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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 57 - 57
1 Jan 2013
Ben-David D Palmanovich E Brin Y Laver L Massarwe S Stern A Nyska M
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Introduction

Degenerative, inflammatory, and posttraumatic arthritis of the ankle are the primary indications for total ankle arthroplasty

Ankle arthrodesis has long been the “gold standard” for the surgical treatment

Total Ankle Arthroplasty. implant survivorship has been reported to range from 70% to 98% at three to six years

The combination of younger age and hindfoot arthrodesis or osteoarthritis may lead to a relative increase in failure rates after TAA

Intraoperative complication include malaligment, fracture and tendon Postoperative complications include syndesmotic nonunion, wound problems, infections and component instability and lysis

After TAA few difficulties mainly due to poor Talar and Tibial bone stock. It is difficult to stabilize the fusion and usually there is shortening after removal of the implant. Also there is a need for massive bone graft-allograft or autograft.

In cases when there is significant bone loss there is a need for stable reconstruction and stabilization of the hindfoot. Bone grafting with structural bone graft may collapse and it has to be stabilized with screws or nail.

Methods

We developed technique which included distraction of the fusion area and inserting a Titanium cylindrical spinal cage filled with bone graft. Than guide wire was inserted in through the cage under fluoroscopy and a compression screw was introduced causing compression of the fusion area against the cage gaining stabilization of the fusion area.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 245 - 245
1 Sep 2012
Brin Y Palmanovich E Nyska M Kish B
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Background

Hip fractures affect annually over 350,000 people in the USA and over 1.6 million worldwide. About 50% of these numbers are intertrochanteric fractures,

The surgeon should be able to minimize the morbidity associated with the fracture by: recognizing the fracture pattern, choosing the appropriate fixation device, performing accurate reductions with ideal implant placement and being conscious of implant costs. In this study we assessed the ability of the orthopaedic surgeons to recognize fractures pattern, and choosing the ideal implant for the recognized fracture.

Methods

We assessed 134 orthopaedic surgeons with questionnaires that assessed 14 different intertrochanteric femoral fractures. We evaluated the fractures as stable or unstable. We chose for each fracture the appropriate fixation device: either a Dynamic Hip Screw (for stable fractures) or an Intra Medullary Nail (for unstable ones), taking into consideration fracture's stability and implants’ costs. We compared the answers of the assessed surgeons to ours.