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At least 1,603 records · Page 89Linked to original sources
PubMed2002

Augmentative Ilizarov external fixation after failure of diaphyseal union with intramedullary nailing.

OBJECTIVE: To investigate the use of the Ilizarov circular fixator and nail retention in treating diaphyseal nonunion following previous intramedullary nailing. DESIGN: Retrospectively reviewed, consecutive series. Mean duration of follow-up after achieving bone union: 19.2 months (range 6 to 33 months). SETTING: A tertiary referral center for nonunion surgery. PATIENTS: Nine patients (two femoral, three tibial, and four humeral nonunions) were included in the study. All patients were referred from other centers after failure to achieve union with intramedullary nailing. Patients who had nonunion with other fixation devices in situ, those with active infection and nonunion following nonoperative treatment, were excluded from the study. The patients had undergone an average of 2.4 operations (range 1 to 5 operations) before application of the Ilizarov fixator. All patients completed the study. INTERVENTION: The circular fixator was used to compress the nonunion site from without, retaining the intramedullary nail in each case. We excluded a patient who had his nonunion site explored followed by bone excision and transport. The mean duration of fixator treatment was 6.2 months (3 to 11 months). MAIN OUTCOME MEASUREMENTS: Clinical and x-ray evidence of bone union, infection, residual deformity, shortening, and assessment of functional outcome. RESULTS: Bone union was achieved in all nine patients using the circular fixator over the nail. The bone results were graded as six excellent, one good, and two fair. All patients reported a reduction in pain and satisfaction with their final outcome. CONCLUSIONS: There is a role for the use of the Ilizarov fixator with nail retention in resistant long bone diaphyseal nonunion in carefully selected patients. This method can achieve high union rates where other treatment methods have failed.

Adult↗
PubMed1983

Compression arthrodesis of the knee and ankle with the Hoffmann external fixator.

We performed 12 arthrodeses of the knee and eight of the ankle, using the Hoffmann device as a compressor-fixator. For the knees, the double rectangular frame was used with the added fixation of a cylinder cast in six cases. In four cases a separate half frame was used in the anterior plane. Posttraumatic arthritis was the indication in seven cases, and failed arthroplasties in five cases (three of them infected). For the ankles, a double triangular compression frame was used, with transfixing pins across the talus (after trauma) or the calcaneus (after ankle replacement). The ankle arthrodeses were done for posttraumatic arthritis in five cases (ankle fracture in one case, pylon fracture in three cases, fracture of the talus in one case), and failed ankle arthroplasty in three cases. Solid union occurred in all but one of the knee arthrodeses and in all but two of the ankle arthrodeses. Two infected total ankle replacements eventually terminated in amputation.

Ankle Injuries↗
PubMed1985

Technique for achievement and maintenance of reduction for severe spondylolisthesis using spinous process traction wiring and external fixation of the pelvis.

A technique is described for achievement and maintenance of reduction for severe spondylolisthesis in conjunction with reconstructive surgery. Spinous-process traction wires exert a posterior and cephalad force on the lumbar spine, while Hoffman pins anchored to the ilium rotate the sacrum in an anterior and caudad direction. Once maximum reduction is achieved, the patient is kept supine for 3 months with pins and traction wires incorporated in a plaster cast. At follow-up, two patients demonstrated excellent correction of slip angle and a solid fusion.

Adult↗