[Correction of complex deformities in infectious conditions].
Skeletal deformities do occur after conservative or operative fracture treatment, as a consequence of congenital growth disturbance and as sequlae after posttraumatic and haematogenous osteomyelitis. In postinfectious deformities the course of the bone and soft tissue infection plays a decisive role when choosing the appropriate operative technique. Even in non active situations with a closed soft tissues envelope and no draining sinus persistence of germs within the bone has to be anticipated. The biological quality of the bone and the soft tissue envelope is often reduced because of local changes and as a result of multiple local revisions. Consequently wide areas of scar tissue and sclerotic bone are often encountered. The apex of the deformity is in most cases identical with the focus of the active or non active infection. The correction of the deformity at the apex can therefore only be accomplished if the infectious bone is also resected. If a correction is not possible at the apex of the deformity, translation at the osteotomy site is necessary to achieve a correct mechanical axis. The later rather complex operative procedure necessitates intensive preoperative planning and an extensive experience with deformity corrections by external fixators.
Suger
G
G
Abteilung für Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Universität Ulm. gebhard.suger@medizin.uni-ulm.de
Schmelz
A
A
Kinzl
L
L
Liener
U
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016267:External Fixators; D005260:Female; D006801:Humans; D007870:Leg Length Inequality / Q000150:complications* / Q000601:surgery; D017880:Limb Deformities, Congenital / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010000:Osteitis / Q000150:complications / Q000601:surgery; D010019:Osteomyelitis / Q000150:complications* / Q000601:surgery; D010027:Osteotomy