Introduction: Peri- and intra-articular fractures about the knee are frequently managed with joint-spanning external fixation before definitive treatment. With a systematic approach, a near-anatomic reduction with respect to length, alignment, and rotation can be obtained.
Methods: This video highlights 2 clinical cases: a bicondylar tibial plateau fracture-dislocation and a distal femur fracture, both of which were treated with temporizing, knee-spanning external fixation.
Results: The indications, principles, and biomechanics of knee-spanning external fixation are presented. In addition, we demonstrate a systematic approach to applying knee-spanning external fixation.
Conclusions: Temporizing, joint-spanning external fixation is a critical treatment modality in the orthopaedic armamentarium for managing fractures about the knee. With a systematic approach, it is possible to obtain a near-anatomic reduction with respect to length, alignment, and rotation.
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http://dx.doi.org/10.1097/BOT.0000000000001207 | DOI Listing |
Indian J Orthop
December 2024
Orthopaedics Department, Bangalore Medical College and Research Institute, Bengaluru, India.
Background: Distal femur infected non-union management is very challenging especially when there is late presentation and after multiple intervention. Various methods have been described and studied in the literature for infected non-union of femur which includes bone transport by fixators (ring fixators/monolateral frames) and by Masquelet method.
Objectives: To study the clinical and radiological outcomes and study the effect on quality of life by patient-reported outcomes (EQ5D5L) and VAS (Visual Analog Scale) score in patients of infected non-union of distal femur managed with combination of Masquelet method and Ilizarov ring fixator.
Clin Orthop Relat Res
August 2024
Department of Orthopaedic Surgery, Naval Medical Center Portsmouth, Navy Medicine and Readiness Training Command, Portsmouth, VA, USA.
Background: The evolution of warfare has resulted in a surge of high-energy blast injuries predominantly involving the lower extremities. Once thought to impact only forward-deployed military, such mechanisms of injury are becoming a harsh reality even in civilian territory. Proficiency in surgical techniques for extremity damage control is vital for surgeons, regardless of specialty.
View Article and Find Full Text PDFJ Orthop Case Rep
August 2024
Department of Orthopaedics, IMS and SUM Hospital, Kalinga Nagar, Bhubaneswar, Odisha, India.
Skeletal Radiol
April 2024
Yale School of Medicine, Department of Orthopaedics & Rehabilitation, New Haven, CT, USA.
After emergent assessment of potentially limb-threatening injuries in knee dislocation or multi-ligament knee injury patients, magnetic resonance imaging is necessary to visualize ligamentous structures and plan for soft tissue repair. However, the application of a knee-spanning external fixator may introduce artifact and reduce overall image quality, which can limit the evaluation of soft tissue injury. As a result, the utility of MRI in the context of a knee-spanning external fixator has been called into question.
View Article and Find Full Text PDFSkeletal Radiol
March 2024
Department of Radiology, Musculoskeletal Imaging, Yale School of Medicine, New Haven, CT, USA.
Objective: Concerns regarding patient safety and image quality have made the use of knee-spanning external fixators in MRI a challenging clinical scenario. The purpose of our study was to poll practicing musculoskeletal radiologists on their personal experiences regarding the use of knee-spanning external fixators in MRI in an effort to consolidate practice trends for the radiologists' benefit.
Methods: A 27-item survey was created to address the institutional use, safety, adverse events, quality, and perspectives of the radiologist related to MRI of an externally fixated knee.
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