scholarly journals Treatment of Non-Union and Bone Loss of Tibial Pilon

10.5772/62664 ◽  
2016 ◽  
Author(s):  
Giorgio Maria Calori ◽  
Massimiliano Colombo ◽  
Emilio Mazza ◽  
Miguel Simon Bucci ◽  
Piero Fadigati ◽  
...  
Keyword(s):  
Bone Loss ◽  
Non Union ◽  
Tibial Pilon

Mechanical Failure of Angle Locking Plates in Distal Comminuted Tibial Fractures

2016 ◽  
Vol 695 ◽  
pp. 118-122 ◽  
Author(s):  
Razvan Ene ◽  
Zsombor Panti ◽  
Mihai Nica ◽  
Marian Pleniceanu ◽  
Patricia Ene ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Tibial Fracture ◽  
Weight Bearing ◽  
Healing Process ◽  
Biomechanical Properties ◽  
Implant Failure ◽  
Locking Plates ◽  
Non Union ◽  
Tibial Pilon

Distal comminuted tibial fracture with or without intra-articular involvement is a very common injury of the lower limb, especially in younger patients due to high energy trauma. The anatomical and biomechanical properties of this segment of tibia, makes this pathology a major surgical challenge with a preserved clinical outcome. The aim of this study is to present different outcome of tibial fracture, treated with open reduction and internal fixation (ORIF) with titanium angle locking plates (ALP) and to underline the physiological and non-physiological bone healing effects on implants. In this study we included 48 patients with tibial pilon fracture who underwent to ORIF, applying ALP in the Orthopedics and Trauma department of the University Emergency Hospital in Bucharest. Due to preserved biomechanical properties of ALP and this anatomical region, weight bearing is not allowed till 6 to 8 weeks. Comminuted fracture of this part of tibia often have de-vascularized bony fragments which leads to delayed union or non-union. These complications often lead to implant failure, improper bone healing or non-union. Internal fixation with angle stable screws, offers a good stability of reduction in the early postoperative period. Titanium angle locking plates offers good anatomical reduction and stable fixation in the early period of healing process. Due to its rigid, fixed position of the screws in the plates, bone remodelling during healing process and early weight bearing, increases the mechanical failure of implant.Keywords: tibial pilon fractures, angle locking plates, implant failure.

scholarly journals Proximal femoral reconstruction with modular megaprostheses in non-oncological patients

2021 ◽  
Author(s):  
Kevin Döring ◽  
Klemens Vertesich ◽  
Luca Martelanz ◽  
Kevin Staats ◽  
Christoph Böhler ◽  
...  
Keyword(s):  
Bone Loss ◽  
Aseptic Loosening ◽  
Periprosthetic Fracture ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Complication Rates ◽  
Non Union ◽  
Prosthetic Joint ◽  
One Year ◽  
Proximal Femoral Reconstruction

Abstract Introduction Multiple revision hip arthroplasties and critical trauma might cause severe bone loss that requires proximal femoral replacement (PFR). The aim of this retrospective study was to analyse complication- and revision-free survivals of patients who received modular megaprostheses in an attempt to reconstruct massive non-neoplastic bone defects of the proximal femur. Questions/purposes (1) What were general complication rates and revision-free survivals following PFR? (2) What is the incidence of complication specific survivals? (3) What were risk factors leading to a diminished PFR survival? Materials and methods Twenty-eight patients with sufficient follow-up after receiving a modular proximal femoral megaprosthesis were identified. The indications for PFR included prosthetic joint infection (PJI), periprosthetic fracture, aseptic loosening, non-union and critical femoral fracture. Complications were grouped according to the ISOLS-classification of segmental endoprosthetic failure by Henderson et al. Results Overall, the complication-free survival was 64.3% at one year, 43.2% at five years and 38.4% at ten years, with 16 patients (57%) suffering at least one complication. Complications were dislocation in eight patients (29%), PJI in 6 patients (21%), periprosthetic fracture in five patients (18%), and aseptic loosening in six patients (21%). Prosthesis stem cementation showed a lower risk for revision in a cox proportional hazard model (95% CI 0.04–0.93, HR 0.2, p = 0.04). Conclusion PFR with modular megaprostheses represents a viable last resort treatment with high complication rates for patients with severe proximal femoral bone loss due to failed arthroplasty or critical fractures. In revision arthroplasty settings, PFR cementation should be advocated in cases of impaired bone quality.

Acute Compression Fracture of the Scaphoid

1994 ◽  
Vol 19 (6) ◽  
pp. 757-758
Author(s):  
G. E. B. GIDDINS ◽  
J. WILSON-MACDONALD
Keyword(s):  
Bone Loss ◽  
Scaphoid Fracture ◽  
Compression Fracture ◽  
Radiological Sign ◽  
Non Union ◽  
Compression Fractures

A previously unreported radiological sign of a sclerotic margin to an acute displaced scaphoid fracture due to bone compression is reported. This should to be recognized because of the implied bone loss and hence risks of both mal-union and non-union, and because of the implication that volar compression fractures of the scaphoid, may occur.

scholarly journals Acetabular Revision with Bone Grafting and Cementation for Aseptic Loosening after Primary Charnley Low-Friction Hip Arthroplasty with Structural Bulk Autografts

2016 ◽  
Vol 24 (3) ◽  
pp. 328-331
Author(s):  
Riazuddin Mohammed ◽  
Efstathios Drampalos ◽  
Paul Siney ◽  
Bodo Purbach ◽  
Peter Kay
Keyword(s):  
Bone Loss ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Bone Grafting ◽  
Acetabular Revision ◽  
Low Friction ◽  
Ectopic Ossification ◽  
Term Outcome ◽  
Non Union ◽  
The Mean

Purpose To review the outcome of acetabular revision with bone grafting and cementation for aseptic loosening after primary Charnley low-friction hip arthroplasty with structural bulk autografts in 15 patients. Methods Records were reviewed for 3 men and 12 women aged 31 to 72 (mean, 53) years who underwent acetabular revision with bone grafting and cementation for aseptic loosening at a mean of 12.4 (range, 6.6–20.3) years after primary Charnley low-friction hip arthroplasty with superolateral structural bulk autografts from the femoral head for dysplastic hip (n=14) or bone loss secondary to acetabular fracture (n=1). Results After a mean follow-up of 6.7 (range, 1.1–14.5) years, the mean Merle d'Aubigné and Postel score improved from 8.55 to 16.5. Bridging trabeculae was noted in 10 hips and graft remodelling in 5 hips. Five hips had ectopic ossification of Brooker grade 1 to 2. The mean hip centre of rotation was 21.6 (range, 16.2–30.6) mm. Two women required re-revision for aseptic loosening of the acetabulum after 8.5 and 6.6 years. The first one underwent re-revision with solid allograft for superolateral deficiency of the acetabulum. The second one underwent re-revision with solid and morselised bone allografts for loosened acetabulum. One patient had superior migration of the acetabulum for 9 mm at year 2, but it was asymptomatic. One patient had a dislocation that was reduced with manipulation under anaesthesia. Three patients had trochanteric non-union and presented with lateral thigh pain and tenderness, but no further surgery was performed. Conclusion The medium-term outcome of acetabular revision with bone grafting and cementation is satisfactory. Repeat bone grafting is required to restore the anatomic acetabular position and bone loss secondary to acetabular loosening.

scholarly journals Atrophic non-union with severe osteolysis of the radius in a healthy child: successful rescue surgery. Management with fibular allograft and autograft growth factors in a paediatric patient

2021 ◽  
Vol 8 (4) ◽  
pp. 461-466
Author(s):  
Daniele Priano ◽  
Mario D'Errico ◽  
Laura Peretto ◽  
Antonio Memeo
Keyword(s):  
Growth Factors ◽  
Bone Loss ◽  
Bone Biopsy ◽  
Single Case ◽  
Kirschner Wire ◽  
Non Union ◽  
Fibula Graft ◽  
Single Case Report ◽  
Fractures In Children ◽  
Wrong Diagnosis

Background. Forearm fractures are the most frequent fractures in children and adolescents and they are more common in males than in females. In the last 20 years the increase of surgical indications have resulted in more complications, among them the non-unions, considered extremely rare and severe in children, have increased in incidence. We report a successful treatment of misdiagnosed forearm atrophic non-union with severe osteolysis using fibula allograft and autograft growth factors in a previously healthy 4-year-old child. Clinical case. A 4 year-old boy presented to our hospital with massive bone loss and a negative bone biopsy for Gorham-Stout Syndrome, he also showed reactive bone tissue with abnormal vascularity, necrotic osteocartilaginous fragments and giant mononucleated cells. Other lab tests did not show any modifications, so all the causes of paediatric osteolysis were ruled out. He had already undergone a few surgeries on that fracture and we performed others before achieving a good result, obtained with an autologous fibula graft with medullary growth factors stabilized with Kirschner wire. At the follow up 28 months later, the patient showed total consolidation of the initial area of non- union, no neurovascular deficit and no joint deficiency. Discussion. Non-union in paediatric patients is rare and therefore difficult to treat and diagnose. Since all of our tests ruled out the main causes of paediatric non-union, we managed the case with strategies usually applied to adult patients, carefully respecting the growth plates. Conclusion. Although this is a single-case report, it underlines the importance of early diagnosis, the difficulty to rule out some pediatric causes of bone loss and the complicances of a wrong diagnosis/treatment. It also shows that the use of allograft bone and autograft growth factors in a pediatric patient, who has undergone multiple surgeries, can lead to excellent results

scholarly journals MANAGEMENT OF INFECTED FRACTURE NON-UNION OF LONG BONES BY MASQUELET TECHNIQUE IN PATIENTS WITH BONE LOSS LESS THAN 4 CM

2018 ◽  
Vol 7 (33) ◽  
pp. 3715-3720
Author(s):  
Bellary Mohammed Ghouse ◽  
Koti Satish ◽  
Buchireddy Jayachandra Reddy ◽  
Zeeshan Mujahid
Keyword(s):  
Bone Loss ◽  
Long Bones ◽  
Non Union ◽  
Masquelet Technique

Hydroxyapatite Coated Plate in the Surgical Treatment of the Forearm Non Union with Bone Loss

1992 ◽  
pp. 73-77
Author(s):  
G. F. Zinghi ◽  
A. Moroni ◽  
L. Specchia ◽  
P. Bungaro ◽  
G. Gualdrini ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bone Loss ◽  
Non Union ◽  
Coated Plate

scholarly journals Managing Difficult Fractures due to Ballistic Trauma with Ilizarov Ring Fixation

1970 ◽  
Vol 9 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Pankaj Chand ◽  
Roshan Lal Shrestha ◽  
Bachu Ram KC ◽  
Bhanu Chand Shah ◽  
Amit Joshi ◽  
...  
Keyword(s):  
Bone Loss ◽  
Weight Bearing ◽  
Joint Stiffness ◽  
Valgus Deformity ◽  
Bone Transport ◽  
Healing Time ◽  
Early Weight Bearing ◽  
Non Union ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator

20 fractures (7 femoral and 13 tibial) were treated with the illizarov apparatus between 2003 to 2006. Allwere old injuries, previously managed by internal fixation (intramedullary rods), external fixation (Hoffman'sexternal fixators), or conservatively with traction and plaster of paris slabs. Ilizarov fixators were appliedto manage infected non-union with or without bone loss and malunion. Corticotomy and bone transportwas carried out in cases with significant bone loss. In others without any limb shortening and minimalbony defect, bone grafting and compression was carried out. In one case valgus deformity along withnon-union was corrected. Early weight bearing with range of motion exercises for ankle and knee jointswere encouraged. Average fracture healing time was 12 months (8 to 18 months). All fractures healed with<5° of malalignment. Complications included pin site inflammation/ infection, muscle transfixation, kneeand ankle joint stiffness and a wire fracture. The ilizarov device provided definitive fixation with acceptableresults in all cases.Key words: Ilizarov ring fixator; distraction osteogenesis; bone transport; infective non-union;corticotomyDOI: 10.3126/mjsbh.v9i1.3482Medical Journal of Shree Birendra Hospital Vol.9(1) 2010 1-8

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