Introduction: There is concern regarding potential non-union of the fibula following distraction osteogenesis and if non-union of the fibula leads to poor outcome.
Hypothesis: Assess the incidence of fibula non-union in patients undergoing distraction osteogenesis of the tibia and to report the effects on patient outcome. We also describe the management of this complication.
Materials And Methods: A consecutive series of patients undergoing distraction osteogenesis at a tertiary centre under a single surgeon. The amount of distraction, site of osteotomy, union of the fibula and tibia were recorded.
Results: Fifty-eight distraction procedures. Mean age was 37.2, 36 males and 22 females. Mean follow-up 23.4 months. 49 (84.5%) achieved fibula union at frame removal, and 9 (15.5%) went on to non-union. Of the fibulas that united, the mean lengthening was 9.25mm. In fibula non-union there was significantly greater lengthening (23.66mm) (p=0.004). Fifty-four (93.1%) of the tibias united following osteotomy and distraction, whilst 4 (6.9%) went onto non-union requiring operative treatment. Of the 4 tibias that did not unite, 3 (75%) also had fibula non-union (p=0.01). Three (33.3%) of the 9 fibulas that did not unite developed symptoms. Two of these required surgery in the form of fibula plating. Both of these patient's symptoms resolved following surgery.
Discussion: Fibula non-union is a relatively common complication following osteotomy in distraction osteogenesis. The length of fibula distraction and tibia non-union are significant risk factors. We recommend surgical intervention for those patients who have symptomatic fibula non-unions.
Level Of Evidence: IV, case series.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.otsr.2018.09.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
How do lesions affect limb lengthening in children with Ollier's disease?
BMC Musculoskelet Disord
January 2025
Department of Pediatric Orthopaedics, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wanyuan Rd, Minhang District, Shanghai, 201102, China.
Purpose: Ollier's disease (multiple enchondromatosis) can cause severe lower limb length discrepancy and deformity in children. Osteotomy and limb lengthening with external fixation can correct the lower extremity deformity. There may be lesions in the osteotomy part (OP), and the internal fixation part of the external fixation(FP).
View Article and Find Full Text PDFEnhanced Bone Regeneration by Schwann Cells through Coupling of Osteogenesis and Angiogenesis via β-catenin signaling in a Preclinical Model of Distraction Osteogenesis.
Int J Med Sci
January 2025
Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Article Synopsis
- The prolonged use of external fixation during distraction osteogenesis (DO) can heighten complications, while bone marrow mesenchymal stem cells (BMSCs) play a crucial role in bone regeneration due to their pro-angiogenic and osteogenic abilities.
- RSC-96, a type of Schwann cell, has been shown to promote the proliferation, migration, and differentiation of BMSCs when co-cultured, enhancing both bone formation and blood vessel development through neurotrophic factor secretion and activation of specific signaling pathways.
- In a rat DO model, RSC-96's conditioned medium improved bone healing outcomes, with notable increases in gene expression markers for osteogenesis and angiogenesis, alongside positive radiological and biomechanical assessments.
Craniosynostosis surgery practice patterns in the United States: what are we doing and how are we doing it?
Neurosurg Focus
January 2025
Departments of3Plastic Surgery and.
Objective: The surgical management of craniosynostosis varies without consensus on technique or standard outcomes reporting. The authors of this study aimed to investigate current surgical management of craniosynostosis in the United States.
Methods: Two hundred seventy-five surgeons actively treating craniosynostosis in the United States were surveyed.
Locking compression plate as a sequential external fixator following the distraction phase for the treatment of tibial bone defects caused by fracture-related infection: experiences from 22 cases.
BMC Musculoskelet Disord
December 2024
Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China.
Background: The purpose of this study was to report the clinical and psychological outcomes of using a locking compression plate (LCP) as a sequential external fixator following the distraction phase in the treatment of tibial bone defects caused by fracture-related infection (FRI).
Methods: We retrospectively analyzed the clinical records and consecutive X-ray images of patients with tibial bone defects who were treated with an LCP as a sequential external fixator following the distraction phase, between June 2017 and December 2022. The ASAMI criteria were applied to assess the bone and functional outcomes, and postoperative complications were evaluated by using the Paley classification.
Posterior Vault Distraction Osteogenesis for Craniosynostosis-Surgical Outcomes Over 12 Years.
J Craniofac Surg
December 2024
Alder Hey Children's Hospital, Eaton Road, Liverpool, UK.
Introduction: Posterior vault distraction osteogenesis (PVDO) allows significant increase in intracranial volume but is associated with complications including cerebrospinal fluid (CSF) leaks, infection and device failure. The authors outline their outcomes over 12 years and the impact of PVDO on pre-existing Chiari malformation type 1 (CM).
Method: Retrospective review of all PVDOs in our unit over a period of 12 years from 2011 to 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!