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PubMed1976

[Specificity of the tibia test].

Studies on hypophysectomized immature female rats showed that the so-called tibia-test was highly specific only in testing the relatively pure preparations of growth hormone. Use of this test for determination of the content of growth hormone in the hypophysis or in the medium after the hypophysis incubation could lead to serious mistakes, since the majority of hypophysis hormones and many of the hormones of the peripheral endocrine glands were capable of influencing the width of the tibial cartilage in the hypophysectomized animals.

Adrenocorticotropic Hormone↗

PubMed1991

Preventing and overcoming equinus contractures during lengthening of the tibia.

The new technique of leg lengthening and deformity correction with different types of external fixators has given the orthopedic surgeon a tool that allows correction of very difficult deformities and leg length discrepancies of the lower extremity. Dissemination of this knowledge has demonstrated that there are many associated problems with these techniques: one of which is resulting equinus deformity after correcting the tibia. The shortened soleus-gastrocnemius-achilles tendon complex is the cause of this deformity. Several techniques are suggested on avoiding this complication and how to correct it once it has occurred.

Bone Lengthening↗

PubMed1991

Resection and reconstruction for bone tumors in the proximal tibia.

The proximal tibia is a common site for both benign and malignant tumors. This article reviews pertinent anatomy, clinical presentation, and staging methods for tumors of this area. Discussion is given to various methods of resection and reconstruction with useful guidelines for procedure selection. The use of allografts for reconstruction is discussed in depth.

Arthrodesis↗

PubMed1991

Endoprosthetic reconstruction after bone tumor resections of the proximal tibia.

The advent of successful adjuvant chemotherapy and radiation therapy protocols for primary malignant tumors and the development of custom-designed metallic endoprostheses has now made possible a successful limb salvage procedure for malignancies of the proximal tibia. Use of the transposed medial gastrocnemius flap, as proposed by Dr. Jean Duboussett of Paris, has been critical to the soft-tissue reconstruction that routinely permits an excellent active and passive range of motion for these patients. This article describes the operative techniques and technical considerations necessary for a successful proximal tibial endoprosthesis reconstruction.

Bone Neoplasms↗

PubMed1991

Prosthetic arthroplasty of the knee after resection of a sarcoma in the proximal end of the tibia. A report of sixteen cases.

The results of a specific type of prosthetic reconstruction of the knee (total replacement arthroplasty) after resection of a sarcoma of the proximal part of the tibia in sixteen patients were retrospectively reviewed. The diagnosis was stage-IIB osteogenic sarcoma in nine patients, stage-IIB malignant fibrous histiocytoma in three patients, and stage-IB sarcoma of various types in four patients. The length of tibial resection ranged from 100 to 257 millimeters. Of the eleven patients who were available for functional examination (mean duration of follow-up, sixty-three months), three patients had an excellent result, seven had a good result, and one had a fair result. Of the five patients who were not available for functional testing, one who was doing well was lost to follow-up at eighty months, one had died of metastases at sixteen months, and three had had a secondary amputation for infection or for loosening of the prosthesis.

Adolescent↗

PubMed1991

Parosteal osteosarcoma of the distal tibia.

We report on the case of a 24-year-old black male who presented to the orthopedic service with a parosteal osteosarcoma of the distal tibia. There have been 206 cases reported on this tumor in all the world's literature, with the distal femur being the most common location; this case report is rare, therefore, because of the unusual location of the tumor. This article was prepared in order to familiarize the general medical community with the occurrence of the tumor and to provide some general background information and treatment recommendations for parosteal osteosarcoma.

Adult↗

PubMed1991

Bone growth and remodeling after distraction epiphysiolysis of the proximal tibia of the rabbit. Effect of electromagnetic stimulation.

The effect of pulsed electromagnetic stimulation on bone formation was tested in a lower-limb-lengthening model in the rabbit. Limb lengthening was performed by distraction epiphysiolysis. A specially designed external distraction device allowed 10 mm of lengthening of the tibia. Coils to generate a pulsed electromagnetic field were clipped onto the distractor. Stimulation started after a distraction period of three weeks and was continuous for 18 weeks. A control group received the same treatment without stimulation. Bone formation in the elongated zone was evaluated by computed tomography, scintigraphy, and histology. Bone healing involved accretion of callus followed by a process of remodeling, resulting in the formation of a solid cortex. The formation of a diaphysislike structure at the original site of the metaphysis progressed from the distal end of the elongated zone upward. Electromagnetic stimulation had no effect on the rate or extent of bone formation and remodeling.

Animals↗

PubMed1991

Assessment of the mechanical axis in adolescent tibia vara.

To assess precision of measurement, the mechanical axis was determined by two independent observers on 52 radiographs of 15 obese patients with adolescent tibia vara. Special, but simple, modifications in radiographic technique are described that allow simultaneous exposure of the hip, knee, and ankle joints. Even in this challenging population, assessment of the alignment of the lower extremity is possible with excellent precision using the mechanical axis. In 42 of the 52 radiographs, the two independent observers differed by less than or equal to 1 degree. The mechanical axis is superior to measurement of the tibial-femoral shaft angle for evaluation of lower extremity alignment.

Adolescent↗

PubMedDate not supplied

[Lucilia sericata infestation of the skin openings for the bone traction device in lengthening of the tibia: apropos of a case].

Fly larvae are responsible for animal disease well known by veterinarians. However, their finding in humans in nontropical countries is a rarity. Recently, we have found several larvae of Lucilia sericata in an achondroplastic child during the phase of lengthening of both tibiae with osteotax. We think that the myasis diagnosed in our patient is the first such case reported in the literature. For the time being, it should be considered a fortuitous finding and not as a complication of surgery.

Adolescent↗

PubMed1990

[Injuries of the upper end of the tibia in children. With the exclusion of fractures of the tibial shaft].

We review 58 cases of proximal tibial fractures in children. Their evolution and prognostic depend on the localisation. The intra epiphyseal fractures have a good prognostic if care is taken in reduction of the great deplacement fractures: as well as the epiphyseal plate fractures. The upper anterior tibial apophysis fractures have been reduced and screwed without any genu recurvatum sequellae. Severe growth disorder may follow proximal tibial contusions without parallelism regarding to them. Among the iatrogenic causes of these contusions, the trans-tibial pine traction may induce a genu recurvatum even far from the tibial tubercle: so we must avoid this method. The proximal metaphyseal tibial fractures and the valgus deformity following them represents a high difficult treatment. This deformity often recurs after osteotomy (with the risks of the operation). Anyway the tibia valga disappears spontaneously. Its evolution shows that it has a double origin: the fracture displacement then the medial overgrowth epiphyseal plate. The first cause can be treatment actually in order to limit the final valgus by closed reduction with anesthesia.

Adolescent↗

PubMed1990

Angular deformities of the tibia in children: a review of three cases.

Children born with prominent bowing of the tibia are an obvious concern to parents and physicians. Managing these congenital angulations requires early and accurate diagnosis. Classification is based on the direction of the angulation and its associated pathology. The three basic classes of tibial angulations commonly accepted are based on the work of Heyman and Herndon. The success of treating these children depends on the type and severity of the angulation. This article presents three cases of tibial bowing and describes the treatment and prognosis of each.

Bone Diseases, Developmental↗

PubMedDate not supplied

[Ultrasonic diagnosis of the changes in human tibia during 370-day antiorthostatic hypokinesia].

Nine volunteers, aged 27 to 41 years, were exposed to 370-day head-down tilting during which their tibia bones were examined by measuring acoustic parameters with the aid of exponential point concentrators located at a 15 mm distance. Although the bone acoustic profile showed individual variations, the decrease of the average ultrasound velocity in the middle part and the gradient of the ultrasound velocity in the distal part of the diaphysis occurred primarily in the first half of the bed rest study, thus reflecting changes in bone adaptation to mechanical loads (redistribution of elastic properties along the bone). The acoustic parameters measured noticeably responded to countermeasures used (or not used) during bed rest (exercise) and therefore can help obtain better prognostic information about bone is compared to the data accumulated by means of monophoton absorptiometry (mineral density measurement). This method can be well used for examining long bones in extended space flight.

Adult↗

PubMed1990

Biomechanical factors in the metaphyseal- and diaphyseal-lengthening osteotomy. An experimental and theoretic analysis in the ovine tibia.

A post hoc comparison of the mechanical factors that affected the outcome of experimental metaphyseal- and diaphyseal-lengthening osteotomies in sheep tibiae was performed. The resulting motions between bone segments at the metaphyseal and diaphyseal levels were estimated using measured fixator stiffnesses, postural muscle activity, ground reaction forces, and calculated internal and external loads. Relative displacements of bone segments of up to 2.8 degrees were estimated in postural activities; displacements were up to 4.9 times larger at the metaphyseal than at the diaphyseal osteotomy level. The results suggest that due to these increased motions, mechanically inferior conditions for healing at the metaphyseal-lengthening osteotomy level may counteract any supposedly superior biologic healing potential that the metaphyseal region of the bone may have compared with the diaphyseal region. These results correlate well with the clinical findings of the earlier animal study.

Animals↗

PubMed1990

[Analysis of the shear force exerted on the tibia during standing on bilateral legs with knee flexion].

Biomechanical analysis of the two-dimensional models composed of roentgenographic pictures and electromyographic analysis about the shear force (Fs) exerted on tibia during standing on bilateral legs was conducted in 21 young adult males. The simultaneous contraction of the quadriceps and hamstrings was observed in all electromyograms (EMGs). Amplitude observed on EMGs of the hamstrings increased as the trunk flexion angle increased. The calculated average values of Fs were negative at every knee flexion angle; Negative value means posteriorly directed force. As the trunk flexion angle increased, posterior drawer force increased at knee flexion angles of 30 degrees and 60 degrees. The simultaneous contraction of the quadriceps and the hamstrings was considered to represent the main factor that influenced these results. The standing on bilateral legs with knee and trunk flexion was considered to be applicable in the early stages after anterior cruciate ligament reconstruction.

Adult↗

PubMed1990

Effect of ciprofloxacin on experimental osteomyelitis in the rabbit tibia, induced with a mixed infection of Staphylococcus epidermidis and Bacteroides thetaiotaomicron.

After induction of experimental polymicrobic osteomyelitis with Staphylococcus epidermidis and Bacteroides thetaiotaomicron (ciprofloxacin MIC, 0.5 micrograms/ml and 4.0 micrograms/ml, respectively), in the presence of a foreign body implant, in a rabbit tibia model, ciprofloxacin was administered to infected animals for 2- and 4-week periods. At necropsy, rabbits in the 2-weeks-treated group had mean ciprofloxacin levels of 5.94 micrograms/ml in serum, 3.63 micrograms/g in marrow, and 1.88 micrograms/g in bone. Rabbits in the 4-weeks-treated group had mean ciprofloxacin levels of 7.77 micrograms/ml in serum, 5.84 micrograms/g in marrow, and 2.01 micrograms/g in bone. Quantitative bacterial plate counts were conducted on weighed samples of infected bone, marrow, and the catheter implant, taken at necropsy from treated and control rabbits. Variable reduction of bacterial numbers was observed in samples from treated animals, as compared to untreated controls. Samples of infected bone, marrow and catheter, showed comparable evidence of osteomyelitis and bacterial colonization in both treated and control animals. Although relatively high tissue levels of ciprofloxacin were attained, little therapeutic effect was observed.

Animals↗

PubMed1990

[Use of an internal fixator in the femur and tibia. Clinical and roentgenological course in animals].

The applicability of a new internal fixator was tested in the femur and tibia of sheep. The device was primarily developed for the spinal column by the association for studies of internal fixation (ASIF). For this investigation 12 sheep were subjected to transverse osteotomy and the bones were then stabilized with a internal fixator: The clinical and radiological follow up shows a stable healing process of the osteotomy within 8 weeks despite full load-bearing on all extremities. During the entire study period the sheep had full freedom of movement. Clinical and radiological observations were confirmed by the results of histological examinations. The results allow the following conclusions: in view of the course of recovery the indications for application of a internal fixator can be extended to fractures of the lower extremities. Further studies pertaining to the suitability of the implant for various fracture types are in progress. The great advantage of this fixation technique is that the fixator is mounted without any damage to either the endosteal or the periosteal circulation.

Animals↗

PubMed1990

[New bone formation following implantation of various hydroxyapatite ceramics. Animal experiment with bore hole models of the sheep tibia].

The aim of this study was to measure new bone formation after implantation of hydroxylapatite ceramic materials compared with autogenous and allogenous cancellous bone implantations. Eight standardised bore holes, each 6 mm in diameter, were drilled in the left medial tibia of each of seven merino sheep. Seven of these holes were filled with hydroxylapatite ceramic materials: Bio-Oss, Pyrost, autogenous and deep frozen allogenous spongiosa in various sequences. The empty hole was used for comparison. Results were evaluated after fluorescent marking with calcein green 6 weeks postoperatively. The extent of new bone formation was determined by means of fluorescence microscopy, microradiography and histological sections and quantified by means of an automatic surface-measuring programme. Whilst implantation of autogenous spongiosa resulted in almost complete slicing of the defect, the holes filled with hydroxylapatite ceramic materials showed no significant difference from the empty defect. We conclude that this purely inorganic material cannot stimulate new bone formation.

Animals↗

PubMed1989

[Studies on the blood circulation at the proximal site of the tibia in rheumatoid arthritis].

It has not been well studied the blood flow of the bone of patients with rheumatoid arthritis. For this reason, the author of this report studied the circulatory state of the venous system at the proximal portion of 28 tibiae from 22 patients with rheumatoid arthritis and one from a healthy male as a control. In this study, we tried to correlate the clinical symptoms with local destruction of the joint and the bone atrophy. We injected 1 ml of saline into the medullary cavity through the cortical bone, then measured the time required for the back-flow of 5 drops-leakage of bone marrow blood. In addition oxygen pressure and carbon dioxide gas pressure of the marrow blood were evaluated, phlebography was also taken. Delayed venous circulation shown on the phlebogram tended to coincide with high rates of back-flow. When the venous circulation surrounding and within the bone marrow was fair, many of our patients were found to have mild pain associated with gradual degeneration and moderate atrophy of the bone. On the other hand, when the venous circulation of the above area showed stasis, most of our patients were found to have progressive destruction and atrophy of the bone. This study has concluded that inflammation and swelling of the synovial membrane produces circulatory disturbances in and out of the joint. These disturbances result in bone atrophy and the aggravation of clinical symptoms including intensified pain.

Adult↗