Articles: tibia-surgery.
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Low tibial osteotomy is one of the significant advances of ankle reconstruction techniques that has been made recently in an effort to halt arthritis in its early stages and leave fusion as the last, not the only, alternative treatment of ankle arthritis. From 1989 to 1995, we performed 18 low tibial osteotomies which included 6 cases of post-traumatic arthritis and 12 cases of degenerative arthritis. The ages of the 7 male and 11 female patients ranged from 18 to 78 years with an average of 41.9 years. ⋯ Complications included one case of late infection and two cases of implant failure, none of which led to nonunion. The indication for low tibial osteotomy is the intermediate stage of moderate ankle arthritis with a medial joint lesion and intact lateral facet. Using pressure redistribution on the joint surface, this procedure is an alternative treatment for ankle arthritis which may save an arthritic ankle from the fate of fusion or at least postpone fusion surgery.
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To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft. ⋯ Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.
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Arch Orthop Trauma Surg · May 2001
Open wedge tibial osteotomy by hemicallotasis for medial compartment osteoarthritis.
Early clinical results were evaluated for 22 adult patients who had undergone an open wedge tibial osteotomy by hemicallotasis (HCO) due to medial compartment osteoarthritis. The mean age at the time of the index operation was 56 (range 33-66) years. The mean duration of follow up was 16 (range 9-23) months. ⋯ We evaluated the clinical results on the HSS, Lysholm, and Tegner activity scores. At the latest follow up examination, all of the scores had improved. Our findings demonstrate that HCO requires an exact correction, is a simple technique, and appears to reduce the chance of nerve and vascular damage.
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The long posterior flap has been the procedure of choice for transtibial amputation for many years, but recently its theoretical basis has been challenged. This study assessed the results with the long posterior flap for leg amputation. ⋯ These results compare favourably with those of other published series. The long posterior flap remains to be bettered for routine transtibial amputation.
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Breakage of an interlocking screw is a known complication in tibial fractures treated by intramedullary nailing. This happens most often in delayed union or nonunion because of the lack of progressive load transference from the nail to the healing bone. To treat this problem, the nail and screws need to be removed. This article describes a simple technique for the removal of broken interlocking screws.