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PubMed2006

Free fasciocutaneous flaps in the treatment of chronic osteomyelitis of the tibia: a retrospective study.

The efficacy of free fasciocutaneous flaps for the treatment of chronic osteomyelitis of the tibia was evaluated in a retrospective study. A series of 14 patients is reported who underwent soft-tissue reconstruction using different free fasciocutaneous flaps after radical debridement. Radical debridement and microvascular reconstruction were performed in two operative steps. The mean duration of disease was 14 years (range: 6 months to 37 years). At a mean follow-up of 31.4 (12 to 52) months, there was no evidence of recurrence of osteomyelitis. This retrospective study validates that fasciocutaneous flaps can be used for microsurgical soft-tissue reconstruction after radical debridement in the treatment of chronic osteomyelitis. The introduction of free fasciocutaneous flaps has challenged the dictum of the therapy of chronic osteomyelitis with muscle flaps.

Adult↗
PubMed1993

[Stress fractures of the tibia in nuclear magnetic resonance tomography].

To demonstrate the usefulness of MR-imaging seven cases of suspected stress fractures are demonstrated and discussed (six stress fractures, one osteoid-osteoma). The results indicate that stress fractures of the tibia may be differentiated early and easily from tumorous lesions, especially in atypical cases. In one case the fracture line could be detected only by MRI. In this respect, MRI is of high diagnostic value in differentiating unclear bone anomalies.

Adolescent↗
PubMed1993

[Tumorous space-occupying lesions of the tibia. A radiological analysis of 459 cases].

The patients' age, location and radiography of 459 bone tumours and tumour-like lesions of the tibia were analysed retrospectively. 79.2% of all lesions were benign, and the portion of malignant tumours increased with increasing age. Predominantly malignant tumours were found in a distal central metadiaphyseal (100%), in proximal central epimetadiaphyseal (90%) and in a proximal central metadiaphyseal (63%) location. Lesions showing a growth rate according to Lodwick IA and those to IB were benign in 99.5% and in 95.4%, respectively. In contrast, tumours showing a grade II or III were malignant in 85.2% and 100% of cases, respectively. Through the construction of subgroups by combination of patients' age, location and growth rate special tumours were selected in that way, that they were predominantly found in that subgroups.

Adolescent↗
PubMedDate not supplied

[KMFTR (Kotz Modular Femur Tibia Reconstruction System) modular tumor endoprosthesis system for the lower extremity].

206 patients with tumorendoprosteses of the KMFTR-type at the lower extremity were operated at the Institute Rizolli Bologna and at the University Clinic of Vienna. The minimum follow up was 2 years (mean 3.2, max. 8 years). In order to bridge the defect caused by tumor resection the proximal femur was replaced in 42 cases, the distal femur in 119 cases and in 6 patients a total femur prosthesis was used. The proximal tibia was replaced in 35 cases and in 4 cases a total knee prosthesis was implanted. Clinical evaluation according to Enneking revealed 71.6% excellent and good results. In 83.4% the radiological score was higher then 20. We saw deep infections in 8.2% (17 patients), breakage of the prosthesis in 6.8% and aseptic loosening in 5.8%. 3 patients had to be amputated due to infection. In the remaining cases of infection in 66% of the patients healing was observed. All cases of aseptic loosening or breakage could be revised successfully by an exchange of the prostheses and therefore salvage of the leg was achieved.

Adolescent↗
PubMedDate not supplied

[Replacement of the anterior cruciate ligament combined with valgization osteotomy of the tibia in incipient medial gonarthrosis with anterior cruciate ligament insufficiency].

In 7 patients with chronic, primarily anteromedial instability and incipient medial gonarthrosis a procedure combining valgization osteotomy of the tibia with anterior cruciate ligament replacement was employed. Postoperative examinations after observation periods of between 6 months and 5 years revealed that the results were good to very good, both subjectively and objectively. There was either no recurrence or a definite alleviation of knee joint pain present preoperatively. In view of the good results the authors now regard a combination of valgization osteotomy and anterior cruciate ligament replacement as the treatment of choice in cases with clear insufficiency of the anterior cruciate ligament and simultaneous incipient medial gonarthrosis. The combined procedure improves chances of achieving the goal of therapy. A valgization osteotomy or an anterior cruciate ligament replacement alone ought to be regarded as inadequate treatment in such cases, especially in the longer term.

Adult↗
PubMedDate not supplied

[Osteochondrosis dissecans of concave joint surfaces: roof of shoulder joint, tibial plateau, distal tibia].

Typically an osteochondrosis dissecans occurs in the region of a convex articular surface, the most frequently localisation observed being the medial femoral condyle. Only few cases of an osteochondrosis dissecans in concave articular surfaces have been reported; these involved the tibial plateau, the distal tibia and the proximal surface of the navicular bone. Two more cases with an osteochondrosis dissecans in the proximal and distal tibial epiphysis are reported and additionally a hitherto unreported localisation in the glenoid fossa of the scapula. True osteochondrosis must be differentiated from ossification variants.

Adolescent↗
PubMed1987

[Microangiographic research on revascularization in the fracture model of the canine tibia].

Micro-angiograms were performed between eight weeks and one year following osteotomies and pressure osteosyntheses in 34 dog tibiae. Seventeen animals also underwent lumbar sympathectomy. In more than half of the cases, vascularisation of the medulla was reduced by damage to the nutrient artery. Segmental connections could be demonstrated by means of transcortical anastomoses. Following sympathectomy, revascularisation was more marked as a result of numerous trans-osseus anastomoses. This, however, did not lead to improved healing; healing was worse after sympathectomy. Transcortical revascularisation and vessel growth along drill holes are of crucial significance.

Animals↗
PubMed2000

Treatment of a case of congenital pseudarthrosis of the tibia-fibular osteosynthesis.

We report the results of a case of congenital pseudarthrosis of the tibia treated by tibiofibular synthesis. A 1-year old girl was first treated by intramedullary fixation followed by an intertibiofibular bone graft. This method failed. She then underwent a new operation that was associated two simultaneous approaches, correction of the axis, tibiofibular synthesis and a new intertibiofibular bone graft. Union was achieved four months later. The child has now been followed up for 20 years. During this time, she has led a normal life as we have observed a "tibialisation" of the fibula. Intramedullary fixation has a success rate of 75% but requires repetitive insertion of intramedullary or telescopic rods. Transplantar intramedullary rods are responsible for significant ankle stiffness. Tibiofibular synthesis associated with an intertibiofibular bone graft after correction of the axis is the equivalent of vascularised graft of the fibula but with neither the difficulties of microsurgery nor valgus deformities of the ankle.

Bone Nails↗
PubMed1995

Dietary phosphorus restriction to half the minimum required amount slightly reduces weight gain and length of tibia, but sustains femur mineralization and prevents nephrocalcinosis in female kittens.

The effects of dietary P restriction to half the recommended minimum level on growth, bone and renal mineralization and urinary composition were studied in female kittens. In two separate experiments, 8-week-old weanling kittens were fed on purified diets containing either 4.6 or 9.2 mmol P/MJ (2.8 or 5.6 g P/kg diet). In the second experiment there was an additional low-P diet in which the Ca concentration was reduced from 9.5 to 4.8 mmol/MJ (7.5 v. 3.8 g Ca/kg diet). P restriction slightly but systematically reduced weight gain (to a maximum of 16%) and growth of the tibia (by 1-4%); the former effect was statistically significant (P < 0.05) between the ages of 15 and 20 weeks in Expt 1 only, and the latter did not reach statistical significance at any time point (P > or = 0.13). No adverse effect of P restriction was found on mineralization of femur at the age of 39 weeks. Kidney Ca concentrations were significantly lowered (Expt 1, 6 v. 20 mumol/g dry weight, P < 0.001; Expt 2, 7 v. 16 mumol/g dry weight, P < 0.01) in cats fed on the low-P diets, this effect not being affected by the dietary Ca:P ratio. Urinary P concentration was significantly depressed (by 50-96%) after feeding the low-P diets (P < 0.001). P intake did not influence P, Ca and Mg retention during the period of 15 to 39 weeks of age.

Animals↗
PubMed1996

Effects of supplemental phytase and phosphorus on histological, mechanical and chemical traits of tibia and performance of turkeys fed on soyabean-meal-based semi-purified diets high in phytate phosphorus.

Tibial traits were investigated for turkey poults fed on soyabean-meal-based semi-purified diets high in phytate P (2.2 g/kg) with added phytase and inorganic P. Dietary treatments were: (1) 2.7 g non-phytate P (nP)/kg; (2) diet 1 + 1000 U phytase/kg diet; (3) 3.6 g nP/kg; (4) diet 3 + 800 U phytase; (5) 4.5 g nP/kg; (6) diet 5 + 600 U phytase; (7) 6.0 g nP/kg. Added phytase and nP increased (P < 0.006) tibial dry matter, ash weight and content, body-weight gain, feed intake and gain:feed. The Mg and Zn concentrations in the tibial ash were also increased (P < 0.001 and P < 0.09 respectively) by added phytase or nP; tibial P and Ca concentrations tended to be increased. Hypertrophy zone width of the tibial proximal end decreased (P < 0.001), while proliferating zone width, tibial length, and widths at the long and short axes increased (P < 0.003) as phytase and nP were added. The addition of phytase also tended to enlarge the cartilaginous zone width, which was linearly increased (P < 0.05) by added nP. Disorganization scores of the hypertrophy zone and trabecular bone were low, approaching normal (P < 0.05), for turkey poults fed on diets with phytase supplementation, and tibial abnormality scores were linearly decreased (P < 0.001) as nP levels increased (zero score is considered normal). Adding phytase and nP improved the orderliness of development, mineralization and arrangement of cartilage and bone cells, and alleviated the effects of P deficiency on the histological and gross structure of the tibias. Tibial shear stress increased (P < 0.04) as phytase and nP were added. In summary, similar improvements in bone characteristics were achieved for turkey poults fed on a P-deficient diet supplemented with either phytase or nP.

6-Phytase↗
PubMed2001

No bone ingrowth into the tibia tunnel in anterior cruciate ligament-reconstructed patients: a 1-year prospective quantified CT study of 10 patients reconstructed with an autologous bone-patellar tendon-bone graft.

10 patients with major instability symptoms due to an acute anterior cruciate ligament injury were operated on with a bone-patellar tendon-bone reconstruction. Tibial condyle bone mineral density (BMD), bone ingrowth and changes in diameter in the tibia bone tunnel were studied with quantified computed tomography (QCT) postoperatively and after 1, 3, 6 and 12 months. We found no sign of bone ingrowth in the form of increased bone mineral density (BMD) in the bone tunnels in any of the patients. The tunnel diameter increased in all patients during the first postoperative months. After 1 year, 5 patients had a smaller diameter than at the first postoperative examination, 2 had the same diameter as immediately after surgery and 2 patients had a larger diameter. A sclerotic zone developed in all patients along the perimeter of the tunnel during the 3-6 months of follow-up. The BMD in the tibial condyle decreased at 3 months; it then increased, but between 6 and 12 months, it levelled out and was slightly lower than postoperatively. In conclusion, we found no growth of bone into the tunnel and tendinous part of the graft during the first postoperative year.

Adult↗
PubMed1998

Fractionation effect on radiation-induced growth retardation of tibia in rabbits and rats.

A study of the sensitivity to fractionation of the growing tibia of rabbits and rats was conducted by comparing the growth of the treated right bone to that of the untreated left side in each individual animal using radiographic measurements. The experimental endpoint was the percentage of normal growth 24 weeks after irradiation in rabbits and 14 weeks after treatment in rats. The results show clear dose-response relationships in all experimental arms. A clear-cut fractionation effect was demonstrated in both species. The alpha/beta-ratios determined by maximum likelihood analysis according to the LQ-model with graded responses were 3.2 Gy (95% C.I. 1.1; 5.6) in rabbits and 6.9 Gy (5.3; 8.7) in rats, when all data were included in the calculations. When single-dose data were excluded the alpha/beta-values were -0.6 Gy (-3.1; 2.3) in rabbits and 5.0 Gy (3.5; 7.0) in rats. Our data provide further evidence that low doses per fraction should be used when irradiation of the epiphysis cannot be avoided in pediatric patients.

Animals↗
PubMed2003

Assessment of the effect of mesh density on the material property discretisation within QCT based FE models: a practical example using the implanted proximal tibia.

A three-dimensional, quantitative computed tomography based finite element model of a proximal implanted tibia was analysed in order to assess the effect of mesh density on material property discretisation and the resulting influence on the predicted stress distribution. The mesh was refined on the contact surfaces (matched meshes) with element sizes of 3, 2, 1.4, 1 and 0.8 mm. The same loading conditions were used in all models (bi-condylar load: 60% medial, 40% lateral). Significant variations were observed in the modulus distributions between the coarsest and finest mesh densities. Poor discretisation of the material properties also resulted in poor correlations of the stresses and risk ratios between the coarsest and finest meshes. Little difference in Young's modulus, von Mises stress and risk ratio distributions were observed between the three finest models; hence, it was concluded that for this particular case an element size of 1.4 mm on the contact surfaces was enough to properly describe the stiffness, stress and risk ratio distributions within the bone. Poor convergence of the material property distribution occurred when the element size was significantly larger than the pixel size of the source CT data. It was concluded that unless there is convergence in the Young's modulus distribution, convergence of the stress field or of other parameters of interest will not occur either.

Computer Simulation↗
PubMed1993

[Use of microbial phytase at different phosphorus supply levels in broiler fattening. 1. Effect on fattening performance and tibia stability].

Two trials with 720 male and female Lohmann-broilers each and a fattening period of 35 days were carried out to study the effects of different phytase supplementations (0; 300; 700 units per kg feed). The basal diets with only ingredients of plant origin or of plant and animal origin contained between 0.4 and 0.5 per cent total-P. The supplementation of inorganic P was 0; 338; 675 and 1350 mg per kg feed. The feed intake increased on average by 15 and 17% resp. after adding of 300 or. 700 units phytase to diets with different phosphorus supply. The body weight of broilers increased also in dependence of feed intake. The feed conversion was not influenced by the different phytase and inorganic P-supply. The bone stability examined as bending and breaking strength of tibia was improved by supplementation of phytase and inorganic P. Based on the fattening parameters 300 units phytase can replace 0.06 per cent inorganic P in the diet.

6-Phytase↗
PubMed1977

Relative activities of some metabolites and analogs of cholecalciferol in stimulation of tibia ash weight in chicks otherwise deprived of vitamin D.

Nine metabolites and analogs of cholecalciferol (CC) were tested for ability to increase tibia ash weight in chicks otherwise deprived of vitamin D. All of the compounds promoted bone mineralization in a linear log dose-response relationship. The maximal response obtained for any compound was an approximate doubling in bone ash weight compared to vehicle-treated controls. Relative potencies, based upon the calculated ash weight doubling dose, were as follows: 1 alpha, 25-(OH)2-CC = 1 alpha-OH-CC greater than CC greater than 25-OH-CC greater than 24R, 25-(OH)2-CC = 1 alpha,24R, 25-(OH)3- CC greater than 5,6-trans-25-OH-CC greater than 1 alpha, 24S, 25- (OH)3-CC greater than 5,6-trans-CC greater than 24S, 25-(OH)2-CC.

Animals↗
PubMed2000

Concentration of mRNA for the natriuretic peptide receptor-C in hypertrophic chondrocytes of the fetal mouse tibia.

The roles of natriuretic peptides in cardiovascular homeostasis have been well characterized. A recent study revealed that mice lacking natriuretic peptide receptor-C (NPR-C) exhibit skeletal-overgrowth. We therefore, performed in situ hybridization with riboprobes to determine the localization of mRNAs for receptors for natriuretic peptides in the growth plate of the fetal mouse tibia The amount of mRNA for NPR-A was below the detectable level in the growth plate. The mRNA for NPR-B was detected predominantly in proliferating chondrocytes. By contrast, high levels of mRNA for NPR-C were found in hypertrophic chondrocytes. In other regions of the growth plate, the levels of mRNA for NPR-C were very low. The patterns of expression of mRNAs for NPR-B and NPR-C, namely, subtype switching during differentiation from proliferating chondrocytes to hypertrophic chondrocytes, suggest that these receptors might be involved in the growth and differentiation of the growth plate during fetal development in the mouse.

Animals↗
PubMed1997

The relationship of various tibia bone measurements in hens.

Tibias from 50 Single Comb White Leghorn hens were used to study the relationships among various bone measurements. The bone ash (BA), length, wet bone volume (V), fat-free dry matter (FFDM), fat-free bone density (BD; mass per unit bone volume), and bone breaking force (BF) were measured, and the BA concentration (BA/V) and BA as a percentage of FFDM (BA/FFDM) were calculated. Bone ash was highly correlated with FFDM (r = 0.975). The BD was poorly correlated with any of the parameters measured in the present study. The BF was highly correlated with BA (r = 0.922) and FFDM (r = 0.918), but less well correlated with BA/FFDM (r = 0.496) and BA/V (r = 0.694). However, the inclusion of volume2 significantly improved the BF predicting models when BA/V was used as predictor (R2 = 0.855), indicating that BF is not only a function of BA density but also of bone size. The BF adjusted for V may better reflect treatment effect upon bone status than BF alone. The coefficient of variation of BA/FFDM and BD was smaller (0.007) than the CV with BA/V (0.026), which may indicate the BA/V is potentially a better indicator of bone status than BA/FFDM and BD. Bone length was poorly correlated with BA, FFDM, and BF, but highly correlated with V (r = 0.844). The volume of the same bone measured by the water weight change method gave the most consistent measurement. The data showed that BA/V may be a better measurement to reflect the bone status changes of hens than other measurements tested. When BA, FFDM, or BF are used in laying hen's bone status studies, the data analysis needs to be adjusted for V, an V is closely correlated with these variables.

Aging↗