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PubMed2000

[Changes of blood circulation of the extremity with tibia shaft defects treated with external fixation].

OBJECTIVE: To study external skeletal fixation for long tubular bony defect by end to end compression with lengthening (EECL) and segmental bone transport by lengthening (STBL). METHODS: About 20% - 30% of the original length was resected from the middle shaft of the tibia in 10 goats of 1 - 2 years of age. The bony defect ends were shortened step by step with the sulcated half-ring external fixator. Changes of the blood flow of the distant extremity were measured with pulse-dopplar monitor, reference blood flow, and angiograph. RESULTS: The blood flow of the distant extremity was not affected when bony defect was less than 15% of the original length. Blood circulation disorder would appear in the distant extremity when bony defect ranged from 15% to 20% of the original length. The distant extremity would necrose because of obstruction of blood circulation when bony defect was more than 20% of the original length. CONCLUSIONS: EECL can be recommended if bony defect is less than 15% of the original length. SBTL might be the only feasible way if bony defect is more than 20% of the original length. If bony defect is within 15% and 20%, EECL should be applied with great care while watching the extremity circulation with pulse-Dopplar monitor.

Animals↗

PubMed2001

Changes of blood circulation of the extremity after external fixation for tibia shaft defect: an experimental study.

OBJECTIVE: To assess and compare two approaches, end to end compression with lengthening (EECL) and segmental bone transport by lengthening (STBL), for long tubular bone defect and nonunion. METHODS: Ten goats were used to establish the bone defect model of the mid-tibia. The bone defect ends were shortened step by step with a sulcated half-ring external fixator. Changes of the blood flow of the distal extremity were measured with pulse-Doppler monitor and angiography. RESULTS: The blood flow in the distal extremity was not affected when bone defect was less than 15% of the original length. Blood circulatory disorder would appear in the distal extremity when bone defect ranged 15%-20% of the original length. The necrosis would appear in the extremity because of the blood circulatory obstacle when bone defect was more than 20% of the original length. CONCLUSIONS: EECL is an appropriate alternative of treatments if bone defect is less than 15%; while SBTL may be feasible if bone defect is over 20% of the original length. When bone defect ranges between 15% and 20%, EECL should be applied with great care on condition of keeping watch on the extremity circulation with pulse-Doppler monitor.

Angiography↗

PubMed2002

[Application of proximal correction osteotomy of the tibia in treatment of the knee joint osteoarthrosis].

High osteotomy of tibia is the method of choice in patients with osteoarthrosis (OA) of the knee joint (KJ) medial portion of I and II stage. To secure positive postoperative result achievement high proximal osteotomy was combined with other interventions, directed on elimination of other morphological or functional disorders of the KJ. We have performed treatment of 43 patients with OA of KJ of II stage with the varus deformity, to whom correcting osteotomy "Opening Wedge". In all of them arthroscopy of the KJ was done, in 14--with stimultant arthroscopic plasty of anterior cruciform ligament, in 17--arthroscopic chondroplasty of articular surface defects of processus lateralis os femoris, in 12--arthroscopic KJ debridement, in 24--partial meniscusectomy. An excellent and good result was noted in 33 patients. Miniinvasive combined reconstructive-restorational interventions are effective in OA of II stage with disorder of an axis or an axis and the KJ stability.

Humans↗

PubMed2002

[Histopathology of congenital pseudarthrosis of tibia].

OBJECTIVE: To investigate the histopathology, origin, and etiology of congenital pseudarthrosis (CPT). METHODS: Specimens of periosteum from 28 CPT cases, 20 cases of traumatic pseudarthrosis (TP), 10 cases of fibromatosis, and 10 normal controls were examined. The pathological changes were observed by electron microscopy and confocal microscopy. The expression of alpha-smooth muscle (SM) actin, vimentin, desmin, bone morphogenic protein (BMP), interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-alpha) and base fibroblast growth factor (b-FGF) were detected by histochemistry and immunofluorescence chemical staining. Chromosomal karyotype was examined among 11 cases of CPT. RESULTS: (1) Electron microscopy showed that the periosteum and soft tissue between the broken ends in CPT were all dense fibrous connective tissue abundant in cells, including fibroblasts, myofibroblasts, etc. (2) The chief collagen element was type I collagen in normal periosteum and was type III collagen in periosteum of patients with CPT and fibromatosis (P < 0.025). (3) Vimentin was positive and desmin was negative in all specimens. The expression of alpha-SM actin was higher in specimens from CPT and fibromatosis than in specimens from normal control and TP (P < 0.01). The expression of BMP was higher in normal periosteum and TP than in the periosteum of CPT and fibromatosis (P < 0.05). The expression of IL-1, IL-6, TNF-alpha, b-FGF was higher in the periosteum of CPT and TP (P < 0.01). (4) The chromosomal karyotype of all CPT patients was normal 46XY or 46XX. CONCLUSION: (1) Neurofibromatosis is probably not the etiological factor of CPT. (2) CPT is a kind of invasive fibromatosis located in periosteum. (3) Abnormal expression of many kinds of cytokine and high expression of type III collagen play an important role in the pathogenesis of CPT. (4) The main pathology of CPT is hyperplasia of fibroblasts, thus causing thickening of periosteum, contractible circinate coarctation, and compression of tibia and surrounding tissues. (5) The chromosomal karyotype of patients with CPT is normal.

Adolescent↗

PubMed1975

[Arterial vascularization of the tibia in the adult].

The arterial vascularization of the tibia in an adult is examined by microangiography (with micropaque).--The proximal epiphysis vessels originate in the periarticular circle of the knee; some are vertical, others horizontal; the condylus medialis is more vascularized than the condylus lateralis.--The metaphysis is vascularized by the arteria nutriciae terminal branches and by numerous vessels originating in the periosteal system.--The diaphysis depends on the nutrition (arteria nutriciae tibialis) and periosteal systems: these two systems are equally important in the two upper thirds but in the lower third the nutrition system is more important.--The proximal metaphysis receives numerous arteries coming from the periosteal system; they anastomose with the terminal ramifications of the arteria nutriciae.--The distal epiphysis is vascularized by three pedicles: anterior, posterior, and medial, whose branches anastomose. These pedicles are provided by the perimalleolar circle.

Adolescent↗

PubMedDate not supplied

[Partial traumatic epiphysiodesis of the lower end of the tibia in children. Treatment with disepiphysiodesis].

The author has treated 20 cases of secondary varus deformity of the tibia after ankle traumas in children. These deformities were related to a partial premature epiphyseal closure, the plate being mashed at the time of the trauma. These cases were usually treated by corrective osteotomy. In two cases an attempt was made at resecting the bone briding the plate and filling the defect by methyl-metacrylate. The results appeared to be encouraging.

Ankle↗

PubMed2002

[Preventive effect of anti-infective reconstituted bone xenograft on osteomyelitis in proximal tibia of the rabbit].

OBJECTIVE: To assess possible beneficial effect in prevention of osteomyelitis by anti-infective reconstituted bone xenograft (ARBX) in the rabbit. METHODS: A proximal tibia osteomyelitis rabbit model was used in which staphylococcus aureus was injected through a bony window, followed by immediate implantation of three ARBX pellets containing 30 mg of slowly-delivered gentamicin in group A, three pellets of RBX in conjunction with intramuscular gentamicin (30 mg) for 5 days in group B, three pellets of RBX without antibiotic in group C. Specimens were harvested 8 weeks postoperatively for gross observation, radiological, histological and bacteriological evaluation, comparing the three groups with regard to the beneficial effect of the above procedures in preventing osteomyelitis. RESULTS: (1) Bacteria counting, modified Norden scoring, and gross and microscopic evidence for osteomyelitis in group B were less than those in group C (P < 0.01). (2) In group A, bacteria culture and counting yielded 0 values at 8 weeks, while radiologically modified Norden scoring for osteomyelitis gave by far the smallest values among all three groups (P < 0.01) with no evidence of osteomyelitis found in gross and histological examinations. CONCLUSIONS: (1) Conventional systemic administration of antibiotics are reasonably effective in prevention of infection, but the anti-infective effect usually is not strong enough to prevent osteomyelitis when used along with primary bone grafting. (2) Apart from its osteoconductive and osteoinductive effects, ARBX is capable of slowly delivering antibiotics, thus being highly anti-infective when administered locally, so it could be used for primary grafting to repair a contaminated bone defect for effective prevention of osteomyelitis.

Animals↗

PubMed1975

[The effects in vivo of some sex hormones on the growth of tibias of normal and chondrodystrophic (Creeper) chick embryos].

Various sex hormones (testosterone, oestradiol, dehydroepiandrosterone), in the form of suspensions in oil, are injected into the allantois of normal and chondrodystrophic (Creeper) chick embryos of 6 days 1/2 incubation. Observations made on each of the phenotypes on the 12th day of incubation show that oil injected alone causes a significant decrease in the dry weight of the tibiae. This inhibitory effect is partially abolished when the oil is injected together with the sex hormones, testosterone being the most effective.

Animals↗

PubMed1976

[The vessel behavior of the bone following plate osteosynthesis and subsequent osteomyelitis. An experimental study at the dog tibia (author's transl)].

In this paper the revascularisation pattern of the dog tibia diaphyse following osteotomy and plate osteosynthesis with subsequent osteomyelitis is described at various stages. As compared to undisturbed plate osteosynthesis the differences and conformities in revascularisation are shown. It is attempted to interpret the vessel behaviour under clinical aspects.

Animals↗

PubMed2003

Posterior cruciate ligament avulsion from the tibia: fixation by a posteromedial approach.

The authors present their experience with a posteromedial approach for fixation of posterior cruciate ligament avulsion from the tibia. The approach is easy, safe and demands no great technical prowess or instruments. Some minor modifications and technical tips for a safer exposure and a better fixation are highlighted. This is a reproducible method for achieving good stability in these avulsion fractures, where early intervention prevents significant late disability. Even in cases delayed up to 3 months we advocate fixation after gradual intra-operative traction and multiple longitudinal stab incidisons, if the ligament with the attached bony fragment has retracted proximally. A single 4-mm screw gives sufficient initial stabilisation to allow supervised mobilisation. A high index of suspicion should be maintained in all dash-board injuries presenting with femoral shaft fractures, especially when the patella is also fractured. The diagnosis may be missed in the acute setting if the bony avulsion is not adequately appreciated; routine MRI in this situation is a good option.

Adolescent↗

PubMed1976

Solitary intraosseous neurilemmoma of the tibia: review of intraosseous neurilemmoma and neurofibroma.

This is a case report of a 59-year-old woman with a neurilemmoma involving the tibia, a site not previously reported for this tumor. Neurilemmoma, a benign neoplasm which rarely involves bone, arises from the Schwann cells in the nerve sheath. It is a distinct pathological entity separate from solitary neurofibroma, and arises from the connective tissue coats of nerves, but which also involves bone. The incidence of the 2 types of nerve sheath tumors is obscured by the tendency of some authors to use the terms interchangeably. Forty-eight cases of true intraosseous neurilemmoma have been reported in the literature. Of 18 cases of solitary intraosseous neurofibroma primary in bone, all were in the jaw and 6 were malignant. The diagnosis of intraosseous neurilemmoma may be missed because of its rarity and roentgenologic appearance of cystic bone disease which is not distinctive except that it resembles other commonly encountered bone lesions. A positive diagnosis is based only on the microscopic pathology. Complete local resection generally produces an excellent result without recurrence.

Bone Neoplasms↗

PubMed1992

[Unilateral tibia vara in young children caused by focal fibrocartilaginous dysplasia. Apropos of 4 new cases].

The authors report 4 cases of tibia vara associated with focal fibrocartilaginous dysplasia observed in 3 boys and 1 girl between the ages of 11 and 17 months. Deformation was usually discovered when the child began to walk. It can worsen during the first years of life, thus explaining that two subjects were operated at 3 years and at 4 years and 8 months, with osteotomy for valgus rotation. The outcome was good. The other 2 recovered spontaneously. The authors discuss the diagnostic and pathophysiological problems in the light of the data in the literature and confirm that correction is usually spontaneous, which justifies refraining from treatment.

Female↗

PubMed1992

Disproportionate short stature, type E brachydactyly and exostoses of tibiae in a patient with an XYY karyotype. A 'new' syndrome?

An 18-year-old male with an XYY karyotype is reported with short stature, normal intelligence and normal personality, in contrast to the XYY syndrome which can be characterized by tall stature, mental subnormality and aggressive behaviour. The patient, in addition, had exostoses of the tibiae bilaterally and type E brachydactyly; this association has not previously been described in patients with the XYY karyotype.

Adolescent↗

PubMed1992

Continued growth of the proximal part of the tibia after prosthetic reconstruction of the skeletally immature knee. Estimation of the minimum growth force in vivo in humans.

We studied five skeletally immature patients who had a cemented endoprosthetic replacement involving the proximal part of the tibia because of a malignant tumor. In each patient, the cement-column fractured, allowing additional physeal growth. With plain radiographs and scanograms, we determined the cross-sectional areas of the physes, the cement-mantle, and the tibial component. Using the known tensile strength of polymethylmethacrylate cement, we then calculated the minimum force that the growth plates must have overcome to fracture the cement. This averaged 584 newtons per square centimeter. This observation of continued tibial growth after partial physeal ablation with a cemented prosthesis in skeletally immature patients presented a unique opportunity to estimate the force generated in the human physis during growth.

Biomechanical Phenomena↗

PubMedDate not supplied

Effects of local administration of growth hormone in peri-implant bone: an experimental study with implants in rabbit tibiae.

PURPOSE: The objective of this study was to evaluate the qualitative and quantitative differences that could appear in newly formed peri-implant bone around Screw-Vent implants placed in rabbit tibiae when treated with local administration of growth hormone (GH). MATERIALS AND METHODS: Eight New Zealand rabbits were randomly divided into 2 groups: the experimental group, which received 4 IU of GH in the form of lyophilized powder added to the ostectomy site before implant placement, and the control group, which did not receive GH before implant placement. Animals were sacrificed 2 weeks later, and histologic sections were obtained for histomorphometry and observation under light microscopy. RESULTS: The sections in the GH-treated group presented enhanced growth of new trabeculae from the periosteal tissue, and the bone-to-implant contact in the experimental group was significantly greater (P < .05). DISCUSSION: Local administration of GH stimulated a more dramatic effect than that seen previously with systemic GH administration, prompting growth from both the periosteum and endosteum. CONCLUSIONS: Local administration of GH at the time of implant placement could enhance peri-implant bone reaction.

Administration, Topical↗

PubMed1992

Tibia development in turkeys and chickens as affected by early-age feed restriction.

Tibia development was studied by histomorphometry in male chickens and turkeys fed ad libitum throughout the growing period, or subjected to an early-age (1-week) severe feed restriction for 6 and 14 days, respectively. In turkeys, the rates of longitudinal bone growth and epiphyseal width growth, both dependent on the activity of chondrocytes, proceeded rapidly and reached maxima at early ages of 24 and 11 days, respectively. Moreover, longitudinal bone growth and the growth of epiphyseal width were reduced during early-age feed restriction, in both chickens and turkeys. On the other hand, the rate of growth of metaphyseal width, determined by activity of bone cells such as osteoclasts and osteoblasts, reached in turkeys a maximum at the relatively late age of 70 days, and was not influenced by feed restriction. Rhythmic variation characterized the temporal behavior of the height of the hypertrophic and non-hypertrophic zones of the growth plate, the trabecular width, and the osteoclasts number at the subchondral region. Rhythmicity appeared similar in both ad libitum-fed and early-age feed-restricted birds of both species. The height of the non-hypertrophic epiphyseal cartilage appeared not to change, whereas the hypertrophic zone decreased with age and early-age feed restriction, demonstrating the importance of cartilage cell hypertrophy as a main determinant of longitudinal bone growth. Sexual maturation was accompanied by the disappearance of both hypertrophic and non-hypertrophic zones of the epiphyseal growth plate and the end of bone elongation. Trabecular width at the end of bone elongation. Trabecular width at the subchondral region increased while osteoclast number decreased with age, reflecting the net increase in bone mass, but were not affected significantly by early age feed restriction. Compensatory growth of the early-age feed-restricted birds, resulted in the complete recovery of affected bone variables within a few weeks of resumed ad libitum feed intake.

Aging↗

PubMed1977

[Action of dicrotophos on the development in vitro of the tibia of chick embryo].

Comparison between Chicken embryos tibias cultured on standard medium and on added dicrotophos medium shows that the organophosphate lead to a great growth and weight decrease. Co-treatment with nicotinamide significantly reduces the teratogenic effects. These above results points to a direct sensibility of long bones to that poison.

Abnormalities, Drug-Induced↗

PubMed2003

Parachordoma of tibia--a case report.

A rare case of a 24-year old male patient with 'parachordoma' of left tibia having the characteristic histopathological and histochemical features of chordoma occurring in an unconventional site, which was clinically and radiologically diagnosed as osteoclastoma is presented here. The case is presented considering the extreme rarity of the lesion in literature in long bones.

Adult↗