Case: A 16-year-old boy presented with a recurrent distal femur aneurysmal bone cyst accompanied by a combined sagittal knee deformity (20° of femoral antecurvatum and 26.8° of tibial recurvatum) and limb shortening. After preoperative planning, the treatment involved new intralesional curettage, phenolization, and bone allograft filling. Additional procedures included distal extension femoral osteotomy with plate fixation, and proximal tibial osteotomy with, gradually corrected through a hexapod frame. At 2-year follow-up, lower limbs exhibited normoalignment and equal length.
Conclusion: Complex knee deformities may occur with tumoral lesions around the knee but can be effectively addressed through double osteotomy and application of a hexapod frame.
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http://dx.doi.org/10.2106/JBJS.CC.23.00496 | DOI Listing |
JBJS Case Connect
October 2024
Cedars Sinai Medical Center Department of Orthopaedic Surgery, Los Angeles, California.
Case: A 14-year-old adolescent boy sustained a Gustilo-Anderson Type 3A tibia fracture treated with medullary nailing. He developed an atrophic nonunion with a 10.5-cm defect after debridement.
View Article and Find Full Text PDFBMC Musculoskelet Disord
November 2024
Department of Orthopaedics and Traumatology, University of Health Sciences Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Background: With the assistance of smart fixator technologies, the correction of complex deformities has been facilitated; however, the accurate integration of specialized radiographs and measurements into the system remains the greatest disadvantage, necessitating specialized imaging and an experienced team. When inexperienced technicians and doctors perform these specialized postoperative radiographs, excessive exposure of the patient and team to radioactive rays exacerbates inadequacies in measurements and delays the correction of residual deformities due to angular and translational adjustments. In this study, we compared postoperative measurements with those taken peroperatively via fluoroscopy, hypothesizing that it reduces the exposure of the patient and team to radioactive rays, allows for more accurate and timely correction of deformities and assembly parameters, and reduces time and costs.
View Article and Find Full Text PDFFoot Ankle Surg
August 2024
Limb Reconstruction Unit, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Doce de Octubre, Madrid, Spain. Electronic address:
Introduction: Foot and ankle pathology can often require complex surgical reconstruction. Until recently, circular external fixators such as the Ilizarov frame have proven to be useful, yet they fall short when progressive, precise corrections are required. Computer-assisted hexapod external fixators seek to address many of the shortfalls of traditional circular fixators.
View Article and Find Full Text PDFOrthop Surg
September 2024
Department of Orthopedics, Rehabilitation Hospital, National Research Center for Rehabilitation, Beijing, China.
The Ilizarov technique is one of the most important tools that is currently employed in bone reconstruction surgeries. Its inception dates back to the mid-20th century and involves various bone reconstruction methodologies implemented using a circular external fixator system devised by G. A.
View Article and Find Full Text PDFOrthop Surg
September 2024
Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital of Capital Medical University, Beijing, China.
Objective: Although several reconstructive methods have been developed to manage large segmental tibial bone defects including bone transport (distraction osteogenesis), contralateral fibular graft, allograft, tibiofibular synostosis, Masquelet technique, and 3D printed scaffold, neglected large tibial defects in adults remain challenging problems. This study describes gradual transverse transport of naturally tibialized fibula using hexapod frames in management of adult patients with neglected large tibial defects.
Methods: We retrospectively reviewed four cases of transverse transport of naturally tibialized fibula from November 2018 to February 2022.
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