Open tibial plafond fracture with massive bone loss presents a challenge for orthopedic surgeons. Particularly unusual is extrusion of an osteoarticular segment of the distal tibia. Here we present the case of such a patient, who was treated using osteochondral allograft (OCA) and fusion procedures. The patients can regain independent walking without pain within 6 months, indicating that OCA may be a sensible option for the treatment of open tibial plafond fracture with extrusion of the osteoarticular distal tibia in cases in which the surrounding soft tissue is intact but bone reimplantation is not possible due to severe damage and contamination.
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http://dx.doi.org/10.1016/j.tcr.2022.100627 | DOI Listing |
Calcif Tissue Int
January 2025
University of Pittsburgh, 3860 S. Water St., Pittsburgh, PA, 15203, USA.
Sport participation affects body composition and bone health, but the association between sport, body composition, and bone health in female athletes is complex. We compared areal bone mineral density (aBMD, DXA) and tibial volumetric bone mineral density (vBMD), geometry, microarchitecture, and estimated strength (HR-pQCT) in cross-country runners (n = 22), gymnasts (n = 23) and lacrosse players (n = 35), and investigated associations of total body lean mass (TBLM), team, and their interaction with tibial bone outcomes. Total body (TB), total hip (TH), femoral neck (FN), and lumbar spine (LS) aBMD were higher in gymnasts than runners (p < 0.
View Article and Find Full Text PDFOrthop 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.
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