Reconstructive procedures for malunion and traumatic arthritis.

D L Fernandez

Home/Archive/PubMed

PubMed · 8479731

Reconstructive procedures for malunion and traumatic arthritis.

D L Fernandez

View original source ↗Export metadata ↓

Abstract

Despite the fact that surgical management of fractures of the distal radius has become more aggressive, leading to substantial improvement of anatomic results, malunion and post-traumatic arthritis remain the two most common complications following conservative treatment. Techniques, operations, and salvage procedures are discussed in this article.

Explore related subjects

Arthrodesis Fracture Fixation Fractures, Ununited Humans Joint Instability Osteoarthritis Osteotomy Postoperative Care Preoperative Care Radius Fractures Wrist Injuries Wrist Joint Journal Article Review

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

D L Fernandez. 1993. Reconstructive procedures for malunion and traumatic arthritis.. https://pubmed.ncbi.nlm.nih.gov/8479731/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Jackson's intrasacral fixation in the management of high-grade isthmic spondylolisthesis.

The aim of this study is to describe a surgical procedure proposed for high-grade isthmic spondylolisthesis, with intraoperative reduction using Jackson's intrasacral fixation. The procedure is performed using a single posterior approach. The intraoperative correction of the deformity is obtained by sacral dome resection and reduction of the lumbosacral kyphosis using Jackson's fixation to rotate the sacrum. After sagittal balance restoration, L4-S1 circumferential fusion is performed with interbody cages. The technique is effective in the restoration of spinal and pelvic parameters of sagittal balance, and optimal conditions for fusion are obtained. The use of Jackson's intrasacral fixation provides the strong stability needed to correct the lumbosacral deformity, with little neurological risk during intraoperative reduction.

Arthrodesis↗

PubMed2007

Use of ventral plates for cervical arthrodesis.

OBJECTIVE: Ventral cervical plates are used to increase the immediate postoperative rigidity of the spine after decompressive and reconstructive procedures. The evidence supporting this practice is reviewed. METHODS: A computerized literature search of the database of the National Library of Medicine was conducted using PubMed. All relevant articles were reviewed and a critique was performed to explore the utility of ventral cervical plating. RESULTS: Several randomized controlled trials of ventral cervical discectomy versus ventral cervical discectomy and fusion were identified. Three randomized controlled trials that included a differentiation between anterior cervical decompression and fusion, with and without plating, were identified. Many retrospective series, technical reports, and topical reviews were also identified. CONCLUSION: There is little support in the literature for the medical usefulness of ventral cervical plates after single-level cervical fusion. There may, however, be a cost-benefit advantage to the use of such devices. In multilevel procedures and in the setting of traumatic instability, there seems to be an advantage to the use of cervical plates.

Arthrodesis↗

PubMed2006

Techniques in the management of juxta-articular aggressive and recurrent giant cell tumors around the knee.

AIM: Juxta-articular aggressive and recurrent giant cell tumors around the knee pose difficulties in management. This article reviews current problems and options in the management of these giant cell tumors. METHODS: A systematic search was performed on juxta-articular aggressive and recurrent giant cell tumor. Additional information was retrieved from hand searching the literature and from relevant congress proceedings. We addressed the following issues: general consensus on early diagnosis and techniques in its management. In particular, we describe our results with resection arthrodesis performed combining the benefits of both interlocking intramedullary nail and Ilizarov fixator in the management of these tumors around the knee. RESULTS: Mean operative age of the 22 patients undergoing resection arthrodesis was 35.63 years. Seven lesions were in the tibia and fifteen in the femur. Mean length of the bone defect was 12.34 cm. The mean external fixator index was 7.44 days/cm and the distraction index was 7.88 days/cm. Mean period of follow-up for the patients was 64.5 months. The function of the affected limb was rated excellent in 10 and good and fair in six patients each as per Enneking criteria. No local recurrence of tumor was seen. Seven complications occurred in five patients. CONCLUSION: Two-ring construct, bifocal bone transport, and early definite plate osteosynthesis with additional bone grafting of the docking site at the end of distraction even before consolidation of the regenerate helps to reduce the problems of pin tract infections drastically. Thin-diameter long intramedullary nail in addition to preserving the endosteal blood supply also prevents mal-alignment of the regenerate. Thus resection arthrodesis using interlocking intramedullary nail and bone transport using Ilizarov fixator is cost effective and effective in achieving the desired goals of reconstruction with least complications in selected patients with specific indications.

Arthrodesis↗