Articles: tibia-surgery.
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Clin. Orthop. Relat. Res. · Jan 2008
Leg lengthening with a motorized nail in adolescents : an alternative to external fixators?
Leg lengthening by external fixation is associated with various difficulties. We evaluated eight adolescent patients who underwent leg lengthening with a motorized intramedullary lengthening device. We asked whether this method could reduce the time of hospitalization and rehabilitation and whether the incidence of complications commonly associated with external fixators could be reduced. We compared our preliminary results with those from other reports, with a focus on leg length achieved, time of rehabilitation, and rate of complications. The average leg-length discrepancy was 3.8 cm (range, 3-5 cm). The average lengthening distance was 3.8 cm (range, 2.9-4.7 cm). In six patients, leg lengthening was combined with successful correction of the mechanical axis alignment. The consolidation index averaged 26 days/cm (range, 19-41 days/cm). The average hospital stay was 9.6 days. No bone or soft tissue infections were observed. In comparison to other studies (1.0-2.8 complications/patient), our results suggest that the difficulties commonly associated with external fixators can be reduced with this method. It also allows good angular correction in patients with mechanical axis deviation. These features combined with a short time of hospitalization and rehabilitation make it a promising procedure for limb lengthening. ⋯ Level IV Therapeutic study.
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Rev Chir Orthop Reparatrice Appar Mot · Dec 2007
[Infection on continuous bone of lower limb: 127 cases].
Infection on continuous bone is a specific diagnostic and therapeutic entity. Treatment requires debridement of infected and necrotic soft tissue and bone, dead space management, effective antibiotic therapy in the bone and good skin coverage with well-vascularized tissues. Results of treatment of infection on continuous bone of the lower limb are presented in this series. ⋯ Infection on continuous bone is a characteristic entity, rarely clearly separated from other bone infections in reported series that combine these infection with septic nonunions and infected arthroplasties. Surgery is essential and is based on quality debridement. The use of flaps (for both dead space management and skin coverage) improves the results for the treatment of such infections but long-term follow-up is needed for a more accurate assessment of success rate.
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Nonoperative treatment of posterolateral knee injuries tends to yield poor results. In patients with chronic posterolateral knee injuries, failure to correct genu varus alignment will often result in failure of the posterolateral knee repair or reconstruction. ⋯ Proximal tibial opening wedge osteotomy can be an effective first method of treatment for patients with chronic combined posterolateral knee injuries and genu varus alignment. Patients with low-velocity knee injuries and isolated chronic posterolateral knee injuries may not require a second-stage soft tissue ligament reconstruction after healing the osteotomy and undergoing a program of rehabilitation.
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J Bone Joint Surg Am · Oct 2007
Distal tibial reconstruction with use of a circular external fixator and an intramedullary nail. The combined technique.
Distal tibial reconstruction with use of an external fixator when there is bone loss, limb-length discrepancy, and/or ankle instability is associated with many problems. The technique of limb-lengthening, ankle arthrodesis, and segmental transfer over an intramedullary nail has been introduced to overcome these problems. The present study investigates this combined technique. ⋯ The combined technique is an improvement over the classic external fixation techniques of distal tibial reconstruction with ankle arthrodesis. It reduces the duration of external fixation, thus increasing patient acceptance, and it is associated with a low complication rate facilitating more rapid rehabilitation.
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Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi · Sep 2007
Case Reports[Free iliac flap grafting for repair of tibia traumatic osteomyelitis complicated with bone-skin defect].
To investigate the method and clinical effect of free iliac flap grafting in repairing the tibia traumatic osteomyelitis complicated with bone-skin defect. ⋯ Free iliac flap which used to repair tibia traumatic osteomyelitis complicated with bone-skin defect, can repair the defect at stage I and enhance the anti-infectious ability. It is one of appropriate and effective clinical methods.