The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Mostafa Ahmed Ayoub - One of the best experts on this subject based on the ideXlab platform.
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Highly unstable complex C3-type Distal Femur Fracture: can double plating via a modified Olerud extensile approach be a standby solution?
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Ayman El-sayed Khalil, Mostafa Ahmed AyoubAbstract:Background Multiplanar complex C3-type unstable Distal femoral Fractures present many challenges in terms of approach and fixation. This prospective study investigates a possible solution to these problems through double plating with autogenous bone grafting via a modified Olerud extensile approach. Materials and methods Twelve patients with closed C3-type injuries were included; eight of them were male, and their mean age was 33.5 years (range 22–44 years). Mechanism of injury was road traffic accident (RTA) in nine patients and fall from height in the other three cases. Eight cases were operated during the first week and four cases during the second week after injury. Mean follow-up was 13.7 months (range 11–18 months). Results Mean radiological healing time was 18.3 weeks (range 12-28 weeks), and all cases had good radiological healing without recorded nonunion or malunion. Clinically, two cases (16.7 %) had excellent results, five cases (41.7 %) had good results, three cases (25 %) had fair results, and two cases (16.7 %) had poor results. No cases developed skin necrosis, deep infection, bone collapse, or implant failure. However, two cases (16.7 %) had limited knee flexion to 90° and required subsequent quadricepsplasty. Conclusions Use of this modified highly invasive approach facilitated anatomical reconstruction of C3-type complex Distal femoral Fractures with lower expected complication rate and acceptable clinical outcome, especially offering good reconstruction of the suprapatellar pouch area. It can be considered as a standby solution for managing these difficult injuries.
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highly unstable complex c3 type Distal Femur Fracture can double plating via a modified olerud extensile approach be a standby solution
Journal of Orthopaedics and Traumatology, 2012Co-Authors: Ayman Khalil, Mostafa Ahmed AyoubAbstract:Background Multiplanar complex C3-type unstable Distal femoral Fractures present many challenges in terms of approach and fixation. This prospective study investigates a possible solution to these problems through double plating with autogenous bone grafting via a modified Olerud extensile approach.
Hyuk Soo Han - One of the best experts on this subject based on the ideXlab platform.
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Retrograde intramedullary nailing for Distal Femur Fracture with osteoporosis.
Clinics in orthopedic surgery, 2012Co-Authors: Ji Hyeung Kim, Seung Baik Kang, Kyungpyo Nam, Seung Hwan Rhee, Jong Won Won, Hyuk Soo HanAbstract:Epidemiologic study in the United Kingdom found Distal Femur Fracture accounts for 0.4% of adult Fractures, with an average patient age of 61 years.1) A population based study2) in Olmsted County, Minnesota, USA suggested that non-hip femoral Fractures increased between 1984 and 2007, largely because of an increase in moderate trauma Fractures in older women over this period. In their study, Distal Femur Fracture comprised 29% of cases. Kannus et al.3) also reported a rising problem of osteoporotic knee Fractures in elderly women. Since the incidence of Distal Femur Fracture has been increasing recently and commonly occurs with osteoporosis, we should pay more attention to the management of Distal Femur Fracture with osteoporosis. Compared to plate osteosynthesis, intramedullary fixation requires less extensive dissection and is better biomechanically. In a biomechanical study, the stiffness of the intramedullary nail was better than a dynamic condylar screw or a locking compression plate.4) Retrograde intramedullary nailing is a good surgical option in the management of Distal Femur Fracture with osteoporosis. Scheerlinck et al.5) reported good surgical results for twelve elderly and osteoporotic patients with a femoral supracondylar nail. However, in the treatment of osteoporotic Distal Femur Fracture, it is very difficult to obtain sufficient implant anchorage. Wahnert et al.6) suggested that Distal locking has a major impact on the implant anchorage in osteoporotic bone, and concluded that a supracondylar nail should be considered for mobile patients where early postoperative mobilization for rehabilitation is required. Cement augmentation has been used to stabilize intramedullary nailing. Dall'Oca et al.7) managed osteoporotic intertrochanteric Fracture with cement augmentation to improve mechanical stability of the implant. Roth et al.8) suggested cement augmented proximal screws to improve stability in the management of the proximal tibia Fracture with osteoporosis. Shape memory alloy (Bio-smart, Ulsan, Korea) has also been used with retrograde intramedullary nailing in the management of periprosthetic supracondylar Fractures.9) Our study was undertaken to analyze clinical outcomes of retrograde intramedullary nailing with cement augmentation and/or shape memory alloy for Distal Femur Fracture with osteoporosis.
Michael P. Bolognesi - One of the best experts on this subject based on the ideXlab platform.
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Computer-assisted reduction method for periprosthetic Distal Femur Fracture.
Journal of surgical orthopaedic advances, 2012Co-Authors: Adam M. Caputo, Robert G. Howard, Tyler Steven Watters, Steven A. Olson, Robert D. Zura, Michael P. BolognesiAbstract:The purpose of this case report is to describe a novel use of computer assistance in identifying and restoring the mechanical axis in the treatment of a periprosthetic Distal Femur Fracture in a 76-year-old female patient with a total knee arthroplasty.
Sanja Dogramadzi - One of the best experts on this subject based on the ideXlab platform.
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rafs a computer assisted robotic system for minimally invasive joint Fracture surgery based on pre and intra operative imaging
International Conference on Robotics and Automation, 2017Co-Authors: Giulio Dagnino, Samir Morad, Payam Tarassoli, Roger Atkins, Ioannis Georgilas, Peter Gibbons, Sanja DogramadziAbstract:The integration of minimally invasive robotic assistance and image-guidance can have positive impact on joint Fracture surgery, providing a better clinical outcome with respect to the current open procedure. In this paper, a new design of the RAFS surgical system is presented. The redesign of the robotic system and its integration with a novel 3D navigation system through a new clinical workflow, overcomes the drawbacks of the earlier prototype. This makes the RAFS surgical system more suitable to clinical scenarios in the operating theatre. System accuracy and effectiveness are successfully demonstrated through laboratory trials and preliminary cadaveric trials. The experimental results demonstrate that the system allows the surgeon to reduce a 2-fragment Distal Femur Fracture in a cadaveric specimen, with a reduction accuracy of up to 0.85 mm and 2.2°. Preliminary cadaveric trials also provided a positive and favorable outcome pointing to the usability and safety of the RAFS system in the operating theatre, potentially enhancing the capacity of joint Fracture surgeries.
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Navigation system for robot-assisted intra-articular lower-limb Fracture surgery
International Journal of Computer Assisted Radiology and Surgery, 2016Co-Authors: Giulio Dagnino, Samir Morad, Roger Atkins, Ioannis Georgilas, Paul Köhler, Sanja DogramadziAbstract:Purpose In the surgical treatment for lower-leg intra-articular Fractures, the fragments have to be positioned and aligned to reconstruct the Fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular Fractures. Physical reduction in the Fractures is then performed by our robotic system based on the virtual reduction. Methods 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the Fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the Fracture physically reduced based on the surgeon’s virtual reduction. To test the system, four Femur models were Fractured to obtain four different Distal Femur Fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. Results The navigation system allowed an orthopaedic surgeon to virtually reduce the Fracture with a maximum residual positioning error of $$0.95 \pm 0.3\,\hbox {mm}$$ 0.95 ± 0.3 mm (translational) and $$1.4^{\circ } \pm 0.5^{\circ }$$ 1 . 4 ∘ ± 0 . 5 ∘ (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and $$1.56^{\circ }\pm 0.1^{\circ }$$ 1 . 56 ∘ ± 0 . 1 ∘ , when the robot reduced the Fracture. Conclusions Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a Fracture reduction accuracy of about 1 mm and $$1.5^{\circ }$$ 1 . 5 ∘ , and meeting the clinical requirements for Distal Femur Fracture reduction procedures.
Hsiaowei Chang - One of the best experts on this subject based on the ideXlab platform.
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finite element comparison of retrograde intramedullary nailing and locking plate fixation with without an intramedullary allograft for Distal Femur Fracture following total knee arthroplasty
Knee, 2014Co-Authors: Shihhao Chen, Mingchieh Chiang, Chinghua Hung, Shangchih Lin, Hsiaowei ChangAbstract:Abstract Purpose Periprosthetic Distal Femur Fracture after total knee arthroplasty due to the stress-shielding phenomenon is a challenging problem. Retrograde intramedullary nail (RIMN) or locking plate (LP) fixation with/without a strut allograft has been clinically used via less invasive stabilization surgery (LISS) for the treatment of these periprosthetic Fractures. However, their biomechanical differences in construct stability and implant stress have not been extensively studied, especially for the osteoporotic Femur. Methods This study used a finite-element method to evaluate the differences between RIMN, LP, and LP/allograft fixation in treating periprosthetic Distal Femur Fractures. There were sixteen variations of two Fracture angles (transverse and oblique), two loading conditions (compression and rotation), and four bony conditions (one normal and three osteoporotic). Construct stiffness, Fracture micromotion, and implant stress were chosen as the comparison indices. Results The LP/allograft construct provides both lateral and middle supports to the displaced Femur. Comparatively, the LP and RIMN constructs, respectively, transmit the loads through the lateral and middle paths, thus providing more unstable support to the construct and high stressing on the implants. The Fracture pattern plays a minor role in the construct stabilization of the three implants. In general, the biomechanical performances of the RIMN and LP constructs were comparable and significantly inferior to those of the LP/allograft construct. The bone quality should be evaluated prior to the selection of internal fixators. Conclusions The LP/allograft construct significantly stabilizes the Fracture gap, reduces the implant stress, and serves as the recommended fixation for periprosthetic Distal Femur Fracture.