Features of Blood Supply to the Bones of the Lower Leg in the Ankle Joint Region

The purpose of the study was to investigate the topography of permeable (nutrition) arteries in the lower third of leg during human ontogenesis. Materials and methods. The research was conducted on 30 specimens of human prefetuses and fetuses aged 3-9 months of prenatal development; 28 bone specimens of adult tibia and fibula and 27 series of computerized tomography scans of lower extremities of adults aged 21-72 were used. We have used a complex of methods for morphological research: anthropometry, morphometry, macromicroscopy, injections of blood vessels of X-ray contrasting mixtures, three-dimensional reconstruction and statistical analysis. Results and discussion. Cartilage osteogenesis occurs in the prefetal period of prenatal human development, in which blood vessels play a crucial morphofunctional role. During endochondral ossification of the tibia, the vessels of the bone cuff grow into the diaphysis of the cartilaginous model of the bone and osteogenic cells go beyond their limits. In the third trimester of prenatal development, blood vessels grow into the epiphyseal part of the cartilaginous model and an epiphyseal centre of ossification forms. Between the epiphysis and diaphysis centers of ossification, a metaphysical growth plate forms that develops intraosseous anastomosis between the diaphyseal and metaphysical blood vessels. In the metaphysis region, there are extra-skeletal anastomoses. Often, the insertion of nutrition arteries into the bone of the tibia is usually the middle third of bones (55%) and distal metaphysis (37%). In 10%, there were nutrition foramina in the upper third of the tibia. Three-dimensional reconstruction also clearly shows a more extensive and developed network of vessels in the bone marrow canal in metaphysical regions. In the middle third of the tibia and fibula, 1-3 nutrient foramina can be traced on most specimens. On the fibular, in addition to the posterior-medial localization of the nutrient arteries, there were variants with a "high" (above the metaphysis) placement of the entrance of the vessel into the bone substance. Conclusion. The most common places where arteries enter the bones of the lower leg are the middle third of the bones (55%) and the distal metaphysis (37%). In 10%, there were nutrient foramina in the upper third of the tibia. The three-dimensional reconstruction also clearly shows a more extensive and developed network of vessels in the bone marrow canal in metaphysical regions. During the postnatal period, we most often encountered the localization of nutritional arteries on the anterior-lateral surface of the tibia (23%), or their combination – the presence of both nutrient arteries on the posterior and medial bone surfaces (18.3%)

Effects of gamma radiation and post-operative cisplatin injection on the incorporation of bone allografts in rats

Background. The reconstruction of long bone defects that occur after resection of tumors is a problem that requires constant study. Bone allografts are often used in this scenario. Unfortunately, while they are prepared, allografts partially lose their strength and osteoinductive properties; their survivability in oncological patients is only 40% after 10 years. This is why the search for superior allograft treatment methods and the study of allograft remodeling and incorporation in oncological patients, whose state has been affected by radiation or chemotherapy, is an area of interest. Purpose – study the structure of bone tissue in the distal metaphysis of a rat’s femur after bone allograft implantation (sterilized using gamma radiation or antibiotic saturation) and post-operative intraperitoneal cisplatin injection. Materials and Methods. Experiments were performed on 20 male white rats aged 5–6 months at the beginning of the experiment and weighed 365.8 ± 6.4g. All rats underwent a surgery that created a defect in the distal metaphysis of the femur which was filled with a bone allograft treated with gamma radiation (Control-1 and Experimental-1 groups) or saturated with an antibiotic (Control-2 and Experimental-2 groups). 14 days after allograft implantation, animals from the control groups received an intraperitoneal injection of 2.0–2.4 ml of 0.9% NaCl, while animals from the experimental groups received 2.5mg/kg of cisplatin. Histological analysis and histomorphometry were completed 30 days after the surgery. Results. 30 days after the operation, the smallest relative area of bone tissue (11.79%) was observed in rats from the Experimental-1 group, with gamma radiation treated allografts and post-operative intraperitoneal cisplatin injections. A somewhat higher value was found in the Experimental-2 group (antibiotic saturation + cisplatin) – 31.64%. In the control groups, (intraperitoneal injection 0.9% NaCl), the relative area of bone tissue was 16.7% (Control-1, gamma radiation treatment) and 58.09% (Control-2, antibiotic saturation). The relative area of fibrous tissue was the largest in the Experimental-1 group – 31.55% and the smallest in the Control-2 group – 12.79%. Conclusions. Allograft remodeling occurs along with the formation of bone and fibrous tissue when allografts are used to fill defects in the distal femoral metaphysis of rats, However, the relative percentages of those tissues depend on the allograft sterilization method and the use of cytostatic agents. The largest relative percentage of bone tissue (58.09%) was obtained using an allograft saturated with antibiotics and without the administration of cisplatin. The smallest (11.79%), on the other hand, occurred in gamma radiation treated allografts with cisplatin injected intraperitoneally after the operation

Bilateral pes valgus in an Anatolian Sheepdog

SummaryA 15-month-old, male, Anatolian Sheepdog weighing 45 kg, was admitted with uneven stance in both hindlegs, a condition it had had since the age of six months. Radiographs of both hindlimbs revealed lateral deviation of 26° in the distal metaphysis of the left tibia and 32° in the distal metaphysis of the right tibia. Corrective osteotomy was used to treat the deformity. Both tibias were aligned with the closed wedge osteotomy and a suitably curved plate was placed on both bones. In the assessment prior to the removal of both plates, it was determined that a valgus deformation of 6° was still present. However, this did not affect the gait, nor did it have an abnormal effect on the cosmetic appearance. It was concluded that if corrective osteotomy is performed before any degenerative changes have taken place, the outcome will be successful.

Treatment of gigantocellular tumor of the tibia metaphysis by means of the Ilizarov method: A case study

The authors show a 36-year old female patient with a gigantocellular tumor of the distal metaphysis of the left tibia (stage III by Campanacci). A 7.6 cm long distal articular defect of the tibia has been formed by radical segmentary resection. The defect was compensated by the extension of the rest of the tibia; whereas the support function of the limb was provided through tibio-talar arthrodesis. 5.5 years after the surgery, there are no signs of local relapses; the patient walks without any orthopedic aids and works at the same job as prior to the operation.