Because of fresh advances in surgical suggestions and implant know-how it truly is now attainable to accomplish limb reconstruction in sufferers with quite a number congenital, posttraumatic, and postinfection pathologies. This publication is a transparent, sensible consultant to the cutting-edge surgeries hired in limb reconstruction for various stipulations. It comprises specified descriptions of the innovations themselves, observed by means of a variety of invaluable drawings and images. Pearls and pitfalls are highlighted, and thorough suggestion is usually supplied on symptoms, preoperative making plans, and postoperative follow-up. The editors have conscientiously chosen the individuals according to their services, and plenty of of the authors have been themselves answerable for constructing the strategies that they describe.

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20 Schematic drawing of the multiple drill hole osteotomy technique of translation. The angular correction is maintained through the application of a unilateral fixator. Intraoperative x-rays of the two planes are required to verify if the desired correction has been achieved. Adjustment of the fixator and repeat x-rays are performed as needed to fine-tune the correction. Antegrade reaming over a guide wire is performed conventionally through a mini incision. Postoperative Period and Follow-Up The patients are mobilized at the first postoperative day with weight bearing as tolerated.

Equinus contractures and knee flexion contractures can occur with tibial lengthening due to stretch on the gastrocsoleus mus- 1 Lengthening over Nails (LON): Femur and Tibia • • • • cles. The foot should be prophylactically splinted in a neutral position. At night, the knee should be positioned in full extension by placing a pillow under the distal ring of the external fixator. Pearl: An alternate method of foot splinting is to extend the external fixator to the foot by adding a foot ring or heel half ring to the distal part of the tibial frame.

8). • If there is only a proximal metaphyseal deformity of the femur, then an antegrade IM nail can be chosen. • The diameter and the size of the IM nail should be determined based on the scaled AP and lateral x-rays of the affected bone segment(s) (Fig. 9a, b). 3 Femoral and Tibial Deformity Correction Fig. 3 Preoperative orthoroentgenograms, AP (a) and lateral (b) 53 a • Paper tracing should be performed to simulate the surgery and to determine the provisional final position of the bone segment(s) (Fig.

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