Biomechanical Stability of Juvidur and Bone Models on Osteosyntesic Materials

Grubor, Predrag; Mitković, Milorad; Grubor, Milan; Meccariello, Luigi; Falzarano, Gabriele

doi:10.5455/aim.2016.24.261-265

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…Ilizarov technique is an effective treatment method for complex limb injuries which is especially applicable to developing countries or poor countries and furthermore in limited resources secondary care public hospitals [32]. Although the Ilizarov frame is not the most stable system from the biomechanical point of view it is always reliable in bone transport [33]. ere are numerous challenges in treating composite tibial bone and soft tissue defects, such as sufficient soft tissue coverage, infection control, and poor bone healing during bone transport, and bone transport alone cannot fully meet therapeutic requirements.…”

Section: Discussionmentioning

confidence: 99%

Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

Zhu

Chen

et al. 2020

BioMed Research International

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Objective. To evaluate the surgical efficacy of bone transport (Ilizarov technique) plus “shortening-lengthening,” “flap surgery,” and “open bone transport” as individualized treatments for traumatic composite tibial bone and soft tissue defects. Methods. We retrospectively analyzed sixty-eight cases (mean age: 35.69 years, (range, 16–65)) treated from July 2014 to June 2017, including 29 middle, 18 distal, and 21 proximal tibial bone defects (4–18 cm, mean: 7.97 cm) with soft tissue defects (2.5 cm × 4.0 cm to 30.0 cm × 35.0 cm after debridement). We adopted the bone transport external fixator to fix the fracture after debriding the defect parts. In the meantime, we adopted the “shortening-lengthening technique,” “flap surgery,” and “open bone transport” as individualized treatment based on the location, range, and severity of the composite tibial bone and soft tissue defects. Postoperative follow-up was carried out. Surgical efficacy was assessed based on (1) wound healing; (2) bone defect healing rate; (3) external fixation time and index; (4) incidence/recurrence of deep infection; (5) postoperative complications; and (6) Association for the Study and Application of the Methods of Ilizarov (ASAMI) score. Results. The mean duration from injury to reconstruction was 22 days (4–80 d), and the mean postoperative follow-up period was 30.8 months (18–54 m). After the repair and reconstruction, 2 open bone transport patients required infected bone removal first before continuing the bone transport treatment. No deep infection (osteomyelitis) occurred or recurred in the remaining patients, and no secondary debridement was required. Some patients had complications after surgery. All the postoperative complications, including flap venous crisis, nail channel reaction, bone nonunion, mechanical axis deviation, and refracture, were improved or alleviated. External fixation time was 12.5 ± 3.41 months, and the index was 1.63 ± 0.44. According to the ASAMI score, 76.47% of the outcomes were good/excellent. Conclusion. The Ilizarov technique yields satisfactory efficacy for composite tibial bone and soft tissue defects when combined with “shortening-lengthening technique,” “flap surgery,” and “open bone transport” with appropriate individualized treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

Zhu

Chen

et al. 2020

BioMed Research International

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“…Although this fracture rarely occurs, periprosthetic fractures around the knee are usually difficult to treat. At present, the most commonly used materials for osteosynthesis are also used for internal fixation of fractures [21]. Surgical treatment is required for periprosthetic fractures with displacement, and a locking plate or retrograde intramedullary nail is often chosen.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of circular external fixator in periprosthetic fractures around the knee

Nozaka

Miyakoshi

Hongo

et al. 2020

BMC Musculoskelet Disord

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Background The incidence of periprosthetic fractures after total joint arthroplasty (TJA) is rising due to an increasing number of TJAs performed annually and the growing elderly population. In many elderly patients with periprosthetic fractures, the bone strength is lowered due to the deterioration of bone quality and a decrease in bone quantity; rigid fixation of the fracture is difficult. It is a challenging operation for orthopedic surgeons. The usefulness of circular external fixation for periprosthetic fractures has been reported in several case studies. The aim of this study was to investigate the rate of union and complications associated with circular external fixation in periprosthetic fractures around the knee. Methods We included 19 patients with periprosthetic femur and tibial fractures who underwent osteosynthesis using a circular external fixator and had at least 2 years of follow-up. All patients had comorbidities and high risks associated with anesthesia. Tourniquets were not used in any of the patients. There were no cases in which the skin incision was placed, and the closed reduction technique was used in all cases. Results A 100% union rate was achieved with no serious complications. All fractures healed after a mean time of 14.3 ± 5.2 weeks (range, 8–38 weeks). The walking ability was the same level as before the injury in 13 cases. Discussion There are many comorbidities associated with periprosthetic fractures in elderly patients. Double-plate or revision surgery were largely invasive and had high risks associated with anesthesia. Circular external fixation is a feasible and effective treatment option because it provides stable fixation, prompt postoperative mobilization, and has no major complications, especially in elderly patients who are treated for periprosthetic fractures. Conclusion Circular external fixation is a safe and reliable method for periprosthetic fractures around the knee in elderly patients. Level of evidence Level IV, retrospective case series.

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“…However, immediate full weight-bearing after surgery is possible because of rigid fixation. Circular hexapod external fixation has great stability as external fixation around the knee joint [ 30 ]. The Ilizarov technique is an effective treatment method for complex limb injuries such as road traffic accidents, sports injuries, war trauma, and severe burns around the knee [ 5 – 7 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of circular hexapod external fixation with soft tissue reconstruction in treating severe knee dislocation due to burn scarring: a case report

Nozaka

Miyakoshi

Saito

et al. 2020

BMC Musculoskelet Disord

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Background Severe varus deformity and soft tissue injury caused by a burn around a complex knee dislocation is a rare injury. Soft tissue reconstruction and deformity correction with circular hexapod external fixation of the knee and hinged total knee arthroplasty (TKA) are challenging and can lead to major complications if not performed appropriately. We present a case in which a combination of soft tissue reconstruction, circular hexapod external fixation, and TKA was used treat severe knee dislocation due to burn scarring. Case presentation We report the case of a 58-year-old woman who presented for knee surgery with soft tissue reconstruction, deformity correction with circular hexapod external fixation, and hinged TKA for a severe complex deformity and soft tissue injury caused by a burn injury at 6 months of age. The left leg was shorter by 35 mm in terms of functional leg length discrepancy. She walked with a limp, with a marked varus deformity of the left knee during the stance phase of walking. After a 3-stage repair, the patient was able to walk without assistance, confirming improvement of mobility. Conclusion The treatment method was an effective use of a combination of soft tissue reconstruction, circular hexapod external fixation, and rehearsal surgery using a 3D printed bone model of the modular rotating hinge component of TKA, which was successfully used to treat a severe knee dislocation due to burn scarring. This staged surgery maintained the leg length and ultimately achieved a satisfactory alignment.

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Biomechanical Stability of Juvidur and Bone Models on Osteosyntesic Materials

Cited by 7 publications

References 14 publications

Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft Tissue Defects: Any Specific Needs besides the Ilizarov Technique?

Effectiveness of circular external fixator in periprosthetic fractures around the knee

Effectiveness of circular hexapod external fixation with soft tissue reconstruction in treating severe knee dislocation due to burn scarring: a case report

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