Browsing by Author "Rothem, David"

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    Temporary bridging trans-hip external fixation in damage control orthopaedics treatment after severe combat trauma : A clinical case series
    (2023-03) Lerner, Alexander; Jakusonoka, Ruta; Jumtins, Andris; Rothem, David; Department of Orthopaedics
    The role of external fixation in Damage Control Orthopaedics has been well described. Temporary external fixation has been recommended to provide relative bone stability while the soft tissue heals, prior to formal open reduction and internal fixation. Temporary bridging external fixation, that spans the joint, is recommended as primary skeletal stabilization in complex intra-articular and peri-articular fractures, in extensive peri-articular soft-tissue damage around the knee, ankle, elbow and wrist joints. Works devoted to temporary trans-hip external fixation in treatment of complex high-energy injuries are relatively rare. The purpose of this article is to present our experience in using temporary hip spanning external fixation during primary treatment of six patients suffered from complex open intra-articular and peri-articular fractures of the proximal femoral bone with extensive soft tissue damage due to war blast or high-velocity gunshot trauma. Primary management was based on the concept of Advanced Trauma Life Support and Damage Control Orthopaedics. Conversion to definitive bone reconstruction was performed on the next stage of the treatment after general and local stabilization.
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    Treatment of Bifocal Periprosthetic Fractures above and below a Knee after Tumor using Spanning Ilizarov Device : A Case Report
    (2023-09) Lerner, Alexander; Jakusonoka, Ruta; Jumtins, Andris; Rothem, David; Department of Orthopaedics
    INTRODUCTION: Multiple treatment options and internal and external devices have been recommended for periprosthetic fractures management around total knee arthroplasty. CASE REPORT: We present the case of the high-energy bifocal periprosthetic fractures of the femur and the tibia after total knee prosthesis following excision of a tumor. One of the fractures was an open tibial fracture Gustilo Type IIIB and the other - comminuted subtrochanteric fracture of the femur with extrusion of periprosthetic cement pieces out from the bone defect. The Ilizarov circular external fixator was used for the skeletal stabilization and early functional treatment in this compound case. CONCLUSION: The use of Ilizarov external fixator for patients with complex periprosthetic fractures, who present severe technical difficulties in bone stabilization, especially by concomitant severe soft-tissue damage after high-energy injuries, is a good surgical alternative.