ABSTRACT
BACKGROUND@#Joint stiffness is a frequent concern in trauma or surgery of the elbow joint. Early resumption of elbow joint motion is said to limit the complication of stiffness. The Hinged Elbow Ilizarov Fixator has been reported to be useful in the management of elbow dislocations. However, early range of motion is not consistent in these cases since elbow movement were done only through patient-initiated exercises. The use of a continuous passive motion (CPM) device can potentially resolve this issue. However, presently available continuous passive motion devices for the elbow are not compatible with the Hinged Elbow Ilizarov Fixator.@*OBJECTIVE@#The objective of the study is to determine the feasibility of using a specially designed continuous passive motion device on a Hinged Elbow Ilizarov Fixator as applied in a cadaver simulation model.@*METHODS@#A Hinged Elbow Ilizarov Fixator was fixed in the elbow of a Thiel-preserved cadaver. The specially designed continuous passive motion device was applied.@*RESULTS@#Test run showed sufficient continuous flexion-extension motion not accompanied by dislocation, subluxation, or disruption of the elbow joint. A point of stress in the current prototype was noted at the motor-screw interface. Limitations in programming and control were also noted.@*CONCLUSION@#A continuous passive machine adopted to the Hinged Ilizarov Fixator is a viable device. Further improvement in the design of the motor-screw interface needs to be made. Further improvement in programming and control are needed. Likewise, study on the safety and service life of the CPM device needs to be done.
ABSTRACT
We evaluated the results following the use of hinged Ilizarov and free tissue transfer to correct the eqinus deformity of the foot associated with extensive scarring of the leg and ankle in nine patients. The deformity was secondary to ischemic and neuropathic changes after trauma to the leg, ankle and foot. The average age of the patients was seventeen years (range, thirteen to thirty-four years). The average duration of follow-up was twenty-one months (range, twelve to thirty-eight months). Free tissue transfer was done in all cases, parascapular flap was done in seyen cases, groin flap was done in two cases. Among the nine cases, free tissue transfer and hinged Ilizaov were done at the same time in four cases, The average interval of the other five patients between free tissue transfer and hinged Ilizaov was three months (range, two to four months). The duration of distraction was four to six weeks, and the apparatus was kept in place for an additional two months after the desired position of correction had been achieved. The results were evaluated using two criteria, dorsiflexion and range of motion of ankle joint. Criteria on dorsiflexion of ankle, the results were good in seven cases, fair in two cases. Criteria on range of motion of ankle, one case being performed ankle fusion was not evaluated. Total eight cases were evaluated for range of motion of ankle. The results were good in six cases, fair in two cases. On the basis of our results, we believe that severe eqinus deformities of the foot associated with extensive scarring of the leg and ankle can be corrected with heel cord lengthening, free tissue transfer and hinged Ilizarov.