Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: 2014 Annual Meeting of the Limb Lengthening and Reconstruction Society 5 articles


Fixator-assisted Technique Enables Less Invasive Plate Osteosynthesis in Medial Opening-wedge High Tibial Osteotomy: A Novel Technique

Dong Hoon Lee MD, PhD, Keun Jung Ryu MD, Hae Hwa Kim MD, PhD, Sahyun Soung MD, Soowan Shin BS

Opening-wedge high tibial osteotomy is a well-established procedure in the management of medial osteoarthritis of the knee and correction of proximal tibia vara. Recently, surgical approaches using less invasive plate osteosynthesis have been used with the goal of minimizing complications from more extensive soft tissue exposures. However, to our knowledge, less invasive fixator-assisted plate osteosynthesis has not been tested in the setting of opening-wedge high tibial osteotomy.

Does Integrated Fixation Provide Benefit in the Reconstruction of Posttraumatic Tibial Bone Defects?

Mitchell Bernstein MD, Austin T. Fragomen MD, Samir Sabharwal BA, Jonathan Barclay BA, S. Robert Rozbruch MD

Limb salvage in the presence of posttraumatic tibial bone loss can be accomplished using the traditional Ilizarov method of distraction osteogenesis with circular external fixation. Internal fixation placed at the beginning of the consolidation phase, so-called integrated fixation, may allow for earlier removal of the external fixator but introduces concerns about cross-contamination from the additional open procedure and maintenance of bone regenerate stability.

Clinical Implications of Psychosocial Factors on Pediatric External Fixation Treatment and Recommendations

Heather M. Richard PsyD, Dylan C. Nguyen MA, John G. Birch MD, FRCS(C), Sandy D. Roland PhD, Mikhail K. Samchukov MD, Alex M. Cherkashin MD

Pediatric limb reconstruction using circular external fixation is a prolonged treatment that interrupts patients’ daily function. Patient personality characteristics and expectations may interfere with planned treatment, making complicated medical procedures more challenging. The aims of this study are to identify factors impacting treatment outcome and recommendations for preoperative evaluation and planning.

What is the Utility Of a Limb Lengthening and Reconstruction Service in an Academic Department of Orthopaedic Surgery?

S. Robert Rozbruch MD, Elizabeth S. Rozbruch, Samuel Zonshayn BS, Eugene W. Borst BS, Austin T. Fragomen MD

Limb lengthening and reconstruction surgery is a relatively new subspecialty of orthopaedic surgery in the United States. Despite increased awareness and practice of the specialty, it is rarely vested as a separate clinical service in an academic department of orthopaedic surgery. We have had experience growing such a dedicated service within an academic department of orthopaedic surgery over the past 9 years.