Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates

Bar‐On, Elhanan; Becker, Talia; Katz, Kalman; Velkes, Steven; Salai, Moshe; Weigl, Daniel

doi:10.1007/s11832-009-0165-x

Cited by 18 publications

(9 citation statements)

References 17 publications

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“…PMAR to overcome magnification element. The correction we achieved with our technique is also comparable with others 57. We had one complication of peroneal nerve palsy in a patient who underwent simultaneous femoral and tibial correction.…”

Section: Discussionsupporting

confidence: 80%

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Ensuring precision in lower limb deformity correction through a combination of temporary external fxation followed by internal fxation

Ganjwala

Shah

Shah³

2014

IJOO

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Background:It is important to plan preoperatively when contemplating internal fixation following deformity correction. Surgeons often find it difficult to retain the achieved correction till the end of internal fixation. To maintain precise correction we used hybrid technique which uses both external and internal fixation. The objective of the study was to evaluate the effectiveness of this hybrid technique in achieving and retaining desired correction.Materials and Methods:In this retrospective study, we evaluated the magnitude of deformity with radiological parameters. We compared correction which was planned and correction which was achieved. The technique was used during surgery for corrective osteotomies. Before carrying out the osteotomy, rail fixator with two swivel clamps was applied. After osteotomy swivel clamps were loosened. Desired correction was achieved. While fixator held the fragments in corrected position, definitive internal fixation was carried out. External fixator was removed after completion of internal fixation. Position of mechanical axis ratio, mechanical lateral distal femoral angle and mechanical medial proximal tibial angle were measured before and 12 weeks after surgery. Student t-test was used to analyze the difference between correction which was planned and correction which was achieved.Results:There was no statistical difference between the desired correction and the correction achieved.Conclusions:Temporary use of external fixator while correcting angular deformities of lower limb allows to achieve accurate correction.

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Section: Discussionsupporting

confidence: 80%

“…Bar-on et al . described a similar technique with tubular fixators 7. We used a rail fixator with a swivel clamps as an external fixator.…”

Section: Discussionmentioning

confidence: 99%

Ensuring precision in lower limb deformity correction through a combination of temporary external fxation followed by internal fxation

Ganjwala

Shah

Shah³

2014

IJOO

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“…Biomaterials can be used for different lengths of time within the host depending on the intended purpose. Temporary biomaterials include contraceptive implants [ 3 – 5 ], pins for bone reconstruction and bone lengthening [ 6 , 7 ], certain dental implants prior to restoration [ 8 ], catheters [ 9 ], stents [ 10 ], and some dermal fillers used for cosmetics and facial reconstruction [ 11 , 12 ]. However, the majority of implantable biomaterials are intended for the duration of the host's lifetime.…”

Section: Introductionmentioning

confidence: 99%

Innate Immunity and Biomaterials at the Nexus: Friends or Foes

Christo

Diener

Bachhuka

et al. 2015

BioMed Research International

114

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Biomaterial implants are an established part of medical practice, encompassing a broad range of devices that widely differ in function and structural composition. However, one common property amongst biomaterials is the induction of the foreign body response: an acute sterile inflammatory reaction which overlaps with tissue vascularisation and remodelling and ultimately fibrotic encapsulation of the biomaterial to prevent further interaction with host tissue. Severity and clinical manifestation of the biomaterial-induced foreign body response are different for each biomaterial, with cases of incompatibility often associated with loss of function. However, unravelling the mechanisms that progress to the formation of the fibrotic capsule highlights the tightly intertwined nature of immunological responses to a seemingly noncanonical “antigen.” In this review, we detail the pathways associated with the foreign body response and describe possible mechanisms of immune involvement that can be targeted. We also discuss methods of modulating the immune response by altering the physiochemical surface properties of the biomaterial prior to implantation. Developments in these areas are reliant on reproducible and effective animal models and may allow a “combined” immunomodulatory approach of adapting surface properties of biomaterials, as well as treating key immune pathways to ultimately reduce the negative consequences of biomaterial implantation.

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“…Results: Seven of the treated patients suffered from neurological disorders such as cerebral palsy or spina bifida, 9 patients had diseases with local or systemic alteration of their bone metabolism such as vitamin D deficiency and phosphate diabetes. The average age of the patients at the time of surgery was 11.18 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years. Implant-associated complications were not seen in this patient group, especially no implant failures.…”

mentioning

confidence: 99%

“…In der Kinderund Jugendtraumatologie gibt es Ansätze, die Vorteile der winkelstabilen Systeme ebenfalls zu nutzen [15,16]. Literatur zur winkelstabilen Versorgung bei kinderorthopädischen Operationen ist rar [17,18]. Diese Untersuchung zeigt anhand einer Fallserie die Ergebnisse nach winkelstabiler Osteosynthese von Korrekturosteotomien der unteren Extremität.…”

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Winkelstabile Implantate zur Osteosynthese nach Korrekturosteotomien in der Kinder- und Neuroorthopädie

Funk

Seidl²,

Perka³

et al. 2011

Z Orthop Unfall

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Locking plates are a safe and effective treatment device not only for adult trauma patients but also for the treatment of children and adolescents. When stabilisation of corrective osteotomies is performed with locking plates especially young patients benefit from this technique since mobilisation can be started earlier as compared to the use of non-angle stable plates or wires and cast immobilisation becomes unneccessary. The surgeon needs to know the range of products to pick the best implant regarding the growing skeleton's special anatomy. When choosing implants for patients with reduced bone density or impaired motor abilities as in cerebral palsy, spina bifida, and other systemic disorders, locking plates have to be taken into account to facilitate mobilisation and to avoid setbacks in motor development as well as pressure ulcers from casts. Clinical studies have to evaluate if early mobilisation combined with shorter inpatient treatment and less time and cost consuming postoperative physiotherapy or rehabilitation justify the use of the more expensive locking plates for the treatment of otherwise healthy patients.

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Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates

Cited by 18 publications

References 17 publications

Ensuring precision in lower limb deformity correction through a combination of temporary external fxation followed by internal fxation

Ensuring precision in lower limb deformity correction through a combination of temporary external fxation followed by internal fxation

Innate Immunity and Biomaterials at the Nexus: Friends or Foes

Winkelstabile Implantate zur Osteosynthese nach Korrekturosteotomien in der Kinder- und Neuroorthopädie

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