Long Bone Lengthening in Children
Intramedullary lengthening nails have revolutionized the field of limb lengthening. Although pediatric patients can benefit from this new technology, the size of the bones and the presence of open physes create potential impediments that must be recognized by the surgeon. This review of pediatric intramedullary limb lengthening describes the key elements and nuances that will help guide the surgeon towards a successful outcome. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
Antegrade Humeral Lengthening With the Motorized Internal Lengthening Nail
Humerus lengthening with internal lengthening nails (ILNs) has been used with success to avoid complications associated with lengthening using external fixators (eg, soft tissue tethering). ILNs can be used in skeletally mature patients with humeral shortening who have an intramedullary canal wide enough to fit the nail, and who has no active infection. Associated deformity (angular or rotational) can be corrected acutely using the ILN as long as it would be tolerated by the neurovascular structures. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
Tibial Lengthening Technique
Lengthening of the tibia with a motorized internal nail is effective and has advantages over the traditional use of external fixation. Since nail entry is through the proximal end of the bone, it is indicated for skeletally mature patients. Principles of leg-lengthening must be followed but the techniques have been modified from those of external fixation. Fibula relationship to the tibia is protected with fibula length stabilization screws. If there is a deformity, then fixator assisted nailing and the use of blocking screws are used to acutely correct the alignment, and then gradual lengthening follows. Judicious use of ...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
Retrograde Femur Technique for Motorized Internal Limb Lengthening
Deformities of the femur that combine deviations of axis and torsion with length discrepancies are seen quite often. Nevertheless, the surgical treatment can be demanding, especially if fully implantable lengthening nails are used for simultaneous lengthening and deformity correction. The technique of retrograde insertion of a lengthening nail into the femur offers a wider range for correction and allows the treatment of even complex deformities with a single-step procedure. The key to successful application of the technique is meticulous preoperative analysis and planning. The surgical procedure should follow a standardiz...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
The Antegrade Femur Technique
In this chapter, we examine the antegrade technique of insertion of magnetically controlled intramedullary lengthening implants. We discuss the indications, preoperative planning, surgical technique, and postoperative management, as well as tips and tricks for success. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
Principles of Motorized Internal Lengthening of Long Bones
Motorized intramedullary lengthening nails (ILNs) have revolutionized limb lengthening surgery and led to an expansion of indications utilizing them for both upper and lower limb lengthening, fracture compression, and nonunion treatment. There are biological and mechanical differences between using ILNs and using external fixators for lengthening surgery that the treating surgeon must be familiar with. Biological factors include regenerate quality, healing indices, and regenerate complications. Mechanical differences pertain to the lengthening axis, stability, and postoperative weight-bearing. Practical principles of ILNs ...
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
Motorized Internal Limb Lengthening: International Perspectives
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Preface Source Type: research
Preface
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - August 30, 2020 Category: Orthopaedics Tags: Preface Source Type: research
Hip Arthroscopy Technique for Acetabular Osteochondral Loose Bodies After Combined Lower Extremity Trauma
We describe a case of an acetabular fracture and ipsilateral open tibia/fibula fracture with osteochondral loose bodies in the hip joint inhibiting physical therapy potential, treated successfully with arthroscopic removal using an adjusted skeletal traction method. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Surgical Technique for Closed Reduction and Percutaneous Pinning of Pediatric Lateral Humeral Condyle Fractures
Lateral condyle fractures are intra-articular injuries of the distal humerus and are the second most common elbow fracture in pediatric patients. When these fractures involve significant displacement, anatomic reduction of the lateral condyle fragment is commonly achieved using open reduction techniques. Although a technique for closed reduction of lateral condyle fractures has been proposed in the literature, an instructional, step-by-step description of such a technique has yet to be published. We have built upon the previously published closed reduction technique by focusing on the pathomechanism of injury, with the goa...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Manual of Wiring Techniques for Orthopedic Surgery
Cerclage and tension band wiring techniques can be inexpensively and effectively utilized in orthopedic surgical procedures, many of which are enumerated in this article. The following cerclage wiring configurations are described and demonstrated in accompanying videos: wrapped around once and wrapped around twice patterns locked with a symmetric twist, knot twist, eyelet bend-back, or crimped double barrel sleeve; doubled symmetric twist; hairpin loop; and Mittelmeier’s double loop bend-back with twist. Tension band wiring variations are also described and illustrated. Modes of wire failure are discussed and displayed i...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Does Patella Resurfacing Affect Postoperative Blood Loss in Patients Undergoing Total Knee Replacement?
Patella resurfacing in total knee arthroplasty remains a surgeon-specific decision. Possible benefits of resurfacing include decreased knee pain and rate of reoperation, while complications can occur. No study has assessed postoperative blood loss and transfusion rate as a function of patella resurfacing. Certain patient groups such as elderly patients, Jehovah’s Witnesses, and coagulopathy patients may especially benefit from decreased blood loss during orthopedic surgeries. A retrospective chart review of patients with total knee arthroplasty performed by a single surgeon was conducted. In total, 124 patients were iden...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Special Technical Articles Source Type: research
Treatment of Periprosthetic Patella Fractures Using a Lag Screw and Neutralization Plate Construct: A Novel Surgical Technique
In this report, we present a novel fixation method for transverse peri-prosthetic patella fractures that was utilized in 3 knees with resurfaced patellas in 2 patients and has yielded good clinical results. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
The Cost of Postoperative Infection Following Orthopaedic Fracture Surgery
The objective of this paper is to describe the costs associated with postoperative infection following orthopedic fracture surgery. The data provided is based on a narrative review and an analysis of national claims and discharge databases in the United States. The narrative research specifically evaluated the costs associated with postoperative infections following the treatment of proximal femur, tibia, humerus, and ankle fractures. Two US databases were used to estimate the annual incidence of a deep surgical site infection following fracture treatment and the costs associated with that treatment. Previous studies sugge...
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
Current Treatments of Tibial Surgical Site Infection and Osteomyelitis After Fracture Surgery
Infections after tibia fracture are one of the most challenging areas of orthopedic care. Specialized techniques are required to achieve resolution of the infection and bony union. We detail here our strategies for infection debridement, temporary skeletal stabilization, antibiotic administration, and definitive reconstruction. Special emphasis is on the treatment of osteomyelitis of the tibial shaft; however, these same techniques can be applied to other areas of the skeleton as well. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - May 22, 2020 Category: Orthopaedics Tags: Symposium Source Type: research
