The TL Hex (Orthofix) is a relatively new hexapod frame system that we have been using at our institution since August 2013 to treat acute fractures and correct tibial and femoral deformity. We report our initial experience of 48 completed treatments with this novel system in 46 patients and discuss illustrative cases. For acute fracture, 30 patients (24 male, 7 female) required framing with a mean age of 43 years (range 19–80). One patient underwent bilateral framing. The tibia was involved in all cases. In two cases, the femur also required framing. Open fractures occurred in 13 cases (43.3%). For elective
Objectives. Fracture non-union poses a significant challenge to treating orthopaedic surgeons. These patients often require multiple surgical procedures. The incidence of complications after Autologous Bone Graft (ABG) harvesting has been reported up to 44%. These complications include persistent severe donor site pain, infection, heterotopic ossification and antalgic gait. We retrospectively compared the use of BMP-7 alone in long bone fracture Non-union, with patients in whom BMP-7 was used in combination with the Autologous Bone Graft (ABG). Material and Methods. The databases of our dedicated
Consequent upon a retrospective audit of all acute tibial nail patients within GRI in 2010, it was agreed, due to variable follow-up, imaging and requirement for secondary intervention, a standardised protocol for management of acutely nailed tibial fractures within GRI was to be established. Subsequently, a Nurse Led Tibial Nail Clinic commenced in July 201. The majority of consultants (11 of 13) devolving follow up of these patients to a protocol based algorithm designed on evidence based principles and consensus expert opinion. Aims were to standardise/improve management of tibial nail patients in terms of patient education, weight bearing, imaging, follow-up intervals and also coordinate secondary intervention via a single consultant with an interest in
The implementation of knee arthrodesis has become synonymous with limb salvage in the presence of chronic sepsis and bone loss around the knee. This can be seen in failed trauma surgery or knee arthroplasty as an alternative to trans-femoral amputation. There is no prior literature assessing which factors affect knee arthrodesis using external fixation devices. Sixteen consecutive patients (four women and twelve men) made up of eleven infected knee implants, three internal fixations of the tibial following fractured tibial plateau as well as 2 infected native joints were identified. The mean age at initial surgery was 56 years (range 25 to 82 years). All procedures were performed under the direct supervision of the
We noted, in the immature ankle, a discrepancy between the alignment of the distal tibial physis, the distal tibial articular surface and the talar dome in the coronal plane. This led to variability in the orientation of wires and half pins used for