Staged Reconstruction of Complex Open Tibial Fractures Using Hoffmann External Fixation

Distraction osteogenesis in management of composite bone and soft tissue defects

“…Besides osseous reconstruction, major plastic surgery in the form of local or distant myocutaneous flaps may be required to reconstruct the soft tissue defects. Unfortunately these flaps remove motor units from their normal position and may produce donor site morbidities [1,3,4]. Yazar et al [7] reported on 62 cases with post-traumatic composite bone and soft tissue defects that were treated by one stage vascularised osteocutaneous flaps.…”

“…Restoration of a healthy soft tissue envelope is a very important step for the proper management of bone defect. This can be achieved by split thickness skin graft, local myocutaneous flap, or distant myocutaneous flaps [1].…”

Effect of physical activity on muscle and bone blood flow after fracture: Exercise andtenotomy studied in rats

“…In experimental fractures, the musculature constitutes the basis for vessel sprouting into the fracture exudate, and treatment of severe fractures demonstrates the importance of soft-tissue coverage (Gothman et al 1961, Edwards et al 1983. Nather et al (1990) showed that in nonvascularized diaphyseal transplants, the bones isolated from their vascular muscle bed were impaired in terms of fracture healing.…”

A new device for external fixation

“…In complex injuries, therefore, a more complex Hoffmann frame is necessary (Huiskes and Chao 1986). Vidal et al (1983) and Edwards (1983) recommended a complementary anteroposterior anchorage with half pins to compensate for low anteroposterior rigidity. A similar, but modified frame was advocated by Knutsson et al (1984).…”

“…Only a few systems allow for pin insertion in a plane parallel to the joint surface in juxtaarticular fractures without additional components (Edwards 1983, De Bastiani et al 1984. The ideal pin clamp should be attached to a simple universal ball joint that permits pin insertion from 0 to 360'in any plane and in any such position allows for angulation of pins in any direction.…”