Articles: tibia-surgery.
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Long-term application of an external fixator to treat leg-length discrepancy and short stature often causes complications, such as pin-tract infection or loss of range of motion at the knee or ankle (or both). Prolonged fixator use also interferes with the activities of daily living. To minimize such problems, we have combined intramedullary nailing with external fixation. Using this technique, the external fixator can be removed more quickly after completing the lengthening. ⋯ A combination of intramedullary nailing and external fixation produces callus formation as good as that obtained by the standard Ilizarov method of lengthening. Furthermore, this combined procedure decreases the external fixation time and is associated with fewer complications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cemented tibial component fixation performs better than cementless fixation: a randomized radiostereometric study comparing porous-coated, hydroxyapatite-coated and cemented tibial components over 5 years.
The question whether the tibial component of a total knee arthroplasty should be fixed to bone with or without bone cement has not yet been definitely answered. We studied movements between the tibial component and bone by radiostereometry (RSA) in total knee replacement (TKR) for 3 different types of fixation: cemented fixation (C-F), uncemented porous fixation (UC-F) and uncemented porous hydroxyapatite fixation (UCHA-F). ⋯ Cementing of the tibial component offers more stable bone-implant contact for 5 years compared to uncemented fixation. When using uncemented components, however, there is evidence that augmenting a porous surface with hydroxyapatite may mean less motion between implant and bone after the initial postoperative year.
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We investigated the effect of hyperbaric oxygen (HBO) therapy on the early phase of tibial lengthening in our established rabbit model. ⋯ The study results suggest that early and full-term administration of HBO therapy on tibial lengthening may achieve better benefits.
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Osteoarthritis of the knee is often diagnosed in the orthopedic trauma practice. One major cause is axial deformity with overload. In the case presented here osteomyelitis of the tibial diaphysis developed in childhood. ⋯ In this way it was possible to eradicate the osteomyelitis of the lower leg and to achieve osseous consolidation between the tibia and fibula. Despite the significant shortening of the lower limb and the varus axial deformity, the knee joint function was satisfactory in the subsequent development. After a long interval without symptoms the patient developed a medially accentuated osteoarthritis of the knee.
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In neuromuscular diseases, limb lengthening and foot deformity correction are associated with a high risk of complications associated with distraction callus and joint contracture. We have found no published articles of tibial lengthening and concomitant foot deformity correction using the Ilizarov method or traditional methods. To compare result of gradual distraction with triple arthrodesis for foot deformity combined with tibial lengthening, we investigated healing index and complications of two methods. ⋯ The gradual foot frame distraction method was associated with major complications, such as recurrent foot deformity, joint luxation, and arthritis. We therefore recommend triple arthrodesis as a concomitant procedure during tibial lengthening