Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
3.6
2.6
Journals
Medicina
Special Issues
Malunion of Fractures of the Lower Extremity
share announcement

Malunion of Fractures of the Lower Extremity

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (1 January 2023) | Viewed by 27510

Special Issue Editors

Dr. Rahul Vaidya

E-Mail Website
Guest Editor
1. Detroit Medical Center, Detroit, MI, USA
2. Wayne State University, Detroit, MI, USA
Interests: orthopaedic trauma; spine surgery; biomechanics; anatomy; clinical outcomes; deformity correction
Dr. Bryant Oliphant

E-Mail
Co-Guest Editor
Detroit Medical Center, University of Michigan, Detroit, MI, USA
Interests: population health; orthopaedic trauma; trauma assessment; clinical outcomes
Dr. Robert A. Teitge

E-Mail Website
Co-Guest Editor
Senior Staff Physician Detroit Medical Center, Detroit, Professor (retired) Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, MI, USA
Interests: patellofemoral joint; anterior knee pain; patellar instability; knee osteotomy

Special Issue Information

Dear Colleagues,

This special issue will highlight a topic that all Orthopaedic Surgeons deal with daily in fracture care. The definition of malunion is an evolving phenomenon. As our populations advance in knowledge and access to health care, their and our expectations of fracture care is changing. One hundred and fifty years ago lower extremity fractures often lead to death, amputation, deformity, disfigurement and the loss of function. With the advent of anesthetic, sterile techniques, antibiotics, imaging, as well as our understanding of bone healing and soft tissue care, we have come to expect fractures to heal, in some cases over 99% of the time. Post traumatic deformity malunion has been described in radiological terms by several authors and has not changed in 30 years. This issue aims to redefine what the expectation of trauma care for simple and complex fractures of the lower extremity should be or can be. In that respect, we are calling for papers that relook at the definition of malunion, and techniques to assess, correct and measure the outcomes.

Dr. Rahul Vaidya
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Post traumatic
  • Lower extremity
  • Deformity evaluation
  • Correction
  • Techniques
  • Outcomes

Published Papers (6 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Review

Jump to: Other

8 pages, 1264 KiB  
Review
Pelvic Malunion: A Systematic Review, Dichotomy of Definitions and Treatment
by Sasha Stine, Austen Washington, Ramesh Kumar Sen, Kerellos Nasr and Rahul Vaidya
Medicina 2022, 58(8), 1098; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58081098 - 14 Aug 2022
Cited by 3 | Viewed by 1982
Abstract
Background and Objectives: Pelvic nonunion and malunion have been documented as rare complications in pelvic fractures and literature describing these topics is severely limited. Articles dedicated solely to pelvic malunion are nearly nonexistent. We conducted a literature search with the goal of [...] Read more.
Background and Objectives: Pelvic nonunion and malunion have been documented as rare complications in pelvic fractures and literature describing these topics is severely limited. Articles dedicated solely to pelvic malunion are nearly nonexistent. We conducted a literature search with the goal of providing a summary of the definition, causes, treatment strategies, and outcomes of pelvic malunion correction. Materials and Methods: An initial review of the literature was performed using the PubMed, ScienceDirect, and Cochrane Database of Systematic Reviews databases. Search terms used were “malunion” AND “pelvic” OR “pelvis”. Duplicate articles, non-English language articles without translations available and non-human subject studies were excluded. Results: Eleven original publications were found describing experiences with pelvic malunion. Seven of the articles were exclusively dedicated to the topic of pelvic fracture malunion, and only two reported on a series of patients treated for malunion with variably staged procedures. Most reports define pelvic pain as the main indication for surgical correction, along with gait disturbance, standing or sitting imbalance, and urinary or sexual dysfunction. Radiographically, vertical displacement of one to two centimeters and rotation of the hemipelvis of fifteen degrees or more have been described in defining malunion. No treatment algorithms exist, and each patient is treated with a unique work-up and operative plan due to the complexity of the problem. Only one series reported a patient satisfaction rate of 75% following malunion treatment. Conclusions: Pelvic malunion is a rare complication of pelvic ring injury and is seldom discussed in the literature. We found two small case series reporting exclusively on malunion treatment and complications. While some of the combination studies made the distinction in the diagnosis of malunion and nonunion, they rarely differentiated the treatment outcomes between the two categories. This paper describes pelvic malunion and highlights the need for more research into surgical outcomes of treatment specifically regarding functionality, patient satisfaction, and recurrence of preoperative symptoms. Full article
(This article belongs to the Special Issue Malunion of Fractures of the Lower Extremity)
►▼ Show Figures

Figure 1

16 pages, 7337 KiB  
Review
The Clamshell Osteotomy for Diaphyseal Malunion in Deformity Correction and Fracture Surgery
by Kevin F. Purcell, George V. Russell and Matthew L. Graves
Medicina 2021, 57(9), 951; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57090951 - 10 Sep 2021
Cited by 5 | Viewed by 3637
Abstract
Diaphyseal malunion poses a great challenge for the orthopedic surgeon, and an inundation of morbidity for the patient. Diaphyseal malunion can cause altered gait, adjacent joint osteoarthritis and body dissatisfaction. This problem is fraught with complications without surgical intervention. There is a myriad [...] Read more.
Diaphyseal malunion poses a great challenge for the orthopedic surgeon, and an inundation of morbidity for the patient. Diaphyseal malunion can cause altered gait, adjacent joint osteoarthritis and body dissatisfaction. This problem is fraught with complications without surgical intervention. There is a myriad of options for the management of a diaphyseal malunion. The clamshell osteotomy was engendered to ameliorate the difficulty in managing this issue. This technique is a viable option to correct diaphyseal malunion about the femur and tibia. Recently, the indications of a clamshell osteotomy have been expanded to function as a derotational or shortening osteotomy. Full article
(This article belongs to the Special Issue Malunion of Fractures of the Lower Extremity)
►▼ Show Figures

Figure 1

Other

Jump to: Review

18 pages, 8909 KiB  
Tutorial
Mathematically Directed Single-Cut Osteotomy
by Stephen J. Wallace, Joseph T. Patterson and Sean E. Nork
Medicina 2022, 58(7), 971; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58070971 - 21 Jul 2022
Cited by 1 | Viewed by 1883
Abstract
A mathematically directed osteotomy (MDO) is a surgical planning technique for correcting long bone deformities. Using a mathematically derived osteotomy plane, the single-cut correction simultaneously addresses angular deformity, axial malrotation, and minor shortening. This review describes an MDO’s indications for use, defines its [...] Read more.
A mathematically directed osteotomy (MDO) is a surgical planning technique for correcting long bone deformities. Using a mathematically derived osteotomy plane, the single-cut correction simultaneously addresses angular deformity, axial malrotation, and minor shortening. This review describes an MDO’s indications for use, defines its input and output variables, includes the required graphs for osteotomy planning, and provides intraoperative tips and tricks for successful execution. Finally, the authors present a digital MDO calculator to simplify the complex computations and allow for more precise planning. Full article
(This article belongs to the Special Issue Malunion of Fractures of the Lower Extremity)
►▼ Show Figures

Figure 1

21 pages, 2344 KiB  
Systematic Review
Malunion of the Tibia: A Systematic Review
by Ishan Patel, Jacob Young, Austen Washington and Rahul Vaidya
Medicina 2022, 58(3), 389; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58030389 - 05 Mar 2022
Cited by 10 | Viewed by 9901
Abstract
Background and Objectives: Tibial malunions are defined as tibial fractures that have healed in a clinically unacceptable position, resulting in deformity such as shortening, lengthening, abnormal rotation, or angulation. These deformities can have adverse effects on patients, such as pain and gait [...] Read more.
Background and Objectives: Tibial malunions are defined as tibial fractures that have healed in a clinically unacceptable position, resulting in deformity such as shortening, lengthening, abnormal rotation, or angulation. These deformities can have adverse effects on patients, such as pain and gait disturbance, as well as long term development of post-traumatic arthritis. This paper seeks to highlight some of the options for surgical management of malunions and detail the strategies and approaches used to manage these complicated cases. Materials and Methods: An exhaustive search was conducted on PubMed using the key search terms “Tibial” OR “Tibia” AND “Malunion” to be included in the title. Exclusions to the search included any article with patients aged < 18 years, any nonhuman subjects, and any article not published or translated into English. Results: A systematic review of the literature revealed 26 articles encompassing 242 patients who had undergone surgical correction for tibia malunion. A total of 19 patients suffered from complications. Methods of treatment included osteotomies, with plate and screws, external fixator, angled blade plate, intramedullary nails, Ilizarov fixator, Taylor Spatial Frame, Precise nail, and total knee arthroplasty. Restoring alignment and the articular surface led to overwhelmingly positive patient outcomes. Conclusions: Tibial malunions take many forms, and as such, there are many approaches to correcting deformities. The literature supports the following radiological parameters to diagnose tibial malunion: 5–10 degrees angulation, 1–2 cm shortening, 10–15 degrees internal rotation, and 10–20 degrees external rotation. Surgical plans should be customized to each individual patient, as there are many approaches to tibial malunion that have been shown to be successful in delivering excellent clinical outcomes. Full article
(This article belongs to the Special Issue Malunion of Fractures of the Lower Extremity)
►▼ Show Figures

Figure 1

26 pages, 104409 KiB  
Tutorial
Focal Dome Osteotomy for the Treatment of Diaphyseal Malunion of the Lower Extremity
by Rafael Neiman
Medicina 2022, 58(2), 308; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina58020308 - 17 Feb 2022
Cited by 3 | Viewed by 4540
Abstract
The treatment of malunion of the lower extremity diaphysis is challenging. Diaphyseal osteotomies require extra care to promote bone healing. This may be enhanced through osteotomies, which do not produce bone gaps and allow for compression. The focal dome osteotomy allows for rotation [...] Read more.
The treatment of malunion of the lower extremity diaphysis is challenging. Diaphyseal osteotomies require extra care to promote bone healing. This may be enhanced through osteotomies, which do not produce bone gaps and allow for compression. The focal dome osteotomy allows for rotation around an axis to correct angular deformity. The production of a successful arcuate or focal dome osteotomy requires a suitable soft tissue host. The deformity analysis is not complex but essential to assess the feasibility of correction and is required for perfect execution of the osteotomy. This tutorial explains the technique for focal dome osteotomy to correct angular deformities of the lower extremities, specifically in the diaphysis. Surgical correction for malunion, infected malunion, and infected mal-nonunion case examples are discussed. With meticulous planning and surgical technique, the focal dome osteotomy is a viable option for correcting diaphyseal malunions with compression techniques that allow a stable construct for early weight-bearing. Full article
(This article belongs to the Special Issue Malunion of Fractures of the Lower Extremity)
►▼ Show Figures

Figure 1

10 pages, 5757 KiB  
Case Report
Limb Salvage after Lower-Leg Fracture and Popliteal Artery Transection—The Role of Vessel-First Strategy and Bone Fixation Using the Ilizarov External Fixator Device: A Case Report
by Vincenzo Giordano, Felipe Serrão Souza, William Dias Belangero and Robinson Esteves Pires
Medicina 2021, 57(11), 1220; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57111220 - 09 Nov 2021
Cited by 1 | Viewed by 4117
Abstract
Open traumatic lesion of the popliteal artery is relatively rare. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss. Severe local infection is critical in the presence of [...] Read more.
Open traumatic lesion of the popliteal artery is relatively rare. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss. Severe local infection is critical in the presence of major soft tissue trauma or open fractures. We report the case of a young female who suffered a traumatic transection of the popliteal artery associated with an open fracture of the distal tibia and fibula managed by direct vessel reconstruction with an end-to-end repair and skeletal stabilization initially with half-pin external fixation, then replaced by an Ilizarov circular frame. The patient had a very satisfactory outcome, but the fracture healed malunited, later corrected by open reduction and internal fixation with lag-screwing and a neutralization plate. Full article
(This article belongs to the Special Issue Malunion of Fractures of the Lower Extremity)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-6
Back to TopTop