{"title":"Prevalence of Vitamin D Deficiency in Pediatric Limb Lengthening and Deformity Patients","authors":"Philip K. McClure","doi":"10.4103/2455-3719.334376","DOIUrl":"https://doi.org/10.4103/2455-3719.334376","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115710673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acquired Long Bone Defect Classifications of the Diaphysis: A Literature Review","authors":"G. Sheridan","doi":"10.4103/2455-3719.334366","DOIUrl":"https://doi.org/10.4103/2455-3719.334366","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133913766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Masquelet′s Induced Membrane Technique for Reconstruction of Large Extra-Articular Intercalary Bone Defect","authors":"Y. Elbatrawy","doi":"10.4103/2455-3719.334378","DOIUrl":"https://doi.org/10.4103/2455-3719.334378","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131550902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Drakou, Konstantinos Zygogiannis, M. Psifis, A. Mitrou
{"title":"A case of personalized limb salvage of the distal femur by three-stage distal femoral replacement","authors":"A. Drakou, Konstantinos Zygogiannis, M. Psifis, A. Mitrou","doi":"10.4103/jllr.jllr_10_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_10_20","url":null,"abstract":"Major distal femur defects involving the knee with underlying osteomyelitis and joint destruction require a staged surgical plan. We describe a case of a 21-year-old patient who suffered high-energy open diaphyseal and articular trauma of his right distal femur. Following radical debridement of bone and soft tissues, we implanted a cement spacer covered by a musculocutaneous flap. Previous tissue scarring did not permit knee function; therefore, we used a 250 ml soft tissue expander to create extra skin cover and we shortened the leg. A custom-made lengthening distal femoral replacement prosthesis was implanted, and the length was gained gradually followed by an intensive full range of motion exercises (0–125). We introduce the combination of first shortening and then lengthening a limb combined with the use of tissue expanders to create a soft tissue functional envelop for a knee prosthesis to work.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"92 8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123169237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evolution of tibial lengthening techniques: Two steps forward, one step back?","authors":"S. Sabharwal","doi":"10.4103/jllr.jllr_14_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_14_20","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123209590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of fixation dynamization on fracture healing: A systematic review","authors":"N. Ferreira, Y. Tanwar, M. Burger","doi":"10.4103/jllr.jllr_11_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_11_20","url":null,"abstract":"Dynamization of fixation has long been used as a strategy to promote fracture healing. Which clinical scenarios would benefit from dynamization, how and when to introduce it and its effectiveness remains to be elucidated. A systematic review of the literature reporting on the use of dynamization in fracture healing using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis was conducted. The primary outcome was time to union and union rate of fractures across all anatomical sites, including adult and pediatric populations. A total of 19 studies fulfilled the inclusion criteria of which 14 studies evaluated the use of dynamization using intramedullary nails, while five studies evaluated external fixator dynamization. The diversity of dynamization strategies, variation in timing of dynamization and contradictory results precludes definitive conclusions. Further research is needed before recommendations for the use of dynamization to improve fracture healing can be considered.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"129 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132769759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Knee Arthrodesis Using Ilizarov Method with Autogenous Bone Graft Application in a Second-Stage Surgery: A Case Report of a Morbidly Obese and Diabetic Patient with a Septic Failure of Total Knee Arthroplasty","authors":"Ricardo Marta, L. Maia, C. Vilela, J. Carvalho","doi":"10.4103/jllr.jllr_7_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_7_20","url":null,"abstract":"Currently, the main indication for knee arthrodesis is septic failure of a total knee arthroplasty (TKA). Circular external fixation has shown good results, and it is a good option to treat these cases. We present a case of a morbidly obese female, 55 years old, with a chronic septic failure of TKA, submitted to a knee arthrodesis using the Ilizarov technique. In a second-stage surgery, the remaining bone defect was filled with autogenous iliac crest graft. A radiographic and clinical fusion was verified 3 and 5 months, respectively, after the primary surgery. Twelve months later, she is very satisfied with the surgery results, presenting a Visual Analog Scale score 1 and a stable and pain-free lower limb. The residual limb length discrepancy was 3 cm, and she walks with a shoe lift without external support. Our case emphasizes the importance of autogenous bone graft application in a second-stage surgery to a successful and fast knee arthrodesis using the Ilizarov method in patients with chronic septic failure of TKA and severe comorbidities.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114664001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hasan Nahouli, Karim Masrouha, Rima A. Abdul-Khalek, Asdghig Der-Boghossian, A. Rteil, Wassim Mourad, S. Saghieh
{"title":"The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study","authors":"Hasan Nahouli, Karim Masrouha, Rima A. Abdul-Khalek, Asdghig Der-Boghossian, A. Rteil, Wassim Mourad, S. Saghieh","doi":"10.4103/jllr.jllr_8_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_8_20","url":null,"abstract":"Context: In patients with large bone defects, the method of bone transport remains one of the most adopted surgical techniques. Nonunion at the docking site is a critical complication of bone transport procedures. Aims: This study aimed to explore the impact of bone grafting at the docking site as well as radiographic parameters on union rates in patients who underwent bone transport for segmental bone defects of the tibia or femur. Settings and Design: This is a retrospective cohort of a consecutive series of adult patients treated with bone transport by a single surgeon at a single academic medical center. Subjects and Methods: Baseline characteristics of patients, bone transport procedure data, radiographic alignment data, and outcomes of those with bone grafting at the docking site were compared to those that did not. Statistical Analysis Used: Wilcoxon–Mann–Whitney U and Fisher's exact tests were used to analyze the study's data. Results: Thirty-two patients were included. Ten of 11 patients with bone graft at the docking site achieved union. Fifteen of 21 patients with no graft achieved union. Of the group that underwent bone transport without grafting, better alignment in the sagittal plane was significantly associated with achieving union (P = 0.026). The distraction gap of those that went on to unite (m = 9.33) was smaller than those that developed nonunion (m = 15.17) (P = 0.051). Conclusion: Although statistically insignificant, grafting of the docking site seemed to decrease the occurrence of nonunion at the clinical level. Higher distraction gap and translation in the sagittal plane may be the best predictors for nonunion of the docking site among nongrafted patients.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129802859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Zayed, A. Hammouda, I. Yasseen, Mahmoud Abo Hashim
{"title":"The use of suspensory fixation for ankle syndesmotic injuries: A modified technique","authors":"F. Zayed, A. Hammouda, I. Yasseen, Mahmoud Abo Hashim","doi":"10.4103/jllr.jllr_2_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_2_20","url":null,"abstract":"Background: Ankle injuries are a common presentation to the orthopedic clinic and can be just isolated sprains or associated with ankle fractures; most of these involve distal tibiofibular syndesmotic disruptions. Bony or deltoid ligament injuries can critically destabilize the ankle and affect its function. Suspensory repair is a relatively new and accepted surgical treatment for acute ankle syndesmotic injuries. Objective: This study was conducted to evaluate the results of the use of suspensory fixation by modified TightRope (hand-made suture-button system) after acute ankle syndesmotic injury in adults. The American Orthopedic Foot and Ankle Society (AOFAS) score was used as a functional result in this study. Patients and Methods: This prospective study included 20 patients (mean age, 29.5 ± 9.7 years) with acute syndesmotic injuries treated with a suspensory fixation system between the period of January 2017 and December 2017, with a mean follow-up (FU) of 2 years. Variables recorded and analyzed were the age, sex, fracture type, mechanism of injury, associated injuries, FU, complications, and final outcomes. Results: As regarded twenty patients in this study, the median AOFAS score was 97 (range, 90–100). One patient needed implant removal as a result of persistent skin irritation. Conclusion: A modified technique of suture-button fixation is an alternative optimal treatment for acute syndesmotic injuries, resulting in stable functional ankles with less costs. Level IV: Level II.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131315180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Abdelaziz, Hosny Gamal, AL-Maleh Ahmad, Abdulalim Abdulsalam
{"title":"Correction of multiplanar proximal tibial deformities using the taylor spatial frame","authors":"A. Abdelaziz, Hosny Gamal, AL-Maleh Ahmad, Abdulalim Abdulsalam","doi":"10.4103/jllr.jllr_5_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_5_20","url":null,"abstract":"Context: The management of multiapical and multidirectional deformities of the proximal tibia is still a challenging task with acute correction. The Taylor spatial frame (TSF) enables gradual correction in all planes. Aims: The study investigated the accuracy of correction for multiplanar proximal tibial deformities which had performed with the preassembled TSF. The complications and functional outcome were investigated. Settings and Design: Retrospectively, we compared the parameters of proximal tibial angles before and after using the preassembled TSF frame technique for correction. We used the mechanical axis deviation (MAD), medial proximal tibial angle (MPTA), posterior proximal tibial angle (PPTA), and tibial rotation as reference parameters for accuracy judgment. The deformities were divided into three main planes, each plane subdivided by two directions of angulations. Subjects and Methods: The study included 15 patients (20 tibiae), who underwent a tibial osteotomy surgery after obtaining informed consent for deformity correction using the TSF (Smith and Nephew, Memphis, TN, USA) between June 2016 and May 2018. Results: The three-plane deformities experienced an accurate correction of MAD. MPTA and PPTA were accurately corrected in patients with coronal and sagittal plane deformities, respectively. Rotational deformities were corrected to a satisfactory degree of accuracy in all cases. TSF correction for multiplanar proximal tibial deformities achieved an excellent result regarding functional outcome. Conclusions: Gradual correction for multiplanar proximal tibial deformities with the TSF is accurate, simple and with few complications.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"168 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116881992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}