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Multiple osteochondromas (MO) in the forearm: a 12-year single-centre experience
We describe visualizing, planning and treating these forearm deformities in MO and, in particular, a detailed account of the surgical correction of Masada type I and Masada type II MO forearm deformities. (Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - October 12, 2016 Category: Orthopaedics Source Type: research

Stability at the half pin –frame interface on external fixation constructs
AbstractA mechanical study investigating the use of two different methods (grub and bolt screws) to secure external fixation half pins to circular frames. A four part experiment: (1) Grub and bolt screws were used to secure half pins in Taylor Spatial frames. Loosening torques were measured using a calibrated torque wrench. (2) Using universal testing machine (UTM), axial loading was applied to establish thresholds for loosening in grub and bolt screw constructs. (3) We established the application torque to produce failure at the head –driver interface using these two methods. (4) Grub and bolt screw constructs were crea...
Source: Strategies in Trauma and Limb Reconstruction - October 12, 2016 Category: Orthopaedics Source Type: research

Comminuted supracondylar femoral fractures: a biomechanical analysis comparing the stability of medial versus lateral plating in axial loading
AbstractThe aim of this study was to compare the biomechanical properties of medial and lateral plating of a medially comminuted supracondylar femoral fracture. A supracondylar femoral fracture model comparing two fixation methods was tested cyclically in axial loading. One-centimetre supracondylar gap osteotomies were created in six synthetic femurs approximately 6  cm proximal to the knee joint. There were two constructs investigated: group 1 and group 2 were stabilized with an 8-hole LC-DCP, medially and laterally, respectively. Both construct groups were axially loaded. Global displacement (total length), wedge displa...
Source: Strategies in Trauma and Limb Reconstruction - October 11, 2016 Category: Orthopaedics Source Type: research

The use of blocking screws with internal lengthening nail and reverse rule of thumb for blocking screws in limb lengthening and deformity correction surgery
AbstractInternal lengthening nail (ILN) is a recent development in limb lengthening and deformity correction specialty. The ILN has the distinct advantage of combining acute deformity correction with gradual lengthening of bone. While using ILN, the short metaphyseal bone fragment may develop a deformity at the time of osteotomy and nail insertion or during bone lengthening because of the wide medullary canal. These deformities are typically predictable, and blocking screws (Poller screws) are helpful in these situations. This manuscript describes the common deformities that occur in femur and tibia with osteotomies at dif...
Source: Strategies in Trauma and Limb Reconstruction - September 23, 2016 Category: Orthopaedics Source Type: research

Recognizing the elbow prosthesis on conventional radiographs
The objective of this study was to make an overview that can be useful in determining which type and brand of prosthesis a patient has when visiting the emergency department or outpatient clinic with a periprosthetic fracture, dislocation, or implant failure. The commonly used prostheses in Europe are opted for this list. The radiographs used for this list are obtained either from the company or from our own patients. This list contains the Coonrad/Morrey total elbow prosthesis, the Nexel total elbow prosthesis, the GSB III Elbow Prosthesis, the iBP Total Elbow System, the Discovery Elbow System, the NESimplavit Elbow Syst...
Source: Strategies in Trauma and Limb Reconstruction - September 22, 2016 Category: Orthopaedics Source Type: research

Distraction osteogenesis for tibial nonunion with bone loss using combined Ilizarov and Taylor spatial frames versus a conventional circular frame
AbstractThis retrospective review assesses 55 tibial nonunions with bone loss to compare union achieved with combined Ilizarov and Taylor spatial frames (I –TSF) versus a conventional circular frame with the standard Ilizarov procedure. Seventeen (31 %) of the 55 nonunions were infected. Thirty patients treated with I–TSF were compared with 25 patients treated with a conventional circular frame. In the I–TSF group, an average of 7.6 cm of bone was resected and the lengthening index (treatment time in months divided by lengthening amount in centimeters) was 1.97. In the conventional circular frame group, a mean of 6...
Source: Strategies in Trauma and Limb Reconstruction - September 21, 2016 Category: Orthopaedics Source Type: research

Reviewers 2015
(Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - July 18, 2016 Category: Orthopaedics Source Type: research

Contribution of G.A. Ilizarov to bone reconstruction: historical achievements and state of the art
Abstract Methodological solutions of Prof. G.A. Ilizarov are the core stone of the contemporary bone lengthening and reconstruction surgery. They have been acknowledged in the orthopaedic world as one of the greatest contributions to treating bone pathologies. The Ilizarov method of transosseous compression–distraction osteosynthesis has been widely used for managing bone non-union and defects, bone infection, congenital and posttraumatic limb length discrepancies, hand and foot disorders. The optimal conditions for implementing distraction and compression osteogenesis were proven by numerous experiment...
Source: Strategies in Trauma and Limb Reconstruction - July 17, 2016 Category: Orthopaedics Source Type: research

The management of paediatric diaphyseal femoral fractures: a modern approach
Abstract The definitive treatment of paediatric femoral diaphyseal fractures remains controversial. Modalities of treatment vary mostly according to age, with fracture pattern and site having a lesser impact. Current evidence is reflective of this variation with most evidence cited by the American Academy of Orthopedic Surgeons being level 4 or 5. The authors present a review of the most up-to-date evidence relating to the treatment of these fractures in each age group. In an attempt to clarify the current trends, we have produced an algorithm for decision-making based on the experience from our own terti...
Source: Strategies in Trauma and Limb Reconstruction - July 10, 2016 Category: Orthopaedics Source Type: research

The outcome of treatment of chronic osteomyelitis according to an integrated approach
In this study, we assessed the short-term treatment outcome in adult patients with long-bone chronic osteomyelitis prospectively where a modified host classification system was integrated with treatment strategy selection through a novel management algorithm. Twenty-six of the 28 enrolled patients were available for follow-up at a minimum of 12 months. The median patient age of was 36.5 years (range 18–72 years). Fourteen patients (54 %) were managed palliatively, and 11 patients (42 %) were managed through the implementation of a curative treatment strategy. One patient required alternative treatment in the form of...
Source: Strategies in Trauma and Limb Reconstruction - June 30, 2016 Category: Orthopaedics Source Type: research

Percutaneous rotational osteotomy of the femur utilizing an intramedullary rod
Abstract The purpose is to describe the technique and report the results and complications of percutaneous femoral rotational osteotomy, secured with a trochanteric-entry, locked intramedullary rod, in adolescents with femoral anteversion. Our series comprised an IRB approved, retrospective, consecutive series of 85 osteotomies (57 patients), followed to implant removal. The average age at surgery was 13.3 years (range 8.8–18.3) with a female-to-male ratio of 2.8:1. The minimum follow-up was 2 years. Eighty-three osteotomies healed primarily. Two patients, subsequently found to have vitamin D deficien...
Source: Strategies in Trauma and Limb Reconstruction - June 17, 2016 Category: Orthopaedics Source Type: research

Femoral locking plate failure salvaged with hexapod circular external fixation: a report of two cases
We report two cases of stiff hypertrophic femoral non-unions after failed locking plate fixation that were successfully treated with a new hexapod circular external fixator. In addition to providing the necessary stability for functional rehabilitation and union, the hexapod circular fixator software allows gradual correction of deformities in order to restore the normal mechanical alignment of the limb. (Source: Strategies in Trauma and Limb Reconstruction)
Source: Strategies in Trauma and Limb Reconstruction - May 26, 2016 Category: Orthopaedics Source Type: research

A novel intramedullary callus distraction system for the treatment of femoral bone defects
Abstract An intramedullary device has some advantages over external fixation in callus distraction for bone defect reconstruction. There are difficulties controlling motorized intramedullary devices and monitoring the distraction rate which may lead to poor results. The aim of this study was to design a fully implantable and non-motorized simple distraction nail for the treatment of bone defects. The fully implantable device comprises a tube-in-tube system and a wire pulling mechanism for callus distraction. For the treatment of femoral bone defects, a traction wire, attached to the device at one end, is ...
Source: Strategies in Trauma and Limb Reconstruction - May 23, 2016 Category: Orthopaedics Source Type: research

Prevention of pin site infection in external fixation: a review of the literature
Abstract Pin site infections are a common complication of external fixation that places a significant burden on the patient and healthcare system. Such infections increase the number of clinic visits required during a patient’s course of treatment, can result in the need for additional treatment including antibiotics and surgery, and most importantly can compromise patient outcomes should osteomyelitis or instability result from pin loosening or need for pin or complete construct removal. Factors that may influence the development of pin site infections include patient-specific risk factors, surgical t...
Source: Strategies in Trauma and Limb Reconstruction - May 11, 2016 Category: Orthopaedics Source Type: research

Evaluation of the muscle morphology of the obturator externus and piriformis as the predictors of avascular necrosis of the femoral head in acetabular fractures
Abstract Avascular necrosis (AVN) of femoral head is a recognised complication of fracture dislocation of the hip joint but is not studied frequently in relation to acetabulum fractures. The aim was to establish the relationship between obturator externus and piriformis muscle morphology in acetabulum fractures and potenital development of AVN of the femoral head. Twenty-five fractures were included in this prospective study and were subjected to radiological assessment and computed tomography of the pelvis. Magnetic resonance imaging (MRI) of the hip was performed to assess the morphology of obturator ex...
Source: Strategies in Trauma and Limb Reconstruction - April 25, 2016 Category: Orthopaedics Source Type: research