Previous designs of internal bone lengthening devices have been fraught with imprecise distraction, resulting in nerve injuries, joint contractures, nonunions, and other complications. Recently, a magnet-operated PRECICE nail (Ellipse Technologies, Inc, Irvine, CA, USA) was approved by the FDA; however, its clinical efficacy is unknown.We evaluated this terms (1) accuracy precision (2) effects on alignment, (3) adjacent-joint ROM, (4) frequency implant-related non-implant-related...

Distraction osteogenesis is an effective method for lengthening, deformity correction, and treatment of nonunions bone defects. The classic uses external fixator both distraction consolidation leading to lengthy times in frames there a risk refracture after frame removal. We suggest new technique: lengthening then nailing (LATN) technique which the used gradual reamed intramedullary nail inserted support during phase, allowing early removal fixator. performed retrospective case-matched...

External fixation has evolved from being used primarily as a last resort method to becoming main stream technique treat myriad of bone and soft tissue pathologies. Techniques in limb reconstruction continue advance largely result the use these external devices. A thorough understanding biomechanical principles is useful for all orthopedic surgeons most will have occasionally mount fixator throughout their career. In this review, various types fixators common clinical applications are...

Objective: To investigate the outcomes of tibial nonunions and bone defects treated with Taylor Spatial Frame (TSF) using Ilizarov method. Design: Retrospective. Setting: Limb Lengthening Deformity Service at an academic medical center. Patients: Thirty-eight consecutive patients 38 were TSF. There 23 (average 5.9 cm) 22 leg-length discrepancy (LLD) 3.1 resulting in average longitudinal deficiency (sum defect LLD) 6.5 cm 31 (1-16). The number previous surgeries was 4 (0-20). At time surgery,...

Ankle arthrodesis may be achieved using the Ilizarov method. Comorbidities, such as diabetes, Charcot neuroarthropathy, osteomyelitis, leg length discrepancy, and smoking, can make an ankle fusion complex associated with lower rates of healing.We asked if (1) smoking other comorbidities led to rates, (2) time wearing frame affected outcome, (3) simultaneous tibial lengthening improved rates.We retrospectively studied 101 patients who underwent technique. The median was 25 weeks (range, 10-65...

A three-dimensional (3D) knee joint computational model was developed and validated to predict contact forces pressures for different degrees of malalignment. 3D created from high-resolution radiological images emulate passive sagittal rotation (full-extension 65°-flexion) weight acceptance. cadaveric mounted on a six-degree-of-freedom robot subjected matching boundary loading conditions. ligament-tuning process minimised kinematic differences between the robotically loaded cadaver specimen...

Optimal leg alignment is the goal of tibial osteotomy. The Taylor Spatial Frame (TSF) and Ilizarov method enable gradual realignment angulation translation in coronal, sagittal, axial planes, therefore, term six-axis correction.We asked whether this approach would allow precise correction deformities.We retrospectively reviewed 102 patients (122 tibiae) with deformities treated percutaneous osteotomy TSF. proximal group was subdivided into two subgroups to distinguish those an intentional...

Rozbruch, S. Robert MD; Fragomen, Austin T. Ilizarov, Svetlana MD Author Information

In recent years ankle distraction arthroplasty has gained popularity in the treatment of arthritis as a means both maintaining range motion and avoiding fusion. We present retrospective review 25 patients who have undergone from 1999 to 2006.The mean age was 43 years; 16 were male, 7 female. Followup 30 months after frame removal (range, 12 60 months). able obtain followup on 23 patients. Adjuvant procedures performed some cases including Achilles tendon lengthening (5), arthroscopy (4),...

Classic bone lengthening requires patients wear external fixation for the distraction and consolidation phases there is fracture risk after frame removal. Our technique of with Taylor Spatial Frame(TM) then insertion a locked plate allows earlier removal fixator during consolidation. Plate accomplished through clean pin-free zone avoiding contamination before maintaining position.We asked (1) whether plating (LAP) decrease time (2) how alignment complications compare those classic method.We...

Lengthening over a nail and internal lengthening nails have been developed to minimize or eliminate patients' time wearing frame during femur lengthening. However it is unclear whether either of these two approaches results in faster times union fewer complications the other.We asked which technique better achieved: (1) goals, (2) distraction rate control, (3) quality regenerate bone, (4) complications, (5) if SF-36 scores American Academy Orthopaedic Surgeons Lower Limb Module (AAOS LLM)...

Objectives: To evaluate the efficacy of 3 commercially available systems: Harvest SmartPReP 2 BMAC, Biomet BioCUE, and Arteriocyte Magellan systems. We compared number concentration progenitor cells achieved both before after centrifugation percentage salvaged centrifugation. Methods: Forty patients, mean age 47 ± 18 years (range: 18–92 years, 19 male/21 female) were prospectively consented for bilateral iliac crest aspiration. The first 20 aspirations systems, based on those results, second...

Patients with limb-length discrepancies often have concomitant deformity. We describe the outcomes of acute, fixator-assisted deformity correction gradual lengthening using retrograde femoral Precice nail (NuVasive).We analyzed a retrospective series 27 patients in whom an external fixator was combined to correct angular or rotational and discrepancy. The applied temporarily restore normal alignment. inserted locked place hold correction, restoration limb length.The (mean age, 28 years) had...

Limb salvage in the presence of posttraumatic tibial bone loss can be accomplished using traditional Ilizarov method distraction osteogenesis with circular external fixation. Internal fixation placed at beginning consolidation phase, so-called integrated fixation, may allow for earlier removal fixator but introduces concerns about cross-contamination from additional open procedure and maintenance regenerate stability. Among patients deemed eligible we sought to determine: (1) Does decrease...

Internal lengthening nail (ILN) is a recent development in limb and deformity correction specialty.The ILN has the distinct advantage of combining acute with gradual bone.While using ILN, short metaphyseal bone fragment may develop at time osteotomy insertion or during because wide medullary canal.These deformities are typically predictable, blocking screws (Poller screws) helpful these situations.This manuscript describes common that occur femur tibia osteotomies different locations while...

"On September 30, 1996, President Clinton signed the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (1996 Act), Pub. L. No. 104-208, 110 Stat. 3009. After an intense lobbying effort by business community, most provisions relating to legal immigration were omitted from final bill. Instead, focuses on illegal reform includes some toughest measures ever taken against immigration." Aspects considered include border enforcement, penalities alien smuggling document fraud,...

Supramalleolar osteotomy using circular external fixation with six-axis deformity correction is a rarely reported treatment method particularly well-suited for complex multidimensional deformities of the adult ankle. The purpose this study was to assess accuracy and change in functional status technique.We present retrospective review 52 patients who underwent supramalleolar application Taylor Spatial Frame (Smith & Nephew, Memphis, TN). Mean age 44 (range, 18 79) years. primary outcome...

Distal femoral osteotomies (DFO) can be used to correct deformities around the knee. Although fixed with either internal or external fixation techniques, advantages of one over other are unclear.We asked whether (1) for both we could accurately based on our preoperative goals mechanical axis deviation (MAD) and lateral distal angle (LDFA), (2) intraoperative times, (3) postoperative knee ROM, (4) complications differed.We identified 26 patients (34 limbs) who underwent osteotomies. We...

Humeral lengthening by distraction osteogenesis historically has relied on bulky circular external fixators. Advances in fixator technology have allowed for the use of monolateral frames. However, it is unclear whether and to what degree function improved after humeral lengthening.We asked: (1) Does performed with fixators improve function? (2) fixation produce comparable restoration length complication rate when compared historical results, using lengthening?We retrospectively reviewed 11...

Although its FDA-approved applications are limited, the pro-osteogenic benefits of recombinant human BMP-2 (rhBMP-2) administration have been shown in off-label surgical applications. However, effects rhBMP-2 on ankle fusions insufficiently addressed literature, which fails to include a case-control study adequate sample size evaluate efficacy treatment.In this we asked whether treatment (1) would increase rate successful fusion complex patients (patients with comorbidities associated poor...