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Determining weight-bearing tissue condition using peak reactive hyperemia response trend and ultrasonographic features: Implications for pressure ulcer prevention

Yapp JH, Raja Ahmad RMK, Mahmud R, Mohtarrudin N, Mohamad Yusof L, Abdul Rahim E, et al.

Wound Repair Regen, 2019 05;27(3):225-234.
PMID: 30667138 DOI: 10.1111/wrr.12698

Frequent repositioning is important to prevent pressure ulcer (PU) development, by relieving pressure and recovering damages on skin areas induced by repetitive loading. Although repositioning is the gold standard to prevent PU, there is currently no strategy for determining tissue condition under preventive approaches. In this study, the peak reactive hyperemia (RH) trends and ultrasonographic (US) features are compared with the tissue condition under histopathological examination to determine the potential use of these features in determining the tissue condition noninvasively. Twenty-one male Sprague-Dawley rats (seven per group), with body weight of 385-485 g, were categorized into three groups and subjected to different recovery times, each with three repetitive loading cycles at skin tissues above of right trochanter area. The first, second, and third groups were subjected to short (3 minutes), moderate (10 minutes), and prolonged (40 minutes) recovery, respectively, while applying fixed loading time and pressure (10 minutes and 50 mmHg, respectively), to provide different degree of recovery and tissue conditions (tissue damage and tissue recovery). Peak RH was measured in the three cycles to determine RH trend (increasing, decreasing, and inconsistent). All rat tissues were evaluated using ultrasound at pre- and post-experiment and rated by two raters to categorize the severity of tissue changes (no, mild, moderate, and severe). The tissue condition was also evaluated using histopathological examination to distinguish between normal and abnormal tissues. Most of the samples with increasing RH trend is related to abnormal tissue (71%); while inconsistent RH trends is more related to normal tissue (82%). There is no relationship between the tissue conditions evaluated under ultrasonographic and histopathological examination. Peak RH trend over repetitive loading may serve as a new feature for determining the tissue condition that leading to pressure ulcer.

Matched MeSH terms: Weight-Bearing*
Simplifying four-strand flexor tendon repair using double-stranded suture: a comparative ex vivo study on tensile strength and bulking

Low TH, Ahmad TS, Ng ES

J Hand Surg Eur Vol, 2012 Feb;37(2):101-8.
PMID: 21636621 DOI: 10.1177/1753193411409840

We have compared a simple four-strand flexor tendon repair, the single cross-stitch locked repair using a double-stranded suture (dsSCL) against two other four-strand repairs: the Pennington modified Kessler with double-stranded suture (dsPMK); and the cruciate cross-stitch locked repair with single-stranded suture (Modified Sandow). Thirty fresh frozen cadaveric flexor digitorum profundus tendons were transected and repaired with one of the core repair techniques using identical suture material and reinforced with identical peripheral sutures. Bulking at the repair site and tendon-suture junctions was measured. The tendons were subjected to linear load-to-failure testing. Results showed no significant difference in ultimate tensile strength between the Modified Sandow (36.8 N) and dsSCL (32.6 N) whereas the dsPMK was significantly weaker (26.8 N). There were no significant differences in 2 mm gap force, stiffness or bulk between the three repairs. We concluded that the simpler dsSCL repair is comparable to the modified Sandow repair in tensile strength, stiffness and bulking.

Matched MeSH terms: Weight-Bearing/physiology
The inter-laboratory equivalence for lower limb kinematics and kinetics during unplanned sidestepping

Donnelly CJ, Weir G, Jackson C, Alderson J, Rafeeuddin R, Sharir R, et al.

Sports Biomech, 2024 Mar;23(3):324-334.
PMID: 33886425 DOI: 10.1080/14763141.2020.1860254

Much inter-intra-tester kinematic and kinetic repeatability research exists, with a paucity investigating inter-laboratory equivalence. The objective of this research was to evaluate the inter-laboratory equivalence between time varying unplanned kinematics and moments of unplanned sidestepping (UnSS). Eight elite female athletes completed an established UnSS procedure motion capture laboratories in the UK and Australia. Three dimensional time varying unplanned sidestepping joint kinematics and moments were compared. Discrete variables were change of direction angles and velocity. Waveform data were compared using mean differences, 1D 95%CI and RMSE. Discrete variables were compared using 0D 95% CI. The mean differences and 95%CI for UnSS kinematics broadly supported equivalence between laboratories (RMSE≤5.1°). Excluding hip flexion/extension moments (RMSE = 1.04 Nm/kg), equivalence was also supported for time varying joint moments between laboratories (RMSE≤0.40 Nm/kg). Dependent variables typically used to characterise UnSS were also equivalent. When consistent experimental and modelling procedures are employed, consistent time varying UnSS lower limb joint kinematic and moment estimates between laboratories can be obtained. We therefore interpret these results as a support of equivalence, yet highlight the challenges of establishing between-laboratory experiments or data sharing, as well as establishing appropriate ranges of acceptable uncertainty. These findings are important for data sharing and multi-centre trials.

Matched MeSH terms: Weight-Bearing
Spinal tuberculosis: the association between pedicle involvement and anterior column damage and kyphotic deformity

Yusof MI, Hassan E, Rahmat N, Yunus R

Spine (Phila Pa 1976), 2009 Apr 1;34(7):713-7.
PMID: 19333105 DOI: 10.1097/BRS.0b013e31819b2159

Pedicle involvement in spinal tuberculosis (TB), the prevertebral abscess formation, severity of vertebral body, and disc collapse were evaluated from magnetic resonance imaging (MRI) of the patients.

Matched MeSH terms: Weight-Bearing/physiology
Fulltext Efficacy and tolerability of celecoxib compared with diclofenac slow release in the treatment of acute ankle sprain in an Asian population

Nadarajah A, Abrahan L, Lau FL, Hwang LJ, Fakir-Bolte C

Singapore Med J, 2006 Jun;47(6):534-42.
PMID: 16752024

INTRODUCTION: Cyclooxygenase (COX)-2 selective inhibitors are attractive candidates for treatment of ankle sprain because of their efficacy as anti-inflammatory and analgesic agents and their overall safety, including lack of effect on platelet aggregation. The objective of this study was to assess the efficacy and tolerability of celecoxib compared with diclofenac slow release (SR) in the treatment of acute ankle sprain in an Asian population.
METHODS: In this seven-day, multicentre, double-blind, randomised, parallel-group trial, 370 patients with first- or second-degree ankle sprain occurring at or less than 48 hours prior to the first dose of study medication were randomised to receive celecoxib 200 mg bid (189 patients) after a 400 mg loading dose or diclofenac SR 75 mg bid (181 patients). Patients were required to demonstrate moderate to severe ankle pain on weight bearing (45 mm or greater on a 100 mm visual analogue scale [VAS]) at baseline. The primary efficacy end point was the patient's assessment of ankle pain (VAS on full weight bearing) on day 4.
RESULTS: Celecoxib was as effective as diclofenac SR in improving the signs and symptoms of ankle sprain. At day 4, mean VAS scores for celecoxib and diclofenac SR had decreased to 28 mm and 30 mm, respectively. Treatment differences were not statistically significant. Incidence of upper gastrointestinal adverse events was low in both treatment groups (0.5 percent versus 2.2 percent for celecoxib and diclofenac SR, respectively).
CONCLUSION: Celecoxib, a COX-2 selective inhibitor, is as effective as diclofenac SR in treating ankle sprains. With its platelet-sparing properties, celecoxib may offer an advantage over diclofenac SR in managing musculoskeletal injuries.

Matched MeSH terms: Weight-Bearing/physiology
A comparison of pressure distributions between two types of sockets in a bulbous stump

Gholizadeh H, Abu Osman NA, Eshraghi A, Arifin N, Chung TY

Prosthet Orthot Int, 2016 Aug;40(4):509-16.
PMID: 25583929 DOI: 10.1177/0309364614564022

BACKGROUND: This article describes a total surface bearing prosthetic socket for a patient (25-year-old female) with a bulbous stump.
CASE DESCRIPTION AND METHODS: The subject had unstable excessive soft tissue at the distal end of the residuum. After 2 years of prosthetic use, she experienced several problems, including pain in the residual limb and knee joint. Pressure distribution was evaluated during ambulation. We also designed a total surface bearing socket with Velcro as suspension system to distribute the load evenly on the residual limb, and to facilitate donning procedure.
FINDINGS AND OUTCOMES: The main site of weight bearing in the old prosthesis (patellar tendon bearing) was anterior proximal region of the residual limb, especially the patellar tendon. The pressure was almost 10 times higher than the distal region during level walking. Pressures were distributed more evenly with the total surface bearing socket design, and the donning was much easier.
CONCLUSION: Pressure distribution within the socket could be affected by socket design and suspension system. Using the total surface bearing socket and Velcro as suspension system might facilitate donning of prosthesis and reduce traction at the end of residual limb during the swing phase of gait.
CLINICAL RELEVANCE: Proper socket design and suspension system based on the amputees' need can facilitate rehabilitation process and lead to the amputee's satisfaction. The pressure is distributed more uniformly over the residual limb by the total surface bearing socket compared to the patellar tendon bearing socket for lower limb amputees with unusual stump shape.

Matched MeSH terms: Weight-Bearing/physiology*
Effect of Milwaukee brace on static and dynamic balance of female hyperkyphotic adolescents

Eshraghi A, Maroufi N, Sanjari MA, Saeedi H, Keyhani MR, Gholizadeh H, et al.

Prosthet Orthot Int, 2013 Feb;37(1):76-84.
PMID: 22751219 DOI: 10.1177/0309364612448805

Biomechanical factors, such as spinal deformities can result in balance control disorders.

Matched MeSH terms: Weight-Bearing/physiology
A new approach for the pistoning measurement in transtibial prosthesis

Gholizadeh H, Abu Osman NA, Lúvíksdóttir Á, Eshraghi A, Kamyab M, Wan Abas WA

Prosthet Orthot Int, 2011 Dec;35(4):360-4.
PMID: 21975850 DOI: 10.1177/0309364611423130

Good suspension lessens the pistoning (vertical displacement) of the residual limb inside the prosthetic socket. Several methods are used for measuring the pistoning.

Matched MeSH terms: Weight-Bearing
Design of new generation femoral prostheses using functionally graded materials: a finite element analysis

Oshkour AA, Abu Osman NA, Yau YH, Tarlochan F, Abas WA

Proc Inst Mech Eng H, 2013 Jan;227(1):3-17.
PMID: 23516951

This study aimed to develop a three-dimensional finite element model of a functionally graded femoral prosthesis. The model consisted of a femoral prosthesis created from functionally graded materials (FGMs), cement, and femur. The hip prosthesis was composed of FGMs made of titanium alloy, chrome-cobalt, and hydroxyapatite at volume fraction gradient exponents of 0, 1, and 5, respectively. The stress was measured on the femoral prosthesis, cement, and femur. Stress on the neck of the femoral prosthesis was not sensitive to the properties of the constituent material. However, stress on the stem and cement decreased proportionally as the volume fraction gradient exponent of the FGM increased. Meanwhile, stress became uniform on the cement mantle layer. In addition, stress on the femur in the proximal part increased and a high surface area of the femoral part was involved in absorbing the stress. As such, the stress-shielding area decreased. The results obtained in this study are significant in the design and longevity of new prosthetic devices because FGMs offer the potential to achieve stress distribution that more closely resembles that of the natural bone in the femur.

Matched MeSH terms: Weight-Bearing/physiology*
Fulltext Use of Sawdust as admixture in cement-sand brick

Rosnani Ahmad, Rohaidah Md Nor, Siti Azliya Ismail

Pertanika Journal of Science & Technology, 2017;25(105):205-210.
MyJurnal

Sawdust is considered a waste material and a number of innovative ways are being taken to mitigate its effects on the environment. The use of sawdust as additional admixture in cement-sand brick production is an alternative option to mitigate the problem. In this study, three different types of cement-sand brick mixture in proportion of 1%, 2% and 3% of sawdust added to the normal mixture are prepared. Compression test was conducted on the brick mixture and results indicated 1% sawdust satisfy the Class 1 loadbearing brick whilst the 2% sawdust is slightly above the minimum required strength of 5.2 MN/ m2 for an ordinary quality brick set by the Standards MS 76:1972. Thus, the use of sawdust as admixture in cement-sand brick should not exceed 3%.

Matched MeSH terms: Weight-Bearing
Fulltext A case series of acquired haemophilia in a Malaysian hospital: unpredictably rare medical emergency

Lee CP, Khalid BB

Oxf Med Case Reports, 2015 Oct;2015(10):330-2.
PMID: 26568837 DOI: 10.1093/omcr/omv055

Acquired haemophilia (AH) is a rare bleeding disorder characterized by the presence of acquired inhibitors against Factor VIII causing disruption of coagulation cascade. It has no known genetic inheritance, and diagnosis remains a challenge. The peculiar presentations are later age of onset as acute pain in weight-bearing joints and spontaneous muscle haematoma with isolated prolonged activated partial thrombin time (APTT). Prevalence is 1 per million per year affecting both genders equally where blood product transfusion is seen in almost 87% of cases. The direct cause of AH is still unknown, and autoimmune dysregulation has been postulated, which predisposes to the development of the factor inhibitors. Being extremely rare, we are reporting two consecutive patients diagnosed by unusual bleeding episodes with isolated prolonged APTT due to Factor VIII inhibitors. AH deserves a special mention as high index of suspicion is required. More studies are required to provide better guidance in diagnosis and management of this condition.

Matched MeSH terms: Weight-Bearing
The patellar tendon bar! Is it a necessary feature?

Abu Osman NA, Spence WD, Solomonidis SE, Paul JP, Weir AM

Med Eng Phys, 2010 Sep;32(7):760-5.
PMID: 20678997 DOI: 10.1016/j.medengphy.2010.04.020

The purpose of this investigation was to vary the load on the patellar tendon bar and to study the subsequent effect this has on the pattern of the pressure distribution at the stump-socket interface. Ten male subjects from the Southern General Hospital in Glasgow, UK participated in this study. Measuring systems utilising strain gauge and electrohydraulic technologies were designed, developed and constructed to enable pressure measurements to be conducted. One transducer, the patellar tendon (PT) transducer, was attached to the patellar tendon bar of the socket such that the patellar tendon bar was capable of being translated by +/-10 mm towards or away from the tendon. The results of this study showed that the position of the patellar tendon bar had no significant effect on the pressure distribution around the socket indicating that it is an unnecessary feature, which, we propose, may be eliminated during manufacture of a trans-tibial socket.

Matched MeSH terms: Weight-Bearing
Biomechanical evaluation of two commonly used external fixators in the treatment of open subtalar dislocation--a finite element analysis

Ramlee MH, Kadir MR, Murali MR, Kamarul T

Med Eng Phys, 2014 Oct;36(10):1358-66.
PMID: 25092623 DOI: 10.1016/j.medengphy.2014.07.001

Subtalar dislocation is a rare injury caused by high-energy trauma. Current treatment strategies include leg casts, internal fixation and external fixation. Among these, external fixators are the most commonly used as this method is believed to provide better stabilization. However, the biomechanical stability provided by these fixators has not been demonstrated. This biomechanical study compares two commonly used external fixators, i.e. Mitkovic and Delta. CT imaging data were used to reconstruct three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones. The 3D models of the bones and cartilages were then converted into four-noded linear tetrahedral elements, whilst the ligaments were modelled with linear spring elements. Bones and cartilage were idealized as homogeneous, isotropic and linear. To simulate loading during walking, axial loading (70 N during the swing and 350 N during the stance phase) was applied at the end of diaphyseal tibia. The results demonstrate that the Mitkovic fixator produced greater displacement (peak 3.0mm and 15.6mm) compared to the Delta fixator (peak 0.8mm and 3.9 mm), in both the swing and stance phase, respectively. This study demonstrates that the Delta external fixator provides superior stability over the Mitkovic fixator. The Delta fixator may be more effective in treating subtalar dislocation.

Matched MeSH terms: Weight-Bearing
Number of pegs influence focal stress distributions and micromotion in glenoid implants: a finite element study

Wahab AH, Kadir MR, Harun MN, Kamarul T, Syahrom A

Med Biol Eng Comput, 2017 Mar;55(3):439-447.
PMID: 27255451 DOI: 10.1007/s11517-016-1525-6

The present study was conducted to compare the stability of four commercially available implants by investigating the focal stress distributions and relative micromotion using finite element analysis. Variations in the numbers of pegs between the implant designs were tested. A load of 750 N was applied at three different glenoid positions (SA: superior-anterior; SP: superior-posterior; C: central) to mimic off-center and central loadings during activities of daily living. Focal stress distributions and relative micromotion were measured using Marc Mentat software. The results demonstrated that by increasing the number of pegs from two to five, the total focal stress volumes exceeding 5 MPa, reflecting the stress critical volume (SCV) as the threshold for occurrence of cement microfractures, decreased from 8.41 to 5.21 % in the SA position and from 9.59 to 6.69 % in the SP position. However, in the C position, this change in peg number increased the SCV from 1.37 to 5.86 %. Meanwhile, micromotion appeared to remain within 19-25 µm irrespective of the number of pegs used. In conclusion, four-peg glenoid implants provide the best configuration because they had lower SCV values compared with lesser-peg implants, preserved more bone stock, and reduced PMMA cement usage compared with five-peg implants.

Matched MeSH terms: Weight-Bearing
Effect of nanofillers on the physico-mechanical properties of load bearing bone implants

Michael FM, Khalid M, Walvekar R, Ratnam CT, Ramarad S, Siddiqui H, et al.

Mater Sci Eng C Mater Biol Appl, 2016 Oct 01;67:792-806.
PMID: 27287178 DOI: 10.1016/j.msec.2016.05.037

Bones are nanocomposites consisting of a collagenous fibre network, embedded with calcium phosphates mainly hydroxyapatite (HA) nanocrystallites. As bones are subjected to continuous loading and unloading process every day, they often tend to become prone to fatigue and breakdown. Therefore, this review addresses the use of nanocomposites particularly polymers reinforced with nanoceramics that can be used as load bearing bone implants. Further, nanocomposite preparation and dispersion modification techniques have been highlighted along with thorough discussion on the influence that various nanofillers have on the physico-mechanical properties of nanocomposites in relation to that of natural bone properties. This review updates the nanocomposites that meet the physico-mechanical properties (strength and elasticity) as well as biocompatibility requirement of a load bearing bone implant and also attempts to highlight the gaps in the reported studies to address the fatigue and creep properties of the nanocomposites.

Matched MeSH terms: Weight-Bearing
Fulltext Fibre-Reinforced Foamed Concretes: A Review

Amran M, Fediuk R, Vatin N, Lee YH, Murali G, Ozbakkaloglu T, et al.

Materials (Basel), 2020 Sep 28;13(19).
PMID: 32998362 DOI: 10.3390/ma13194323

Foamed concrete (FC) is a high-quality building material with densities from 300 to 1850 kg/m3, which can have potential use in civil engineering, both as insulation from heat and sound, and for load-bearing structures. However, due to the nature of the cement material and its high porosity, FC is very weak in withstanding tensile loads; therefore, it often cracks in a plastic state, during shrinkage while drying, and also in a solid state. This paper is the first comprehensive review of the use of man-made and natural fibres to produce fibre-reinforced foamed concrete (FRFC). For this purpose, various foaming agents, fibres and other components that can serve as a basis for FRFC are reviewed and discussed in detail. Several factors have been found to affect the mechanical properties of FRFC, namely: fresh and hardened densities, particle size distribution, percentage of pozzolanic material used and volume of chemical foam agent. It was found that the rheological properties of the FRFC mix are influenced by the properties of both fibres and foam; therefore, it is necessary to apply an additional dosage of a foam agent to enhance the adhesion and cohesion between the foam agent and the cementitious filler in comparison with materials without fibres. Various types of fibres allow the reduction of by autogenous shrinkage a factor of 1.2-1.8 and drying shrinkage by a factor of 1.3-1.8. Incorporation of fibres leads to only a slight increase in the compressive strength of foamed concrete; however, it can significantly improve the flexural strength (up to 4 times), tensile strength (up to 3 times) and impact strength (up to 6 times). At the same time, the addition of fibres leads to practically no change in the heat and sound insulation characteristics of foamed concrete and this is basically depended on the type of fibres used such as Nylon and aramid fibres. Thus, FRFC having the presented set of properties has applications in various areas of construction, both in the construction of load-bearing and enclosing structures.

Matched MeSH terms: Weight-Bearing
Fulltext Numerical Prediction of Residual Stresses Distribution in Thin-Walled Press-Braked Stainless Steel Sections

Mutafi A, Yidris N, Koloor SSR, Petrů M

Materials (Basel), 2020 Nov 26;13(23).
PMID: 33256257 DOI: 10.3390/ma13235378

Stainless steels are increasingly used in construction today, especially in harsh environments, in which steel corrosion commonly occurs. Cold-formed stainless steel structures are currently increasing in popularity because of its efficiency in load-bearing capacity and its appealing architectural appearance. Cold-rolling and press-braking are the cold-working processes used in the forming of stainless steel sections. Press braking can produce large cross-sections from thin to thick-walled sections compared to cold-rolling. Cold-forming in press-braked sections significantly affect member behaviour and joints; therefore, they have attained great attention from many researchers to initiate investigations on those effects. This paper examines the behaviour of residual stress distribution of stainless steel press-braked sections by implementing three-dimensional finite element (3D-FE) technique. The study proposed a full finite element procedure to predict the residual stresses starting from coiling-uncoiling to press-braking. This work considered material anisotropy to examine its effect on the residual stress distribution. The technique adopted was compared with different finite element techniques in the literature. This study also provided a parametric study for three corner radius-to-thickness ratios looking at the through-thickness residual stress distribution of four stainless steels (i.e., ferritic, austenitic, duplex, lean duplex) in which have their own chemical composition. In conclusion, the comparison showed that the adopted technique provides a detailed prediction of residual stress distribution. The influence of geometrical aspects is more pronounced than the material properties. Neglecting the material anisotropy shows higher shifting in the neutral axis. The parametric study showed that all stainless steel types have the same stress through-thickness distribution. Moreover, R/t ratios' effect is insignificant in all transverse residual stress distributions, but a slight change to R/t ratios can affect the longitudinal residual stress distribution.

Matched MeSH terms: Weight-Bearing
Fulltext Properties of a New Insulation Material Glass Bubble in Geo-Polymer Concrete

Shahedan NF, Abdullah MMAB, Mahmed N, Kusbiantoro A, Tammas-Williams S, Li LY, et al.

Materials (Basel), 2021 Feb 08;14(4).
PMID: 33567696 DOI: 10.3390/ma14040809

This paper details analytical research results into a novel geopolymer concrete embedded with glass bubble as its thermal insulating material, fly ash as its precursor material, and a combination of sodium hydroxide (NaOH) and sodium silicate (Na2SiO3) as its alkaline activator to form a geopolymer system. The workability, density, compressive strength (per curing days), and water absorption of the sample loaded at 10% glass bubble (loading level determined to satisfy the minimum strength requirement of a load-bearing structure) were 70 mm, 2165 kg/m3, 52.58 MPa (28 days), 54.92 MPa (60 days), and 65.25 MPa (90 days), and 3.73 %, respectively. The thermal conductivity for geopolymer concrete decreased from 1.47 to 1.19 W/mK, while the thermal diffusivity decreased from 1.88 to 1.02 mm2/s due to increased specific heat from 0.96 to 1.73 MJ/m3K. The improved physicomechanical and thermal (insulating) properties resulting from embedding a glass bubble as an insulating material into geopolymer concrete resulted in a viable composite for use in the construction industry.

Matched MeSH terms: Weight-Bearing
Fulltext Morphological Change of Heat Treated Bovine Bone: A Comparative Study

Pramanik S, Hanif ASM, Pingguan-Murphy B, Abu Osman NA

Materials (Basel), 2012 Dec 21;6(1):65-75.
PMID: 28809294 DOI: 10.3390/ma6010065

In this work, untreated bovine cortical bones (BCBs) were exposed to a range of heat treatments in order to determine at which temperature the apatite develops an optimum morphology comprising porous nano hydroxyapatite (nanoHAp) crystals. Rectangular specimens (10 mm × 10 mm × 3-5 mm) of BCB were prepared, being excised in normal to longitudinal and transverse directions. Specimens were sintered at up to 900 °C under ambient pressure in order to produce apatites by two steps sintering. The samples were characterized by thermogravimetric analysis, X-ray diffraction (XRD), and scanning electron microscopy (SEM) attached to an energy-dispersive X-ray spectroscopy detector. For the first time, morphology of the HAp particles was predicted by XRD, and it was verified by SEM. The results show that an equiaxed polycrystalline HAp particle with uniform porosity was produced at 900 °C. It indicates that a porous nanoHAp achieved by sintering at 900 °C can be an ideal candidate as an in situ scaffold for load-bearing tissue applications.

Matched MeSH terms: Weight-Bearing
Fulltext Ankle Arthrodesis using Ilizarov Ring Fixator: A Primary or Salvage Procedure? An Analysis of Twenty Cases

Hasan O, Fahad S, Sattar S, Umer M, Rashid H

Malays Orthop J, 2018 Nov;12(3):24-30.
PMID: 30555643 DOI: 10.5704/MOJ.1811.006

Introduction: Ankle arthrodesis using the Ilizarov technique provides high union rate with the added benefits of early weight-bearing, and the unique advantage of its ability to promote regeneration of soft tissue around the bone, including skin, muscle and neuro-vascular structures, and its versatility to allow correction of the position of the foot by adjusting the frame post-operatively as needed. We describe our experience with this technique and the functional outcomes in our patients. Materials and Methods: This retrospective study was conducted in 20 ankle fusion cases using the Ilizarov method between the years 2007 and 2017. We defined success in treatment by loss of preoperative symptoms and radiological union on plain radiographs of the ankle. Results: Fusion was achieved in all patients (100%). Immediate post-operative ambulation was with full weight bearing (FWB) in 16 (83%) of the participants and non-weight bearing (NWB) in 3 patients (17%). Post-procedure 11 patients (67%) of the participants who were full weight bearing required some form of support for walking for 2-3 weeks. Post-operatively three patients had pin tract infection requiring intravenous antibiotics. Radiological union took range of 6-12 weeks, mean union time was 8 weeks. Only one patient required bone grafting due to bone loss. Average follow-up period was 10-45 months. Conclusion: The Ilizarov technique has a high union rate and leads to general favourable clinical outcome and may be considered for any ankle arthrodesis but is especially useful in complex cases such as for revisions, soft-tissue compromise, infection and in patients with risk for non-union. Early weight bearing is an extra benefit.

Matched MeSH terms: Weight-Bearing

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