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Internal bone transport using a cannulated screw as a mounting device in the treatment of a post-infective ulnar defect.

Tsitskaris K, Havard H, Bijlsma P, Hill RA - Strategies Trauma Limb Reconstr (2016)

Bottom Line: We report a case of a segmental ulnar bone defect in a young child treated with internal bone transport using a cannulated screw as the mounting device.We found this technique particularly useful in the treatment of bone loss secondary to infection, where previous treatment and prolonged immobilisation had led to osteopenia.This technique has not been previously reported.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. tsitskaris@yahoo.com.

ABSTRACT
Bone transport techniques can be used to address the segmental bone loss occurring after debridement for infection. Secure fixation of the bone transport construct to the bone transport segment can be challenging, particularly if the bone is small and osteopenic. We report a case of a segmental ulnar bone defect in a young child treated with internal bone transport using a cannulated screw as the mounting device. We found this technique particularly useful in the treatment of bone loss secondary to infection, where previous treatment and prolonged immobilisation had led to osteopenia. This technique has not been previously reported.

No MeSH data available.


Related in: MedlinePlus

Bone transport segment is secured on a traction wire by threading the latter through a 3.5-mm cannulated screw positioned perpendicular to the long axis of the bone
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Fig2: Bone transport segment is secured on a traction wire by threading the latter through a 3.5-mm cannulated screw positioned perpendicular to the long axis of the bone

Mentions: An Ilizarov fixator (Smith & Nephew Orthopaedics Ltd, Warwick, UK) was used. The ulnar osteotomy was performed percutaneously by pre-drilling the bone prior to attaching the frame. The level for the osteotomy was the proximal metaphysis just distal to the coronoid process. Initially, the Ilizarov fixator was set up for external transport, with a proximal half ring, a half ring for bone transport and a distal complete ring using the elevator method. The osteotomy was then completed with an osteotome after attachment of the frame. Within the first 2 weeks of treatment, the transport wire pulled through the osteopenic bone, necessitating revision. At the time of revision, the treatment was converted to an internal bone transport construct. We secured the bone transport segment with a 1.5-mm transport wire by threading the wire through a 3.5-mm cannulated screw, positioned perpendicular to the long axis of the bone (Fig. 2). The transport wire exited at the level of the wrist and was mounted to a slotted rod distraction device (Fig. 3).Fig. 2


Internal bone transport using a cannulated screw as a mounting device in the treatment of a post-infective ulnar defect.

Tsitskaris K, Havard H, Bijlsma P, Hill RA - Strategies Trauma Limb Reconstr (2016)

Bone transport segment is secured on a traction wire by threading the latter through a 3.5-mm cannulated screw positioned perpendicular to the long axis of the bone
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4814383&req=5

Fig2: Bone transport segment is secured on a traction wire by threading the latter through a 3.5-mm cannulated screw positioned perpendicular to the long axis of the bone
Mentions: An Ilizarov fixator (Smith & Nephew Orthopaedics Ltd, Warwick, UK) was used. The ulnar osteotomy was performed percutaneously by pre-drilling the bone prior to attaching the frame. The level for the osteotomy was the proximal metaphysis just distal to the coronoid process. Initially, the Ilizarov fixator was set up for external transport, with a proximal half ring, a half ring for bone transport and a distal complete ring using the elevator method. The osteotomy was then completed with an osteotome after attachment of the frame. Within the first 2 weeks of treatment, the transport wire pulled through the osteopenic bone, necessitating revision. At the time of revision, the treatment was converted to an internal bone transport construct. We secured the bone transport segment with a 1.5-mm transport wire by threading the wire through a 3.5-mm cannulated screw, positioned perpendicular to the long axis of the bone (Fig. 2). The transport wire exited at the level of the wrist and was mounted to a slotted rod distraction device (Fig. 3).Fig. 2

Bottom Line: We report a case of a segmental ulnar bone defect in a young child treated with internal bone transport using a cannulated screw as the mounting device.We found this technique particularly useful in the treatment of bone loss secondary to infection, where previous treatment and prolonged immobilisation had led to osteopenia.This technique has not been previously reported.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. tsitskaris@yahoo.com.

ABSTRACT
Bone transport techniques can be used to address the segmental bone loss occurring after debridement for infection. Secure fixation of the bone transport construct to the bone transport segment can be challenging, particularly if the bone is small and osteopenic. We report a case of a segmental ulnar bone defect in a young child treated with internal bone transport using a cannulated screw as the mounting device. We found this technique particularly useful in the treatment of bone loss secondary to infection, where previous treatment and prolonged immobilisation had led to osteopenia. This technique has not been previously reported.

No MeSH data available.


Related in: MedlinePlus