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At least 19 recordsLinked to original sources
PubMedDate not supplied

Foam-reinforced elderly human tibia approximates young human tibia better than porcine tibia: a study of the structural properties of three soft tissue fixation devices.

BACKGROUND: Because there is an insufficient supply of young human knees, an alternative is needed for evaluating anterior cruciate ligament reconstructions. The authors determined whether an elderly human tibia reinforced with foam is a better substitute for a young human tibia than a porcine tibia in this study of the tibialfixation of a soft tissue anterior cruciate ligament graft using 3 devices. HYPOTHESIS: A foam-reinforced elderly human tibia more closely approximates the performance of a young human tibia than porcine tibia. STUDY DESIGN: Biomechanical study. METHODS: Failure mode, stiffness, yield, and slippage were determined for a double-looped tendon graft fixed with either an interference screw, WasherLoc, or tandem washers in young human tibiae, foam-reinforced tibiae from elderly humans, and porcine tibiae. RESULTS: The stiffness and yield of interference screw and WasherLoc fixation in foam-reinforced tibiae more closely approximate those in young human tibiae than in porcine tibiae. Slippage of all combinations of tibiae and fixation devices was similar CONCLUSIONS: A foam-reinforced human tibia more closely approximates the performance of a young human tibia than that of porcine tibia in this study. CLINICAL RELEVANCE: Fixation devices should be tested in foam-reinforced tibiae from elderly humans rather than tibiae from large farm animals when the supply of young human knees is insufficient.

Adolescent↗
PubMedDate not supplied

Porcine tibia is a poor substitute for human cadaver tibia for evaluating interference screw fixation.

BACKGROUND: Animal tissues are commonly used in anterior cruciate ligament graft fixation studies. HYPOTHESIS: Porcine bones and tendons provide good surrogates for human cadaver tissues in the biomechanical evaluation of anterior cruciate ligament reconstruction. STUDY DESIGN: Randomized experimental study. METHOD: Three different tissue models-pure porcine (porcine graft fixed in porcine tibia, group 1), combination (human hamstring graft and porcine tibia, group 2), and pure human (human graft and tibia, group 3)-were compared using both cyclic-loading and subsequent single-cycle load-to-failure tests to assess the effect of graft and bone tissue source (porcine vs human) on the fixation strength of anterior cruciate ligament reconstruction. RESULTS: In the cyclic-loading test, the displacement (slippage) after 1500 cycles was 2.0 mm +/- 0.7 mm, 1.6 mm +/- 0.4 mm, and 4.4 mm +/- 1.9 mm for groups 1, 2, and 3, respectively (P <.001 between 1 and 2 vs 3). In the subsequent single-cycle load-to-failure test, the corresponding average yield loads were 668 N +/- 157 N, 962 N +/- 238 N, and 448 N +/- 98 N, all differences being statistically significant. CONCLUSIONS: In comparison to young human cadaver tibia, porcine tibia underestimate graft slippage and overestimate the failure load of the soft tissue graft in anterior cruciate ligament reconstruction. CLINICAL RELEVANCE: Porcine tibia does not provide a reasonable surrogate for human cadaver tibia for evaluating ACL reconstructions.

Adolescent↗
PubMed2006

Using tibia fragments from South Africans of European descent to estimate maximum tibia length and stature.

Intact long limb bones have been used in the derivation of regression equations for stature assessment in different population groups. Since intact long bones are not always present for analyses in forensic cases, it has become necessary to derive regression equations for the estimation of stature from the fragments of these bones which are obtained in forensic and archaeological cases. Regression equations have been derived for stature estimation from fragments of the tibia. Since these equations are population specific, it was the aim of this study to derive similar equations for estimation of stature and maximum tibia length from measurements of different fragments of tibia of South Africans of European descent. Analyses were based on a sample of 50 male and 50 female complete skeletons of adult South Africans of European descent. Total skeletal height for the individual skeletons was measured using the Fully's (anatomical) method. Six variables were measured on the tibia which included the medial tibial condyle lengths and breadths, lateral tibial condyle lengths and breadths, proximal breadth and distal breadth. Univariate and multivariate regression equations were formulated for estimation of total skeletal height (and subsequent estimation of living stature) and maximum tibial length from measurements of the tibia. The standard errors of estimate for the equations were higher than those obtained for intact long bones which when present in forensic cases should be used for stature estimation. In the absence of intact long bones, the equations derived from the present study can provide a reliable estimate of skeletal height and living stature.

Aged↗
PubMed1978

["Fibula-pro-tibia-fusion" (Hahn-Brandes-Graft) in treatment of bone defects of the tibia (author's transl)].

The authors use the "fibula-pro-tibia fusion" (also called Hahn-Brandes Graft, for the treating large bone defects of the tibia shaft. This method is preferred both with congenital partial tibial aplasias with acquired extensive pseudarthrosis defects of the tibia. In congenital cases, grafting of the distal end of the fibula onto the calcaneal end of the foot with careful preservation of the epiphyseal disc, should precede surgery. Large differences in leg length can be treated after fusion surgery by means of elongation osteotomies. Attention is drawn to this method in the second example of pseudarthrosis defect. Lastly the authors mention a further method for mediation of large diaphyseal tibia defects, namely the transplantation of the opposing fibula. This can lead to good results when an aggressive form of fibrous dysplasia is not present, as was the case however in the third example. In such a case the process only heals after removal of the cover of the periosteum as well.

Adult↗
PubMed1980

[Study on histological and histochemical appearance of fetal mouse tibiae cultured in vitro in comparison with freshly excised tibiae (author's transl)].

The histological and histochemical appearance of murine fetal tibiae was studied in order to furnish the morphological background for biochemical investigations on in vitro cultures of these organs, used as an experimental model for the study of drug influences on metabolic processes of mesenchymal tissues. Freshly excised tibiae until the 14th day of gestation showed solely cartilagenous structures; first signs of calcification were found after 15 days of gestation and ossification of the diaphysis proceeds until the 17th day. A comparison of tibiae explants excised on the 17th day of gestation and cultured for 6 days in vitro with freshly excised tibiae of the same age (17 days) indicates a continuous growth of the explants in vitro without any signs of degenerative processes which could be due to the culture conditions.

Animals↗
PubMed1997

Treatment of traumatic defect of the tibia with two exposed fractured ends--reduction and lengthening at the proximal metaphysics of tibia.

From Jan. 1995 to June 1996, 6 cases of traumatic defect of the tibia were treated by remodeling and reduction of fractured ends and osteotomy and distraction at the proximal metaphysics of the tibia. In 6 patients, aged 19 to 54, with the limb-length discrepancy being at least 3 to 4.5 cm, the tibia was lengthened by 3 cm in 3 cases, 4 to 4.5 cm in 3 cases. The consolidation and maturation of the bone were accomplished within 3 to 6 months. The authors believe that this procedure is simple, less invasive and involves no bone-graft.

Adult↗
PubMedDate not supplied

Late-onset tibia vara: a histopathologic analysis. A comparative evaluation with infantile tibia vara and slipped capital femoral epiphysis.

Histopathologic and histochemical studies were performed on the entire physes and contiguous structures of five knees (three patients) with late-onset tibia vara (Blount's disease). A constellation of abnormalities of both medial and lateral physeal components resulted in disorganization and misalignment of the physeal zones. The changes were remarkably similar to those observed in both infantile tibia vara and slipped capital femoral epiphysis, suggesting a common etiology. Our evaluation indicates that asymmetric compressive and shear forces acting across the proximal tibial physis effect its disruption and causes suppression and deviation of normal endochondral ossification, thereby resulting in tibia vara.

Adolescent↗
PubMedDate not supplied

Tibia vara: osteochondrosis deformans tibiae. Blount's disease.

Tibia vara is a deformity of abrupt angulation into varus below the knee and inward rotation of the tibia. The condition appears as an infantile type manifesting itself at age one to three years, and as an adolescent type. Although the etiology of the infantile type is obscure, cartilage changes in the medial part of the growth plate and the epiphysis suggest that is belongs in the category of osteochondroses. The adolescent type, a separate entity secondary to infection or trauma, is not discussed here. Untreated infantile tibia vara will likely worsen and progress to severe bowleg. It is generally agreed that early osteotomy, adequately performed before the age of eight years, ordinarily results in a cure; however, when treatment is delayed to the age of nine or older, partial epiphyseal arrest often occurs. Simple osteotomy is then followed by recurrence, after which other operative measures are necessary.

Adolescent↗
PubMed2004

Biomechanical investigation of the primary stability of intramedullary compression nails in the proximal tibia: experimental study using interlocking screws in cryopreserved human tibias.

The biomechanical properties of the proximal tibia with respect to the application of compressible intramedullary nails were examined in a biomechanical model using human cadaver bones. A reference level was examined histomorphometrically in 24 cryopreserved human tibias. Three series of single or double interlocking fixations were tested at various distances from the tibial plateau. Yield strength, rigidity of the bone stock, maximum load, and compression distances were determined during axial strain. The positioning of the interlocking screws had a considerable influence on maximum load and deformation behavior of the bone. The double interlocking tended to display the best stability in the bone stock, and the distally placed single interlocking method was next best. Failure of the bone stock was observed with significant variations in compression distance and load, with great variations between individual specimens. The stability of the bone stock could not be accurately predicted using such clinical parameters as the patient's age, bone dimensions, radiographic parameters, and bone density. When using a tibial compression nail, the proximal interlocking screw should be placed relatively distal to achieve adequate support. It is possible to apply compression with one proximal interlocking screw under low preload or, preferably, with two interlocking screws.

Adult↗
PubMedDate not supplied

Congenital pseudarthrosis of the tibia: successful one stage transposition of the fibula into the distal tibia. A case report.

An infant male presented at age 17 months with an established pseudarthrosis in a kyphoscoliotic right tibia. During the ensuing 6 years, three unsuccessful McFarland bypass bone grafts were performed. Then the distal end of the proximal fibula was placed into the medullary cavity of the proximal end of the distal tibia without disturbing the proximal portion of the fibula. This was augmented by autogenous bone graft. Union occurred in one year. The child has been followed for 7 years and the pseudarthrosis remains healed.

Bone Diseases↗
PubMedDate not supplied

Rotational osteotomies of the leg: tibia alone versus both tibia and fibula.

From a chart review of 45 consecutive cases (mean age 8.9 years) of patients who had rotational osteotomies of the tibia alone (group 1, 27 cases) or of both the tibia and fibula (group 2, 18 cases) for torsional deformities of the leg, we compared the length of surgery and postoperative complications. We also describe the surgical technique for tibial osteotomy alone. The most common complication, posterior and varus/valgus angulation at the osteotomy site, was significantly higher in group 2 than in group 1 (p < 0.05). The mean operative time was 21% faster for tibial osteotomy alone. One case of chronic lateral compartment syndrome occurred in group 2. When indicated, tibial osteotomy alone is a simple, safe, fast, and stable surgical procedure for correcting excessive tibial torsion.

Adolescent↗
PubMed2004

[Relationship between tibia callus diameter ratio and prognosis during tibia lengthening].

OBJECTIVE: To investigate the relationship between the tibia callus diameter ratio (CDR) and prognosis during tibial distraction and the occurrence of late deformity or fracture. METHODS: We measured tibial lengthening callus diameter and added up the cases of angular deformity and fracture in 68 cases from January 1996 to December 2001, to calculated callus diameter ratios and compare the relationship between the tibia callus diameter during tibial distraction and the occurrence of late callus angular deformity or fracture. RESULTS: In 23 cases of CDR < 80%, 13 cases had new bone fracture, 21 cases had angular deformity > 5 degree. In 6 cases of 81% < CDR < 85%, there were 4 cases of angular deformity > 5 degree. In the other 39 cases of CDR > 85%, there were no fracture and angular deformity. CONCLUSION: When the CDR was > 85%, there were no angular deformity and fracture, but when the CDR was < 80%, the complications of fracture and angular deformity occur. CDR is a better alarming index for preventing the complications occurring in tibial lengthening.

Adolescent↗
PubMed1989

Works in progress #5. Total knee arthroplasty using a long-stem tibia component A novel approach to traumatic arthritis accompanying nonunion and multiple stress risers of the tibia.

Constrained total knee arthroplasty (TKA) using a long-stem modular tibia component has been successful in three cases that presented an unusual combination of technical problems. The constrained TKA described allows successful salvage in patients with traumatic arthritis, extreme ligamentous damage, and either nonunion or the presence of multiple screw holes of the proximal tibia. The average follow-up period for these three cases has been only 18 months, but the results so far are very promising.

Aged↗
PubMed1993

Central grafting for persistent nonunion of the tibia. A lateral approach to the tibia, creating a central compartment.

We report the operative technique and results of a new method of central grafting for persistent nonunion of the tibial shaft. The operation is performed through a lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula above, below and at the level of the nonunion. In 48 tibiae, most with long-standing nonunion and some with infection or bone defects, sound healing was obtained in 45 after one operation. Only one failure needed amputation.

Adolescent↗
PubMed1987

Stress fractures of the distal tibia and calcaneus subsequent to acute fractures of the tibia and fibula.

Stress fractures (two in the calcaneus and four in the distal tibia) occurring distal to the site of a healing fracture of the tibia or fibula were discovered in five patients. Three of these fractures were identified radiographically at the time of their occurrence, and three were identified only after retrospective review of the radiographs of 74 patients with previous tibial or fibular fractures. Three of the patients were less than 10 years old. All five patients had disuse osteopenia and recently had begun weight-bearing. Four patients had healing of their acute fractures with angulation or displacement. Stress fractures can easily be overlooked on radiographic studies in this setting and may be a source of pain that mistakenly can be attributed to malunion or nonunion. Stress fractures should be considered in patients with fractures of the lower extremity, particularly those who experience new or persistent pain or discomfort.

Adolescent↗
PubMed1992

The fibula pro tibia procedure in the treatment of nonunion of the tibia.

We reserve the fibula pro tibia procedure for infected nonunions or for cases that already have been subjected to one or more other methods of treatment. The fibula pro tibia procedure is a technically simple one-stage procedure. The site of the pseudarthrosis is not exposed; hence there is less risk of recurrent infection. Consolidation was achieved in 75% of our cases. The objective findings are positive: consolidation after an average of one year. Knee mobility is normal in most cases, and ankle mobility is only slightly decreased. In most cases the angular deformities are clinically acceptable. All infections have cleared.

Fibula↗
PubMedDate not supplied

Deformity in flexion of proximal tibia secondary to bifocal fracture and anterior instability of knee (deformity in flexion of tibia and ACL reconstruction).

We present a clinical case of anterior instability of the knee due to chronic rupture of the ACL; where there was also proximal deformity of the tibia, secondary to consolidation in flexion of the proximal fragment in a bifocal fracture of the tibia, treated by non-reamed intramedullary nailing, which consolidated in flexion of the proximal fractured segment, causing a marked increase in the angle of the tibial slope. The patient refers an articular instability, which prevented her from walking correctly and causing her frequent falls. We repaired under same chirurgical act, all the problems of the patient, her vicious consolidation and her articular instability. The result is perfect.

Adult↗