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Foot and Ankle Symposium: Post-traumatic Reconstruction

Foot and Ankle Symposium: Post-traumatic Reconstruction. S. Robert Rozbruch, MD Director, Institute for Limb Lengthening and Reconstruction www.LimbLengthening.com. Fibula lengthening. Short fibula. End Distraction, 2weeks. Preop 4 weeks. 4 months.

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Foot and Ankle Symposium: Post-traumatic Reconstruction

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  1. Foot and Ankle Symposium:Post-traumatic Reconstruction S. Robert Rozbruch, MD Director, Institute for Limb Lengthening and Reconstruction www.LimbLengthening.com

  2. Fibula lengthening

  3. Short fibula

  4. End Distraction, 2weeks

  5. Preop 4 weeks

  6. 4 months

  7. Ankle Fusion with Ilizarov Frame Septic arthritis and osteomyelitis after ankle fracture and initial treatment

  8. Richard, injury ORIF

  9. After ORIF, osteomyelitis, septic arthritis

  10. 2 months

  11. 4 months

  12. Bone Transport ankle fusion Septic arthritis andosteomyelitis with bone loss after trauma

  13. preop Needs 8 cm lengthening and tibio-talar fusion

  14. Infected Use beads

  15. 15 months 8 cm lengthening Tibia Diaphysis To talus fusion

  16. Repair of distal tibia nonunion and simultaneous ankle fusion Septic arthritis and osteomyeltis and nonunion after trauma

  17. One year Infected nonunion pilon Metaphyseal nonunion and joint arthrosis Osteopenia, NWB for 1 year

  18. Ankle arthrodesis with gradual positioning of the foot Post-traumatic arthritis with severe rigid equinovarus deformity associated with head injury

  19. Cavovarus Head injury Post-trauma

  20. Tibia to Calcaneous ankle fusion with simultaneous lengthening For failed ankle fusion with necrosis of the talus

  21. Dead talus

  22. Proximal tibia lengthening Talus excision IV antibiotics LLD 3.5 cm

  23. 1” lengthening TC fusion

  24. Distal tibia and fibula osteotomy for lengthening and deformity correction Malunion of tibia with valgus, shortening, and pain/early arthritis of ankle

  25. 25 y/o M, open tibia fx Boating accident

  26. PREOP Tibial malunion 15 deg VALGUS 1.5 cm short Lateral ankle OA and pain BIG FLAP

  27. 4 months

  28. 5 months at Frame Removal

  29. 5.5 months LLD = 0 ADTA 800 LDTA 90 deg

  30. Osteotomy and gradual correction of a malpositioned ankle fusion and simultaneous lengthening at the proximal tibia

  31. Malposition of ankle fusion Anterior translation Calcaneus Dorsiflexion def LLD- too short

  32. 6 months 1 inch lengthening

  33. Gradual correction of an equinus ankle contracture

  34. Ankle contracture

  35. 25 degrees

  36. ankle contracture • we choose the center of the talus as the rotation point • ankle is also inclined 10 degrees off the neutral coronal plane • mount ring 10 degrees off neutral

  37. Ankle distraction for ankle arthritis and AVN of the talus

  38. preop

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