Clinical Value of Computer-Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Theoretical Basis ◽  
New Technology ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Clinical Value

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

Ankle spanning external fixator with limited internal fixation for distal tibial extra-articular fractures

2017 ◽  
Vol 5 (10) ◽  
pp. 4355
Author(s):  
Siddharth Goel ◽  
Abhay Elhence
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tibial Fractures ◽  
Fixation Method ◽  
Ankle Pain ◽  
Distal Tibial Fractures ◽  
Tract Infections

Background: Fractures of the distal tibia are among the most difficult fractures to treat. The short distal segment presents difficulty in choosing the appropriate fixation method. The greatest challenge lies in the relatively tight soft tissue around the ankle. As a result, it has been a recent interest in treating these fractures with external fixation and limited internal fixation. The external stable fixation methods used are tubular or ring fixators, with or without immobilising the ankle. This minimally invasive nature of the surgery can avoid catastrophic wound complications like dehiscence, implant exposure and infection.Methods: 18 patients with extra-articular distal tibial fractures (AO Type 43A) were treated with the technique of ankle spanning external fixation. Lag screws or K-wires were supplemented for limited internal fixation when required. Fibula was stabilised in all cases. Intra- articular and Compound fractures were excluded. In addition to union at fracture site, ankle pain and motion was noted in each follow-up.Results: The mean follow-up was 25 months. Of the 18 patients included all but one fractures united with an average healing time of 16 to 18 weeks. Ankle pain and motion was graded according to Mazur modified by Teeny and Wiss clinical scoring system. 15 of them had excellent or good results, 2 had fair results. One patient had poor result. Five pin tract infections occurred. 17 patients had no evidence of osteoarthritis after completing follow up of at least 2 years.Conclusions: Distal tibial fractures are complex injuries, not only regarding the bony component, but also in terms of the management of the soft tissue problem. Ankle Spanning External Fixator with Limited Internal fixation is a relatively simple and cost-effective method for treating these fractures, achieving union and also maintaining ankle function.

scholarly journals Surgical treatment for patients with hemophilic pseudotumor-related femoral fracture: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Keyu Chen ◽  
Guiyong Jiang ◽  
Yaowen Xu ◽  
Yunping Yang ◽  
Zexiong Mao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
Femoral Fracture ◽  
Mechanical Stability ◽  
Demographic Data ◽  
Femoral Fractures ◽  
Fracture Stabilization ◽  
The Mean

Abstract Background Hemophilic pseudotumor (HPT)-related fracture is a rare but severe complication in patients with HPTs. These fractures often occur in femurs. There is no consensus on the standard surgical protocol for HPT-related femoral fracture. The present retrospective study evaluated the outcomes of these patients treated with surgical interventions. Methods Ten patients with HPT-related femoral fractures who were treated with 14 surgical procedures due to 11 fractures in our hospital from January 2014 to April 2020 were evaluated retrospectively. Demographic data, fracture location, complications after surgery, and follow-up outcomes were recorded and analyzed. The mean follow-up period was 39.7 months. Results The mean age at surgery was 31 years. Closed reduction external fixation (CREF) was originally performed in 2 patients, open reduction internal fixation (ORIF) was performed in 4 patients, screw fixation alone was performed in 1 patient, brace immobilization was performed in 1 patient, and amputation was performed in 3 patients. Bone union was observed in 5 patients, and an adequate callus was visible in 2 patients. Both patients with CREF had pin infections. Nonunion combined with external fixation (EF) failure occurred in 1 patient, and the plate was broken after ORIF. Three patients underwent autogenous or allogeneic cortical strut grafting. Three patients had HPT recurrence. Conclusions It is necessary to perform surgery in patients with HPT-related femoral fractures. Surgical treatments must consider fracture stabilization and HPT resection. Internal fixation is preferable, and EF should only be used for temporary fixation. If the HPT erodes more than one third of the bone diameter, strut grafts are necessary for mechanical stability. Amputation is an appropriate curative method in certain situations.

scholarly journals Biomechanically validated transosseus fixation in patients with femur pseudarthrosis complicated by chronic osteomyelitis

2018 ◽  
Vol 25 (3-4) ◽  
pp. 71-78
Author(s):  
A. V Tsiskarashvili ◽  
A. V Zhadin ◽  
K. A Kuzmenkov ◽  
K. M Bukhtin ◽  
R. E Melikova
Keyword(s):  
Retrospective Study ◽  
External Fixation ◽  
Clinical Outcomes ◽  
External Fixator ◽  
Chronic Osteomyelitis ◽  
Weight Bearing ◽  
Femur Bone ◽  
Bone Consolidation ◽  
Hybrid External Fixator

The aim of the study is to evaluate results of follow-up in patients with femur pseudarthrosis complicated by chronic osteomyelitis who underwent biomechanically validated transosseus fixation. Materials and methods. A retrospective study of transosseus fixation in 72 patients with femur pseudarthrosis complicated by chronic osteomyelitis was conducted. Described fixation was completed according to the biomechanical fixation conception from 2011 to 2017. Hybrid external fixator was applied to 38 (52,8%) patients, rod-based external fixator - to 34 (47,2%). Results. Full bone consolidation and pyoinflammatory process remission in treated femur bone is achieved in all cases. Results classified as excellent were acquired in 21 patients (29,5%), good - in 41 (57,7%), satisfactory - in 7 (9,8%), unsatisfactory - in 2 (3%). patients results were classified as unsatisfactory because of lacking of weight-bearing ability of the leg because of other reasons not related to consolidation. Conclusion. In patients with infected femur pseudarthroses external fixation using biomechanical conception allows to provide up to 97% positive clinical outcomes of the treatment.

scholarly journals Surgical Treatment for Patients With Hemophilic Pseudotumor-Related Femoral Fracture: A Retrospective Study

2020 ◽  
Author(s):  
Keyu Chen ◽  
Guiyong Jiang ◽  
Yaowen Xu ◽  
Yunping Yang ◽  
Zexiong Mao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
Femoral Fracture ◽  
Mechanical Stability ◽  
Demographic Data ◽  
Femoral Fractures ◽  
Surgical Interventions ◽  
Fracture Stabilization

Abstract Purpose: Hemophilic pseudotumor (HPT)-related fracture is a rare but severe complication in patients with HPTs. These fractures often occur in femurs. There is no consensus on the standard surgical protocol for HPT-related femoral fracture. The aim of this retrospective study is to evaluate the outcome of these patients treated with surgical interventions.Methods: Ten patients with HPT-related femoral fractures who were treated with 12 surgical procedures in our hospital from Jan 2014 to April 2020 were retrospectively evaluated. Demographic data, fracture location, complications after operation and follow-up outcomes were recorded and analyzed with a mean follow-up period of 39.7 months.Results: Bone union was observed in five patients, an adequate callus was visible in two patients, and three patients underwent amputation. Both of 2 patients with closed reduction external fixation (CREF) had pin infection. Nonunion combined with external fixation (EF) failure occurred in one of whom, and the plate was broken after open reduction internal fixation. Three patients underwent autogenous or allogeneic cortical strut grafting. Three patients had HPT recurrence.Conclusion: It is necessary to perform surgery in patients with HPT-related femoral fractures. Surgical treatments must take both fracture stabilization and HPT resection into account. Internal fixation is preferable and EF should be dismissed unless for the purpose of temporary fixation. If the HPT erodes more than one-third of the bone diameter, struct grafts are necessary for mechanical stability. Amputation is a proper curative method in certain situations.

scholarly journals A case report of early unilateral external fixation by 3D printing and computer-assisted and secondary bone graft internal fixation in pseudarthrosis of the tibia surgery

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052094551
Author(s):  
Hua Zhong ◽  
Sushuang Ma ◽  
Yibiao Cen ◽  
Limin Ma ◽  
Deqiang Li ◽  
...  
Keyword(s):  
Case Report ◽  
3D Printing ◽  
Internal Fixation ◽  
Bone Graft ◽  
External Fixation ◽  
Elective Surgery ◽  
Abnormal Development ◽  
Computer Assisted ◽  
Limb Deformity

Congenital pseudarthrosis of the tibia (CPT) is a rare congenital malformation. It is characterized by a tibial anterior bowing deformity or specific types of non-union, which typically result from abnormal development of the tibia, leading to the formation of local pseudarthrosis. The treatment of CPT is very challenging. The advent of 3D printing and computer-assisted techniques in recent years has provided a new ancillary technique for treatment planning and implementation. This case report describes the successful surgical treatment of a 14-year-old male that presented with a shortened limb deformity. Ahead of elective surgery, 3D printing and computer-assisted techniques were used to provide a 1:1 model of his left tibia, fibula and ankle joint to precisely determine the surgical procedure. The first surgery did not result in complete calcification of the tibial extension area, so a second proximal tibia iliac bone graft and internal fixation surgery was undertaken. Following regular follow-up and rehabilitation, by the 18-month follow-up, the proximal tibial bone graft had healed and the patient had resumed walking with a normal gait. This case report describes in detail the successful use of unilateral external fixation using the Ilizarov technique, 3D printing and computer-assisted orthopaedic surgery in the planning of treatment for CPT.

scholarly journals Application of Intelligent Computer Information Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Tissue Injury ◽  
Plate Fixation ◽  
Soft Tissue Injury ◽  
Three Dimensional ◽  
High Energy ◽  
Tibial Fractures ◽  
Intelligent Computer

BACKGROUND Background: With the development of social economy, severe and complex tibial fractures caused by high-energy injuries such as traffic accidents have gradually increased. At present, the commonly used methods for the treatment of tibial fractures include plate fixation, intramedullary nail fixation, and external fixation. Most of these fractures are open wounds with severe soft tissue injury and wound contamination, and some even have bone defects, which makes the previous internal fixation treatment difficult. OBJECTIVE Objective: This study was aimed to explore Intelligent Computer Information Assisted Taylor Three-dimensional External Fixation for the treatment of tibiofibular fractures. METHODS Methods: 70 patients were collected and divided into Taylor three-dimensional external fixation (TSF) group (28 patients with severe tibial fractures treated with TSF) and the internal fixation group (42 patients with severe complicated tibiofibular fractures treated by internal fixation). After the treatment, the follow-up evaluation of Intelligent Computer Information Assisted Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. RESULTS Results: The results showed that Intelligent Computer Information Assisted Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. CONCLUSIONS Conclusions: Intelligent Computer Information Assisted Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures which is worthy of clinical promotion. CLINICALTRIAL

scholarly journals Can a linear external fixator stand as a surgical alternative to open reduction in treating a high-grade supracondylar humerus fracture?

2018 ◽  
Vol 47 (1) ◽  
pp. 133-141
Author(s):  
Barak Rinat ◽  
Eytan Dujovny ◽  
Noam Bor ◽  
Nimrod Rozen ◽  
Guy Rubin
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Closed Reduction ◽  
Open Reduction ◽  
High Grade ◽  
Supracondylar Humerus Fractures ◽  
Long Term Follow Up ◽  
Humerus Fractures ◽  
Carrying Angle

Objective High-grade pediatric supracondylar humerus fractures are commonly treated with closed reduction and internal fixation with percutaneous pinning. When this fails, open reduction followed by internal fixation is the widely accepted procedure of choice. Use of a lateral external fixator was recently described as an optional procedure, but evidence is scarce. Methods We investigated the outcomes of upper limbs treated by either open reduction with internal fixation or closed reduction and external fixation. Results Twenty-one patients completed the long-term follow-up; 11 underwent open reduction, and 10 underwent external fixation. Most patients in both groups reported excellent satisfaction. In both groups, the modified Disabilities of the Arm, Shoulder, and Hand score was extremely low and the average elbow range of motion was almost identical. Radiographic analysis consisting of Baumann’s angle and the carrying angle revealed no statistical difference between the two groups. Discussion Optional treatment using a linear external fixator for complex nonreducible supracondylar humerus fractures yielded acceptable clinical and radiographic results, as with open reduction. Our sample size was small, but the promising results may assist in the implementation of an alternative surgical procedure, especially in more complicated cases involving flexion-type fractures or severe soft tissue damage and swelling.

scholarly journals Outcomes of Hindfoot and Ankle Arthrodesis in Neuropathic Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0028
Author(s):  
David Macknet ◽  
Andrew Wohler ◽  
Carroll P. Jones ◽  
J. Kent Ellington ◽  
Bruce E. Cohen ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Limb Salvage ◽  
Median Number ◽  
Ankle Arthrodesis ◽  
High Rate ◽  
Hardware Failure ◽  
Radiographic Outcomes ◽  
Fixation Group

Category: Ankle Arthritis, Diabetes, Hindfoot Introduction/Purpose: Charcot neuropathy of the ankle and hindfoot is a progressive and destructive process that can lead to instability and ulceration resulting in significant morbidity which can end with amputation. The foot and ankle surgeon’s aim is to reconstruct the high risk foot with the creation of a stable plantigrade foot, while reducing the risk of ulceration and allowing the patient to mobilize in commercially available footwear. There are numerous techniques for the reconstruction of the neuropathic hindfoot, but the most utilized of these include multiplanar external fixation or internal fixation with a plate or intramedullary nail. It is our goal to further elucidate outcomes of Charcot patients undergoing corrective ankle and hindfoot fusion comparing internal versus external fixation. Methods: We retrospectively collected 377 patients undergoing hindfoot and ankle arthrodesis at our institution from 2006- 2017. 77 patients were identified that underwent arthrodesis for Charcot arthropathy, 56 of which met our inclusion and exclusion criteria. This included 47 who had internal fixation as their primary procedure and 9 patients who underwent external fixation with a multi-planar external fixator. Our median follow up time was 3.4 years (IQR .5 to 12.9). Preoperatively we collected basic demographic variables, reasons for neuropathy, and ulcer status. Postoperatively we collected complications including infection, hardware failure, ulceration, recurrent deformity, and radiographic outcomes including union and hardware backout. Reoperation numbers and indications were also collected. Our primary outcome was limb salvage at final follow up. Secondarily, we collected final ambulatory and footwear status. Results: The limb salvage rate was 82% with 10 patients undergoing amputation, which did not vary between groups (p=.99). The primary reasons for amputation were persistent infection (4 of 10) and nonunion (4 of 10). Thirteen (24%) patients developed an infection. The median number of reoperations per patient was 1 (IQR 0-2) with the patients who underwent amputation undergoing a median of 2 (IQR 2-4) reoperations. The rate of union was 54%, occurring at a median of 26.5 (IQR 12-47) months. 44% (4/9) of patients in the external fixation group had a preoperative ulceration versus 19% (9/47) of the patients in the internal fixation group (p=.19). Preoperative ulceration was not a risk factor for amputation. Forty-two (75%) patients were ambulatory at final follow up. Conclusion: We report on the single largest series of Charcot patients undergoing hindfoot and ankle arthrodesis. The surgical management of this population has a high rate of complications with infection and reoperation being common. Despite a high nonunion rate most patients are able to ambulate in a brace or orthotic. Limb salvage can be expected with either internal or external fixation techniques.

scholarly journals Comparison of Monolateral External Fixation and Internal Fixation for Skeletal Stabilisation in the Management of Small Tibial Bone Defects following Successful Treatment of Chronic Osteomyelitis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yicun Wang ◽  
Hui Jiang ◽  
Zhantao Deng ◽  
Jiewen Jin ◽  
Jia Meng ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Bone Defect ◽  
Fasting Blood Glucose ◽  
Bone Defects ◽  
Significant Difference ◽  
Systemic Antibiotics ◽  
Time Since Injury ◽  
Small Bone

Background. To compare the salvage rate and complication between internal fixation and external fixation in patients with small bone defects caused by chronic infectious osteomyelitis debridement. Methods. 125 patients with chronic infectious osteomyelitis of tibia fracture who underwent multiple irrigation, debridement procedure, and local/systemic antibiotics were enrolled. Bone defects, which were less than 4 cm, were treated with bone grafting using either internal fixation or monolateral external fixation. 12-month follow-up was conducted with an interval of 3 months to evaluate union of bone defect. Results. Patients who underwent monolateral external fixation had higher body mass index and fasting blood glucose, longer time since injury, and larger bone defect compared with internal fixation. No significant difference was observed in incidence of complications (23.5% versus 19.3%), surgery time (156±23 minutes versus 162±21 minutes), and time to union (11.1±3.0 months versus 10.9±3.1 months) between external fixation and internal fixation. Internal fixation had no significant influence on the occurrence of postoperation complications after multivariate adjustment when compared with external fixation. Furthermore, patients who underwent internal fixation experienced higher level of daily living scales and lower level of anxiety. Conclusions. It was relatively safe to use internal fixation for stabilization in osteomyelitis patients whose bone defects were less than 4 cm and infection was well controlled.

Three-Dimensional Digital Design for Osteotomy in the Treatment of Congenital Hemivertebra

2013 ◽  
Vol 804 ◽  
pp. 167-173
Author(s):  
Huan Wen Ding ◽  
Guang Wen Yu ◽  
Qiang Tu ◽  
Jian Jian Shen ◽  
Ying Jun Wang
Keyword(s):  
Computer Simulation ◽  
Internal Fixation ◽  
Pedicle Screw ◽  
Operative Time ◽  
Design Method ◽  
Three Dimensional ◽  
Digital Design ◽  
Computer Assisted ◽  
Computer Assisted Design ◽  
Computer Aided

To establish a new three-dimensional (3D) digital design method for osteotomy and assess its application value in the surgical treatment of hemivertebrae. Preoperative 3D digital designs for osteotomy of the hemivertebrae were performed, which included computer simulation of the osteotomy and the internal fixation process, and computer-assisted design (CAD) of the templates for osteotomy of the hemivertebrae, pedicle screw positioning, and internal fixation rods. Template-guided osteotomy of the hemivertebrae plus pedicle screw and rod internal fixation were accurately implemented. The preoperative use of this new computer-aided 3D digitized and paperless surgical design can improve the safety, accuracy, and operative time for osteotomy in the treatment of hemivertebrae.

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