SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Serial radiographs are difficult to compare when the position of the shin is not accurately controlled in rotation. We have designed a device which can be used easily by the radiographer to produce accurately standardised radiographs of the tibia.
Chronobiological characteristics of temporal [correction of temper]-dimensional organization of compact bone remodelling in right tibia after the femoral diaphysis osteotomy on the same side were studied using roentgenometry and roentgenodensitometry. These characteristics were studied in experiments on 179 outbred male albino rats. Circaseptan periodicity of osseous tissue reorganization was established.
A case of osteofibrous dysplasia (OFD) of the tibia with 10 years of follow-up is presented. Spontaneous healing of this lesion occurred without any surgical intervention at the age of 10 years. The diagnosis was made retrospectively on the basis of clinical and radiographic appearance and evolution. The capricious nature and indolent course of this neoplasm has led to uncertainty regarding its etiology, evolution, and treatment. A review of the literature and the ongoing discussion about this matter is presented.
The results presented contribute to the still unclarified question of the role of bone blood flow in the metabolism and mineralization of the bone tissue. We investigated correlation relationships between 85Sr-microsphere uptake (in % dose per g) or local blood flow (in ml/min per g) and density or ash weight (in g per ml of bone tissue) in the tibia of female rats. In four experiments a total of 16 correlations was computed. The following relationships were found statistically significant (p < 0.05): in exp. A (20 intact females): microsphere uptake--ash weight, blood flow--density, blood flow--ash weight, in exp. B (oophorectomy 4 weeks before the experiment, 28 rats): microsphere uptake--ash weight, blood flow--density, blood flow--ash weight, in exp. C (estradiol benzoate 1 mg s.c. twice a week for 4 weeks, 40 rats): microsphere uptake--density, microsphere uptake--ash weight, blood flow--density, in exp. D (20 oophorectomized females on estradiol): microsphere uptake--ash weight, blood flow--ash weight. The results support the hypothesis of an interconnection between the mineralization of bone tissue and local bone blood flow.
The purpose of our review is to describe and report results of a surgical technique for the treatment of adolescent Blount's disease. We retrospectively reviewed the results of 15 inverted arcuate osteotomies combined with external fixation. The inverted arc provides a proximal and stable osteotomy that can correct deformity in three planes. External fixation provides stable fixation, access to surgical wounds, and postoperative adjustment. According to the criteria of Schoenecker, we had 80% good results. Two patients with poor results were the most overcorrected, suggesting that overcorrection may not be so desirable as once suggested. We conclude that the inverted arcuate osteotomy with external fixation is an effective, reliable, and simple technique for treating adolescent tibia vara.
The use of the Garamycin sponge in the treatment of infected pseudoarthrosis of the tibia has been presented. The study included 6 male patients aged from 27 to 56 years; the sponge filled the defect after resection of the pseudoarthrosis. The method seems to be the one of choice to support adequate surgical intervention grossly contributing to the final positive result.
Correction osteotomy of the tibia in genu valgum and varum is discussed on the basis of the literature and two cases. After considering critically the well-known techniques of fixation, the almost forgotten bone-suture with silk or Perlon is recalled which may replace osteosynthesis. The advantages of the plaster cast of the leg which permits much earlier weightbearing then osteosynthesis and adds to bony union are emphasized. The author warns against too early mobilization.
This study presents a histomorphometric and biomechanical comparison of bone response to commercially pure titanium screws with 4 different types of surface topographies placed in the tibial metaphysis of 12 rabbits. Each rabbit had 4 implants placed, 2 in each tibia. The 4 surface topographies were a machined surface, a grit-blasted surface, a plasma-sprayed surface, and an acid-etched (Osseotite) surface. After a healing period of 5 weeks, histomorphometric and removal torque data revealed a significantly higher percentage of bone-to-implant contact and removal torque for acid-etched implants compared to machined, blasted, and plasma-sprayed implants. Within the limits of this short-term experimental study, the results indicated that micro-rough titanium surfaces obtained with acid-etching procedures achieved a 33% greater bone-to-implant contact over machined titanium surfaces with an abutment-type roughness and provided enhanced mechanical interlocking.
Focal fibrocartilaginous dysplasia is a rare and benign condition associated with unilateral tibia vara in toddlers. Three additional cases are reported in children aged 17, 18 and 26 months with spontaneous resolution. The authors discuss, based on a meta-analysis, the natural history of the disorder and review the diagnostic and pathophysiological problems. Since spontaneous remodeling of varus angulation and healing of the bony defect can be expected, biopsy and surgical intervention should be avoided.
BACKGROUND: The purpose of the present study was to compare the rate of short-term wound complications associated with rotational flaps and that associated with free flaps for coverage of traumatic soft-tissue defects about the tibia. METHODS: Of 601 patients prospectively enrolled in a multicenter study of high-energy trauma of the lower extremity, 190 patients (195 limbs) required flap coverage and had six months of follow-up. The injury data included the ASIF/OTA classification of the tibial fracture and the soft-tissue injury and the functional status of the neurovascular and muscular structures of the soft-tissue compartments at the time of soft-tissue coverage. The treatment data consisted of the type of flap, the timing of the flap coverage, and the type of fixation. The patient characteristics that were recorded included the age, gender, presence of comorbidities, and smoking status at the time of the injury. Short-term complications included wound infection, wound necrosis, and loss of the flap within the first six months after the injury. RESULTS: Eighty-eight limbs were treated with a rotational flap, and 107 limbs were treated with a free flap. Overall, complications occurred after fifty-three (27 percent) of the 195 flap procedures; forty-six (87 percent) of the fifty-three required operative treatment. The two treatment groups were similar with respect to age, gender, comorbidities, preinjury smoking status, ASIF/OTA classification of the fracture, and prevalence of vascular injury requiring repair (p>0.05). There were two important differences between the two groups. First, three of the four leg compartments--that is, the anterior, lateral, and deep posterior compartments--were more likely to be functionally compromised in the free-flap group than in the rotational flap group (p<0.05), suggesting that patients in the free-flap group had sustained more severe soft-tissue injuries. Second, the Injury Severity Score was significantly higher (p = 0.001) in the rotational flap group (mean, 14 points) than in the free-flap group (mean, 11 points), suggesting that patients in the former group had sustained more substantial total body trauma. Overall, there were no significant differences between the two groups with respect to the complication rates. However, among those with the most severe grade of underlying osseous injury (an ASIF/OTA type-C injury), 44 percent of the limbs that were treated with a rotational flap had a wound complication compared with 23 percent of the limbs that were treated with a free flap (p = 0.10). To control for any differences between the two groups with respect to the severity of the injury, the treatment methods, or the patient characteristics, multivariate regression modeling was performed. An interaction effect between the type of flap and the severity of the underlying osseous injury demonstrated significance (p<0.05) after controlling for other factors. Of the limbs that sustained an ASIF/OTA type-C osseous injury, those that were treated with a rotational flap were 4.3 times more likely to have a wound complication requiring operative intervention than were those treated with a free flap. No significant difference in the rate of complications was detected with respect to the type of flap used for the limbs that had lower-grade osseous injuries. CONCLUSIONS: We found that use of a free flap to treat limbs with a severe underlying osseous injury was significantly less likely to lead to a wound complication requiring operative intervention than was use of a rotational flap.
The report is based on the experience with treatment, using the method of dosaged distraction of 39 pseudarthroses and unhealing fractures of the tibia in 38 patients. Twenty three patients showed osteomyelitis, 32-shortening of crural bones and 27-their deformation. With the aim of distraction the G. A. Ilizarov apparatus was employed. Up to data, the treatment is termined in all 38 patients. Healing was gained after 36 operations in 35 patients. No union was obtained after 3 operations of distraction the osteosynthesis in avascular forms of pseudarthrosis. Some regularities in formation of the regenerate and its reoconstruction during the process of lasting fixation were studied in 25 patients.
As a chemical medium for preservation of tissues, glycerin has shown good results because it maintains the cellular integrity despite the tissue dehydration it causes. Taking advantage of the osteoinducing properties of the osseous matrix and glycerin as a proper medium for tissue preservation, osseous matrix was implanted in rat tibias. Twenty-four rats were used, each receiving two surgical wounds. In one of the wounds an osseous matrix preserved in 98% glycerin was implanted and the other received a matrix without preservatives. Six animals were sacrificed on days 10, 20, 30 and 60 post-implant. After routine histological processing, the specimens were stained in hematoxylin-eosin and Masson's trichrome. The results showed that the matrixes preserved in glycerin presented faster resorption with replacement by newly formed tissue.
The patient was a 38-years-old woman. A chest X-ray film demonstrated the presence of an abnormal lesion. Her past history included osteosarcoma on the left tibia for which she received amputation of the left inferior limb at 17 years of age without any relapse thereafter. Considering that the patient might have lung metastasis of osteosarcoma on the basis of lung biopsy performed under CT guide, and then a tumor was removed under the thoracoscope. The tumor, 2.8 x 2.2 x 2.1 cm in size, was located right under the pleura at left S10 with its inside being filled up with fragile necrotic tissues. When compared pathohistologically with the primary lesion of osteosarcoma which had occurred 21 years before, the lung tumor was almost identical in terms of the tumor cell morphology but had a higher cell density without evidence of osteoid formation. The diagnosis of lung metastasis of osteosarcoma was established on the basis of the clinical course and the immunohistochemical staining. It is extremely rare case that osteosarcoma recurs in the form of lung metastasis 21 years after the operation of primary lesion. We report this case as a valuable one to identify the prognosis of osteosarcoma and the development mechanism of lung metastasis.
OBJECTIVE: Ultrasonic techniques have been used to assess the mechanical properties of bone. Recently, a new ultrasonic bone instrument, which measured the SOS (speed of sound) at the tibial shaft, has been introduced (Sound Scan 2000, Myriad Ultrasound Systems Ltd.). The aim of this work was to investigate the correlation of tibial SOS with bone mineral density (BMD). METHODS: The tibial SOS was measured in 213 healthy women (aged 22-83 years) and 56 female primary osteoporosis with vertebral fractures (aged 53-82 years). Values of SOS were compared with BMD assessed by dual energy x-ray absorptiometry (DEXA) at spine and hip sites and single photon absorptiometry (SPA) at the distal forearm. RESULTS: Tibial SOS correlated more closely with the BMD of lumbar, hip and forearm (r = 0.387-0.928, P < 0.001). The tibia SOS values and the BMD values measured by the DEXA and SPA were negatively correlated to age and years since menopause. In particular, they were obviously lower in the group of 50 years old. The tibial SOS of vertebral fracture group was significantly lower than that of well-matched non-fracture-group (n = 104, aged 51-84 years). CONCLUSIONS: Tibial SOS was significantly correlated with BMD measured by DEXA or SPA respectively and able to discriminate patients with vertebral fracture from the age-matched controls.
The authors present their experiences with various applications of the Zespol stabilizer and different kinds of vascularized bone transfers used in the treatment of septic non-unions of the tibia. The clinical material consisted of 24 patients with infections of the lower extremities treated with different vascularized bone transplants. The Zespol method was used in 23 cases. Compression osteosynthesis was applied every time with the stabilizer placed over the skin. The necessity of mounting the stabilizer far from the bone did not influence the stability of the osteosynthesis. Depending on the length of the transplant single or multiple plare supports were used. Additional plaster cast was applied only during wound healing. No loosening of the stabilizer was observed. The importance of early weight bearing in order to achieve bone union and remodelling of the bone graft is strongly emphasized by the authors. The described treatment allows bone union within 8 months on average. The advantages of the Zespol stabilizer in treatment of complicated disturbances of bone union are presented.
Titanium-aluminum-vanadium (Ti-6Al-4V) implants were placed in the tibiae of 32 rats (male Sprague-Dawley, 350 g) to examine healing and bone response. Half of the implants were treated with fibroblast growth factor 1 (FGF-1) delivered in an activated fibrinogen matrix. Animals were injected with a radiopharmaceutical imaging agent, technetium-99m-methylene diphosphonate (Tc-99m-MDP), which concentrates in bone, especially in areas of higher osteoblastic activity. Binding of Tc-99m-MDP to the implant was detected in vivo by Anger gamma camera imaging. Fourteen days after implant surgery, specimens were recovered and prepared for histomorphometric analysis. Histologic examination revealed that samples treated with FGF-1 demonstrated significantly greater amounts of bone-to-implant contact (P < .05) compared to controls. Also, FGF-1-treated samples showed significantly greater amounts of bone (percent volume) adjacent to implants (P < .005). These findings were supported by analyses of the non-invasive Tc-99m-MDP images, which demonstrated significantly greater uptake of Tc-99m-MDP adjacent to FGF-1-treated implants (P < .05). Results of the experiments supported the hypothesis that FGF-1 could increase bone production around implants in a rat model.
The ossification level of tarsal bones and the distal end of the tibia in human foetuses of both sexes from 4 to 9 month gestational age was estimated. Our results show that ossification of the cartilaginous model tarsal bones begins from 6 to 7 months of the gestational age with the appearance of a single ossification point in the ankle bone and two ossification points in the heel bone with the following ossification of the periosteum.
The authors comment on the experience acquired in the treatment of chronic osteomyelitis of the long bones with intramedullary reaming. The procedure is reserved for the femur and tibia with stage I chronic osteomedullary infection according to the Cierny-Mader classification. 2 A total of 36 patients were treated. Surgical treatment consists in reaming of the medullary canal and in its contra-opening with antiseptic solutions. Mean time for lavage is 6 days. Criteria for healing involves the absence of clinical, humoral, and radiologic signs of active medullary sites of infection. The percentage of healing was 83.2%, mean long-term follow-up was 2.9 years.