• Title/Summary/Keyword: Tibia fracture

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Treatment of Distal Tibia Fracture using MIPPO Technique with Locking Compression Plate: Comparative Study of the Intraarticular Fracture and Extraarticular Fracture (잠김-압박 금속판을 사용하여 MIPPO 수기를 적용한 원위부 경골 골절의 치료: 관절내 골절과 관절외 골절의 비교)

  • Chung, Soo-Tae;Kim, Hyung-Soo;Cha, Seung-Do;Yoo, Jeong-Hyun;Park, Jai-Hyung;Kim, Joo-Hak;Jung, Jin-Ha
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.162-168
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    • 2009
  • Purpose: To evaluate the efficiency of the minimally invasive percutaneous plate osteosynthesis (MIPPO) with locking compression plate (LCP) for distal tibial metaphyseal intra-articular fracture compared with extra-articular fracture. Materials and Methods: From February 2006 to June 2008, 21 patients with distal tibia metaphyseal intra-articular fracture and 20 patients with extra-articular fracture were treated operatively by MIPPO technique with LCP and followed for at least one year. In the group with intra-articular fracture, mean age was 48.85 years old and a mean follow-up was 15 months. In the other group with extra-articular fracture, mean age was 52.35 years old and a mean follow-up was 14.5 months. The type of fracture was evaluated using the AO/OTA classification and open-fractures were according to the Gustilo-And gron classification. Radiologic evaluation with fracture healing and tibial alignment, clinical evaluation with Olerud and Molander ankle score and restriction of motion were done for treatment. Results: According to AO/OTA classification, There were 21 type A, 15 type B, 5 type C. Average union time of the intra-articular fracture (type B, C) was 18.7 weeks. Average union time of the extra-articular fracture (type A) was 17.1 weeks. All fractures were healed without malunion. There were no difference of mean restriction angle between intra-articular fracture (ankle dorsiflexion was 3.57 degree, plantar-flexion was 5.95 degree) and extra-articular fracture (ankle dorsiflexion was 3 degree, plantar-flexion was 3.75 degree). There were no difference of Olerud and Molander ankle score between them as a mean score of intra-articular and extra-articular was 89.25, 91.25 each other. As a complication, there were 3 case of skin necrosis, 8 case of discomfortable skin tenting by plate and 1 superficial infection, but could be healed by conservative care. Conclusion: MIPPO technique, combined articular reduction, with LCP of distal tibial metaphyseal fracture was a good method with high functional recovery.

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Arthroscopic Cannulated Screw Fixation Technique for Avulsion Fracture of the Intercondylar Eminence of the Tibia (삽관 나사못(Cannulated screw)을 사용한 경골 과간 융기부 견열 골절의 관절경적 치료 기법)

  • Lee, Kee-Byoung;Chang, Ho-Guen;Lee, Seok-Beom;Moon, Young-Wan;Kang, Ki-Hoon;Lee, Wook-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.127-131
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    • 1999
  • Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.

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Effects of Safflower-seed on the Fracture Healing in Rat Tibia (홍화씨의 경골골절치유에 미치는 영향)

  • 정수연;최현진;정면우;안미령;유태무;류항묵;양지선
    • YAKHAK HOEJI
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    • v.43 no.4
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    • pp.526-534
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    • 1999
  • We investigated the effect of safflower-seed on fracture healing of fracture model in rat. Fracture healing was evaluated by examining the degree of wound healing macroscopically, radiography, bone histomorphometry and biochemical examination. After 1, 3, 5, 7 days, the would healing was accelerate in safflower-seed diet group. Radiography does not reveal the difference in fracture healing between two group. After 2 weeks, safflower-seed had a significant, stimulatory effect on external callus formation (p<0.05). But after 4, 6, 8 weeks, no difference was observed between normal and safflower-seed dietgroup in callus size. Urinary hydroxyproline, osteocalcin and total alkaline phosphatase decreased significantly (p<0.05) in safflower-seed treated group at 2 week after tracture.

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Reconstruction of Large Bone and Soft Tissue Defect Combined with Infection in the Lower Extremity with Free Flap Followed by Ipsilateral Vascularized Fibular Transposition

  • Chung, Duke Whan;Han, Chung Soo;Lee, Jae Hoon;Kim, Eun Yeol;Park, Kwang Hee;Kim, Dong Kyoon
    • Archives of Reconstructive Microsurgery
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    • v.22 no.2
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    • pp.57-62
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    • 2013
  • Purpose: The aim of this study is to report on the results and discuss the role of free flap followed by ipsilateral vascularized fibular transposition (IVFT) for reconstruction of large bone and soft tissue defect combined with infection by open tibia fracture. Materials and Methods: During the research period, lasting from December 2002 to June 2008 (Kyung Hee University Medical Center), data were collected from three patients who underwent IVFT after free flap. We analyzed the successiveness and persistency of the infection using free flapping, bone union, and hypertrophy between transposed fibula and tibia. Results: Regarding free flap, successive results were observed in all examples. In the final follow-up results, transposed fibulas all survived, having hypertrophy similar to that of adjacent tibia. Conclusion: Reconstruction of tibia defect with free flap followed by IVTF is a useful and safe method for avoidance of the potential risk of infection for patients with a large tibial bone defect and soft tissue defect associated with infection.

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Anatomical Differences of the Fibular Incisura of the Tibia between Ankle Fracture with Syndesmotic Injury and without Syndesmotic Injury (족관절 골절 환자에서 원위 경비 인대 결합 손상 유무에 따른 경골의 비골 구에 대한 해부학적 차이)

  • Kim, Hyong-Nyun;Kim, Soo-Bum;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.150-155
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    • 2008
  • Purpose: This study was performed to compare the anatomic differences of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries. Materials and Methods: 42 patients were involved in this study: Group I was composed with 14 cases of ankle fractures with syndesmotic injuries; Group II was composed with 14 cases of ankle fractures without syndesmotic injuries; Group III was composed with 14 cases of volunteers. The height averaged 170.1 cm (range, $159{\sim}181$ cm) in group I, 168.9 cm (range, $156{\sim}184$ cm) in group II, and 170.4 cm (range, $161{\sim}77$ cm) in group III. The mean height did not show a statistically significant difference between groups (p>0.05). All patients were taken axial computed tomography. The length of anterior and posterior facets, angle between anterior and posterior facet, and depth of the fibular incisura of the tibia were measured. Results: The mean length of the anterior facet was 11.5 mm (range, $9.2{\sim}15.7$ mm) in group I, 12.2 mm (range, $7.3{\sim}17.0$ mm) in group II, and 10.3 mm (range, $8.7{\sim}14.0$ mm) in group III (p>0.05). The mean length of the posterior facet was 12.3 mm (range, $9.0{\sim}14.5$ mm) in group I, 11.0 mm (range, $7.3{\sim}16.2$ mm) in group II, and 13.0 mm (range, $9.2{\sim}15.9$ mm) in group III (p>0.05). The mean angle between anterior and posterior facet was 139.1 degrees (range, $125.5{\sim}154.0$ degrees) in group I, 144.2 degrees (range, $134.7{\sim}152.6$ degrees) in group II, and 131.5 degrees (range, $117.6{\sim}144.4$ degrees) in group III (p<0.05). The mean depth of the fibular incisura of the tibia was 4.1 mm (range, $3.2{\sim}15.8$ mm) in group I, 4.6 mm (range, $3.1{\sim}7.1$ mm) in group II, and 3.1 mm (range, $1.5{\sim}4.0$ mm) in group III (p<0.05). Conclusion: There are some statistical differences of angle between anterior and posterior facet and depth of the fibular incisura of the tibia between ankle fractures with and without syndesmotic injuries.

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Osteochondral Fracture on the Articular Surface of the Medial Malleolus of the Tibia - A Case Report - (경골 원위부 내과 관절면에 발생한 골연골 골절 - 1례 보고 -)

  • Kang, Jae-Do;Kim, Hyung-Chun;Kyoung, Chi-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.4 no.1
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    • pp.35-38
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    • 2000
  • Osteochondral fracture is common in adolescent and usually occurs in the knee and ankle. Many authors have written concerning osteochondral fracture of the ankle joint, however, many of these pertain only to the talus. The author has found an osteochondral fracture of the articular surface of the medial malleolus within the ankle joint not previously described. We report a case of this lesion that was treated by arthroscopic osteochondral fragment removal.

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Research on Computer-aided and Robotic-assisted Surgery of Fracture Reduction and Bone Deformity Correction under External fixation (외고정법을 이용한 컴퓨터이용 및 로봇지원 골절수술 및 골변형교 정술에 대한 연구)

  • Kim Y.H.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.10a
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    • pp.131-134
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    • 2005
  • This paper presents a computer-aided simulation and robotic-assisted execution technology of external fixation method to achieve fracture reduction and deformity correction in long bones. Combining the kinematic analysis with a graphic model of the tibia and the fixator allowed 3D simulation and visualization of the adjustments required to reduce fracture or correct bone deformity as a pre-operative planning tool. The developed robot model provided accurate deformity correction with small residual deformity based on the results of the planning. By incorporating the robot model with image-guided system and computer-aided planning, the integrated system could be useful for computer-aided pre-operative planning and robotic-assisted execution in fracture treatment and bone deformity surgery.

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Study of Suitable Angle of Tibia-Foot and X-ray Tube for Navicular in Foot X-ray Examination (족부 X선 검사에서 주상골 관찰에 용이한 Tibia-Foot angle과 X-ray tube 각도에 대한 연구)

  • Moon, Joo-Wan;Han, Jae-Bok;Choi, Nam-Gil
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.39-46
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    • 2018
  • The purpose of this study was to determine suitable angle of Tibia-foot and the X-ray tube for scaphoid in foot X-ray examination. A total of twenty patients(mean age $32.12{\pm}years)$ are participated in this study. In the positions of Foot AP, internal and external oblique, tibia-foot angle was defined as $90^{\circ}$ and $135^{\circ}$, and x-ray tube angle was defined as $0^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$ and $20^{\circ}$ respectively. The image quality was evaluated with blind test yielding scores ranging from 0 to 5 by the evaluation team consisted of 2 radiogical technologists, 2 radiologists, and 2 orthopedic surgeons. In case of Foot AP position, the degree of overlap between cuneiform and navicular was 3% and the blind test result was 4.89 at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle. When the tibia-foot angle is $135^{\circ}$, the degree of overlap was 5%, also the blind test result was 4.30 at $15^{\circ}$ X-ray tube angle. The degree of overlap and blind test result were 30% and 3.75 respectively at $0^{\circ}$ X-ray tube angle. In case of internal oblique position, at tibia-foot angle of $90^{\circ}$ and $0^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test result was 4.70. The 5% overlapping and highest score as 4.55 were obtained on tibia-foot angle of $135^{\circ}$ and $0^{\circ}$ X-ray tube angle. In case of external oblique position, at tibia-foot angle of $90^{\circ}$ and $15^{\circ}$ X-ray tube angle, the degree of overlap was 4% and the blind test score was 4.85. The 5% overlapping and highest score as 4.75 were obtained on tibia-foot angle of $135^{\circ}$ and $15^{\circ}$ X-ray tube angle. In conclusion, we confirmed suitable angle of tibia-foot and X-ray tube for scaph46oid in foot X-ray examination in this study. These findings will be helpful for us to reading for navicular fracture.

Skeletal Manifestations of Hydatid Disease in Serbia: Demographic Distribution, Site Involvement, Radiological Findings, and Complications

  • Bracanovic, Djurdja;Djuric, Marija;Sopta, Jelena;Djonic, Danijela;Lujic, Nenad
    • Parasites, Hosts and Diseases
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    • v.51 no.4
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    • pp.453-459
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    • 2013
  • Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was $40.9{\pm}18.8$ years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.

Effects of Yuhyangjeongtong-san on Fracture Healing in Rats

  • Kim, Ki-Tae;Jo, Na-Young
    • The Journal of Korean Medicine
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    • v.40 no.4
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    • pp.61-71
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    • 2019
  • Objectives: The purpose of this study is to determine the effect of Yuhyangjeongtong-san on the recovery of tibial fractures in rats. Methods: In this study, osteocalcin and Calcitonin, CTX-2, TGF-β and BMP-2, which are used as indicators of bone formation, were analyzed after hematologic fractures using experimental rats. In addition, the fracture union process was confirmed using X-rays. Results: Osteocalcin, Calcitonin and BMP-2 showed a significant increase compared with the control at 4 weeks. CTX-2 and TGF-β showed a significant increase compared with the control at 3 weeks. On X-ray, YJS treated group, as the experiment progressed, the boundary line became blurred, the bone outline was clearly visible, and the fracture recover was progressing. Conclusion: The findings suggest that YJS can play a significant role in the repair of fractures. Therefore YJS is likely to be used to treat fractures.