Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 6.450
Filtrar
2.
Zhongguo Gu Shang ; 34(2): 131-6, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33665999

RESUMO

OBJECTIVE: To analyze effect of accordion technique on bone mineralization of extended bone segment in treating tibial bone defect with bone transport. METHODS: From May 2017 to October 2019, 22 patients with tibial bone defects were treated with Ilizarov bone-transport technique, and divided into two groups after bone-transport was completed, 11 patients in each group. In observation group, there were 9 males and 2 females aged from 20 to 60 years old with an average of (42.6± 13.3) years old;the length of bone defect ranged from 3 to 13 cm with an average of(6.4±2.6) cm;2 patients were suffered from upper tibial bone defects, 3 patients were middle and 6 patients were lower;patients were treated with accordion technique for 35 days. In control group, there were 10 males and 1 female aged from 41 to 60 years old with an average of (51.6±6.4) years old;the length of bone defect ranged from 3 to 10.7 cm with an average of (6.6±2.5) cm;1 patient was suffered from upper tibial bone defects, 3 patients were middle and 7 patients were lower;patients were treated with lock external fixator to waiting bone mineralization. The content of hydroxyapatite (HAP) extended bone segment was measured after bone-transport completed immediately, 35, 65 and 95 days after bone-transport was completed, respectively, then the mineralization time and healing time were compared between two groups, and the therapeutic effect of bone defect was evaluated by using Paley scoring criteria. RESULTS: Twenty-two patients were followed up from 18 to 36 months with an average of (27.0±6.3) months. The wounds on the bone defects healed spontaneously during bone transport, and there were no wound complications such as skin infection or skin necrosis occurred. There were statisticaldifference in the content of HAP of the extended bone segments at 35, 65 and 95 days after bone-transport between two groups (P<0.05). There were difference in mineralization time and healing time between two groups (P<0.05). According to Paley standard evaluation, 10 patients got excellent results, and 1 good in observation group; while 9 patients got excellent results, 2 good in control group;and there was no differences between two groups (Z=-0.607, P= 0.544). CONCLUSION: Accordion technique and locking external fixator mineralization in prolonging bone segment healing after bone-transport have the equal clinical effect, while the accordion technique could significantly accelerate the growth rate of HAP and shorten the mineralization time and healing time.


Assuntos
Técnica de Ilizarov , Fraturas da Tíbia , Adulto , Idoso , Calcificação Fisiológica , Fixadores Externos , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Tíbia/cirurgia , Resultado do Tratamento , Adulto Jovem
3.
Zhongguo Gu Shang ; 34(2): 148-52, 2021 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-33666002

RESUMO

OBJECTIVE: To explore clinical effect of bridge-link combined fixation system(BCFS) in treating open middle and lower tibial fractures by external fixation. METHODS: From October 2016 to September 2017, 11 patients with open middle and lower tibial fractures were treated with BCFS by external fixation, including 7 males and 4 females aged from 23 to 65 years old with an average of 44.2 years old;the course of disease ranged from 7 to 10 days. All fractures were open, middle and lower tibiofibular fractures. According to AO classification, 5 patients were type A, 5 patients were type B, and 1 patient was type C. All fractures were classified as typeⅡaccording to Gustilo-Anderson classification. The time of fracture healing, postoperative complications were observed, Johner-Wruhs standard were used to evaluate clinical effect. RESULTS: All patients were followed up from 7 to 13 months with an average of 10.1 months. Fracture healing time ranged from 4 to 8 months with an average of 6.2 months. The removal time of BCFS ranged from 5 to 11 months with an average of 7.8 months. No screws loosening and BCFS breakage occurred after operation, while 1 patient occurred infection of proximal and distal tibia after operation which was healed by anti-inflammatory treatment and dressing change. According to Johner-Wruhs standard, 8 patients were excellent and 3 patients good at the latest follow-up. CONCLUSION: BCFS could be used to treat open middle and lower tibial fractures by external fixation, which had features of small size, flexible use, solid and elastic fixation. It could not effectively reduce tissue injury and promote fracture healing, but also have advantages of less postoperative complications and better recovery of limb function.


Assuntos
Fraturas Expostas , Fraturas da Tíbia , Adulto , Idoso , Placas Ósseas , Fixadores Externos , Feminino , Fixação de Fratura , Fixação Interna de Fraturas , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas da Tíbia/cirurgia , Resultado do Tratamento , Adulto Jovem
4.
Medicine (Baltimore) ; 100(10): e25129, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725914

RESUMO

ABSTRACT: A neglected Monteggia fracture is defined as the fracture of the proximal ulna associated with radial head dislocation (RHD) without undergoing any treatment for 4 weeks or more after injury. One-stage operation of ulnar corrective osteotomy and open reduction of RHD might result in many complications. Therefore, a two-stage strategy, including ulnar osteotomy (UO) with or without annular ligament reconstruction (ALR), was adopted at our institute since 2010.We performed a retrospective review of 51 patients with neglected Monteggia fracture between January 2010 and January 2018. Patients with bilateral problems or concomitant injuries in the ipsilateral extremity were excluded. Radiological and clinical data were collected from Hospital Database and clinical visits. All patients were divided into 2 groups based on the status of the ALR: the UO alone (UO) group and the ALR group.There were 15 patients in the UO group and 36 patients in the ALR group. The age in the UO group (6.1 ±â€Š2.3, year) was significantly younger than the ALR group (9.8 ±â€Š2.8, year) (P < .001). Concerning the duration from initial injury to surgery, there was a significant difference between the UO group (8.6 ±â€Š3.2 months) and the ALR group (23.3 ±â€Š12.6 months, P < .001). Concerning the preoperative elbow function, there was no significant difference between the UO group (67.6 ±â€Š5.0) and the ALR group (66.6 ±â€Š4.4) according to the Mayo elbow performance score (MEPS) (P = .51). Concerning the postoperative parameters, including postoperative ROM of the joint, removal of external fixator (6.7 ±â€Š0.8, 6.9 ±â€Š0.9 weeks) (P = .55), lengthening (8.9 ±â€Š2.5, 10.3 ±â€Š2.5 mm) (P = .10) and MEPS (92.7 ±â€Š2.1, 91.6 ±â€Š2.1) (P = .08), there was no significant difference between the UO group and ALR group.Two-stage strategy is a reasonable choice for selected patients with long-lasting RHD with ulnar deformity.


Assuntos
Articulação do Cotovelo/cirurgia , Ligamentos Articulares/cirurgia , Fratura de Monteggia/cirurgia , Redução Aberta/métodos , Ulna/cirurgia , Criança , Pré-Escolar , Articulação do Cotovelo/lesões , Fixadores Externos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Redução Aberta/instrumentação , Osteotomia , Amplitude de Movimento Articular , Estudos Retrospectivos , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento
5.
Zhongguo Gu Shang ; 34(3): 208-14, 2021 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-33787162

RESUMO

OBJECTIVE: To retrospectively analyze the clinical efficacy of external fixation in the treatment of femoral neck fracture with two different pin layout. METHODS: From April 2000 to April 2018, 140 cases of femoral neck fracture were treated with closed reduction and percutaneous pin external fixation, among them 121 cases were followed up for more than 1 year, including 31 cases in traditional group, 12 males and 19 females, aged 45 to 74(65.4±8.4) years;90 cases in modified group, 39 males and 51 females, aged 12 to 75 (64.5±7.8) years. In traditional group, the first needle was put on the femoral talus, the second and third needles were put under the tension line, and the three needles were not on the same line in the lateral phase; in modified group, the first needle was drilled into the lateralcortex of the femur, obliquely penetrating the distal and proximal end of the femoral talus fracture, and the other two needles were drilled into the medial cortex of the femoral neck and the femoral talus, respectively. The operation time, hospital stay, postoperative ambulation time, femoral neck shortening rate, fracture healing time, fracture healing rate and femoral head necrosis rate of the two groups were observed and compared. Harris hip function score was used one year after operation. RESULTS: These 121 patients were followed-up, the follow up time of traditional group was 13 to 45(30.5±11.4) months;the follow-up time of modified group was 14 to 120(34.5±12.5) months. There was no significant difference in operation time, hospital stay and femoral head necrosis rate between two groups (P>0.05). There were significant differences between two groups in the time of going to the ground, shortening rate of femoral neck, fracture healing time, fracture healing rate and Harris functional score of the hip 1 year after operation (P<0.05). CONCLUSION: Compared with the traditional group, the modified group has the advantages of lower femoral neck shortening rate, shorter fracture healing time, higher fracture healing rate and higher Harris hip function score.


Assuntos
Fraturas do Colo Femoral , Adolescente , Adulto , Idoso , Criança , Fixadores Externos , Feminino , Fraturas do Colo Femoral/cirurgia , Fixação de Fratura , Fixação Interna de Fraturas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
6.
Orthop Clin North Am ; 52(2): 167-175, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33752838

RESUMO

Proximal humerus fractures (PHF) are a common orthopedic injury; however, their treatment remains largely controversial with evidence supporting a wide array of treatments. Although many injuries can be treated nonoperatively, there has been much debate about surgical management of PHF. A detailed review of the literature was performed relative to operative management options specifically related to implant choices. Although no definitive answers are available regarding best practice, there is literature to guide operative decision-making and implant selection based on both patient- and surgeon-specific factors.


Assuntos
Artroplastia do Ombro , Tomada de Decisão Clínica , Fixadores Externos , Fixação Interna de Fraturas , Próteses e Implantes , Fraturas do Ombro/cirurgia , Humanos , Desenho de Prótese
7.
J Hand Surg Asian Pac Vol ; 26(1): 1-9, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33559566

RESUMO

Metacarpals are unique bones that support the finger to aid hand function. Metacarpals are also the commonest bones to get fractured in the hand. Historically, most metacarpal fractures were managed conservatively. Due to increased patient expectations as well as advancements in diagnosis and osteosynthesis, various surgical options are now available for metacarpal fractures. The goal of operative management of metacarpal management is no longer limited to achieving clinical or radiological union. To restore hand function to a preinjury level, the surgeon must achieve adequate anatomical reduction and stable fixation with minimal soft tissue damage. Similar to tendon repair, to start early active motion should be the goal after metacarpal fracture fixation. Intraoperative consideration should also include minimizing soft tissue damage and avoiding tendon, ligament or capsular entrapment. The aim of this article is to explain the principles of surgical management, the different options available for metacarpal fractures, the techniques, pearls, advantages and disadvantages of each technique, so the surgeon can choose the ideal option to achieve the best result.


Assuntos
Fraturas Ósseas/terapia , Ossos Metacarpais/lesões , Ossos Metacarpais/cirurgia , Pinos Ortopédicos , Placas Ósseas , Parafusos Ósseos , Redução Fechada , Fixadores Externos , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Humanos , Imobilização , Ossos Metacarpais/anatomia & histologia , Contenções
8.
BMC Surg ; 21(1): 95, 2021 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-33612116

RESUMO

BACKGROUND: The hexapod external fixator (HEF) is increasingly used for high-energy tibial shaft fracture care as more general orthopedic surgeons are gaining expertise of this versatile device. The purpose of this study was to evaluate the clinical effectiveness of the HEF for definitive management in patients with high-energy tibial shaft fractures. METHODS: The study was conducted on 34 patients with tibial shaft fractures who were admitted or referred to our institution and consented to HEF treatment from Jan 2016 to June 2019, including 27 males and 7 females with a mean age of 39 years (range 18 to 65 years). Patients' clinical and radiological data, and the final clinical outcomes at a minimum of 12 months follow-up were collected and retrospectively analyzed. All complications were documented according to Paley's classification. The clinical outcomes were evaluated using the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the last clinical visit. RESULTS: All patients remained in the HEF for a mean of 26 weeks (range 15 to 52 weeks) and acquired complete bone union. The satisfactory alignment was achieved in all patients, and all the patients were able to perform daily activities with no difficulty at the last clinical visit. Complications included pin tract infection (44%), delayed union (6%), nonunion (3%), and joint stiffness (3%). The ASAMI bony result was excellent in 31 patients and good in 3. The ASAMI functional result was excellent in 27 patients, good in 6, and fair in 1. CONCLUSIONS: Definitive management using the hexapod external fixator is an alternative and effective method for high-energy tibial shaft fractures, including technical advantages of early trauma-control, the versatility of achieving excellent alignment, and the continuity of device until bone union.


Assuntos
Fixadores Externos , Fraturas da Tíbia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas da Tíbia/cirurgia , Resultado do Tratamento , Adulto Jovem
9.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(2): 144-148, 2021 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-33624464

RESUMO

Objective: To investigate the effectiveness of suspensory external fixation technique in treatment of proximal humeral fractures. Methods: Between August 2013 and October 2018, 14 patients with proximal humeral fractures were treated with suspensory external fixation technique. There were 10 males and 4 females with an average age of 55.9 years (range, 43-76 years). There were 10 cases of falling injury and 4 cases of traffic accident injury. Among them, there were 9 cases of Neer type Ⅲ and 5 cases of Neer type Ⅳ. The time from injury to operation was 3-7 days (mean, 4.6 days). Nine cases were complicated with osteoporosis. The preoperative visual analogue scale (VAS) score was 6.1±1.2. The effectiveness was comprehensively evaluated by hospital stay, fracture healing time, removal time of external fixator, postoperative complications, VAS score, and Neer score of shoulder joint function. Results: All operations were successfully completed, and the hospital stay was 6-14 days, with an average of 9.4 days. All the incisions healed by first intention, and no infection or other complications occurred. All patients were followed up 16-60 months (mean, 35.4 months). X-ray films examination showed that all fractures healed, the healing time was 4-7 months (mean, 4.9 months). The removal time of external fixator was 5-8 months (mean, 6.3 months). VAS scores were 1.5±0.8 at 1 month after operation and 1.0±0.9 at last follow-up, both of which were significantly improved when compared with preoperative score, the differences were significant between different time points ( P<0.05). Neer score of shoulder joint function was 75-100 (mean, 91.1); 9 cases were excellent, 4 cases were good, and 1 case was fair. The excellent and good rate was 92.9%. During follow-up, there was no adverse events such as acromion impingement, nonunion, or pseudoarthrosis. Conclusion: For proximal humeral fractures, the suspensory external fixation technique is a simple and reliable treatment method that can significantly improve joint function.


Assuntos
Fixadores Externos , Fraturas do Ombro , Adulto , Idoso , Feminino , Fixação de Fratura , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas do Ombro/cirurgia , Resultado do Tratamento
10.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 35(2): 195-199, 2021 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-33624473

RESUMO

Objective: To investigate the effectiveness of the nose ring drain (NRD) technique combined with Ilizarov circular external fixation in treatment of Gustilo ⅢA Pilon fracture. Methods: Between March 2017 and December 2019, 17 patients with Gustilo ⅢA Pilon fractures were admitted and treated with NRD technique combined with Ilizarov circular external fixation. Among them, there were 11 males and 6 females; the age ranged from 24 to 63 years, with an average of 38.2 years. There were 3 cases of traffic accident injury, 13 cases of falling injury, and 1 case of penetrating injury. There were 13 cases of emergency admittance and 4 cases of wound infection after surgical treatment. Furthermore, there were 2 cases of fibula fractures and 3 cases of lateral malleolus fractures. Results: All patients were followed up 8-12 months, with an average of 9.9 months. All wounds healed by first intention, and 4 patients with preoperative infection had no recurrence during the follow-up. The external fixator was removed after fracture healing in 17 patients at 3-7 months after operation (mean, 4.5 months). At last follow-up, the pain score of the ankle joint Kofoe score was 40-50, with an average of 44; the functional score was 17-27, with an average of 25; the mobility score was 8-18, with an average of 14; and the effectiveness was rated as excellent in 8 cases, good in 7 cases, and poor in 1 case. Conclusion: For Gustilo ⅢA Pilon fractures, the NRD technique combined with Ilizarov circular external fixation has advantages of good fracture fixation and drainage effects, which greatly reduces the complications of traditional treatment options and the number of operations.


Assuntos
Fraturas do Tornozelo , Adulto , Drenagem , Fixadores Externos , Feminino , Fixação de Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
11.
J Hand Surg Asian Pac Vol ; 26(1): 112-117, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33559581

RESUMO

In baseball players, a high degree of functional recovery is required for the treatment of fractures in the distal interphalangeal (DIP) joint, especially on the throwing side. While dynamic external fixation is a useful treatment option to restore the joint function, existing external fixators are too large for use on DIP joints. Three cases of DIP joint intra-articular comminuted fractures in baseball players treated using the new dynamic external finger fixator which we developed are reported. The external fixator was kept attached for four weeks. The patients returned to play baseball 7-8 weeks after surgery. The total arc of the DIP joint was 90-100% of the contralateral side. Follow-up radiographs demonstrated that joint congruity had been reacquired. This technique was adaptive in the treatment of comminuted intra-articular fractures of the DIP joint and resulted in a near-normal range of joint motion and remodeling of the joint surface.


Assuntos
Beisebol/lesões , Fixadores Externos , Falanges dos Dedos da Mão/cirurgia , Fraturas Intra-Articulares/cirurgia , Redução Aberta , Falanges dos Dedos da Mão/lesões , Humanos , Masculino , Adulto Jovem
12.
Bone Joint J ; 103-B(2): 279-285, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33517738

RESUMO

AIMS: Pin-site infection remains a significant problem for patients treated by external fixation. A randomized trial was undertaken to compare the weekly use of alcoholic chlorhexidine (CHX) for pin-site care with an emollient skin preparation in patients with a tibial fracture treated with a circular frame. METHODS: Patients were randomized to use either 0.5% CHX or Dermol (DML) 500 emollient pin-site care. A skin biopsy was taken from the tibia during surgery to measure the dermal and epidermal thickness and capillary, macrophage, and T-cell counts per high-powered field. The pH and hydration of the skin were measured preoperatively, at follow-up, and if pin-site infection occurred. Pin-site infection was defined using a validated clinical system. RESULTS: Out of 116 patients who were enrolled in the study, 23 patients (40%) in the CHX group and 26 (44%) in the DML group had at least one bad or ugly pin-site infection. This difference was not statistically significant (p = 0.71). There was no significant relationship between pH or hydration of the skin and pin-site infection. The epidermal thickness was found to be significantly greater in patients who had a pin-site infection compared with those who did not (p = 0.01). Skin irritation requiring a change of treatment occurred in four patients (7%) using CHX, and none using DML. CONCLUSION: We found no significant difference in the incidence of pin-site infection between the CHX and DML treatment groups. Dermol appeared to offer a small but significant advantage in terms of tolerability. We did not find a significant association between patient or treatment related factors and pin-site infection. It is therefore difficult to make specific recommendations based upon these results. The use of either cleaning agent appears to be appropriate. Cite this article: Bone Joint J 2021;103-B(2):279-285.


Assuntos
Pinos Ortopédicos/efeitos adversos , Emolientes/uso terapêutico , Fixadores Externos/efeitos adversos , Fixação de Fratura/instrumentação , Cuidados Pós-Operatórios/métodos , Infecções Relacionadas à Prótese/prevenção & controle , Fraturas da Tíbia/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Feminino , Seguimentos , Fixação de Fratura/métodos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Relacionadas à Prótese/epidemiologia , Método Simples-Cego , Resultado do Tratamento , Adulto Jovem
13.
Medicine (Baltimore) ; 100(1): e22393, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429725

RESUMO

ABSTRACT: Calcaneal fractures are rare in pediatric population, with more displaced intra-articular fractures encountered due to the increasing number of high-energy trauma. Operative interventions are gaining popularity because of the unsatisfactory outcomes of traditional conservative methods. This study investigated the clinical outcomes of a minimally invasive technique using the sinus tarsi approach and external fixator in the treatment of intra-articular calcaneal fractures in pediatric patients.Patients who underwent open reduction between January 2010 and January 2018 at our institute were included in this study and reviewed retrospectively. Radiological and clinical parameters were all recorded and analyzed.Overall, 29 patients were included in the study, including 23 boys and 6 girls (10.2 ±â€Š2.2 years old). The average follow-up was 29.5 months postoperatively (range, 26-72 months). Bohler angle was 15.2 ±â€Š3.3° preoperatively, and 34.0 ±â€Š3.8° postoperatively (P < .001); Gissane angle was 101.8 ±â€Š6.2 degrees preoperatively, and 129.7 ±â€Š6.2° postoperatively (P < .001). The average length of incision was 3.4 ±â€Š0.7 cm. At the last follow-up, all patients showed satisfactory clinical outcomes and the score was 90.0 ±â€Š2.3 according to American Orthopedic Foot and Ankle Society Scale.Minimally invasive approach with external fixator is an effective method for treating displaced intra-articular calcaneal fractures in pediatric patients, with a lower incidence of wound-related complications and good cosmetic outcomes.


Assuntos
Calcâneo/lesões , Calcâneo/cirurgia , Fixadores Externos/normas , Adolescente , Criança , Pré-Escolar , Fixadores Externos/efeitos adversos , Fixadores Externos/tendências , Feminino , Pé/cirurgia , Traumatismos do Pé/diagnóstico por imagem , Traumatismos do Pé/cirurgia , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Resultado do Tratamento
14.
BMC Musculoskelet Disord ; 22(1): 88, 2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33461532

RESUMO

BACKGROUND: We present a case of an immense unprecedented tibial bone lengthening of 33.5 cm. The management of chronic osteomyelitis of the right tibia with subtotal tibial bone defect, talus defect and equinus ankle deformity. We demonstrate limb reconstruction by distraction osteogenesis and correction of ankle deformity with the Ilizarov technique. Limb salvage was preferred as an alternative to amputation to restore basic limb function. CASE PRESENTATION: A 16-year-old male patient fell and injured his right lower leg. He attempted to treat the symptoms with traditional home remedies. During 15 months of self-treating, he developed osteomyelitis of the right tibia and had lost function in his foot. Radiology revealed immense bone defect of the right tibia, including talus bone defect and equinus deformity of the calcaneus. The patient's right tibia was non weight-bearing, had drainage sinus just below his knee and a large scar anteriorly along the entire length of the tibia. CONCLUSION: Upon completion of treatment, the patient was able to avoid amputation of his leg with partially restored function for weight-bearing. He carried himself without assistance after 3 years of lost function in his right leg. Tibial bone distraction osteogenesis of 33.5 cm was done after 90% of the tibial length was defected. To the best of our best knowledge, this case is one of a kind to achieve distraction of tibial bone to such length.


Assuntos
Técnica de Ilizarov , Osteogênese por Distração , Tíbia , Adolescente , Fixadores Externos , Humanos , Salvamento de Membro , Masculino , Tíbia/diagnóstico por imagem , Tíbia/cirurgia , Resultado do Tratamento
15.
Clin Podiatr Med Surg ; 38(1): 111-116, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33220740

RESUMO

The use of external fixators for distraction osteogenesis has revolutionized treatment options for segmental bone defects in the tibia. Following corticotomy, the latency phase allows the biologic environment to initiate healing, and optimized distraction rates produce regenerate. Regenerate consolidation can be improved with local and systemic biologic optimization. Consolidation time is often considered to be 3 to 4 times longer than distraction in adults. Soft tissue considerations are important during external fixation and distraction. Additionally, slow regenerate can be benefited by various techniques discussed in this article. Distraction osteogenesis is a beneficial tool for segmental bone defects.


Assuntos
Alongamento Ósseo , Fixadores Externos , Osteogênese por Distração , Tíbia/cirurgia , Regeneração Óssea , Osso Cortical/fisiologia , Osso Cortical/cirurgia , Humanos
16.
Clin Podiatr Med Surg ; 38(1): 55-71, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33220744

RESUMO

Non-weight bearing is mandatory after soft tissue reconstructions of the weight-bearing and the high-pressure areas in the lower extremity. The most common method of patient mobilization after surgical reconstruction of chronic foot and ankle wounds has been to place patients non-weight bearing with crutches, walkers, or a wheelchair. Often patients are older, have more complex medical comorbidities, are deconditioned, and simply cannot comply with the prescribed weight-bearing status with these methods, which leads to deconditioning, depression, or noncompliance. Noncompliance quickly leads to failure of the reconstructive effort and the serious threat of limb loss.


Assuntos
Deambulação Precoce , Fixadores Externos , Salvamento de Membro/métodos , Amputação , Membros Artificiais , Pé Diabético/cirurgia , Humanos , Extremidade Inferior/lesões , Extremidade Inferior/cirurgia , Osteomielite/cirurgia , Retalhos Cirúrgicos
17.
Zhongguo Yi Liao Qi Xie Za Zhi ; 44(6): 499-502, 2020 Dec 08.
Artigo em Chinês | MEDLINE | ID: mdl-33314857

RESUMO

A kind of adjustable external fixation device for lower extremity is designed. The circuit is mainly composed of TEC1-00703 semiconductor refrigeration chip, HZC-30A pressure sensor, STC89C52RC single chip microcomputer and other electrical components. It can realize the timing intelligent temperature control and meet the local fixed-point refrigeration. The design of adjustable structure and the application of intelligent air cushion can satisfy the full fixation of lower limbs of different individuals. Its operation does not need much medical knowledge. It can solve the problem of emergency transportation and follow-up treatment of lower limb injury in ice and snow sports. It has a good application prospect and universality.


Assuntos
Fixadores Externos , Extremidade Inferior , Refrigeração , Semicondutores , Fixação de Fratura , Humanos
18.
Medicine (Baltimore) ; 99(52): e23921, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350796

RESUMO

ABSTRACT: To analyze the efficacy of arthrodesis with Ilizarov external fixator for the treatment of end-stage ankle osteoarthritis.This retrospective study included 88 patients with end-stage (stage-3) ankle osteoarthritis according to Morrey-Wiedeman classification who underwent arthrodesis with Ilizarov external fixator from January 2016 to January 2019. There were 47 males and 41 females with a mean age of (57.21 ±â€Š7.12) years old (range 49-76). Outcomes were measured by the American Orthopaedic Foot and Ankle society (AOFAS) Ankle Hindfoot Scale, Visual Analog Scale (VAS) pain scores, complications, subjective satisfaction, ankle function, correction of deformity, and complications.With an average follow-up of (13.50 ±â€Š5.41) months (range 10-21), all 88 patients returned for final follow-up. All patients achieved bony healing with a success rate of 100%. Mean postoperative healing time (3.56 ±â€Š1.04) months (range 3-6). Two patients developed sinus tract infection, delayed healing in 1 patient, and 2 patients had pain and swelling again in the ankle joint. No serious complications occurred in other patients. All the patients evaluated with the VAS scores and AOFAS scores at final follow-up showed significant improvement (P < .05). Through imaging analysis, medical tibial talar angle (MTTA) improved from (85.76 ±â€Š6.01) degrees to (88.98 ±â€Š1.35) degrees postoperative. Lateral talar station (LTS) decreased from (5.32 ±â€Š3.81) mm to (2.71 ±â€Š2.62) mm after operation (P < .05). The overall satisfaction of patients is 88.64%.In the treatment of end-stage ankle osteoarthritis, arthrodesis with Ilizarov external fixator can achieve good radiological and clinical outcomes with low prevalence of ankle joint malalignment and high fusion rates and satisfaction.


Assuntos
Articulação do Tornozelo , Artrodese , Osteoartrite , Complicações Pós-Operatórias , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/patologia , Articulação do Tornozelo/cirurgia , Artrodese/efeitos adversos , Artrodese/instrumentação , Artrodese/métodos , China/epidemiologia , Progressão da Doença , Fixadores Externos , Feminino , Humanos , Técnica de Ilizarov , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/fisiopatologia , Osteoartrite/cirurgia , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Radiografia/métodos , Estudos Retrospectivos
19.
Sensors (Basel) ; 21(1)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33375087

RESUMO

This manuscript introduces a programable active bone fixator system that enables systematic investigation of bone healing processes in a sheep animal model. In contrast to previous systems, this solution combines the ability to precisely control the mechanical conditions acting within a fracture with continuous monitoring of the healing progression and autonomous operation of the system throughout the experiment. The active fixator system was implemented on a double osteotomy model that shields the experimental fracture from the influence of the animal's functional loading. A force sensor was integrated into the fixator to continuously measure stiffness of the repair tissue as an indicator for healing progression. A dedicated control unit was developed that allows programing of different loading protocols which are later executed autonomously by the active fixator. To verify the feasibility of the system, it was implanted in two sheep with different loading protocols, mimicking immediate and delayed weight-bearing, respectively. The implanted devices operated according to the programmed protocols and delivered seamless data over the whole course of the experiment. The in vivo trial confirmed the feasibility of the system. Hence, it can be applied in further preclinical studies to better understand the influence of mechanical conditions on fracture healing.


Assuntos
Fixadores Externos , Fraturas Ósseas , Animais , Técnicas Biossensoriais , Consolidação da Fratura , Osteotomia , Ovinos , Estresse Mecânico
20.
J Surg Orthop Adv ; 29(3): 154-158, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33044155

RESUMO

This study analyzes the outcomes of patients treated for high energy midfoot injuries with temporary stabilization (TS) prior to definitive operative fixation compared to a control group (C) treated initially with splint only. Three Level 1 trauma centers reduced and temporized high energy Lisfranc injuries. A matched control group was compared with the intervention group. Clinical parameters, complications and need for additional surgery were evaluated. There were 15 patients in group C and 29 patients with temporary stabilization (TS). Both the TS and C groups demonstrated no significant difference in the number of additional operations, infection rate, incidence of deep vein thrombosis (DVT), nonunion and need for orthotics postoperatively (p > 0.05). Staged treatment of high energy Lisfranc injuries in the TS group led to a delay in definitive fixation or arthrodesis while having a similar minimal complication rate relative to the controls. This is a Level III, Retrospective Case Control Study. (Journal of Surgical Orthopaedic Advances 29(3):154-158, 2020).


Assuntos
Fixadores Externos , Fixação de Fratura , Estudos de Casos e Controles , Fixação Interna de Fraturas , Humanos , Estudos Retrospectivos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...