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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 11 - 11
1 Jan 2013
Fadel M
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Conventional surgical treatment of relapsed or neglected club foot deformities is not always successful or easy to apply. The presence of shortened neurovascular structures and unhealthy skin may preclude the surgical interference. Bone resection in severe deformities results in short foot which is not satisfactory functionally and cosmetically.

Objectives

In this study we evaluate the use of the bloodless technique for management of relapsed or neglected club foot deformities.

Methods

From Jan 2000–2006, 64 cases older than 2 years with relapsed or neglected club foot deformities were referred to our center. Four cases were excluded because of inadequate follow up data. This thesis based on 60 consecutive cases (67 feet). The patients average age was 8 years and 4 months (range, 2–16 years). Seven cases were bilateral, 20 Left sides, and 34 Right sides. There were 57 relapsed club foot (5 bilateral), and 3 cases were neglected (2 bilateral). Patients with relapsed club foot had average 3 previous operations (range, 1–8 operations).

There was no preoperative assembling of the apparatus. The construct was designed according to the condition of deformity: equinus, varus forefoot etc. Additional procedures, elongation of tendoachilis was done concomitantly with the original procedure in 10 cases. The patients were discharged from the hospital the same day of the operation


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_3 | Pages 18 - 18
1 Jan 2013
Fadel M Hosny G
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Abstract

The specific methods of skeletal reconstruction of massive bone loss remains a topic of controversy. The problem increased in case of massive bone loss, extensive soft tissue scar, vascular compromise, and short tibial remnants.

Aim of the work

We evaluate the use of fibula in association of Ilizarov external fixator in management of massive post traumatic bone loss of tibial shaft.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_IV | Pages 547 - 547
1 Oct 2010
Fadel M Hosny G
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The specific methods of skeletal reconstruction of massive bone loss remains a topic of controversy. The problem increased in case of massive bone loss, extensive soft tissue scar, vascular compromise, and short tibial remnants.

Aim of the work: We evaluate the use of fibula in association of Ilizarov external fixator in management of massive post traumatic bone loss of tibial shaft.

Materials and Methods: Between December 1999 and 2004, we treated 8 adult patients with bone loss 10 cm and more. The indication was massive bone loss, extensive soft tissue scar, vascular compromise, and short tibial remnants. Whole fibula was used in 6 conditions and partial fibula in 2. The average age was 30.5 years (range: 25:51). The fibulas was prepared for transfer either as a whole or partially transfer. Ilizarov device was applied with a special construct for each condition accordingly. Free latismus dorsi was applied in 1 patient, and fasciocutanious flaps in 2. Four patients with whole fibula transfer continued to wear orthosis for outdoor activities.

Results: The mean follow-up period was 40 months (range: 24:96) after healing. All fractures heeled between 8 and 24 months.

Conclusion: We concluded that the Ilizarov external fixator is effective in management of management of massive post traumatic bone loss of tibial shaft. It provides advantages of compensation of bone defects, length, and early rehabilitation. It has the disadvantages of long healing time, long orthotic support. Its advantages are clear in case of massive bone loss, extensive soft tissue scar, vascular compromise, and short tibial remnants