scholarly journals Correction of Length Discrepancy of Radius and Ulna with Distraction Osteogenesis: Three Cases

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Kenan Koca ◽  
Serkan Akpancar ◽  
Cemil Yıldız
Keyword(s):  
External Fixation ◽  
Distraction Osteogenesis ◽  
External Fixator ◽  
Normal Side ◽  
Length Discrepancy ◽  
Radial Deviation ◽  
Multiple Enchondromatosis

Objectives. The aim of the study was to investigate the results of patients with isolated length discrepancy between ulna and radius who underwent distraction osteogenesis with unilateral external fixator.Material and Methods. A patient with ulna shortening due to multiple enchondromatosis, a patient with ulna shortening due to ulnar club hand, and a patient with radial shortening due to radial club hand were included in the study. The patients underwent ulna and radial distraction osteogenesis with unilateral external fixator. Range of wrist and forearm motion, deformities, and length discrepancy of ulna and radius were compared at preoperative and postoperative.Results. Duration of external fixation and followup were 2.6 and 23.3 months, respectively. Mean distraction osteogenesis was 1.66 cm. No patient reached the length of normal side. Range of rotation of forearm was increased by 15°. Range of ulnar-radial deviation was increased by 21.6°. Deformity of 15° at patient with multiple enchondromatosis was corrected.Conclusion. Isolated ulna or radius shortening may reduce with distraction osteogenesis by unilateral external fixator to prevent serious deformity.

scholarly journals Femoral Reconstruction Using External Fixation

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Yevgeniy Palatnik ◽  
S. Robert Rozbruch
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Deformity Correction ◽  
Orthopedic Procedures ◽  
Entire Group ◽  
Fixation Time ◽  
Limb Alignment ◽  
Length Discrepancy ◽  
Wide Range ◽  
Femoral Reconstruction

Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur.Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD), limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups.Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD) and lateral distal femoral angle (LDFA) for the entire group as well as the subgroups.Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

Clinical Value of Computer-Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Theoretical Basis ◽  
New Technology ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Clinical Value

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

scholarly journals Open segmental fractures of the tibia treated by external fixation

2012 ◽  
Vol 140 (11-12) ◽  
pp. 732-737 ◽  
Author(s):  
Ivan Golubovic ◽  
Zoran Vukasinovic ◽  
Predrag Stojiljkovic ◽  
Zoran Golubovic ◽  
Sonja Stamenic ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Tibial Fractures ◽  
Type I ◽  
Severe Injuries ◽  
Results Of Treatment ◽  
Additional Surgery ◽  
Segmental Fracture ◽  
Segmental Fractures ◽  
Angular Deformities

Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg) creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Nis from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3%) type I, 6 (28.6%) type II, 8 (38.1%) type IIIA, and 4 (19.0%) type IIIB. All the patients were treated by a unilateral type Mitkovic external fixator by Traffix Company. Results. Union was attained in 16 (76.2%) fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees). Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitkovic external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections.

scholarly journals External skeletal fixation of the tibial shaft fractures

2005 ◽  
Vol 62 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Mile Radenkovic
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Tibial Shaft ◽  
Closed Fracture ◽  
Early Weight Bearing ◽  
Shaft Fractures ◽  
Pin Tract Infection ◽  
Tibial Shaft Fractures

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitkovic?s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16?84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitkovic?s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

Methyl methacrylate in external fixation of supracondylar humerus fractures: An experimental study

2018 ◽  
Vol 232 (10) ◽  
pp. 1025-1029
Author(s):  
Ali Güleç ◽  
Mehmet Ali Acar ◽  
Bahattin Kerem Aydin ◽  
Teyfik Demir ◽  
Mustafa Özkaya
Keyword(s):  
Methyl Methacrylate ◽  
External Fixation ◽  
External Fixator ◽  
External Fixators ◽  
Three Point Bending ◽  
Fixation Methods ◽  
Supracondylar Humerus Fractures ◽  
Methacrylate Group ◽  
Humerus Fractures ◽  
K Wires

Supracondylar humerus fractures are common fractures around the elbow. Open fractures, comminuted metaphyseal fractures and also fractures with bone loss may need to be treated with external fixators. The aim of this study is to compare two different external fixators, tubular external fixators and polymethyl methacrylate with K wires external fixators, with regard to stiffness and stability for metaphyseal-diaphyseal osteotomies of distal humerus close to the joint. Six matched pairs (24 specimens) of second-generation sawbone humerus were prepared in a standard fashion to create a metaphyseal fracture, 5 cm proximal to the distal joint line of humerus and were randomly divided into two groups of 12 specimens each. Each sawbone humerus was osteotomized transversely at the mid-olecranon fossa with a 2-mm oscillating saw to simulate a Gartland type III fracture. The osteotomy was then reduced and stabilized using two different external fixation methods: carbon tubular external fixator with Schanz screws and methyl methacrylate with multiple K wires. Three-point bending and torsion tests were performed on the specimens. Bending and torsional stiffness of specimens were obtained for the fixation methods. According to the results of the study, the methyl methacrylate group has provided higher stiffness than classical tubular fixator with Schanz screws in three-point bending test (7.79 ± 2.33 N/mm vs 3.78 ± 1.18 N/mm, p = 0.006). The methyl methacrylate group also showed better stiffness in torsion test (0.12 ± 0.042 N m/° vs 0.067 ± 0.013 N m/°, p = 0.02). We determined for the first time in literature that external fixation with methyl methacrylate was significantly superior to the classical tubular external fixator with Schanz screws with regard to stiffness and stability under three-point bending and torsional loads. Moreover, methyl methacrylate is inexpensive and easily applied.

scholarly journals Can a linear external fixator stand as a surgical alternative to open reduction in treating a high-grade supracondylar humerus fracture?

2018 ◽  
Vol 47 (1) ◽  
pp. 133-141
Author(s):  
Barak Rinat ◽  
Eytan Dujovny ◽  
Noam Bor ◽  
Nimrod Rozen ◽  
Guy Rubin
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Closed Reduction ◽  
Open Reduction ◽  
High Grade ◽  
Supracondylar Humerus Fractures ◽  
Long Term Follow Up ◽  
Humerus Fractures ◽  
Carrying Angle

Objective High-grade pediatric supracondylar humerus fractures are commonly treated with closed reduction and internal fixation with percutaneous pinning. When this fails, open reduction followed by internal fixation is the widely accepted procedure of choice. Use of a lateral external fixator was recently described as an optional procedure, but evidence is scarce. Methods We investigated the outcomes of upper limbs treated by either open reduction with internal fixation or closed reduction and external fixation. Results Twenty-one patients completed the long-term follow-up; 11 underwent open reduction, and 10 underwent external fixation. Most patients in both groups reported excellent satisfaction. In both groups, the modified Disabilities of the Arm, Shoulder, and Hand score was extremely low and the average elbow range of motion was almost identical. Radiographic analysis consisting of Baumann’s angle and the carrying angle revealed no statistical difference between the two groups. Discussion Optional treatment using a linear external fixator for complex nonreducible supracondylar humerus fractures yielded acceptable clinical and radiographic results, as with open reduction. Our sample size was small, but the promising results may assist in the implementation of an alternative surgical procedure, especially in more complicated cases involving flexion-type fractures or severe soft tissue damage and swelling.

Comparison between External Locking Plate Fixation and Conventional External Fixation for Extraarticular Proximal Tibial Fractures: A Finite Element Analysis

2021 ◽  
Author(s):  
Dejan Blažević ◽  
Janoš Kodvanj ◽  
Petra Adamović ◽  
Dinko Vidović ◽  
Zlatko Trobonjača ◽  
...  
Keyword(s):  
Finite Element ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fracture ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Fractures ◽  
Proximal Tibial Fracture ◽  
Locking Plate Fixation ◽  
Maximum Stiffness

Abstract BackgroundGood clinical outcomes for locking plates as an external fixator to treat tibial fractures have been reported. However, external locking plate fixation is still generally rarely performed. This study aimed to compare the stability of external locking plate fixator with that of conventional external fixator for extraarticular proximal tibial fractures, using finite element analysis. MethodsThree models were constructed: (1) external locking plating of proximal tibial fracture with lateral proximal tibial locking plate and 5-mm screws (ELP), (2) conventional external fixation of proximal tibial fracture with an 11-mm rod and 5-mm Schanz screws (EF-11), and (3) conventional external fixation of proximal tibial fracture with a 7-mm rod and 5-mm Schanz screws (EF-7). The stress distribution, displacement at the fracture gap, and stiffness of the three finite element models at 30-, 40-, 50-, and 60-mm plate–rod offset from the lateral surface of the lateral condyle of the tibia were determined. ResultsThe conventional external fixator showed higher stiffness than did the external locking plate fixator. In all models, the stiffness decreased as the distance of the plate–rod from the bone surface increased. The maximum stiffness was 121.06 N/mm in the EF-11 model with 30-mm tibia–rod offset. In the EF-7 model group, the maximum stiffness was 40.00 N/mm in the model with 30-mm tibia–rod offset. In the ELP model group, the maximum stiffness was 35.79 N/mm in the model with 30-mm tibia–plate offsetConclusionsExternal locking plate fixation is more flexible than conventional external fixation, which can influence secondary bone healing. External locking plate fixation requires the placement of the plate as close as possible to the skin, which allow low-profile design, because the increased distance of the plate from bone can be too flexible for bone healing.

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