Correction of post-traumatic lower limb deformities using the Taylor spatial frame.

Twenty-five post-traumatic leg length discrepancies combined with axial deviation in 22 patients were treated with the Taylor spatial frame. We retrospectively analysed the accuracy of correction, the complication rate and the clinical outcome including the duration of treatment. The cases were divided into three sub-groups according to the level of the osteotomy. The mean age at operation was 22.7 years; the mean follow-up was 21.1 months. The patients presented uniplanar and multiplanar deformities in combination with leg length discrepancy. Twenty-one of 25 cases showed a frontal plane malalignment preoperatively. Only three of those 21 cases continued to show minimal malalignment postoperatively. The preoperative mechanical axis deviation present in 15 of 17 lower extremities was fully corrected in 13 extremities. The 25 lengthening and correction procedures were associated with a total of 61 difficulties, including 44 problems, seven obstacles and ten complications. In conclusion, the Taylor spatial frame allows accurate results in correction of complex post-traumatic deformities with minimal morbidity.

Fracture of the scapular body: functional outcome after conservative treatment.

BACKGROUND: Scapular body fractures, irrespective of the number of fragments, are usually managed non-operatively, with favorable results. We evaluated results after non-operative management to determine the outcomes of scapular body fractures. METHODS: We evaluated 22 patients following a fracture of the scapular body that had been treated non-operatively. To assess the influence of accompanying injuries other than those of the involved limb, we used both patient-oriented general health and shoulder-based outcome measures. RESULTS: In this series the functional outcome, reflected by the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Simple Shoulder Test (SST) score and the range-of-motion, showed a difference between multiple injured patient group and a group sustaining a isolated scapular fracture. There was no significant difference in the SF-36 scores of the overall group compared with an age-matched population control in any subcategory beside the subcategory social function. The SF-36 scores of the multitrauma patient group were significantly lower than the scores of the age-matched population controls in several subcategories. CONCLUSION: Whereas isolated scapular body fractures healed leading to a functional shoulder score level equal to the general population and a range of motion equal to the uninjured contralateral shoulder, the multitrauma patient group showed a less favorable outcome.