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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 78 - 78
1 Dec 2019
Pützler J Alexander M Everding J Raschke MJ Arens D Zeiter S Richards GR Moriarty FT
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Aim

Focused high energy extracorporeal shockwave therapy (fhESWT) is used to support fracture healing in non-union cases and has been shown to have antibacterial effects. We trialed fhESWT as an adjunct to conventional treatment in a clinically relevant rabbit model of fracture related infection.

Method

A complete humeral osteotomy was performed in 31 rabbits and fixed with a 7-hole-LCP. A fracture-related infection (FRI) was established with Staphylococcus aureus. After two weeks, a revision surgery was performed with debridement, irrigation and implant retention. Rabbits then received: no further treatment (controls); shockwaves (at day 2 and 6 after revision, 4'000 Impulses each time with 23kV); systemic antibiotics (rifampin and nafcillin) over one week in weight adjusted dosages; or the combination of antibiotics and shockwaves. Treatments were applied over one week. Blood cultures were taken before and after shockwave sessions. After an additional week without treatment, rabbits were euthanized, and quantitative bacteriology was performed on implants and tissues to determine infection burden. Indicator organs (brain, heart, liver, lungs, kidneys and spleen) were cultured to assess possible bacteraemia due to fhESWT.


The Journal of Bone & Joint Surgery British Volume
Vol. 93-B, Issue 3 | Pages 418 - 420
1 Mar 2011
Mathew SE Madhuri V Alexander M Walter NM Gibikote SV

Florid reactive periostitis is a pronounced periosteal reaction, usually affecting the hands and feet, for which there is no obvious cause. It is rare in children and in long bones. We report an unusual case of florid reactive periostitis in a ten-year-old girl that involved both bones of the forearm. The lesion resolved over a period of one year, leaving a residual exostosis. She developed a physeal bar in the distal ulna in the region of the lesion at one-year follow-up. This was thought to be a complication of the biopsy procedure and was treated by resection and proximal ulnar lengthening.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 297 - 297
1 Mar 2004
Alexander M Michail Z Guta AE
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Aims: The arthrodesis is a method of selection at a purulent destruction of a talocrural joint. By loss of motions the pain and the deformation are eliminated, capacity of a load of an extremities is restored. Methods: We allocate by experience of treatment 73 ill with a chronic infection of an ankle joint, which one executes in period with 1976 for 2002 an arthrodesis of a talocrural joint with applying of apparatus of external þxation. The external þxator consists of 2 rings on the anticnemion and 2 semirings on the foot. On the foot a pin was passed through talus, which provided maximum rigid of þxation and created conditions for early mobilization of a subtalar joint. At destruction of talus or distal metaphysis of a tibial is executed the autospongioid osteal plasty for 15 ill, which one has allowed to keep an axis of an extremity without shortening one. Results: The follow-up for 65 ill are studied in terms from 1 till 25 years. The osteal ankylosis is reached in 63 cases; the resistant remission of infected process is reached in 59 cases. Conclusions: Thus an arthrodesis of a ankle joint by the apparatus of external þxation enables to avoid the many-stage treatment, to reach an ankylosis in minimum terms and to restore function of an extremity.