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Complex reconstruction after wide excision of juvenile aponeurotic fibromatoses of upper one-third of leg
This report presents a 12-year-old boy with a juvenile musculoaponeurotic fibromatosis in the anteromedial aspect of the upper third of a left leg. Following wide local excision, two local flaps, medial gastrocnemius and a distally based peroneal artery perforator flap, were used to reconstruct the soft tissue defect. Reconstruction has provided an acceptable functional and cosmetic result. (Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - August 1, 2014 Category: Orthopaedics Source Type: research

Nailing treatment in bone transport complications
Abstract A series of cases of reamed intramedullary nailings carried out after complications in regenerated bone and docking site had occurred in bone transport is presented here. Nine patients (femur = 5; tibia = 4) had treatment with resection after open fractures or infection and underwent bone transport. The mean length of regenerated bone was 9.5 cm (range 6–18 cm). After bone transport, the fixator remained in place for a mean period of 12.8 months (range 8–24 months). In six cases (femur 4; tibia 2), the thickness of the cortical wall of the regenerate column was insufficient, and in ...
Source: Strategies in Trauma and Limb Reconstruction - August 1, 2014 Category: Orthopaedics Source Type: research

Results in treatment of distal femur fractures using polyaxial locking plate
In conclusion, there is a high union rate for complex distal femoral fractures associated with a good clinical outcome in this series. (Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Bicondylar tibial plateau fractures treated with fine-wire circular external fixation
Abstract Bicondylar tibial plateau fractures are serious injuries to a major weight-bearing joint. These injuries are often associated with severe soft tissue injuries that complicate surgical management. We reviewed 54 consecutive patients who sustained bicondylar tibial plateau fractures that were treated with limited open reduction and cannulated screw fixation combined with fine-wire circular external fixation. Forty-six patients met the inclusion criteria of this retrospective review. Eight patients were excluded because they did not complete a minimum of 1-year follow-up. Thirty-six patient...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Patient-reported outcomes following treatment of tibial non-union with circular frames
Abstract The management of tibial non-union is challenging with protracted, often arduous, treatments. The purpose of this study was to assess patient-reported outcomes following treatment of tibial non-union in circular external fixators. Twenty-one patients with tibial non-unions who successfully completed treatment at a mean of 10.1 months (range 6–20) in a circular external fixator were sent questionnaires utilising the Enneking scoring system and Euroqol EQ-5D. There were 14 responses. The mean Enneking score was 58.0 % (34.3–77.1). Two patients were enthusiastic about their treatment, while ...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Can the material properties of regenerate bone be predicted with non-invasive methods of assessment? Exploring the correlation between dual X-ray absorptiometry and compression testing to failure in an animal model of distraction osteogenesis
Abstract Evaluation of the material properties of regenerate bone is of fundamental importance to a successful outcome following distraction osteogenesis using an external fixator. Plain radiographs are in widespread use for assessment of alignment and the distraction gap but are unable to detect bone formation in the early stages of distraction osteogenesis and do not quantify accurately the structural properties of the regenerate. Dual X-ray absorptiometry (DXA) is a widely available non-invasive imaging modality that, unlike X-ray, can be used to measure bone mineral content (BMC) and density quantit...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Success of torsional correction surgery after failed surgeries for patellofemoral pain and instability
Abstract Torsional deformities of the femur and/or tibia often go unrecognized in adolescents and adults who present with anterior knee pain, and patellar maltracking or instability. While open and arthroscopic surgical techniques have evolved to address these problems, unrecognized torsion may compromise the outcomes of these procedures. We collected a group of 16 consecutive patients (23 knees), with mean age of 17, who had undergone knee surgery before torsion was recognized and subsequently treated by means of rotational osteotomy of the tibia and/or femur. By follow-up questionnaire, we soug...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Percutaneous cerclage wiring for the surgical treatment of displaced patella fractures
Abstract The patella plays an important role in the knee joint extension, and a patella fracture requires surgical treatment when it is accompanied by displacement of bone fragments and a joint surface gap. In patella fractures, there is disruption of the soft tissue structures that support the knee extension mechanism. We use a method of percutaneous cerclage wiring to fix the patella and include the peripatellar soft tissues in five patients. All cases were closed fractures, and the AO classification was type A in 1 and type C in 4. At a mean follow-up of 11.2 months, union was achieved in four cases...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Guided growth of the trochanteric apophysis combined with soft tissue release for Legg–Calve–Perthes disease
Abstract During the initial fragmentation stage of Perthes disease, the principle focus is to achieve containment of the femoral head within the acetabulum. Whether by bracing, abduction casts, femoral and/or pelvic osteotomy, the goals are to maximize the range of hip motion and to avoid incongruity, hoping to avert subsequent femoro-acetabular impingement or hinge abduction. A more subtle and insidious manifestation of the disease relates to growth disturbance involving the femoral neck. We have chosen to tether the greater trochanteric physis, combined with a medial soft tissue release, as par...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Epiphysiodesis for limb length discrepancy: a comparison of two methods
This study has led to our preference for the Canale method, which in our hands has fewer complications and is more successful at reaching the desired discrepancy correction. (Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Correction osteotomy of distal radius malunion stabilised with dorsal locking plates without grafting
Abstract The purpose of this study was to evaluate the results of our correction osteotomies of distal radial malunions without a bone graft. Eleven consecutive patients (mean age 52 years, range 18–71) were treated. A dorsal approach was utilised to perform an opening-wedge osteotomy which then was stabilised with two dorsal columnar plates without filling the osteotomy gap. All patients went on to radiographic union with a filling of the osteotomy gap within a mean period of 3 months (range 2–6 months). All patients had satisfactory results in terms of function and pain. Correction osteotomy an...
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Local perforator island flaps in post-traumatic reconstruction of middle third of the leg
We report that it is possible to raise these flaps in cases of post-traumatic lower limb reconstruction with good results. Consideration must be given to the type of movement that is planned vis-a-vis the number of perforators identified. (Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research

Reviewers 2013
(Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - April 1, 2014 Category: Orthopaedics Source Type: research