Tibiadefekt- und Infektpseudarthrosen

Moghaddam, Arash; Ermisch, C.; Fischer, Christian; Zietzschmann, Severin; Schmidmaier, Gerhard

doi:10.1007/s00132-016-3305-2

Cited by 18 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…30 A relatively recent review concluded that this “holistic” therapeutical approach can yield significantly higher nonunion healing rates of > 89 to 100%, compared with 44 to 90% when certain principles of the diamond concept were insufficiently addressed. 31 32 33 34…”

Section: Basic Diagnostic Workflow and Advanced Nonunion Diagnosticsmentioning

confidence: 99%

Delayed Fracture Healing

Mick

Fischer

2022

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

Physiologic bone healing involves numerous parameters, such as microstability, fracture morphology, or tissue perfusion, to name just a few. Slight imbalances or a severe impairment of even one of these factors may, as the figurative weakest link in the chain, crucially or completely inhibit the regenerative potential of a fractured bone. This review revisits the physiology and pathophysiology of fracture healing and provides an insight into predispositions, subtypes, diagnostic tools, and therapeutic principles involved with delayed fracture healing and nonunions. Depending on the patients individual risk factors, nonunions may develop in a variety of subtypes, each of which may require a slightly or fundamentally different therapeutical approach. After a detailed analysis of these individual factors, additional diagnostic tools, such as magnetic resonance imaging (MRI), dynamic contrast-enhanced MRI, sonography, or contrast-enhanced ultrasonography, may be indicated to narrow down the most likely cause for the development of the nonunion and therefore help find and optimize the ideal treatment strategy.

show abstract

Section: Basic Diagnostic Workflow and Advanced Nonunion Diagnosticsmentioning

confidence: 99%

Delayed Fracture Healing

Mick

Fischer

2022

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

show abstract

“…) is an alternate method to the current Ilizarov technique of excision followed by the distraction osteogenesis procedure. However, the difficulties faced, like pin loosening, pin site infection, and joint stiffness, are common with Ilizarov's technique [3,8,9].…”

Section: The Diamond Concept (Masquelet Techniquementioning

confidence: 99%

“…Highvelocity injuries lead to compound fractures and severe soft tissue damage. Also, pre-existing risk factors like diabetes mellitus and smoking contribute to a prolonged hospital stay, thereby increasing the risk of infection and non-union [3,4]. Treatment of compound fractures of the distal femur with bone defects and polymicrobial infection remains challenging for orthopaedic trauma surgeons.…”

Section: Introductionmentioning

confidence: 99%

The Utility of Supracutaneous Plating in the Staged Management of Compound Distal Femur Fracture: A Case Report

Kekatpure¹,

Khan²,

Kekatpure³

2022

Cureus

View full text Add to dashboard Cite

The aim of this report is to draw attention to the use of a vilipend technique 'supracutaneous plating' in the management of compound distal femur fractures. Treatment of compound fractures of the distal femur with bone defects and microbial infection remains a challenging task for orthopaedic trauma surgeons. In this case report, we share our experience with the use of the locking distal femoral plate as an external fixator for the staged management of a compound infected distal femur fracture in a 22-year-old male patient. Staged procedures with proper planning give excellent results for infected fractures. Supracutaneous plating can be a viable and patient-friendly alternative in the staged management of compound distal femur fractures instead of the conventional external fixators.

show abstract

“…If an infection is present, therapies intend to eradicate the infection before achieving bone regeneration and finally osseous union. 3,5,7,15,16,37 A recent review from 2015 stated that no robust evidence regarding the outcome of the treatment of infected long-bone NU is available, 38 thus highlighting the need for further large-scale studies of high-quality. The current study is the largest single-center study to date investigating the influence of OI on the outcome of bone reconstruction, and our data showed that union was achieved in patients without an OI in 79.38% and in patients with an OI in 71.4%.…”

Section: Does An Oi Have a Detrimental Effect On The Outcome Of Therapy?mentioning

confidence: 99%

The Influence of an Occult Infection on the Outcome of Autologous Bone Grafting During Surgical Bone Reconstruction: A Large Single-Center Case-Control Study

Tanner¹,

Heller²,

Grimm³

et al. 2021

JIR

View full text Add to dashboard Cite

Background Occult infections (OI) lack typical inflammatory signs, making them challenging to diagnose. Uncertainty remains regarding OI’s influence on the outcome of autologous bone grafting (ABG), and evidence-based recommendations regarding an appropriate course of action are missing. Thus, we sought to determine the incidence of an OI in patients receiving ABG, evaluate whether it influences the outcome of ABG and whether associated risk factors have a further negative influence. Methods This study was designed as a large size single-center case-control study investigating patients treated between 01/01/2010 and 31/12/2016 with a minimum follow-up of 12 months. Patients ≥18 years presenting with a recalcitrant non-union of the lower limb receiving surgical bone reconstruction, including bone grafting, were included. A total of 625 patients were recruited, and 509 patients included in the current study. All patients received surgical non-union therapy based on the “diamond concept” including bone reconstruction using ABG. Additionally, multiple tissue samples were harvested and microbiologically analyzed. Tissue samples were microbiologically evaluated regarding an OI. Bone healing was analyzed using clinical and radiological parameters, patient characteristics and comorbidities investigated and ultimately results correlated. Results Forty-six out of 509 cases with OI resulted in an incidence of 9.04%. Overall consolidation time was increased by 15.08 weeks and radiological outcome slightly impaired (79.38% vs 71.42%), differences were at a non-significant extent. Diabetes mellitus had a significant negative influence on consolidation time (p=0.0313), while age (p=0.0339), smoking status (p=0.0337), diabetes mellitus (p=0.0400) and increased BMI (p=0.0315) showed a significant negative influence on the outcome of bone grafting. Conclusion Surgeons treating recalcitrant non-unions should be aware that an OI is common. If an OI is diagnosed subsequent to ABG the majority of patients does not need immediate revision surgery. However, special attention needs to be paid to high-risk patients.

show abstract

Tibiadefekt- und Infektpseudarthrosen

Abstract: The two-step bone grafting method in the Masquelet technique used for tibia non-unions according to the diamond concept is a promising treatment option. Its application for tibia shaft non-unions with large bone defects or infections means a high degree of safety for the patient.

Cited by 18 publications

References 26 publications

Delayed Fracture Healing

Delayed Fracture Healing

The Utility of Supracutaneous Plating in the Staged Management of Compound Distal Femur Fracture: A Case Report

The Influence of an Occult Infection on the Outcome of Autologous Bone Grafting During Surgical Bone Reconstruction: A Large Single-Center Case-Control Study

Contact Info

Product

Resources

About