Congenital Pseudarthrosis of the Tibia-Treatment by Tibial Lengthening and Corrective Osteotomy Seven Years After Successful Bone Graft

1973 ◽  
Vol 55 (1) ◽  
pp. 193-196 ◽  
Author(s):  
C. C. MCKELLAR
2016 ◽  
Vol 21 (02) ◽  
pp. 133-139 ◽  
Author(s):  
Tsuyoshi Murase

The conventional corrective osteotomy for malunited distal radius fracture that employs dorsal approach and insertion of a trapezoidal bone graft does not always lead to precise correction or result in a satisfactory surgical outcome. Corrective osteotomy using a volar locking plate has recently become an alternative technique. In addition, the use of patient-matched instrument (PMI) via computed tomography simulation has been developed and is expected to simplify surgical procedures and improve surgical precision. The use of PMI makes it possible to accurately position screw holes prior to the osteotomy and simultaneously perform the correction and place the volar locking plate once the osteotomy is completed. The bone graft does not necessarily require a precise block form, and the problem of the extensor tendon contacting the dorsal plate is avoided. Although PMI placement and soft tissue release technique require some degree of specialized skill, they comprise a very useful surgical procedure. On the other hand, because patients with osteoporosis are at risk of peri-implant fracture, tandem ulnar shortening surgery should be considered to avoid excessive lengthening of the radius.


2001 ◽  
Vol 36 (3) ◽  
pp. 191
Author(s):  
Moon Sang Chung ◽  
Goo Hyun Baek ◽  
Young Ho Lee ◽  
Chung Hoon Lee ◽  
Whan Seong Cho

2018 ◽  
Vol 23 (04) ◽  
pp. 479-486 ◽  
Author(s):  
Kosuke Shintani ◽  
Kenichi Kazuki ◽  
Masahiro Yoneda ◽  
Takuya Uemura ◽  
Mitsuhiro Okada ◽  
...  

Background: Three-dimensional computed tomography (3D-CT) imaging has enabled more accurate preoperative planning. The purpose of this study was to investigate the results of a novel, computer-assisted, 3D corrective osteotomy using prefabricated bone graft substitute to treat malunited fractures of the distal radius. Methods: We investigated 19 patients who underwent the computer-assisted 3D corrective osteotomy for a malunited fracture of the distal radius after the operation was stimulated with CT data. A prefabricated bone graft substitute corresponding to the patient’s bone defect was implanted and internal fixation was performed using a plate and screws. We compared postoperative radiographic parameters of the patient’s operated side with their sound side and analyzed clinical outcomes using Mayo wrist score. Results: All patients achieved bone union on X-ray imaging at final follow-up. The mean differences of palmar tilt, radial inclination and ulnar variance between the operation side and the sound side were 4.3°, 2.3° and 1.2 mm, respectively. The Mayo wrist score was fair in 4 patients and poor in 15 patients before surgery. At the final follow-up after surgery, the scores improved to excellent in 3 patients, good in 11 patients and fair in 5 patients. There were two patients with correction loss at the final follow-up, but no patient complained of hand joint pain. Conclusions: We believe that computer-assisted 3D corrective osteotomy using prefabricated bone graft substitute achieved good results because it worked as a guide to the accurate angle.


2018 ◽  
Vol 23 (04) ◽  
pp. 571-576
Author(s):  
Kenji Goto ◽  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Mayuko Kinoshita ◽  
Nana Nagura ◽  
...  

Corrective osteotomy with callus filling at fracture site for malunion after distal radius fracture is a rare technique, but it achieved a favorable postoperative outcome. The patient, 66-year-old female, visited our hospital 4 months after distal radius fracture. Corrective osteotomy of the distal radius was planned aiming at improving the wrist joint function, and was performed using a volar locking plate, then the bone defect was filled with callus as autogenous bone grafting. At 12 months after surgery, left wrist joint pain and the range of motion have improved, and the Mayo wrist score was excellent. To our knowledge, there has been no study on the treatment of bone defects by filling with callus. Since favorable bone fusion was achieved with callus, this treatment method may overcome the disadvantages of autogenous bone graft, such as pain at the donor region.


2007 ◽  
Vol 27 (8) ◽  
pp. 915-920 ◽  
Author(s):  
Tae-Joon Cho ◽  
In Ho Choi ◽  
Ki Seok Lee ◽  
Sang Min Lee ◽  
Chin Youb Chung ◽  
...  

2007 ◽  
Vol 32 (3) ◽  
pp. 282-288 ◽  
Author(s):  
F. C. YONG ◽  
S. H. TAN ◽  
B. P. B. TOW ◽  
L. C. TEOH

Metacarpal and phalangeal fracture malunions with significant angulation deformity are associated with bone shortening, prominence of the metacarpal head in the palm or pseudoclaw deformity and may be symptomatic. If so, they may need corrective osteotomy procedures. Conventional methods of closing, or opening, wedge osteotomy do not restore the length of the bone exactly. Simultaneous correction of the angular deformity and restoration of bone length can be addressed by a trapezoid rotational bone graft osteotomy. A double osteotomy is done and the segment of bone is rotated and re-inserted as a bone graft. This was done successfully in four metacarpal and two phalangeal fracture malunions with angulation deformities.


TRAUMA ◽  
2021 ◽  
Vol 22 (4) ◽  
pp. 23-29
Author(s):  
S.O. Khmyzov ◽  
E.S. Katsalap ◽  
M.Yu. Karpinsky ◽  
O.V. Yaresko

Background. Congenital pseudarthrosis of the lower leg bones belongs to the group of orphan diseases and manifests itself in non-union (pseudarthrosis) of the lower leg bones, which leads to the formation of deformity and shortening of the limb, and, as a result, is accompanied by a persistent violation of the limb’s supportability. To date, the question of choosing a surgical technique and optimal fixation in the surgical treatment of congenital pseudarthrosis of the lower leg bones remains unresolved. The purpose was to investigate the stress-strain state of the shin model with pseudarthrosis of its bones in the lower third during their osteosynthesis using a titanium mesh. Materials and methods. Osteosynthesis was simulated with an intramedullary nail, wires, and a block of bone grafts on both shin bones with the imposition of a titanium mesh over the grafts under the influence of two types of compression and torsion loads. Results. Studies have shown that additional fixation of the bone graft block with a titanium mesh allows reducing the stress level at almost all control points of the model of osteosynthesis of the lower leg bones in their congenital pseudarthrosis, both under compression and torsion. As the most positive changes, we can note a decrease in the stress values on the tibia around the nonunion line. This can be explained by the fact that the bone graft block reinforced with a titanium mesh takes on a great load. The same fact contributes to the increase in the level of stress at the lower border of the graft block and tibia. The negative factors include an increase in the level of stress along the line of non-union of the fibula. This is also explained by an increase in the modulus of elasticity of the bone graft block, which further loads the fibula. Conclusions. The use of a titanium mesh for additional fixation of the shin bones in the treatment of their congenital pseudarthrosis has a positive effect on the stress-strain state of the model, which is confirmed by a decrease in the stress level at almost all control points of the model, both under compression and torsion loads. The most positive changes are observed along the line of non-union of the tibia.


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