Prevention Of Shortening Research Articles

Outcomes of Defect Management at Tibiotalocalcaneal Fusion Treated with Innovative ‘Bamboo Hut’ Technique

Category:HindfootIntroduction/Purpose:Tibiotalocalcaneal (TTC) fusion is a salvage procedure for post-traumatic as well as neuropathic cases. Many of these cases are characterised by some or other form of loss of talus resulting in a defect. At TTC fusion, prevention of shortening following such a defect is a challenge. Though allografts have helped solve this issue, they may not be easily available in developing countries. A retrospective analysis of prospectively collected data of 14 cases of TTC fusion with loss of talus is presented here. Cases were managed with innovative defect bridging ‘Bamboo Hut’ technique.Methods:Cases with either preoperative or perioperative loss of talus who required bridging of defect were included in the present study. Resultant defect following excision of the talus was bridged with two or three vertically placed fibular strut grafts. Grafts were snugly tied with each other with sutures to prepare a construct like a hut supported with wooden steaks (Bamboo). Fixation was carried out with indigenous TTC nail with a built-in compression device to generate compression of grafts between tibia and calcaneus.Results:Present series comprised of 6 post-traumatic cases, 7 cases of diabetic Charcot neuroarthropathy and 1 case of neuroarthropathy following operated meningomyelocele. Cases were followed up for an average period of 36 months with the average time to union being six months. All posttraumatic cases went on to the bony union but two out of eight neuropathy cases ended up in fibrous union with collapse & loss of fixation. Wound healing issues were noticed in two cases. None of the cases required amputation.Conclusion:With non-availability of allografts, prevention of shortening at TTC fusion is a challenge. This issue can be successfully managed with innovative ‘Bamboo Hut’ grafting technique, supported with in-built compression of the fusion site with the use of an indigenous nail.

同側大腿骨・下腿骨骨折の治療経験

We treated twenty-seven ipsilateral fractures of the femur and tibia from 1970 through 1988. All the fractures except one tibial fracture and two amputations were, in the most cases, treated surgically with plates.Nineteen patients were examined in person. According to the criteria for assessment of end results by Karlstrom and Olerud, the patients were graded as excellent, good, fair and poor. Excellent results were achieved in eight patients, good in six, fair in one and poor in four. We found that plates were especially useful regarding prevention of shortening and deformity. Poor results were more associated with severity of fractures and concomitant soft tissue injury, such as nerve injury, than the type of fractures.

EFFECT OF VARYING FINAL INTERNAL TEMPERATURE ON SHEAR VALUES AND SENSORY SCORES OF MUSCLES FROM CARCASSES SUSPENDED BY TWO METHODS

ABSTRACTA comparison of changes in tenderness in response to heat was made between meat from three animals that had one side suspended from the achilles tendon and the other side suspended from the obturator foramen. There was a decrease in tenderness due to heating muscles to higher internal temperatures as evidenced by higher shear force values and lower sensory panel scores for all muscles, except for shear of the longissimus, biceps femoris, and psoas major and ease of fragmentation for the longissimus and the gluteus medius. Analysis of the regression lines of shear and fragmentation versus mean temperature at a given cooking time indicated there was more toughening due to higher internal temperatures in a majority of muscles that were allowed to shorten than there was in those that had been prevented from shortening. These data indicate that muscles which are tenderized by prevention of shortening are less susceptible to toughening when cooked to greater degrees of doneness.