• Title, Summary, Keyword: Tibia

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Surgical Treatment of Distal Tibia Fractures (원위 경골 골절의 수술적 치료)

  • Jeong, Jae-Jung;Kang, Do-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.3
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    • pp.174-181
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    • 2013
  • Distal tibia fractures were mainly caused by high energy trauma and the lower legs were enveloped in poor soft tissue. Therefore, there are many open fractures and concomitant soft tissue injuries in distal tibia fractures. For the restoration of ankle function, the surgical treatment was performed in distal tibia fractures. However, it is difficult to treat the distal tibia fracture surgically. There are many complications in distal tibia fracture due to highly comminuted fracture and poor soft tissue condition. There are many surgical methods for distal tibia fractures, such as, external fixator, intramedulary nailling, open reduction & internal fixation, and minimally invasive plate osteosynthesis. We reviewed the surgical treatments of distal tibia fractures.

Lateralization of Tibial Plateau Reference Point Improves Accuracy of Tibial Resection in Total Knee Arthroplasty in Patients with Proximal Tibia Vara

  • Thippana, Rajshekhar K;Kumar, Malhar N
    • Clinics in Orthopedic Surgery
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    • v.9 no.4
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    • pp.458-464
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    • 2017
  • Background: The tibial cut referenced to the center of the intercondylar eminence often leads to varus malalignment in the presence of preexisting proximal tibia vara. The purpose of this study was to investigate the effect of lateralization of the lateral tibial plateau reference point (based on the amount of proximal tibia vara) on the postoperative coronal plane alignment. Methods: In this prospective cohort study, 62 patients (95 knees) with osteoarthritis and proximal tibia vara underwent primary total knee arthroplasty using a lateral tibial plateau reference point for the extramedullary jig. The pre- and postoperative radiographs were obtained for measurement of mechanical axis deviation, degree of tibia vara, proximal lateral reference point of the tibial condyle, and coronal alignment of the femoral and tibial components. The distance between the tibial reference point and the center of the intercondylar eminence was measured intraoperatively. Results: The mean tibia vara was $7.1^{\circ}$ (standard deviation [SD], $2.3^{\circ}$). The mean lateral displacement of the reference point was 7 mm (SD, 2.2 mm). Postoperative tibiofemoral angle was $6^{\circ}$ to $10^{\circ}$ of valgus in 94% of cases. There was a strong correlation between the magnitude of tibia vara and the amount of lateralization of the tibial reference point ($R^2=0.79$, p < 0.001). Conclusions: In total knee arthroplasty patients with proximal tibia vara, reasonable accuracy can be achieved with use of the extramedullary jig for tibial component alignment by lateralizing the proximal tibial reference point.

Effect of Step Width and TOA on Q-Angle and CTA in Walking (보행에 있어서 보격과 발목각도가 종경골각 및 대퇴사두근각에 미치는 영향)

  • Hwangbo Gak;Lee Jin-Hee;Chung Hyung-Kuk;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.8 no.1
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    • pp.33-47
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    • 1996
  • This study was performed to examine the correlation between calcaneus to tibia angle and Q-angle, and the effects of step width and toe out angle on the calcaneus to tibia angle and Q-angle. The age of participated subjects was from 19 to 29 years(Mean=22.95, SD=2.23) who have no significant orthopedic and neurological dysfunction. The marking tapes for measurement of Q-angle and calcaneus to tibia angle were placed on seven location of each subject. Video data were collected while the subject walked on a walking grid. The result as follows : 1. There were significant differences in the step width, toe out angle, and Q-angle but not calcaneus to tibia angle between male and female. 2. There were significant differences in toe calcaneus to tibia angle and Q-angle n step width increased, respectively. 3. There were significant differences between tee out angle and calcaneus to tibia angle but not toe out angle and q-angle. 4. There was statistically significant correlation between calcaneus to tibia angle and Q-angle.

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Analysis of the Lower Extremity's Coupling Angles During Forward and Backward Running (앞으로 달리기와 뒤로 달리기 시 하지 커플링각 분석)

  • Ryu, Ji-Seon
    • Korean Journal of Sport Biomechanics
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    • v.16 no.3
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    • pp.149-163
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    • 2006
  • The purpose of this study was to compare the lower extremity's joint and segment coupling patterns between forward and backward running in subjects who were twelve healthy males. Three-dimensional kinematic data were collected with Qualisys system while subjects ran to forward and backward. The thigh internal/external rotation and tibia internal/external rotation, thigh flexion/extension and tibia flexion/extension, tibia internal/external rotation and foot inversion/eversion, knee internal/external rotation and ankle inversion/eversion, knee flexion/extension and ankle inversion/eversion, knee flexion/extension and ankle flexion/extension, and knee flexion/extension and tibia internal/external rotation coupling patterns were determined using a vector coding technique. The comparison for each coupling between forward and backward running were conducted using a dependent, two-tailed t-test at a significant level of .05 for the mean of each of five stride regions, midstance(1l-30%), toe-off(31-50%), swing acceleration(51-70%), swing deceleration(71-90), and heel-strike(91-10%), respectively. 1. The knee flexion/extension and ankle flexion/extension coupling pattern of both foreward and backward running over the stride was converged on a complete coordination. However, the ankle flexion/extension to knee flexion/extension was relatively greater at heel-strike in backward running compared with forward running. At the swing deceleration, backward running was dominantly led by the ankle flexion/extension, but forward running done by the knee flexion/extension. 2. The knee flexion/extension and ankle inversion/eversion coupling pattern for both running was also converged on a complete coordination. At the mid-stance. the ankle movement in the frontal plane was large during forward running, but the knee movement in the sagital plane was large during backward running and vice versa at the swing deceleration. 3. The knee flexion/extension and tibia internal/external rotation coupling while forward and backward run was also centered on the angle of 45 degrees, which indicate a complete coordination. However, tibia internal/external rotation dominated the knee flexion/extension at heel strike phase in forward running and vice versa in backward running. It was diametrically opposed to the swing deceleration for each running. 4. Both running was governed by the ankle movement in the frontal plane across the stride cycle within the knee internal/external rotation and tibia internal/external rotation. The knee internal/external rotation of backward running was greater than that of forward running at the swing deceleration. 5. The tibia internal/external rotation in coupling between the tibia internal/external rotation and foot inversion/eversion was relatively great compared with the foot inversion/eversion over a stride for both running. At heel strike, the tibia internal/external rotation of backward running was shown greater than that of forward(p<.05). 6. The thigh internal/external rotation took the lead for both running in the thigh internal/external rotation and tibia internal/external rotation coupling. In comparison of phase, the thigh internal/external rotation movement at the swing acceleration phase in backward running worked greater in comparison with forward running(p<.05). However, it was greater at the swing deceleration in forward running(p<.05). 7. With the exception of the swing deceleration phase in forward running, the tibia flexion/extension surpassed the thigh flexion/extension across the stride cycle in both running. Analysis of the specific stride phases revealed the forward running had greater tibia flexion/extension movement at the heel strike than backward running(p<.05). In addition, the thigh flexion/extension and tibia flexion/extension coupling displayed almost coordination at the heel strike phase in backward running. On the other hand the thigh flexion/extension of forward running at the swing deceleration phase was greater than the tibia flexion/extension, but it was opposite from backward running. In summary, coupling which were the knee flexion/extension and ankle flexion/extension, the knee flexion/extension and ankle inversion/eversion, the knee internal/external rotation and ankle inversion/eversion, the tibia internal/external rotation and foot inversion/eversion, the thigh internal/external rotation and tibia internal/external rotation, and the thigh flexion/extension and tibia flexion/extension patterns were most similar across the strike cycle in both running, but it showed that coupling patterns in the specific stride phases were different from average point of view between two running types.

Clinical Outcomes of Combinations of Locking Compression Plate Fixation through Minimally Invasive Precutaneous Plate Osteosynthesis and Interfragmentary Screw Fixation in Distal Tibia Fracture (경골 원위부 골절에서 최소 침습적 잠김 압박 금속판 고정술과 함께 최소 절개를 통한 골절편간 지연 나사 고정술을 시행한 경우의 치료 결과)

  • Chung, Hyung-Jin;Choo, Ji Woong
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.136-142
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    • 2013
  • Purpose: To analyze the outcome of distal tibia fracture treated with the Distal Tibia LCP with combination of interfragmentary screw. Materials and Methods: Between January 2008 and March 2012, data of 34 patients with fracture of distal tibia treated with the Distal Tibia LCP with or without combination of interfragmentary screws were reviewed. There were 17 males and 17 females with an average age of 51.8 years (range, 18~77 years). Radiographic union time and time from surgery until ability to full weight bearing were measured and compared. Callus index was measured as quotient of callus thickness and diameter of corticalis both in AP and sagittal direction. Results: 12 fractures were treated with interfragmentary screws and 22 fractures were treated with bridging plate alone. In interfragmentary fixation group, time to full weight bearing was 14 weeks versus 15.75 weeks without screw. Callus index at bearing was not significantly lesser in patients with screw compated with those without, but callus index difference at posterative 4weeks was sigficant. Radiologic union time was 11.3 weeks in interfragmentary fixation group and 12.58 weeks without screw. Conclusion: The osteosynthesis with the Distal tibia LCP with combination of interfragmentary screw seems to be more stable in postoperative 4weeks than Distal tibia LCP alone, expecting to earlier ROM exercise and rehabilitation.

Relationship between Impact and Shear Forces, and Shock during Running (달리기 시 충격력과 충격 쇼크 변인들과의 관계)

  • Park, Sang-Kyoon;Ryu, Ji-Seon
    • Korean Journal of Sport Biomechanics
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    • v.30 no.2
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    • pp.145-154
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    • 2020
  • Objective: The purpose of this study was to determine the relationship between impact and shear peak force, and tibia-accelerometer variables during running. Method: Twenty-five male heel strike runners (mean age: 23.5±3.6 yrs, mean height: 176.3±3.3 m/s, mean mass: 71.8±9.7 kg) were recruited in this study. The peak impact and anteroposterior shear forces during treadmill running (Bertec, USA) were collected, and impact shock variables were computed by using a triaxial accelerometer (Noraxon, USA). One-way ANOVA was used to test the influence of the running speed on the parameters. Pearson's partial correlation was used to investigate the relationship between the peak impact and shear force, and accelerometer variables. Results: The running speed affected the peak impact and posterior shear force, time, slope, and peak vertical and resultant tibial acceleration, slope at heel contact. Significant correlations were noticed between the peak impact force and peak vertical and resultant tibia acceleration, and between peak impact average slope and peak vertical and resultant tibia acceleration average slope, and between posterior peak (FyP) and peak vertical tibia acceleration, and between posterior peak instantaneous slop and peak vertical tibial acceleration during running at 3 m/s. However, it was observed that correlations between peak impact average slope and peak vertical tibia acceleration average slope, between posterior peak time and peak vertical and resultant tibia acceleration time, between posterior peak instantaneous slope and peak vertical tibial acceleration instantaneous slope during running at 4 m/s. Conclusion: Careful analysis is required when investigating the linear relationship between the impact and shear force, and tibia accelerometer components during relatively fast running speed.

EXPERIMENTAL STUDIES OF THE EFFECT OF TETRACYCLINE ON GROWTH OF TIBIA AND MANDIBLE IN RATS (Tetracycline이 백서의 경골 및 하악골발육에 미치는 영향에 관한 실험적 연구)

  • Lee, Mi Dae
    • The korean journal of orthodontics
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    • v.5 no.1
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    • pp.33-41
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    • 1975
  • To study the effect of the tetracycline-HCl on the growth of the rats, the author made a daily injection of tetracycline-HCl in the amount of 40mg/kg of body weight to the lactating mother and weanling rats for 7 days. Lactating and weanling young rats were killed at a week intervals and removed tibia and mandible from soft tissues. The effect of the tetracycline on the growth of rats were analysed from the weight, the length of tibia and the size of mandible. The results were as follows: 1. Tetracycline inhibited the growth of young rats. 2. Inhibitory effects were greater ill the weanling group than the lactating group. 3. The inhibitory effect was marked just after the injection of tetracycline-HCl in body weight and after a week in mandible and tibia. 4. The inhibitory effect of growth nab continued for 2-3 weeks in body weight and 3-4 weeks in tibia and mandible. 5. In growth of mandible, the antero-posterior growth was more inhibited than the vertical.

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Reconstruction of Large Femur and Tibia Defect with Free Vascularized Fibula Graft and Locking Plate

  • Kim, Min Bom;Lee, Young Ho;Baek, Jeong Kook;Choi, Ho Sung;Baek, Goo Hyun
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.68-74
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    • 2015
  • Purpose: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. Materials and Methods: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. Results: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. Conclusion: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.

Effect of Bone Demineralization and Tibia Lead on Blood Lead in Retired Lead Workers (퇴직한 납 취급 근로자들에서 골밀도 저하와 경골납량이 혈중납량에 미치는 영향)

  • Kim, Nam-Su;Kim, Jin-Ho;Kim, Hwa-Seong;Kim, Hui-Seon;Lee, Seong-Su;Todd, Andrew C.;Lee, Byeong-Guk
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.16 no.4
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    • pp.324-333
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    • 2006
  • This study was designed to investigate the effect of bone demineralization and tibia lead on blood lead in retired lead workers. Two hundred thirty five(126 females and 109 males) retired lead workers who worked in 4 different lead factories and 101 non-occupationally lead exposed subjects(51 females and 51 males) were recruited from March 2004 to October 2004. Bone mineral density(BMD) was measured at left calcaneous bone area by broadband ultrasound attenuation(BUA) method with QUS-2(Metra Biosystems Inc, USA). The BUA value transformed into T-score by WHO standard conversion criteria. Tibia bone lead was measured for skeletal bone lead with K-xray fluorescence(K-XRF) and blood lead was analyzed with flameless atomic spectrophotometer. Hemoglobin, hematocrit, serum calcium and iron were also analyzed. In addition, information for smoking and drinking status and basic personal data such as age, gender and lead exposure were also collected using questionnaire inquiry. Blood lead was correlated with tibia lead (r=0.664) and these two variables were negatively correlated with BMD in bivariate analysis. BMD showed significant main effect on the change of blood lead independent to tibia lead without any effect modification of age or gender; the one T-score unit decrease of mineral bone density made $0.43{\mu}g/dl$ increase of blood lead. On the other hand, tibia lead showed effect modification with gender on blood lead; the slope of tibia lead on blood lead in male was steeper than in female and crossed at around zero of tibia lead. In the multiple regression analysis of blood lead and tibia lead on BMD after adjustment of related covariates, only blood lead showed statistically significant effect on BMD. This study confirmed that BMD and blood lead were significantly associated. To verify the causal association of BMD on blood lead and vice versa, further longitudinal studies are needed.