scholarly journals A Challenging Case of Extraordinary – Long standing Forearm Non-union Treated with Extensive Debridement, Locking Plates, and Bone Grafting. Technical Considerations in Multiple-operated, Neglected Non-unions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
George A Komnos ◽  
Fotis Papageorgiou ◽  
Konstantinos N Malizos
Keyword(s):  
Blood Supply ◽  
Proper Function ◽  
Locking Plates ◽  
Significant Treatment ◽  
Non Union ◽  
Orthopedic Surgeons ◽  
Extensive Debridement ◽  
Thorough Debridement ◽  
Fully Functioning ◽  
Technical Considerations

Introduction: Forearm non-unions pose a significant treatment challenge to orthopedic surgeons. Repetitive treatment failures can lead to a devastating situation for the patient. Forearm function influences both elbow and wrist proper function. Case Report: A functionless hand is presented, describing a longstanding non-union, treated with multiple surgeries before. A thorough debridement with respect to blood supply and local biology are of major importance before applying the locking plates along with the use of bone-graft. The reconstruction of the forearm converted a functionless arm to a fully functioning arm and the patient returned eventually to her previous activities. Conclusion: Fixation with locking plates combined with the use of autograft can lead to very satisfactory results even in extraordinary cases, especially when attention is paid to local anatomy and blood supply. Keywords: Forearm nonunion, locking plates, multiple surgeries.

scholarly journals Result of closed interlocking intramedullary nail in tibial shaft fracture

2012 ◽  
Vol 44 (1-2) ◽  
pp. 15-17
Author(s):  
AHSM Kamruzzaman ◽  
S Islam
Keyword(s):  
Intramedullary Nail ◽  
Joint Stiffness ◽  
Shaft Fracture ◽  
Autogenous Bone ◽  
Tibial Shaft Fracture ◽  
Early Mobility ◽  
Non Union ◽  
Orthopedic Surgeons ◽  
Interlocking Intramedullary Nail ◽  
Diaphyseal Fractures

The management of tibial diaphyseal fractures has always held a particular interest for orthopedic surgeons. Not only they are relatively common but also they are often difficult to treat. This prospective study was carried out at Rangpur from April 2008 to November 2009. 34 patients were treated by closed interlocking intramedullary nail. Goal of this study was to find out a safe & effective management of fracture, early mobility of patient, functional joint motion and short stay in hospital. Routine follow up was carried out in 29 patients. In 24 cases, fracture (81.76%) were united, 4 cases (13.79%) needed dynamisation with autogenous bone grafting and 1 case devoloped non union. Study showed interlocking nailing in tibia provides early mobility of patients, reduces hospital stay and fracture unites without joint stiffness and less complication.DOI: http://dx.doi.org/10.3329/bmjk.v44i1-2.10470Bang Med J (Khulna) 2011: 44(1&2) 15-17

Mechanical Failure of Angle Locking Plates in Distal Comminuted Tibial Fractures

2016 ◽  
Vol 695 ◽  
pp. 118-122 ◽  
Author(s):  
Razvan Ene ◽  
Zsombor Panti ◽  
Mihai Nica ◽  
Marian Pleniceanu ◽  
Patricia Ene ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Tibial Fracture ◽  
Weight Bearing ◽  
Healing Process ◽  
Biomechanical Properties ◽  
Implant Failure ◽  
Locking Plates ◽  
Non Union ◽  
Tibial Pilon

Distal comminuted tibial fracture with or without intra-articular involvement is a very common injury of the lower limb, especially in younger patients due to high energy trauma. The anatomical and biomechanical properties of this segment of tibia, makes this pathology a major surgical challenge with a preserved clinical outcome. The aim of this study is to present different outcome of tibial fracture, treated with open reduction and internal fixation (ORIF) with titanium angle locking plates (ALP) and to underline the physiological and non-physiological bone healing effects on implants. In this study we included 48 patients with tibial pilon fracture who underwent to ORIF, applying ALP in the Orthopedics and Trauma department of the University Emergency Hospital in Bucharest. Due to preserved biomechanical properties of ALP and this anatomical region, weight bearing is not allowed till 6 to 8 weeks. Comminuted fracture of this part of tibia often have de-vascularized bony fragments which leads to delayed union or non-union. These complications often lead to implant failure, improper bone healing or non-union. Internal fixation with angle stable screws, offers a good stability of reduction in the early postoperative period. Titanium angle locking plates offers good anatomical reduction and stable fixation in the early period of healing process. Due to its rigid, fixed position of the screws in the plates, bone remodelling during healing process and early weight bearing, increases the mechanical failure of implant.Keywords: tibial pilon fractures, angle locking plates, implant failure.

Bone transport osteogenesis for treatment of canine osteomyelitis

2010 ◽  
Vol 23 (02) ◽  
pp. 134-140 ◽  
Author(s):  
S. W. Petersen ◽  
L. M. Déjardin ◽  
D. Ting
Keyword(s):  
Bone Defects ◽  
Bone Transport ◽  
Infected Nonunion ◽  
Non Union ◽  
Post Surgery ◽  
Bone Segment ◽  
Extensive Debridement ◽  
Segmental Bone ◽  
Osseous Defects

SummaryBone transport osteogenesis, as described by Ilizarov, has been used to resolve segmental bone defects in both human and veterinary patients. These defects are created when a large osseous tumour, sequestrum, or non-union fracture is resected. This report documents two cases in which the principle of bone transport osteogenesis was applied by utilising the Ilizarov technique to bridge large osseous defects resulting from debridement of an infected nonunion fracture (case 1) and debridement of a sequestrum (case 2). Defects were treated by transporting either a complete or a hemi-circumferential bone segment. Both cases had resolution of osteomyelitis, satisfactory fracture union, and functional usage of the limb 39 weeks and 15 weeks post-surgery, respectively. Although manageable complications were encountered during the treatment of these cases, the long-term clinical outcome was eventually favorable. The authors believe that bone transport osteogenesis offers a valid restorative option in the treatment of bone defects resulting from extensive debridement and sequestrectomy.

A Combined Intracapsular and Extracapsular Fracture of the Hip

2002 ◽  
Vol 12 (1) ◽  
pp. 43-46
Author(s):  
S. Shabat ◽  
G. Mann ◽  
V. Barchilon ◽  
B. Kish ◽  
B. Fredman ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Blood Supply ◽  
Weight Bearing ◽  
Surgical Techniques ◽  
Optimal Solution ◽  
Anatomical Site ◽  
Rare Type ◽  
Non Union ◽  
Extracapsular Fracture

We report a case of an unusual hip fracture that involved the intracapsular area and continued vertically to the extracapsular region below the trochanteric line. The division between these two types of fractures is based on the anatomical site, the blood supply and the mechanical forces that act on the hip. This division is important and influences the different surgical techniques to treat these individual fractures. Femoral neck fractures (intracapsular), particularly those with displacement, can disrupt the blood supply to the femoral head and may be associated with an increased incidence of complications, especially non-union and avascular necrosis (AVN) of the femoral head. These fractures are usually treated either by reduction and fixation, or by hemiarthroplasty. Non-union and avascular necrosis following extracapsular fractures are rare. Treatment involves reduction of the fracture and insertion of a dynamic hip screw. The combination of these two types of fractures is extremely rare and creates a surgical problem without any optimal solution. The focus of this case report is placed on the mechanical axis and weight-bearing forces that play a role in the hip and on the optional surgical techniques in such a rare type of fracture in an elderly osteoporotic patient.

scholarly journals Policy Problems with Multi-Product Logging in Ontario

1970 ◽  
Vol 46 (5) ◽  
pp. 378-380
Author(s):  
A. J. Herridge
Keyword(s):  
Land Tenure ◽  
Pulp And Paper ◽  
Provincial Government ◽  
Non Union ◽  
Forest Industries ◽  
Policy Problems ◽  
Technical Considerations

The development of multi-product logging in Ontario has long been recognized as desirable for the forest economy as a whole. However, the growth of multi-product logging practice has been hindered by technical considerations in logging and transportation, by the resistance of organized labour to handling materials produced by non-union workers, and — most important — by constraints arising from the system of land tenure and timber licences. Flexibility and cooperation are needed among pulp and paper companies, other forest industries, and the provincial government.

Femoral and tibial blood supply: A trigger for non-union?

Injury ◽  
2014 ◽  
Vol 45 (11) ◽  
pp. 1665-1673 ◽  
Author(s):  
Emmanuele Santolini ◽  
Stavros D. Goumenos ◽  
Marilena Giannoudi ◽  
Francesca Sanguineti ◽  
Marco Stella ◽  
...  
Keyword(s):  
Blood Supply ◽  
Non Union

scholarly journals Sternal non-union in a professional hockey player: considerations for return to play

2009 ◽  
Vol 1 (1) ◽  
pp. 6 ◽  
Author(s):  
Samuel Mark Sanders ◽  
John Richardson, Jr ◽  
William Hartrich ◽  
Leslie J Bisson
Keyword(s):  
Case Report ◽  
Return To Play ◽  
Professional Athlete ◽  
Contact Sports ◽  
Non Union ◽  
Orthopedic Surgeons ◽  
Hockey Player ◽  
Aortic Root Surgery ◽  
Professional Hockey ◽  
Work Up

We describe a healthy 40-year old professional hockey player with an asymptomatic sternal non-union following aortic root surgery. The purpose of this case report is to make orthopedic surgeons aware of the possibility of this complication following sternotomy, and to discuss the considerations involved in return to play in contact sports. We will discuss our work-up, evaluation, and management of a sternal non-union in a professional athlete. Patient’s consent has been obtained.

scholarly journals Chemoembolization of Hepatocellular Carcinoma with Extrahepatic Collateral Blood Supply: Anatomic and Technical Considerations

Radiographics ◽  
2017 ◽  
Vol 37 (3) ◽  
pp. 963-977 ◽  
Author(s):  
Amr Soliman Moustafa ◽  
Ahmed Kamel Abdel Aal ◽  
Nathan Ertel ◽  
Nael Saad ◽  
Derek DuBay ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Blood Supply ◽  
Technical Considerations

Repair of post-laryngectomy pharyngeal fistulae

1989 ◽  
Vol 103 (3) ◽  
pp. 302-305 ◽  
Author(s):  
J. S. Rubin
Keyword(s):  
Blood Supply ◽  
Primary Closure ◽  
Myocutaneous Flaps ◽  
Pharyngeal Reconstruction ◽  
Pharyngocutaneous Fistulae ◽  
Technical Considerations

AbstractPost-laryngectomy pharyngeal fistulization is an unpleasant occurrence. Presented herein is the author's approach to this problem, along with two cases in which closure was effected by sternocleidomastoid (SCM) myoplasty.SCM myocutaneous flaps have previously been considered for pharyngocutaneous fistulae and then disregarded due to the doubtful nature of the blood supply to the skin. The SCM myoplasty obviates this problem as it relies on muscle rather than skin. SCM myoplasty has been used as a bolster in pharyngeal reconstruction after the pharynx has been closed by pharyngeal mucosal advancement or rotation. The author has extended this idea utilizing the raw muscle of the SCM to directly reconstruct the defect in fistulae deemed too large for primary closure.Anatomical, oncological and technical considerations are discussed, as well as the author's protocol for post-laryngectomy pharyngocutaneous fistulae.

scholarly journals Pseudoartrosis séptica de tibia por pseudomona aeruginosa. Tratamiento mediante transporte óseo.

2020 ◽  
pp. 131-135
Author(s):  
E FERRANDO MESEGUER ◽  
FRANCISCO SEGURA LLOPIS ◽  
F L ALMEIDA HERRERO ◽  
ALBERTO TEJEDA GÓMEZ ◽  
DAMIAN MIFSUT MIEDES
Keyword(s):  
Antibiotic Therapy ◽  
Bone Grafting ◽  
Multidisciplinary Approach ◽  
Soft Tissues ◽  
Distal Tibia ◽  
Bone Transport ◽  
Docking Site ◽  
Non Union ◽  
Orthopedic Surgeons ◽  
Common Location

Septic non union has still been a challenge for orthopedic surgeons. Its resolution is complex and has hight morbility. It needs a multidisciplinary approach. Distal tibia is a common location due its poor vascularity and soft tissues. We present a patient with pseudoarthrosis of the tibia treated with resection and bone transport. Contact was achieved at the docking site at 5 months. Bone grafting and freshening of fracture ends was performed. At 12 months the frame was removed after complete consolidation. As the only complication, the patient suffered two episodes of cellulitis that were resolved with antibiotic therapy.

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