Treatment by modified huntington fibula transference operation in fracture and non union of tibia diaphysis with extensive bone defect

1993 ◽  
Vol 6 (1) ◽  
pp. 128
Author(s):  
Chan Soo Park ◽  
Kang Hyun Lee ◽  
Myung Ku Kim ◽  
Geon Woo Lee
Keyword(s):  
Bone Defect ◽  
Non Union ◽  
Tibia Diaphysis

Correction of Dorsi-Flexed Intercalated Segment Instability after Restoration of Scaphoid Height in a Cadaver Model of Scaphoid Non-Union

1995 ◽  
Vol 20 (5) ◽  
pp. 596-602 ◽  
Author(s):  
M. YASUDA ◽  
M. KUSUNOKI ◽  
K. KAZUKI ◽  
Y. YAMANO
Keyword(s):  
Mechanical Loading ◽  
Bone Defect ◽  
Carpal Instability ◽  
Rigid Fixation ◽  
Anatomical Reduction ◽  
Non Union ◽  
Herbert Screw ◽  
Palmar Approach ◽  
Wrist Joints

Models of scaphoid non-union with static dorsi-flexed intercalated segment instability were produced in five frozen arms from cadavers or subjects following accidents by repetitive mechanical loading of the wrist joints longitudinally after a bone defect has been made at the mid-portion of the scaphoid. We designed four models of reduction: anatomical reduction; reduction with a shortened scaphoid; anatomical reduction but with the radio-lunate ligament sectioned, and a shortened scaphoid with the radio-lunate ligament sectioned. Results suggested that anatomical reduction with rigid fixation with a Herbert screw was most effective for correction of malalignment with DISI. Preservation of the radio-lunate ligament during the palmar approach to the scaphoid seemed to be important to prevent ligamentous carpal instability.

CASE REPORT: THREE CASES OF NON-UNION FRACTURE IN DOGS TREATED WITH ADIPOSE-DERIVED ADULT STEM CELLS COMBINED WITH AUTOLOGOUS CANCELLOUS BONE AND SYNTHETIC BONE SUBSTITUTES

2017 ◽  
Vol 43 (01) ◽  
pp. 1-9
Author(s):  
Kun-Lung Tsai
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Cell Therapy ◽  
Bone Defect ◽  
Stem Cell Therapy ◽  
Bone Plates ◽  
Intact Male ◽  
Non Union ◽  
Post Surgery ◽  
Veterinary Hospital

The first case was a 4-year old, 10[Formula: see text]kgs intact male Shiba Inu presenting fracture of the distal third of its right ulna and radius. The patient was first managed at a Local Veterinary Hospital (LVH) twice with bone plates but non-union was observed, along with bone infection and bone defect on a large area. The fracture site was re-stabilized and given stem cell therapy at Famous Veterinary Hospital (FVH). The area of bone defect reduced significantly with prominent callus formation. The second case was a 9-year old, 3.3[Formula: see text]kgs intact female Toy Poodle with fracture of the distal right radius and ulna. The fracture was first stabilized with bone plates at LVH but non-union was observed. Resorption of bone was visible radiographically around the proximal screw, which led to fracture and implant loosening at that location. Pan-arthrodesis followed after stem cells administration was performed at FVH. Radiography showed sufficient growth of the radius and union of the ulna occurred at 145 days after therapy. The third case was a 3.5-year old, 10[Formula: see text]kgs intact male Mongrel attended at LVH for a humerus fracture. Fracture reduction with bone plates was attempted twice at LVH but both loosened eventually. At FVH, an external skeletal fixator was used to stabilize the fracture, followed by stem cell therapy. There was radiographic evidence that the humerus healed well by the 35th day after therapy and was completely united by Day 113 of post-surgery and therapy.

scholarly journals Computer navigated reduction of scaphoid non-unions and displaced scaphoid fractures- a cadaveric study

10.29007/h9w1 ◽  
2018 ◽  
Author(s):  
Michael Chu-Kay Mak ◽  
Elvis Chun-Sing Chui ◽  
Wing-Lim Tse ◽  
Pak-Cheong Ho
Keyword(s):  
Bone Defect ◽  
Bone Grafting ◽  
Scaphoid Fracture ◽  
Computer Navigation ◽  
Anatomical Reconstruction ◽  
Scaphoid Bone ◽  
Computer Assisted ◽  
Proximal Fragment ◽  
Non Union ◽  
K Wires

IntroductionScaphoid non-union results the typical humpback deformity, pronation of the distal fragment, and a bone defect in the non-union site with shortening. Bone grafting, whether open or arthroscopic, relies on fluoroscopic and direct visual assessment of reduction. However, because of the bone defect and irregular geometry, it is difficult to determine the precise width of the bone gap and restore the original bone length, and to correct interfragmentary rotation. Correction of alignment can be performed by computer-assisted planning and intraoperative guidance. The use of computer navigation in guiding reduction in scaphoid non-unions and displaced fractures have not been reported.ObjectiveWe propose a method of anatomical reconstruction in scaphoid non-union by computer-assisted preoperative planning combined with intraoperative computer navigation. This could be done in conjunction with a minimally invasive, arthroscopic bone grafting technique.MethodsA model consisting of a scaphoid bone with a simulated fracture, a forearm model, and an attached patient tracker was used. 2 titanium K-wires were inserted into the distal scaphoid fragment. 3D images were acquired and matched to those from a computed tomography (CT) scan. In an image processing software, the non-union was reduced and pin tracts were planned into the proximal fragment. The K-wires were driven into the proximal fragment under computer navigation. Reduction was assessed by direct measurement.These steps were repeated in a cadaveric upper limb. A scaphoid fracture was created and a patient tracker was inserted into the radial shaft. A post-fixation CT was obtained to assess reduction.Results and DiscussionIn both models, satisfactory alignment was obtained. There were minimal displacement and articular stepping, and scaphoid length was restored with less than 1mm discrepancy. This study demonstrated that an accurate reduction of the scaphoid in non-unions and displaced fractures can be accurately performed using computed navigation and computer-assisted planning. It is the first report on the use of computer navigation in correction of alignment in the wrist.

scholarly journals The deleterious relationship of Pseudomonas aeruginosa and Induced Membranes in infected non-union treatment

2021 ◽  
Vol 12 (1) ◽  
pp. 388-391
Author(s):  
Thiyagarajan U ◽  
Senthil Loganathan ◽  
Raghavendar ◽  
Pradeep P
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bone Graft ◽  
Bone Defect ◽  
Bone Defects ◽  
Reconstructive Procedures ◽  
Induced Membrane ◽  
Non Union ◽  
Masquelet Technique ◽  
Slime Layer ◽  
Pseudomonas Infection

The Masquelet technique was originally described for the treatment of an infected non-union with an extensive bone defect where a staged protocol was needed to first eliminate an infection then secondarily bone graft a defect. Though this is a versatile technique, certain limitations/ complications must be recognized. The study was done between 2012 to 2019 at SRIHER university. 19 patients in whom the Masquelet technique has failed is taken into study. 17 male and two females, with a mean age of 31 years (range of 13 yrs. – 51 yrs.) with a mean follow up of 12 months. The 19 patients who presented with Pseudomonas aeruginosa infected non-union of the tibia and femur with bone defects underwent the Masquelet technique. All patients failed to form adequate induced membrane at the non-union site. Infected non-union with a bone defect is difficult to treat. Bone defects of 2cms can be treated by cancellous bone grafting. Defects more than 4-5cms will require specialized reconstructive procedures to prevent amputation. The two common techniques used are Ilizarov technique with bone transport and bone graft into an induced membrane as described by Masquelet. This study shows a high failure rate of the Masquelet technique with Pseudomonas infection. The most difficult issue faced by the surgeon in treating P. aeruginosa is its ability to develop resistance to multiple classes of antibiotics during the course of treating the patient. Masquelet technique is used extensively for the treatment of infective non-union. Pseudomonas secretes a slime layer that may lead to a weak or deficient formation of the induced membrane. And the elution of antibiotics may not be adequate for intramedullary osteomyelitis with pseudomonas growth. This limits the Masquelet technique in the management of infected non-union with pseudomonas infection.

scholarly journals 921. In Vivo Non Viral Gene Delivery of BMP-9 Regenerates Non Union Bone Defect

2006 ◽  
Vol 13 ◽  
pp. S355-S356
Author(s):  
Nadav Kimelman ◽  
Gadi Pelled ◽  
Yoram Zilberman ◽  
Evellin Zeira ◽  
Hagit Yotvat ◽  
...  
Keyword(s):  
Gene Delivery ◽  
Bone Defect ◽  
Viral Gene ◽  
Non Union ◽  
Viral Gene Delivery

scholarly journals Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases

2013 ◽  
Vol 46 (03) ◽  
pp. 543-548 ◽  
Author(s):  
Gurdayal Singh Kalra ◽  
Pradeep Goel ◽  
Pradeep Kumar Singh
Keyword(s):  
Soft Tissue ◽  
Bone Defect ◽  
Bone Defects ◽  
High Energy ◽  
Long Bone ◽  
Non Union ◽  
Skeletal Defects ◽  
Free Fibula ◽  
Post Traumatic ◽  
Long Bone Defect

ABSTRACT Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma.

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