Due to contemporary advances in surgical thoughts and implant know-how it truly is now attainable to accomplish limb reconstruction in sufferers with various congenital, posttraumatic, and postinfection pathologies. This booklet is a transparent, sensible advisor to the cutting-edge surgeries hired in limb reconstruction for various stipulations. It contains distinctive descriptions of the thoughts themselves, followed through a number of beneficial drawings and images. Pearls and pitfalls are highlighted, and thorough suggestion is additionally supplied on symptoms, preoperative making plans, and postoperative follow-up. The editors have conscientiously chosen the participants in response to their services, and plenty of of the authors have been themselves liable for constructing the strategies that they describe.
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Additional info for Advanced Techniques in Limb Reconstruction Surgery
In order to minimize the risk of infection after inserting the locking screws, a meticulous prep and drape procedure is recommended: wash the leg and fixator with antimicrobial soap, then rinse with saline or alcohol. Next, prep the skin and the fixator with an alcohol-based iodine or chlorhexidine solution, painting the pin sites last. Apply sterile drapes, and then take Betadine- or chlorhexidinemoistened sponges and wrap each pin site in them to isolate the contaminated pinskin interface. Apply sterile towels to those parts of the external fixator that can be covered, minimizing the exposure to less than fully sterile components.
Orthop Clin North Am 25:425–465 Paley D, Herzenberg JE, Bor N (1997a) Fixator-assisted nailing of femoral and tibial deformities. Tech Orthop 12:260–275 Paley D, Herzenberg JE, Paremain G et al (1997b) Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg Am 79:1464–1480 Sharma L, Song J, Felson DT et al (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286:188–195 47 Slawski DP, Schoenecker PL, Rich MM (1994) Peroneal nerve injury as a complication of pediatric tibial osteotomies: a review of 255 osteotomies.
Ideally, preoperative planning included an estimation of where the locking holes in the distal end of the nail would be at the end of lengthening relative to the middle ring. In the operating room, position the patient supine with a bump under the ipsilateral hemisacrum, and bring the image intensifier to the true lateral position, to confirm that you can see “perfect circles” for the distal interlocking sights. If necessary, one or two threaded rods of the external fixator 31 can be removed to provide better visualization and surgical access.
Advanced Techniques in Limb Reconstruction Surgery