Introduction. A clinical case of catastrophic ring failure in a 13 year old autistic overweight patient during treatment for tibial lengthening and deformity using a
Introduction. In my paediatric Orthopaedic practice I use Kirchner wires for the fixation of the TSF on bone. I noted a significant percentage of wire loosening during the post-operative period. The aim of this project was to establish the effectiveness of the wire clamping mechanism and find ways to reduce the incidence of wire loosening when using the TSF. Materials and Methods. In the first instance wire slippage was measured intra-operatively after the tensioner was removed using an intra-operative professional camera. Following this study mechanical tests were performed in the lab measuring the pull out properties of Kirchner wires using different bolts and different torque levels in order to tighten the wire on the fixator. Results. Our clinical study confirmed wire slippage intra-operatively immediately after the tensioner was removed. Wire slippage after the tensioner was removed was found to vary from 0.01 mm to 0.51 mm (mean 0.19 mm). Our mechanical tests showed that the ideal torque for tightening the wire on the frame using a bolt was around 15 N.m. A comparison between cannulated and slotted bolts suggested that cannulated bolts are more effective as a clamping mechanism. A comparison between aluminium made
Purpose of study. The primary treatment of congenital talipes equinus varus with the Ponsetti method remains the gold standard of treatment. Relapsed, neglected and/or teratogenic clubfeet pose a significant treatment challenge as the long term outcome of posteromedial release surgery is poor. Advances in circular fixation offer predictable deformity correction without the need for extensive soft tissue release. The
Introduction. Lower limb mal-alignment as a result of fracture malunion can result in knee degenerative arthritis or predispose to early arthroplasty failure due to the altered mechanical axis. The choice of corrective osteotomy is often determined by potential complications. Opening wedge osteotomy is associated with poor bone healing especially in adult diaphyseal bone. Distraction osteogenesis enables gradual deformity correction with the gap filled by regenerate bone. Bone formation however is formed less favourably in the diaphysis and metaphyseal osteotomy is advised. We present a consecutive series of adult tibial diaphyseal correction using the
Introduction. Charcot Arthropathy related foot and ankle deformities are a serious challenge. Surgical treatment of these deformities is now well established. The traditional surgical method of extensive surgical exposure, excision of bone, acute correction and internal fixation is not always appropriate in presence of active ulceration, deep infection and poor bone quality. Minimally invasive osteotomies and gradual correction of deformities with a circular frame are proving helpful in minimizing complications. We present our experience with the use of
Purpose of the study. To assess use of
Introduction. Open fractures are fortunately rare but pose an even greater challenge due to poor soft tissues, in addition to poor bone quality. Co-morbidities and pre-existing medical conditions, in particular, peripheral vascular diseases make them often unsuitable for free flaps. We present our experience in treating severe open fractures of tibia with Acute Intentional Deformation (AID) to close the soft tissues followed by gradual correction of deformity to achieve anatomical alignment of the tibia and fracture healing with
We present our experience of lower limb reconstruction for patients with obvious defects in the tibia, by bone transport using a stacked
Introduction. We present our experience of lower limb reconstruction for patients with obvious defects in the tibia, by bone transport using a stacked
Introduction. The use of the
Purpose of the study. To use a simple way of manipulating
Introduction.
Purpose of the study. To use a simple way of manipulating
Introduction. Torsional malalignment syndrome (TMS) is a unique combination of rotational deformities in the lower limb, often leading to severe patellofemoral joint pain and disability. Surgical management of this condition usually consists of two osteotomies in each affected limb, with simultaneous correction of both femoral anteversion and external tibial torsion. However, we believe that a single supratubercular osteotomy followed by tibial derotation with the
Introduction. The optimal treatment of high-energy tibia fractures remains controversial. The role of external fixators has been shown to be crucial. This study aimed to compare the effectiveness of using either
We would like to present this service evaluation of
Abstract. We present here the results of a prospective follow-up study of radiological and functional outcome in 43 patients treated using the
Introduction. The
The Ilizarov (IF) and Taylor Spatial (TSF) external fixator frames are commonly used to manage complex fractures and bone deformities and a dedicated Frame Service Team at our unit supports patients during pre- and post-operative period. Few studies have assessed the satisfaction of patients who have been treated with Circular frames. A questionnaire was designed and distributed to 56 consecutive patients treated with a circular frame. Data was collected prospectively. Questions were focused on information given pre op, during treatment, overall satisfaction with the frame, morbidity and areas in which the frame service could be improved.Introduction
Methods
We conducted a study to assess the accuracy of Spatial CAD software in computing the mounting and deformity parameters. We mounted a two-ring construct on a sawbone tibia and accurately measured the mounting parameters of this frame. Then we obtained three sets of x-rays – orthogonal without magnification marker, orthogonal with magnification marker placed at the level of the bone and non orthogonal views – and put these images through software and obtained mounting and deformity parameters. Results were independently assessed and we found that the Spatial CAD™ software was accurate within 1 mm and 1 degree when orthogonal images with marker sphere placed at the bone level were used. Non-orthogonal images, with marker sphere, yielded accurate axial frame offset but other mounting parameters were at least 6 mm more than the actual measurements. Understandably angular measurements were different. In the third set of films we used frame hardware – Rancho Cube width (12 mm) as a calibrator. Since the cube was not in the same plane as the bone all measurements were way off actual measurements.Purpose of the study
Methods and end results