Distraction osteogenesis in combined sequential use of external fixation and nailing (lengthening and then nailing): An experimental study in rabbits.

Limb lengthening relies on the process of distraction osteogenesis. The active periosteal bone formation has been detected in clinical practice with a lengthening and then nail (LATN) technique but has not been confirmed by experimental studies to date. The aim of this study is to compare the tissue regeneration of the distraction regenerate during tibial lengthening in rabbits using a LATN technique.

Artificial Deformity Creation as a Method for Limb Salvage for Patients with Massive Tibial and Soft Tissue Defects: A Report of 26 Cases.

Unlabelled: Soft tissue and bone defects that occur consequence of high-energy trauma are serious and challenging problems. The aim of this retrospective cohort study is to show that the artificial deformity creation (ADCr) method allows the closure of soft-tissue defects, avoids amputation, and can facilitate the reconstruction of bone defects and restore limb length.

Patients And Methods: Twenty-six adult patients (age range 20-81 years) with soft tissue defects of the lower limb were treated at the Riga East University Hospital from 2018 to 2021.

Universal Long Bone Nonunion Classification.

Aim And Background: The management of bone union disorders is a complex problem in orthopaedics, requiring a reliable and comprehensive classification system for accurate diagnosis and treatment. Despite advances in understanding pathophysiology, diagnosis, and treatment in this area, there is no generally accepted classification system. The aim of our work was to create a comprehensive classification, which will systemize the vast majority of bone union disorders, underline their differences and form the basis for their treatment.

Acute Shortening for Open Tibial Fractures with Bone and Soft Tissue Defects: Systematic Review of Literature.

Introduction: The presence of massive soft tissue loss in open tibial fractures is a challenging problem. Acute limb shortening is an alternative solution in situations where the use of flaps is limited.

Materials And Methods: A review was conducted following the Preferred Reported Items for Systematic Reviews and Meta-analyses checklist (PRISMA) guidelines.

A 52-Year-Old Man with a Gustillo-Anderson IIIB Open Tibial Shaft Fracture with Extensive Soft-Tissue Defect Requiring Limb Salvage with Artificial Deformity-Creating Technique.

BACKGROUND In this case report, an alternative way of treating Gustillo-Anderson IIIB type fractures with severe soft-tissue damage is provided for cases where, for various reasons, it is not possible to close a soft-tissue defect with a flap. CASE REPORT An artificial deformity-creating technique was applied for a patient with a right distal tibial open fracture (Gustillo IIIB type) with complete tibial cartilage and bone loss of 10 cm and severe soft-tissue defect after high-energy trauma. This technique includes damaged limb shortening, translation, angulation, and rotation for closure of soft-tissue defects using orthopedic hexapod and bifocal bone transport without need for plastic surgery.

Foot Deformity Correction Planning in the Sagittal Plane Based on the Vitruvian Foot First Metatarsal Mechanical Axis and Calcaneus Anatomic Axis.

The aim of the study was to test a novel planning method for simultaneous midfoot and hindfoot deformity correction, based on reference lines and angles (RLA) of the talus, calcaneus and first metatarsal in 64 normal radiographs from 55 patients. Talus Joint Line (TJL), from the border of the articular surface of the talus and the posterior process of talus, and mechanical axis of the first metatarsal form the mechanical Lateral Talometatarsal Angle (mLTMA) = 23.6º (±3.

Knee Joint Bone Defects: Reconstruction With Bone Transport and Arthrodesis.

Background: The increasing in primary total knee arthroplasty has led to an increase in infectious complications, revision surgery, and bone loss. Knee joint bone defects (KJBD) may be managed using bone transport and arthrodesis with Ilizarov or bone transport over nail (BTON) techniques. The aim of this study is to compare both techniques in the reconstruction of KJBDs.

Foot Deformity Correction Planning in the Sagittal Plane Based on the Vitruvian Foot First Metatarsal Anatomic Axis.

The aim of this study was to test a novel planning method for midfoot deformity correction, based on reference lines and angles (RLA) of talus and first metatarsal of 64 normal radiographs from 55 patients. The anatomic lateral talometatarsal angle (aLTMA), resulting from the intersection of talus joint line (TJL), from the border of the articular surface of the talus to the posterior process of talus, and the anatomic axis of the first metatarsal, was 28.5° ± 4.

New Sagittal Plane Reference Parameters for Foot Deformity Correction Planning: The Vitruvian Foot.

Currently available methods for analysis and planning of post-traumatic or congenital deformity correction of the foot have some limitations. The aim of this retrospective study was to establish reference lines and angles (RLAs), and the resulting ratios, based on reproducible anatomic points on sagittal feet radiographs. The key starting point of our evaluation was the previously undescribed length and position of the talus joint line (TJL), from the border of the articular surface of the talus and the posterior process of talus.

Advances in modern osteotomies around the knee : Report on the Association of Sports Traumatology, Arthroscopy, Orthopaedic surgery, Rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017.

Corrective lower limb osteotomies are innovative and efficient therapeutic procedures for restoring axial alignment and managing unicompartmental knee osteoarthritis. This review presents critical insights into the up-dated clinical knowledge on osteotomies for complex posttraumatic or congenital lower limb deformities with a focus on high tibial osteotomies, including a comprehensive overview of basic principles of osteotomy planning, biomechanical considerations of different implants for osteotomies and insights in specific bone deformity correction techniques. Emphasis is placed on complex cases of lower limb osteotomies associated with ligament and multiaxial instability including pediatric cases, computer-assisted navigation, external fixation for long bone deformity correction and return to sport after such osteotomies.

Hallux Valgus Correction With Rotational Scarf Combined With Adductor Hallucis Tendon Transposition.

Hallux valgus affects 23% of people older than 40 years, and there are hundreds of methods dealing with this pathology, which have their advantages and disadvantages. The aim of the present prospective cohort study was to report our experience in treating the patients with hallux valgus and to perform a comparative analysis of the outcomes of the innovative and standard methods of surgical correction. Data on 78 patients (113 feet) with hallux valgus operated on between March 2010 and December 2015 using either an innovative method, which included rotational scarf osteotomy with bone fragment impaction and adductor hallucis tendon reinsertion, or the classical scarf osteotomy were analyzed.

Reference positions for transosseous elements in femur: A cadaveric study.

Introduction: During external fixator treatment, displacement of soft tissue at pin sites may cause infection and contracture. Due to surrounding soft tissue thickness, the femur is especially susceptible to severe complications. However, standard textbooks demonstrate only how major neurovascular bundles should be avoided.

Efficacy of Bilateral Simultaneous Hallux Valgus Correction Compared to Unilateral.

Background: Hallux valgus affects up to 29% of adults and can be bilateral in 84% of cases. Contemporary surgical techniques provide the possibility of simultaneous bilateral correction, but still there is no consensus on whether staged or simultaneous correction should be performed if both feet are involved. The aim of the present study was to report our experience of treatment of patients with hallux valgus and to perform comparative analysis of results obtained from unilateral and simultaneous bilateral surgical correction.

Mechanical rigidity of the Ortho-SUV frame compared to the Ilizarov frame in the correction of femoral deformity.

The Ortho-SUV frame (OSF) is a novel hexapod circular external fixator which draws upon the innovation of the Ilizarov method and the advantages of hexapod construction in the three-dimensional control of bone segments. Stability of fixation is critical to the success or failure of an external circular fixator for fracture or osteotomy healing. In vitro biomechanical modelling study was performed comparing the stability of the OSF under load in both original form and after dynamisation to the Ilizarov fixator in all zones of the femur utilising optimal frame configuration.

Determination of the Maximal Corrective Ability and Optimal Placement of the Ortho-SUV Frame for Femoral Deformity with respect to the Soft Tissue Envelope, a Biomechanical Modelling Study.

Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for trauma and deformity. One shortcoming of the traditional fixator is its limited ability to correct more than one plane of deformity simultaneously, leading to lengthy frame-time indices. Hexapod circular fixation utilising computer guidance is commonplace for complex multidimensional deformity but difficulties often arise with correction of femoral deformity due to bulkiness of the frame construct, particularly in proximal deformity and in patients of increased size.

Avoidance of external fixation pin induced rotational stiffness in the forearm; a cadaver study of soft tissue displacement relative to the varying position of radius and ulna fixation.

Introduction: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent complication of external fixation. Conventional surgical atlases do not consider the effect of rotation on skin displacement and thus do not provide a comprehensive answer. We asked: (1) in what locations in the forearm is soft tissue displacement relative to the ulna and radius least during rotation; (2) in what positions are major neurovascular structures absent; and (3) what maximal range of rotation can be expected in forearm external fixation.

Definitive management of significant soft tissue loss associated with open diaphyseal fractures utilising circular external fixation without free tissue transfer, a comprehensive review of the literature and illustrative case.

Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intramedullary stabilisation with free or rotational musculocutaneous flap coverage. Circular external fixation is a powerful tool in the management of limb trauma and with recent advances has been developed to provide multiple techniques for which even massive tissue loss can be addressed without the need for free tissue transfer. Gradual and acute shortening, acute fracture deformation and gradual lengthening with restoration of deformity combined with distraction tissue histiogenesis can provide the surgeon with an array of options which can be precisely tailored to the particular personality of a severe open diaphyseal fracture.

A comparative study of the correction of femoral deformity between the Ilizarov apparatus and Ortho-SUV Frame.

Purposes: This study compared the six-axis external fixator Ortho-SUV Frame (OSF) and the Ilizarov apparatus (IA) in femoral deformity correction. Our specific questions were: (1) which of the fixators (OSF or IA) provides shorter period of femoral deformity correction, and (2) which of the fixators (OSF or IA) provides better accuracy of correction.

Methods: We retrospectively analysed 123 cases of femoral deformities (127 femora): 45 (47) treated with OSF (20 male and 27 female) and 78 (80) with IA (53 male and 27 female).

Foot deformity correction with hexapod external fixator, the Ortho-SUV Frame™.

External fixators enable distraction osteogenesis and gradual foot deformity corrections. Hexapod fixators have become more popular than the Ilizarov apparatus. The Ortho-SUV Frame™ (OSF; Ortho-SUV Ltd, St.