Limb Lengthening and Reconstruction Surgery Case Atlas: Adult Deformity • Tumor • Upper Extremity PDF
Preview Limb Lengthening and Reconstruction Surgery Case Atlas: Adult Deformity • Tumor • Upper Extremity
. . Editors Limb Lengthening and Reconstruction Surgery Case Atlas Adult Deformity · Tumor Upper Extremity 1 3 Reference Limb Lengthening and Reconstruction Surgery Case Atlas S. Robert Rozbruch (cid:129) Reggie C. Hamdy Editors Limb Lengthening and Reconstruction Surgery Case Atlas Adult Deformity – S. Robert Rozbruch Tumor – Levent Eralp Upper Extremity – John E. Herzenberg With934Figuresand1Table Editors S.RobertRozbruch ReggieC.Hamdy LimbLengtheningandComplex ShrinersHospitalandMontrealChildrenHospital ReconstructionService DivisionofPaediatricOrthopaedics HospitalforSpecialSurgery McGillUniversity NewYork,NY,USA Montreal,QC,Canada Chief,LimbLengthening FRCSCProfessorofSurgeryandDirector andComplexReconstruction DivisionofPaediatricOrthopaedics Service,Hospitalfor McGillUniversity SpecialSurgery Montreal,QC,Canada NewYork,NY,USA ViceChair(PlanningandDevelopment) ProfessorofClinical DepartmentofPaediatricSurgery OrthopaedicSurgery Montreal,QC,Canada WeillCornellMedicalCollege ChiefofStaff CornellUniversity ShrinersHospitalforChildren NewYork,NY,USA Montreal,QC,Canada PresidentEmeritus Director,LimbLengthening LimbLengtheningand andBoneRegenerationUnit ReconstructionSociety PaediatricOrthopaedicSurgeon NewYork,NY,USA MontrealChildrenHospital Montreal,QC,Canada President LimbLengthening&Reconstructive SocietyofNorthAmerica(2015–2016) Montreal,QC,Canada ISBN978-3-319-18019-9 ISBN978-3-319-18020-5(eBook) ISBN978-3-319-18021-2(printandelectronicbundle) DOI10.1007/978-3-319-18020-5 LibraryofCongressControlNumber:2015946599 SpringerChamHeidelbergNewYorkDordrechtLondon #SpringerInternationalPublishingSwitzerland2015 Thisworkissubjecttocopyright.AllrightsarereservedbythePublisher,whetherthewholeorpartofthematerialis concerned,specificallytherightsoftranslation,reprinting,reuseofillustrations,recitation,broadcasting,reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,computersoftware,orbysimilarordissimilarmethodologynowknownorhereafterdeveloped. Theuseofgeneraldescriptivenames,registerednames,trademarks,servicemarks,etc.inthispublicationdoesnot imply,evenintheabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevantprotectivelawsand regulationsandthereforefreeforgeneraluse. Thepublisher,theauthorsandtheeditorsaresafetoassumethattheadviceandinformationinthisbookarebelieved tobetrueandaccurateatthedateofpublication.Neitherthepublishernortheauthorsortheeditorsgiveawarranty, expressorimplied,withrespecttothematerialcontainedhereinorforanyerrorsoromissionsthatmayhavebeen made. Coverillustration:Artist:YoninaJacobs,NewGrowth2(2012),Mixedmediaonwood,11in.x14in#Yonina Jacobs Printedonacid-freepaper SpringerInternationalPublishingAGSwitzerlandispartofSpringerScience+BusinessMedia(www.springer.com) To my wife Yonina and to my children Jason and Libby: thanks for your love and support. You have added immense joy and meaning to my life. In memory of my dear parents Max and Frieda, whose survival created purpose for me and from whom I learned that while ideas are great, follow-through and completion are awesome. S.RobertRozbruch,M.D. I dedicate this Atlas to my wife Sylvie and to my son Sebastien, who have endured so much while I was working on the various chapters; to my mother, who – at the age of 97 – never fails to remind me every time I speak to her, “Don’t work too much”; and to a very special person, the best teacher I have ever had, the best mentor I would have ever dreamed of having, my father. He will not see this atlas, but I am sure he would have been proud of it. Reggie C. Hamdy, M.D. In memory of our dear friends, colleagues, and past presidents of the Limb Lengthening and Reconstruction Society (LLRS), George Cierny, M.D., and Doreen Di Pasquale, M.D. You are sorely missed, and we know how pleased you would have been to see this society publication. SRR and RCH Foreword There is a saying in Russian: it’s better to see something once than hear about it a hundred times. Dr.RobertRozbruchandIhaveknowneachotherformanyyears.Wewerefirstintroduced byacolleague,andmutualfriend,ataChristmaspartyin2001;withinayear,planningbegan to develop a new service at Hospital for Special Surgery focusing on specialized orthopedic treatmentandresearchstrategies.Iwasinstantlyimpressedbyhisunsurpassedenthusiasmand goal-oriented personality and a certain indescribable quality, the combination of which resembled that of my father. The service rapidly took off, thanks to the leadership of Dr. Rozbruch and the team’s approach, which mimicked my father’s style in review of cases, detailed documentation (including pre- and postoperative photographs), X-rays, and anoverallunbridledsenseofquality.Pre-opconferences,publications,andpresentations,all ofwhichwereapriorityfortheteam,graduallybecamearoutine(thoughnotmonotonous!) and finally a well-oiled machine. This was still just the beginning of the limb lengthening programatHospitalforSpecialSurgery! Throughoutmyprofessionalcareer,Iplacedagreatdealoffocusandeffortintostudying the cases presented in my father’s book, Transosseous Osteosynthesis, also a Springer publication, which numbered in the hundreds and depicted fascinating transformations through before and after photographs and radiographs; I used this all-encompassing tool as mybibleandwouldalwaysrefertoitsomniscienceinsearchofasimilarcaseorasasourceof inspirationtoapplyinourpractice. TheideaforthisatlaswasconceivedbyDr.Rozbruchwhileintheeditingstageofourbook Limb Lengthening and Reconstruction Surgery (Informa, 2007). Thanks to his tireless enthusiasm, unlimited energy, and perseverance, this book found life. I can truly say that Idonotknowanyonecapable,inrecordtime,toachieveknowledge,experience,andsuccess with such complex cases and simultaneously bring together the now thriving LLRS community in an organized and constructive way to allow for sharing of this wealth of informationwiththeworld. Dr.RozbruchiscurrentlythechiefoftheLimbLengtheningandComplexReconstruction ServiceatHospitalforSpecialSurgeryandservedasPresidentoftheLimbLengtheningand ReconstructionSociety (LLRS) in2012–2013. Heis alsoaProfessorofClinical Orthopedic SurgeryatWeillCornellMedicalCollege,CornellUniversity. Dr. Reggie Hamdy is well known for his achievements in orthopedics and research, and especially in limb lengthening and reconstruction. Dr. Hamdy is the Chief of Staff and Director of Clinical Research (Orthopedics) at Shriners Hospital for Children in Montreal andProfessorofSurgery(Orthopedics)atMcGillUniversity.HeiscurrentlyVicePresident andwillbePresidentofLLRSin2014–2015.HeistheProgramChairofLimbLengthening andReconstructionSocietyannualmeetinginMontreal,Canada,2014.Dr.Hamdywaseditor of Management of Limb-Length Discrepancies, an American Academy of Orthopaedic Surgeonsmonographseriespublishedin2011. Drs.RozbruchandHamdy’sgoalsinthisatlasaretopresentauniquecollectionofcasesin thealreadyuniquefieldoflimblengtheningandreconstruction.Thisisthefirstandonlyatlas vii viii Foreword of a truly worldwide nature, depicting cases without national boundaries and, even more importantly, demonstrating a true sense of cooperation among physicians in sharing informationforthebettermentofmankind. Despitethewonderfulworkthatthecontributorsperformintheoperatingroom,onemust not forget the sometimes tedious task of documentation in office notes, taking into consideration the very particular state of current medicine. As such, I applaud each and every contributor that has made this atlas possible by making an extra effort, creating extra time (in an already overbooked schedule), and sharing their successes with the small, yet robust,limblengtheningandreconstructioncommunity. Itismyhopethatthisatlas,withitsinvaluableinformation,willhelpnotonlythecurrent butfuturephysicianstofindsolutionsinthischallengingfieldandbeasourceofinspirationto bothbeginnersandseasonedveteranswhenfacedwithcomplexcasesandhopelesspatients. Withthewealthofknowledgeetchedintothepagesofthiswork,everymedicalsubspecialty mayusethisasasourcetoexpandupontheirknowledgeandbeabletoprovidepatientswith evenmoreoptionsinarapidlyexpandingmedicalworld. I would encourage reviewing these cases and can fully assure that you will encounter patients in your practice who spark an urge to thumb through this book and locate a similar casethatremindsyouofyourchallenge.Intimesofdoubtaboutthedirectionofacase,reach forthisatlas.Ipromisethesolutionwillcometoyou,andevenifitdoesn’t,youwillholdin your hands the names of people who possess and represent the world knowledge in limb lengthening and reconstruction. You will find your hand ultimately reaching for this atlas, Iguaranteeit. My other hope in the release of this atlas is that it will serve as an example of good old medicalpractice,encouragingyoutodocumentchallengingcasestonotonlylearnfromthem butsharethemwiththenowglobalmedicalcommunity. March2014 SvetlanaIlizarov Introduction During the second decade of the eighteenth century, Dutch physician Herman Boerhaave revolutionizedmedicaleducationwhenhesubstitutedclinicalcaseteachingfortheprevious method of abstract pedantic instruction. His system soon catapulted Leiden’s School of MedicinetotheAlistoftheera. Withinageneration,Europe’sothertopmedicalschools–Stockholm,Paris,London,and Edinburgh–hadadoptedBoerhaave’smethodology.TheUniversityofEdinburgh,epicenter oftheScottishEnlightenment,educatedColonialAmerica’sfirstphysicians;theirclinicsand dispensaries became the nucleus of future medical schools in Boston, New York, and Philadelphia.It’snowonder,therefore,thatclinicalcasepedagogyhasalwaysbeenahallmark of North American medical education. The New England Journal of Medicine’s Clinical- PathologicalConferenceexemplifiesthisprinciple. In 1951, Soviet surgeon G. A. Ilizarov unlocked from within bone a previously hidden capacity to form limitless quantities of new osseous tissue under appropriate conditions of fracture,preliminaryhealing,andrhythmicdistractioninastablemechanicalenvironment.As aresult,surgeonscouldcurepreviouslyuntreatablecongenital,developmental,andacquired conditionsinwaysneverbeforethoughtpossible. Ilizarov’s monograph, Transosseous Osteosynthesis, contains introductory chapters summarizingresearchthatvalidatestheunderlyingbiologicalprincipleoftheIlizarovmethod. For the most part, however, his textbook is a compendium of case examples, selected to illustrate the range of therapeutic options available to deal with conditions amenable to treatmentwithdistractionosteogenesis. Like Boerhaave, Ilizarov realized that case study is often the best way to convey clinical and technical information to those interested in learning the practical aspects of a body of knowledge. AsinterestinIlizarov’sdiscoveriesspreadaroundtheworld,like-mindedsurgeonsformed nationalASAMIs(AssociationfortheStudyandApplicationofMethodsofIlizarov),starting inItaly in1982.Bythe endofthe 1980s, dozens ofsuch organizations were holding annual meetings where reports of basic research and biomechanical studies were interspersed with clinical case and series reports. Likewise, new therapeutic strategies and ingenious devices debutedatsuchmeetings. ASAMI-North America, formed in 1989, evolved into the Limb Lengthening and Reconstruction Society, now a component of the American Academy of Orthopaedic Surgeons’ Board of Specialty Societies. LLRS members attending the group’s annual meetingswereamongthefirstclinicianstolearnaboutmodificationsofIlizarov’sapparatus. These included half-pin mounting strategies, radiolucent components, internal-external fixation combinations, motorized lengthening rods, computer-associated hexapod frame configurations,andfullyimplantabledistractiondevices. Additionally, attendees heard about new treatment-based disease classification systems, inventiveosteotomiesandsoft-tissuereleases,and,mostsignificantly,protocolstoreducethe incidenceofpitfallsandcomplications. ix
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