scholarly journals Quadriceps-splitting midline approach in the treatment of distal femur infected nonuinon with stiff knee and severely scarred soft tissues

2020 ◽  
Vol 6 (2) ◽  
pp. 276
Author(s):  
Jeremy Bliss ◽  
Dan Barnabas Inja ◽  
Manasseh Nithyananth ◽  
Vinoo Mathew Cherian
Keyword(s):  
Bone Grafting ◽  
Iliac Crest ◽  
Soft Tissues ◽  
Distal Femur ◽  
Bony Union ◽  
Infected Nonunion ◽  
Non Union ◽  
Knee Stiffness ◽  
Iliac Crest Bone Grafting ◽  
Stiff Knee

<p class="abstract"><strong>Background:</strong> Treatment of infected distal femur non-union with a stiff knee and severely scarred soft tissues is a challenging problem. We describe a method of addressing the non-union using quadriceps splitting approach to the distal femur.</p><p class="abstract"><strong>Methods:</strong> We retrospectively reviewed 5 patients with distal femur infected nonunion and knee stiffness, who, after infection control, required distal femur bone grafting. All patients had autogenous iliac crest bone grafting of the distal femur using the quadriceps splitting approach. The parameters assessed were the time to surgical wound healing, wound infection, time to bony union, and if any additional procedures were needed.<strong></strong></p><p class="abstract"><strong>Results:</strong> 5 patients were referred with distal femur infected non-union in addition to knee stiffness, with or without an implant <em>in situ</em>. All patients underwent debridement, implant exit, and external fixation of the femur spanning the knee as the primary surgery here, followed later on by iliac crest bone grafting of the distal femur using the above approach. All patients united well within 12 to 16 weeks, without the need for additional procedures.</p><p class="abstract"><strong>Conclusions:</strong> In the presence of pre-existing knee stiffness with severely scarred and contracted soft tissues the quadriceps-splitting approach is a useful method to address bony problems in the distal femur, without the need for a separate procedure for soft tissue or flap cover.</p>

Functional Outcome of Antibiotic Impregnated Nail in Infected Non-Union of Tibia and Femur - A Prospective Observational Study, Trichur, Kerala

2021 ◽  
Vol 8 (29) ◽  
pp. 2620-2624
Author(s):  
Arjun Dev Naroth Palakandy ◽  
Manoj Murungodiyil Kunjappan ◽  
Jose Francis
Keyword(s):  
Side Effects ◽  
Functional Outcome ◽  
Bone Grafting ◽  
Bony Union ◽  
High Concentration ◽  
Duration Of Treatment ◽  
Infected Nonunion ◽  
Non Union ◽  
Open Injury ◽  
Systemic Side Effects

BACKGROUND Infected non-union is a complex, debilitating and challenging disorder affecting orthopaedic surgeon and patient in terms of cost and time.1 Antibiotic impregnated nail has been a cheap and effective method used for treatment of infected nonunion. Factors that may lead to infected non-union are many.2,3 High local concentrations of antibiotics with minimal systemic levels and without systemic side effects make local antibiotic therapy a very useful technique in treating infected non-union. 4 Buchholz and Engelbrecht were the first to use antibiotic impregnated cement.5 Major advantage of using antibiotic impregnated cement is, it provides high concentration of antibiotics locally with less systemic side effects.6 The purpose of this study was to determine the functional outcome of antibiotic impregnated nail in treatment of infected non-union of femur and tibia. Antibiotic cement impregnated intra-medullary nail can provide stability, help in control of infection,7 is easy to remove, and also provides all the advantages of the cement beads.8,9 METHODS This prospective study was done on 25 cases at Government Medical College Thrissur from 01 September 2016 to 01 April 2018. Functional results were evaluated with regard to control of infection, bony union, deformity, limb leg discrepancy and complications (both intra and post-operative complications). RESULTS Most of the cases had type 2 open injury initially, accounting for 49 %. Staphylococcus aureus was reported in 56 % of cases. Infection control was achieved in 23 cases. Bony union was visualised in 18 cases, remaining 5 cases united following bone grafting. In 2 cases there was no control of infection and no bony union was achieved, later antibiotic nail removal and Ilizarov fixation was planned. Bone grafting was done in 10 cases. CONCLUSIONS Antibiotic impregnated cement nailing is a simple, economical and very effective procedure with less complication and shorter duration of treatment when compared with other conventional procedures. KEYWORDS Infected Non-Union, Long Bones, Antibiotic Impregnated Cement Nail

Surgical management of an isolated symptomatic talonavicular coalition: a paediatric perspective

2021 ◽  
Vol 14 (11) ◽  
pp. e243761
Author(s):  
Keval Patel ◽  
Abdullah Khawaja ◽  
Aman Patel ◽  
Michail Kokkinakis
Keyword(s):  
Paediatric Patient ◽  
Reconstructive Surgery ◽  
Bone Grafting ◽  
Iliac Crest ◽  
Early Stage ◽  
Operative Management ◽  
Lateral Column ◽  
Iliac Crest Bone Grafting ◽  
Lateral Column Lengthening

Talonavicular (TN) coalition is a rare pathological union of the talus and navicular bones. We report the case of a 7-year-old girl with a symptomatic TN coalition, who underwent operative management with a lateral column lengthening procedure using autologous iliac crest bone grafting. There are no complications to report and the graft was incorporated at an early stage. At 3 year follow-up the patient has remained pain-free since the operation and maintained alignment. To our knowledge, this is the first reported case of TN coalition treated with reconstructive surgery in a paediatric patient.

scholarly journals Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Dongxu Feng ◽  
Xiaolong Wang ◽  
Liang Sun ◽  
Xiao Cai ◽  
Kun Zhang ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Nerve Palsy ◽  
Iliac Crest ◽  
Humeral Shaft ◽  
Autogenous Bone ◽  
Salvage Procedure ◽  
Iliac Crest Bone Grafting ◽  
Ulnar Nerve Palsy ◽  
Humeral Shaft Nonunion ◽  
The Mean

Abstract Background Although most cases of humeral shaft nonunion respond well to surgical intervention, surgeons still encounter patients with humeral shaft nonunion who have already undergone repeated surgeries for nonunion. This study retrospectively analyzed the efficacy of double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting for recalcitrant humeral shaft nonunion. Methods A consecutive series of patients with aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in our institution. Standardized treatment included thorough debridement, double LCP and screw fixation, and autogenous iliac bone grafting. The injury type and the duration of nonunion were recorded for all patients. The main outcome measurements were the Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function, and visual analog scale (VAS) for pain. In addition, all complications were documented. Results The study cohort comprised six females and nine males with a mean age of 45.3 ± 13.1 years. Each patient had already undergone at least one failed surgery for humeral shaft nonunion. The average duration of nonunion before the index intervention was 126.8 ± 124.2 months. All patients achieved bone union without implant failure. At final follow-up, the mean Constant and Murley score and mean MEPI were significantly improved, and the mean VAS score was significantly decreased. Each patient was very satisfied with the treatment. Four patients had complications, including one with a superficial wound infection, one with radial nerve palsy, one with ulnar nerve palsy, and one with discomfort at the iliac crest. Conclusion Double plate fixation combined with autogenous iliac crest bone grafting results in successful salvage of humeral shaft nonunion after prior failed surgical interventions.

Efficacy of anterior cervical decompression and fusion procedures for monomelic amyotrophy treatment: a prospective randomized controlled trial

2013 ◽  
Vol 19 (4) ◽  
pp. 412-419 ◽  
Author(s):  
Feizhou Lu ◽  
Hongli Wang ◽  
Jianyuan Jiang ◽  
Wenjun Chen ◽  
Xin Ma ◽  
...  
Keyword(s):  
Bone Grafting ◽  
Iliac Crest ◽  
Plate Fixation ◽  
Cervical Collar ◽  
Therapeutic Effects ◽  
Iliac Crest Bone Grafting ◽  
Anterior Cervical Decompression ◽  
Significant Difference ◽  
Internal Plate Fixation

Object Monomelic amyotrophy (MMA) is a benign, self-limiting lower motor neuron disease. Optimal surgical strategies—discectomy decompression and fusion (DDF) or corpectomy decompression and fusion (CDF)—for patients with aggravated symptoms (within 6 months of presentation) are controversial, particularly in those who are ineligible for conventional treatment. These 2 methods of anterior cervical decompression and fusion for MMA in patients unwilling or unable to wear a conventional cervical collar long term were evaluated. Methods Anterior cervical decompression and fusion were performed in 48 male patients with MMA between September 2007 and September 2010. Patients were randomly treated with anterior cervical discectomy decompression with autologous iliac crest bone grafting and internal plate fixation (DDF group: 24 patients) or anterior cervical corpectomy, posterior longitudinal ligament resection, autologous iliac crest bone grafting, and internal plate fixation (CDF group: 24 patients). Subjective symptom assessments and electromyography (EMG) examinations were conducted both preoperatively and postoperatively. Results Subjective assessments and EMG studies (mean follow-up duration 25.9 months) indicated improvement in 64.6% and 60% of patients, respectively. No significant correlations between the effectiveness of surgery and age at symptom onset, preoperative symptom duration, or postoperative follow-up time were found. Conclusions The lack of a significant difference in effectiveness between DDF and CDF favors DDF as more clinically applicable because of its lower procedural risks. As a second-line alternative to cervical collar treatment, surgical anterior cervical decompression and fusion via DDF or CDF may prevent further deterioration and produce good short-term therapeutic effects in patients with MMA; however, cervical collar treatment is recommended for eligible patients because of its lower associated risks.

Pain following iliac crest bone grafting of alveolar clefts

1996 ◽  
Vol 24 (3) ◽  
pp. 151-154 ◽  
Author(s):  
K.H. Dawson ◽  
M.A. Egbert ◽  
R.W.T. Myall
Keyword(s):  
Bone Grafting ◽  
Iliac Crest ◽  
Iliac Crest Bone Grafting
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