Injury
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Reconstruction of large bone defects around the elbow joint is surgically demanding due to sparse soft tissue coverage, complex biomechanics and the close proximity to neurovascular structures. Modular megaprostheses are established reconstruction tools for the elbow, but only small case series have been reported in the literature. ⋯ Modular megaprosthesis is a reliable and effective reconstruction tool in large bone defects around the elbow joint. The complication rates are lower than seen in osteoarticular allografts and allograft-prosthesis composites while the functional outcome is equal. In palliative situations with metastatic disease involving the elbow, modular megaprosthesis enables rapid recovery and pain relief and preserves elbow function.
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The Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes after osteosynthesis with reverse LISS plates. ⋯ The use of reverse LISS plate appeared to be an alternative procedure for the specific pattern in the present study. We recommend using this reverse locking plate to treat unstable proximal femoral fractures with meticulous techniques of placing plates. Adequate purchase of the proximal locking screws might decrease the risks of complications.
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We hypothesize that inserting a curved intramedullary internal fixation device which follows curved osseous fixation paths (OFPs) would be more versatile and mechanically stronger than straight screws for fixation of pelvic ring and acetabular injuries. This study characterizes the dimensions of curved OFPs of the pelvic ring and acetabulum and suggests design parameters for such a curved device. ⋯ This study shows that if a flexible implant which could be stiffened once in place was available, it would enable the use of larger and longer fixation taking advantage of the pelvis's curved intracortical spaces. Even for dysmorphic pelves, accessible tunnels support a long, strong, curved fixation device.
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The goal of the study was to evaluate both clinical and radiological outcome of a consecutive series of 11 patients submitted to lumboiliac fixation after lumbopelvic disjunction or associated injuries of the pelvis and lumbosacral tract in mid- and long-term follow-up. ⋯ Lumbopelvic fixation is an effective surgical technique for treatment of spinopelvic disjunction. The patient numbers in this series, and in the literature in general, are low; therefore, a multicentre study is advisable to give evidence and statistical importance to our findings.