The Epibloc system of percutaneous endomedullary internal fixation is best indicated for AO type A2-3 extra-articular fractures of the distal radius and AO type C1 slightly comminuted articular fractures. This system includes pins that can be inserted into the medullary canal and advanced without breaking through the second cortex. This fixation is stabilised by an external plate and rendered dynamic by the pins' elasticity which compresses the fractured surfaces. Moreover, this system results in transversal ligamentotaxis which helps prevent secondary reduction losses. The result of a preliminary series of 326 cases is evaluated.
presentation and lack of adequate treatment in the acute stage explain the high rate of complications.The aim of this presentation is to illustrate the different clinical presentations and the surgical procedures performed at CORU. Particular emphasis is given on limb reconstruction techniques by means of bone transport and non-vascularised autologus bone graft and periostium. Methods: This retrospective clinical study covers a period of 5 years (January 2002-December 2006), whereby clinical files, surgical data and X-ray films of children treated for osteoarticular infections of the forearm were reviewed. A total of 59 surgical procedures were performed on 58 patients. In about 27% of cases, the forearm infection was just a site in a clinical picture of multiple sites osteomyelitis.All the cases underwent a sequestrectomy procedure and limb reconstruction was carried out in nine cases because of the bone loss and the associated impairment of the function. Bone transport was used in three cases, free autologus bone graft in four and radioulnar synostosis (one bone forearm) in two. Results: Fifty-three patients were reviewed and five patients were lost during the follow-up. The overall longterm results were rated as good when parameters as pain, motion, function, patient satisfaction were evaluated. Discussion: The functional outcome of surgery for forearm infections, in children, is usually good. In cases with segmental bone loss, the use of external fixation techniques for limb reconstruction has proven to be ideal.
case necessitated a complete trapeziectomy for trapezometacarpal arthritis because of a bad first indication. All eight other cases had excellent results without any pain. Discussion: The indications are rare but when the rules of surgical placement are respected (sufficient resection, good capsule fixation), the results are very good. The use of wrist arthroscopy allows a short approach for implant placement increasing primary stability. The indications are limited to only isolated STT arthritis.
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