Explore the vast range of titles available.

Background Acetabular fractures typically require open surgery to restore hip joint function. Openness may lead to serious tissue damage, increased bleeding, and the risk of nerve and vascular damage. Minimally invasive closed reduction or percutaneous fixation aims to minimize additional harm to patients and provide reliable fixation to promote fracture recovery and functional rehabilitation. This study aimed to assess the radiographic and clinical effectiveness of pedicle screw external fixation as a definitive treatment approach for selective acetabular fractures. Methods The present study enrolled 43 patients with acetabular fractures who were categorized into three groups based on their definitive treatment plans: pedicle screw external fixation group, traditional external fixation stent fixation group, and open reduction internal fixation group, comparing the operative duration and the time required for fracture healing. Fracture reduction was evaluated using the Tornetta and Matta grading system, and postoperative clinical outcomes were analyzed using the Majeed score. Analyze three surgical methods by comparing clinical indicators and prognostic references. Results Among the 43 patients, there were 12 cases in the pedicle screw external fixation group, 14 cases in the traditional external fixation stent fixation group, and 17 cases in the open reduction internal fixation group. There were no significant differences in age, gender, injury mechanism, Injury Severity Score (ISS), or other demographic factors among the three groups. The reduction of fractures with internal fixation was significantly better than that with external fixation( p  = 0.032). Operative duration and quality of reduction did not significantly differ between the pedicle screw external fixation group and the traditional external fixation stent fixation group. However, the pedicle screw external fixation group exhibited distinct advantages in postoperative quality of life ( p  = 0.041) and a lower incidence of loose fixing screws compared to the traditional external fixation stent fixation group. Conclusion Compared to traditional external fixation stent fixation, pedicle screw external fixation represents a superior definitive treatment option for acetabular fractures due to its stability and improved patient quality of life.

Distal radius fractures are common injuries in older adult patients. The present prospective study aimed to compare the efficacies of bridging external fixation (BEF) and combined external fixation (CEF) in preventing radial height loss in older patients with distal radius fractures. Between January 2018 and December 2022, a total of 118 patients with distal radius fractures, aged 55-70 years, were randomly subjected to either BEF or CEF. Standard radiographs were used to measure radiological parameters, including radial height, palmar tilt, radial inclination, ulnar variance, articular step-off and Lidström classification. All patients were examined for active range of motion, grip strength, supination torque, level of pain during specified activities with a numeric rating scale, modified Mayo Wrist Score, Disabilities of the Arm Shoulder and Hand score, Patient-Rated Wrist Evaluation score and patient satisfaction. The patient characteristics showed significant differences in terms of operative time (t=12.52; P<0.01), successful closed reduction (χ2=32.74; P<0.01), change to open surgery (χ2=32.74; P<0.01) and cost (t=4,585.26; P<0.01). The t-tests showed significant differences (P<0.01) in the radiological parameters of intraoperative closed reduction between the two groups. By contrast, no significant differences (P>0.05) were observed in the radiological parameters between bone healing and final follow-up within each group, and in the radiological parameters of bone healing and final follow-up between the two groups. Lidström classification showed significant differences between bone healing and final follow-up within the BEF group (χ2=5.96; P<0.05) and the CEF group (χ2=8.18; P<0.01), but no significant differences at the time of bone healing (χ2=3.57; P=0.06) and final follow-up (P=0.12) between the two groups. Furthermore, the t-tests showed no significant differences (P>0.05) in the functional and clinical outcomes between the two groups at the final follow-up. In conclusion, CEF may be as effective as BEF in preventing radial height loss in older patients with distal radius fractures. Percutaneous bony distraction may be more effective than conventional distraction manoeuvres in achieving anatomical reduction with minor morbidity. The two techniques demonstrate a similar ability for bone remodeling. Further studies on the therapeutic advantages of CEF over BEF are warranted, especially considering its lower cost compared with BEF.

The goals of this study were to evaluate the outcomes of bone healing, patient comfort during the treatment, functional results, and complications in pelvic fractures treated with external fixation, as well as to propose a classification system for the applied external frames. A total of thirty-two canine patients with pelvic fractures of different origins were treated. To provide a better reference for the frames used, an alphanumeric classification system was developed, detailing the frame structure and the number and location of the pins used. In this study, eighty-six fractures were treated in the 32 patients of this work, with an average fixation time of 9.88 ± 4.15 weeks. No major complications were detected in this case cohort, and the outcomes were rated at 9.46 based on a visual assessment scale for the patient’s comfort during treatment. Outcomes graded as excellent and good were 96%. The use of external fixation for stabilization of pelvic fractures should be considered as a technical option, especially for minimally invasive stabilization of complex fractures, either as a primary or secondary stabilization.

PurposeManagement of anterior ring injuries is still a matter of discussion, and there are only few studies reporting anterior external fixator as definitive treatment for unstable pelvic injuries. This study aimed to describe the clinical and radiological outcomes of a consecutive series of mechanically unstable pelvic injuries that were treated with definitive anterior supra-acetabular external fixator for the anterior ring, and to identify risk factors for failure.MethodsWe included a consecutive series of patients with unstable pelvic ring fractures who underwent anterior supra-acetabular external fixation for definitive treatment, between January 2012 and January 2020. All demographics, associated injuries and procedures, injury mechanism, and complications were analysed. Pelvic fracture was classified based on Orthopaedic Trauma Association/Tile AO (OTA/AO) and Young–Burgess classifications. Complications associated with the external fixator were revised. All patients were functionally evaluated at final follow-up and asked to report their clinical outcomes using the Majeed score.ResultsA total of 47 patients were included, of which 25 were females. The median age was 44 years (interquartile range 23–59). Median follow-up duration was 14 months (interquartile range 6–31). The most frequent aetiology was motor vehicle accident (35), followed by fall from height (8). All fractures required posterior pelvic ring fixation. The median time during which patients had external fixation in situ was 11 weeks (interquartile range 9–13). All patients achieved healing of pelvic fracture at median time of 10 weeks (interquartile range 8–12). At final follow-up, the median displacement of the anterior pelvis was 6 mm (interquartile range 0–11). Superficial infection was the most common complication (n = 7). No washout procedures were needed. No major complication was reported. No patient required reoperation for anterior ring fracture. The median Majeed score was 88 points (range 60–95; interquartile range 80–90) at final follow-up.ConclusionOur findings suggest that the use of supra-acetabular external fixator is safe and effective for definitive treatment of the anterior ring in unstable pelvic fractures. It is a method with high proportion of excellent results, regardless of the type of fracture. The rate of complications is low, and it does not compromise functional results.

With the development of modern society, severe and complex tibial fractures caused by high-energy injuries such as traffic accidents have gradually increased. At present, the commonly used methods for the treatment of tibial fractures include plate fixation, intramedullary nail fixation, and external fixation. Most of these fractures are open wounds with severe soft tissue injury and wound contamination, and some involve bone defects, which makes internal fixation treatment difficult. This study aims to explore the use of intelligent computer-assisted Taylor 3D external fixation for the treatment of tibiofibular fractures. In total, 70 patients were included and divided into the Taylor 3D external fixation (TSF) group (28 patients with severe tibial fractures treated with TSF) and the internal fixation group (42 patients with complicated tibiofibular fractures treated by internal fixation). After the treatment, the follow-up evaluation of TSF for the treatment of tibiofibular fractures noted the incidence of complications, as well as the efficacy and occurrence of internal fixation for the treatment of tibial fractures in our hospital. The results showed that TSF was superior to orthopedics in the treatment of tibiofibular fractures in terms of efficacy and complications. TSF for the treatment of tibiofibular fractures is more effective than internal fixation and the incidence of complications is low. This is a new technology for the treatment of tibiofibular fractures that is worthy of clinical promotion.

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

Objective This study aims to evaluate the result of a two‐stage (delayed conversion) management of nonunion after failed external fixation of the lower limb. Methods A case series of 25 patients (19 males and six females) enrolled in this study between February 2008 and October 2016, mean age 33.4 years (range, 22–65 years). Eight had femoral fractures, and 17 had tibial fractures. All were due to high‐energy trauma and were open fractures. All cases were presented by non‐union after external fixation in the lower limb long bones. All patients were managed by two stages (delayed conversion) osteosynthesis. The patients have been assessed for rate and time for union, range of motion of adjacent joints, the Modified functional outcome score of Karlstrom‐Olerud, and Trauma outcomes measure score. Results The mean follow‐up was 36.5 months (range 24–54 months). Twenty‐two cases (88%) were fully united on an average of 5.3 months. According to the Karlstrom‐Olerud scores, the final functional outcome score was excellent 12 cases, good 9 cases, accepted 2 cases, and poor in two cases. As regards the trauma outcome measure score, the mean TOM after 3 months was 26.1 (25.3–27.3), 30.4 (29.3–32.1) after 12 months, and 33.4 (32.3–40) after 24 months. Conclusions The technique of two‐stage treatment of nonunions of long bone after external fixation is a successful tool to achieve bony union. It could be a favorable option with a low risk of complications and a high level of functional outcomes. In cases of failed external fixation of the lower limb, The technique of two stage internal fixation is highly successful with 88% union rate and 84% satisfactory functional outcome.

External fixation has proven a valuable tool in the effort to correct deformities, improve healing of fractures, and improve outcomes of orthopedic surgery. This expertly constructed reference, External Fixators of the Foot and Ankle, explores the ways in which external fixators are used to reduce tissue damage, reduce strain on nerves and vasculature, and improve healing in the surgical treatment of foot and ankle deformities and injuries. Authoritative perspectives from leading orthopedic and podiatric surgeons help to build an understanding and strengthen your technique. The multidisciplinary team approach in treating complex trauma, reconstructive, or diabetic patients is emphasized throughout this textbook. Detailed coverage of the tools of external fixation describes the roles, applications, and limitations of the various rings, rods, wires, pins, and designs used in external fixation. How-to, step-by-step instruction addresses a range of fixation procedures, helping readers understand the relevant anatomy and avoid potential complications. Abundant illustrations highlight the text, providing a surgeon's eye view of a range of commonly performed procedures.

Increased fixation strength of the bone-pin interface is important for inhibiting pin loosening after external fixation. In a previous study, an apatite (Ap) layer was formed on anodically oxidized titanium (Ti) pins by immersing them in an infusion fluid-based supersaturated calcium phosphate solution at 37 °C for 48 h. In the present study, an Ap layer was also successfully formed using a one-step method at 25 °C for 48 h in an infusion fluid-based supersaturated calcium phosphate solution, which is clinically useful due to the immersion temperature. After percutaneous implantation in a proximal tibial metaphysis for four weeks in rabbits (n = 20), the Ti pin coated with the Ap layer showed significantly increased extraction torque compared with that of an uncoated Ti screw even with partial osteomyelitis present, owing to dense bone formation on the Ap layer in the cortical and medullary cavity regions. When the infection status was changed from “no osteomyelitis” to “partial osteomyelitis,” the extraction torque in the Ap group with “partial osteomyelitis” was almost identical to that for “no osteomyelitis” cases. These results suggest that the Ap layer formed by the room temperature process could effectively improve the fixation strength of the Ti pin for external fixation clinically even with partial osteomyelitis present.

The paper refers to presenting the current state of scientific research in the field of Ilizarov fixators used in orthopedic surgeries. The approach is not exhaustive, as the aim of the paper is to outline the general coordinates that can form the basis for structuring the information in the specialized literature in this field. To provide a scientific presentation of the current state of research, a logical-combinatorial technical creation method was used, the idea diagram method. In this way, the variety of technical solutions developed to date can be visualized in a single view. The method also presents the advantage that information is classified by fields and subfields, which allows the systematization and coding of information. The paper presents two concept diagrams, in which technical solutions are classified according to mechanical functionality and the anatomical area in which they are located on the patient’s limbs. Given the open and critical nature of the method, the paper concludes by defining future avenues for development in the field.