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At least 1,261 records · Page 70Linked to original sources
PubMed1988

The anterior tibial vessels and their role in epiphyseal and diaphyseal transfer of the fibula: experimental study and clinical applications.

The blood supply to the fibula from the anterior tibial and peroneal arteries was investigated in 66 fresh cadaver limbs by India ink injection and radiographic studies. These studies revealed a reliable blood supply to the proximal epiphysis and the proximal two-thirds of the diaphysis of the fibula from the anterior tibial artery. Although the peroneal artery provided the dominant supply to the shaft of the bone, its contribution to the head of the fibula was scanty. The cutaneous supply of each vessel was defined and correlated with the territories of the other vessels supplying the leg. The vascular anatomy of the leg was examined in 100 clinical angiograms, revealing 21 limbs with anomalies. This reinforces the case for preoperative angiogram studies where transfer of the fibula is contemplated. The technique of harvesting the proximal growth plate and the shaft of the fibula on the anterior tibial vessels alone is described and illustrated with two successful clinical cases, each followed for 4 years. The growth rate of the transferred epiphysis averaged 1 cm per year.

Blood Vessels↗
PubMed1987

The classification and prognosis of epiphyseal injuries.

Because of the difficulty of assessing prognosis, a clinical and radiological review of 103 injuries of growth plates was performed. Thirteen patients showed retardation of growth and in 4 it was clinically obvious. In addition, external deformity occurred because of failure of remodelling in 1 case. In 9 cases there appeared to be slight stimulation of growth. The correlation between the Salter-Harris classification and retardation of growth was not always clear, especially in Salter-Harris type IV injuries, wherein prognosis varied with site. At the distal end of the tibia two groups of type IV injury were identified having respectively a 0 and 62.5 per cent incidence of retardation of growth. A new classification of distal injuries of the tibia is proposed, with superior predictive value for retardation of growth than that of Salter and Harris. This is valuable as a guide to prognosis and may facilitate treatment.

Adolescent↗
PubMed1989

Epiphyseal fractures of the proximal tibia.

During a 12-year period there were 15 patients with proximal tibial epithyseal fractures. Eleven were examined at follow-up with a mean observation time of 7 years (range 3.5-12.5). Five patients with type IV or type V lesions had concomitant avulsion fractures of the tibial insertion of the anterior cruciate ligament, two being displaced. Eight out of twelve patients had concomitant ligamentous injuries. At follow-up two patients complained of instability, confirmed by clinical examination. Another two patients had symptom-free anterior laxity. Serious angular deformity was found in two patients, while important leg length discrepancy was observed in one. Degenerative changes of the knee joint were found in three patients. An active reconstructive approach is recommended, and attention is drawn to concomitant ligamentous injuries which, it seems, in the past have tended to be underestimated.

Adolescent↗