Aims. The aim of the present study was to assess the outcomes of the
Aims. This study aimed to evaluate the effectiveness of the
Aims. The purpose of this study was to: review the efficacy of the
Aims. To clarify the effectiveness of the
Aims. Treatment of chronic osteomyelitis (COM) for young patients remains a challenge. Large bone deficiencies secondary to COM can be treated using
Aims. In contrast to operations performed for other fractures, there is a high incidence rate of surgical site infection (SSI) post-open reduction and internal fixation (ORIF) done for tibial plateau fractures (TPFs). This study investigates the effect of
Introduction. The reconstruction of segmental long bone defects remains one of the holy grails of orthopaedic surgery. The optimal treatment of which remains a topic of great debate. This study aimed to evaluate the outcomes following the management of critical-sized bone defects using a classification-based treatment algorithm. Materials & Methods. A retrospective review of all patients undergoing treatment for segmental diaphyseal defects of long bones at a tertiary-level limb reconstruction unit was performed. The management of the bone defect was standardised as per the classification by Ferreira and Tanwar (2020). Results. A total of 96 patients (mean age 39.8, SD 15.2) with a minimum six months follow-up were included. Most bone defects were the result of open fractures (75/96) with 67% associated with Gustilo-Anderson IIIB injuries. There was a statistical difference in the likelihood of union between treatment strategies with more than 90% of cases undergoing acute shortening and bone transport achieving union and only 72% of cases undergoing the
The optimal treatment strategy for post-traumatic long bone non-unions is subject of an ongoing discussion. At the Maastricht University Medical Center (MUMC+) the
The human amniotic membrane (hAM), derived from the placenta, possesses a low (nay inexistant) immunogenicity and exerts an anti-inflammatory, anti-fibrotic, antimicrobial, antiviral and analgesic effect. It is a source of stem cells and growth factors promoting tissue regeneration. hAM acts as an anatomical barrier with adequate mechanical properties (permeability, stability, elasticity, flexibility, resorbability) preventing the proliferation of fibrous tissue and promoting early neovascularization of the surgical site. Cryopreservation and lyophilization, with sometimes additional decellularization process, are the main preservation methods for hAM storage. We examined the use of hAM in orthopaedic and maxillofacial bone surgery, specially to shorten the
Objectives. Induced membrane technique is a relatively new technique in the reconstruction of large bone defects. It involves the implantation of polymethylmethacrylate (PMMA) cement in the bone defects to induce the formation of membranes after radical debridement and reconstruction of bone defects using an autologous cancellous bone graft in a span of four to eight weeks. The purpose of this study was to explore the clinical outcomes of the
Introduction:. 20 cases of bone defect have been treated by the
In chronically infected fracture non-unions, treatment requires extensive debridement to remove necrotic and infected bone, often resulting in large defects requiring elaborate and prolonged bone reconstruction. One approach includes the
Introduction. 20 cases of bone defect have been treated by the
Aim. The aim of this systematic review was to determine the reported treatment strategies, their individual success rates, and other outcome parameters in the management of critical-sized bone defects in Fracture-Related Infection (FRI) patients between 1990 and 2018. Method. We performed a systematic literature search on treatment and outcome of critical-sized bone defects in FRI. Treatment strategies identified were, autologous cancellous grafts, autologous cancellous grafts combined with local antibiotics, the
Background:. Segmental defects of long bones are notoriously demanding and difficult to treat. We evaluate nine cases where the Masquelet
Introduction. Purpose: Injuries to the long bones of the upper limb resulting in bone defects are rare but potentially devastating. Literature on the management of these injuries is limited to case reports and small case series. The aim of this study was to collate the most recent published work on the management of upper limb bone defects to assist with evidence based management when confronted with these cases. Materials and Methods. Methods: Following a preliminary search that confirmed the paucity of literature and lack of comparative trials, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was conducted. A literature search of major electronic databases was conducted to identify journal articles relating to the management of upper limb long bone defects published between 2010 and 2020. Results. Results: A total of 46 publications reporting on the management of 341 patients were reviewed. Structural autograft, bone transport, one-bone forearm and the
The August 2012 Oncology Roundup. 360. looks at: prolonged symptom duration; peri-operative mortality and above-knee amputation; giant cell tumour of the spine; surgical resection for Ewing’s sarcoma; intercalary allograft reconstruction of the femur for tumour defects; and an
Purpose of the study: Resection of a malignant primary tumour of the proximal humerus implies sacrifice of a large part of the humeral shaft and the periarticular muscles. Reconstruction can be difficult and raises the problem of preserving function. Recent work has demonstrated the pertinence of combining a glenohumeral prosthesis with an allograft. Several complications are nevertheless reported: non-union, allograft resorption, loosening. We report three cases of malignant primary tumours requiring wide resection of the humerus which were treated by reconstruction with a shoulder arthrodesis applying the
Purpose of the study: The different conflicts in ex-You-goslavia left a health care desert. A few medicosurgical units attempted to reconstruct, but their capacities were limited and focused on emergencies. Many patients had to be abandoned. One was a 13-year-old Kosovar boy with active torpid osteomyelitis of the humerus whose family brought him to the French military field hospital in Mitrovica. Case report: The patient’s general status was mediocre with a hanging left arm which was painful upon mobilization. The skin had a normal aspect. Plain x-rays showed a purulent disintegration of the proximal third of the humerus with 11 cm shortening and loss of bone continuity. The forearm and hand were free of vascular or nervous deficits. Joint testing of the elbow and should was not contributive. The infectious agent was identified (multiple susceptible staphylococcus) and treated. A sequential strategy was undertaken for bone healing. The focus was exposed and stabilized by external fixation with insertion of a spacer and cement. At day 45, an autologous graft was inserted into the induced membrane. The fixator was removed at bone healing (20 days). Results: The gain was 8 cm. Postoperatively, the patient responded well to double antibiotic therapy. Recovery of joint motion was spectacular for the shoulder but difficult for the elbow. The autologous graft inserted on day 45 was composed of a non-vascularized fibular component completed with grafts harvested from the two anterior iliac crests. At one year follow-up, the infectious focus remains quiescent. The patient can use his arm with no problem. The shoulder motion is subnormal and there is a certain degree of persistent stiffness of the elbow but with no functional complaint. Discussion: This is a unusual clinical case where the
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