Abstract book 6th RMS 16.indd

inclusion criteria with a mean age of 48
years (20-72). 20 cases were long bone
non-unions (13 femurs and 7 tibias) and
10 cases were bone defects (6 tibias and 4
femurs). The mean length of bone defect
was 6cm (4-10cm). All bone defect cases
were of septic origin. The mean time of
previous re-operations was 2.6 (1-5). All
cases underwent revisions of fixation
(16 cases of broken metal work). In the
non-union group, all patients united at a
mean time of 5 months (3-7). The mean
time of bone restoration with the induced
membrane technique for the bone defect
cases was 7.5 months (5-9). Post-operative
complications included 2 superficial
infections, one DVT, one PE and one blade
plate failure (femoral non-union) requiring
revision blade plate and anterior femoral
plate. At the final follow up all patients
were able to ambulate with painless full
weight bearing.
Conclusion: For difficult recalcitrant
long bone non-unions and bone
defects the ‘diamond concept’ restores
optimum mechanical and biological
environment facilitating fracture healing
and restoration of bone defects. This
approach can minimise the risk of
reoperations and should be considered in
the surgeon’s armamentarium in complex
non-union cases and bone defects.
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Correct Screw Positioning in MIS
Trauma Stabilization
Arnold J Suda MD*, Stefan Matschke, Martin
Adams, Marco Tinelli
* Dr. med. univ. Consultant Orthopaedic and
Trauma Surgeon BG Trauma Center Ludwigshafen
(Germany)
arnold@drsuda.com
Objectives: Minimal invasive spine surgery
in trauma patients is challenging. A short
operation time and a perfect positioning of
pedicle screws is demanded. In this study
we show for the first time, that the new
VIPER®2 Minimally Invasive Pedicle Screw
System allows both.
Methods: Between may 2009 and march
2011, 121 patients (131 fractures) with
fractures between Th 3 and L 5 were
treated with the VIPER®2 Minimally
Invasive Pedicle Screw System. The most
common fracture type was A3. We
treated 52 females and 69 men, the mean
age at operation time was 56.7 years.
Postoperatively, all patients were examined
using a CT scan and the screw-positions
have been controlled.
Results: In 61 patients, ventral stabilization
was additionally performed, in 33
patients, vertebroplasty or kyphoplasty
was performed. 15 patients underwent
laminectomy. Mean operation time was 80
minutes. No patient developed any new
nervous debility postoperatively. 5 patients
had neurological deficits preoperatively, in
one patient we saw remission after surgery.
678 screws were placed. In the CT scan,
we found 15 screws (2.2%) in suboptimal
position. Because of no neurologic debility,
no revision was performed because of
the screw´s position. In one patient, septic
revision without removal of the screws was
performed.
Conclusion: With this System, spinal
fractures can be treated in a short operation
time with percutaneous stabilization and a
correct positioning of the pedicle screws in
almost 98%. In our study, no screw was so
much malpositioned that revision surgery
would have been necessary.
297
Pelvic Fracture Overview
Said Abdul Majeed MD (Jordan)
Pelvic fractures are life threatening injuries
that deserve all attention & remain a
permanent challenge
To all concerned. History of pelvic
fractures management Is very interesting &
impressive .It is a long march surprising us
all the time with new ideas & achievements
from the days when the “ hammock
was the best treatment orthopedic
surgeons could offer for patients with
unstable pelvic fractures (who could die
on the hammock!) ,through the days of
emergency external pelvic fixation( saving
so many lives) & ending with the days of
advanced definitive surgical treatment
combining external & internal fixation
using a huge armamentarium . Having
so many methods of pelvic treatments,
the need arose for a system to accurately
assess the pelvic functions. This made me
introduce a grading scoring system to
assess pelvic functions . This was published
in 1989 JBJS-B (71)
www.jrms.gov.jo
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