Articles: tibia-surgery.
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Observational Study
Prediction of loss of correction after hemiepiphysiodesis for the alignment of lower limb angular deformities.
Guided growth by temporary hemiepiphysiodesis (HEPD) is established for the alignment of lower limb angular deformities. This retrospective cohort study was designed to assess the effect of HEPD in idiopathic coronal plane deformities around the knee and on the frontal knee joint line orientation, and to test the frontal knee joint line as predictive means for recurrence. Fourty-four patients (78 deformities: valgus n = 64, varus n = 14) were enrolled in the retrospective observational study. ⋯ An unphysiological change of the frontal knee joint line is associated with a high risk of recurrent angular deformities. CombiHEPD instead of singleHEPD seems to be safer to prevent detrimental frontal knee joint line shift. Level of Evidence: Retrospective comparative therapeutic study, Level III.
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Arch Orthop Trauma Surg · Sep 2021
Randomized Controlled TrialTranexamic acid is beneficial for blood management of high tibial osteotomy: a randomized controlled study.
The purpose of this study was to investigate whether TXA can effectively reduce blood loss after HTO and related complications and to evaluate its safety. ⋯ Intravenous TXA can effectively and safely reduce blood loss and bleeding-related complications after HTO and was beneficial for the blood management of HTO.
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Comparative Study
Comparison of topical and intravenous Tranexamic acid for high tibial osteotomy: A retrospective study.
High tibial osteotomy (HTO) is a promising surgery that can treat osteoarthritis of the medial septum of the knee. However, the extensive release of soft tissue and the osteotomy gap may produce intraoperative and postoperative bone bleeding. Tranexamic acid (TXA) is an effective blood management strategy, as it competitively inhibits the activation process of plasminogen and prevents fibrinolytic enzymes from degrading fibrin. ⋯ The hemoglobin concentration of the IV TXA group was obviously higher than that of the topical medication group. No patients had thromboembolic complications during the entire study period. In our study, it seemed that either IV or topical use of TXA might reduce blood loss after open-wedge HTO, and the blood loss and amount of drainage in the IV TXA group showed huge decreases compared to those in the topical group.
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Arch Orthop Trauma Surg · Jun 2021
Extracorporal noninvasive acute retraction of STRYDE® for continued lengthening in cases with limited nail stroke: a technical less invasive solution to reload the STRYDE®.
With STRYDE® nails (NuVasive Specialized Orthopedics, San Diego, CA), lengthening nails for full weight-bearing during callus distraction have been available CE-certified since February 2019 in Europe. At present only antegrade femur nails and tibia nails with various lengths and diameters are available. Due to a mismatch of bone length and realizable (implantable) nail length e.g., in cases of skeletal dysplasia or achondroplastic dwarfism, it may happen that a desired lengthening of 6-8 cm cannot be realized because of a nail stroke from only 5 cm. ⋯ The acute reload of the STRYDE nail stroke for further distraction is possible without skin incision or invasive soft tissue approaches. Application of the fast distractor extracorporeal within a few minutes is described in detail. The intervention is technically reproducible and can be performed for the proximal femur with antegrade STRYDE nails as well as for the distal femur with retrograde STRYDE nails in adult patients.
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Postgraduate medicine · May 2021
Case ReportsComplications after tibial tubercle traction and femoral neck fractures in children: A case report.
Background: Genu recurvatum and femoral neck fracture in children are very rare, and relevant literaturewas reported. However, there were no reports on avascular necrosisafter internal fixation of femoral neck fractures in children, and genu recurvatum and tibial dysplasia after tibial tubercle traction. Case presentation: In this case, a 32-year-old female patient suffered from a femoral neck fracture at the age of 10. The tibial tubercle traction was applied in the conservative treatment, and closed reduction and internal fixationwere adopted after the failure of the conservative treatment. When the patient came to our hospital for the treatment of hip and knee joint pain for 20 years, the doctor discovered that the patient had severe genu recurvatum and avascular necrosis. ⋯ Meanwhile, tibial traction should be avoided for children with lower extremity fractures, because it may damage the tibial growth plate, thus leading to the early closure of the metaphyseal region in children, and genu recurvatum. The modified surgery for the treatment of genu recurvatum is simple to operate and can avoid patella Baja, so it has a strong healing ability in the osteotomy area. The results of the surgery technique were ideal in this case. P.