Amputation to treat osteomyelitis of the metatarsus in two partially domesticated springboks (Antidorcas marsupialis)

2019 ◽  
Vol 7 (2) ◽  
pp. e000599
Author(s):  
Luke Alexander Poore ◽  
Katja Koeppel ◽  
Gerhard Steenkamp
Keyword(s):  
Fracture Healing ◽  
Chronic Osteomyelitis ◽  
Open Fractures ◽  
Subcutaneous Tissues ◽  
Antidorcas Marsupialis

Two springboks were diagnosed with chronic osteomyelitis of the metatarsus of the left hindlimb. The springboks had both suffered open fractures of the metatarsus of the left hindlimb 12 weeks and one week prior to presentation. External coaptation had initially been used to give stability and encourage fracture healing. This had proved unsuccessful in both cases and an infection and osteomyelitis had developed at the fracture sites. Two amputations had been subsequently performed in case 1 but had failed to resolve infection of the skin and subcutaneous tissues. An osteomyelitis of the underlying metatarsus had developed. No treatment apart from external coaptation had been performed before referral in case 2. Surgical amputation of the metatarsus and tarsus was performed as salvage procedures in both cases. The springboks adjusted to the loss of the left tarsus and metatarsus with no orthopaedic disorders at re-examinations 12 months after surgery.

scholarly journals External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

2020 ◽  
Author(s):  
DongDong Sun ◽  
Dan Lv ◽  
Kun Zhou ◽  
Jian Chen ◽  
Li-Lan Gao ◽  
...  
Keyword(s):  
Blood Loss ◽  
Fracture Healing ◽  
External Fixator ◽  
Distal Tibia ◽  
Operation Time ◽  
Healing Time ◽  
Open Fractures ◽  
Group A ◽  
Group B ◽  
Ankle Function

Abstract Background To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula. Methods From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n=35), plate-screw (group B, n=30) and Kirschner wire(group C, n=26).The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. Results Four patients were lost to follow-up, and 87 patients were followed up for 5-35 months (average, 14.2 months). The operation time of group C(114.92±36.09min) was shorter than that of group A (142.27±47.05min) and group B(184.00±48.56min) (P<0.05). There was no difference in intraoperative blood loss among the three groups (P>0.05). The surgical and implants costs in group C (5.24±1.21, thousand dollars) is lower than that in group A (6.48±1.11, thousand dollars) and group B (9.37±2.16, thousand dollars) (P < 0.05).The fracture healing time of group C(5.67±1.42months) was significantly less than that of group A (6.90±1.33months) and group B(6.70±1.12months) (P<0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P<0.05). The wound infection and needle-tract infection did not differ among the three groups (P>0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P>0.05). conclusion Compared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.

scholarly journals External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

2020 ◽  
Author(s):  
DongDong Sun ◽  
Dan Lv ◽  
Kun Zhou ◽  
Jian Chen ◽  
Li-Lan Gao ◽  
...  
Keyword(s):  
Blood Loss ◽  
Fracture Healing ◽  
External Fixator ◽  
Distal Tibia ◽  
Operation Time ◽  
Healing Time ◽  
Open Fractures ◽  
Group A ◽  
Group B ◽  
Ankle Function

Abstract Background To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula. Methods From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n=35), plate-screw (group B, n=30) and Kirschner wire(group C, n=26).The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. Results Four patients were lost to follow-up, and 87 patients were followed up for 5-35 months (average, 14.2 months). The operation time of group C(114.92±36.09min) was shorter than that of group A (142.27±47.05min) and group B(184.00±48.56min) (P<0.05). There was no difference in intraoperative blood loss among the three groups (P>0.05). The surgical and implants costs in group C (5.24±1.21, thousand dollars) is lower than that in group A (6.48±1.11, thousand dollars) and group B (9.37±2.16, thousand dollars) (P < 0.05).The fracture healing time of group C(5.67±1.42months) was significantly less than that of group A (6.90±1.33months) and group B(6.70±1.12months) (P<0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P<0.05). The wound infection and needle-tract infection did not differ among the three groups (P>0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P>0.05). Conclusion Compared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.Fund program: National Natural Science Foundation of China (11572222)

scholarly journals External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

2020 ◽  
Author(s):  
DongDong Sun ◽  
Dan Lv ◽  
Kun Zhou ◽  
Jian Chen ◽  
Li-Lan Gao ◽  
...  
Keyword(s):  
Blood Loss ◽  
Fracture Healing ◽  
External Fixator ◽  
Distal Tibia ◽  
Operation Time ◽  
Healing Time ◽  
Open Fractures ◽  
Group A ◽  
Group B ◽  
Ankle Function

Abstract PurposeTo compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula.MethodsFrom January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and kirschner wire(group C, n = 26).The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups.ResultsFour patients were lost to follow-up, and 87 patients were followed up for 5–35 months (average, 14.2 months). The operation time of group C(114.92 ± 36.09 min) was shorter than that of group A (142.27 ± 47.05 min) and group B(184.00 ± 48.56 min) (P < 0.05). There was no difference in intraoperative blood loss among the three groups (P > 0.05). The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) (P < 0.05).The fracture healing time of group C(5.67 ± 1.42months) was significantly less than that of group A (6.90 ± 1.33months) and group B(6.70 ± 1.12months) (P < 0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P < 0.05). The wound infection and needle-tract infection did not differ among the three groups (P > 0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P > 0.05).conclusionCompared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shorten the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.Fund program: National Natural Science Foundation of China (11572222)

scholarly journals Effects of growth hormone in patients with tibial fracture: a randomised, double-blind, placebo-controlled clinical trial

2007 ◽  
Vol 156 (3) ◽  
pp. 341-351 ◽  
Author(s):  
Michael Raschke ◽  
Michael Højby Rasmussen ◽  
Shunmugam Govender ◽  
David Segal ◽  
Mette Suntum ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Tibial Fracture ◽  
Open Fractures ◽  
Tibial Fractures ◽  
Controlled Study ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Post Surgery ◽  
Significant Difference ◽  
Closed Fractures

Objective: Investigate whether intervention with GH after tibial fracture enhances fracture healing. Design: Randomised, double-blind, placebo-controlled study in 406 patients (93 women, 313 men, age: 18–64 years) with tibial fracture. Methods: Patients were stratified by tibial fracture (open or closed) and allocated to placebo or GH treatment (15, 30 or 60 μg/kg daily, until clinically assessed healing or until 16 weeks post-surgery). Primary outcome was time from surgery until fracture healing and assessment of healing was done centrally and observer blinded. Patients reported for evaluation every 4 weeks until 24 weeks, and at 9 and 12 months. Results: GH did not accelerate time to healing in the combined group of open and closed fractures. When separately analysing the closed and open fractures, a significant difference in time to healing was observed between treatment groups, exclusively in the closed fractures (P<0.05; subgroup analysis revealed that the 60 μg/kg group was significantly different from placebo). The relative risk of fracture healing for 60 μg/kg versus placebo during the 12 month was: all fractures, 1.16; 95% CI: (0.86; 1.57) (ns); closed fractures, 1.44; 95% CI: (1.01; 2.05; P<0.05); open fractures, 0.75; 95% CI: (0.42; 1.31) (ns). The estimated median number of days before fracture healing in closed fractures was 95 with 60 μg/kg versus 129 with placebo (95% CI: (94; 129) and (94; 249)) corresponding to approximately 26% decrease in healing time. Conclusions: In the overall group of open and closed tibial fractures, no significant enhancement of fracture healing was observed with GH, whereas in closed tibial fractures, GH accelerated healing significantly.

scholarly journals External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Dong-Dong Sun ◽  
Dan Lv ◽  
Kun Zhou ◽  
Jian Chen ◽  
Li-Lan Gao ◽  
...  
Keyword(s):  
Blood Loss ◽  
Fracture Healing ◽  
External Fixator ◽  
Distal Tibia ◽  
Operation Time ◽  
Healing Time ◽  
Open Fractures ◽  
Group A ◽  
Group B ◽  
Ankle Function

Abstract Background To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula. Methods From January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and Kirschner wire (group C, n = 26). The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. Results Four patients were lost to follow-up, and 87 patients were followed up for 5–35 months (average, 14.2 months). The operation time of group C (114.92 ± 36.09 min) was shorter than that of group A (142.27 ± 47.05 min) and group B (184.00 ± 48.56 min) (P < 0.05). There was no difference in intraoperative blood loss among the three groups (P > 0.05). The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) (P < 0.05). The fracture healing time of group C (5.67 ± 1.42 months) was significantly less than that of group A (6.90 ± 1.33 months) and group B (6.70 ± 1.12 months) (P < 0.05). The postoperative complications such as fractures delayed union and nonunion in group C (2 cases, 8.00%) is less than that in group A (13 cases, 39.39%) and group B (11cases, 37.93%) (P < 0.05). The wound infection and needle-tract infection did not differ among the three groups (P > 0.05). The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups (P > 0.05). Conclusion Compared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation.

scholarly journals New concept in external fixation

2005 ◽  
Vol 52 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Z. Golubovic ◽  
Ivan Micic ◽  
D. Mladenovic ◽  
...  
Keyword(s):  
Fracture Healing ◽  
External Fixation ◽  
External Fixator ◽  
Open Fractures ◽  
Simple Application ◽  
War Wounds ◽  
Dynamic Fixation ◽  
Closed Fractures ◽  
Three Components

A new concept in external skeletal fixation is presented. A 3D unilateral system developed by Mitkovic has widely been investigated biomechanically in AO institute in Davos (Switzerland). Consists of three components only providing extremely simple application and dynamic fixation of bones and different joints. This simple external fixator functions as an accurate reduction device at the same time, minimizing need for fluoroscopy. Clinically this system has been applied to mere then 13 thousand patients in 43 clinics. This paper presents the results of its application for treatment of open fractures, war wounds with fractures and for comminuted and intraarticular closed fractures in the series of 597 patients. Overall average time for union time was 3.2 months. Overall success of fracture healing was 96.8% including open and closed fractures. Our study suggests that the use of this 3D unilateral system is suitable for routine use.

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