Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique

Background: Distal tibial reconstruction with use of an external fixator when there is bone loss, limb-length discrepancy, and/or ankle instability is associated with many problems. The technique of limb-lengthening, ankle arthrodesis, and segmental transfer over an intramedullary nail has been in...

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Main Authors:	Eralp, Levent, Kocaoglu, Mehmet, Mohd Yusof, Nazri, Bulbul, Murat
Format:	Article
Language:	English
Published:	The Journal of Bone and Joint Surgery 2007
Subjects:	RD701 Orthopedics
Online Access:	http://irep.iium.edu.my/29869/ http://irep.iium.edu.my/29869/ http://irep.iium.edu.my/29869/ http://irep.iium.edu.my/29869/1/combine_technique.pdf

id	iium-29869
recordtype	eprints
spelling	iium-298692015-01-27T01:14:16Z http://irep.iium.edu.my/29869/ Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique Eralp, Levent Kocaoglu, Mehmet Mohd Yusof, Nazri Bulbul, Murat RD701 Orthopedics Background: Distal tibial reconstruction with use of an external fixator when there is bone loss, limb-length discrepancy, and/or ankle instability is associated with many problems. The technique of limb-lengthening, ankle arthrodesis, and segmental transfer over an intramedullary nail has been introduced to overcome these problems. The present study investigates this combined technique. Methods: Between 2002 and 2005, six patients, who ranged from seventeen to seventy years old, underwent distal tibial reconstruction and ankle arthrodesis with use of a circular external fixator and an intramedullary nail to treat a distal tibial defect following resection for chronic osteomyelitis or tumor or to treat a limb-length discrepancy combined with ankle instability. Functional and radiographic results were evaluated, with use of the criteria described by Paley et al., at an average follow-up of thirty-four months. Results: The mean size of the bone defects in three patients was 5.3 cm (2, 7, and 7 cm), and the mean amount of the limb-shortening in four patients was 5.25 cm (range, 4 to 6 cm). The mean external fixation time was 3.5 months, and the mean external fixator index was 0.57 mo/cm. There was no recurrence of infection in the two patients with osteomyelitis. All six patients had excellent bone results, and the functional results were excellent for two patients and good for four patients. There were four complications, three of which were categorized, according to Paley, as a problem (a difficulty that occurs during lengthening and is resolved without operative intervention) and one that was categorized as an obstacle (a difficulty that occurs during lengthening and needs operative treatment). Conclusions: The combined technique is an improvement over the classic external fixation techniques of distal tibial reconstruction with ankle arthrodesis. It reduces the duration of external fixation, thus increasing patient acceptance, and it is associated with a low complication rate facilitating more rapid rehabilitation. The Journal of Bone and Joint Surgery 2007 Article PeerReviewed application/pdf en http://irep.iium.edu.my/29869/1/combine_technique.pdf Eralp, Levent and Kocaoglu, Mehmet and Mohd Yusof, Nazri and Bulbul, Murat (2007) Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique. The Journal of Bone and Joint Surgery, 89. pp. 2218-2224. ISSN 0021-9355 http://europepmc.org/abstract/MED/18829932/reload=0;jsessionid=BpBYwbq3IOEFsWQCLrwH.22 10.2106/JBJS.H.00467
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RD701 Orthopedics
spellingShingle	RD701 Orthopedics Eralp, Levent Kocaoglu, Mehmet Mohd Yusof, Nazri Bulbul, Murat Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique
description	Background: Distal tibial reconstruction with use of an external fixator when there is bone loss, limb-length discrepancy, and/or ankle instability is associated with many problems. The technique of limb-lengthening, ankle arthrodesis, and segmental transfer over an intramedullary nail has been introduced to overcome these problems. The present study investigates this combined technique. Methods: Between 2002 and 2005, six patients, who ranged from seventeen to seventy years old, underwent distal tibial reconstruction and ankle arthrodesis with use of a circular external fixator and an intramedullary nail to treat a distal tibial defect following resection for chronic osteomyelitis or tumor or to treat a limb-length discrepancy combined with ankle instability. Functional and radiographic results were evaluated, with use of the criteria described by Paley et al., at an average follow-up of thirty-four months. Results: The mean size of the bone defects in three patients was 5.3 cm (2, 7, and 7 cm), and the mean amount of the limb-shortening in four patients was 5.25 cm (range, 4 to 6 cm). The mean external fixation time was 3.5 months, and the mean external fixator index was 0.57 mo/cm. There was no recurrence of infection in the two patients with osteomyelitis. All six patients had excellent bone results, and the functional results were excellent for two patients and good for four patients. There were four complications, three of which were categorized, according to Paley, as a problem (a difficulty that occurs during lengthening and is resolved without operative intervention) and one that was categorized as an obstacle (a difficulty that occurs during lengthening and needs operative treatment). Conclusions: The combined technique is an improvement over the classic external fixation techniques of distal tibial reconstruction with ankle arthrodesis. It reduces the duration of external fixation, thus increasing patient acceptance, and it is associated with a low complication rate facilitating more rapid rehabilitation.
format	Article
author	Eralp, Levent Kocaoglu, Mehmet Mohd Yusof, Nazri Bulbul, Murat
author_facet	Eralp, Levent Kocaoglu, Mehmet Mohd Yusof, Nazri Bulbul, Murat
author_sort	Eralp, Levent
title	Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique
title_short	Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique
title_full	Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique
title_fullStr	Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique
title_full_unstemmed	Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique
title_sort	distal tibial reconstruction with use of a circular external fixator and an intramedullary nail. the combine technique
publisher	The Journal of Bone and Joint Surgery
publishDate	2007
url	http://irep.iium.edu.my/29869/ http://irep.iium.edu.my/29869/ http://irep.iium.edu.my/29869/ http://irep.iium.edu.my/29869/1/combine_technique.pdf
first_indexed	2023-09-18T20:43:51Z
last_indexed	2023-09-18T20:43:51Z
_version_	1777409543771258880

Distal tibial reconstruction with use of a circular external fixator and an intramedullary Nail. the combine technique

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