No arthrosis of the ankle 20 years after malaligned tibial-shaft fracture

Kristensen, Kristian D.; Kiaer, T; Blicher, Jakob Udby

doi:10.3109/17453678909149256

Cited by 68 publications

(14 citation statements)

References 8 publications

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“…Dickson et al found malunion in 5.7% patients treated with Ilizarov [24] . In long term follow-ups after tibial fractures there is no evidence that the malalignment of the lower limb will lead to any restriction of motion, pain or osteoarthrosis of knee and ankle even with an angulation of upto 15 degree [36,37,38] . Anterior knee pain after IMN remains a troublesome complication regardless of the surgical approach used, ranging from 5 to 86% [39] .…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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Introduction: Tibia shaft fractures can be treated with various modes, each having its merits and demerits. The aim of our study was to analyze clinical outcome of Ilizarov technique in patients with tibia shaft fracture. Method: 50 patients with isolated tibia shaft fracture treated with Ilizarov external fixator were followed prospectively for one year. Depending upon the level of fracture 4 or 5 rings were used. Weight bearing as per patient pain tolerance was allowed within 24 to 48 hours. The decision of frame removal was taken based on Ramos criteria. The function was evaluated based on Johner and Wruh's criteria. Results: According to Johner and Wruh's criteria, 34 patients had excellent, 12 patients had good and 4 patients had fair results. No poor results were noted. There was no case of re-operation and re-fracture. Pin-site infections were seen in 14% cases but there were no deep infections. Conclusion: Ilizarov technique can be used as an early definitive management in tibia shaft fractures with excellent clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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“…In the absence of a Bonferroni correction, the more outcome measures that are used, the more chance that one of them (erroneously) may have a 'significant' p value (a type I or alpha error). 2 Secondly, since the only difference between the prostheses and their implantation was the design of the head, the most relevant outcome measure that could be objectively assessed is acetabular erosion. It is notable that three Thompson patients and no Monk patients had gross acetabular erosion on early radiographs.…”

Section: Sirmentioning

confidence: 99%

“…Trepanning of simple bone cysts is effective in decompressing the internal pressure of the cysts, improving the blood flow through the medullary bone of the cyst wall, stimulating the periosteum to induce bone formation, and eliminating bone destruction. 2,3 It is, in itself, an effective method of treatment. The study does not distinguish between the effect of trepanning and of the additional grafting with bone marrow.…”

Section: Sirmentioning

confidence: 99%

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Fractures of the Coracoid Process

Goss

1997

The Journal of Bone and Joint Surgery. British volume

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“…It is uncertain whether malalignment of the tibia after malunion of a fracture of the shaft causes osteoarthritis of the knees and ankles. [1][2][3][4] Further investigation requires accurate measurement of any angulation of the fracture. It is usual to measure the angle between lines drawn distally from the centre of the knee down the middle of the proximal shaft, and proximally from the centre of the ankle up the middle of the distal shaft (Fig.…”

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confidence: 99%

A More Accurate Method of Measurement of Angulation After Fractures of the Tibia

Milner

1997

The Journal of Bone and Joint Surgery. British volume

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Accurate measurement of the alignment of the tibia is important both clinically and in research. The conventional method of measuring the angle of malunion after a fracture of the shaft of the tibia is potentially inaccurate because the mechanical axis of the normal bone may not pass down the centre of the medullary canal. An alternative method is described in which a radiograph of the opposite tibia is used as a template. A sample of 56 sets of standard radiographs of healed fractures of the shaft of the tibia was evaluated. The 95% limits of agreement between this and the conventional method were wide, being -6.2° to +5.5° for coronal angulation and -6.7° to +8.1° for sagittal angulation.These results suggest that the conventional method is inaccurate. The new method has good inter-and intraobserver reliability. It is uncertain whether malalignment of the tibia after malunion of a fracture of the shaft causes osteoarthritis of the knees and ankles. [1][2][3][4] Further investigation requires accurate measurement of any angulation of the fracture. It is usual to measure the angle between lines drawn distally from the centre of the knee down the middle of the proximal shaft, and proximally from the centre of the ankle up the middle of the distal shaft (Fig. 1). The slight 'S'shape of the shaft of the tibia in many normal individuals means that the mechanical axis of the normal bone rarely passes down the middle of the medullary canal (Fig. 2); this makes the conventional method of measuring the angulation of malunion potentially unreliable. A new method which avoids this problem is presented. METHODSIn the normal subject, the right and left tibiae form a mirror image of each other. In patients with malunion of a unilateral fracture, a standard radiograph of the contralateral tibia can be used as a template to show the proximal and distal segments of the original mechanical axis. This is marked on the radiograph of the normal side as a straight line between the centre of the knee and the centre of the ankle, defined as the midpoint of the distal tibial articular surface (Fig. 2). This radiograph is turned over and the radiograph of the fracture is laid over it. By superimposing successively the proximal and distal parts of the tibia, the corresponding proximal and distal segments of the original mechanical axis of the tibia can be accurately traced on to the radiograph of the fracture. When the radiographs are very dense, a piece of acetate film can be used as an intermediate template. The method is illustrated in Figure 3, using the same radiograph as in Figure 1. The intersection of the two lines is at the centre of rotation of angulation (CORA), 5 and the angle between them is the true degree of malunion in that plane. The CORA may not coincide with the centre of the fracture, and minimal angulation with considerable translation may cause the CORA to lie outside the field of the radiograph. In such cases, the mechanical axis after the fracture, from the centre of the knee to the centre of the ankle, can be ma...

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No arthrosis of the ankle 20 years after malaligned tibial-shaft fracture

Cited by 68 publications

References 8 publications

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Fractures of the Coracoid Process

A More Accurate Method of Measurement of Angulation After Fractures of the Tibia

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