Bone and soft tissue reconstruction with tendon balance in severe foot trauma.

In severe foot trauma, it is difficult to determine the level of amputation when the crush injury is severe. We report a case of amputation near Lisfranc that achieved forefoot amputation-like results by using bone and soft tissue reconstruction while considering tendon balance. The patient was a 40-year-old male.

Efficacy of Orthoplastic Management in the Treatment of Traumatic Popliteal Artery Injury.

Background: Popliteal artery injury (PAI) is a challenging condition. Even with appropriate initial treatment and reconstruction of the associated injuries, extensive soft-tissue necrosis may occur, requiring lower leg amputation. There are no reports on the effectiveness of orthoplastic surgery in treating traumatic PAI.

Cross-Limb Vascular Shunting for Traumatic Popliteal Artery Injury.

Background: Popliteal artery injury (PAI) is a challenging trauma that requires prompt and accurate treatment since the probability of lower-limb amputation increases with the ischemic time. Intravascular shunting and cross-limb vascular shunting (CLS) are used as temporary vascular shunting (TVS) methods to shorten the ischemic time for limb vascular injury. CLS involves sending blood from an artery in a healthy body part to a peripheral vessel in an injured part to immediately resume blood flow to the injured limb.

Surgical delay in reverse sural artery flap prevents congestion of the flap: a case report of the stepwise delay method.

We performed reverse sural artery flap (RSAF) with the stepwise delay method, cutting the vascular pedicle step by step, as the patient had a high risk of flap necrosis. Surgical delay in RSAF is anticipated to prevent not only flap cyanosis but also flap congestion.

Management of bone loss in acute severe open tibial fractures: a retrospective study of twenty nine cases-a treatment strategy with bone length preservation.

Purpose: The present study investigated the outcomes of bone loss associated with acute open tibial fractures classified as Gustilo-Anderson classification grade III B (GIIIB) using a bone length preservation strategy.

Methods: Among acute GIIIB open tibial fractures, 29 limbs of 29 patients requiring bone loss treatment were included. The reconstruction methods for bone loss were selected among the Masquelet technique (MT), bone transport (BT), acute shortening followed by gradual lengthening (ASGL), and free vascularized fibula graft (FVFG).

One incision-two windows approach for fixation of multifragmentary coronoid process fracture of the ulna: A case report.

Since the range of access of each surgical approach around the elbow has limitations, it is difficult to treat all types of fractures using only one approach. In the case reported herein, anterior and medial fragments of the comminuted ulnar coronoid process fracture were treated by preparing two access routes through one skin incision and effectively performing the buttress plating of each fragment. The subject was a 27-year-old female who sustained a fracture of the coronoid process of the right ulna by falling during snowboarding.

Pull-in suture: a novel reconstruction technique for tendon avulsion injury at the musculotendinous junction associated with forearm open fracture.

We present three cases of strong one-staged tendon reconstruction for musculotendinous junction avulsion tendon injuries, and called it a 'pull-in suture'. The clinical outcomes of this method are comparable to those of tendon transfer; it is an effective reconstruction method that should be considered as an initial treatment procedure.

Risk factors for over-telescoping in reverse oblique intertrochanteric fractures.

Purpose: Postoperative over-telescoping (OT) with lag screws is often observed in reverse oblique intertrochanteric fractures. This study aimed to clarify the risk factors of OT in patients with reverse oblique intertrochanteric fractures.

Methods: Electronic medical records of patients diagnosed with reverse oblique intertrochanteric fractures using plain radiography who underwent operative fixation with an intramedullary nail between August 2013 and December 2019 were reviewed.

A novel technique for stabilising sacroiliac joint dislocation using spinal instrumentation: technical notes and clinical outcomes.

Purpose: Currently, sacroiliac joint dislocations, including crescent fracture-dislocations, are treated using several techniques that have certain issues. We present the technical details and clinical outcomes of a new technique, anterior sacroiliac stabilisation (ASIS), performed using spinal instrumentation.

Methods: ASIS is performed with the patient in a supine position via the ilioinguinal approach.

Plate coverage predicts failure for volarly unstable distal radius fractures with volar lunate facet fragments.

Introduction: Loss of reduction after operative fixation of volarly unstable distal radius fractures with a volar lunate facet fragment (VLF) is considered problematic because it results in carpal subluxation or dislocation and subsequent impaired function. We hypothesized that the indicator of loss of reduction of the VLF after fixation is plate coverage of the bony fragment. We investigated the relationship between the plate coverage of the VLF and loss of reduction after fixation, and calculated the plate coverage that was associated with failure of fixation of the VLF.

Fracture dislocation of the ankle with posterior tibial tendon entrapment within the tibiofibular interosseous space: A case report.

In rare cases of ankle fracture dislocation, the posterior tibial muscle tendon (TP tendon) is incarcerated between the tibia and fibula, thereby impeding reduction. Here we describe a case that presented with such a condition, in which ankle reduction was achieved and surgical repair of the incarcerated TP was delayed. The subject was a 30-year-old male who sustained a fracture dislocation of the left ankle (AO:44-C1.

"Within ring"-based sacroiliac rod fixation may overcome the weakness of spinopelvic fixation for unstable pelvic ring injuries: technical notes and clinical outcomes.

Purpose: Spinopelvic fixation and triangular osteosynthesis give firm internal fixation for unstable pelvic ring injuries (UPRI), but with sacrifice of mobility of the lumbar spine. Here, we describe the procedure and outcomes of a new approach, which we refer to as "within ring"-based sacroiliac rod fixation (SIRF).

Methods: The patient was placed in a prone position and longitudinal skin incisions were made at the medial margins of the bilateral posterior superior iliac spines (PSIS).

A biomechanical study of sacroiliac rod fixation for unstable pelvic ring injuries: verification of the "within ring" concept.

Purpose: The aim of this study was to compare the fixation power of sacroiliac rod fixation (SIRF), which was developed based on our original "within ring" concept to exclude the lumbar vertebra from the fixation range, and spinopelvic fixation (SPF) in a biomechanical experiment.

Methods: SPF and SIRF were applied to the posterior element in four bones each with the pelvic ring fracture model (AO/OTA classification 61-C1.3).

Difficulty in Fixation of the Volar Lunate Facet Fragment in Distal Radius Fracture.

Recent reports suggest the presence of a rare fracture type for which reduction and fixation cannot be achieved with volar locking plate (VLP). In particular, it is difficult to achieve reduction and fixation with volar lunate facet (VLF) fragments present on the volar ulnar aspect of the lunate facet, because of the anatomical structure and biomechanics in this region. Herein, we report two challenging cases of difficulty in fixation of the VLF fragment in distal radius fracture.

Malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view.

Purpose: Malalignment of syndesmosis is generally associated with a poor outcome, yet occurs at a high rate in malleolar ankle fractures. In this study, we examine whether malreduction of syndesmosis injury associated with malleolar ankle fracture can be avoided using Weber's three indexes in the mortise view.

Materials And Methods: Of 156 patients with malleolar ankle fracture who underwent surgery from December 2012 to March 2016 at two medical facilities, 24 patients who received syndesmotic screw fixation were included in the study.

New classification focusing on the relationship between the attachment of the iliofemoral ligament and the course of the fracture line for intertrochanteric fractures.

Purpose: There are various types of intertrochanteric fractures that are unstable pertrochanteric fractures of the hip. The aim of this study was to develop a systematic and comprehensive classification of intertrochanteric fractures.

Materials And Methods: This study enrolled 74 patients with intertrochanteric fractures treated by us between 2012 and 2015.

New classification focusing on implant designs useful for setting therapeutic strategy for periprosthetic femoral fractures.

Purpose: In periprosthetic femoral fractures, our hypothesis was that when the bone and implant are stable, the fracture does not occur at the biologic or cement fixation regions but occurs at the no fixation region. The aim of this study was to investigate the validity of our new classification for periprosthetic femoral fractures and compare reliability of radiographic evaluation for implant stability between our classification and the Vancouver classification.

Patients And Methods: Sixty-six patients with periprosthetic femoral fracture were operatively treated by us between 2005 and 2013.

Comparison of therapeutic outcomes of periprosthetic femoral fracture between treatments employing locking and conventional plates.

Introduction: Locking plate is considered biomechanically advantageous for porotic bone, compared with conventional plate. However, clinical evaluations of locking and conventional plates for periprosthetic femoral fracture are still controversial. Thus, we investigated the usefulness of a locking plate compared with the conventional plate for treatment for this fracture.