Fatigue behavior of Ilizarov frame versus tibial interlocking nail in a comminuted tibial fracture model: a biomechanical study

Hasenboehler, Erik A.; Smith, Wade R.; Laudicina, Laurence; Philips, Giby C.; Stahel, Philip F.; Morgan, Steven J.

doi:10.1186/1749-799x-1-16

Cited by 26 publications

(5 citation statements)

References 25 publications

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“…The intramedullary nail is a load-sharing device that allows early ambulation. It provides higher stability for axial compression and torsion than external fixation-illizarov or a circular frame according to a biomechanical study on the comminuted tibia shaft fracture model by Hasenboehler ( 35 ); it provides higher stability for axial compression and torsion. Due to the unsatisfactory bone quality of Charcot neuropathy, rigid fixation is mandatory to achieve union post-reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review

et al. 2022

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BackgroundCharcot neuroarthropathy of the ankle and the hindfoot is a complex clinical entity with a high risk of amputation. Charcot neuroarthropathy limb reconstruction has been proposed as a limb-salvaging procedure. However, there was a lack of information on the various available reconstruction methods, including the outcomes and complications. The present study aimed to evaluate the current literature and update on the trends regarding the surgical management of Charcot neuroarthropathy of the ankle and the hindfoot.MethodsAll data published from January 2010 to January 2020 that investigated the methods of fixation and their respective outcomes for the surgical reconstruction in Charcot neuroarthropathy were analyzed. The union rate, amputation rates, and complications associated with these techniques were taken for statistical analysis.ResultsA total of 16 studies fit the inclusion criteria of this study, with four Level-III studies and 12 Level-IV studies were included. Ten studies utilized internal fixation only; five used a combination of internal fixation and circular external fixator, whereby there are three comparative studies between internal and external fixations, and two studies applied combined technique of internal and external fixations (hybrid fixation). One study describes the usage of circular external fixation only.ConclusionsThe use of retrograde intramedullary nail as a treatment of choice in the reconstruction of Charcot neuroarthropathy ankle is recommended before an ulcer occurrence. Hydroxyapatite (HA)- coated screws are recommended for the locking mechanism to prevent migration in Charcot neuroarthropathy due to poor bony quality. Hybrid fixation is recommended for reconstruction in a condition of ulceration and more complex deformity as it provides a higher rate of limb salvage with less soft tissue irritation.

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Section: Discussionmentioning

confidence: 99%

Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review

et al. 2022

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“…The overall incidence of adult patients who experience nonunion tibial shaft fractures varies between 2% and 10% 14 and that in severe comminuted fractures is reported as high as 25%. 28 Accordingly, a considerable number of patients with tibial shaft fractures treated with IMN will not heal their fractures one year postoperatively. 13 Therapeutics and Clinical Risk Management 2022:18 https://doi.org/10.2147/TCRM.S379135…”

Section: Discussionmentioning

confidence: 99%

Use of a Minimally Invasive Traction Repositor versus Conventional Manual Traction for the Treatment of Tibial Fractures: A Comparative Study from a Tertiary Hospital in China

Zha¹,

Zhang²,

Wang³

et al. 2022

TCRM

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Background Closed reduction and intramedullary nail fixation of tibial fractures may not utilize a fracture table or reduction aids like a femoral distractor, and only manual traction will help aid the reduction process. This study aimed to describe and further investigate the effectiveness of an originally designed minimally invasive traction repositor (MITR) for the treatment of tibial fractures. Methods From January 2018 to April 2021, a total of 119 eligible patients with tibial shaft fractures were included and retrospectively assigned to two groups according to different reduction methods: MITR group vs conventional manual traction (CMT) group. The baseline characteristics between the two groups were comparable, including age, gender, BMI, residence, smoking history, drinking history, injury mechanism, fracture type, ASA, method of anesthesia, and surgical delay (all P > 0.05). The operation time, fracture reduction duration, intraoperative blood loss, fluoroscopy time, number of intraoperative fluoroscopies, VAS, HSS, fracture healing time, and complications were compared. Results All patients completed the follow-ups with an average of 18.5 months (range 12–42 months). The operation time, fracture reduction duration, intraoperative blood loss, fluoroscopy time, and number of fluoroscopies were significantly decreased in the MITR group (all P < 0.05). At one month postoperatively, the VAS score was statistically lower in the MITR group (1.8±0.8) than in the CMT group (2.6±1.5). At 6 months postoperatively, the HHS score was statistically higher in the MITR group (90.8±2.3) than in the CMT group (86.4±3.8). We observed no statistical difference in the mean fracture healing time, bone nonunion, implant failure, and infection between the two groups (all P > 0.05). Conclusion Compared with CMT, MITR facilitates the minimally invasive treatment of tibial fractures and has the advantages of operation time, fracture reduction duration, intraoperative blood loss, fluoroscopy time, number of fluoroscopies, and satisfactory VAS and HSS scores.

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“…Intramedullary nail (IMN), internal fixation or external fixation can be employed in isolation or combination. Biomechanical advantages of IMN include load sharing to allow earlier mobilisation and better stability and load distribution in axial compression and torsion than external fixation[ 119 ]. This in turn can aid fusion[ 119 , 120 ].…”

Section: Charcot Managementmentioning

confidence: 99%

Surgical management of the diabetic foot: The current evidence

Roberts,

Davies-Jones,

Brock

et al. 2024

World J Orthop

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The prevalence of diabetes mellitus and its associated complications, particularly diabetic foot pathologies, poses significant healthcare challenges and economic burdens globally. This review synthesises current evidence on the surgical management of the diabetic foot, focusing on the interplay between neuropathy, ischemia, and infection that commonly culminates in ulcers, infections, and, in severe cases, amputations. The escalating incidence of diabetes mellitus underscores the urgency for effective management strategies, as diabetic foot complications are a leading cause of hospital admissions among diabetic patients, significantly impacting morbidity and mortality rates. This review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers, infections, and skeletal pathologies such as Charcot arthropathy, emphasising the critical role of early diagnosis, comprehensive management strategies, and interdisciplinary care in mitigating adverse outcomes. In addressing surgical interventions, this review evaluates conservative surgeries, amputations, and reconstructive procedures, highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot pathologies. The integration of advanced diagnostic tools, novel surgical techniques, and postoperative care, including offloading and infection control, are discussed in the context of optimising healing and preserving limb function.

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Fatigue behavior of Ilizarov frame versus tibial interlocking nail in a comminuted tibial fracture model: a biomechanical study

Cited by 26 publications

References 25 publications

Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review

Charcot Neuroarthropathy: Current Surgical Management and Update. A Systematic Review

Use of a Minimally Invasive Traction Repositor versus Conventional Manual Traction for the Treatment of Tibial Fractures: A Comparative Study from a Tertiary Hospital in China

Surgical management of the diabetic foot: The current evidence

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