Articles: tibia-surgery.
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Clin. Orthop. Relat. Res. · Feb 2016
Multicenter Study Comparative StudyOutcomes of a Modular Intercalary Endoprosthesis as Treatment for Segmental Defects of the Femur, Tibia, and Humerus.
Resection of diaphyseal bone tumors for local tumor control and stabilization often results in an intercalary skeletal defect and presents a reconstructive challenge for orthopaedic surgeons. Although many options for reconstruction have been described, relatively few studies report on the functional outcomes and complications of patients treated with modular intercalary endoprostheses. ⋯ The results of this study indicate that this modular intercalary endoprosthesis yields equivalent results to other studies of intercalary endoprostheses in terms of MSTS scores. We found that patients treated with intercalary endoprostheses in the femur experienced more frequent complications than those treated for lesions in either the humerus or tibia and that the femoral complication rate of this endoprosthesis is higher when compared with other studies of intercalary endoprostheses for femoral reconstruction. Further studies are still needed to determine the long-term outcomes of this endoprosthesis in patients with primary tumors where longevity of the implant is of more importance than in the metastatic setting. We recommend cemented fixation for this intercalary modular endoprostheses because this provides improved MSTS scores and allows immediate return to weightbearing, which is of advantage to metastatic patients with limited lifespans. Level of Evidence: Level III, therapeutic study.
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Multicenter Study
Tibiotalocalcaneal fusion using the hindfoot arthrodesis nail: a multicenter study.
Tibiotalocalcaneal arthrodesis is a salvage option for severe ankle and hindfoot deformities, arthritis of the ankle and subtalar joints, avascular necrosis of the talus, failed total ankle arthroplasty, and Charcot arthropathy. This multicenter study reports clinical experience with the hindfoot arthrodesis nail (HAN) in the treatment of patients with severe ankle and foot abnormalities. ⋯ Level IV, retrospective case series.
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Knee Surg Sports Traumatol Arthrosc · Jan 2013
Multicenter Study Comparative Study Clinical TrialShort-term safety and efficacy of a novel high tibial osteotomy system: a case controlled study.
To evaluate the safety and efficacy of the novel iBalance Medial Opening Wedge High Tibial Osteotomy (HTO) system in executing lower limb realignment in patients with symptomatic varus gonarthrosis. ⋯ The iBalance medial opening wedge HTO system has been shown to be a safe, novel implant for use in proximal tibial osteotomy. This study shows that the iBalance medial opening wedge HTO system has an equivalent short-term safety and efficacy profile to the 2nd generation Puddu system.
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Multicenter Study
The management of acute distal tibio-fibular syndesmotic injuries: results of a nationwide survey.
Ankle fractures are one of the most frequently encountered musculoskeletal injuries, and 10% of patients have a concomitant distal tibiofibular syndesmotic disruption necessitating surgical repair. A national survey was conducted to gain more insight into the current approaches in the management of syndesmotic injuries in the Netherlands. ⋯ Compared with previous surveys our survey is more complete, has the highest response rate and has almost national coverage. Most individual items reviewed compare well with current literature, except for the routine removal of the syndesmotic screw, which might not be encouraged from a literature point of view. For this reason, the results of the current survey will be used in the development of a multicentre randomised controlled trial comparing the functional outcome in routine removal of the syndesmotic screw compared with removal on indication.
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Randomized Controlled Trial Multicenter Study
Reamed versus minimally reamed nailing: a prospectively randomised study of 100 patients with closed fractures of the tibia.
It is generally accepted that in tibial fractures the results of reamed intramedullary nailing are better than those of unreamed. However, it is not known whether the clinical effects of reaming are cumulative or if minimal reaming would induce the same beneficial effects as more extensive reaming. This international multicentre study has investigated the effects of different degrees of reaming. 100 patients with closed diaphyseal tibial fractures were prospectively randomised in two centres. ⋯ A considerable number of outcome parameters including knee and ankle function, as well as the comparison of time intervals to restart certain activities, and return to work showed no significant statistical difference between the two groups. However, patients of the extensive reamed group returned earlier to running, training, and normal sports activities. This study found no significant evidence that more extensive reaming gave better results, however there seemed to be a tendency of more aggressive reaming to induce earlier fracture healing with a tendency of faster recovery times.