Search Results (3)

Percutaneous Osseointegrated Implants (POI) affix artificial limbs to the body after amputation. Several adverse events challenge mainstream uptake of this technology. This study aims to achieve a consensus regarding “the challenges and adverse events to POI integration and long-term fixation in limb amputation”. We sought a panel of clinical experts divided by profession into surgical, clinical, or clinical academic categories. We used a real time eDelphi method to develop consensus on both the challenges and adverse event items, enabling anonymity, iteration, controlled feedback, and statistical aggregation of group responses. The full panel agreed that the most impactful items are amongst 10 key challenges and eight adverse events. Panellists were in consensus regarding the five most impactful challenges, which were, in decreasing order: patient selection, absence of a multidisciplinary team, design of the implant, soft tissue stability and an experienced surgical team. Panellists considered the five most impactful adverse events, in decreasing order, to be the following: no biological fixation, deep infection, aseptic loosening, no mechanical fixation, and implant breakage. Consensus was obtained on implant breakage and deep infection items. The proportion of consensus from the whole panel across all items was in line with the literature, and we observed an improvement in consensus once the panel was stratified based on job, expertise and implant system. Full article

Leg Length Discrepancy (LLD) is a critical problem which not only impacts the quality of life but also causes other physical ailments such as limping and severe back pain. Most people had a non-negligible difference in the length of their two legs, and 0.1% of the population with differences of 20 mm or more are diagnosed as a difference in limb length. The Ilizarov external fixator is commonly used in treating LLD as conventional therapeutic equipment, but often causes serious complications that cannot be prevented. Therefore, intramedullary leg-lengthening treatment has become popular in distraction osteogenesis to eliminate extracorporeal surgery. This paper presents a study on the design and optimization of a novel electromagnetic-driven Intramedullary Skeletal Distraction Robot (ISDR) with robust mechanical stiffness and surplus electromagnetic driving force. Compared with PRECICE, the split structure of ISDR eases the optimal design and manufacturing difficulties to strengthen mechanical stiffness, and the electromagnetic configuration allows improving the distraction force by adjusting the Permanent Magnet Brushless Direct Current (PMBLDC) motor parameters. ISDR, which is implanted in the medullary cavity, has the Von-Mises stress of 952.15 MPa, and the first mode of natural frequency is 28.823 Hz indicating that it can withstand the load during the walking gait phases. On the other hand, the ISDR distraction force encounters resistance from muscle fibers, and an average driving torque of 9 Nmm ensures its distraction. Based on the results, ISDR is proven secure and reliable during and after leg-lengthening treatment, which can significantly reduce lifestyle disruption and medical complications. Full article

Open traumatic lesion of the popliteal artery is relatively rare. Ischemia time longer than 6 h and severity of limb ischemia have been shown to be associated with an increased risk of limb loss. Severe local infection is critical in the presence of major soft tissue trauma or open fractures. We report the case of a young female who suffered a traumatic transection of the popliteal artery associated with an open fracture of the distal tibia and fibula managed by direct vessel reconstruction with an end-to-end repair and skeletal stabilization initially with half-pin external fixation, then replaced by an Ilizarov circular frame. The patient had a very satisfactory outcome, but the fracture healed malunited, later corrected by open reduction and internal fixation with lag-screwing and a neutralization plate. Full article