Ankle Salvage Following Nonunion of Distal Tibia Fractures.
| Autor: | Lovisetti G; 1 Department of Orthopedics, Menaggio Hospital, Menaggio, Italy., Kirienko A; 2 Department of Orthopedics, Humanitas Research Hospital, Milan, Italy., Myerson C; 3 Tulane School of Medicine, New Orleans, LA, USA., Vulcano E; 4 Department of Orthopedics, Icahn School of Medicine at Mount Sinai, Mount Sinai West, New York, NY, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Foot & ankle international [Foot Ankle Int] 2018 Oct; Vol. 39 (10), pp. 1210-1218. Date of Electronic Publication: 2018 Jun 04. |
| DOI: | 10.1177/1071100718781327 |
| Abstrakt: | Background: Nonunions of the distal tibia in close proximity to the ankle joint can be a challenge to treat. The purpose of this study was to evaluate radiographic and clinical outcomes of patients who underwent ankle-sparing bone transport for periarticular distal tibial nonunions. Methods: Twenty-one patients underwent ankle-sparing bone transport between January 2006 and July 2016. The mean age of the patients was 48.6 years, and 71% (15/21) were male. Patients were followed for an average of 14.6 months (range, 10.6-17.7 months), with an average of 8.6 months in-frame. Thirteen of 21 patients had infected nonunions. Primary endpoints included time to union and American Orthopaedic Foot & Ankle Society (AOFAS) score. Results: All fractures achieved union. Mean time to union was 37.4 weeks. Mean AOFAS score was 86.3 points (range, 37-100). A score of 37 was observed in 1 patient with preexisting Charcot foot. Radiographic evaluation at 6 months revealed a mean lateral distal tibial angle of 89.2 degrees and a mean anterior distal tibial angle of 76 degrees. Leg length discrepancy was less than 1.2 cm in all patients. Superficial pin infection was observed in 7 patients, and operative wound infection at the level of bone resection was observed in 3 patients. Conclusion: The ankle-sparing bone transport technique was an effective alternative to bone graft and arthrodesis for the treatment of periarticular nonunions of the distal tibia and was safe for use in patients with infected nonunions in close proximity to the ankle joint. Level of Evidence: Level IV, case series. |
| Databáze: | MEDLINE |
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