Salvage of Pseudoarthrosis After Tibiotalar Arthrodesis

1997 ◽  
Vol 18 (9) ◽  
pp. 580-585 ◽  
Author(s):  
Stuart E. Levine ◽  
Mark S. Myerson ◽  
Paul Lucas ◽  
Lew C. Schon
Keyword(s):  
Bone Loss ◽  
Reflex Sympathetic Dystrophy ◽  
Ankle Arthrodesis ◽  
Autogenous Bone ◽  
Poor Bone Quality ◽  
Autogenous Bone Grafting ◽  
Subtalar Arthritis ◽  
Tibiotalar Arthrodesis ◽  
Hindfoot Arthrodesis ◽  
With Screws

We retrospectively reviewed the treatment of a selected group of 23 patients with pseudoarthrosis after ankle arthrodesis who underwent revision arthrodesis at an average of 1.7 years (range, 0.3–17.0 years) after the initial, unsuccessful procedure. Fourteen patients underwent isolated revision tibiotalar arthrodesis, and 9 had an additional hindfoot arthrodesis (7 tibiotalocalcaneal, 2 pantalar) performed at the time of the procedure. Rigid internal fixation with screws was performed when possible, and, in patients with poor bone quality, an external fixator was used. Autogenous bone grafting was used in 14 patients where bone loss was present. Twenty-one of 23 patients had successful union (average, 14 weeks; range, 6–48 weeks). Two patients had persistent ankle nonunions; one was asymptomatic, and one had symptomatic subtalar arthritis. Two patients underwent successful arthrodesis but had persistent pain from reflex sympathetic dystrophy. Overall, 19 of 23 patients were satisfied with the surgery. We conclude that revision arthrodesis for tibiotalar pseudoarthrosis is a worthwhile procedure.

Tibiotalocalcaneal (Hindfoot) Arthrodesis by Retrograde Intramedullary Nailing Using a Curved Locking Nail. The Results of 52 Procedures

2005 ◽  
Vol 26 (10) ◽  
pp. 810-815 ◽  
Author(s):  
Rodney Hammett ◽  
Steve Hepple ◽  
Ben Forster ◽  
Ian Winson
Keyword(s):  
Intramedullary Nailing ◽  
Intraoperative Complications ◽  
Ankle Arthrodesis ◽  
Deep Infection ◽  
Foot Deformities ◽  
Medial Malleolus ◽  
Subtalar Arthritis ◽  
Fracture Nonunion ◽  
Hindfoot Deformities ◽  
Hindfoot Arthrodesis

Background: The purpose of this study was to report the results of 52 combined subtalar and ankle arthrodesis using an intramedullary nail. Methods: Retrospective review identified 49 patients who had 52 combined ankle and subtalar arthrodeses with an ACE® retrograde locked intramedullary humeral nail (DePuy-Ace®, Warsaw, IN). Most procedures included bone grafts from the fibula, proximal tibia, or iliac crest or femoral head allograft. Intraoperative complications included one fractured tibia and one fractured medial malleolus. The procedure was done mainly for the treatment of combined ankle and subtalar arthritis (31) or complex hindfoot deformities (12). Outcome was assessed by a combination of chart review, clinical examination, and telephone questionnaire. Followup averaged 34 (8 to 73) months. Results: At followup 82% of patients were satisfied with the results of surgery, 82% reported improvements in pain levels, and 67% reported improved foot function. The average postoperative American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 63. Postoperative complications included deep infection, amputation, stress fracture, nonunion, and prominent hardware. Conclusion: Hindfoot arthrodesis with intramedullary nailing is an effective technique for treating complex foot deformities and often is the only alternative to amputation. Patient satisfaction is high, but the procedure is demanding and complications are frequent.

Bone Loss in Open Fractures

2020 ◽  
pp. 75-92
Keyword(s):  
Bone Loss ◽  
Open Fractures ◽  
Autogenous Bone ◽  
Ilizarov Method ◽  
Challenging Problem ◽  
Related Factors ◽  
Limb Reconstruction ◽  
Induced Membrane ◽  
Optimum Mode ◽  
Autogenous Bone Grafting

This chapter deals with the management of bone loss in open fractures with particular reference to the tibia. This is a challenging problem and requires input and expertise from orthopaedic and plastic surgery specialists in limb reconstruction. The different sizes, shapes, and location of the defect will have diverse implications, and management must be individualised. Individualisation of treatment entails an assessment of the local, systemic, and patient-related factors such that the optimum mode of treatment is chosen. The techniques available include autogenous bone grafting, with or without prior induced membrane creation, vascularised free transfer of bone, and bone regeneration by the Ilizarov method.

scholarly journals Management of Isolated Capitate Nonunion: A Case Series and Literature Review

2018 ◽  
Vol 07 (05) ◽  
pp. 419-423 ◽  
Author(s):  
Rishabh Jethanandani ◽  
Schneider Rancy ◽  
Keith Corpus ◽  
Jeffrey Yao ◽  
Scott Wolfe
Keyword(s):  
Literature Review ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Relevant Literature ◽  
Case Series ◽  
Rare Condition ◽  
Vascular Supply ◽  
Autogenous Bone ◽  
Rare Injury ◽  
Autogenous Bone Grafting

Background Isolated capitate nonunion is rare. No consensus on the appropriate treatment for this condition exists. Case Description We reported two cases of capitate fracture nonunion presenting several months after untreated high-impact wrist trauma. Treatment was delayed as both patients' nonunions were missed on conventional radiographs. Both were ultimately diagnosed with advanced imaging and successfully treated with internal fixation and autogenous bone grafting. The relevant literature pertaining to capitate nonunion was reviewed. Literature Review Immobilization and internal fixation with bone grafting for capitate nonunion have been described in the literature. Loss of vascular supply and progression to avascular necrosis is a concern after capitate nonunion. Clinical Relevance We present two cases and review the literature on the diagnosis and treatment of this rare injury to guide management. Internal fixation with autogenous bone grafting could play a role in management for this rare condition.

scholarly journals Application of 3D Printed Biocompatible Plastic Surgical Template for the Reconstruction of a Nasoalveolar Cleft with Preoperative Volume Analysis

2019 ◽  
Vol 56 (2) ◽  
pp. 413-415
Author(s):  
Zoltan Fabian ◽  
Kristof Kadar ◽  
Lajos Patonay ◽  
Krisztian Nagy
Keyword(s):  
Open Source Software ◽  
Gold Standard ◽  
Surgical Planning ◽  
Autologous Bone Graft ◽  
Optimal Shape ◽  
Autogenous Bone ◽  
Additive Technology ◽  
Alveolar Cleft ◽  
Autogenous Bone Grafting ◽  
3D Printed

Secondary autogenous bone grafting is the gold standard for the closure of an alveolar cleft. A preoperative surgical planning helps to determine the optimal shape and volume of the graft, that ideally guide canine eruption to the cleft area and ensure adequate nasal support. The authors describe their experience with design and use of an individually shaped 3D template for an autologous bone graft with fibrin glue for correct volume design. The conforming template is designed using freeware and open source software, it is manufactured by means of additive technology using autoclavable resin.

scholarly journals Reconstruction of Calcaneal Fracture Malunion With Osteotomy and Subtalar Joint Salvage

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0053
Author(s):  
Ming-Zhu Zhang ◽  
Guang-rong Yu
Keyword(s):  
Confidence Interval ◽  
Bone Graft ◽  
Subtalar Joint ◽  
Preoperative Assessment ◽  
Calcaneal Fracture ◽  
Autogenous Bone Graft ◽  
Average Score ◽  
Autogenous Bone ◽  
Superficial Infection ◽  
Subtalar Arthritis

Category: Hindfoot Introduction/Purpose: The goal of this study was to discuss the outcomes of treating calcaneal fracture malunion by restoring the subtalar joint with a reconstructive osteotomy. Methods: From May 2005 to November 2016, 85 patients (88 feet) with calcaneal malunions after a displaced intraarticular calcaneal fracture were treated by osteotomy and autogenous bone graft. The subtalar joint was preserved. The mean time from initial injury to reconstructive operation was 8.9 months (95% confidence interval, 4.5-11.6 months). The displaced posterior facet was restored through a reconstructive osteotomy, whereas the bone defect in the calcaneus after reduction was filled with the lateral exostosis that had been removed, iliac bone graft was used if necessary. All patients were evaluated clinically and radiographically at a minimum of 24 months. Sixty two patients (63 feet) were followed for a mean of 45.4 months (29.0-52.3 months). Results: According to American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot score, the average score was 81.6 points (95% confidence interval, 78.5-90.4 points), which was significantly higher than the preoperative assessment. Radiographs showed that Böhler’s angle, Gissane’s angle, talus declination angle, and width and height of calcaneus were improved to a great extent. Eight patients had wound edge necrosis, and 4 had superficial infection. Two patient required a subtalar fusion for subtalar arthritis at 2 years after surgery. Conclusion: Restoring the subtalar joint with a reconstructive osteotomy and autogenous bone graft was an effective treatment method for selected calcaneal fracture malunions. It reconstructed calcaneal morphology and preserved the subtalar joint.

Septopal Beads and Autogenous Bone Grafting for Bone Defects in Patients With Chronic Osteomyelitis

1993 ◽  
Vol &NA; (295) ◽  
pp. 112???118 ◽  
Author(s):  
MICHAEL J. PATZAKIS ◽  
KAI MAZUR ◽  
JEANETTE WILKINS ◽  
RANDOLPH SHERMAN ◽  
PAUL HOLTOM
Keyword(s):  
Bone Grafting ◽  
Chronic Osteomyelitis ◽  
Bone Defects ◽  
Autogenous Bone ◽  
Autogenous Bone Grafting
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