Strategies in Trauma and Limb Reconstruction最新文献

{"title":"Antiglide Plate vs Horizontally Oriented Parallel Screws in Vertical Shear Medial Malleolus Fracture.","authors":"Mostafa I Awad, Fahad A Hayyawi, Hussein A Hussein, Mohamed El-Hariry, Ahmed Lymona, Mohamed Ae Hussein","doi":"10.5005/jp-journals-10080-1658","DOIUrl":"10.5005/jp-journals-10080-1658","url":null,"abstract":"<p><strong>Background: </strong>Vertical shear medial malleolus fracture is less common than transverse. A plurality of methods is used for fixation, including lag screws, buttress plating, neutralisation plating with screws, and antiglide plating. But none of them has been proved to be the optimal choice. The study aimed to evaluate the clinical and functional findings and complications that might occur after vertical shear medial malleolus fracture fixation using either an antiglide plate or horizontally placed parallel screws oriented perpendicular to the fracture line.</p><p><strong>Materials and methods: </strong>A prospective cohort investigation included 56 cases with vertical shear medial malleolus fractures. The individuals were categorised into two divisions based on the fixation methods used: Antigliding plate (25 cases) or screws (31 cases). The median age in the antiglide plate division was 34 years (IQR: 23-50 years), while in the screws category, it was 38 years (IQR: 29.5-48 years). Functional outcomes were evaluated using the AOFAS score.</p><p><strong>Results: </strong>Operative time and incision length were substantially shorter in the screws category compared to the antiglide plate division (<i>P</i> _eff = 0.001 and <i>p</i> < 0.001, respectively) and union time was statistically shorter in the antiglide plate category compared to the screws division (<i>P</i> _eff = 0.019), no clinically or statistically significant difference was observed in functional outcomes based on the AOFAS score at 3-month and 1-year follow-ups.</p><p><strong>Conclusion: </strong>In this type of ankle injury, the use of an antiglide plate or screws can provide nearly equal clinical and radiological outcomes, but with longer operative time and incision length towards the antiglide plate.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 3","pages":"147-152"},"PeriodicalIF":0.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Techniques Utilising External Fixation to Motorised Intramedullary Nails in the Treatment of Lower Limb Discrepancy: Systematic Review and Meta-analysis.","authors":"Wojciech Bocheński, Gabriela Luba, Federica Manca, Maria Lk Philippi, Sebastiano Vasta, Daniele Pili, Guglielmo Torre","doi":"10.5005/jp-journals-10080-1644","DOIUrl":"10.5005/jp-journals-10080-1644","url":null,"abstract":"<p><strong>Aim: </strong>This systematic review and meta-analysis compares the clinical outcomes of motorised lengthening intramedullary nails (MLNs) with techniques utilising external frames for lower limb discrepancy (LLD) treatment.</p><p><strong>Materials and methods: </strong>The systematic review was conducted under the guidance of PRISMA guidelines and reported to the PROSPERO registry in December 2022. Out of 3,422 articles, only six eligible studies were identified from PubMed, Scopus, and EMBASE, meeting inclusion criteria. Meta-analysis was conducted for total lengthening, time to union, and incidence of reoperations.</p><p><strong>Results: </strong>Pooled MD for total lengthening was -0.50 (95% CI: -0.93, -0.08), showing a slightly better outcome (statistically significant) for the comparison treatment. For time to union, pooled MD was -0.12 (95% CI: -1.38, 1.14), indicating no statistically significant difference between the treatments. Lastly, with the reoperation rates, the overall log odds ratio (OR) was 0.91 in favour of MLN and statistically significant (95% CI: -1.77, -0.04).</p><p><strong>Conclusion: </strong>This study suggests that techniques that incorporate external fixators have a greater potential for the amount of total lengthening over the use of motorised lengthening MLN but may increase complications requiring reoperation. There is no significant difference in time to union.</p><p><strong>Clinical significance: </strong>This is the first systematic review and meta-analysis comparing MLN with other techniques utilising external frames. Finite conclusions cannot be drawn owing to the use of a small number of observational studies with relatively small numbers in each study. Further studies should be developed to support the suggested conclusions, and this study may serve as a foundation for future studies.</p><p><strong>How to cite this article: </strong>Bocheński W, Luba G, Manca F, <i>et al</i>. Comparison of Techniques Utilising External Fixation to Motorised Intramedullary Nails in the Treatment of Lower Limb Discrepancy: Systematic Review and Meta-analysis. Strategies Trauma Limb Reconstr 2025;20(2):100-108.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"100-108"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cadaveric Comparative Study between Anterolateral Thigh Flap and Posteromedial Thigh Flap.","authors":"Kumari Ayushree, Nitisha, Pramita Kumari, Ravi K Narayan, Jayanta Biswas","doi":"10.5005/jp-journals-10080-1646","DOIUrl":"10.5005/jp-journals-10080-1646","url":null,"abstract":"<p><strong>Introduction: </strong>For soft tissue repair, the anterolateral thigh (ALT) flap has been a cornerstone since its inception. The posteromedial thigh (PMT) perforator flap, introduced in 2001, has gained traction over the last decade. This study aims to compare the two flaps to determine which is anatomically more suitable for reconstruction.</p><p><strong>Materials and methods: </strong>Both thighs of 30 cadavers were used for this study over 3 years, involving the dissection of 60 ALTs and 60 PMTs. The comparison focused on the number, length, and type of perforators along with the pedicle length.</p><p><strong>Results: </strong>The PMT flap showed a higher percentage of septocutaneous perforators while matching the ALT flap in length, number of perforators, and pedicle length. Additionally, the musculocutaneous perforators in the PMT flap had a more straightforward course. The ALT flap had an average of 1.78 perforators, having a mean perforator length of 4.35 cm, while the PMT flap had an average of 1.72 perforators with a mean length of 4.3 cm. The average pedicle length was 11.41 cm for the ALT flap and 9.98 cm for the PMT flap. The ALT flap predominantly featured musculocutaneous perforators (81.3%), whereas the PMT flap had 58.3%.</p><p><strong>Conclusion: </strong>The PMT flap is comparable to the ALT flap in all evaluated parameters. It offers advantages such as a higher number of septocutaneous perforators, an obscured scar at the donor site, and more soft tissue bulk, making it a viable alternative to the ALT flap.</p><p><strong>How to cite this article: </strong>Ayushree K, Nitisha, Kumari P, <i>et al</i>. A Cadaveric Comparative Study between Anterolateral Thigh Flap and Posteromedial Thigh Flap. Strategies Trauma Limb Reconstr 2025;20(2):66-71.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"66-71"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Precision for Deformity Correction Planning: Revision of Values for the Vitruvian Foot Quadrilateral with Demonstrative Case Report.","authors":"Leonid Solomin, Konstantin Ukhanov, Alexander Kirienko, Filippo Vandenbulcke, John E Herzenberg","doi":"10.5005/jp-journals-10080-1651","DOIUrl":"10.5005/jp-journals-10080-1651","url":null,"abstract":"<p><strong>Aim and background: </strong>The introduction of the 'Vitruvian' Foot concept in 2019 established initial parameter measurements of the 'normal' foot quadrilateral (FQ) in the sagittal plane. This effort had been aimed at increasing precision when analysing alignment abnormalities in post-traumatic and congenital foot deformities, so as to more accurately guide corrective treatment planning with osteotomies. The current study enhances the prior, existing data with an expanded normal cohort. We also offer a case report that describes the successful application of the revised reference angles for our analysis and correction of a congenital foot deformity in a 29-year-old woman.</p><p><strong>Materials and methods: </strong>Included in the present analysis were 100 normal radiographs (78 patients). We followed the FQ delineated by our previous studies, which uses the distance between the posterior process of the talus and the anterior edge of the articular surface of the talus body (points a and b, respectively) to form the talus joint line (TJL). The FQ is then transcribed in the sagittal plane, anchored by the dual weight-bearing apices created by the junctures of the TJL and the most definitively plantar points of (1) the first metatarsal head (c) and (2) the posterior calcaneus (d). Reference angles were designated as: The anatomic lateral talometatarsal angle (aLTMA, ∠bcd), the mechanical talometatarsal angle (mLTMA, ∠bac), and the lateral heel angle (LHA, ∠acd). Additionally, we measured ∠dab, ∠abc, and ∠cda, as well as the proportional values of line lengths bc:ab (k1), cd:ab (k2), and ad:ab.</p><p><strong>Results: </strong>The resulting, revised measurements and standard deviations (SDs) were as follows: ∠abc = 144.5 ± 3.7 degrees, ∠bcd = 32.6 ± 1.9 degrees, ∠cda = 79.1 ± 3.7 degrees, ∠dab = 103.8 ± 3.4 degrees, k1 = 3.02 ± 0.24, k2 = 3.83 ± 0.31, and k3 = 1.62 ± 0.17.</p><p><strong>Conclusion: </strong>We expanded the dataset of previous publications and to corroborate and more accurately define upon the concept of the normalised 'Vitruvian' foot. The larger sample size allowed refinements in the previously established reference values. Though the newer calculations showed only slight referential changes, there was a noticeable tightening of the SD over the previously published reference lines and angles (RLAs) measurements.</p><p><strong>Clinical significance: </strong>The updated normalised parameters can offer the surgeon a reliable framework to enhance precision in foot deformity correction planning.</p><p><strong>Level of clinical evidence: </strong>III.</p><p><strong>How to cite this article: </strong>Solomin L, Ukhanov K, Kirienko A, <i>et al</i>. Enhanced Precision for Deformity Correction Planning: Revision of Values for the Vitruvian Foot Quadrilateral with Demonstrative Case Report. Strategies Trauma Limb Reconstr 2025;20(2):72-81.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"72-81"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy of Indocyanine Green Fluorescence Angiography in Lower Extremity Injuries: A Systematic Review.","authors":"Lasse Wp van 't Hof, Paula J van Oosten, Vere S Smitka, Floortje Gm Verspoor, Georgios F Giannakópoulos, Mark-Bram Bouman, Matthijs Botman, Caroline Driessen","doi":"10.5005/jp-journals-10080-1647","DOIUrl":"10.5005/jp-journals-10080-1647","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of tissue viability is essential in the surgical management of lower extremity injuries, particularly during debridement and soft tissue reconstructions. Fluorescence imaging (FI) with indocyanine green (ICG) enables real-time visualisation of tissue perfusion and may offer advantages over conventional clinical assessment. This systematic review evaluates the current evidence on the use of FI in lower extremity injury management.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase and the Cochrane Library was conducted up to February 2025. Studies were eligible if they examined the use of FI in debridement, soft tissue reconstruction or amputation stump viability in lower extremity injuries. Only studies with cohorts of at least 10 patients were included. Two reviewers independently screened the studies. Data were extracted on FI timing, imaging protocols, methods for quantitative perfusion analysis, and the impact on intra-operative decision-making and clinical outcomes.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria: Two evaluated FI in debridement procedures, six in reconstructive procedures, and five in amputation stumps. There was notable heterogeneity in study design, objectives and imaging protocols. Fluorescence imaging was used both in the intra- and post-operative settings. In four studies, intra-operative assessment with FI directly guided surgical interventions, including debridement planning, adjusting flap design or perforator selection. In three of these four studies, intra-operative FI contributed to improved outcomes compared to conventional assessment methods. Seven studies incorporated quantitative perfusion analysis in their study.</p><p><strong>Conclusion: </strong>Fluorescence imaging appears to be a valuable adjunct in the surgical management of lower extremity injuries, with potential to improve assessment of tissue viability and reduce post-operative complications. However, wide variation in protocols, interpretation methods, and outcome measures currently limits broader clinical adoption.</p><p><strong>Clinical significance: </strong>This review highlights the clinical potential of fluorescence imaging to enhance intra-operative assessment and guide surgical strategy in the management of lower extremity injuries.</p><p><strong>How to cite this article: </strong>van 't Hof LWP, van Oosten PJ, Smitka VS, <i>et al</i>. Evaluating the Efficacy of Indocyanine Green Fluorescence Angiography in Lower Extremity Injuries: A Systematic Review. Strategies Trauma Limb Reconstr 2025;20(2):109-119.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"109-119"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>In Vitro</i> Wire Tension in Circular External Fixation Frames.","authors":"Isobel S Burridge, Anthony Howard, Paul Harwood, Alice M Benton, Charlotte Merrell, Pete Culmer, William Bolton, Todd D Stewart","doi":"10.5005/jp-journals-10080-1653","DOIUrl":"10.5005/jp-journals-10080-1653","url":null,"abstract":"<p><p>Circular frames are applied to control fracture and osteotomy mechanics, which is dependent on frame design. As the clinical application of these devices is individualised, clinical performance can be difficult to compare from one case to another. In fine wire constructs, stability is dependent on wire tension, which can degrade over time. As such, wire tension is a parameter that surgeons may attempt to keep consistent between cases or indeed adapt to the clinical situation. However, there is little evidence regarding what variables in fixator application might influence this. The aim of the study was to monitor wire tension in an <i>in vitro</i> symmetrical circular frame construct using strain gauge instrumented wires and to use these to investigate the clinical factors in assembly and use of a frame that may be associated with tension loss. The results demonstrated that variability in wire tension was associated with the application of the tensioner itself, along with wire slippage associated primarily with the bolt torque used to tighten the ends of the wires to the frame. These two variables could easily lead to a 50% variation in the actual wire tension achieved. Surprisingly, under dynamic loading, despite an initial loss in tension due to slippage, wire tension generally remained constant and was not significantly different between wires applied with different wire pre-tensions after the initial three cycles. A calibrated tensioner with a high initial tension (110 kg), along with a controlled wire clamp bolt torque (14 Nm), is required to achieve the most consistent frame performance.</p><p><strong>How to cite this article: </strong>Burridge IS, Howard A, Harwood P, <i>et al. In Vitro</i> Wire Tension in Circular External Fixation Frames. Strategies Trauma Limb Reconstr 2025;20(2):94-99.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"94-99"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Assessment of Regenerate Bone Maturation using the Pixel Value Ratio Following Distraction Osteogenesis: A Scoping Review.","authors":"Anirejuoritse Bafor, Marie Fridberg, Alison Gehred, Ole Rahbek, Christopher Iobst, Søren Kold","doi":"10.5005/jp-journals-10080-1654","DOIUrl":"10.5005/jp-journals-10080-1654","url":null,"abstract":"<p><strong>Aim and background: </strong>The objective assessment of regenerate bone maturation during distraction osteogenesis traditionally relied on expensive and impractical methods such as quantitative computerised tomography (qCT) and dual-energy X-ray absorptiometry (DEXA) scans. The pixel value ratio (PVR), derived from standard digital radiographs, has emerged as a cost-effective and reliable alternative for evaluating bone mineralisation. However, its clinical utility, particularly in determining the threshold for safe full weight-bearing (FWB), remains unclear.</p><p><strong>Methods: </strong>This scoping review was conducted according to PRISMA-ScR guidelines and the participants, concept, and context (PCC) framework, systematically identified and analysed human clinical studies published in English and involving the use of PVR in human subjects undergoing distraction osteogenesis. We carried out a systematic search of seven databases using relevant keywords.</p><p><strong>Results: </strong>Of 215 records, 22 studies met the inclusion criteria [21 retrospective, one randomised controlled trial (RCT)]. Fourteen studies assessed extramedullary lengthening, six intramedullary, and two both. Ten focused on the tibia, four on the femur, seven on both, and one included the humerus. Sample sizes ranged from 12 to 125. Sixteen studies calculated PVR using adjacent cortices; only eight reported PVR at FWB, mostly between 0.85 and 0.94. Most did not report PVR at hardware removal. Pixel value ratio was the sole assessment tool in only three studies; complications related to regenerate bone were rarely discussed.</p><p><strong>Conclusion: </strong>The PVR has been primarily used as an adjunctive tool for assessing regenerate bone mineralisation during distraction osteogenesis. There is no standardised method for its calculation, and its role in guiding key clinical decisions, such as FWB initiation or hardware removal, remains limited.</p><p><strong>Clinical significance: </strong>The PVR is a cost-effective tool for assessing regenerate bone maturation, but inconsistent methods and unclear thresholds limit its clinical utility. Standardisation and prospective validation are needed to guide safe weight-bearing and hardware removal decisions.</p><p><strong>How to cite this article: </strong>Bafor A, Fridberg M, Gehred A, <i>et al</i>. Quantitative Assessment of Regenerate Bone Maturation using the Pixel Value Ratio Following Distraction Osteogenesis: A Scoping Review. Strategies Trauma Limb Reconstr 2025;20(2):120-129.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"120-129"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Actionability of TikTok Content on Cosmetic Limb Lengthening: A Comparison between Healthcare Professional and Non-professional Sources.","authors":"Akram Al Ramlawi, Munir Sidani, Chelsea Missi, Michael Assayag, Philip K McClure","doi":"10.5005/jp-journals-10080-1648","DOIUrl":"10.5005/jp-journals-10080-1648","url":null,"abstract":"<p><strong>Introduction: </strong>In the modern digital era, social media platforms, such as TikTok, have become significant sources of medical information for the general public. This study explores the content of TikTok videos related to cosmetic limb lengthening to understand the quality and accuracy of information shared.</p><p><strong>Methods: </strong>The 50 most-viewed English-language videos tagged with #Heightsurgery and #lengtheningsurgery on TikTok were analysed by two independent reviewers. The analysis covered creator demographics, video format, and predominant themes. Each video was also evaluated for medical accuracy and scored for clarity and actionability using the patient education materials assessment tool (PEMAT).</p><p><strong>Results: </strong>The selected videos amassed 186.5 million views, 7.9 million 'likes,' 1,52,000 'shares,' and 67,000 comments. Nearly half (47%) were produced by healthcare professionals (HCPs), with orthopaedic surgeons accounting for 70% of the HCP contributors (32.9% of total creators). Medically accurate content was found in 60% of all videos, with 80% of HCP videos featuring accurate information. Educational content dominated (72%), with the remainder being anecdotal (28%). Tone varied, with videos presenting either positive (50%), negative (32%), or neutral (18%) perspectives. Common themes included post-operative experiences (30%), medical education (15%), surgical techniques (12%), risks vs benefits (10%), and treatments for achondroplasia (10%). Concerns about pain, fear, permanent injury (24%), cost (10%), and a lack of understanding of procedures (10%) were also frequently mentioned. Notably, there was no focus on racial or socio-economic barriers in any of the videos. The average understandability and actionability scores, according to the PEMAT, were 67.5 and 67.15%, respectively.</p><p><strong>Conclusions: </strong>The widespread popularity of these videos underscores the growing role of social media in disseminating medical information. This analysis highlights the need for HCPs to leverage platforms like TikTok to provide accurate, reliable information and address common concerns, misconceptions, and fears surrounding cosmetic limb lengthening.</p><p><strong>How to cite this article: </strong>Ramlawi AA, Sidani M, Missi C, <i>et al</i>. Accuracy and Actionability of TikTok Content on Cosmetic Limb Lengthening: A Comparison between Healthcare Professional and Non-professional Sources. Strategies Trauma Limb Reconstr 2025;20(2):90-93.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"90-93"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ollier's Disease Regenerate Healing Rates: Is there Cause for Concern?","authors":"Peter Calder, Joseph Wanas, Elizabeth K Tissingh, Jonathan Wright, David Goodier","doi":"10.5005/jp-journals-10080-1645","DOIUrl":"10.5005/jp-journals-10080-1645","url":null,"abstract":"<p><strong>Background: </strong>Ollier's disease, characterised by multiple enchondromas, can result in significant limb length discrepancy and angular deformities. Anecdotal evidence suggests faster healing rates and a risk of premature consolidation during lengthening. The aim is to evaluate healing rates in Ollier's and assess the need for change in practice.</p><p><strong>Materials and methods: </strong>A total of 12 patients with Ollier's disease underwent limb lengthening utilising an external fixator or intramedullary lengthening nail. A latency period of 6 days was followed by a lengthening rate of 1 mm per day. Parameters, including lengthening index (LI), bone healing index (BHI), and external fixation index (EFI), were recorded. The regenerate quality was assessed using the pixel value ratio (PVR) when lengthening was achieved, at frame removal, and equivalent cortex formation following a nail. Change in lengthening rates and complications were noted.</p><p><strong>Results: </strong>Eleven males and one female underwent 20 lengthening episodes at a mean age of 14 years (8-29 years). The mean lengthening was 4.9 cm (1-10 cm). Full regeneration consolidation occurred in all patients. Following external fixation, the mean LI was 17.78 days/cm (9.5-71), the BHI was 33.62 days/cm (4-133), and the EFI was 53.60 days/cm (21.43-210). A lower, but not statistically significant, BHI of 11.23 days/cm (3.5-22.86) was recorded in the nail group. The mean PVR was 0.84 (0.53-1.2) at the end of lengthening and 0.94 (0.64-1.13) at frame removal following external fixation, compared to 0.78 (0.74-0.86) and 0.86 (0.77-0.94) with nails; again, no significant difference was noted. Complications included one case of premature consolidation during humeral lengthening requiring re-osteotomy. One case of knee flexion deformity and pain during radial lengthening required a slowing of the distraction rate. One case of tibial valgus deformity was deliberately corrected slowly to avoid traction injury to the common peroneal nerve. No other cases had a change in lengthening rate or rhythm.</p><p><strong>Discussion: </strong>All our patients undertook successful lengthening with good bone consolidation. The healing indices recorded are similar to the published literature. We accept the limitations of a retrospective study with small numbers. With only one case of premature consolidation, we have no evidence to support the concept of faster regenerate consolidation in patients undergoing lengthening in Ollier's disease.</p><p><strong>How to cite this article: </strong>Calder P, Wanas J, Tissingh EK, <i>et al</i>. Ollier's Disease Regenerate Healing Rates: Is there Cause for Concern? Strategies Trauma Limb Reconstr 2025;20(2):59-65.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"59-65"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Approach for Closed Femoral Shortening Osteotomy with Deformity Correction Using Reverse Planning and Retrograde Surgical Technique.","authors":"Bartosz Musielak, James A Fernandes","doi":"10.5005/jp-journals-10080-1652","DOIUrl":"10.5005/jp-journals-10080-1652","url":null,"abstract":"<p><strong>Aim: </strong>To describe a retrograde femoral shortening technique that allows simultaneous deformity correction over an intramedullary nail.</p><p><strong>Background: </strong>Leg length discrepancy (LLD) can be managed by lengthening the short limb or shortening the long limb, either gradually or acutely. To our knowledge, the combined femoral shortening and deformity correction using a retrograde nail has not been previously reported in the literature.</p><p><strong>Technique: </strong>Shortening and correction are planned using a modified Baumgart reverse-planning method. Based on the planning, the position of the guidewire is replicated intraoperatively. After achieving the \"cortical contact\" point, further steps are taken for the nail insertion. A percutaneous shortening osteotomy is then performed, with bone and nail alignment controlled using locking and poller screws.</p><p><strong>Conclusion: </strong>This report outlines a reproducible retrograde technique for femoral shortening osteotomy with concurrent deformity correction.</p><p><strong>Clinical significance: </strong>This method provides a safe, technically straightforward, and effective option for treating LLD with associated femoral deformity in the longer limb.</p><p><strong>How to cite this article: </strong>Musielak B, Fernandes JA. Novel Approach for Closed Femoral Shortening Osteotomy with Deformity Correction Using Reverse Planning and Retrograde Surgical Technique. Strategies Trauma Limb Reconstr 2025;20(2):130-134.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"20 2","pages":"130-134"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}