Strategies in Trauma and Limb Reconstruction
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Removal of a broken intramedullary femoral nail with an unusual pattern of breakage: a case report
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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...
Source: Strategies in Trauma and Limb Reconstruction - September 24, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Functional salvage of a mangled lower limb using custom-made endoprosthetic replacementEmail this article to a colleague.
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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 w...
Source: Strategies in Trauma and Limb Reconstruction - September 24, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The use of a retrograde fixed-angle intramedullary nail for tibiocalcaneal arthrodesis after severe loss of the talusEmail this article to a colleague.
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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 comorbiditi...
Source: Strategies in Trauma and Limb Reconstruction - September 15, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
External fixation as a primary and definitive treatment for tibial diaphyseal fracturesEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - August 28, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Reamed interlocking intramedullary nailing for the treatment of tibial diaphyseal fractures and aseptic nonunions. Can we expect an optimum result?Email this article to a colleague.
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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 I...
Source: Strategies in Trauma and Limb Reconstruction - August 24, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Treatment of chronically unreduced complex dislocations of the elbowEmail this article to a colleague.
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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 ...
Source: Strategies in Trauma and Limb Reconstruction - August 24, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Magnetic resonance imaging analysis of the bioabsorbable Milagro™ interference screw for graft fixation in anterior cruciate ligament reconstructionEmail this article to a colleague.
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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, P...
Source: Strategies in Trauma and Limb Reconstruction - August 20, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Intramuscular myxoma of the hypothenar musclesEmail this article to a colleague.
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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 Amma...
Source: Strategies in Trauma and Limb Reconstruction - August 19, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Principles of the therapy of bone infections in adult extremitiesEmail this article to a colleague.
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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 G...
Source: Strategies in Trauma and Limb Reconstruction - July 6, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Fixation of subtrochanteric fracturesEmail this article to a colleague.
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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 tw...
Source: Strategies in Trauma and Limb Reconstruction - June 6, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
First dorsal metacarpal artery flap for thumb reconstruction: a retrospective clinical studyEmail this article to a colleague.
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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 islan...
Source: Strategies in Trauma and Limb Reconstruction - April 2, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Combined surgical treatment for missed rupture of triceps tendon associated with avulsion of the ulnar collateral ligament and flexor-pronator muscle massEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - April 2, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Soft tissue distraction in hand surgery: the “pentagonal frame” techniqueEmail this article to a colleague.
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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 s...
Source: Strategies in Trauma and Limb Reconstruction - March 25, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Management of distal tibial intra-articular fractures with circular external fixationEmail this article to a colleague.
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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 fractu...
Source: Strategies in Trauma and Limb Reconstruction - March 20, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Strategies for the analysis of osteitic bone defects at the diaphysis of long bonesEmail this article to a colleague.
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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, fo...
Source: Strategies in Trauma and Limb Reconstruction - March 14, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Neglected Achilles tendon rupture with central insertional plantaris tendon hypertrophy: two casesEmail this article to a colleague.
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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 occupie...
Source: Strategies in Trauma and Limb Reconstruction - March 11, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Undisturbed theatre dressing during the first postoperative week. A benefit in the treatment by external fixation: a cohort studyEmail this article to a colleague.
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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 1828-892...
Source: Strategies in Trauma and Limb Reconstruction - March 11, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Unusual cause of haemorrhage from surgical wound in a childEmail this article to a colleague.
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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 Rad...
Source: Strategies in Trauma and Limb Reconstruction - March 11, 2009 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Relapsed clubfoot correction with soft-tissue release and selective application of Ilizarov techniqueEmail this article to a colleague.
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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 ...
Source: Strategies in Trauma and Limb Reconstruction - December 5, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Use of the Ilizarov apparatus to improve alignment in proximal humeral fractures treated initially by a unilateral external fixatorEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - November 28, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Infrequent physeal wrist injury of the ulna and radius: a case reportEmail this article to a colleague.
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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 ...
Source: Strategies in Trauma and Limb Reconstruction - November 26, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Hand dominance and gender in forearm fractures in childrenEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - November 23, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Recurrence after correction of acquired ankle equinus deformity in children using Ilizarov techniqueEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - November 20, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Bone lengthening with extra-articular arthrodesis of the hip using external fixationEmail this article to a colleague.
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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.
Conte...
Source: Strategies in Trauma and Limb Reconstruction - September 23, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Methicillin-resistant
Staphylococcus aureus
infected pseudo-arthrosis of the distal tibia treated with debridement, mesh cage, autologous grafting and locking plate fixationEmail this article to a colleague.
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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: Str...
Source: Strategies in Trauma and Limb Reconstruction - September 9, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Profunda femoris artery pseudoaneurysm after surgery and traumaEmail this article to a colleague.
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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 Departm...
Source: Strategies in Trauma and Limb Reconstruction - September 9, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The management of distal ulnar fractures in adults: a review of the literature and recommendations for treatmentEmail this article to a colleague.
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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.
Conten...
Source: Strategies in Trauma and Limb Reconstruction - September 3, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fractureEmail this article to a colleague.
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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 ...
Source: Strategies in Trauma and Limb Reconstruction - September 2, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The pelvic support osteotomy: indications and preoperative planningEmail this article to a colleague.
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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 Eato...
Source: Strategies in Trauma and Limb Reconstruction - August 30, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The incidence of associated fractures of the upper limb in fractures of the radial headEmail this article to a colleague.
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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%....
Source: Strategies in Trauma and Limb Reconstruction - July 11, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Open reduction and internal fixation in a case with transscaphoid perilunate dislocation 8 months after the injury: a patient with a 5-year follow-upEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - June 13, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The study of the feasibility of segmental bone defect repair with tissue- engineered bone membrane: a qualitative observationEmail this article to a colleague.
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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, inclu...
Source: Strategies in Trauma and Limb Reconstruction - April 12, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
External fixator-assisted acute shortening with internal fixation for leg length discrepancy after total hip replacementEmail this article to a colleague.
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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, Co...
Source: Strategies in Trauma and Limb Reconstruction - April 4, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Percutaneous compression plating versus gamma nail for the treatment of pertrochanteric hip fracturesEmail this article to a colleague.
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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 impl...
Source: Strategies in Trauma and Limb Reconstruction - March 29, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The treatment of stable and unstable proximal femoral fractures with a new trochanteric nail: results of a multicentre study with the VeronailEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - March 29, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Traumatic anterior hip dislocation associated with anterior and inferior iliac spines avulsions and a capsular–labral lesionEmail this article to a colleague.
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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)
Source: Strategies in Trauma and Limb Reconstruction - March 5, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Results of treatment of displaced supracondylar humeral fractures in children by percutaneous lateral cross-wiring techniqueEmail this article to a colleague.
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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 soli...
Source: Strategies in Trauma and Limb Reconstruction - February 22, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
High-pressure injection injury of the hand: an often underestimated trauma: case report with study of the literatureEmail this article to a colleague.
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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 po...
Source: Strategies in Trauma and Limb Reconstruction - February 2, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Fibular lengthening by Ilizarov method secondary to shortening by osteochondroma of distal tibiaEmail this article to a colleague.
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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 radiograph...
Source: Strategies in Trauma and Limb Reconstruction - January 11, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
A pseudo-iatrogenic case of medial clavicular fractureEmail this article to a colleague.
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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 pla...
Source: Strategies in Trauma and Limb Reconstruction - January 3, 2008 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Corrective osteotomy after malunion of mid shaft fractures of the clavicleEmail this article to a colleague.
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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 ...
Source: Strategies in Trauma and Limb Reconstruction - December 7, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The tantalum screw for treating femoral head necrosis: rationale and resultsEmail this article to a colleague.
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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 - December 7, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Monolateral external fixation for the progressive correction of neurological spastic knee flexion contracture in childrenEmail this article to a colleague.
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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...
Source: Strategies in Trauma and Limb Reconstruction - December 6, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Safe corridors in external fixation: the lower leg (tibia, fibula, hindfoot and forefoot)Email this article to a colleague.
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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 Artic...
Source: Strategies in Trauma and Limb Reconstruction - December 6, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Safety and reliability of external fixation for basicervical and intertrochanteric fractures in high-risk elderly patientsEmail this article to a colleague.
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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 m...
Source: Strategies in Trauma and Limb Reconstruction - December 5, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
The dynamic condylar screw in the management of subtrochanteric fractures: does judicious use of biological fixation enhance overall results?Email this article to a colleague.
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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 plate...
Source: Strategies in Trauma and Limb Reconstruction - December 3, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Limb reconstruction surgery in China: an evaluation of its role in the largest developing nationEmail this article to a colleague.
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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 A...
Source: Strategies in Trauma and Limb Reconstruction - November 14, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Peri-acetabular external fixation for hip disease: an anatomical studyEmail this article to a colleague.
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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 De...
Source: Strategies in Trauma and Limb Reconstruction - November 9, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
A life without pain: a case reportEmail this article to a colleague.
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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)
Source: Strategies in Trauma and Limb Reconstruction - April 30, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
Correction of complex foot deformities using the V-osteotomy and the Ilizarov techniqueEmail this article to a colleague.
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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 thre...
Source: Strategies in Trauma and Limb Reconstruction - April 30, 2007 Category: Orthopaedics Tags: Strategies in Trauma and Limb Reconstruction Source Type: journals
