ABSTRACT
Objective To introduce a new computer-assisted external frame for osteotomy to correct complex tibial and fibular deformity.Methods From January 2012 to December 2013,15 patients with complex tibial and fibular deformity were treated with a computer-assisted external frame and related computer software for surgical correction.All were unilateral limb deformity,involving the left lower limb in 8 cases and the right lower limb in 7 cases.They were 8 males and 7 females,15 to 43 years of age (average,26.8 years).The deformity was caused by old osteomyelitis in 9 cases and trauma sequela in 6.The related angles,distances and rotations were measured on the postoperative radiographs of the lower limbs.The data were input into the software to calculate the daily adjustment lengths of the frame rods.Daily frame adjustments were conducted according to the data calculated.The frame was removed when expected results were achieved.The patients lived independently during the adjustment.Results The 15 patients were effectively followed up for 10 to 22 months (average,15 months).Frame fixation time averaged 8.4 months (from 5.5 to 13.1 months).The reunion time averaged 8.0 months (from 5.4 to 12.1 months).The hospitalization time averaged 2.4 months (from 2.0 to 2.8 months).In 10 cases of limb shortening,the shortening lengths averaged 0.5 cm (from 0 to 0.9 cm) after adjustment.In 12 cases of angulation deformity,the angulation averaged 3.3° (from 0° to 5.4°) after adjustment.In 5 cases of rotation deformity,the maximum internal rotation was 5° and the maximum external rotation 10° after correction,deviating from the normal values by 3.5° on average.In 6 cases of horizontal displacement,the displacements averaged 0.5 crn after correction.All patients were satisfactory with corrected lower limb alignment,improved symptoms and appearance,giving a subjective satisfaction rate of 100％.Conclusion Use of computer-assisted external frame in surgical correction of tibial and fibular deformity can achieve satisfactory outcomes in simple,accurate,standardized,minimally invasive manners.
ABSTRACT
Objective To research on treament of femoral head of patients with osteoneerosis of the femoral head fracture.Methods Twenty-six patients half of femaoral head of patients with osteonecrosis of the femoral head fracture who treated with vascularzed bone graft were determined.Twenty-one hips treated with internal fixation unloaded and vascularzed bone graft after selective digital subtraction angiography (DSA) was performed to confirm the blood supply of femoral head.one case underwent total hip replacement after internal fixation unloaded.Results All patients were followed up for a mean of 23 months (range,12-38months)and were assessed clinically and radiologically according to Harris scoring.Selective digital subtraction angiography (DSA) was performed in 15 cases to confirm the blood reconstruction of femoral head.Two cases underwent total hip replacement postoperatively.Preoperative and postoperative Harris score were 54 and 86.2,clinical success rate was 92.0% and radiological success rate was 84.0%.DSA demonstrated blood supply was found reconstruction in the necrotic femoral head.Conclusion Femoral head of patients with osteonecrosis of the femoral head fracture was very much (recent 40%).Taking out of internal fixation,treatment of osteonecrosis of the femoral head by using vascularzed bone graft was confirmed,early clinical results were satisfied.