Introduction: The major limitation of any intramedullary telescopic system is rotational and longitudinal instability. The combination of telescopic system with an external fixator in patients with osteogenesis imperfecta (OI) demonstrated advantages of stability, early weight-bearing and rehabilitation. This study aimed to examine the outcomes of deformity correction by combined technique uniting titanium telescopic rod and reduced Ilizarov frame in children with types III or IV of OI with a minimum 1-year follow-up.
Material And Methods: The study included 12 children with OI who underwent femoral deformity correction (20 segments) or tibial deformity correction (4 segments) by combined technique. The children ranged in age between 2 years and 3 months and 12 years and 4 months (mean: 8.9 ± 2.02 years) at the time of the rodding. Parameters of surgery, clinical examination data, data of 3D gait analysis were assessed in the study.
Results: External fixation lasted 35.8 ± 13.2 days in average. Neither loss of threaded fixation in the distal femoral and tibial epiphyses and apophysis of the greater trochanter nor migration of the rod into the knee and ankle joints were observed in follow-up. No secondary rotational or longitudinal bone displacement was noted. Telescoping gain related to spontaneous growth assessed at one-year follow-up control was 13.7 mm in the tibia and 15.9 mm in the femur. There were no deep infection or neurologic complications. The alignment measured by radio anatomical reference angles was maintained throughout the follow-up period.Gait abnormalities in postoperative period were caused by bulk and weight of EF: external hip rotation, slight external angle of foot progression, increased stride width and increased hip abduction angle. The second feature was reduced ROM in sagittal plane at all levels associated with significantly reduced ankle plantarflexion, hip and knee joint moments in comparison to kinetics of limb without EF. These abnormalities resolved by the one-year assessment.
Conclusion: The combination of titanium telescopic rod with reduced external fixation is reliable advantage in reconstructive orthopaedic surgery for OI children. Reduced external fixation allows to overcome inconveniencies of longitudinal and rotational instability of telescopic systems. Children were able to walk with weight-bearing since early postoperative period because of external fixation. Gait temporary changes were influenced by external device size and by strategy to reduce pin site pain.
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http://dx.doi.org/10.1016/j.jor.2020.05.017 | DOI Listing |
Injury
January 2025
Temple University Hospital, Department of Orthopaedic Surgery, USA.
Objectives: Long bone fractures with concomitant vascular injury have the potential to be life and limb threatening injuries, with increased risk for limb loss. There is currently no established surgical order of operations for orthopaedic and vascular intervention. This study compares injury classification, warm ischemia time and patient outcomes in patients with long bone fractures and associated vascular injury after orthopaedic versus vascular primary intervention.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, West Yorkshire, England.
Background: In this study, we estimated the risk of surgically treated postoperative periprosthetic femoral fractures (POPFFs) associated with femoral implants frequently used for total hip arthroplasty (THA).
Methods: In this cohort study of patients who underwent primary THA in England between January 1, 2004, and December 31, 2020, POPFFs were identified from prospectively collected revision records and national hospital records. POPFF incidence rates, adjusting for potential confounders, were estimated for common stems.
Trauma Case Rep
February 2025
Department of Orthopaedic Surgery and Sports Medicine, University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203, United States of America.
Introduction: Revision quadriceps tendon repair is a challenging problem. In this four-case series, novel quadriceps tendon revision resulted in improved range of motion and durable repair for patients with recurrent rupture.
Methods: Our technique includes a combination of a running locked #5 FiberWire or 2 mm SutureTape suture placed through parallel medial, lateral, and central drill holes in the patella with running Krackow-type quadriceps tendon repair medially and laterally resulting in four strands, delivering the vastus medialis and medial quadriceps tendon to an anatomic repair at the superior pole of the patella, with 2 sutures passed centrally and 1 each passed medially and laterally and then tied.
JSES Rev Rep Tech
February 2025
Department of Orthopaedics, Krishna Institute of Medical Sciences, Secunderabad, Telanagana, India.
Hypothesis: Proximal humerus fractures present a treatment challenge due to varied fracture configurations and a lack of consensus on optimal management. Locking plate designs offer promising solutions, yet technical guidelines for successful outcomes remain elusive. Complications are common, with fixation-related failures often attributed to varus collapse.
View Article and Find Full Text PDFAim: Fixed retention is the method of choice for permanent stabilization of the treatment outcome. In recent years, CAD/CAM techniques have been developed to produce retainers with high precision and tension-free fit. The aim of this retrospective study was to evaluate the suitability of a semi-industrial retainer manufacturing process (office-based construction, external laboratory manufacturing) in terms of positioning accuracy and post-treatment changes.
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