Orthopaedic Surgery


Orthopedic surgery or Orthopedics, also spelled Orthopaedics, is the branch of surgery concerned with conditions involving the musculoskeletal system.

Orthopedic surgeons are doctors who specialize in the musculoskeletal system - the bones, joints, ligaments, tendons, and muscles that are so essential to movement and daily living. They use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.

World- renowned Professor Dr. Michael Weber - Orthopaedic and Trauma Surgeon has more than 37 years of professional expertise for the following orthopaedic medical services:

  • Orthopaedic and Trauma Surgery
  • Special Orthopaedic Surgery
  • Paediatric Orthopaedics
  • Foot Surgery
  • Sports Medicine
  • Chiropractic
  • Physical Therapy
  • Technical Orthopaedics
  • Limb Lengthening & Reconstruction
  • Regenerative Medicine

The Beginning of Limb Lengthening and Limb (Re) Construction

The Beginning of Limb Lengthening and Limb (Re) Construction

Dr. Weber was one of the first doctors from Germany who was invited to visit Prof. Dr. Gavriil A. Ilizarov in 1990. He took part on Dr. Illizarov’s first international course for limb lengthening and limb reconstruction at his impressive Hospital in Kurgan, Siberia, toured the hospital facilities, took part on the clinical and surgical routine and was invited to Dr. Ilizarov 70th Birthday celebration. Inspired by Ilizarov’s genius achievements and encouraged by him personally, Dr. Weber followed up his own ideas, techniques and concepts for limb lengthening and limb reconstruction and established them in Germany.

After eight years of intensive clinical and scientific work Dr. Weber went to the very first launch of the Taylor Spatial Frame (TSF) and there met the inventor Dr. Charles Taylor one year before Dr. Taylor got the USA-Patent. Prof. Weber was one of the first surgeons in Germany to use the TSF. Due to his comprehensive knowledge and skills in limb lengthening and limb reconstruction he became national and international lecturer for the application of Mini-Ring-Fixator, Ilizarov-Fixator and Taylor-Spatial-Frame and is instructor for A.S.A.M.I. international courses. Due to his continuous scientific and exceptional clinical work Prof. Weber was elected twice as President of the A.S.A.M.I. (Association for the study and application of the method of Ilizarov, Limb Lengthening and Limb Reconstruction Society) of Germany and was awarded as Honorary President of the A.S.A.M.I.-Germany.


In the following presentation are some examples of Prof. Weber’s patients treated for limb deformities, deficiencies, discrepancies, malformations and birth defects. Besides general information and techniques about limb lengthening and limb reconstruction the focus of the presentation is based on some of Prof. Weber’s invented world renowned techniques to prevent limb amputation, to improve limb function and the patient quality of life

 

Deformities: Deformity Correction

For correction of deformities a precise pre-operative deformity correction planning, an experienced surgical performance and a careful post-operative care is crucial [1-5]. Minor deformity correction can be done conservatively with night braces in young children or operatively with growth guidance (8-plate, Fig. 2) and with acute correction of curved bones stabilized internally (plates, nail, rods etc.) or externally (fixators, Figs. 3, 5, 6 ,10, 11, 13, 14-17, 20). In major deformities or deformities combined with a shortening the correction has to be performed continuously by callus distraction. Complex deformities in combination with severe shortening demand a stable fixation with ring fixators [17]. The main principle of callus distraction is to apply man-made growth to a bone at the location where it is needed. Therefore, the bone has to be cut and the bone fragments have to be stabilized internally (lengthening nail) or externally (fixators). After a couple of days, the cut bone fragments attempt to heal like in a fracture. This healing tissue is called callus. After several days, the callus is formed and due to its softness it can be distracted. With a rate of approximately 1mm per day the bone deformity can be corrected in all axis and additionally the short bone can be lengthened. The advantage of callus distraction is that with this continuous distraction the surrounding soft tissue (muscles, vessels, nerves, tendons etc.) is growing (like in a child). The distracted and growing callus maturates by time into full quality bone. The two main reasons of deformities are congenital (figs. 2, 5-13, 16-20) and acquired (figs. 3,4,14,15),[6,7,19-22,24,25]. The congenital deformities and malformations are due to external caused growth disturbances of limb(s) in the womb of the mother (e.g. breech position, lack of amnion fluid [23] etc.) or genetic reasons and appear usually with multiple malformations of the whole limb. Prof. Weber found that the lack of amniotic fluid was related to the fetus developing limb and joint hip dysplasia and hip luxation. Prof. Dr. Weber was honoured for his discovery and awarded for his Human Oligohydramnios-Sequence-Model for hip dysplasia and luxation at the 22 SICOT Conference in Sydney, Australia in 2002 [23]. The acquired deformities are the result of incorrect fracture healing or of a damage to the growth plate, bone and joints in childhood due to injury, disturbance of the blood support, paralysis or spasticity of muscles or weakening of the bone due to Vitamin-D deficiency (very common in UAE) which can lead to the typical O or X-curved legs (Fig. 4). In adult's deformities occur mainly due to injuries of bone and joints with fracture healing problems like persisting deformities, delayed or non-union of the bones. Many adults also suffer from persisting deformities since childhood (Fig. 4). In childhood minor deformities can be treated conservatively with night braces or operatively with small surgeries using special plates (8-plate, Fig. 2) for guidance of growth at the growth plates. In major deformities or deformities with additional bone shortening callus distraction has to be performed with external fixators or internal methods like lengthening nails. The following pictures are giving few examples of different reasons and techniques for treatment of deformities, defects and malformations.

Fig. 1 A precise deformity correction planning is crucial for successful outcome of surgery. Deformity-Correction-Planning-Femur-Tibia
Fibular-Hemimelia-8-plate-growth-guidance-left

Fig. 2 a. Both legs have valgus deformity and right leg has additional shortening. b.-c. The left side is treated with growth guidance by 8-plate which stops temporarily the growth at side of application while inserted. d. After achieving the correction (couple of months) the plate can be removed and the growth at the application side of the plate can continue. Full weight bearing is possible at all times. The right leg has beside the valgus deformity also a shortening and needs therefore a combination of deformity correction and lengthening with a fixator via callus distraction.

Deformity-after-tibial-growth-plate-injury-ventrally

Fig. 3 a. After tibial growth plate injury in childhood at the ventral proximal tibia this adolescent suffered from a severe recurvatum deformity of the tibia combined with a flexion contracture of the knee. b. Both problems could be solved with two attached Taylor Spatial Frames (TSF). The upper TSF corrects the knee flexion contracture by soft tissue distraction. The lower TSF corrects the tibial recurvatum deformity with callus distraction. The TSF allows full weight bearing during the whole treatment. c. Clinical picture after correction. d. X-ray. Severe osseous recurvatum deformity before surgery. e. X-ray. Perfect axis after correction with good callus formation.

Patients-with-different-reasons-and-kind-of-deformities

Fig. 4 a. An 11-year-old girl with severe O-curved legs of the same degree on both sides due to Morbus Blount was treated successfully with TSF of the left leg. b. A young man with severe X-curved legs of the same degree on both sides due to Vitamin-D deficiency in childhood was treated with ring fixators successfully of the left leg. c. A man suffering from severe shortening and deformities of the right leg due to poliomyelitis in childhood. Note the tilted pelvic line (red) d. Same patient as c. after correction of the shortening and all deformities. Note the corrected pelvic line. He is able to walk now without his brace.

Malformations (Birth defects, 25):

Longitudinal Reduction Deficiencies like Tibial or Fibular Hemimelia are representing rare birth defects where the leading bone structure is either the tibia or the fibula (figs.2, 5-11), [1-5]. Both types of malformations have their special characteristics with leg length discrepancies, deformities, instabilities, and malfunctions. The surgical treatment should address not only a part of the problem but the whole leg and body to achieve body balance and best functions. The treatments have to be adapted to the growing child and require often a multi-step procedure during the childhood. In the following presentation only a few examples of Prof. Weber's proprietary techniques can be presented demonstrating the extraordinary possibilities of limb reconstruction and lengthening and especially the construction of limbs and joints to improve the limb function to its best.

Malformation: Severe Type of Fibular Hemimelia

Fibular Hemimelia (fibular reduction deficiency) is a rare malformation with an occurrence of 1 in 40,000 births [7]. The main problems associated with this birth defect is that depending on the severity of this disease additional deformities and instabilities occur around the hip, knee, ankle and foot as well as limb length discrepancy. Especially the severe form of this disease requires a treatment concept of the entire leg to achieve good results. Here are some examples:

Fibular-Hemimelia-Wedge-osteotomy-reverse

Fig. 5 a. Severe type of fibular hemimelia with severe shortening, tibial deformity and ankle instability. b. and c. Osseous wedge osteotomy with reverse transplantation of bone-wedge above the oblique tibial growth plate. This gives an acute correction of the tibial deformity and ensures a further straight growth of the tibia due to acute correction of the ankle joint line axis. d. Simultaneous lengthening at the proximal tibia. e. The acute wedge correction and lengthening of tibia is supported by a mini-ring-fixator, a smaller version of the Ilizarov fixator allowing treatment also on infants. Prof. Weber was the first who used the mini-ring-fixator in Germany. This pictures shows the fixator after 10 cm lengthening and before removal. The anchor wire and central tibia wire fixating the wedge osteotomy was removed already.

Fibular-Hemimelia-Webers-Malleolus-Plasty

Fig. 6 To prevent a luxation of the foot during lengthening or to treat a severe ankle instability, Prof. Weber invented a unique technique to create a lateral malleolus which is missing in severe types of fibular hemimelia or if present is not sufficient enough [8]. For this technique a triangular free iliac crest transplant with adhering gluteal fascia is mobilized from the patient's iliac crest and transplanted into the missing lateral malleolus of the ankle joint. The transplant with the apophysis (cartilage which is responsible for growth) ensures further temporary growth (in average 3 years). The defect at the iliac crest is healing by itself. The transplanted gluteal fascia is working as a stabilizing lateral ankle tendon. The advantage of this procedure is that it gives permanent stability to the ankle joint for the lengthening and during the further growth of the leg. No luxation has been observed after this procedure. a. Incision is made to implant a skin expander b. With a skin expander the skin can be expanded by filling the balloon with fluid through a syringe. With the needle of the syringe the port (white rubber circle) of the skin expander is punctured every week and a certain volume applied. Usually after six weeks the skin has grown enough to cover the transplant. c. X-ray: Ongoing lengthening with ring fixator after malleolus transplantation. d. X-ray: Tibial bone after deformity correction, malleolus transplant and 10 cm lengthening. e. X-ray: Detail of malleolus transplant at ankle joint.

Fibular-Hemimelia-Foot-and-ankle-correction

Fig.7 The foot has no normal joint between talar and calcaneal bone but a solid osseous fusion. This leads beside a missing motion in the lower ankle joint to a lateral shift of the foot with severe imbalance of the mechanical axis. Additionally, the joint line of the ankle is about 15 degrees' oblique which increases the axis problem. a. Frontal X-ray of the foot and ankle with the described malformation and deformities. b. For treatment of the talo-calcaneal fusion the bony bridge between the talus and calcaneus is cut and the calcaneus shifted into the corrected position (c). d. The upper ankle joint shows a valgus deformity of 15 degrees. e. With a dome osteotomy the deformity is corrected acutely. All corrections are done with a TSF application where all deformities were corrected and the lower limb leg discrepancy equalized. The clinical pictures are shown in Fig. 8.

Fibular-Hemimelia-Weber-Procedure-Outcome

Fig. 8 a. This patient has undergone a Weber-Malleolus-Plasty, deformity correction of the tibia and lengthening of the lower limb of 10 cm before. b. The foot and ankle shows the deformities described above. c. After correction of ankle deformity and correction of the talo-calcaneal fusion including second lengthening of 7 cm the foot is perfectly aligned with the mechanical axis of the leg and the leg length discrepancy is equalized. d. and e. The range of motion of the upper ankle joint is very good.

Malformation: Weber's Transformation Surgery for Treatment of Tibial Hemimelia

Tibial Hemimelia (tibial reduction deficiency) is a very rare birth defect (1/1,000,000 births) and is characterized by different amounts of reduction of tibial bone up to completely missing tibial bone. This malformation can appear with a cartilaginous anlage (remnant of missing tibial part made of cartilage) or without. According to the occurrence of the tibial missing part the adjacent joint (knee or ankle) is missing too. For the new construction of a joint Prof. Weber was the first worldwide who used the cartilaginous anlage with extraordinary results [Booster-Technique, 1,4]. This disease is categorized under congenital malformations and is the most challenging disease to treat for Orthopaedic surgeons. The most severe form Type VII-B according to Weber-Classification shows a lower leg with complete lack of the tibial bone. For this type of disease, the usual treatment undergone worldwide is the amputation of the lower leg. To prevent amputation Prof. Weber invented special techniques by transforming the patella to a knee joint and the fibula to a tibia. With this world-wide unique techniques, the patients are able to walk and do sports [1,4,10]. For the discovery of this new innovative techniques Prof. Weber was awarded by the German and the European Society for Paediatric Orthopaedics. According to Prof. Weber's classification [3] all 12 different types of this disease (Fig. 9) can be treated successfully with different Weber-Special- Techniques [1,4]. Prof. Weber has treated worldwide the most patients with this rare disease.

Weber-Classification-of-Tibial-Hemimelia

Fig. 9 Prof. Weber's classification of Tibial Hemimelia [3] with the main twelve different types according to the severity of the malformation and respecting the cartilaginous anlage which was discovered by Prof. Weber (black = bones; blue = cartilaginous anlage)

Webers-Transformation-Surgery-of-Tibial-Hemimelia

Fig. 10 a. The child has all four limbs malformed. b. After lengthening with a Mini-Ring-Fixator and performing the Weber-Transformation-Surgery (patella is used as tibial plateau, fibula is used as tibia) for creating a knee joint and a tibia on the right leg the patient has full weight bearing with very good range of motion (c). The affected left leg was also treated successfully. Worldwide this technique is the only procedure preventing lower extremity limb amputation in children suffering from type VII-b Tibial Hemimelia (10). The treatment of the hands was performed later and subsequently the boy was able to play soccer (d).

Malformation: Weber's Booster Surgery for Treatment of Tibial Hemimelia

The use of the cartilaginous anlage (remnant of tibia made of cartilage) in tibial hemimelia is a breakthrough in the construction of missing joints and recovery of the original growth plates [3]. With Weber's Booster Surgery, the cartilaginous anlage of the malformed tibia is shifted by bone lengthening methods until contact with the adjacent joint partners. Due to this manoeuvre the cartilaginous anlage develops a joint and their own growth plates can maturate. This principle is applicable in all types of tibial hemimelia with cartilaginous anlagen (types IIIa � VIIa). After the Weber's procedure further own growth of the tibia can be expected [1,4].

Weber-Type-Va-Booster-Technique

Fig. 11 a. The malformed leg and foot before surgery. b. and c. Ring fixators are stabilizing the leg during lengthening process. d. and e. The X-rays show the creation of knee and ankle joint including 400% lengthening of tibial remnant after two lengthening's by Weber's Booster Technique. Growth plates are developing during the Weber's procedure ensuring further own tibial growth.

Bone Defect: Internal Bone Transport with Weber-Cable-Technique

Defects of bones can occur due to an injury or by surgical resection. Bone segments have to be removed surgically because of severe infection [14,16], death bone and tumors e.g. The usual technique of filling the bone defect is performed by external bone transport with callus distraction. During this external bone transport, the wires and half pins fixing the bones are cutting through the soft tissue (skin, muscle etc.). This is painful and requires multiple and repeated incisions through the soft tissue around the wires and half pins during the whole transport process. All these painful incisions with additionally higher infection risk are obsolete with the Weber-Cable-Technique [15,18]. With this technique the transported bone segment is fixed internally with cables and pulled internally without any damage or stress to the soft tissue until the bone defect is closed. The patient doesn't feel anything of the bone transport. Prof. Weber received the Medical-Orthopaedic- Technique Award for his achievement in Germany.

Weber-Classification-of-CCSD-CPT

Fig. 12 The Congenital Crural Segmental Dysplasia (CCSD, so called congenital tibial pseudarthrosis) is one of the most challenging diseases in paediatric orthopaedics. In the literature you will find that most of the cases were treated unsuccessfully more than 20 times and are often ending with amputations [9,12]. One of the reasons for insufficient results is that this disease is misdiagnosed [13] as a normal fracture in childhood. Own researches have shown that the periosteum (bone skin) which is normally responsible for bone growth and nutrition shows severe pathological changes [13] not fulfilling any longer this task. The blood supply and nutrition of the bone is disturbed by the pathological periosteum which weakens the bone until it gets fractured. Additionally, this pathological periosteum prevents the fractured bones from healing [5,6]. In Germany Prof. Weber has treated the most cases with a success rate of over more than 90%. The reason for this excellent result lies in a well-defined treatment concept which originates from results of own researches according to the origin of the disease as well as own proprietary techniques [2,5]. In his classification (Fig. 12) the main different types of CCSD are represented with the focus on appropriate treatment options regarding each different type. For the first time in the literature the importance of the fibula is respected. Type a represents an intact fibula, type b represents a broken fibula.

weber-cable-technique

Fig. 13 a. This 5-year-old boy is suffering from a Type-Vb CCSD with fracture and pseudarthrosis of fibula and tibia. b. The model shows the principle of the Weber-Cable-Technique. A cable is attached to the bone segment which will be transported and directed internally along the bones and leaded out to pulleys. These pulleys redirect the cable to distractors mounted on the ring fixator. By turning the distractors, the mobilized bone segment can be transported internally (1mm/day) after a callus (red) has formed. The transport is stopped when the bone defect is closed. The callus will maturate into normal high quality bone tissue. The docking of the transported bone segment with the opposite bone heals like a fracture. c. The X-ray of the boy shows the fracture and pseudarthrosis of the lower leg. d. X-ray: Ongoing cable-transport before docking. Good callus formation. e. X-ray: Complete permanent healing of the pseudarthrosis.

weber-cable-technique-Bifocal-transport

Fig. 14 a. The patient undergoing the bone transport after resection of a bone tumor is able to have full weight bearing on the leg because the bone fragments are stabilized with a ring-fixator (patients with ring-fixators can walk, go to school or university, do household work or work in an office etc.). b. The X-ray picture shows the two bone cuts to mobilize the both bone segments for bifocal transport and the bone defect of 12 cm is closed in 60 days [15,18]. At these bone cuts the bone attempts to heal by producing a healing tissue called callus. This callus is soft and can be extended. b.-d. With the attached cables at both bone ends the bone segments can be pulled towards each other at a growth rate of 1mm a day. d. Once the bone ends have reached each other (docking) the transport is stopped and the bone can heal together at the docking area. e. In the gaps of distraction, the callus produced by the bone maturates to high quality own bone tissue.

webers-TCNC-Arthrodesis-plus-lengthening

Fig. 15 a. This young man had a severe sports injury with damage to his talar bone. In the following years he developed necrosis of the complete bone and cartilage so that it had to be removed. With the Weber's TCNC-Arthrodesis [1,16] it is possible to give the foot stability again and to enable the patient full weight bearing and to return to sports. b. With the ring fixator the tibial bone can be osteo-synthesized to the calcaneal, navicular and cuboidal bone after resection of the talus. Additionally, with the fixator the resulting shortening of the bone can be equalized by lengthening of the tibia simultaneously. c. Schematic drawing of the resection of talus and affected joint-cartilage. d. TCNC-Arthrodesis. e. Postoperative X-ray of the successful Arthrodesis. Prof. Weber's TCNC-Arthrodesis was awarded during the 22nd SICOT Conference in Sydney, Australia. This proprietary technique can be used to prevent amputations in all ailments where the talus has to be removed due to infection after failed ankle arthrodesis, necrosis due to trauma or in diabetic foot, tumor, neurological or congenital diseases for stabilizing the foot [11,16].


Foot Problems: Growth disturbances of rays

The under development of bones in the foot are usually congenital [birth defect, 1,4,21,22]. Single or multiple bones can be affected and also the whole leg can show malformations. The problem for the patient with a hypoplasia of foot rays is that the normal architecture of the foot is disturbed and the weight load to the foot is imbalanced. Additionally, the normal digits grow into the gap of the shortened digit. These can lead to second deformities, pain and inability to wear normal shoes. Conservative treatments with custom made insoles can help to reduce the complications of this foot problem. The original problem of the shortened bone can be treated better by lengthening of the affected bone. Once the correct length is achieved the foot has its normal architecture, the weight load is balanced and no secondary deformities of the other digits can occur.

hypoplasia-Metatarsal-Bone-IV-right

Fig. 16 a. This young lady is suffering from a birth defect of her fourth metatarsal bone. Due to its shortening the healthy digits are shifting already into the resulting gap. This leads to pain and problems with shoe wearing. See the interrupted midfoot arch line (red wave). b. After cutting the bone in the midshaft a mini-ring-fixator is applied to perform the lengthening. c. The X-ray shows the corrected length of toe and midfoot arch. The patient can wear normal shoes and do sports. The development of secondary deformities of the healthy digits is prevented.

hypoplasia-of-complete-first-ray-left

Fig. 17 a. X-ray, this 7-year-old boy was suffering from a complete malformation and hypoplasia of the first ray left (red arrow). The digits 2 � 5 are deviating into the gap of the short first ray (white arrows). b. After realignment of the three bone segments of the first ray the metatarsal bone is lengthened with a mini-ring-fixator. c. The X-ray shows the reconstructed first ray with corrected length. The toe deviation 2-4 have started correcting itself. d. Result after removal of fixator.

hypoplasia--digit-II-right

Fig. 18 a. The over-length of digit two of this female patient leads to severe problems wearing shoes resulting in pain and the risk of craw-toe development, beside the cosmetic problem. After resection of a bone segment at the ground-phalanx of digit-II (s-shape skin incision) the patient has no more problems wearing shoes and is very happy with the cosmetic result (b).


Foot Problems: Clubfoot

The clubfoot (congenital talipes equinovarus, CTEF) is a general term according the reasons as well as the characteristic and appearance of typical deformities. Most of the clubfoot types are present at birth, can affect one or both feet and can be part of a longitudinal reduction deficiency like tibial hemimelia [1,3,4,21,22]. The utmost importance for a successful treatment is to start treatment at the earliest to address the origin of the deformity, due to the fact that the newborn tissue (ligaments, tendons, muscles etc.) are soft and immediate treatment after birth with repetitive stretching and versatile manual manipulation of the mal-rotated and deviated structures in the foot with keeping the corrections arrested in special casts (Ponseti-technique) guarantees the best results with less invasive procedure. Thus, the older the patient, the more rigid the clubfoot, the more invasive treatment required.

webers-clubfoot-treatment-algorithm

Fig. 19 Schematic drawing shows the different treatment options of clubfoot according to the age of patient and the severity of disease which Prof. Weber is performing successfully since 24 years. If the patient is treated immediately after birth in most of the cases the foot can be corrected with several casts according to the Ponseti method and only minor surgeries like Achilles tendon lengthening is needed. So much older the patients, so more rigid the deformity, so more invasive the surgery. These surgeries range from peritalar release to fixator treatment without or with osteotomies of the deformed foot bones. During all different kind of treatments, physiotherapy is always included in the treatment concept as well as a custom made special braces to reduce the risk of reoccurrence.

club-foot-correction-with-fixator

Fig. 20 a. and b. This seven-year-old boy suffered from severe deformed neurological clubfeet due to spina bifida. His feet were twisted and he was walking on the back of his feet. c. The ring fixator treatment was done according to the principles of the Ponseti method correcting the different deformities step by step with several pain free re-mountings of the fixator in the outpatient clinic. d. The postoperative result is perfect. For prevention of recurrence of club foot and to compensate the paralyzed feet muscles the patient has to wear a stabilizing inner shoe.

A-good-circle-of-cooperation-is-crucial-for-success

Fig. 21 Beside the versatile surgical treatment of a very much experienced Orthopaedic Surgeon the positive patient treatment outcome depends on best treatments and a continuous support cycle process that includes the joint contributed efforts of the Orthopaedist, the parents or patients and the multiple disciplinary team.

References:

1. Weber, M.: Treatment of Tibial Hemimelia in M. Kocaoğlu et al. (eds.), Advanced Techniques in Limb
Reconstruction Surgery, Springer Berlin Heidelberg, 2015
2. Weber, M.: Congenital Pseudarthrosis of the Tibia: Redefined (Congenital Crural Segmental Dysplasia) in
M. Kocaoğlu et al. (eds.), Advanced Techniques in Limb Reconstruction Surgery, Springer, Berlin Heidelberg,
2015
3. Weber M.: New classification and score for tibial hemimelia. J Child Orthop (2008) 2:169-175
4. Weber, M.: Congenital Leg Deformities: Tibial Hemimelia in S.R. Rozbruch and S. Ilizarov (eds.), Limb
Lengthening and Reconstruction Surgery, Informa Healthcare, New York, 2007
5. Weber, M.: Congenital Pseudarthrosis of the Tibai. Redefined: Congenital Crural Segmental Dysplasia in
S.R. Rozbruch and S. Ilizarov (eds.), Limb Lengthening and Reconstruction Surgery, Informa Healthcare, New
York, 2007
6. Hermanns B., Senderek, J., Füzesi, L., Weber, M.: Periostal proliferations in bone lesions of congenital
pseudarthrosis of the tibia have morphological features of neurofibromatosis type-I. Pathology in Research
and Practice (2004)
7. Hermanns, B., Senderek, J., Klosterhalfen, B., Stemper, A., Büttner, R., Weber, M.: Malexpression of
Hox c11 causes fibular a- or hypoplasia (FAH) in humans? Pediatr Dev Pathol (2004)
8. Weber, M.: Siebert, C.H., Goost, H., Johannisson, R., Wirtz, D.: Malleolus externus plasty for joint
reconstruction in fibular aplasia: Preliminary report of a new technique. J Pediatr Orthop (B) 11: 1-11 (2002)
9. Weber, M.: Neurovascular calcaneo-cutaneus pedicle graft for stump capping in congenital pseudarthrosis
of the tibia: Preliminary report of a new technique. J Pediatr Orthop (B) 11: 47-52 (2002)
10. Weber, M.: A new knee arthroplasty versus Brown´s procedure in congenital total absence of the tibia:
A preliminary report. J Pediatr Orthop (B) 11: 53-59 (2002)
11. Weber, M., Schwer, H., Zilkens, K.W., Siebert, Ch.: The tibio-calcaneo-naciculo-cuboidale (TCNC)
arthrodesis. - A new technique for treatment of difficult talar pathology -. Acta Orthop Scand 73: 98-103 (2002)
12. Weber, M.: Eine neue Technik der Stumpfkappenplastik am Unterschenkel. Orthopädie – Technik 4:
240-246 (2001)
13. Mahnken, A.H., Staatz, G., Hermanns, B., Gunther, R.W., Weber, M.: Congenital pseudarthrosis of the tibia
in pediatric patients: MR Imaging. Am J Roentgenol 177: 1025-1029 (2001)
20
14. Weber, M., Schwer, H.: Der diabetische Fuß- Eine interdisziplinäre Herausforderung. Z Orthop 139: 54-55
(2001)
15. Weber, M., Siebert C.H., Heller, K.D., Birnbaum, K., Kaufmann, A.:
Segmental transport utilizing cable wires and pulleys mounted on an Ilizarov frame –
A new technique-. J Bone Joint Surg (Suppl.) 81-B: 148 (1999)
16. Weber, M., Schwer, E.H., Siebert, C.H.: Fokussanierung einer chronisch sequestrierten Talusosteomyelitis
durch die TCNC (tibio - calcaneo - naviculo - cuboidale) Arthrodese. Eine neue Technik am Ringfixateur.
Unfallchirurg 102 402-405 (1999)
17. Schwer, E.H., Siebert, C.H., Kaufmann, A., Wilke, M., Weber, M.: Indication of change from unilateral to
Ilizarov ring fixator. J Bone Joint Surg (Suppl.) 81-B: 148 (1999)
18. Weber, M.: Segmenttransport des Knochens mittels Kabelrollen und flexiblem Draht – Eineneue Technik
am Ringfixateur-. Med Orth Tech 118: 134-140 (1998)
19. Weber, M.: Wenz, W., van Riel, A., Kaufmann, A., Graf, J.: Das Holt-Oram Syndrom (HOS). –
Literaturüberblick und aktuelle orthopädische Behandlungskonzepte-Z Orthop 135: 368-375 (1997)
20. Axt, M. W., Niethard, F. U., Döderlein, L., Weber, M.:
Principles of treatment of the upper extremity in arthrogryposis multiplex congenital type
I. J Pediatr Orthop (B) 6: 179-185 (1997)
21. Spranger, S., Weber, M., Tröger, J., Tariverdian, G., Opitz, J.M.:
Bilateral radial deficiency with lower limb involvement. Am J Med Genet 63: 193-197 (1996)
22. Merkelbach, H., Carstens, C., Weber, M.: Orthopädische Probleme beim Morbus Down.
Monatsschr Kinderheilkd 144: 778-785 (1996)
23. Weber, M.: Johannisson, R., Bos, I., Schröder, S., Rehder, H.: Oligohydramnios sequence as human
morphological model of hip dysplasia and luxation. SICOT/SIROT XXII World Congress, 25.-30. August in
San Diego, USA (Poster) Abstractbook: S. 583, P 1634 (2002)
24. F.U. Niethard, M. Weber, K.-D. Heller (eds.): Orthopaedie compact. Thieme, Stuttgart, New York, 2005
25. Rehder, H., Weber, M., Heyne, K., Lituania, M.: Fetal Pathology – Nonchromosomal in E.F. Gilbert,
J.M. Opitz (eds.) Genetic Aspects of Developmental Pathology, Alan R. Liss, Inc., New York, 1987

 

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