weight bearing was allowed immediately. The primary indication for surgery was the squeal of fracture os calcis in terms of subtalar joint arthritis, loss of heel height, malalignment of the hindfoot, and pain with weight bearing. There were 12 male and 4 female patients with a mean age of 30 (range 17–52). Patients were followed up for a period of 40.8 months (range 36–48 months). The mean interval from injury to fusion was 2 (+0.6) years ranging from 6 months to 6 years post fracture. The average clinical rating scale based on the ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3356733 Wed, 10 Mar 2010 12:54:22 +0100 3356733 http://www.medworm.com/index.php?rid=3356732&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fcn74175744688558%2F In conclusion, semi-open reduction and minimal internal fixation through a small lateral approach is an effective treatment for carefully selected cases of displaced intra-articular calcaneal fractures. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-010-0082-zAuthors Mohamed F. Mostafa, Mansoura University Department of Orthopedic Surgery and Traumatology, Faculty of Medicine PO Box 2 Mansoura 35516 EgyptGamal El-Adl, Mansoura University Department of Orthopedic Surgery and Traumatology, Faculty of Medicine PO Box 2 Mansoura 35516 EgyptEhab Y. Hassanin, Mansoura University Department of Orthopedic Surgery and Traumatology, Faculty of Medicine PO Box 2 Mansoura 35516 EgyptM-Serry Abdellatif, Mansoura University Department of Orthopedic Surgery and Traumatolo... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3356732 Wed, 10 Mar 2010 12:54:22 +0100 3356732 http://www.medworm.com/index.php?rid=3356734&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkm1244vg24h5u57m%2F We present the results of treatment of 100 patients (72 men, 28 women) by the Ilizarov method of bone transport using circular (55) and monolateral external fixators (45). A total of 26 femurs (18 monolateral, 8 circular) and 74 tibias (49 circular, 25 monolateral) was examined. There were no significant differences between the circular fixator and the monolateral fixator with regard to treatment time, complications in the treated bone segments or compliance with the presence of the fixator. The main complications (pseudoarthrosis at bone contact points after transport, insufficient ossification of lengthened bone, knee stiffness) were resolved with further treatment for all patients with the exception of one case which continued with repeated infections. The circular fixator allows ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3356734 Wed, 10 Mar 2010 12:54:21 +0100 3356734 http://www.medworm.com/index.php?rid=3270629&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr5638414h22l5r83%2F We report the case of a 56-year-old, healthy, left-handed person who consulted for progressive painful swelling of 8-month duration in the right thumb, which had developed after direct trauma. The plain radiograph of the thumb revealed extensive destruction of the proximal phalanx associated with pathological fracture. Magnetic resonance imaging (MRI) showed replacement of the affected phalanx with prominent soft tissue mass with extension outside the bone margins. The diagnosis of tuberculous dactylitis was based on histological characteristics and positive acid fast bacilli using Ziehl-Neelsen stain. Surgical debridement and anti-tuberculous chemotherapy eradicated the infection. Seven years post treatment, the patient had good function of the thumb with no significant disability i... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3270629 Fri, 12 Feb 2010 07:31:13 +0100 3270629 http://www.medworm.com/index.php?rid=3248082&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1160112p31x7j651%2F We present the relevant clinical anatomy, mechanism of injury, methods of treatment available and suggest a single treatment algorithm for use in the management of these injuries. Content Type Journal ArticleCategory ReviewDOI 10.1007/s11751-010-0079-7Authors Shelain Patel, University College Hospital Department of Trauma and Orthopaedics 235 Euston Road London NW1 2BU UKAnish Potty, University College Hospital Department of Trauma and Orthopaedics 235 Euston Road London NW1 2BU UKEmma J. Taylor, University College Hospital Department of Trauma and Orthopaedics 235 Euston Road London NW1 2BU UKElliot D. Sorene, University College Hospital Department of Trauma and Orthopaedics 235 Euston Road London NW1 2BU UK Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3248082 Fri, 05 Feb 2010 18:19:17 +0100 3248082 http://www.medworm.com/index.php?rid=3169524&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe22746687821r320%2F We present our experience in revision knee arthroplasty for infection associated with massive bone defects. The aim of the study is to present the preliminary results of a direct exchange endoprosthetic reconstruction with tumour prosthesis for periprosthetic infection associated with segmental bone defects. This is a retrospective study of prospectively collected data, involving six patients with periprosthetic infection and massive bone defects treated by direct exchange tumour prostheses between 2003 and 2007 (four distal femoral replacements and two total femoral replacements). The mean age and follow-up were 74.2 (±5.2) years and 32.5 (±8.2) months respectively. Each patient had an infected revised knee arthroplasty at the time of referral to our institution. Staphylococcus au... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3169524 Mon, 11 Jan 2010 18:23:44 +0100 3169524 http://www.medworm.com/index.php?rid=3169525&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw8j25h8g23w064rv%2F We report a case of a 27-year-old man who was involved in a high-speed car accident. He sustained multiple organ damage including multiple brain petechiae suggesting diffuse axonal damage, aortic dissection, retroperitoneal haematoma and a fracture-dislocation of the right hip with a femoral head fracture and an ipsilateral intertrochanteric fracture. Due to the general condition of the patient, physiological stabilisation was prioritized, and at 2 weeks the fracture-dislocation of the hip was treated with a proximal femoral nail for the intertrochanteric fracture and Herbert screws for the femoral head fracture. Postoperatively, two episodes of recurrent hip dislocation occurred, and this was stabilized eventually with a Steinman pin inserted across the hip joint and taken out ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3169525 Mon, 11 Jan 2010 18:23:42 +0100 3169525 http://www.medworm.com/index.php?rid=3087430&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb701343hg388k312%2F Abstract  The callotasis lengthening technique was used to gradually lengthen the capitate after resection of the lunate in stage IIIa necrosis in 23 patients. Results of ten patients with a follow-up of at least 5 years showed rapid and sufficient callus formation in every patient regardless of age. The callotasis lengthening modification of the Graner II operation provides all advantages and avoids the major inconvenience of the traditional Graner II operation. There was no increased rate of disturbed fracture healing. Results of the DTPA-gadolinium MRI study did not show any significant impairment of vascularization within the region of the capitate bone. With the “intrinsic bone formation,” contrary to every other intercarpal arthrodesis at the wrist, there is ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3087430 Fri, 11 Dec 2009 06:54:40 +0100 3087430 http://www.medworm.com/index.php?rid=3065330&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F976518j8gm05j75h%2F In this study, our aim is to discuss the problems encountered in different resection and reconstruction approaches in childhood bone and soft tissue tumors, and the recommended solutions addressed to these problems. From 1990 to 2003, a total of 68 patients (38 female, 30 male) with a mean age of 13.1 (1.5–18) were included in the study. 85.3% of patients were diagnosed as osteosarcoma and the rest was Ewing’s sarcoma. Seventy-five percent of patients had stage IIB disease. The lesions of 34 patients were detected to be in distal femur, 26 in proximal tibia and fibula, 4 in foot and ankle joint, and the remaining 4 in pelvis. As reconstructive surgery, 40 patients had modular prosthesis, vascularized fibular graft was performed in 13 patients, and 10 patients underwent arthrodesi... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3065330 Wed, 02 Dec 2009 08:39:01 +0100 3065330 http://www.medworm.com/index.php?rid=3042270&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F54304w3155k15750%2F Abstract  There are several theoretic advantages of using intramedullary rod fixation for tibial osteotomy fixation. We performed a retrospective review of patients who were treated with a mid-diaphyseal osteotomy of the tibia fixed with an intramedullary rod for isolated, symptomatic tibial torsion. Forty patients (59 tibias) were included in the study and were followed for a minimum of 12 months or until rod removal (average follow-up 22.6 months). Major complication rate was 8.5%, which is comparable to alternative methods of fixation. We believe that intramedullary rods are a safe alternative for fixation of tibial rotational osteotomy in patients with physeal closure. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-009-0076-xAuthors ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3042270 Thu, 26 Nov 2009 08:15:04 +0100 3042270 http://www.medworm.com/index.php?rid=3042271&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Flppu72mw8x70831l%2F Abstract  Traumatic thumb amputation represents an extremely disabling entity, thus rendering its reconstruction a procedure of paramount importance. A case of a patient, who sustained a traumatic amputation of his left index finger at the metacarpophalangeal joint and of his left thumb in the middle of the proximal phalanx 4 months ago and was initially treated elsewhere, is described. For the thumb reconstruction, an osteocutaneous flap of the radial side of the 2nd metacarpal, which consisted of a 3, 5-cm bony segment with the overlying skin and its blood and nerve supply was used. The flap was transferred and fixed with a plate and screws to the palmar-medial side of the stump of the thumb, while the 1st web space was deepened by removing the rest of the second met... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3042271 Thu, 26 Nov 2009 08:15:03 +0100 3042271 http://www.medworm.com/index.php?rid=3032446&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4242221021334246%2F We present a case of an acute traumatic dorsal DRUJ dislocation treated with cast immobilization with recurrence of the dislocation after a new trauma some months later. At follow-up, 17 months after the first dislocation and 9 months after the second, he experienced no pain and had no restrictions in work or sports-related activities. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-009-0073-0Authors Sander Wassink, Spaarne Hospital Spaarnepoort 1 2134 TM Hoofddorp The NetherlandsLukas A. Lisowski, Academic Medical Center Meibergdreef 9 1105 AZ Amsterdam The NetherlandsBernard G. Schutte, Spaarne Hospital Spaarnepoort 1 2134 TM Hoofddorp The Netherlands Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3032446 Tue, 24 Nov 2009 07:14:57 +0100 3032446 http://www.medworm.com/index.php?rid=3032447&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk3p22v607210701g%2F This study reports the incidence and proposes a probable cause of flexion deformity and extensor weakness following lengthening of quadriceps tendon for the congenital dislocation of the knee and also proposes a modification of the functional grading given in the literature to this effect. Seventeen knees in ten patients were treated with a follow-up from 3 to 8 years. Fifteen knees were grade III and were operated with quadriceps lengthening and anterior capsulotomy. Two knees were Grade II and were initially closed reduced, but operated later due to recurrence. The results were graded on a modification of functional grading system given in the literature [1]. There were excellent results in four, good in five and fair in eight knees. There was an extensor weakness in ten knees ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3032447 Tue, 24 Nov 2009 07:14:55 +0100 3032447 http://www.medworm.com/index.php?rid=3032448&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F36532277j70h3717%2F In conclusion, the quality of life and functional outcome returned to normal after post-traumatic distraction osteogenesis of the lower limb. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-009-0070-3Authors Niels Willem Luitzen Schep, Erasmus MC, University Medical Center Rotterdam Department of Surgery-Traumatology P.O. Box 2040 3000 CA Rotterdam The NetherlandsEsther M. M. van Lieshout, Erasmus MC, University Medical Center Rotterdam Department of Surgery-Traumatology P.O. Box 2040 3000 CA Rotterdam The NetherlandsPeter Patka, Erasmus MC, University Medical Center Rotterdam Department of Surgery-Traumatology P.O. Box 2040 3000 CA Rotterdam The NetherlandsLucas M. M. Vogels, Erasmus MC, University Medical Center Rotterdam Department of Surgery-Traumatology P... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3032448 Tue, 24 Nov 2009 07:14:53 +0100 3032448 http://www.medworm.com/index.php?rid=3021204&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb2005v46312512mg%2F This study included 415 femur fractures (312 men and 101 women with a mean age of 27.8 years) that were treated from 1993 to 2004. The fractures were classified according to AO, and 74 open fractures were included and typed according to the Gustilo classification. Dynamic nailing was performed for nearly all type A fractures and static nailing for types B and C. After a mean follow-up of 1.5 years, union rate was 97.8%. The complications were: 9 non-unions, 14 delayed-unions, 4 torsional malunions, 6 limb length discrepancies (shortening) and 30 nerve pareses due to traction. Deep venous thrombosis (DVT) occurred below the knee in 4 patients, while there were recorded 3 pulmonary and 2 fat embolisms, 1 superficial and 1 deep infection. There were 28 broken screws identified... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3021204 Sat, 21 Nov 2009 08:30:56 +0100 3021204 http://www.medworm.com/index.php?rid=2840813&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv0550m66655w836u%2F We report the case of a 31-year-old patient who sustained an open femoral shaft fracture . The fracture was stabilized with a Kuntcher femoral nail. After 7 months of the initial surgery he presented with a three part broken intramedullary nail and the distal locking screw broken. We used a combined technique for the removal of the nail through the nonunion fracture site; we used a pull out technique for the middle fragment and a curved thin hook for the distal fragment. Then we applied bone allograft and stabilized with a cannulated intramedullary femoral nail (Synthes, Oberdorf, Switzerland). After 2 years of follow up the nonunion was consolidated and the patient presented a good clinical outcome. This is of particular interest because it is a unique case and the association with... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2840813 Thu, 24 Sep 2009 05:50:30 +0100 2840813 http://www.medworm.com/index.php?rid=2835666&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc45v15224455647t%2F We report a case of a woman presenting with severely injured lower limb and bone loss, which was managed using a custom-made endoprosthetic replacement for successful functional outcome. Despite being complicated by bone loss, nerve injury and infection; a planned staged surgical treatment and rehabilitation have resulted in satisfactory outcome. At 3-year follow-up, the functional score according to the Musculoskeletal Tumor Society-International Symposium on Limb Salvage System was 70% and the Toronto Extremity Salvage Score was 62%. Endoprosthetic replacements may have a limited role in managing selected patients with mangled extremity and can lead to a good functional outcome to these patients. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-009-0068-xAuthor... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2835666 Thu, 24 Sep 2009 05:50:30 +0100 2835666 http://www.medworm.com/index.php?rid=2811273&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F47u17108q32349h3%2F We present the early results of a prospective study on tibiocalcaneal arthrodesis using a latest-generation retrograde intramedullary nail. In the period 2006–2007, nine patients underwent tibiocalcaneal arthrodesis with retrograde intramedullary nailing. Five of these patients had infection-related loss of the talus. SF-36, AOFAS ankle-hindfoot, and Mazur Ankle Arthrodesis scores were obtained pre-fusion, and at 6 weeks, 6 months and 1 year post-fusion. The patients were also followed up clinically and radiologically. Previous surgical procedures, chronic musculoskeletal problems and other comorbidities, and complications were recorded and analyzed. All patients were available for initial follow-up and were subjectively satisfied with their outcomes. Solid fusion wa... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2811273 Tue, 15 Sep 2009 21:56:36 +0100 2811273 http://www.medworm.com/index.php?rid=2745107&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd962751uv311g165%2F Abstract  The aim of this study was to evaluate the effectiveness of unilateral external fixator as primary and definitive treatment for open tibial fractures, fractures with severe soft tissues injuries, threatened compartment syndrome, and in multiply injured patients. Two hundred and twenty-three tibial shaft fractures (212 patients) were treated. In open fractures, union was achieved in 25 weeks, while in closed in 21. There were 18 nonunions, 21 delayed unions, 4 malunions, 58 pin infections and 3 osteomyelitis. A reoperation was performed in 42 patients. Fat embolism was diagnosed in three patients, pulmonary embolism in five and deep venous thrombosis in 14. The external fixator was definitive treatment in 87.27%. Unilateral external fixators can be used as prim... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2745107 Fri, 28 Aug 2009 15:00:20 +0100 2745107 http://www.medworm.com/index.php?rid=2732481&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fll5u42714471l088%2F We describe the results of reamed interlocked IM nails in 233 patients with 247 tibial fractures (190 closed, 27 open and 30 nonunions). Ninety-six percent of the fractures were united at review after an average of 4.9 years. No correlation was found between union and nail diameter (P = 0.501) or the number of locking screws used (P = 0.287). Nail dynamization was effective in 82% of fractures. Locking screw(s) breakage was associated with nonunion in 25% of cases. Bone grafting during IM nailing was found not to increase the healing rate in tibial nonunions (P = 0.623). None of the IM nails were removed or revised due to infection. A dropped hallux and postoperative compartment syndrome were found in 0.8 and 1.6% of cases, respectively. Anterior kne... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2732481 Mon, 24 Aug 2009 16:56:16 +0100 2732481 http://www.medworm.com/index.php?rid=2732482&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc472l42182426l5q%2F We report our treatment strategy in three patients suffering from chronically unreduced fracture-dislocations of the elbow. The treatment protocol consists of in situ neurolysis of the ulnar nerve, distraction and reduction of the joint using unilateral hinged external fixation and repair of the osseous stabilizers. A stable elbow was achieved in all patients, without the need of reconstruction of the collateral ligaments. At final follow-up, the average extension/flexion arc of motion was 107° (range, from 100° to 110°). The average MEPI score at follow-up was 93, and the average DASH score was 19. This is a promising treatment protocol for the treatment of chronically unreduced complex elbow dislocations to restore elbow stability and regain an excellent functional outcome... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2732482 Mon, 24 Aug 2009 16:56:15 +0100 2732482 http://www.medworm.com/index.php?rid=2723764&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr074453305430080%2F In conclusion, the resorption behaviour of the Milagro™ screw is closely linked to the graft healing process. The screws were rapidly resorbed after 6 months and, at 12 months, only the screw remnants were detectable. Moreover, the Milagro™ screw is biocompatible and osteoconductive, promoting bone ingrowth during resorption. Tunnel enlargement is not prevented in the first months but is reduced by bone ingrowth after 12 months. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-009-0063-2Authors K.-H. Frosch, Georg-August-University Goettingen Department of Trauma Surgery, Plastic and Reconstructive Surgery Robert-Koch-Str. 40 37075 Goettingen GermanyT. Sawallich, Georg-August-University Goettingen Department of Trauma Surgery, Plastic and R... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2723764 Thu, 20 Aug 2009 19:24:22 +0100 2723764 http://www.medworm.com/index.php?rid=2718213&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb7677552t51863xx%2F This article describes a case of hypothenar muscles myxoma treated with local surgical excision after frozen section biopsy with tumor-free margins. Radiographic images of the axial and appendicular skeleton were negative for fibrous dysplasia, and endocrine studies were within normal limits. The 8-year follow-up period has been uneventful, with no complications. The patient is currently recurrence free, with normal intrinsic hand function. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-009-0061-4Authors Freih Odeh Abu Hassan, Jordan University Hospital The Department of Orthopaedic Surgery Amman JordanMaha Shomaf, Jordan University Hospital Pathology Department Amman Jordan Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print IS... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2718213 Wed, 19 Aug 2009 12:04:19 +0100 2718213 http://www.medworm.com/index.php?rid=2578732&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx26104j8870g0556%2F This article provides an overview of the diagnostic features and different surgical procedures as well as the current literature in order to reach the above named goals. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-009-0059-yAuthors Andreas Heinrich Tiemann, Klinik für Unfall- und Wiederherstellungschirurgie, BG-Kliniken Bergmannstrost Halle (Saale) Funktionsbereich Septische und Rekonstruktive Chirurgie Merseburger Str. 165 06112 Halle GermanyGunther O. Hofmann, Klinik für Unfall- und Wiederherstellungschirurgie, BG-Kliniken Bergmannstrost Halle (Saale) Merseburger Str. 165 06112 Halle Germany Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2578732 Mon, 06 Jul 2009 16:20:35 +0100 2578732 http://www.medworm.com/index.php?rid=2466321&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4645740641ur32h6%2F Abstract  The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult for the treating surgeon. The preferred type of device is a matter of debate. Increased understanding of mechanical characteristics of the dynamic hip screw (DHS) has reduced the incidence of complications. Our hypothesis is based on the technical optimization of the DHS application. We prospectively studied 37 patients with subtrochanteric fractures with a mean age of 42.9 years. We utilized a two-stage protocol: initially, conversion of the comminuted fractures into two part fractures; then application of the implant with a technique that allowed dynamization of the DHS. Clinical and radiographic data were used to assess the outcome ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2466321 Sat, 06 Jun 2009 11:31:48 +0100 2466321 http://www.medworm.com/index.php?rid=2314740&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm111k57q761p6374%2F Abstract  Extensive pulp (zone 4) defects of the thumb, with the exposure of tendon or bone, are challenging reconstructive problems. Surgical treatment includes the use of local, regional, and free flaps. The first dorsal metacarpal artery flap has been used successfully for defects of the thumb. The innerved first dorsal metacarpal artery flap from the dorsum of the index finger was first described by Hilgenfeldt and refined by Holevich. An island flap carried on a neurovascular pedicle consisting of the first dorsal metacarpal artery was first demonstrated by Foucher and Braun. Seven innervated FDMCA island flaps were performed from May 2005 until July 2007 for thumb reconstruction. There were three women and four men with an average age of 54.9 years (range 28–89... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2314740 Thu, 02 Apr 2009 05:57:42 +0100 2314740 http://www.medworm.com/index.php?rid=2314745&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv173j61x20848333%2F Abstract  Triceps tendon ruptures are rare injuries. Coexistence of ipsilateral ulnar collateral ligament injury is even rarer. Here, we describe an unusual combination injury to elbow of a 39-year-old male construction worker consisting of triceps tendon rupture, avulsion of elbow ulnar collateral ligament and flexor pronator muscle origin ipsilaterally. A simultaneous repair and reconstruction of all damaged structures was proposed with individualized postoperative rehabilitation. Return to pre-injury level of activities obtained with this treatment protocol. High degree of suspicion and careful examination were needed to prevent missed diagnosis and prolonged instability which may be inevitable after inappropriate treatment of such injury. Content Type Journal ArticleC... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2314745 Thu, 02 Apr 2009 05:57:41 +0100 2314745 http://www.medworm.com/index.php?rid=2314747&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F4255w136578p4682%2F We describe a technique by which STD of the hand and fingers is done with no joint or tendon involvement overcoming the aforementioned drawbacks. Thirty-three patients with hand contractures were treated. In this method, a thin 1–1.5-mm Kirschner wire was passed horizontally at the proximal head of the distal phalanx and bent like a frame around the finger, forming a pentagonal shape for anchorage. The distal distraction was exerted at the distal phalanx. Various forms of external fixation were then used to distract a finger, several fingers, or the hand by placing tension on this frame; the distraction was either static (with a wire exerting pressure) or dynamic (using a rubber band to adjust the tension). After obtaining the desired result, the wire or rubber band was temporaril... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2314747 Wed, 25 Mar 2009 07:07:27 +0100 2314747 http://www.medworm.com/index.php?rid=2290403&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq40314635107m143%2F Abstract  The treatment of tibial plafond fractures requires careful management of the soft tissue envelope, reconstruction of the articular surface and stable fixation with minimal additional damage. Thirty cases of AO type 43 C tibial fractures were treated by transosseous osteosynthesis (Ilizarov technique). The external fixator constructs used were Ilizarov (Transosseous osteosynthesis: theoretical and clinical aspects of the regeneration and growth of tissue, Springer, Berlin, 1992) and Sheffield (Classification AO des fractures, Springer, Berlin, 1987) circular fixator systems. All tibial plafond fractures healed. Using radiological criteria for assessment of reduction of the articular fragments and the clinical scoring system described by Teeny and Wiss, there were e... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2290403 Fri, 20 Mar 2009 10:50:43 +0100 2290403 http://www.medworm.com/index.php?rid=2279358&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqn68585554272j62%2F Abstract  Septic diseases of the bone and the immediate surrounding soft tissue, i.e., osteitis, belong to the most alarming findings in recent traumatology and orthopedic surgery. The paramount goal of this therapy is to preserve the stable weight-bearing bones while maintaining a correct axis and proper working muscles and joints, in order to avoid permanent disability in the patient. “State-of-the-art” therapy of osteitis/osteomyelitis therapy has two priorities: eradication of the infection and reconstruction of bone and soft tissue. Surgical treatment of the affected bone segments and soft tissue, followed by reconstructive methods, continues to be the main basic therapy. It is often extremely difficult to decide whether the affected bone segment has to be resected... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2279358 Sat, 14 Mar 2009 13:59:28 +0100 2279358 http://www.medworm.com/index.php?rid=2265440&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg6x7x6821kw04274%2F Abstract  A neglected Achilles tendon rupture is often characterized by muscle weakness and an overlengthened repair by scar tissue. Reconstructive surgery is usually performed taking into account the patient’s required level of function. Two surgical cases of neglected Achilles tendon rupture are presented in this article. In both instances it was expected that central fibrosis, possibly after neglected tendon rupture, would be found. However, after longitudinal opening of the tendons, a thickened plantaris tendon was evident at the insertion on the calcaneus in both cases. This hypertrophic tendon occupied most of the diameter of the Achilles tendon. Due to partial or complete rupture of the Achilles tendon, there was notable weakening and tendon transfer-augmentation w... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2265440 Wed, 11 Mar 2009 11:25:37 +0100 2265440 http://www.medworm.com/index.php?rid=2265439&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1441005418368574%2F In conclusion, the increased use of antibiotics indicates that leaving the theatre dressing undisturbed during the first postoperative week is beneficial to the treatment by external fixation and is probably of importance in the prophylactic pin-site care. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-009-0053-4Authors Annette W-Dahl, Lund University Hospital Department of Orthopedics, Clinical Science Lund 221 85 Lund SwedenSören Toksvig-Larsen, Hässleholm Hospital Department of Orthopedics Hässleholm Sweden Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2265439 Wed, 11 Mar 2009 11:25:37 +0100 2265439 http://www.medworm.com/index.php?rid=2265441&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8457p34838t124rt%2F We report an unusual cause of haemorrhage from the surgical incision in a 9-year-old child. We emphasize that a high index of suspicion is required for early diagnosis, and pseudoaneurysm and neoangiogenesis should be considered in the differential diagnosis of soft tissue masses resulting from direct, blunt trauma even in children. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-009-0052-5Authors Roop Singh, Pt. B.D. Sharma PGIMS Department of Orthopaedic Surgery, Paraplegia and Rehabilitation 9-J/52, Medical Enclave Rohtak 124001 Haryana IndiaSarita Magu, Pt. B.D. Sharma PGIMS Department of Radio Diagnosis and Imaging Rohtak 124001 Haryana IndiaVirender Kumar Kadian, Pt. B.D. Sharma PGIMS Department of Orthopaedic Surgery, Paraplegia and Rehabilitation 9-J/52, ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2265441 Wed, 11 Mar 2009 11:25:36 +0100 2265441 http://www.medworm.com/index.php?rid=2018237&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffgqj422542242130%2F Abstract  The Ilizarov technique is an alternative for the treatment of complex foot deformities in children. The authors retrospectively reviewed children with relapsed clubfoot deformity, treated with soft tissue procedures and additional correction with an Ilizarov frame. Twelve consecutive patients (13 feet) with relapsed clubfoot deformity after previous surgical correction were reviewed. Treatment included open releases. An Ilizarov frame was applied as an adjunct in seven patients (mean age of 7.8 years) with severe deformity where complete intraoperative correction was not achieved. Clinical and radiographic assessment was undertaken. The mean Laaveg–Ponseti score, for the 7 feet treated with the Ilizarov frame, was 85.1 after minimum 4 years follow-up. ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=2018237 Fri, 05 Dec 2008 09:29:31 +0100 2018237 http://www.medworm.com/index.php?rid=1999390&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa1665901h782654r%2F Abstract  One of the recommended methods for the management of displaced unstable proximal humeral fractures is the unilateral external fixator. In polytrauma cases this method may be especially useful for the stabilisation of these fractures. However, problems may arise if the fracture is fixed in a malaligned or distracted position. Conversion of the treatment concept to other modalities is difficult because of the problem of pin tract infection. The Ilizarov apparatus provides an useful method in such situations, as it allows distraction, translation and compression without the need for further anaesthesia and additional fixation. Content Type Journal ArticleCategory Technical ReportDOI 10.1007/s11751-008-0044-xAuthors Shabir Ahmed Dhar, The Government Hospital for Bo... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1999390 Fri, 28 Nov 2008 14:14:53 +0100 1999390 http://www.medworm.com/index.php?rid=1996919&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc6r507555771w266%2F We describe the case of a 13-year-old patient with a left wrist physeal fracture of the ulna and radius. X-Ray showed a Salter–Harris type II injury of the radius, and CT and MRI identified the following: type II epiphysiolysis of the radius with a metaphyseal wedge and type IV fracture of the ulna, with interposition in the focus of the fracture of the extensor carpi ulnaris tendon, as well as a tear in the central area of the triangular fibrocartilage complex. All these injuries were checked intraoperatively during open reduction. We believe that this clinical case illustrates the importance of carefully assessing physeal wrist injuries when they occur, especially in those cases involving the ulna and the radius. Diagnostic methods such as CT and MRI scans are indispensable for t... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1996919 Wed, 26 Nov 2008 19:48:57 +0100 1996919 http://www.medworm.com/index.php?rid=1985307&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg45k8356x531377w%2F Abstract  No published studies have addressed the role of hand dominance in various types of forearm fractures. The present study aims to investigate the effects of the dominant hand and gender in forearm fractures in children and adolescents. In a prospective study, 181 children aged 2–15 years presenting with unilateral forearm fracture were examined over a 6-year period, investigating the role of the dominant hand, fractured side, fractured site, and gender in different types of forearm fractures. Forearm fractures occur more often in boys and are more common on the left side (P = 0.001, 0.029, respectively). Isolated distal radius fracture is more common than distal radius and ulna fracture in right-handed children (P = 0.008). Increases in the... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1985307 Sun, 23 Nov 2008 06:49:10 +0100 1985307 http://www.medworm.com/index.php?rid=1981385&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F98l11782l57n0147%2F Abstract  To describe our Ilizarov technique for the treatment of acquired equinus deformity in children and to determine if compliance with continuous use of an ankle foot orthosis (after removal of the fixator and until skeletal maturity) can influence the severity of recurrence. A cohort of 26 children with post-traumatic or post-burn contractures producing an equinus deformity was followed up for a minimum of 2 years after skeletal maturity. Cases with a bony deformity and/or nerve injury were excluded from this study. All patients were managed by a percutaneous tendo-Achilles lengthening followed by application of an Ilizarov external fixator. Post-operative treatment was in the form of gradual correction at a rate of 0.5 mm per day. Correction started from t... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1981385 Thu, 20 Nov 2008 08:17:57 +0100 1981385 http://www.medworm.com/index.php?rid=1826309&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F612h22334w240111%2F Abstract  This is a case series of 11 children and adolescents who underwent femoral lengthening and percutaneous hip arthrodesis using a method of extra-articular joint compression in combination with callotasis. Clinical review indicated a significant improvement in physical function and psychological well-being. The average lengthening was 5.3 cm or 16% of the initial length. Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021). No additional operations were required to achieve the surgical objective. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-008-0041-0Authors Pedro Antonio Sánchez Mesa, Clinic of Niño ISS “Jorge Bejarano” and Clinic 10... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1826309 Tue, 23 Sep 2008 10:24:29 +0100 1826309 http://www.medworm.com/index.php?rid=3098654&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw8373x326j0u3815%2F We present a 42-year-old patient who had Methicillin-resistant S. aureus infected pseudo-arthrosis of the tibia that was treated with debridement, mesh cage, autologous bone-grafting, and plating of the tibia. The outcome was satisfactory despite residual limb deformity and discrepancy. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0042-zAuthors Silas N. S. Motsitsi, University of Pretoria Department of Orthopaedic Surgery, Kalafong Hospital Private Bag x 396 Pretoria South Africa Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal Volume Volume 3 Journal Issue Volume 3, Number 2 / September, 2008 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3098654 Tue, 09 Sep 2008 09:39:24 +0100 3098654 http://www.medworm.com/index.php?rid=1783005&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw8373x326j0u3815%2F We present a 42-year-old patient who had Methicillin-resistant S. aureus infected pseudo-arthrosis of the tibia that was treated with debridement, mesh cage, autologous bone-grafting, and plating of the tibia. The outcome was satisfactory despite residual limb deformity and discrepancy. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0042-zAuthors Silas N. S. Motsitsi, University of Pretoria Department of Orthopaedic Surgery, Kalafong Hospital Private Bag x 396 Pretoria South Africa Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1783005 Tue, 09 Sep 2008 09:39:24 +0100 1783005 http://www.medworm.com/index.php?rid=1783006&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdg10547416033l53%2F Abstract  Pseudoaneurysms of the profunda femoris artery have been reported following different types of trauma and from orthopedic procedures performed in the proximal femur. Two cases of profunda femoris artery pseudoaneurysm with two rare causes are presented. The first one is a core decompression of femoral head for osteonecrosis and the second one is a proximal femur fracture nailing. Awareness and careful follow-up are the key issues for the early diagnosis. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0043-yAuthors Koray Unay, Goztepe Research and Training Hospital Department of Orthopaedic and Traumatology Istanbul TurkeyOguz Poyanli, Goztepe Research and Training Hospital Department of Orthopaedic and Traumatology Istanbul TurkeyKaya Aka... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1783006 Tue, 09 Sep 2008 09:39:23 +0100 1783006 http://www.medworm.com/index.php?rid=1764334&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6w17605297736701%2F Abstract  The distal ulna represents the fixed point around which the radius and the hand acts in daily living. The significance of distal ulnar fractures is often not appreciated and often results in inadequate treatment in comparison to its larger counterpart; the radius. There is little guidance in the current literature as how to manage these fractures and their associated injuries. This paper aims to critically review the current literature and combine it with treatment suggestions based on the experience of the authors to help guide investigation and management of these often complex injuries. Content Type Journal ArticleCategory ReviewDOI 10.1007/s11751-008-0040-1Authors A. J. Logan, University Hospital of Wales Department of Orthopaedics Heath Park Cardiff CF14 4... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1764334 Wed, 03 Sep 2008 12:39:10 +0100 1764334 http://www.medworm.com/index.php?rid=1760250&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fvv71407022j33745%2F This study investigate the efficacy of pre-operative pain treatment for patients with hip fractures using fascia lliaca compartment block (FIB) technique performed by junior registrars (JR) as a supplement to conventional pain treatment. The FIB technique has routinely been used pre-operatively in the emergency department since 1 January 2004 for all patients with hip fractures. Over an 8-month period, 187 patients were treated. FIB was performed with 40 ml lidocaine and bubivacaine. A simple 5-step verbal pain score and maximal passive hip flexion was used as objective and subjective pain measurements. Effect of FIB was prospectively assessed on 70 patients: 2/3 females, mean age 80.7 (SD = 7.8), 36% in ASA-group III and IV (95% CI, 0.25–0.48). The median pain-free ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1760250 Tue, 02 Sep 2008 08:23:29 +0100 1760250 http://www.medworm.com/index.php?rid=1750477&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc8673867344k010l%2F We present an analysis of the preoperative assessment that will assist the surgeon to plan out the procedure. Specifically, we set out to answer the following questions: (a) Where should the first osteotomy be performed and what is the magnitude of valgus and extension correction desired at this level? (b) Where should the second osteotomy be performed and what is the magnitude of varus and derotation desired at this level? Content Type Journal ArticleCategory Technical ReportDOI 10.1007/s11751-008-0039-7Authors Dimitrios Pafilas, Royal Liverpool University and Royal Liverpool Children’s Hospitals NHS Trusts Eaton Road Liverpool L12 2AP UKSelvadurai Nayagam, Royal Liverpool University and Royal Liverpool Children’s Hospitals NHS Trusts Eaton Road Liverpool L12 2AP UK Jou... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1750477 Sat, 30 Aug 2008 08:16:14 +0100 1750477 http://www.medworm.com/index.php?rid=1616524&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff0013v8gh273m295%2F This study describes the epidemiology of radial head and associated fractures of the upper extremity in a Dutch population by a retrospective radiographic review of all patients with a radial head fracture between 1 January 2006 and 1 July 2007. A total of 147 radial head fractures were diagnosed in 145 patients. The incidence in the general population was 2.5 per 10.000 per year. The average age was 45.9 (SD 17.3) years and male–female ratio was 2:3. The mean age of males was significantly lower (37.1, SD 14.2 years) than of women (53.9, SD 16.4 years). Associated fracture of the upper extremity was found in 10.2%. Coronoid fractures were most common (4.1%). Associated upper limb fractures in patients with a radial head fracture are common in the European population. It is of cli... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1616524 Fri, 11 Jul 2008 07:24:28 +0100 1616524 http://www.medworm.com/index.php?rid=3098655&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa845164138103980%2F We report a 22-year-old male with transscaphoid perilunate dislocation who reported to our hospital 8 months after sustaining the injury. Open reduction was done along with bone grafting. Five years after the surgery the patient is symptom-free with an excellent range of motion. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0036-xAuthors Bashir Ahmed Mir, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir IndiaShabir Ahmed Dhar, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir IndiaMohammed Ramzan Mir, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir IndiaMohammed Farooq Butt, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir Indi... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=3098655 Fri, 13 Jun 2008 05:57:14 +0100 3098655 http://www.medworm.com/index.php?rid=1519007&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa845164138103980%2F We report a 22-year-old male with transscaphoid perilunate dislocation who reported to our hospital 8 months after sustaining the injury. Open reduction was done along with bone grafting. Five years after the surgery the patient is symptom-free with an excellent range of motion. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0036-xAuthors Bashir Ahmed Mir, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir IndiaShabir Ahmed Dhar, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir IndiaMohammed Ramzan Mir, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir IndiaMohammed Farooq Butt, Government Hospital for Bone and Joint Surgery Barzullah Srinagar 190005 Kashmir Indi... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1519007 Fri, 13 Jun 2008 05:57:14 +0100 1519007 http://www.medworm.com/index.php?rid=1370956&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F708w3606461j7389%2F The objective of the study was to investigate the feasibility of intramembranous osteogenesis from tissue-engineered bone membrane in vivo. Bone marrow mesenchymal stem cells (MSCs) of rabbits were harvested, expanded and some of them were induced into osteoblasts. Porcine small intestinal submucosa (SIS) was converted by a series of physical and chemical procedures into a scaffold. MSCs and induced osteoblasts were seeded separately onto the scaffold, thus fabricating two kinds of tissue-engineered bone membrane. A total of 12 New Zealand rabbits were subjected to a surgical operation; a 15 mm bone segment, including the periosteum, was resected from the radius on both sides of each rabbit to create critical bone defects. The two kinds of tissue-engineered bone membrane and SIS... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1370956 Sat, 12 Apr 2008 08:54:15 +0100 1370956 http://www.medworm.com/index.php?rid=1356502&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw427h88514411384%2F We report a case of a 51-year-old lady, who underwent a femoral shortening using a fixator assisted blade plate after total hip replacement. The patient had a total hip replacement on the other side with previous revisions, which resulted in a leg length discrepancy. We used the above technique to control the shortening and preserve the mechanical and anatomical axis of the femur. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0031-2Authors Ata George Kasis, 139 Audley, Jesmond Newcastle NE2 2HR UKI. Stockley, Northern General Hospital Sheffield S5 7AU UKM. Saleh, University of Sheffield, Coleridge House, Northern General Hospital Academic Unit of Orthopaedics Sheffield S5 7AU UK Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-892... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1356502 Fri, 04 Apr 2008 16:54:52 +0100 1356502 http://www.medworm.com/index.php?rid=1338293&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx718475671700pu3%2F The objective of this study is to compare percutaneous compression plating (PCCP) device with standard gamma nail (GN). A sample was prospectively followed and compared to a historical cohort: 82 intertrochanteric hip fractures in 81 patients treated with PCCP in 2004 versus 51 hip fractures treated with GN in 2003 (AO type 31A1, 31 A2). The main outcome measures were: surgery times, blood loss (Hb serum level and transfusions), complication, costs, for a 1-year follow-up. The minimally invasive PCCP technique resulted in a lower blood loss and consequently lower transfusion need (statistically significant), fewer implant-related complications and comparable surgery times. Overall surgical costs were lower for a comparable outcome in terms of healing and surgical time. Content Typ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1338293 Sat, 29 Mar 2008 08:59:01 +0100 1338293 http://www.medworm.com/index.php?rid=1338291&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F73nx66t5065u8p78%2F This study is the first evaluation of a new intramedullary implant, the Veronail, that provides double axis fixation into the femoral head and allows the surgeon to choose whether to use sliding or fixed locked proximal screw fixation for trochanteric femoral fractures. The fractures were classified according to the AO classification, and function was assessed with the Modified Harris Hip Score. 111 patients with trochanteric fractures were evaluated in eight Italian hospitals. The stable 31.A1 fractures were treated with sliding proximal screws, the subtrochanteric 31.A3 fractures with converging proximal screws, and the unstable 31.A2 fractures were treated with both types of proximal fixation. The unstable fractures treated with locked converging screws had the same function at on... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1338291 Sat, 29 Mar 2008 08:59:01 +0100 1338291 http://www.medworm.com/index.php?rid=1284895&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ftnw635534g226824%2F We present the case and a review of the literature for this lesion. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11751-008-0033-0Authors A. Reggiori, Ospedale Santissima Trinità Orthopaedic and Trauma Department Viale Zoppis 10 28021 Borgomanero, Novara ItalyG. Brugo, Ospedale Santissima Trinità Orthopaedic and Trauma Department Viale Zoppis 10 28021 Borgomanero, Novara Italy Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1284895 Wed, 05 Mar 2008 07:59:59 +0100 1284895 http://www.medworm.com/index.php?rid=1258800&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7x635514632827k7%2F Abstract  Seventy children with displaced type II and III supracondylar fractures of the humerus were managed with percutaneous lateral cross-wiring technique from January 2006 to January 2007. There were 54 boys and 16 girls with a mean age of 6.1 ± 3.07 years. All patients were operated within 24 h after trauma using the Dorgans percutaneous lateral cross-wiring technique. Patients were followed up for a mean period of 6.1 ± 2.6 months and assessed both radiologically for union; and functionally and cosmetically according to Flynn’s criteria. All patients achieved solid union. Functionally, all patients achieved satisfactory results, while cosmetically, 91.4% of patients had satisfactory results and 8.6% had unsatisfactory results. Th... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1258800 Fri, 22 Feb 2008 15:57:05 +0100 1258800 http://www.medworm.com/index.php?rid=1198218&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd452x76340u86727%2F Abstract  The real extent of damage in high-pressure injection injuries (grease gun injuries, paint gun injuries, pressure gun in juries) is hidden behind a small and frequently painless punctiform skin lesion on the finger or the hand. These kinds of injuries require prompt surgical intervention with surgical debridement of all ischemic tissue. Possibility of a general intoxication by the fluid must always be ruled out. Postoperative intensive physiotherapy is essential for the final hand function. The initial benign aspect is frequently causing a delay for an adequate treatment while in the mean time the possibility for subcutaneous damage continuously increases. Because of this delay the chance of permanent reduced functionality in the hand or finger amputation raises. N... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1198218 Sat, 02 Feb 2008 16:49:37 +0100 1198218 http://www.medworm.com/index.php?rid=1146952&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa34472q03q52258q%2F Abstract  Osteochondroma is the most common benign bone tumour. They most commonly affect the long tubular bones and almost half of osteochondromata are found around the knee. Osteochondroma arising from the distal metaphysis of the tibia typically result in a valgus deformity of the ankle joint secondary to relative shortening of the fibula. This case describes the use of Ilizarov technique for fibular lengthening following excision of a distal tibial osteochondroma. A 12-year-old girl presented with a 3-year history of a large swelling affecting the lateral aspect of the right distal tibia. Plain radiographs confirmed a large sessile osteochondroma arising from the postero-lateral aspect of the distal tibia with deformity of the fibula and 15 mm of fibular shortening... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1146952 Fri, 11 Jan 2008 16:24:52 +0100 1146952 http://www.medworm.com/index.php?rid=1131293&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F247844m686801053%2F Abstract  Medial fractures are the least common type of clavicular fracture (2–10%). The patient is a 29-year-old gynaecology resident with hyper-laxity and sternoclavicular instability. The latter had been surgically stabilized with Dacron® tape, which eroded the bone causing an usura. Acute right shoulder pain occurred 10 years later. CT revealed medial clavicular stress fracture. After 4 weeks of conservative management, internal fixation followed. Five months postoperatively the patient performed all activities without pain. In this patient the weakened medial clavicle due to usura clearly played a role in both the site and nature of the fracture. Furthermore, CT is essential in arriving at the correct diagnosis. Content Type Journal ArticleCategory Case R... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1131293 Thu, 03 Jan 2008 16:31:12 +0100 1131293 http://www.medworm.com/index.php?rid=1082212&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu0408nkt0007n473%2F Abstract  Displaced mid shaft fractures of the clavicle result in some degree of shortening and rotation. These fractures often heal with some degree of malunion which can be symptomatic. The question arises as to whether surgical correction of the deformity will relieve the symptoms associated with the malunion. Ten patients with a symptomatic malunion of the clavicle were treated by means of a corrective osteotomy with plate and screw fixation. Outcome measurement was a pre and postoperative DASH score, range of motion and patient satisfaction. At follow up after a mean duration of 37 months there was a significant improvement of the DASH score, eight patients were satisfied, and range of motion did not differ significantly. Two patients had a complication resulting ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1082212 Fri, 07 Dec 2007 16:38:46 +0100 1082212 http://www.medworm.com/index.php?rid=1082211&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk6vw02q2h766n3t7%2F The objective for the foreseeable future is to resolve the pain, improve the quality of life and prevent or at least postpone arthroplasty. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-007-0021-9Authors R. Aldegheri, Orthopaedic Clinic of the Padua University Via Giulio Alessio 21 35121 Padova ItalyG. Taglialavoro, Orthopaedic Clinic of the Padua University Via Giulio Alessio 21 35121 Padova ItalyA. Berizzi, Orthopaedic Clinic of the Padua University Via Giulio Alessio 21 35121 Padova Italy Journal Strategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1082211 Fri, 07 Dec 2007 16:38:46 +0100 1082211 http://www.medworm.com/index.php?rid=1079915&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9021872077204411%2F Abstract  The purpose of this study was to report the results of the surgical treatment of spastic knee flexion contracture using tenotomy and progressive correction by external fixator–distractor devices. The study design involved a prospective observational study of 16 knees in nine patients with spastic flexion contracture greater than 30�. Treatment was indicated for both ambulatory and nonambulatory patients; and, in the latter group when sitting or personal hygiene was compromised. The average age was 11.6 years (range 10–17). Five of the patients were male and four female. There was one case of hemiplegia (11.1%), two cases of paraplegia (22.2%), and six cases of quadriplegia (66.7%). Six patients retained some walking capacity, while three had none. In al... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1079915 Thu, 06 Dec 2007 16:25:07 +0100 1079915 http://www.medworm.com/index.php?rid=1079914&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F167135v46j68m451%2F Abstract  It is a prerequisite for surgeons using external fixation systems to be familiar with safe corridors for half pin or wire insertion. Several atlases of cross-sectional anatomy are available, mostly in print, to provide guidance [1–3]. This series of articles provides high-quality cross-sectional anatomical images together with guidance in locating safe corridors; the added benefit here is that the information can be downloaded and stored on the surgeon’s or in the operating room computer for ease of reference. This review covers the lower leg from knee joint to foot. Content Type Journal ArticleCategory ReviewDOI 10.1007/s11751-007-0023-7Authors Selvadurai Nayagam, Royal Liverpool University Hospital Department of Trauma and Orthopaedics Prescot Street Liver... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1079914 Thu, 06 Dec 2007 16:25:07 +0100 1079914 http://www.medworm.com/index.php?rid=1075256&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F43268q46174280j2%2F Abstract  Forty elderly patients with basicervical and pertrochanteric fractures were managed with uniplanar AO external fixator under regional anaesthetic block of the femoral nerve and lateral cutaneous nerve of the thigh from April 2003 to March 2006. The mean age of the patients was 67.9 � 5.5 years. External fixator application was performed under radiological control after closed reduction had been obtained. Comorbid factors, duration of surgery, duration of hospitalisation, complications, walking ability, time to union and mortality rate were recorded. Patients were followed up for a mean period of 12 � 4.5 months. Superficial pin tract infection occurred in 13 patients, healing in varus >10� and with shortening >2 cm occ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1075256 Wed, 05 Dec 2007 16:37:24 +0100 1075256 http://www.medworm.com/index.php?rid=1075257&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6r0t325628256263%2F Abstract  Subtrochanteric fractures are fraught with certain anatomic, biologic and biomechanical challenges. Evolution of implants like the Gamma nail, fixed-angle nail plates, compression hip screws and dynamic hip screws with trochanteric stabilization plates underlines a persistent quest for a better implant. We studied the dynamic condylar screw DCS as an implant on a series of 30 consecutive patients with subtrochanteric fractures. Our purpose was to assess this implant as a panacea for subtrochanteric fractures. All cases of AO type A and B were anatomically fixed, whereas type C was biologically plated. The idea was to assess the applicability and adaptability of the DCS. Fractures in 29 cases united, with one patient suffering from an implant failure. There were 17... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1075257 Mon, 03 Dec 2007 18:21:01 +0100 1075257 http://www.medworm.com/index.php?rid=1030321&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9666nn5l56716670%2F Abstract  China is the “economic tiger” of the twenty-first century. Its new economic policies have overturned the outlook and futures of many industries in this nation, and parallel to this industrial progress have been strides in medicine. However a country steeped in a history of several millennia does not replace generations of experience nor knowledge in a few decades. The author explores the history of limb reconstruction surgery in this country, setting it in context of a population exposed to both traditional Chinese medicine and Western medicine. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-007-0020-xAuthors Lei Huang, Beijing Ji shui Tan Hospital, The fourth Medical College of Peking University Department of Orthopaedics and Traum... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1030321 Wed, 14 Nov 2007 16:05:52 +0100 1030321 http://www.medworm.com/index.php?rid=1019480&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkw4163k6m30826m2%2F This study indicated that whilst there are a number of anatomic constraints, it is still possible to insert three pins with good divergence into the limited bony corridor of the peri-acetabular region recognising that the more posterior of the laterally inserted pins poses a potential risk to the sciatic nerve if not inclined away from the sciatic notch. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11751-007-0019-3Authors Shaun Brown, Royal Children’s Hospital Department of Orthopaedic Surgery Flemington Road, Parkville Melbourne VIC 3052 AustraliaIrwin Lasrado, Royal Children’s Hospital Department of Orthopaedic Surgery Flemington Road, Parkville Melbourne VIC 3052 AustraliaLeo Donnan, Royal Children’s Hospital Department of Orthopaedic Surgery Flemingto... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=1019480 Fri, 09 Nov 2007 15:46:08 +0100 1019480 http://www.medworm.com/index.php?rid=796008&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F81l3543v16p134uj%2F Abstract  Congenital insensitivity to pain is a rare condition with an abnormality of interpretation of painful stimuli. This case report illustrates how a sequence of injuries after no or trivial trauma incapacitated a young boy. Especially the bilateral collapse and dislocation of the hip is an unusual sequela of this disorder. Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal VolumeVolume 2 Journal IssueVolume 2, Number 1 / April, 2007 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796008 Mon, 30 Apr 2007 07:03:52 +0100 796008 http://www.medworm.com/index.php?rid=796004&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg360384772134h73%2F We present our experience with a group of severe deformities of the foot that we managed using the V-osteotomy combined with the Ilizarov technique. We present our algorithm of management of complex foot and ankle deformities, together with our prerequisites for patient selection. A detailed description of the operative technique, postoperative care and possible complications is also presented. The combination of the Ilizarov technique and the V-osteotomy offers versatility in foot deformity correction, enabling correction of individual components of the deformity at rates that may be tailored to achieve accurate three-dimensional control. Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal Volum... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796004 Mon, 30 Apr 2007 07:03:52 +0100 796004 http://www.medworm.com/index.php?rid=796005&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F020j83168u171416%2F Abstract  The treatment of chronic radial head dislocation remains controversial. Open reduction of the radial head in combination with correction of malalignment with ulnar osteotomy can be the key to a good surgical result. Between 2001 and 2006, 9 (6 female, 3 male, average age 8.4 (5-11) years) patients were treated surgically for chronic radial head dislocation by one surgeon. The time between trauma and surgery was 7 (1.5-14) months. The procedure consisted of open reduction of the dislocated radial head and reconstruction of the annular ligament in combination with an ulnar osteotomy. An upper arm cast was applied with the forearm in neutral rotation for six weeks. Plates were removed in all patients. Clinical and radiological evaluation took place preoperatively and... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796005 Mon, 30 Apr 2007 07:03:51 +0100 796005 http://www.medworm.com/index.php?rid=796006&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp011ug061k35204l%2F Abstract  Unilateral external fixation can be used in the provisional or definitive treatment of tibial fractures. A properly applied fixator allows bony and soft tissue stability, whereas an improperly applied fixator achieves neither and can be a hindrance. The principles for the successful application of monolateral external fixation, including the rationale for choosing this type of device, the assembly of its components and deciding on planes of application, are discussed in this article. Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal VolumeVolume 2 Journal IssueVolume 2, Number 1 / April, 2007 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796006 Mon, 30 Apr 2007 07:03:49 +0100 796006 http://www.medworm.com/index.php?rid=796003&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy855015302380k74%2F In this study the authors evaluate the results of internal synthesis of femoral fractures in polytraumatised patients initially treated by external fixation (EF). From January 2002 to December 2005, 39 femurs in 37 polytraumatised patients (average age 34.2 years, range 18-44) with closed fractures and an ISS>20 were initially treated with EF. There were three groups: Group A, 13 cases when conversion to internal osteosynthesis occurred after 4-7 days (average 5.6 days); Group B, 11 cases with a 4-6-month interval before internal osteosynthesis, and after investigation using MRI and scintigraphy with labelled leucocytes; Group C, the remaining cases treated definitively with EF. Time of healing, lower limb function, time of return to previous activities and short and long-term com... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796003 Mon, 30 Apr 2007 07:03:49 +0100 796003 http://www.medworm.com/index.php?rid=796010&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7160727n87670285%2F Abstract:  The case of a eleven-year-old girl who had a fracture dislocation of the left elbow with entrapment of the ulnar nerve into the dislocated ulnar epicondyle anlage and unstable forearm fracture of the ipslateral upper extremity is described. This severe injury to the elbow and the ipsilateral forearm is termed “floating forearm” injury. The forearm was stabilized percutaneously and the elbow fracture dislocation, remaining unstable after internal fixation was treated with a pediatric elbow fixator with motion capacity. Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal VolumeVolume 2 Journal IssueVolume 2, Number 1 / April, 2007 (Source: Strategies in Trauma and Limb Re... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796010 Mon, 30 Apr 2007 07:03:48 +0100 796010 http://www.medworm.com/index.php?rid=796009&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff24168h6170l5113%2F Abstract  Injury to the anterior cruciate ligament (ACL) is regarded as critical to the physiological kinematics of the femoral-tibial joint, its disruption eventually causing long-term functional impairment. Both the initial trauma and the pathologic motion pattern of the injured knee may result in primary degenerative lesions of the secondary stabilisers of the knee, each of which are associated with the early onset of osteoarthritis. Consequently, there is a wide consensus that young and active patients may profit from reconstructing the ACL. Several factors have been identified as significantly influencing the biomechanical characteristics and the functional outcome of an ACL reconstructed knee joint. These factors are: (1) individual choice of autologous graft material... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796009 Mon, 30 Apr 2007 07:03:48 +0100 796009 http://www.medworm.com/index.php?rid=796007&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fxl2n63721812521m%2F Abstract  A retrograde nail with posterior-to-anterior (PA) locking into os calcis, talus and tibia was used to correct deformity and achieve fusion after failed fusion. A variety of methods have been published to achieve union of the ankle and subtalar joint in a failed fusion situation. We have studied a retrograde locking nail technique through a 2.5-cm incision in the non-weightbearing part of the sole of the foot. Remaining cartilage in the ankle joint, where necessary, was percutaneously removed through an anterior approach and the locking nail was inserted after reaming of os calcis, talus and tibia. Locking screw insertion was in the sagittal plane (p.a. direction), in talus os calcis and tibial diaphysis using a nail mounted jig. Ten patients were entered in the st... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796007 Mon, 30 Apr 2007 07:03:46 +0100 796007 http://www.medworm.com/index.php?rid=796012&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6707220r47qg5p88%2F Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal VolumeVolume 1 Journal IssueVolume 1, Number 1 / December, 2006 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796012 Wed, 03 Jan 2007 18:24:54 +0100 796012 http://www.medworm.com/index.php?rid=796011&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw87j6301r162p487%2F Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal VolumeVolume 1 Journal IssueVolume 1, Number 1 / December, 2006 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796011 Wed, 03 Jan 2007 18:24:54 +0100 796011 http://www.medworm.com/index.php?rid=796020&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq05311182r314138%2F We report a case of a 9 year old female child with congenital pseudarthrosis of the radius. She had a history of fractures of both bones of the left forearm after trivial trauma at the age of 7 years (2003) and 8 years (2004). On each occasion she was treated conservatively in a POP cast 4 weeks. She reported to us in January 2005 complaining of a gradually increasing deformity of the left forearm. Radiologically, it was an apex anterior deformity of the distal aspect of the left radius. Clinically she had multiple caf au lait spots over her body. Neurological and ophthalmological examinations were normal. The fibrous tissue and the fracture ends were excised. The fracture was stabilized with a 6-hole DCP with iliac crest graft to bridge the gap along with cortico-cancellous c... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796020 Thu, 14 Dec 2006 20:37:01 +0100 796020 http://www.medworm.com/index.php?rid=796019&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgh48x51053445544%2F Abstract  While osteotomies are necessary for rotational correction and limb lengthening, angular correction or moderate length inhibition may be achieved by other, less invasive means. Several techniques of epiphysiodesis have evolved, enabling gradual correction of angular correction and/or length equalisation through guided growth. This manuscript comprises a historical and comparative review of those techniques. The 8-plate method of guided growth affords the opportunity to provide a tension band (rather than compression) that expedites angular correction, compared to stapling or transphyseal screws, which rely upon the principle of compression. When applied to each side of a given physis, longitudinal growth is inhibited, in the same fashion as stapling or epiph... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796019 Thu, 14 Dec 2006 20:37:01 +0100 796019 http://www.medworm.com/index.php?rid=796018&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh38k23m1165k3881%2F Abstract  In a prospective randomised trial, the effects of an intermittent compression hand pump vs. cryotherapy were compared on reduction of postoperative hand swelling and gain in finger movement after distal radius fractures. Although intermittent compression as a physical method for thromboprophylaxis and swelling reduction in orthopaedic and trauma patients of the lower leg are established, a prospective randomised trial for an objective evaluation of the effects of intermittent compression in the upper extremity has not been previously performed. Forty-three subjects (6333 years, 32 women, 11 men) with a unilateral distal radius fracture treated with transarticular external fixation were randomised into two treatment groups. In group A 21 patients were treate... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796018 Thu, 14 Dec 2006 20:37:01 +0100 796018 http://www.medworm.com/index.php?rid=796017&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0456xgn43822njw1%2F Abstract  Distal tibial extra-articular fractures are often a result of complex high-energy trauma, which commonly involves associated fibular fractures and soft tissue injury. The goal of tibial fixation is to maximise fracture stability without increasing soft tissue morbidity from surgical intervention. The role of adjunctive fibular fixation in distal tibial metaphyseal fractures has been controversial; although fibular fixation has been shown to improve stability of distal tibial fractures, there has been increased potential for soft tissue-related complications and a delay to tibial fracture healing. Adjunctive fixation of concomitant fibular fractures without associated syndesmotic or ankle pathology is not necessary in surgically stabilised extra-articular met... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796017 Thu, 14 Dec 2006 20:37:01 +0100 796017 http://www.medworm.com/index.php?rid=796016&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F86067h36364u5360%2F Abstract  Salvage of a failed valgus osteotomy for nonunion of an unstable pertrochanteric fracture is reported. A valgus intertrochanteric osteotomy was performed for a failed sliding hip screw fixation of an unstable pertrochanteric fracture at another institution. Four months following osteotomy, the fracture was still un-united with two distal screws of the hip plate broken and a coxa vara deformity. Reconstruction was performed with a nine-hole 95 angle blade plate and cancellous bone graft, because the insufficient fixation of the distal fragment was considered to be the main reason for failure. The osteotomy was healed at six months post-surgery and the patient reported complete resolution of symptoms. Intertrochanteric valgus osteotomy is an effective procedu... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796016 Thu, 14 Dec 2006 20:37:01 +0100 796016 http://www.medworm.com/index.php?rid=796015&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F93407u3r1knn033t%2F Abstract  Comminuted fractures of the distal end of the radius are caused by high-energy trauma and present as shear and impacted fractures of the articular surface of the distal radius with displacement of the fragments. The force of the impact and the position of the hand and carpal bone determine the pattern of articular fragmentation and their displacement and the amount and the extent of frequent concommitant ligament and carpal bone injury. The result of the osseous lesion in comminuted fractures was termed "pilon radiale", which emphasizes the amount of damage to the distal radius and the difficulties to be expected in restoring the articular congruity. Besides this the additional injury, either strain of disruption of the ligaments and the displacement of the... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796015 Thu, 14 Dec 2006 20:37:01 +0100 796015 http://www.medworm.com/index.php?rid=796014&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr226377g55048125%2F This article describes the specific attributes of Schatzker type 6 injuries (AO 41C) that enable decisionmaking algorithms to be generated and balances the merits for plate stabilisation and external fixation against injury characteristics. A detailed description is given for circular fixation in these injuries to assist those unfamiliar with the technique. Content TypeJournal Article JournalStrategies in Trauma and Limb ReconstructionOnline ISSN 1828-8928Print ISSN 1828-8936 Journal VolumeVolume 1 Journal IssueVolume 1, Number 1 / December, 2006 (Source: Strategies in Trauma and Limb Reconstruction) Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796014 Thu, 14 Dec 2006 20:37:01 +0100 796014 http://www.medworm.com/index.php?rid=796013&cid=s_36009_31_f&fid=36009&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F162867415k030976%2F Abstract  The aim of this article is to help clinicians and allied professionals understand problems that may arise with use of external fixators in limb reconstruction and trauma, and in particular describe how preventative strategies can be implemented. The indications for splinting and orthotic use with external fixators can be broadly subdivided into those that facilitate functional loading and those that maintain joint integrity and function. Specific techniques to accompany use of external fixators in fracture management and limb reconstruction are described. In particular, problems concerning knee, ankle and foot support together with leg length issues are covered and proposals for dealing with joint subluxation, forefoot deformity and toe clawing, regenerate ... Strategies in Trauma and Limb Reconstruction journals http://www.medworm.com/rss/comments.php?id=796013 Thu, 14 Dec 2006 20:37:01 +0100 796013