Articles: tibia-surgery.
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Arch Orthop Trauma Surg · Jan 1992
Complications of high tibial osteotomy and internal fixation with staples.
Osteotomy for osteoarthritis of the knee has established itself well since its first description by Jackson and Waugh [8, 9]. Internal fixation with staples allows early functional treatment with only a minimum of operative intervention. Removal of the metal is optional. ⋯ The staples became loose intraoperatively in eight cases (4.5%); only once did a dislocated staple have to be reoperated on post-operatively. Further complications which are independent of the method of internal fixation are summarized in the article. Complications of surgery on the long bones of the leg are inevitable, but with only one postoperatively dislocated staple and one case of non-infected pseudarthrosis (i.e. a method-related complication rate of 1.1%), internal fixation with staples for high tibial osteotomy presents itself as a reliable and safe procedure.
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Arch Orthop Trauma Surg · Jan 1991
ReviewTen-year results of tibial osteotomy for medial gonarthrosis. The influence of overcorrection.
The results in relation to the correction achieved 1 year after surgery of a series of tibial osteotomies in 50 patients (52 knees) are presented with a total observation time of 10 years. Mean age at the time of osteotomy was 56 years. ⋯ One out of 34 overcorrected knees recurred in varus. Five knees were revised by knee arthroplasty or reosteotomy one of which was overcorrected.
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J Bone Joint Surg Am · Feb 1988
Anterior approach to the knee with osteotomy of the tibial tubercle for bicondylar tibial fractures.
Eight patients--six who had a bicondylar fracture of the tibia and two who had a complex fracture-dislocation--were treated by open reduction and internal fixation that was achieved through an anterior approach to the knee. The approach included elevation of the tibial tubercle, proximal retraction of the extensor mechanism (patellar tendon, retropatellar fat pad, and patella), and transection and detachment of the anterior horn of one or both menisci. ⋯ The main advantage of this approach is that the tibial plateau and the intercondylar notch are exposed clearly and completely; this is a prerequisite for the rapid reconstruction of the joint surface and, in some patients, for the reattachment or primary suture of the cruciate ligaments. I recommend the anterior approach with osteotomy of the tibial tubercle in the treatment of patients who have a severe displaced bicondylar fracture of the proximal end of the tibia.
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Clin. Orthop. Relat. Res. · Nov 1986
Locked intramedullary nailing. Its application to femoral and tibial axial, rotational, lengthening, and shortening osteotomies.
Interlocking nailing is an alternative method of internal fixation following corrective osteotomies for malunions or after correction of leg length inequality. Of 13 osteotomies (six femoral, seven tibial) for angular or rotational malunion, all healed following dynamic locked nailing. Eleven were considered anatomic and two had mild residual deformity. ⋯ The recommended technique of shortening osteotomy consists of resection of a cylindric segment of bone from the distal diaphyseal metaphyseal area. Shortening should not exceed 4.5 cm in the femur or 3.0 cm in the tibia. In ten patients who were shortened, all healed, but radiologic signs of union appeared very slowly in most cases.
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Ital J Orthop Traumatol · Mar 1986
Management of the fibula in high tibial osteotomy for arthritis of the knee. Union times and complications.
An evaluation of 300 high tibial osteotomies in 285 patients showed that the more distal the fibular osteotomy the longer the union time. The union time of the tibial osteotomy was unaffected by the site of the fibular osteotomy, but union was most rapid in both when staples were used. Most complications in curved osteotomy occurred when the fibular osteotomy was performed 15 cm below the fibular head. In wedge osteotomy loosening of the staples used for fixation was the most frequent complication.