scholarly journals Two case reports of lower limb posttraumatic angular deformities correction by dynamic hinged external fixation

2015 ◽  
Vol 62 (1) ◽  
pp. 69-74
Author(s):  
Milan Mitkovic ◽  
Sasa Milenkovic ◽  
Ivan Micic ◽  
Igor Kostic ◽  
Predrag Stojiljkovic ◽  
...  
Keyword(s):  
Hospital Stay ◽  
External Fixation ◽  
External Fixator ◽  
Lower Limb ◽  
Deformity Correction ◽  
Operation Time ◽  
Angular Deformity ◽  
Surgical Trauma ◽  
Hinged External Fixation ◽  
Angular Deformities

The aim of this study was to present two patients with lower limb posttraumatic angular deformity treated by dynamic hinged external fixation. CD-V mode Mitkovic type external fixator had been used in both cases for correction of these deformities. The method is based on hemicallotasis - bone callus distraction after a partial transversal bone cut (hemocorticotomy). The first patient had varus-recurvatum posttraumatic deformity of the ankle joint. Operation time was 65 min and hospital stay was 9 days. Superficial pin-track infection was resolved by the pin removal and by daily wound toilette. The second patient had varus-antecurvatum malunion deformity of the femoral diaphysis. Operation time was 50 min and hospital stay was 6 days. Mild knee contracture had been successfully treated by physical therapy. Angular deformity correction had been performed by distraction (for the first patient) and compression (for the second patient) in the fixator frame. Hemicallotasis of femur or tibia using CD-V mode Mitkovic type external fixator is a good alternative in the treatment of posttraumatic lower limb angular deformities, providing minimal surgical trauma and maximal use of the bone osteogenetic capacity. Gradual compression or distraction in the fixator frame allows to perform accurate angular correction in both coronal and sagital plane in one act.

scholarly journals Evaluation Of The Trochantertc Fracture Of The Femur Treated By Uniaxial External Fixator In Risk Elderly Patient.

1970 ◽  
Vol 39 (3) ◽  
Author(s):  
AKM Zahiruddin ◽  
SK Paul ◽  
MLR Khan ◽  
SN Alam
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Low Cost ◽  
Operation Time ◽  
Attractive Alternative ◽  
Surgical Trauma ◽  
Trochanteric Fractures ◽  
Fracture Union ◽  
Medical Disorders ◽  
Fractures Of The Femur

Trochanteric fractures occur in elderly osteoporotic patients with concomitant medical disorders, who are unable to tolerate lengthy periods of anaesthesia or any appreciable blood loss. For this reason, external fixation represents an attractive alternative. External fixation can be easily applied by modern equipments like c-arm. It is simple, quick, low cost with minimal surgical trauma, lower rate of morbidity, less operation time, shorter duration of hospital stay and early mobilization.This clinical study is the result of trochanteric fractures of the femur in high risk elderly patients treated with an external fixator on 11 patients over a period of 2 years from July 2005 to June 2007 at NITOR.The object of the study was to evaluate the outcome of operation. All the patients were in a poor general condition and with severe associated medical diseases and also more than one condition were present. The external fixator was removed after adequate clinical radiological sign of fracture union (averaged 16.54 weeks) as an out patient procedure. The overall radiological improvement was observed in 11 cases in 6 months followup. The overall satisfactory result was observed in 9 (81.8%) and unsatisflictory in 2(18.2%).DOI: http://dx.doi.org/10.3329/bmj.v39i3.9951 BMJ 2010; 39(3)

scholarly journals Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Deformity Correction ◽  
Genu Valgum ◽  
Angular Deformity ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
The Mean ◽  
Low Incidence ◽  
Angular Deformities

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

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 Improving postoperative radiographs for the parameter measurement of hexapod external fixator using an additional foot ring

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yanshi Liu ◽  
Kai Liu ◽  
Feiyu Cai ◽  
Tao Zhang ◽  
Aihemaitijiang Yusufu
Keyword(s):  
External Fixation ◽  
Clinical Outcomes ◽  
External Fixator ◽  
Demographic Data ◽  
Deformity Correction ◽  
Parameter Measurement ◽  
Fixation Time ◽  
Trauma Patients ◽  
Group I ◽  
Outcomes Evaluation

Abstract Background It is challenging to determine the orthogonality of radiographs in daily clinical practice. The purpose of this study was to show the usefulness of an additional foot ring which might determine the orthogonality of postoperative radiographs for the parameter measurement of hexapod external fixator. Methods We retrospectively analyzed 81 consecutive trauma patients with tibial shaft fractures treated by the hexapod external fixator at our institution from September 2014 to July 2019. Starting in March 2016, the postoperative radiographs for parameter measurement were obtained under the control of an additional foot ring. The final data consisted of 47 patients in traditional radiographs (Group I) and 34 patients under the control of foot ring during the radiographic process (Group II). The demographic data, original postoperative deformities, residual deformities after final correction, number of repeated radiographs after the first postoperative radiographs, time to the satisfactory reduction achieved, and external fixation time in all patients were documented and analyzed. The Johner–Wruhs criteria were used for the final clinical outcomes evaluation at the last clinical visit. Results Satisfactory reduction and bone union were achieved in all patients. There were no statistical significances between the two groups in the demographic data, original postoperative deformities, residual deformities after final correction, external fixation time, and the final clinical outcomes (P > 0.05). The mean number of repeated radiographs after the first radiographs (1.4 times) and mean time to the satisfactory reduction achieved (3.3 days) in patients with an additional foot ring used were all less than those without foot ring (2.4 times, 5.3 days) (P < 0.05). Conclusions The additional foot ring is a practical device to ensure the orthogonality of postoperative radiographs for the hexapod external fixator parameter measurement. Radiation exposure, duration of deformity correction, and cost for patients might be reduced due to the less repeated radiographs with the wrong position.

scholarly journals A study of the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds

2019 ◽  
Vol 6 (3) ◽  
pp. 669
Author(s):  
Byomokesh Patro ◽  
Pankaj Surana ◽  
Kailash Chandra Mahapatra
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Working Environment ◽  
Lower Limbs ◽  
Control Group ◽  
Study Group

Background: Infection of a diabetic foot wound heralds a poor outcome, early diagnosis and treatments are important. The aim of the study was to study the efficacy of external fixation in healing large, deep and unstable diabetic foot wounds.Methods: 50 patients with diabetic foot ulcer considered for the present study. Out of this 50 cases 25 are selected for external fixations (study group), after fulfilling the inclusion criteria and rest 25 cases are managed by posterior slab support. After reducing the infective load, the external fixator was applied as per application of external fixator procedure. The fixator is kept for 4 to 6 weeks. Daily dressings are done with advance dressing materials. Posterior slab group 25 patients are included having large, deep ulcers and unstable joints, to which posterior slabs were supported after proper and extensive debridement of wound under SA/LA.Results: DFU predominantly affects right lower limb than left lower limb. Both lower limbs affected in 4% cases. Because of different working environment males are more vulnerable to foot ulcerations. Out of 50 cases 48 (96%) of DFU are unilateral and 32 no of cases (64%) are predominantly occurs in right lower limb (Table 2). Out of 50 cases 38 no. of patient are males and 12 no. of patient are females. External fixator in exposed joint decreases the wounds in 52 days where as by posterior slab support 59 days. The mean surfaces are of the wound after therapy in study group is 75 cm2 and in control group it was 78 cm2.Conclusions: Large ulcers and exposed joints due to diabetic foot can be managed by external fixator for better prognosis than posterior slab method.

scholarly journals Correction of Complex Lower Limb Deformities by the Ilizarov Technique: An Audit of Complications

2000 ◽  
Vol 8 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Jean-Claude Theis ◽  
H Simpson ◽  
J Kenwright
Keyword(s):  
Lower Limb ◽  
Deformity Correction ◽  
Limb Lengthening ◽  
Bone Transport ◽  
Angular Deformity ◽  
Ilizarov Technique ◽  
Leg Lengthening ◽  
Limb Deformities ◽  
Lower Limb Reconstruction ◽  
Tract Infections

This is an audit of complications resulting from correction of complex lower limb deformities by the Ilizarov technique. 33 patients (40 bone segments) were reviewed and divided into 4 groups according to the type of surgery carried out: limb lengthening and/or correction of deformity, bone or joint stabilisation, treatment of nonunion or bone defect, angular and/or rotation correction. Most minor complications were fixator specific. Pin tract infections were almost universal but responded well to oral antibiotics and rarely resulted in osteomyelitis. Major complications were procedure specific and more common in those patients who underwent leg lengthening, treatment for nonunion and bone transport. There was also a high incidence of nerve injury as a result of acute angular deformity correction. Despite the high complication rate the Ilizarov technique remains an effective tool for complex lower limb reconstruction surgery.

scholarly journals Reconstructive procedures on lower extremities using Mitkovic external fixation system

2005 ◽  
Vol 52 (2) ◽  
pp. 117-119 ◽  
Author(s):  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Z. Golubovic ◽  
D. Mladenovic ◽  
S. Milenkovic ◽  
...  
Keyword(s):  
External Fixation ◽  
Low Cost ◽  
Deformity Correction ◽  
Lower Extremities ◽  
Limb Lengthening ◽  
Bone Transport ◽  
Invasive Technique ◽  
Angular Deformity ◽  
Reconstructive Procedures ◽  
Fixation System

The results of limb lengthening, correction of limb deformities and solving of bone loss, by the use of Mitkovic external fixation system and minimally invasive technique on the series of 96 operations in 89 patients are shown. Only lower extremities were included in this series. The advantages of this external fixation system in comparison to other systems are pointed out. The main advantages are the optimal biomechanical conditions including unilateral but 3-dimensional frame, which provides conditions very similar to natural biomechanical features of the human long bones, simplicity of application and low cost. The received result was excellent or very good in 98.4%. Maximal limb lengthening was 18 cm (at the same time in the femur and the tibia). Angular deformity correction is extremely simplified with minimized possibility of complications. The frame for bone transport is very simple. It can be concluded that presented methods are suitable for routine use.

scholarly journals Improving Postoperative Radiographs for the Correction Planning of Hexapod External Fixator Using an Additional Foot Ring

2021 ◽  
Author(s):  
Yanshi Liu ◽  
Kai Liu ◽  
Feiyu Cai ◽  
Xingpeng Zhang ◽  
Hong Li ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Demographic Data ◽  
Deformity Correction ◽  
Radiological Examination ◽  
Fixation Time ◽  
Trauma Patients ◽  
X Rays ◽  
Examination Time ◽  
Mean Time

Abstract Background: It is challenging to determine the orthogonality of radiographs in daily clinical practice. The purpose of this study was to show the usefulness of an additional foot ring which might determine the orthogonality of postoperative radiographs for the correction planning of hexapod external fixator.Methods: We retrospectively analyzed 81 consecutive trauma patients with tibial shaft fractures treated by the hexapod external fixator at our institution from September 2014 to July 2019. Starting in March 2016, the postoperative radiographs for fracture reduction planning were obtained under the control of an additional foot ring. In this simple way, the radiologist and the patient himself can easily control the rotation position of the limb while taking the radiographs, and the two X-rays are orthogonal to each other. The final data consisted of 47 patients in traditional radiographs (Group Ⅰ) and 34 patients under the control of foot ring during the radiographic process (Group Ⅱ). The demographic data, original postoperative deformities, number of repeated radiographs after the first postoperative radiological examination, time to the satisfactory reduction achieved, and external fixation time in all patients were documented and analyzed.Results: Satisfactory reduction and bone union were achieved in all patients. There were no statistical significances between the two groups in the demographic data, original postoperative deformities, and external fixation time (P>0.05). The mean number of repeated radiographs after the first postoperative radiological examination (1.2 times) and mean time to the satisfactory reduction achieved (3.0 days) in patients with an additional foot ring used were all less than that (2.1 times, 5.3 days) in patients without foot ring (P<0.05).Conclusions: The additional foot ring is a practical device to ensure the orthogonality of postoperative radiographs for the correction planning of hexapod external fixator. Radiation exposure, duration of deformity correction, and cost for patients might be reduced due to the less repeated radiographs with the wrong position.

Sign in / Sign up

Export Citation Format

Share Document