Bone reconstruction: Subjective evaluation and objective analysis based on conventional digital X-rays - a retrospective evaluation.

Background: Various approaches have been used to evaluate callus stiffness in distraction osteogenesis. This assessment becomes even more critical as inadequate corticalization and premature removal of the frame lead to bending, refracture, and loss of length. This study aimed to verify the objective Pixel Value Ratio (PVR) and define an evaluation scheme to assess callus tissue development during internal and external bone lengthening.

The influence of advanced age in bone healing after intramedullary limb lengthening.

Background: Distraction osteogenesis with an intramedullary motorized nail is a well-established method to treat leg length discrepancy (LLD). The complex process of bone consolidation is affected by age, location, comorbidities, smoking and gender. The purpose of this case series was to investigate influencing factors in bone regeneration after intramedullary callus distraction.

Implant failure after externally magnetic-controlled nail lengthening.

The number of intramedullary procedures to treat leg length discrepancy (LLD) has risen in the past decade and this has led to increased complications such as nail breakage. The aim of this study was to reveal our experience with implant failure after externally magnetic-controlled telescopic bone lengthening. We observed nail-breakage in 4 out of 24 patients (16.

Computed Tomography in Limb Salvage and Deformity Correction-3D Assessment, Indications, Radiation Exposure, and Safety Considerations.

Computed tomography (CT) is an essential tool in orthopedic surgery but is known to be a method with that entails radiation exposure. CT increases the risk of developing fatal cancer, which should not be underestimated. However, patients with bone defects and/or deformities must frequently undergo numerous investigations during their treatment.

Intramedullary Bone Lengthening Following Preceding Hip Surgery-A Case Series.

Limb length discrepancy (LLD) is a common problem after joint-preserving hip surgeries, hip dysplasia, and hip deformities. Limping, pain, sciatica, paresthesia, and hip instability are common clinical findings and may necessitate limb-lengthening procedures. The study included five patients (two female and three male, mean age of 28 years (20-49; SD: 12)) with symptomatic limb length discrepancy greater than 2.

Anatomical Considerations of Intramedullary Humeral Nailing and Lengthening.

Intramedullary lengthening, in cases of extensive humeral shortening, offers the advantages of preventing external-fixator-associated problems. The humeral cavity, as the main parameter in nailing, however, has been neglected in recent literature. It was hypothesized that available implants might be too large and therefore increase the risk of intraoperative fractures.

Innovative Technique in Extended Intramedullary Humeral Lengthening: A Case Report.

Case: Intramedullary humeral lengthening is still a very uncommon procedure to treat humeral limb length discrepancy (LLD). This approach has various advantages compared with external devices but is limited in its ability to lengthen bones because of the length of the telescopic nail. This case report describes a middle-aged patient with a short right humerus secondary to a childhood growth plate injury that was successfully lengthened with an off-label application of a tibial distracting device.

Traumatic periimplant fracture after nail arthrodesis of the knee in a limb reconstruction case.

Many principles of bone reconstruction were successfully applied in this unique case of a 1.92m (6 ft 3 in.) tall 15 year old boy with intercalary leg amputation.

[Intramedullary upper arm lengthening].

The new technology of motorized intramedullary telescopic nails has simplified the treatment for upper limb lengthening surgery. Improved patient comfort, low infection rates and absence of fractures in the regenerated bone are contrasted by the limitations of the methods, such as a current maximum distraction of 5cm and the fact that they cannot be used when the growth plates are still open.

Femoral shortening does not impair functional outcome after internal fixation of femoral neck fractures in non-geriatric patients.

Introduction: Aim of this study was to investigate the incidence and extent of femoral shortening in non-geriatric patients after internal fixation of femoral neck fractures in relation to the clinical outcome at mid-term follow-up.

Materials And Methods: Reviewing our admission data, we identified non-geriatric patients (18-65 years) with femoral neck fractures treated with either dynamic hip screw or cancellous screws between 2007 and 2015. Patients were then contacted and invited to a follow-up clinical investigation including whole-leg standing X-rays.

Tibio-talo-calcaneal fusion after limb salvage procedures-A retrospective study.

Background: The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies.

Intramedullary magnetically actuated limb lengthening in a patient with congenital humeral limb shortening.

The treatment of leg length discrepancy has become a common procedure in orthopaedic surgery. However, lengthening of humeral deformities is still infrequent. The purpose of this case report was to present humeral lengthening with a new intramedullary lengthening device (PRECICE® P2 for tibia) in a 32 year old female patient with congenital shortening.

Unusual complication with an intramedullary lengthening device 15 months after implantation.

The treatment of leg length discrepancy and deformities has become more important over the last decades due to newly developed implants. Several different devices have been presented with various complications reported in literature. The purpose of this case report was to present an unusual complication 15 months after implantation of an intramedullary lengthening device (PRECICE(®)).

Plate failure following plate osteosynthesis in periprosthetic femoral fractures.

Background: Increasing numbers of total knee and hip arthroplasties result in a growing number of periprosthetic femoral fractures (PPFF). PPFF with a stable stem component are treated commonly with plate osteosynthesis. Therefore plate failure is seen as a major complication.

Limb salvage in a partially amputated distal femur with extensive segmental bone loss using the nailing after lengthening technique: a case report.

Segmental long bone defects resulting from high-energy trauma with severe soft tissue loss are difficult problems to manage. Amputation was for a long time the primary mainstay of treatment. This is the report on a 15-year-old male patient who sustained a third-degree open, traumatic fracture with partial amputation of the left distal femur and extensive bone loss of 26 cm.

Impaired joint motion and contractures in callus distraction and segment transport: a retrospective data analysis.

Purpose: The temporary loss of motion of adjacent joints is a common complication after distraction osteogenesis of the lower limb. The aim of this study was to investigate the incidence of tendon contracture and impaired joint motion of the knee and/or ankle joint during and after callus distraction with a ring fixator.

Material And Methods: Twenty patients (2 female, 18 male, average age: 36 years) were surgically treated for callus distraction and segment transport with an external ring fixator after traumatic bone loss in 21 lower limbs.

Bone graft harvesting using the RIA (reaming irrigation aspirator) system - a quantitative assessment.

Introduction: Autologous bone graft is still considered to be the gold standard for treating non-unions in trauma and orthopedic surgery. Intramedullary bone graft harvest appears to be an alternative to other bone graft options such as iliac crest bone graft and synthetic bone substitutes. A one-step reamer-irrigator-aspirator (RIA) system has been developed to reduce the intramedullary pressure and, as a consequence, minimize the risk of fat embolization.

A treatment strategy for complex cases of osteomyelitis in children and its applicability on three exemplary cases.

The aim of this study was to carry out a two-step surgical approach for complex cases of pediatric osteomyelitis. The surgical technique used here involved initial bone debridement and stabilization by a customized spacer (intramedullary Kirschner wires mantled with refobacin-palacosa cement). After infection eradication, the spacer was removed and distraction osteogenesis performed.

Femoral shortening after surgical treatment of trochanteric fractures in nongeriatric patients.

Background: Femoral shortening is a well-known clinical finding after surgical treatment of per- and intertrochanteric fractures. Particularly, in geriatric patients with poor bone quality and unstable fracture types, secondary compression of these fractures often leads to length inequality of the lower limbs. In younger patients with good bone quality and mobilization with delayed weight bearing, limb length shortening is expected to be a rare complication.

Surgical treatment of femoral bending deformity in a patient with vitamin D-resistant rickets.

Surgical treatment of patients with vitamin D-resistant rickets is reserved for management of severe deformities or pathological fractures of the lower limbs. This case report describes the operative management of a child with vitamin D-resistant rickets suffering from a pathological fracture and a bending deformity of the right femoral bone. A modified technique of fragmentation and realignment by intramedullary fixation was performed using an unreamed humerus nail.

Mid- to long-term clinical findings in nailing of distal femoral fractures.

The purpose of the study was to evaluate clinical long-term results after nailing of distal femoral fractures. The first 22 consecutive cases of distal femoral fractures in 22 patients (2 males and 20 females, age 65 years, range, 16-97 years) treated with retrograde femoral nailing from October 1994 to May 1997 are reported. Indications were AO 33 A1 (n = 7), 33 A2 (n = 2), 33 A3 (n = 3), and 33 C2 (n = 7) fractures.

[Occult scaphoid-lunate dissociation in distal radius fractures].

Introduction: The aim of this study was to investigate the clinical consequences of scapholunate dissociation associated with fractures of the distal radius and the impact on wrist function. Fractures of the distal radius and scapholunate dissociation overlap in pathomechanics. The diagnosis however is frequently missed initially.