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Plain radiograph and three-dimensional computed tomogram show a highly comminuted pilon fracture with large metaphyseal bone defect
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We present two patients with open pilon fractures with large bone defects treated successfully with fibular strut allografts. The patients were initially treated by massive irrigation, wound debridement, and temporary external fixation. After complete wound healing, the bone defects were managed. Because autologous iliac crest or fibular bone graft...
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... attempted suicide by falling from the 4th Xoor of a building. She had multiple fractures involving the calcaneus bilaterally, spine, and the right distal tibia and Wbula. Plain radiographs of the right ankle showed a Gustilo-Anderson type IIIA open pilon fracture with a large segmental bone defect approximately 10 cm in size at the distal tibia (Fig. 1). Because neurologic symptoms resulted from the spine fracture, the patient had to undergo an emergency spine operation. Massive irriga- tion and wide debridement of the right leg were performed at the same time. For the length and stability of the right leg, which was shortened by a large segmental bone defect, open reduction and ...Similar publications
Nonunion of diaphyseal fractures of the humerus are frequently seen in clinical practice (incidence of up to 15% in certain studies) and osteosynthesis using dynamic compression plates, intra medullary nails and Ilizarov fixators have been reported previously. Locking compression plates (LCP) are useful in the presence of disuse osteoporosis, segme...
Citations
Bone graft in trauma surgery is commonly used in managing bone defects, non-union, fracture related infections, arthrodesis or to provide structural support in fractures. A variety of bone grafts are made available to the treating physician, which includes autograft, allograft and bone graft substitutes. The future of bone grafting in trauma surgery is exciting with the incorporation of technological advancement such as gene therapy, 3D-printing and tissue engineering. Regardless, there are still limitations to what we understand regarding current bone grafting techniques with conflicting literature on their clinical utility and indication. The aim of this review article therefore is to take a step back and critically evaluate the current concepts of bone grafting in trauma surgery, with special emphasis made on reviewing the types of bone graft, biology of bone graft incorporation and indication for its use in various clinical scenarios.
BACKGROUND: Studies have shown that there is a controversy between blood supply and the fast fracture fixation. Selection of the suitable fixation method for the patients with tibia and fibula fracture is the important issue in face of every clinician. OBJECTIVE: To review various types of research literatures on tibia and fibula fracture fixation in recent years, in order to provide reference and evaluation criteria for objective and reasonable selection of tibia and fibula fracture fixation method. METHODS: A computer-based online search was performed in the PubMed database and the China National Knowledge Infrastructure database for the clinical and basic experimental research papers on the surgical fixation of tibia and fibula fracture from January 1990 to May 2012. The key words were "tibiofibular fracture, fixation method, research progress" in Chinese and English. The articles published earlier and repetitive researches were excluded. RESULTS AND CONCLUSION: Due to the special anatomy structure and physiologic function of tibia and fibula, the first step in the treatment of the fracture is to consider how to balance the blood supply and stability, and the functional exercise must be practiced as soon as possible after fixation, which will rely on a stable fixation in a large extent. Various factors for the adequate fixation of tibia and fibula fractures need to be considered, according to the fracture site, tibia and fibula fracture type, the degree of contamination and the degree of soft tissue injury. Strictly implement and understanding of the AO and biological fracture fixation improvement theory is very important. A new range of steel plate and external fixator also worth for study and the application of the external fixator combined with limited internal fixation as well as the sequential therapy require further study with large amount samples. Arthroscopy or arthroplasty for severe cases of replace difficulties or joint injury can effectively improve fracture prognosis and postoperative life. The indirect reduction technique of percutaneous plate osteosynthesis indirect reduction can reduce the poor wound healing, infection, delayed union and nonunion, and it is gradually become the best choice for comminuted fracture of the distal tibia, while with the biological osteosynthesis principle designed locking compression plate equipment to make percutaneous plate osteosynthesis a worth to be promoted fixation technique.
