Bifocal Techniques for Non-Union and Deformity
Patients with limb shortening and diaphyseal bone loss or deformity (angulation and/or non-union) secondary to trauma have caused a considerable challenge to orthopaedic surgeons. Deformity correction alone using modern techniques such as nailing and external fixation may leave residual shortening, resulting in concomitant disability. Segmental skeletal defects due to trauma or resection of bone for infection have conventionally been treated with massive autogenous cancellous bone grafts (Christian et al 1989), or vascularized bone grafts (Weiland et al 1983a, 1983b). In the case of infection, sequestration of the graft is a problem. In such situations resection of the bone, granulation of the bed and Papineau type open grafting (Papineau et al 1979) have been used. These methods may not be capable of allowing realignment or restoration of limb length and may be associated with significant donor site morbidity.
KeywordsRadionuclide Etion Crest Osteomyelitis Technetium
Unable to display preview. Download preview PDF.
- Catagni M. Personal communication 1992.Google Scholar
- Christian E.P., Bosse M.J., Robb G. ‘Reconstruction of large diaphyseal defects, without free fibular transfer, in grade HIB tibial fractures’. J Bone Joint Surg[Am] 1989; 71A: 994–1004. Google Scholar
- Dagher F., Roukoz S. ‘Compound tibial fractures with bone loss treated by the Ilizarov technique’. J Bone Joint Surg[Br] 1991; 73B: 316–21. Google Scholar
- Kreibich N., Scott L, Wells J., Saleh M. ‘Donor site morbidity after conventional and percutaneous bone graft harvesting’. Accepted J Bone Joint Surg [Br] 1994; 76B: 847–8. Google Scholar
- Morandi M., Zembo M.M., Ciotti M. ‘Infected tibial pseudarthosis -a 2-year follow-up on patients treated by the Ilizarov Technique’.Orthopaedics 1989; 12: 497–508.Google Scholar
- Ribbans W.J., Stubbs D.A., Saleh M. ‘Non-union Surgery Part II.The Sheffield Experience - 100 consecutive cases, results and lessons’. Int J Orthop Trauma 1992; 2: 19–24.Google Scholar
- Saleh M., Harriman P., Edwards D.J. ‘A radiological method for producing precise limb alignment’. J Bone Joint Surg [Br] 1991;73B: 515–6.Google Scholar
- Saleh M. ‘Non-union Surgery Part I. Basic Principles of Management’ Int J Orthop Trauma 1992a; 2: 4–18.Google Scholar
- Saleh M. ‘Technique selection in limb lengthening: The Sheffield Practice’. Seminars in Orthop 1992b; 7: 137–51.Google Scholar
- Saleh M., Scott B.W. ‘Pitfalls and Complications of Leg Lengthening: The Sheffield Experience’. Seminars in Orthop 1992; 7:207–222.Google Scholar
- Saleh M. ‘Bone Grafting Harvesting: a percutaneous technique’. J Bone Joint Surg [Br] 1991; 73B: 867–8.Google Scholar
- Sveshnikov A.A., Barabash A.P., Chepelenko T.A., Smotrova L.A., Larionov A.A. ‘Radionuclide studies of osteogenisis and circulation in substitution of large defects of the leg bones’ in Experiment Ortop Travmatol Protex 1984; 11: 33–7.Google Scholar