The treatment of talar body fractures with compression screws: a case series

Fractures of talar body are rare and serious injuries and frequently seen in multiply injured and polytraumatised patients. The high variability of talar fractures, their relatively low incidence together with the high percentage of concomitant injuries makes treatment of these injuries a challenge to the surgeon

Intramedullary skeletal kinetic distractor in lower extremity lengthening

[No Abstract Available

Surgical Techniques for Lengthening and Deformity Correction of the Femur With Lengthening Nails

WOS: 000218133100009Limb lengthening and deformity correction using fully implantable nails have gained increasing acceptance. The nails used in these procedures are either straight or have an acute proximal angle such that they differ from standard trauma nails, which have sagittal radius of curvature. Use of straight nails must take into account both the bowed shape of the femur and the prevention of coronal plane translation along the mechanical axis after femoral lengthening along the anatomic axis. Here, we describe the preoperative planning, surgical technique, and postoperative complications of lengthening with fully implantable nails in patients with femoral deformities and length discrepancies

Femoral lengthening and deformity correction using the Fitbone motorized lengthening nail

This study reports our results with retrograde Fitbone insertion in patients with femoral shortening and deformity. We also present our experience regarding the benefits, complications, and factors associated with complications of the Fitbone technique. Twelve males and ten females had femoral shortening and deformities treated using the retrograde Fitbone technique between 2009 and 2012. The etiologies were post-traumatic in 12 patients, poliomyelitis in four, cosmetic in two, congenital hypoplasia in two, achondroplasia in one, and Perthes sequela in one. The follow-up time was 30.8 months. The mean lengthening was 5.8 (range 2-14) cm. The degree of acute angular correction was 9A degrees (5-22A degrees) in nine cases. The time to full weight-bearing was 5.9 months. The consolidation index was 1.07 (0.75-1.62) months/cm. Complete consolidation was obtained in all cases except two. Running back was observed in two cases. The Fitbone technique allows accurate deformity correction. The rigid reamers allow the surgeon to use the Fitbone even in patients with a narrow medullary canal. As this might result in poor bone regeneration, thinner lengthening nails should be considered

Femoral lengthening and deformity correction using the Fitbone motorized lengthening nail

WOS: 000348307300019PubMed ID: 25326815This study reports our results with retrograde Fitbone insertion in patients with femoral shortening and deformity. We also present our experience regarding the benefits, complications, and factors associated with complications of the Fitbone technique. Twelve males and ten females had femoral shortening and deformities treated using the retrograde Fitbone technique between 2009 and 2012. The etiologies were post-traumatic in 12 patients, poliomyelitis in four, cosmetic in two, congenital hypoplasia in two, achondroplasia in one, and Perthes sequela in one. The follow-up time was 30.8 months. The mean lengthening was 5.8 (range 2-14) cm. The degree of acute angular correction was 9A degrees (5-22A degrees) in nine cases. The time to full weight-bearing was 5.9 months. The consolidation index was 1.07 (0.75-1.62) months/cm. Complete consolidation was obtained in all cases except two. Running back was observed in two cases. The Fitbone technique allows accurate deformity correction. The rigid reamers allow the surgeon to use the Fitbone even in patients with a narrow medullary canal. As this might result in poor bone regeneration, thinner lengthening nails should be considered

Extramembranous transfer of the tibialis posterior tendon for the correction of drop foot deformity

Objectives: We evaluated the effectiveness of extra-membranous transfer of the tibialis posterior (TP) tendon for the treatment of drop foot deformity

Use of a magnetic bone nail for lengthening of the femur and tibia

WOS: 000391162800021PubMed ID: 28031510Purpose. To report our experience with the PRECICE nail for limb lengthening in 23 patients. Methods. Records of 15 female and 8 male patients aged 14 to 38 (mean, 23.6) years who underwent lengthening of the tibia (n=6) or femur (n=21) using the PRECICE nail were reviewed. The reasons for lengthening included trauma (n=7), hemihypertrophy (n=2), focal femoral deficiency (n=2), Ellis-van Creveld syndrome (n=1), hip septic arthritis sequelae (n=1), hereditary multiple exostosis (n=1), club foot sequela (n=1), congenital tibial pseudoarthrosis (n=1), fibrous dysplasia (n=1), idiopathic limb length discrepancy (n=7), and cosmetic (n=1). Results. The mean follow-up duration was 20.72 months. The mean lengthening was 48.20 mm, and the mean acute angular correction was 15.5 degrees. The mean time to full weight-bearing was 5.15 months, and the mean consolidation index was 1.12 months / cm. The mean maturation index was 0.78 months / cm. One patient had nail breakage during the consolidation phase. The nail was replaced by an intramedullary nail until consolidation, after which another PRECICE nail was used to treat the residual shortening. Eight patients had over-lengthening and the nails were driven back to the desired length. No patient had infection. Conclusion. The PRECICE nail is a viable option for lengthening of the femur and tibia

Anatomic Course of the Superficial Branch of the Radial Nerve in the Wrist and Its Location in Relation to Wrist Arthroscopy Portals: A Cadaveric Study

Purpose: The aim of this study was to assess the course of the superficial branch of the radial nerve (SBRN) at the level of the wrist and its branches in relation to wrist arthroscopy portals. Methods: Dissections were performed on I I hands from 6 cadavers in the section starting from the point where the SBRN begins to emerge and ending at the terminal branches of the dorsal hand. The distribution of the SBRN, the distance from the superficial branch to the dorsal portals used in wrist arthroscopy, and the distance from the superficial branch to the anatomic determinants (styloid process of the radius, Lister tubercle) were studied. Results: At the level of the wrist, the nerve bifurcated into 2 branches in 8 of I I wrists (73%) and into 3 branches in 3 of I I wrists (27%). The mean distance from the SBRN where it was first detected proximal to the Lister tubercle was 73 mm. The mean distance between the styloids was 52 rum; the distance between the Lister tubercle and styloid process of the radius was 23 trim. At the wrist level, the distance from the branch closest to the radial side to the Lister tubercle was 28 mm (L-D 1), 21 mm (L-D2/3), and 7 mm (RS-D1). The distance of the closest nerve branch to the 3-4 portal was 9 min. The distances of the other portals were 5 mm (1-2RMC-D1), 8 min (1-2RMC-D2/3), 8 mm (1-2P-D1), and 9 mm (1-2P-D2/3). Conclusions: The limited size of the area where portals can be positioned and the anatomic variations between individuals are major obstacles in developing a guideline for reducing the risk of SBRN injury in wrist arthroscopy. Clinical Relevance: Great care must be taken when using the 1-2 portal. We suggest making a skin-only incision for this portal and then using blunt dissection to help prevent injury to the SBRN

Simultaneous bilateral correction of genu varum with Smart frame

WOS: 000403656900001PubMed: 28617182Purpose: The aim of this study is to evaluate clinical and radiological results of simultaneous bilateral correction of genu varum with Smart frame. Methods: Between 2011 and 2015, a total of 25 patients (10 females, 15 males) who had bilateral genu varum deformity were operated bilaterally with tibial and fibular osteotomy in the same session, using Smart frame. The mean follow-up period was 28.7 (range, 13-45) months. All patients had bilateral tibial varus deformity. Femoral deformity was corrected in an earlier session in nine patients. Mechanical axis deviation (MAD), mechanical lateral distal femoral angle, mechanical medial proximal tibial angle (mMPTA) and posterior proximal tibial angle (PPTA) were measured preoperatively and postoperatively. Short Form-36 questionnaire was filled by the patients preoperatively and during the last follow-up. Results: The mean preoperative MAD was 37.6 mm (range, 9-98 mm), which improved to 8.4 mm (range, 3-44 mm) postoperatively (p < 0.05). The mean preoperative mMPTA was 76 degrees, which improved to 89 degrees (p < 0.05). The mean preoperative PPTA was 75.5 degrees, which improved to 80.3 (p < 0.05). Ten problems (20%), two obstacles (4%) and no sequelae occurred in 50 legs of 25 patients. Conclusions: In conclusion, Smart frame is an accurate and reliable method for performing bilateral simultaneous deformity correction in patients with bilateral genu varum deformity. It can be applied for various childhood-induced severe tibial deformities such as achondroplasia, rickets, skeletal dysplasia and Blount's disease

Retrospective analysis of AO 42A-B type tibia fractures treated with percutaneus locked plating and intramedullary nailing

BACKGROUND: In this study, the results of AO 42A and 42B type tibia fractures treated with intramedullary nail (IMN) and percutaneus locking plate (PLP) were evaluated. The complications were examined, and it was questioned whether the type of fixation had an effect on union time and functional results