Because of contemporary advances in surgical innovations and implant expertise it's now attainable to accomplish limb reconstruction in sufferers with a variety of congenital, posttraumatic, and postinfection pathologies. This booklet is a transparent, functional advisor to the state of the art surgeries hired in limb reconstruction for various stipulations. It contains exact descriptions of the options themselves, followed via a number of useful drawings and pictures. Pearls and pitfalls are highlighted, and thorough recommendation is usually supplied on symptoms, preoperative making plans, and postoperative follow-up. The editors have rigorously chosen the participants according to their services, and lots of of the authors have been themselves answerable for constructing the recommendations that they describe.
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Additional info for Advanced Techniques in Limb Reconstruction Surgery
2005 84º 10º LPFA:120 37º MAD 55 mm 81º MLDFA:110 MPTA:91 Fig. 3 Deformity analysis is performed on the x-ray of the right femur. 5 Preoperative Planning • Deformity analysis should be performed according to the deformity planning guidelines given by Paley et al. (CORA planning method using joint orientation lines) (Paley and Tetsworth 1992; Paley et al. 1994) (Fig. 3). • Determination of the level(s) of the osteotomy(ies) should be conducted. • If the deformity is at the distal femoral metaphysis, retrograde IM nail insertion should be performed through the intercondylar notch.
The external fixator is removed and the incisions are closed primarily. 7 Fig. 20 Schematic drawing of the multiple drill hole osteotomy technique of translation. The angular correction is maintained through the application of a unilateral fixator. Intraoperative x-rays of the two planes are required to verify if the desired correction has been achieved. Adjustment of the fixator and repeat x-rays are performed as needed to fine-tune the correction. Antegrade reaming over a guide wire is performed conventionally through a mini incision.
If the fibula was transfixed distally by a screw, leave that screw in place until the fibular osteotomy has fully healed. If the fibula was transfixed by an external fixator wire only, then a “permanent” internal tibialfibular syndesmosis screw should be inserted before removing the distal fibular wire. 2. Pearls • If regenerate bone formation is noted to be poor at the time of distal nail locking and fixator removal, consider concentrated bone marrow injection to the regenerate. • After fixator removal, allow partial weight bearing.