The goal of this article is to aid the orthopedic surgeon in determining whether an intra-medullary (IM) device for fixation of a distal tibia fracture is feasible. Using Computed Tomography (CT) scans of the fracture, this review demonstrates a simple way to determine whether two or even three distal interlocking screws are achievable in stable bone. Additionally, this paper offers a summary chart of commonly used tibial nails which can be used for planning purposes. Finally, a clinical summary of very distal tibial shaft fractures treated with IM fixation is provided.
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http://dx.doi.org/10.1016/j.injury.2021.11.040 | DOI Listing |
Orthop J Sports Med
January 2025
Orthopedic Hospital Markgroeningen, Centre for Sports Orthopaedics and Special Joint Surgery, Markgroeningen, Germany.
Background: Distal tibial deformities are not assessed using the proximal anatomical axis (PAA) to determine the posterior tibial slope (PTS). Therefore, it seems advantageous to measure PTS on full-length lateral tibial radiographs using the mechanical axis (MA).
Purposes: To (1) compare the PTS measurements using the MA and the PAA and (2) determine whether using the PAA fails to detect a certain number of significantly elevated PTS values compared with using the MA.
JSES Rev Rep Tech
February 2025
Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
The utilization of free bone grafts to reconstruct large anterior glenoid defects has increased. Distal tibia allograft is commonly used due to its lack of donor site morbidity, ability to restore large bony defects, and near anatomic osteoarticular restoration. However, the intact coracoid and conjoint tendon often impair adequate visualization and access to perform an anatomic reconstruction during open free bone graft reconstruction and often requires violation of the subscapularis tendon to gain exposure.
View Article and Find Full Text PDFMicrosurgery
January 2025
Plastic, Reconstructive, and Aesthetic Surgery Unit, Nantes University Hospital, Nantes, France.
Introduction: Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double-barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects.
View Article and Find Full Text PDFJ Bone Miner Res
January 2025
Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
The socioeconomic burden of hip fractures, the most severe osteoporotic fracture outcome, is increasing and the current clinical risk assessment lacks sensitivity. This study aimed to develop a method for improved prediction of hip fracture by incorporating measurements of bone microstructure and composition derived from high-resolution peripheral quantitative computed tomography (HR-pQCT). In a prospective cohort study of 3028 community-dwelling women aged 75 to 80, all participants answered questionnaires and underwent baseline examinations of anthropometrics and bone by dual x-ray absorptiometry (DXA) and HR-pQCT.
View Article and Find Full Text PDFPurpose: Anterior tibial closing wedge osteotomy (ATCWO) has been shown to significantly reduce failure rates of revision anterior cruciate ligament (ACL) reconstructions in patients with a posterior tibial slope (PTS) ≥12°. Recent findings suggest a slight but significant reduction of the medial proximal tibial angle (MPTA) resulting in a varus knee where the sagittal osteotomy plane is based on a total of two guide wires defining the osteotomy wedge without respecting the frontal plane. We hypothesize that the placement of a total of four guide wires intraoperatively can reduce the influence on the MPTA.
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