Bones of Lower Extremity ; injuries ; Fracture Fixation ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans

OBJECTIVE: To compare the effect of traditional fibula flap combined with allogeneic bone transplantation and composite bone flap transplantation combined with bone lengthening in staged repair of severe soft tissue and bone defect caused by lower limb burn. METHODS: Total 68 patients with severe soft tissue and bone defect caused by lower limb burn from March 2015 to January 2018 were retrospectively analyzed, and they were divided into control group (34 cases) and study group (34 cases) according to the treatment plan. All patients had different degrees of soft tissue and bone tissue defects. In the study group, 34 patients were treated with composite bone flap transplantation combined with bone lengthening. There were 22 males and 12 females; the age ranged from 32 to 46(39.18±6.01) years; the time from injury to treatment was (16.69±5.11) h;28 cases were caused by explosion injury and 6 cases were caused by firearm burn; the length of bone defect was (12.10± 2.34) cm;and 16 cases were on the left side of affected limb 18 cases were on the right side. In the control group, there were 24 males and 10 females, aged 31 to 47 (38.93 ± 5.81) years;the time from injury to treatment was(17.10±5.63) h;the causes of injury were explosive injury in 30 cases and firearm burn in 4 cases; the length of bone defect was (11.96±2.51) cm;19 cases were on the left side and 15 cases on the right side. All patients were followed up for 6 months. The FMA scores before operation and 3 and 6 months after operation, treatment satisfaction, curative effect and complications of the two groups were recorded. RESULTS: Limb function:there was no significant difference in FMA scores between the two groups before operation ( CONCLUSION the combined use of composite bone flap transplantation and bone lengthening staged repair in the treatment of severe soft tissue and bone defect caused by lower limb burn can achieve good therapeutic effect, improve limb function, and have high treatment satisfaction and certain safety.
Adult ; Bone Lengthening ; Bone and Bones ; Female ; Humans ; Lower Extremity/surgery* ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Skin Transplantation ; Soft Tissue Injuries/surgery* ; Treatment Outcome

Pre-contoured anatomical locking plates were designed to address the clinical need of fixing small epiphyseal segments with a larger number of screws. Those plates match the contour and shape of a variety of bones allowing for optimal buttress properties. The aim of this manuscript is to highlight the benefits of applying proximal humerus locking plates in the fixation of lower extremity bones. Although designed for the proximal humerus, the low-profile plate shape and anatomic contour also provides versatile use in certain areas of the lower extremity. This technical narrative highlights the versatile and reliable use of this plate for other anatomical areas than the one to which it has been originally conceived.
Adolescent ; Adult ; Bone Plates ; Bone Screws ; Bones of Lower Extremity/surgery* ; Child ; Female ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Humans ; Humerus ; Male ; Middle Aged

PURPOSE: The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy. MATERIALS AND METHODS: We retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation. RESULTS: Significant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (p<0.001). There was no difference in the mean IMA correction between the 2 groups (6.1+/-2.7degrees in group A and 6.0+/-2.1degrees in group B). However, a greater correction in the HVA and distance from the first to the second metatarsal were found in group B (HVA, 13.2+/-8.2degrees; distance, 25.1+/-0.2 mm) compared to group A (HVA, 20.9+/-7.7degrees; distance, 28.1+/-0.3 mm; p<0.001). AOFAS scores were improved in both groups. However, group B demonstrated a greater improvement relative to group A (p=0.005). CONCLUSION: Compared with a straight first metatarsal osteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes.
Adult ; Aged ; Bone Plates ; Epiphyses/surgery ; Ethnic Groups ; Female ; Foot ; Fracture Fixation, Internal/*instrumentation ; Hallux Valgus/radiography/*surgery ; Humans ; Lower Extremity ; Male ; Metatarsal Bones/*radiography/*surgery ; Middle Aged ; Osteotomy/*methods ; Range of Motion, Articular ; Retrospective Studies ; Treatment Outcome ; Upper Extremity