Dr. Mark Brinker, Houston Orthopedic Surgeon Content Managers RSS Feed

Our Location

Thu, 27 May 2010 17:54:31 GMT

Texas Orthopedic Hospital

7401 South Main Street
Houston, TX 77030
713- 799-2300

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Bone Transport

Thu, 27 May 2010 17:54:04 GMT

Bone transport is a technique that allows the Orthopedic Surgeon to regenerate bony tissue within the patient’s extremity. This regeneration is typically used to fill a gap of missing bone due to trauma or infection. The method is particularly useful in cases of: Infected Nonunions Segmental Defects (large areas of missing bone) Chronic Bone Infections In order to perform a bone transport, the Ilizarov fixator is applied to the extremity and the bone is broken between rings using a variety of specialized techniques The controlled breaking of the bone is known as an “osteotomy” or “corticotomy”. After waiting about a week, bone transport begins at a rate of ¾ to 1 millimeter per day. Slow transport of one or more bone segments is accomplished by progressively moving a segment or segments of bone from one position to another (by distracting the ring connectors). Bone forms in the distraction site by a process known as distraction...

Limb Lengthening

Thu, 27 May 2010 17:53:53 GMT

The Ilizarov method can be used to lengthen a foreshortened bone. In order to accomplish this, the Ilizarov fixator is applied to the extremity and the bone is broken between rings using a variety of specialized techniques.

The controlled breaking of the bone is known as an “osteotomy” or “corticotomy”.

After waiting about a week, lengthening begins at a rate of ¾ to 1 millimeter per day. Slow gradual lengthening is accomplished by moving the rings progressively apart (by distracting the ring connectors). Bone forms in the distraction site by a process known as distraction osteogenesis.

View a Limb Lengthening Case Study

Distraction

Thu, 27 May 2010 17:53:31 GMT

Certain types of nonunions respond well to distraction.

Slow gradual distraction of bone segments is generally applied at the rate of ½ to ¾ millimeter per day by moving the rings progressively apart (by distracting the ring connectors)

Although it may seem counter intuitive, the mechanical force transmitted during the process of distraction (pulling the bone segments apart) results in improved local vascularity and rapid healing in certain types of nonunions.

View a Distraction Method Case Study

Compression

Thu, 27 May 2010 17:53:17 GMT

Compression is a useful treatment method for certain types of slow healing fractures (delayed unions) and fracture nonunions.

Slow gradual compression of bone segments is generally applied at the rate of ¼ to ½ millimeter per day by moving the rings closer together (by tightening the ring connectors).

The compressive force generated leads to rapid healing in certain types of cases.

View a Compression Method Case Study

Ilizarov Surgery

Thu, 27 May 2010 17:53:08 GMT

Dr. Brinker has performed more than 1,000 Ilizarov surgeries. The Ilizarov method utilizes a circular external fixator to stabilize bony segments. The system is comprised of a series of external rings which are attached to one another via various types of ring connectors. Tensioned wires and half pins are transfixed to bone and are also attached to the external rings, thereby stabilizing the entire bone. Because of the circumferential nature of the device, the Ilizarov external fixator provides superior mechanical strength and stability, resisting shear and rotational forces. In fact the method not only allows for early weight-bearing in lower extremity applications, but weight bearing actually promotes healing and is therefore encouraged throughout treatment. The Ilizarov technique offers many advantages over other treatments, including: Minimal Soft Tissue Dissection Required Bone Regeneration Potential Tremendous Versatility Ability to Stabilize Small Bone...

Foot

Thu, 27 May 2010 17:52:46 GMT

The foot is comprised of 26 bones, 33 joints, and more than 100 muscles, tendons and ligaments. High energy trauma to the lower extremity can result in devastating bone and soft tissue injuries of the foot. Because of the potentially disastrous consequences of severe foot injuries and their long-term consequences, it is of paramount importance to choose a surgeon with vast experience in foot reconstruction. With proper treatment, even the most severe foot injuries can be treated and the patient’s quality of life can be significantly improved. Foot Problems Treated by Dr. Brinker* Problem Types Number of Surgical Cases Fracture Nonunions 25 View Case Studies Infected Nonunions 2 ...

Ankle

Thu, 27 May 2010 17:52:37 GMT

Three bones form the ankle joint: - the bottom portion of the tibia (known as the tibial plafond) - the bottom portion of the fibula known as the lateral malleolus - the top portion of the talus bone. Many fractures involving the ankle require operative treatment. When the bones around the ankle fail to heal (a nonunion) or heal in a deformed position, surgical intervention is almost always required to restore lower extremity function. Ankle Problems Treated by Dr. Brinker* Problem Types Number of Surgical Cases Fracture Nonunions 117 View Case Studies Infected Nonunions 28 View Case Studies Deformities 47 View Case Studies ...

Tibia

Thu, 27 May 2010 17:52:26 GMT

The tibia and fibula provide the structural support of the lower portion of the leg with the tibia being the major weight bearing bone. The top of the tibia has two concave surfaces and makes up the lower portion of the knee joint. This portion of the tibia is known as the tibial plateau. The tibia is a somewhat tubular structure that runs from the tibial plateau above to the distal tibia (tibial plafond) below. The plafond makes up the upper portion of the ankle joint. Many fractures of the tibia require operative stabilization. Fractures of the tibial shaft are most commonly stabilized with a metal rod placed in the central medullary canal, although several other methods are used depending on specific injury and patient characteristics. Fractures of the top (a tibial plateau fracture) and bottom (a tibial pilon fracture) portions of the tibia are most commonly stabilized with either plate and screw fixation or external fixation, again depending on specific injury and patient...

Knee

Thu, 27 May 2010 17:52:15 GMT

The knee is a hinge joint located in the middle of the lower extremity. Four bones form the knee joint and include: the bottom portion of the femur (known as the femoral condyles); the top portion of the tibia and fibula (the bones of the lower leg); and the patella (knee cap). Many fractures around the knee require operative treatment. When the bones around the knee fail to heal (a nonunion) or heal in a deformed position, surgical intervention is almost always required to restore lower extremity function. Knee Problems Treated by Dr. Brinker* Problem Types Number of Surgical Cases Fracture Nonunions 39 Infected Nonunions 8 Deformities 66 ...

Femur

Thu, 27 May 2010 17:52:06 GMT

The femur is the largest bone of the human skeleton and provides the structural support of the thigh. The top of the femur is spherical (femoral head) and comprises the ball portion of the ball-and-socket hip joint. The femoral shaft is a tubular bone that runs from the femoral head above to the femoral condyles below. These condyles make up the upper portion of the knee joint. Nearly all fractures of the femur require operative stabilization. Fractures of the femoral shaft are most commonly stabilized with a metal rod placed in the central medullary canal. Fractures of the top and bottom portions of the femur are most commonly stabilized with plate and screw fixation or a metal rod placed in the central medullary canal. Whereas most femur fractures will successfully heal with proper treatment, those that fail to heal (a femoral nonunion) represent one of the most challenging situations in the field of Orthopedic Traumatology. An even greater challenge exists when the...

Wrist

Thu, 27 May 2010 17:51:49 GMT

The wrist is a multidirectional hinge joint located between the forearm and the hand. Ten bones form the complex wrist joint and include: the ulna styloid which is the bottom portion of the ulna, one of two bones of the forearm; the distal radius which is the bottom portion of the radius, the other bone of the forearm; and the eight carpal bones that are arranged in two parallel rows. Because of this architecture, the wrist is an extremely flexible joint and allows for a wide range of motion in multiple directions. Many wrist injuries can be managed non-operatively but severe fractures and dislocations often require surgery. When a fracture of the wrist fails to heal (a nonunion) or heal in a deformed position, surgical intervention is almost always required to restore function. Wrist Problems Treated by Dr. Brinker Problem Types Number of Surgical Cases Fracture...

Forearm

Thu, 27 May 2010 17:51:41 GMT

The radius and ulna bones provide the skeletal structure of the forearm. The top of the radius is known as the radial head and the top of the ulna is known as the olecranon. These two bones make up the lower portion of the elbow joint. The bottom of the radius is known as the distal radius and the bottom of the ulna is known as the ulna styloid. These two bones make up the upper portion of the wrist. Some forearm injuries can be managed non-operatively but severe fractures and dislocations always require surgery. When the bones of the forearm fail to heal (a radius or ulna nonunion, or both) surgical stabilization and bone grafting is the treatment of choice. More severe situations involving the forearm (infection, bone loss, etc.) require a complex reconstruction. Forearm Problems Treated by Dr. Brinker* Problem Types Number of Surgical Cases Fracture Nonunions ...

Elbow

Thu, 27 May 2010 17:51:31 GMT

The elbow is a specialized hinge joint located in the middle of the upper extremity. Three bones form the elbow joint: -the bottom portion of the humerus (known as the humeral condyles) -the top portion of the radius (one of the bones of the forearm) -the top portion of the ulna (the other bone of the forearm) The elbow is a complex joint and allows for two kinds of motion: -Hinge-like bending (flexion) and straightening (extension). This bending occurs between the humerus and ulna. -The unique motion of rotating the forearm, such as when screwing in a light bulb, occurs between the radius and ulna. When the palm is being rotated towards the ceiling the motion is known as supination. When the palm is being rotated towards the floor the motion is known as pronation. Most fractures of the bones of the elbow require surgical stabilization. Elbow Problems Treated by Dr. Brinker* Problem Types Number of...

Humerus

Thu, 27 May 2010 17:51:17 GMT

The humerus bone provides the skeletal structure of the upper arm. The top of the humerus is spherical (humeral head) and comprises the ball portion of the ball-and-socket shoulder joint. The humeral shaft is a tubular bone that runs from the humeral head above to the humeral condyles below. These condyles make up the upper portion of the elbow joint. Many injuries of the humerus can be managed non-operatively but severe fractures often require surgery. When a humerus fracture fails to heal (a humeral nonunion) surgical stabilization and bone grafting is the treatment of choice. More severe situations involving the humerus (infection, bone loss, etc.) require a complex reconstruction. Humerus Problems Treated by Dr. Brinker* Problem Types Number of Surgical Cases Fracture Nonunions 147 View Case Studies ...

Clavicle

Thu, 27 May 2010 17:51:01 GMT

The clavicle, or collar bone, is an important stabilizer of the shoulder girdle. Because it is located just beneath the skin, the clavicle is one of the most common sites of fracture. Many clavicle injuries can be managed non-operatively but severe fractures and dislocations often require surgery.

When a clavicle fracture fails to heal (a clavicle nonunion) surgical stabilization and bone grafting is the treatment of choice.

More severe situations involving the clavicle (infection, bone loss, etc.) require a complex reconstruction.

Clavicle Problems Treated by Dr. Brinker*

Problem Types	Number of Surgical Cases
Fracture Nonunions	51	View Case Studies
Infected Nonunions	9
Complex Fractures	37	View Case Studies

*This chart does not represent all of Dr. Brinker's Cases.

Limb Lengthening

Thu, 27 May 2010 17:50:38 GMT

About Limb Lengthening Residual limb foreshortening following high energy trauma is not uncommon. In the upper extremity, significant foreshortening can result in decreased dexterity and functional capacity. In the lower extremity, foreshortening of an inch or more may lead to several problems including: gait disturbances (limping), lower back and hip pain and abnormal loading of the hip, knee and ankle joint. Limb Lengthening Treatment Options Not all limb foreshortening requires surgical correction. Because of the complex nature of this area of orthopedics, choosing a surgeon who has substantial experience evaluating and treating limb length inequality is crucial. Several methods are available to treat those cases of limb foreshortening that require surgical correction. These methods include the use of either internal skeletal stabilization or external fixation, including the use of the Ilizarov method. Limb Lengthening Cases Treated by Dr. Brinker* ...

Periprostetic Fractures/Non unions

Thu, 27 May 2010 17:50:28 GMT

About Periprosthetic Fractures/Nonunions

With the aging population, more and more individuals are undergoing joint replacement surgery. The increase in joint replacement procedures has been accompanied by a greater number of patients with a fracture of the bone surrounding the prosthetic joint implant. These Periprosthetic Fractures are particularly challenging because the metal prosthesis is anchored within the central canal of the bone, making fracture fixation with customary plates and screws or rods extremely difficult. An even more challenging situation exists with a Periprosthetic Nonunion in which the bone has been broken for months and refuses to heal.

Periprosthetic Fracture/Nonunion Treatment Options

A variety of special techniques are available to treat Periprosthetic Fractures and Nonunions including internal and external fixation. These cases often require patient specific or even custom-constructed fixation devices. With proper treatment, even the most difficult Periprosthetic injuries can be cured and the patient’s quality of life can be substantially improved or returned to normal. Because of the complex nature of this area of orthopedics, choosing a surgeon with vast experience is paramount.

Bone Infections

Thu, 27 May 2010 17:50:00 GMT

About Bone Infections Infection of bone (osteomyelitis) remains one of the most challenging problems in the field of Orthopedic Surgery. The infection can be associated with purulent drainage from a sinus tract that runs from the bone to the skin. Alternatively, bacteria may lay dormant for years, hiding within the honeycomb structure of bone and may reactivate at any time. Bone Infection Treatment Options Antibiotics, alone, are rarely curative. Treatment consists of surgical debridement (removal) of infected and non-viable bone, local high dose local antimicrobial therapy via antibiotic beads, intravenous antibiotics and soft tissue reconstruction as needed. Bony reconstruction is indicated in cases requiring complete removal of a section of structural bone. With proper treatment, even the most longstanding cases of bone infection can be cured and the patient’s quality of life can be substantially improved or returned to normal. Because of the complex nature of this area of...

Complex Fractures

Thu, 27 May 2010 17:49:48 GMT

About Complex Fractures The term “complex fracture” describes a broken bone that is more severe than what is common or routine. Fractures are considered to be complex when: The fragments are comminuted (broken into many pieces) The soft tissues are severely damaged There is loss of bone due to severe trauma There is disruption of the articular surface (severe cartilage injury at a joint) There are multiple fractures at several levels in a single bone There is an associated joint dislocation Complex Fracture Treatment Options A variety of methods are available to stabilize complex fractures. These include a vast array of internal and external fixation devices. Because of the complex nature of this area of orthopedics, choosing a surgeon who has substantial experience treating complex fractures is important. Complex Fractures Treated by Dr. Brinker* Anatomic Location Number of Surgical Cases ...