A simple and light weight external fixator for distraction advancement manoplasty.

Background: With the growing interest in long bone distraction several types of distractors have been introduced; all have the same principle of an outer structure which acts like a scaffold and the distracting mechanism is a separate device which is mounted on this outer structure.

Objectives: We have used a simple and very light weight external fixator we designed and discuss the results of distraction and advantages of this device .

Materials And Methods: We applied our distractor to treat 14 men and four women, with a mean age of 39 years.

Combined rib-latissimus flap; the "picket fence" concept for reconstruction of upper tibia defects.

Background: Upper tibia defects ,type3b Gustilo, due to huge size and volume are very difficult to reconstruct; usually several operations are needed for bone and soft tissue defects and the definite one stage reconstruction is yet to be found.

Objectives: In this article we reintroduce the rib- latissimus flap as an acceptable method to reconstruct tibia defects in selected cases.

Materials And Methods: The latissimus muscle with one or two ribs revascualrized by reverse flow from perforators is harvested; the ribs are bisected after harvest yielding four to six struts of vascularized bone to fill the huge upper tibia defect.