Independent segmental bone transport of the radius and ulna: A case report

Birkholtz, Franz; Greyling, P

doi:10.17159/2309-8309/2016/v15n2a4

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…This benefits from the dead space management conferred by the antibiotic-loaded cement spacer after osteomyelitis debridement [72]. Although predominantly used for forearm single bone defects in the current review, four publications reported on its application for both bone forearm reconstruction [34,37,38,42]. Birkholtz et al emphasised the independent transport of the radius and ulna with two monolateral rails to maintain forearm function throughout the reconstructive process [34].…”

Section: Bone Transportmentioning

confidence: 97%

“…Eleven publications reported on the use of bone transport to reconstruct 82 forearm bone defects [33,34,35,36,37,38,39,40,41,42,43]. The majority of cases (n = 76, 91%) were performed for defects post-osteomyelitis debridement and all cases used external fixation for stabilization.…”

Section: Bone Transportmentioning

confidence: 99%

“…Sixteen publications reported on the management of 105 combined radius and ulna defects [7,11,19,20,22,25,27,28,34,37,38,42,44,45,46,47] (Table 4). After the one-bone forearm technique, structural autograft in the form of vascularized grafts were used in the majority of cases (n = 14, 42%).…”

Section: Forearm Both-bone Defects (Radius and Ulna Defects)mentioning

confidence: 99%

“…Although predominantly used for forearm single bone defects in the current review, four publications reported on its application for both bone forearm reconstruction [34,37,38,42]. Birkholtz et al emphasised the independent transport of the radius and ulna with two monolateral rails to maintain forearm function throughout the reconstructive process [34]. When performing this type of reconstruction some tips and tricks are useful to remember: cement spacer induced membranes prior to bone transport are useful in providing a biological envelope for transport, but also prevent synostosis formation; The rail fixator is lined up to the desired pathway of new bone generation, ensuring the regenerate shape mimics the original anatomical shape of the forearm bone; Distraction rate is slowed down, due to the small surface area of the osteotomy site; Formal open docking is indicated, with bone grafting of the docking site; Rehabilitation focus throughout the treatment phase emphasizes active and passive pro-and supination.…”

Section: Bone Transportmentioning

confidence: 99%

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Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

Ferreira

Saini

Birkholtz

et al. 2021

Eur J Orthop Surg Traumatol

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Injuries to the long bones of the upper limb resulting in bone defects are rare but potentially devastating. Literature on the management of these injuries is limited to case reports and small case series. The aim of this study was to collate the most recent published work on the management of upper limb bone defects to assist with evidence based management when confronted with these cases.Methods: Following a preliminary search that confirmed the paucity of literature and lack of comparative trials, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was conducted. A literature search of major electronic databases was conducted to identify journal articles relating to the management of upper limb long bone defects published between 2010 and 2020.Results: A total of 46 publications reporting on the management of 341 patients were reviewed. Structural autograft, bone transport, one-bone forearm and the induced membrane technique were employed in an almost equal number of cases. The implemented strategies showed similar outcomes but different indications and complication profiles were observed. Conclusion:Contemporary techniques for the management of post-traumatic upper limb bone defects all produce good results. Specific advantages, disadvantages and complications for each modality should be considered when deciding on which management strategy to employ for each specific patient, anatomical location, and defect size.

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Section: Bone Transportmentioning

confidence: 97%

Section: Bone Transportmentioning

confidence: 99%

Section: Forearm Both-bone Defects (Radius and Ulna Defects)mentioning

confidence: 99%

Section: Bone Transportmentioning

confidence: 99%

See 2 more Smart Citations

Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

Ferreira

Saini

Birkholtz

et al. 2021

Eur J Orthop Surg Traumatol

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show abstract

“…Techniques depicted in writing incorporate interposition grafting, twofold barrel free fibula reproduction, actuated film strategies, and changing over to a solitary bone lower arm by setting up a cross union [1]. Despite the fact that the congruity of bone can be reestablished, the complex relationship of the radius and ulna might be interrupted, prompting a constraint of pro and supination [2]. Distraction osteogenesis was created by Gavriil Abramovich Ilizarov from Russia in 1951 and it is a weakening and tedious strategy in orthopedics [3].…”

Section: Introductionmentioning

confidence: 99%

Bone Transport Over Radius Over Ulna: A Case Report

Etiapan¹

2020

OROAJ

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Consequential bone disappearance in the lower arm including both the radius and ulna is a troublesome issue to oversee. Similarly, infected non-union with bone defects is difficult to manage. The practical result might be restricted because of loss of expert and supination. We present a situation where noteworthy bone loss of both the range and the ulna in an adult which was effectively recreated utilizing segmental bone transport. The radius and ulna were shipped autonomously from one another to attempt to look after capacity. This report features the viability of distraction osteogenesis in the administration of lower arm bones deformity auxiliary to infection and thus a sensible utilitarian outcome was accomplished.

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Femoral lengthening using the Precice intramedullary limb-lengthening system

Calder

McKay

Timms

et al. 2019

The Bone & Joint Journal

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Aims The Precice intramedullary limb-lengthening system has demonstrated significant benefits over external fixation lengthening methods, leading to a paradigm shift in limb lengthening. This study compares outcomes following antegrade and retrograde femoral lengthening in both adolescent and adult patients. Patients and Methods A retrospective review of prospectively collected data was undertaken of a consecutive series of 107 femoral lengthening operations in 92 patients. In total, 73 antegrade nails and 34 retrograde nails were inserted. Outcome was assessed by the regenerate healing index (HI), hip and knee range of movement (ROM), and the presence of any complications. Results The mean lengthening was 4.65 cm (1.5 to 8) in the antegrade group and 4.64 cm (1.6 to 8) in the retrograde group. Of the 107 lengthenings, 100 had sufficient datapoints to calculate the mean HI. This was 31.6 days/cm (15 to 108). There was a trend toward a lower (better) HI with an antegrade nail and better outcomes in adolescent patients, but these were not statistically significant. Hip and knee ROM was maintained and/or improved following commencement of femoral lengthening in 44 patients (60%) of antegrade nails and 13 patients (38%) of retrograde nails. In female patients, loss of movement occurred both earlier and following less total length achieved. Minor implant complications included locking bolt migration and in one patient deformity of the nail, but no implant failed to lengthen and there were no deep infections. Three patients had delayed union, five patients required surgical intervention for joint contracture. Conclusion This study confirms excellent results in femoral lengthening with antegrade and retrograde Precice nails. There is a trend for better healing and less restriction in hip and knee movement following antegrade nails. There are clinical scenarios, that mandate the use of a retrograde nail. However, when these are not present, we recommend the use of antegrade nailing. Cite this article: Bone Joint J 2019;101-B:1168–1176

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Independent segmental bone transport of the radius and ulna: A case report

Cited by 3 publications

References 3 publications

Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

Bone Transport Over Radius Over Ulna: A Case Report

Femoral lengthening using the Precice intramedullary limb-lengthening system

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