Is rigid fixation of the fibula indicated in tibial plafond fractures?
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Long-bone defects resulting from trauma can be managed with a variety of techniques, including conventional bone grafting, distraction osteogenesis, bone graft substitutes, prosthetic devices, and vascularized bone grafting. Although there is an array of available methods for long-bone reconstruction of bony defects, vascularized bone transfer is particularly useful in large defects (> 6 cm) and in cases in which osteomyelitis and unstable soft-tissue or beds make conventional techniques difficult.
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The authors describe a surgical technique for high tibio-fibular osteotomy used eighty seven times to correct varus or valgus deviations causing arthrosis of the knee. Osteotomy of the tibia is carried out above the tibial tuberosity. Fixation is by two nails with a compression device. This allows immediate movement of the knee, thereby preventing stiffness. After forty five days the osteotomy is usually consolidated. Of the complications, only the neuro-muscular type is of importance and the possible causes of this are discussed. The overall results are good and the technique described has proved to be effective in the treatment of mechanical arthrosis of the knee.
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