Limb reconstruction is a collaborative effort involving orthopaedic, plastic, and vascular surgeons, as well as anaesthetists, infectious disease specialists, physiotherapists, and nursing staff. This team works together to ensure effective debridement, bone fixation, soft tissue coverage, and post-operative rehabilitation. Each specialist plays a critical role in restoring function and preventing complications in complex limb injuries.
Limb reconstruction is a complex surgical approach aimed at restoring function to an injured or diseased limb. The process involves thorough assessment, soft tissue reconstruction, and bone regeneration using techniques like fine wire frames and corticotomy. Patients undergoing limb reconstruction must be prepared for a long-term recovery journey, with regular follow-ups to monitor bone healing and alignment.
Fine wire frame fixation offers a unique approach to managing complex limb injuries, providing enhanced stability and promoting weight-bearing. This guide explores key principles, indications, and challenges of this technique.
Further alignment improvements observed on X-ray and clinically. New prescription issued to fine-tune valgus, equinus, and medial translation.
First correction completed with improved alignment visible on X-rays. Progressing as planned.
X-rays show the screw is clear in the AP view but less visible in the lateral view, which was never the main issue.
During revision surgery, a 6.5mm cancellous cannulated screw was carefully positioned to guide docking, though the optimal tibial docking site remains uncertain—whether on the calcaneum alone or both the calcaneum and navicular. A new foot plate was attached, but the docking site was not modified per standard procedure.
Following resection of the distal tibia and talus due to chronic osteomyelitis, bone transport using a fine wire frame was performed. However, misalignment at the docking site became evident only after frame removal. A review of similar cases suggests that the commonly used “dynamisation” period may not be a reliable test for confirming bony healing.
Achieving accurate alignment in tibio-calcaneal fusion using a fine wire frame is a significant challenge. While past successes have relied on luck, recent failures prompted a reassessment of targeting methods. With limited imaging options, a 6.5mm cannulated cancellous screw is now being explored as a surgical target marker to improve precision.
