Leonid Solomin | R.R.Vreden Russian Research Institute of Traumatology and Orthopedics (original) (raw)

Papers by Leonid Solomin

Research paper thumbnail of Acute Shortening for Open Tibial Fractures with Bone and Soft Tissue Defects: Systematic Review of Literature

Strategies in Trauma and Limb Reconstruction

Introduction: The presence of massive soft tissue loss in open tibial fractures is a challenging ... more Introduction: The presence of massive soft tissue loss in open tibial fractures is a challenging problem. Acute limb shortening is an alternative solution in situations where the use of flaps is limited. Materials and methods: A review was conducted following the Preferred Reported Items for Systematic Reviews and Meta-analyses checklist (PRISMA) guidelines. A complete search of PubMed, EMBASE and MEDLINE was undertaken. Twenty-four articles related to closure of soft tissue defects through acute limb shortening were identified and included in this review. Results: All report on restoration of limb function without or with minimal residual shortening. The authors note a decrease in the need for microsurgery. The external fixation devices used for deformity correction after closure of the soft tissue defect by acute shortening, angulation and rotation were the Ilizarov apparatus and circular fixator hexapods mainly. Conclusion: Acute shortening is an alternative to microsurgical techniques. A ring external fixator is useful for restoring limb alignment after closing the soft tissue defect through creating a temporary deformity. The use of circular fixator hexapods can enable accurate correction of complex multicomponent deformities without the need to reassembly of individual correction units.

Research paper thumbnail of Planning hindfoot deformity correction

The results of the developed method of analysis and planning hindfoot deformities correction in t... more The results of the developed method of analysis and planning hindfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible midfoot deformities or equinus of the ankle joint.

Research paper thumbnail of A novel method of planning midfoot deformity correction

The results of the developed method of analysis and planning midfoot deformities correction in th... more The results of the developed method of analysis and planning midfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible hindfoot deformities or equinus of the ankle joint

Research paper thumbnail of Characteristics of Effective and Safe Methods of Treatment for Fresh Fracture-Dislocations of the Proximal Humerus

Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proxi... more Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics. Patients and Methods This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis. Results Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s...

Research paper thumbnail of Use of Orthopaedic Hexapod (Ortho-SUV Frame) in Nonunion of Shaft of Long Bones

Research paper thumbnail of Atlas of "recommended positions" for insertion of transosseous elements through foot

Orthopaedic Genius, 2014

Purpose. To create an improved atlas designed to insert transosseous elements through foot bones.... more Purpose. To create an improved atlas designed to insert transosseous elements through foot bones. Materials and Methods. The study performed in two stages using eight frozen (fixed) and ten non-fixed cadaveric preparations of leg-foot complex. The foot was divided in 14 transverse and 3 oblique levels. 12 positions were determined at each of the levels for each bone of the level. Both prohibited positions (the projection of significant blood vessels and nerves) and safe positions determined in the frozen preparations. The displacement amounts of soft tissues in the non-fixed preparations studied relative to foot bones for movements in the ankle, metacarpophalangeal, and interphalangeal joints. The positions with minimum displacement of soft tissues and with the absence of significant vessels and nerves were designated as “recommended positions” for insertion of wires and half-pins in transosseous osteosynthesis. Results. The data obtained during the experiment were processed graphic...

Research paper thumbnail of Ortho-SUV frame: a transosseous device, the work of which is based on computer navigation

Orthopaedic Genius, 2011

The three-fold, five-fold change of unified repositional hinges is necessary for correction of co... more The three-fold, five-fold change of unified repositional hinges is necessary for correction of complex multicomponental multiplanar deformities using the Ilizarov fixator. Transosseous devices the work of which is based on computer navigation (so-called hexapods) allow to move bone fragments in a single-stage manner along the “integral” trajectory. The length of each of connecting telescopic rods – struts – conforms to the initial position of bone fragments. The software calculates the change of each strut length to achieve the required bone fragment position. The made comparative analysis of the hexapods used nowadays (Taylor Spatial Frame, Ilizarov Hexapod System and Ortho-SUV Frame) has demonstrated the advantages of Ortho-SUV frame in the potentials of reposition, osteosynthesis rigidity, comfort of hardware and software use. Ortho-SUV Frame has been evaluated in treatment of 93 patients (109 cases of the frame appliance). Deformity correction (fracture reposition) was achieved ...

Research paper thumbnail of Complications in the Combined and Consecutive Use of External and Internal Fixation of the Femur with Reference to Use of the Extracortical Clamp Device

Orthopedics Research and Traumatology – Open Journal, 2018

The Extracortical Clamp Device (ECD) is a novel external fixation component which unlike conventi... more The Extracortical Clamp Device (ECD) is a novel external fixation component which unlike conventional implants does not perforate long bone cortices. Therefore, it simplifies methods of combined and consecutive internal and external fixation, periprosthetic fracture osteosynthesis and deformity correction. This study compared the incidence of complications with the use of the ECD in combined external fixation of the femur.

Research paper thumbnail of Identification of Femoral Reference Lines and Angles in Sagittal Plane (Preliminary Report)

Journal of Bone Reports & Recommendations, 2017

The Reference Lines and Angles (RLA) of femur in the sagittal plane which characterize its physio... more The Reference Lines and Angles (RLA) of femur in the sagittal plane which characterize its physiological sagittal bowing have not been found till now. Mutual relations of the mid-diaphyseal lines of the proximal, middle and distal thirds of femur in 30 femoral bones were studied. The angle between the mid-diaphyseal lines at the level of the proximal third is 10°, at the level of the middle third-16°, at the level of the distal third-7°. A comparatively small amount of the experimental bones makes it possible to consider our results as a preliminary data.

Research paper thumbnail of Tne stiffness of first-order and second-order modules assembled with extracortical clamp devices

Traumatology and Orthopedics of Russia, 2015

теоретические и экспериментальные исследования т р а в м а т о л о г и я и о р т о п е д и я р о ... more теоретические и экспериментальные исследования т р а в м а т о л о г и я и о р т о п е д и я р о с с и и 2015-1 (75)

Research paper thumbnail of Determination of optimal assemblies of software-based Ortho-SUV frame for correction of complex midfoot and hindfoot deformities

Traumatology and Orthopedics of Russia, 2014

Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the corre... more Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the correction of complicated midfoot and hindfoot deformities. Material and methods: The study was carried out using plastic “shin-foot”complexes, on which different versions of Orto-SUV device layout: five versions for midfoot deformities and three versions for hindfoot deformities. A model providing maximum amplitude of the movement was considered optimal. Results: Optimal layout for midfoot provides dorsiflexion of 41,1±1,7°; plantar flexion - 32,1±1,4°; supination - 53,3±1,8°; pronation - 35±1,6°; abduction - 44,2±2,1°; adduction - 43,2±1,7°. Optimal layout for the correction of hindfoot deformities provides rotation in sagittal plane upwards - 96,5±2,4°;rotation in sagittal plane downwards - 36,2±1,4°;“varusation” (angulationmedially in the frontal plane) - 31±1,3°; “valgusation” (in the frontal plane outwards) - 44,5±1,9°; movement upwards and backwards, angle of 45° to the horizontal plan...

Research paper thumbnail of Complications after use of extracortical clamp device in combined and consecutive external and internal fixation of femoral bone

Traumatology and Orthopedics of Russia, 2015

Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins... more Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins, does not perforate long bone cortex. Therefore, its use simplifies methods of combined and consequtive use of internal and external fixation, osteosynthesis in periprosthetic fractures and deformities. Purpose of the study - to compare the rate of complications and their structure depending on extracortical clamp device application and conventional transosseous elements in combined external fixation of femur. Materials and methods. We analyzed the complications arising in treatment of 66 patients with frames where ECD were used (group «ECD»). The results were compared with the results of treatment 29 patients, when utilizing combination of external and internal fixation, external fixation device included conventional transosseous elements only (group «W-P»). Results. In the group «ECD» inflammation of the soft tissues around fixing elements was identified in 14.8% of cases. In these pa...

Research paper thumbnail of Avoidance of external fixation pin induced rotational stiffness in the forearm; a cadaver study of soft tissue displacement relative to the varying position of radius and ulna fixation

SICOT-J, 2015

Introduction: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent comp... more Introduction: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent complication of external fixation. Conventional surgical atlases do not consider the effect of rotation on skin displacement and thus do not provide a comprehensive answer. We asked: (1) in what locations in the forearm is soft tissue displacement relative to the ulna and radius least during rotation; (2) in what positions are major neurovascular structures absent; and (3) what maximal range of rotation can be expected in forearm external fixation. Methods: Thirty-four matched cadaver arms were used to assess displacement of soft tissues at 10°, 30°and 70°of pronation and supination in relation to a testing frame. The results of these were correlated with positions in which neurovascular structures were absent and deemed insertional ''Reference Positions (RP)''. Results: Expected range of rotation in diaphyseal fractures of different levels of both forearm bones was found with RP for the ulna occurring along the length of the forearm. Reference positions for the radius which provide full forearm rotation are situated only in the distal third; positions which provide partial rotation are located in the proximal and middle third. Discussion: Full range of rotation may be maintained in the case of isolated external fixation of ulnar diaphyseal fractures. In isolated external fixation of the radius a reduced range of forearm rotation may be expected.

Research paper thumbnail of Планирование и коррекция деформаций длинных костей на основе использования моделей трехмерной печати (предварительное сообщение)

Genij Ortopedii, 2015

исследовательский детский ортопедический институт им. Г.И. Турнера» Министерства здравоохранения ... more исследовательский детский ортопедический институт им. Г.И. Турнера» Министерства здравоохранения Российской Федерации, г. Санкт-Петербург 2 ФГБУ "Российский научно-исследовательский институт травматологии и ортопедии имени Р.

Research paper thumbnail of Use of the Extracortical Clamp Device in the treatment of periprosthetic femoral fractures and deformities

Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) tradit... more Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) traditionally require fixation with cable or divergent screw plates or allograft struts. Union rates of 86% and complication rates of 29% have been reported 1,2. Circular external fixation has been used successfully, however the presence of an implant restricts pin position opions, and risks endoprosthetic infection 3,4. A novel percutaneously inserted Extracortical Clamp Device (ECD) was developed to allow stable capture of the endoprosthetic femoral fragment without disturbing the prosthesis or cortical envelope and to permit a minimally invasive external fixation solution to achieve union without fracture site or prosthetic bed violation.

Research paper thumbnail of Definitive management of significant soft tissue loss associated with open diaphyseal fractures utilising circular external fixation without free tissue transfer, a comprehensive review of the literature and illustrative case

European journal of orthopaedic surgery & traumatology : orthopédie traumatologie, 2015

Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intr... more Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intramedullary stabilisation with free or rotational musculocutaneous flap coverage. Circular external fixation is a powerful tool in the management of limb trauma and with recent advances has been developed to provide multiple techniques for which even massive tissue loss can be addressed without the need for free tissue transfer. Gradual and acute shortening, acute fracture deformation and gradual lengthening with restoration of deformity combined with distraction tissue histiogenesis can provide the surgeon with an array of options which can be precisely tailored to the particular personality of a severe open diaphyseal fracture.

Research paper thumbnail of Determination of the Maximal Corrective Ability and Optimal Placement of the Ortho-SUV Frame for Femoral Deformity with respect to the Soft Tissue Envelope, a Biomechanical Modelling Study

Advances in Orthopedics, 2014

Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for... more Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for trauma and deformity. One shortcoming of the traditional fixator is its limited ability to correct more than one plane of deformity simultaneously, leading to lengthy frame-time indices. Hexapod circular fixation utilising computer guidance is commonplace for complex multidimensional deformity but difficulties often arise with correction of femoral deformity due to bulkiness of the frame construct, particularly in proximal deformity and in patients of increased size. The Ortho-SUV frame is an innovative hexapod which permits unique customisation to individual patient anatomy to maximise tolerance and optimal range of deformity correction. We hypothesised that the optimal configuration and maximal degree of correction achievable by the Ortho-SUV frame can be biomechanically modelled and applied clinically. A study was constructed using Ortho-SUV and femoral limb models to measure deformi...

Research paper thumbnail of Deformity Correction and Fracture Treatment Using the Software-Based Ortho-SUV Frame

In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) ... more In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) using the Ilizarov frame, unified reduction nodes have to be replaced three to five times (Fig. 17.1) [368]. Every frame re-assembly involves a change in the reductional units and is a highly laborious process in which there is additional patient exposure to radiation. Sometimes, due to the peculiarities of frame assembly (external supports are not oriented at a right angle to the axes of the bone fragments, a bone is not at the center of a support, the support for some reason is not closed, etc.), correction of one component can lead to the secondary translation of other(s). These secondary translations will, in turn, require correction and therefore additional frame re-assembly.

Research paper thumbnail of Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device | Solomin, Leonid | 9788847005129 | Springer

Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device ... more Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device al precio 169,52 € de Solomin, Leonid, tienda de Libros de Medicina, Libros de Nefrologia - Nefrologia clinica

Research paper thumbnail of Foot Deformity Correction Planning in the Sagittal Plane Based on the Vitruvian Foot First Metatarsal Anatomic Axis

The Journal of Foot and Ankle Surgery

wThe aim of this study was to test a novel planning method for midfoot deformity correction, base... more wThe aim of this study was to test a novel planning method for midfoot deformity correction, based on reference lines and angles (RLA) of talus and first metatarsal of 64 normal radiographs from 55 patients. The anatomic lateral talometatarsal angle (aLTMA), resulting from the intersection of talus joint line (TJL), from the border of the articular surface of the talus to the posterior process of talus, and the anatomic axis of the first metatarsal, was 28.5° ± 4.5°. The intersection of those 2 lines divided the TJL in 2 segments (ac and ab) with the ratio k1 = 0.7 ± 0.3. The length of the first metatarsal line was measured from its intersection with the TJL and first metatarsal head, and it was 3.6 times longer that of the TJL (k2). To analyze foot deformity, we propose to draw the TJL line as follows. Use the k1 ratio to determine the point where the aLMTA intersects the TJL. From this point, an idealized anatomic first metatarsal line should be drawn, at 28.5° from the TJL. The distal end of that line is based on the k2 ratio (3.6 × TJL length). Next, the actual anatomic lateral talometatarsal line of the deformed foot is drawn. The intersection between these 2 lines identifies the apex and magnitude of the deformity. Deformity correction planning using the proposed method was demonstrated and confirmed in 2 cases. A reference method for analysis and planning of midfoot sagittal plane deformity correction independent of foot position relative to the ankle joint or the presence of concomitant hindfoot deformity appears promising for future investigation and use.

Research paper thumbnail of Acute Shortening for Open Tibial Fractures with Bone and Soft Tissue Defects: Systematic Review of Literature

Strategies in Trauma and Limb Reconstruction

Introduction: The presence of massive soft tissue loss in open tibial fractures is a challenging ... more Introduction: The presence of massive soft tissue loss in open tibial fractures is a challenging problem. Acute limb shortening is an alternative solution in situations where the use of flaps is limited. Materials and methods: A review was conducted following the Preferred Reported Items for Systematic Reviews and Meta-analyses checklist (PRISMA) guidelines. A complete search of PubMed, EMBASE and MEDLINE was undertaken. Twenty-four articles related to closure of soft tissue defects through acute limb shortening were identified and included in this review. Results: All report on restoration of limb function without or with minimal residual shortening. The authors note a decrease in the need for microsurgery. The external fixation devices used for deformity correction after closure of the soft tissue defect by acute shortening, angulation and rotation were the Ilizarov apparatus and circular fixator hexapods mainly. Conclusion: Acute shortening is an alternative to microsurgical techniques. A ring external fixator is useful for restoring limb alignment after closing the soft tissue defect through creating a temporary deformity. The use of circular fixator hexapods can enable accurate correction of complex multicomponent deformities without the need to reassembly of individual correction units.

Research paper thumbnail of Planning hindfoot deformity correction

The results of the developed method of analysis and planning hindfoot deformities correction in t... more The results of the developed method of analysis and planning hindfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible midfoot deformities or equinus of the ankle joint.

Research paper thumbnail of A novel method of planning midfoot deformity correction

The results of the developed method of analysis and planning midfoot deformities correction in th... more The results of the developed method of analysis and planning midfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible hindfoot deformities or equinus of the ankle joint

Research paper thumbnail of Characteristics of Effective and Safe Methods of Treatment for Fresh Fracture-Dislocations of the Proximal Humerus

Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proxi... more Aim The study was aimed to assess the results of treatment for fracture-dislocations of the proximal humerus (PH) within different time frames for optimizing treatment tactics. Patients and Methods This retrospective cohort study evaluated clinical outcomes of 25 patients with fracture-dislocations of the PH (15 patients were analyzed for short- and medium-term results, and 10 – for long-term results). The follow-up period ranged from 1 to 9-years. All patients underwent: clinical examination, constant score assessment and shoulder X-ray examination. Clinical, radiological and statistical methods were used for analysis. Results Assessment of the degree of initial displacement of tubercles and its impact on the results of treatment showed that significantly better results were obtained in case of displacement no more than 10 mm (p=0.041). Patients with displacement no more than 10 mm had an average score of 68.0±16.1 points (Mean=69.5), while those with displacement of the tubercle(s...

Research paper thumbnail of Use of Orthopaedic Hexapod (Ortho-SUV Frame) in Nonunion of Shaft of Long Bones

Research paper thumbnail of Atlas of "recommended positions" for insertion of transosseous elements through foot

Orthopaedic Genius, 2014

Purpose. To create an improved atlas designed to insert transosseous elements through foot bones.... more Purpose. To create an improved atlas designed to insert transosseous elements through foot bones. Materials and Methods. The study performed in two stages using eight frozen (fixed) and ten non-fixed cadaveric preparations of leg-foot complex. The foot was divided in 14 transverse and 3 oblique levels. 12 positions were determined at each of the levels for each bone of the level. Both prohibited positions (the projection of significant blood vessels and nerves) and safe positions determined in the frozen preparations. The displacement amounts of soft tissues in the non-fixed preparations studied relative to foot bones for movements in the ankle, metacarpophalangeal, and interphalangeal joints. The positions with minimum displacement of soft tissues and with the absence of significant vessels and nerves were designated as “recommended positions” for insertion of wires and half-pins in transosseous osteosynthesis. Results. The data obtained during the experiment were processed graphic...

Research paper thumbnail of Ortho-SUV frame: a transosseous device, the work of which is based on computer navigation

Orthopaedic Genius, 2011

The three-fold, five-fold change of unified repositional hinges is necessary for correction of co... more The three-fold, five-fold change of unified repositional hinges is necessary for correction of complex multicomponental multiplanar deformities using the Ilizarov fixator. Transosseous devices the work of which is based on computer navigation (so-called hexapods) allow to move bone fragments in a single-stage manner along the “integral” trajectory. The length of each of connecting telescopic rods – struts – conforms to the initial position of bone fragments. The software calculates the change of each strut length to achieve the required bone fragment position. The made comparative analysis of the hexapods used nowadays (Taylor Spatial Frame, Ilizarov Hexapod System and Ortho-SUV Frame) has demonstrated the advantages of Ortho-SUV frame in the potentials of reposition, osteosynthesis rigidity, comfort of hardware and software use. Ortho-SUV Frame has been evaluated in treatment of 93 patients (109 cases of the frame appliance). Deformity correction (fracture reposition) was achieved ...

Research paper thumbnail of Complications in the Combined and Consecutive Use of External and Internal Fixation of the Femur with Reference to Use of the Extracortical Clamp Device

Orthopedics Research and Traumatology – Open Journal, 2018

The Extracortical Clamp Device (ECD) is a novel external fixation component which unlike conventi... more The Extracortical Clamp Device (ECD) is a novel external fixation component which unlike conventional implants does not perforate long bone cortices. Therefore, it simplifies methods of combined and consecutive internal and external fixation, periprosthetic fracture osteosynthesis and deformity correction. This study compared the incidence of complications with the use of the ECD in combined external fixation of the femur.

Research paper thumbnail of Identification of Femoral Reference Lines and Angles in Sagittal Plane (Preliminary Report)

Journal of Bone Reports & Recommendations, 2017

The Reference Lines and Angles (RLA) of femur in the sagittal plane which characterize its physio... more The Reference Lines and Angles (RLA) of femur in the sagittal plane which characterize its physiological sagittal bowing have not been found till now. Mutual relations of the mid-diaphyseal lines of the proximal, middle and distal thirds of femur in 30 femoral bones were studied. The angle between the mid-diaphyseal lines at the level of the proximal third is 10°, at the level of the middle third-16°, at the level of the distal third-7°. A comparatively small amount of the experimental bones makes it possible to consider our results as a preliminary data.

Research paper thumbnail of Tne stiffness of first-order and second-order modules assembled with extracortical clamp devices

Traumatology and Orthopedics of Russia, 2015

теоретические и экспериментальные исследования т р а в м а т о л о г и я и о р т о п е д и я р о ... more теоретические и экспериментальные исследования т р а в м а т о л о г и я и о р т о п е д и я р о с с и и 2015-1 (75)

Research paper thumbnail of Determination of optimal assemblies of software-based Ortho-SUV frame for correction of complex midfoot and hindfoot deformities

Traumatology and Orthopedics of Russia, 2014

Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the corre... more Aim: to find the optimal configuration of passive computer-assisted ORTO-SUV device for the correction of complicated midfoot and hindfoot deformities. Material and methods: The study was carried out using plastic “shin-foot”complexes, on which different versions of Orto-SUV device layout: five versions for midfoot deformities and three versions for hindfoot deformities. A model providing maximum amplitude of the movement was considered optimal. Results: Optimal layout for midfoot provides dorsiflexion of 41,1±1,7°; plantar flexion - 32,1±1,4°; supination - 53,3±1,8°; pronation - 35±1,6°; abduction - 44,2±2,1°; adduction - 43,2±1,7°. Optimal layout for the correction of hindfoot deformities provides rotation in sagittal plane upwards - 96,5±2,4°;rotation in sagittal plane downwards - 36,2±1,4°;“varusation” (angulationmedially in the frontal plane) - 31±1,3°; “valgusation” (in the frontal plane outwards) - 44,5±1,9°; movement upwards and backwards, angle of 45° to the horizontal plan...

Research paper thumbnail of Complications after use of extracortical clamp device in combined and consecutive external and internal fixation of femoral bone

Traumatology and Orthopedics of Russia, 2015

Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins... more Introduction. Extracortical Clamp Device (ECD) is a tool that, unlike conventional wires and pins, does not perforate long bone cortex. Therefore, its use simplifies methods of combined and consequtive use of internal and external fixation, osteosynthesis in periprosthetic fractures and deformities. Purpose of the study - to compare the rate of complications and their structure depending on extracortical clamp device application and conventional transosseous elements in combined external fixation of femur. Materials and methods. We analyzed the complications arising in treatment of 66 patients with frames where ECD were used (group «ECD»). The results were compared with the results of treatment 29 patients, when utilizing combination of external and internal fixation, external fixation device included conventional transosseous elements only (group «W-P»). Results. In the group «ECD» inflammation of the soft tissues around fixing elements was identified in 14.8% of cases. In these pa...

Research paper thumbnail of Avoidance of external fixation pin induced rotational stiffness in the forearm; a cadaver study of soft tissue displacement relative to the varying position of radius and ulna fixation

SICOT-J, 2015

Introduction: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent comp... more Introduction: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent complication of external fixation. Conventional surgical atlases do not consider the effect of rotation on skin displacement and thus do not provide a comprehensive answer. We asked: (1) in what locations in the forearm is soft tissue displacement relative to the ulna and radius least during rotation; (2) in what positions are major neurovascular structures absent; and (3) what maximal range of rotation can be expected in forearm external fixation. Methods: Thirty-four matched cadaver arms were used to assess displacement of soft tissues at 10°, 30°and 70°of pronation and supination in relation to a testing frame. The results of these were correlated with positions in which neurovascular structures were absent and deemed insertional ''Reference Positions (RP)''. Results: Expected range of rotation in diaphyseal fractures of different levels of both forearm bones was found with RP for the ulna occurring along the length of the forearm. Reference positions for the radius which provide full forearm rotation are situated only in the distal third; positions which provide partial rotation are located in the proximal and middle third. Discussion: Full range of rotation may be maintained in the case of isolated external fixation of ulnar diaphyseal fractures. In isolated external fixation of the radius a reduced range of forearm rotation may be expected.

Research paper thumbnail of Планирование и коррекция деформаций длинных костей на основе использования моделей трехмерной печати (предварительное сообщение)

Genij Ortopedii, 2015

исследовательский детский ортопедический институт им. Г.И. Турнера» Министерства здравоохранения ... more исследовательский детский ортопедический институт им. Г.И. Турнера» Министерства здравоохранения Российской Федерации, г. Санкт-Петербург 2 ФГБУ "Российский научно-исследовательский институт травматологии и ортопедии имени Р.

Research paper thumbnail of Use of the Extracortical Clamp Device in the treatment of periprosthetic femoral fractures and deformities

Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) tradit... more Periprosthetic femoral fractures with a well fixed endoprosthesis (Vancouver types B1 & C) traditionally require fixation with cable or divergent screw plates or allograft struts. Union rates of 86% and complication rates of 29% have been reported 1,2. Circular external fixation has been used successfully, however the presence of an implant restricts pin position opions, and risks endoprosthetic infection 3,4. A novel percutaneously inserted Extracortical Clamp Device (ECD) was developed to allow stable capture of the endoprosthetic femoral fragment without disturbing the prosthesis or cortical envelope and to permit a minimally invasive external fixation solution to achieve union without fracture site or prosthetic bed violation.

Research paper thumbnail of Definitive management of significant soft tissue loss associated with open diaphyseal fractures utilising circular external fixation without free tissue transfer, a comprehensive review of the literature and illustrative case

European journal of orthopaedic surgery & traumatology : orthopédie traumatologie, 2015

Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intr... more Accepted management of diaphyseal fractures associated with significant tissue loss is rigid intramedullary stabilisation with free or rotational musculocutaneous flap coverage. Circular external fixation is a powerful tool in the management of limb trauma and with recent advances has been developed to provide multiple techniques for which even massive tissue loss can be addressed without the need for free tissue transfer. Gradual and acute shortening, acute fracture deformation and gradual lengthening with restoration of deformity combined with distraction tissue histiogenesis can provide the surgeon with an array of options which can be precisely tailored to the particular personality of a severe open diaphyseal fracture.

Research paper thumbnail of Determination of the Maximal Corrective Ability and Optimal Placement of the Ortho-SUV Frame for Femoral Deformity with respect to the Soft Tissue Envelope, a Biomechanical Modelling Study

Advances in Orthopedics, 2014

Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for... more Circular fixation according to the Ilizarov method is a well-recognised modality of treatment for trauma and deformity. One shortcoming of the traditional fixator is its limited ability to correct more than one plane of deformity simultaneously, leading to lengthy frame-time indices. Hexapod circular fixation utilising computer guidance is commonplace for complex multidimensional deformity but difficulties often arise with correction of femoral deformity due to bulkiness of the frame construct, particularly in proximal deformity and in patients of increased size. The Ortho-SUV frame is an innovative hexapod which permits unique customisation to individual patient anatomy to maximise tolerance and optimal range of deformity correction. We hypothesised that the optimal configuration and maximal degree of correction achievable by the Ortho-SUV frame can be biomechanically modelled and applied clinically. A study was constructed using Ortho-SUV and femoral limb models to measure deformi...

Research paper thumbnail of Deformity Correction and Fracture Treatment Using the Software-Based Ortho-SUV Frame

In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) ... more In the correction of complex multi-component and multi-planar deformities (Tables 16.1 and 16.3) using the Ilizarov frame, unified reduction nodes have to be replaced three to five times (Fig. 17.1) [368]. Every frame re-assembly involves a change in the reductional units and is a highly laborious process in which there is additional patient exposure to radiation. Sometimes, due to the peculiarities of frame assembly (external supports are not oriented at a right angle to the axes of the bone fragments, a bone is not at the center of a support, the support for some reason is not closed, etc.), correction of one component can lead to the secondary translation of other(s). These secondary translations will, in turn, require correction and therefore additional frame re-assembly.

Research paper thumbnail of Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device | Solomin, Leonid | 9788847005129 | Springer

Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device ... more Tienda online donde Comprar Basic Principles of External Skeletal Fixation using Ilizarov Device al precio 169,52 € de Solomin, Leonid, tienda de Libros de Medicina, Libros de Nefrologia - Nefrologia clinica

Research paper thumbnail of Foot Deformity Correction Planning in the Sagittal Plane Based on the Vitruvian Foot First Metatarsal Anatomic Axis

The Journal of Foot and Ankle Surgery

wThe aim of this study was to test a novel planning method for midfoot deformity correction, base... more wThe aim of this study was to test a novel planning method for midfoot deformity correction, based on reference lines and angles (RLA) of talus and first metatarsal of 64 normal radiographs from 55 patients. The anatomic lateral talometatarsal angle (aLTMA), resulting from the intersection of talus joint line (TJL), from the border of the articular surface of the talus to the posterior process of talus, and the anatomic axis of the first metatarsal, was 28.5° ± 4.5°. The intersection of those 2 lines divided the TJL in 2 segments (ac and ab) with the ratio k1 = 0.7 ± 0.3. The length of the first metatarsal line was measured from its intersection with the TJL and first metatarsal head, and it was 3.6 times longer that of the TJL (k2). To analyze foot deformity, we propose to draw the TJL line as follows. Use the k1 ratio to determine the point where the aLMTA intersects the TJL. From this point, an idealized anatomic first metatarsal line should be drawn, at 28.5° from the TJL. The distal end of that line is based on the k2 ratio (3.6 × TJL length). Next, the actual anatomic lateral talometatarsal line of the deformed foot is drawn. The intersection between these 2 lines identifies the apex and magnitude of the deformity. Deformity correction planning using the proposed method was demonstrated and confirmed in 2 cases. A reference method for analysis and planning of midfoot sagittal plane deformity correction independent of foot position relative to the ankle joint or the presence of concomitant hindfoot deformity appears promising for future investigation and use.

Research paper thumbnail of Lond Bones Reference Lines and Angles

Reference lines and angles (RLA) include: - Anatomic axes - Mechanical axes - Joint lines - Anato... more Reference lines and angles (RLA) include:
- Anatomic axes
- Mechanical axes
- Joint lines
- Anatomic angles
- Mechanical angles
Each of them defines for frontal and sagittal planes.

Research paper thumbnail of Use of Orthopaedic Hexapod (Ortho-SUV Frame) in Nonunion of Shaft of Long Bones

Research paper thumbnail of Long Bones Reference Lines and Angles

Reference lines and angles (RLA) include: - Anatomic axes - Mechanical axes - Joint lines - Anato... more Reference lines and angles (RLA) include:
- Anatomic axes
- Mechanical axes
- Joint lines
- Anatomic angles
- Mechanical angles
Each of them defines for frontal and sagittal planes.

Research paper thumbnail of Planning hindfoot deformity correction

The results of the developed method of analysis and planning hindfoot deformities correction in ... more The results of the developed method of analysis and planning hindfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible midfoot deformities or equinus of the ankle joint.

Research paper thumbnail of A novel method of planning midfoot deformity correction

The results of the developed method of analysis and planning midfoot deformities correction in t... more The results of the developed method of analysis and planning midfoot deformities correction in the sagittal plane is shown, which is easy to implement and it allows using this way regardless of the possible hindfoot deformities or equinus of the ankle joint

Research paper thumbnail of Deformity Сorrection and Fracture Treatment by software-based Ortho-SUV Frame