UNASSIGNED: To investigate the effectiveness of single Taylor external fixator combined with biplanar osteotomy on correction of tibial multiplanar deformities.
UNASSIGNED: Between October 2016 and December 2021, 11 patients with tibial multiplanar deformities (20 sides) were treated with single Taylor external fixator and biplanar osteotomy. Of them, 4 were male and 7 were female; the average age ranged from 13 to 33 years (mean, 21.9 years). Diagnosis included rickets severe genu varum deformity (7 cases, 14 sides), rickets severe genu valgum deformity (2 cases, 4 sides), multiple osteochondromatosis calf deformity (1 case, 1 side), neurofibromatosis medial lower leg anterior arch deformity with short of leg (1 case, 1 side). After fibular osteotomy and tibial multiplanar osteotomy, a Taylor external fixator was installed. After operation, the deformities were corrected successively and fixed completely. The osteotomy healed, then the external fixator was removed. Before operation and at 12 months after operation, the full-length X-ray films were taken. The leg-length discrepancy, medial proximal tibial angle (MPTA), lateral distal tibial angle (LDTA), posterior proximal tibial angle (PPTA), anterior distal tibial angle (ADTA), and tibial rotation angle were measured. The degree of lower limb deformity was scored with reference to a customized tibial mechanical axis scoring table.
UNASSIGNED: Osteotomy was successfully completed without neurovascular injury and other complications. The external fixator was adjusted for 28-46 days, with an average of 37 days, and the external fixator was worn for 136-292 days, with an average of 169 days. Mild needle infection during the fixation period occurred in 3 sides, refracture at the distal tibial osteotomy in 1 side after removing the external fixator, and nonunion of the distal fibular osteotomy in 1 side. All patients were followed up 369-397 days (mean, 375 days). At 12 months after operation, the lower limb discrepancy decreased, but there was no significant difference ( P>0.05). MPTA, LDTA, PPTA, ADTA, and tibial rotation angle improved, and the differences in LDTA, ADTA, and tibial rotation angle were significant ( P<0.05). The score of lower limb deformity was significantly higher than that before operation ( P<0.05), and the results were excellent in 9 sides, good in 8 sides, fair in 3 sides, with the excellent and good rate of 85%.
UNASSIGNED: Single Taylor external fixator combined with biplanar osteotomy is effective in the correction of tibial multiplanar deformities.
UNASSIGNED: 探讨应用单套Taylor外固定架联合双平面截骨矫正胫骨多平面畸形的疗效。.
UNASSIGNED: 2016年10月—2021年12月，采用单套Taylor外固定架联合双平面截骨治疗11例（20侧）胫骨复杂多平面畸形患者。其中男4例，女7例；年龄13～33岁，平均21.9岁。佝偻病重度O型腿畸形7例（14侧）、佝偻病重度X型腿畸形2例（4侧），多发性骨软骨瘤病小腿畸形1例（1侧），神经纤维瘤病小腿中下段前弓畸形合并短缩1例（1侧）。术中行腓骨截骨以及胫骨两个畸形平面截骨后，安装Taylor外固定架；术后双平面畸形依次矫正后再整体固定，待截骨愈合后拆除外固定架。术前及术后12个月摄双下肢全长X线片，测算双下肢长度差值以及与胫骨机械轴评价相关的指标，包括胫骨近端内侧角（medial proximal tibial angle，MPTA）、胫骨远端外侧角（lateral distal tibial angle，LDTA）、胫骨近端后倾角（posterior proximal tibial angle，PPTA）、胫骨远端前倾角（anterior distal tibial angle，ADTA）以及胫骨旋转角度；参照自定胫骨机械轴评分表评价小腿畸形程度。.
UNASSIGNED: 截骨手术均顺利完成，未出现神经、血管损伤等并发症。术后矫形顺利，外固定架调整矫形时间28～46 d，平均37 d；外固定架佩戴时间136～292 d，平均169 d。3侧带架期间轻度针道感染，1侧拆除外固定架后出现胫骨远端截骨处再骨折，1侧腓骨远端截骨不愈合。患者均获随访，随访时间369～397 d，平均375 d。术后12个月，双下肢长度差值较术前减小，但差异无统计学意义（ P>0.05）；MPTA、LDTA、PPTA、ADTA、胫骨旋转角度均较术前改善，其中LDTA、ADTA、胫骨旋转角度手术前后差异有统计学意义（ P<0.05）。根据自定胫骨机械轴评分表，下肢畸形评分较术前提高（ P<0.05）；其中获优9侧，良8侧，中3侧，优良率达85%。.
UNASSIGNED: 应用单套Taylor外固定架联合双平面截骨可有效矫正胫骨多平面畸形。.

Major trauma is a condition that can result in severe bone damage. Customised orthopaedic reconstruction allows for limb salvage surgery and helps to restore joint alignment. For the best possible outcome three dimensional (3D) medical imaging is necessary, but its availability and access, especially in developing countries, can be challenging. In this study, 3D bone shapes of the femur reconstructed from planar radiographs representing bone defects were evaluated for use in orthopaedic surgery. Statistical shape and appearance models generated from 40 cadaveric X-ray computed tomography (CT) images were used to reconstruct 3D bone shapes. The reconstruction simulated bone defects of between 0% and 50% of the whole bone, and the prediction accuracy using anterior-posterior (AP) and anterior-posterior/medial-lateral (AP/ML) X-rays were compared. As error metrics for the comparison, measures evaluating the distance between contour lines of the projections as well as a measure comparing similarities in image intensities were used. The results were evaluated using the root-mean-square distance for surface error as well as differences in commonly used anatomical measures, including bow, femoral neck, diaphyseal-condylar and version angles between reconstructed surfaces from the shape model and the intact shape reconstructed from the CT image. The reconstructions had average surface errors between 1.59 and 3.59 mm with reconstructions using the contour error metric from the AP/ML directions being the most accurate. Predictions of bow and femoral neck angles were well below the clinical threshold accuracy of 3°, diaphyseal-condylar angles were around the threshold of 3° and only version angle predictions of between 5.3° and 9.3° were above the clinical threshold, but below the range reported in clinical practice using computer navigation (i.e., 17° internal to 15° external rotation). This study shows that the reconstructions from partly available planar images using statistical shape and appearance models had an accuracy which would support their potential use in orthopaedic reconstruction.

OBJECTIVE: Presentation of the joint angle tool (JAT), a low-cost goniometer for intraoperative assessment of the lower limb alignment.
BACKGROUND: Intraoperative assessment of coronal alignment is important when performing corrective osteotomies around the knee and ankle, limb lengthening, and trauma surgery. JAT provides surgeons with information about the anatomic and mechanical axes intraoperatively based on true anteroposterior radiographs.
METHODS: JAT consists of pre-printed joint orientation angles of the anatomic and mechanical axis including normal variations on a plastic sheet. It is placed on the screen of the image intensifier after obtaining a true anteroposterior image. The pre-printed joint orientation angles can assist the surgeons intraoperatively in achieving the pre-planned axis correction. Here, its feasibility is demonstrated in four cases.
CONCLUSIONS: JAT is a modified goniometer that allows intraoperative assessment of the mechanical and anatomic axis. JAT is applicable throughout the entire surgical procedure irrespective of the method of internal fixation and may provide additional reassurance of correct alignment. JAT consists of a plastic sheet with printed joint orientation angles and their normal variation. JAT is freely available from profeedback.dk/JAT/JAT.pdf for use and modification according to the Creative Commons license (CC BY-SA 4.0) if this paper is attributed.
UNASSIGNED: Abood AA-H, Petruskevicius J, Vogt B, et al. The Joint Angle Tool for Intraoperative Assessment of Coronal Alignment of the Lower Limb. Strategies Trauma Limb Reconstr 2020;15(3):169-173.

Accurate models of bone shapes are essential for orthopaedic reconstructions. The commonly used methods of using the contralateral side requires an intact bone and anatomical symmetry. Recent studies have shown that statistical shape and appearance models (SSAMs) as an alternative can predict accurate geometric models, but the accuracy of the mechanical property prediction is typically not addressed. This study compares stress and strain differences under identical loading conditions for reconstructions from partial anatomies. SSAMs representing shape and grey values were created using 40 female cadaveric X-ray computed tomography scans. Finite element models were created for shape reconstructions from partial bone of various lengths with boundary conditions obtained from musculoskeletal simulations. Commonly used anatomical measures, measures of the surface deviations and maximal stresses and strains were used to compare the reconstruction accuracy to the contralateral side. Surface errors were smaller compared to the contralateral side for reconstructions with 90% of the bone and slightly bigger when less bone was available. Anatomical measures were comparable. The contralateral side showed slightly smaller relative errors for strains of up to 6% on average. This study has shown that SSAM reconstructions using partial bone geometry are a possible alternative to the contralateral side.