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[Reconstruction of dia- and metaphyseal post-traumatic cortical bone defects].

Forty-one of 55 defect pseudarthroses, most of them with infections, were cured to healing in five years. Autogenic spongiosa proved to be best suitable for soft-tissue repair in cases of non-segmental defects, whereas structured corticalis worked better as a transplant for somewhat stretched and longish segmental defects. Compact osteomyocutaneous free tissue transfer was found to be accompanied by high rates of complications. The tactics of small steps seems to be more promising than anything else for both spongiosa transplantation and corticalis transfer. Fibula-pro-tibia transposition, comparable to the short-distance flap technique, as well as distractive corticotomy should be applied more often, especially to younger patients.

Bone Transplantation↗

Modifications of the distal metaphyseal osteotomy to better facilitate use of the Herbert bone screw for fixation.

The Herbert bone screw was initially developed for management of fractures of the carpal scaphoid. Due to its unique features, the applications of this rigid internal fixation device have been expanded. The most common use of the Herbert screw in podiatric surgery has been for fixation of the Austin osteotomy of the first metatarsal head, for correction of hallux abducto valgus. Technical difficulties encountered in this procedure may have discouraged its use or led to discontinuance. These problems are addressed, and modifications in technique are suggested. The most important modification involves a change in the angle and orientation of the osteotomy.

Bone Screws↗