MyMedR

Fulltext Comparison of fracture patterns between rural and urban populations in a developing country

Saw A, Sallehuddin AY, Chuah UC, Ismail MS, Yoga R, Hossain MG

Singapore Med J, 2010 Sep;51(9):702-8.

PMID: 20938610

The pattern of fracture, including the anatomical location and age distribution, may differ among urban and rural populations due to various factors such as the inhabitants' occupation and living environment.

Matched MeSH terms: Tibial Fractures/diagnosis; Tibial Fractures/pathology

Fulltext Recalcitrant post-traumatic chronic osteomyelitis/infected non-union of the tibia following open grade-ill fractures: treatment with vascularized osteocutaneous fibular graft

Halim AS, Imran Y

Med J Malaysia, 2006 Feb;61 Suppl A:66-70.

PMID: 17042234

Post-traumatic chronic osteomyelitis and infected non-unions of the tibia following severe type-III open fracture are difficult to treat Refractoy cases often necessitate amputation despite attempts to salvage the limb. We report our experience in treating such difficult cases with an alternative surgical option using free osteocutaneous fibular graft. Eight consecutive patients with post-traumatic chronic osteomyelitis/infected non-union were treated surgically with free vascularized osteocutaneous fibular graft. Outcomes in term of graft-host union and complication were evaluated. Four patients had anastomotic venous thrombosis requiring anastomotic revision. Five patients developed surgical site infections needing extended antibiotic therapy to achieve resolution at an average of 15.2 weeks. Fibular graft fracture occurred in three patients but all grafts survived and united after a mean time to union of 42.3 weeks (range 31 to 82 weeks). At the final follow-up, union of host-graft junction and control of infection were achieved in all patients except one who required a secondary amputation. Free vascularized osteo-cutaneous fibular graft is a viable limb salvage option for refractory chronic osteomyelitis or infected non-union following treatment of grade-III open tibial fractures.

Matched MeSH terms: Tibial Fractures/complications; Tibial Fractures/microbiology; Tibial Fractures/surgery*

Fulltext An unusual radiographic presentation of posterior cruciate ligament avulsion fracture

Nizlan MNM, Suhail A, Samsudin OC, Masbah O

Med J Malaysia, 2004 Dec;59 Suppl F:65-8.

PMID: 15941168

A case of traumatic posterior cruciate ligament (PCL) avulsion fracture presenting with unusual radiographic findings is described. CT scan of the right knee showed features suggestive of combined ACL and PCL avulsion fractures. Arthroscopic findings showed that the injury was in fact a PCL avulsion fracture that was displaced anteriorly so as to mimic an ACL avulsion fracture on CT scan.

Matched MeSH terms: Tibial Fractures/etiology; Tibial Fractures/radiography; Tibial Fractures/surgery

Fulltext Highly Crosslinked Polyethylene Tibial Post Fracture in the Unafflicted Limb of a Patient with Unilateral Lower Limb Poliomyelitis: A Case Report

Lee WC, Wee L

Malays Orthop J, 2019 Mar;13(1):42-44.

PMID: 31001383 DOI: 10.5704/MOJ.1903.008

We present a unique case of tibial post fracture of a posterior-stabilised total knee arthroplasty (PS-TKA) using highly crosslinked polyethylene (HXLPE) in the unafflicted limb of a patient who had poliomyelitis. The tibial post is an upright structure perpendicular to the PE insert articular surface which articulates with the cam of the femoral component to prevent excessive posterior translation of the tibia. We explore the choice of PS polyethylene (PE) inserts in patients with neuromuscular disorders (NMD). A 74-year old gentleman presented with recurrent knee pain seven years after the index PS-TKA with HXLPE. The TKA was performed on the unafflicted left limb (contralateral to the weak side affected by poliomyelitis). The posterior drawer test was positive. During the single-stage revision surgery, the HXLPE tibial post was noted to be broken. The liner was replaced with a thicker non-HXLPE. The patient achieved an excellent outcome at one-year post-surgery. This is the first report of HXLPE tibial post fracture in the unaffected knee of a patient with NMD affecting the lower limb. The HXLPE's reduced resistance to fatigue crack propagation might not be suitable in PS-TKA where there might be focal stress points on the tibial post, which was amplified in this case as it was the limb that the patient most depended on. When managing end-stage osteoarthritis with TKA in the unafflicted knee of a patient with NMD causing lower limb weakness, the selection of polyethylene material in PS-TKA may need more consideration than previously thought.

Matched MeSH terms: Tibial Fractures

Reconstruction of a tibial defect with a previously fractured fibula including the fractured segment as a free osteoseptocutaneous flap

Sadek AF, Halim AS, Ismail FW, Imran YM

Ann Plast Surg, 2014 Oct;73(4):402-4.

PMID: 23851368 DOI: 10.1097/SAP.0b013e31827fb387

Reconstruction of major bone defects using free fibular transfer provides a good biological option in unsound situations. Most authors recommend selection of the recipient blood vessels outside the zone of injury to achieve successful free fibular transfer. Occasionally, in polytraumatized patients, the surgeon has to use a previously fractured fibula as a graft, with increased risk of inclusion of the injury zone that may lead to failure.

Matched MeSH terms: Tibial Fractures/surgery*

Higher division of the tibial nerve in the leg: gross anatomical study with clinical implications

Norzana AG, Farihah HS, Fairus A, Teoh SL, Nur AK, Faizah O, et al.

Clin Ter, 2013;164(1):1-3.

PMID: 23455733 DOI: 10.7417/CT.2013.1501

Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications.

Matched MeSH terms: Tibial Fractures/surgery

Simple method for retrieval of distal segment of the broken interlocking intramedullary nail

Marwan M, Ibrahim M

Injury, 1999 Jun;30(5):333-5.

PMID: 10505126

A simple technique for removal of the distal fragment of the broken intramedullary interlocking nail is described. It was successfully used in three patients with a broken nail due to nonunion. The technique requires only cerclage wire, which is available in any operating room, avoiding the difficulties obtaining the custom made hook and of excessive exposure to radiation.

Matched MeSH terms: Tibial Fractures/surgery*

Fulltext Compartment syndrome of the calf and foot following a displaced Salter-Harris type II fracture of the distal tibia: a review of the literature and a case report

Yeap JS, Fazir M, Ezlan S, Kareem BA, Harwant S

Med J Malaysia, 2001 Jun;56 Suppl C:66-9.

PMID: 11814253

A 14 year-old boy with an epiphyseal fracture of the distal right tibia and fibula developed compartment syndrome of the calf and foot. The diagnosis of compartment syndrome was delayed and a fasciotomy resulted in uncontrolled infection, which ultimately resulted in an above knee amputation. Constant vigilance is necessary in uncooperative or non-complaining patients to detect the signs and symptoms of compartment syndrome, even where the injury is not often associated with this complication. The difficulties in management, following a fasciotomy for delayed diagnosis of compartment syndrome, are discussed.

Matched MeSH terms: Tibial Fractures/complications*

A simple method for removal of a broken intramedullary nail

Sivananthan KS, Raveendran K, Kumar T, Sivananthan S

Injury, 2000 Jul;31(6):433-4.

PMID: 10831741

The removal of broken implanted intramedullary nails secondary to re-fracture or non-union is challenging. In 12 cases a simple and safe method has been used to remove broken implants.

Matched MeSH terms: Tibial Fractures/surgery

Fulltext Clinical experience with reamed locked nails for close and open comminuted tibial diaphyseal fractures: a review of 50 consecutive cases

Zainudin M, Razak M, Shukur SH

Med J Malaysia, 2000 Sep;55 Suppl C:59-67.

PMID: 11200046

We present the results of our experience in treating comminuted tibial shaft fractures with reamed interlocking intramedullary nail from September 1993 to December 1995. In this retrospective study, there were fifty patients with an average follow-up of 14.3 months (range six to twenty-eight months). Ninety-eight percent of the fractures were due to motor-vehicle accident with majority of the patients being motorcyclist (96%). Thirty-eight fractures were closed and twelve were open (Gustilo grade I--8; grade II--4); 44% of them had additional fractures or other injuries. According to Winquist-Hansen classification of diaphyseal fracture comminution, there were 24% type I; 18% type II; 26% type III and 32% type IV. The union rate was 98%. There were 6 infections, 2 superficial and 4 deep. All these infections arose from closed fractures, which was possibly due to the long operative time. No patients with open fractures, which underwent delayed nailing, had infection. One of the patient had severe deep infection which required early nail removal before union. Anterior knee pain following nailing occurred in 6% of the patients. The average hospital stay after operation was 3.4 days. Ninety-four percent of the patients had excellent to good functional outcome after nailing. The mean time to regain full range of movement of knee and ankle was 8.4 weeks. Patients were allowed full weight bearing in the average time of 10.7 weeks and the mean time to return to work was 24.7 weeks.

Matched MeSH terms: Tibial Fractures/surgery*

Fulltext A report of the first 20 cases using a simple external fixator

Masbah O, Noor MA

Med J Malaysia, 1992 Jun;47(2):122-7.

PMID: 1494332

The results of treatment using a locally-designed external fixator in 20 patients are presented. Open fractures were the main indications for external fixation. Pin tract infection occurred in 8 patients. Only 2 patients had unstable fixation which required removal of the device. One third of patients developed malunion exceeding 15 degrees and two thirds had joint stiffness after conversion to plaster cast. This external fixator is adequate in the treatment of most open fractures of the tibia. However, improved techniques of pin insertion and cast application upon removal of the external fixator may help to reduce the incidence of pin tract infections and malunion.

Matched MeSH terms: Tibial Fractures/therapy

Fulltext Does right leg require extra protection? Five-year review of type 3 open fractures of the tibia

Imran Y, Vishvanathan T

Singapore Med J, 2004 Jun;45(6):280-2.

PMID: 15181523

Open fracture of the tibia is very common among motorcyclists. The morbidity associated with this injury is well-documented as treatment of severe open fractures is very difficult. There is currently no study done in the literature to see the relationship between fracture severity and the side of the injury.

Matched MeSH terms: Tibial Fractures/epidemiology*

Fulltext Simple approach to the management of aseptic non-union of the shaft of long bones

Devnani AS

Singapore Med J, 2001 Jan;42(1):20-5.

PMID: 11361233

Internal fixation with a plate in the management of non-union for shaft of long bones has been condemned but the review of the literature does not provide such unequivocal evidence. Also there are certain situations where it is either technically not feasible or contraindicated to do closed intramedullary nailing. This study was done to see the outcome of plate-fixation for the treatment of non-union of the shaft of long bones.

Matched MeSH terms: Tibial Fractures/surgery

Fulltext Outcomes of infected grade IIIB open tibial fractures

Yusof NM, Halim AS

Singapore Med J, 2012 Sep;53(9):591-4.

PMID: 23023900

Infection following grade IIIB open tibial fracture is common. The primary aim of managing this condition is to achieve control of infection before the bone reconstruction procedure is performed. The outcomes for such patients have not been evaluated in the literature. This study was conducted to examine the outcome of a multi-stage procedure for the treatment of infected grade IIIB open tibial fractures.

Matched MeSH terms: Tibial Fractures/complications; Tibial Fractures/surgery*

Fulltext Targeted delivery of lovastatin and tocotrienol to fracture site promotes fracture healing in osteoporosis model: micro-computed tomography and biomechanical evaluation

Ibrahim N', Khamis MF, Mod Yunoh MF, Abdullah S, Mohamed N, Shuid AN

PLoS One, 2014;9(12):e115595.

PMID: 25526611 DOI: 10.1371/journal.pone.0115595

Osteoporosis is becoming a major health problem that is associated with increased fracture risk. Previous studies have shown that osteoporosis could delay fracture healing. Although there are potential agents available to promote fracture healing of osteoporotic bone such as statins and tocotrienol, studies on direct delivery of these agents to the fracture site are limited. This study was designed to investigate the effects of two potential agents, lovastatin and tocotrienol using targeted drug delivery system on fracture healing of postmenopausal osteoporosis rats. The fracture healing was evaluated using micro CT and biomechanical parameters. Forty-eight Sprague-Dawley female rats were divided into 6 groups. The first group was sham-operated (SO), while the others were ovariectomized (OVx). After two months, the right tibiae of all rats were fractured at metaphysis region using pulsed ultrasound and were fixed with plates and screws. The SO and OVxC groups were given two single injections of lovastatin and tocotrienol carriers. The estrogen group (OVx+EST) was given daily oral gavages of Premarin (64.5 µg/kg). The Lovastatin treatment group (OVx+Lov) was given a single injection of 750 µg/kg lovastatin particles. The tocotrienol group (OVx+TT) was given a single injection of 60 mg/kg tocotrienol particles. The combination treatment group (OVx+Lov+TT) was given two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks of treatment, the fractured tibiae were dissected out for micro-CT and biomechanical assessments. The combined treatment group (OVx+Lov+TT) showed significantly higher callus volume and callus strength than the OVxC group (p<0.05). Both the OVx+Lov and OVx+TT groups showed significantly higher callus strength than the OVxC group (p<0.05), but not for callus volume. In conclusion, combined lovastatin and tocotrienol may promote better fracture healing of osteoporotic bone.

Matched MeSH terms: Tibial Fractures/complications; Tibial Fractures/drug therapy*

Congenital pseudoarthrosis of the tibia: healing by lengthening over a rod without compression of the nonunion. A preliminary report

Muhammad Abdul Jamil MK, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 May;22(3):207-12.

PMID: 22182834 DOI: 10.1097/BPB.0b013e32834ecc01

This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.

Matched MeSH terms: Tibial Fractures/etiology; Tibial Fractures/radiography; Tibial Fractures/surgery

Fulltext Massive Tibial Bone Regeneration with Autologous Peripheral Blood Stem Cells using Ilizarov Bone Transport: A Case Report

Saw KY, Gill R, Low TC

Malays Orthop J, 2020 Nov;14(3):166-169.

PMID: 33403079 DOI: 10.5704/MOJ.2011.026

This is a case report of a Gustilo-Anderson Type IIIB comminuted open right tibial fracture with massive bone loss, complicated by methicillin-resistant Staphylococus aureus (MRSA) infection. Non-viable and contaminated bony fragments were removed and infected bone resected. Soft tissue coverage and antibiotics were effective against the MRSA infection. A unifocal bone transport with the Ilizarov method regenerated 13cm of the missing tibia. Autologous peripheral blood stem cells (PBSC) injections into the osteogenesis site boosted bone regeneration and consolidation with a shortened Bone Healing index (BHI) of 23 days/cm.

Matched MeSH terms: Tibial Fractures

Fulltext Minimally Invasive Osteosynthesis of Distal Tibia Fractures using Anterolateral Locking Plate

Choudhari P, Padia D

Malays Orthop J, 2018 Nov;12(3):38-42.

PMID: 30555645 DOI: 10.5704/MOJ.1811.008

Introduction: Plating in distal tibia fractures are associated with higher rate of soft tissue complications. As adequate soft tissue cover is available over anterolateral surface of the tibia, use of anterolateral plate fixation in distal tibia fractures has increased. The purpose of our research is to evaluate the outcomes of anterolateral locking plate fixation in distal tibia fractures using ORIF. Materials and Methods: A retrospective analysis of 25 patients, who had distal tibia fractures and underwent open reduction and anterolateral plating. Bone and soft tissue healing and complications encountered were analysed. Result: Full weight bearing was allowed at an average of 5.4 months (range: 3-12 months) after seeing radiological union. We have observed superficial wound infection in four cases. Two cases had marginal necrosis, two cases had sensory disturbance over dorsolateral aspect of foot and two cases had delayed non-union. Mean length of surgical incision was 9cm (range: 5-12 cm). Conclusion: Open reduction internal fixation of distal tibia fractures with anterolateral plating is a reliable way of fracture fixation and stabilisation with proper surgical technique and aseptic precautions.

Matched MeSH terms: Tibial Fractures

Fulltext Evaluation of Functional Outcome Following Hybrid External Fixation in The Management of Schatzkers Type V and VI Tibial Plateau Fractures - A Prospective Study of 30 Patients

Subash Y

Malays Orthop J, 2021 Mar;15(1):48-54.

PMID: 33880148 DOI: 10.5704/MOJ.2103.008

Introduction: Fractures of the proximal tibia are high velocity injuries often associated with soft tissue compromise especially in the type V and VI fracture patterns. Dual plating is the preferred treatment option for these injuries but not in a setting where there is extensive soft tissue injury, as this can lead to problems with wound healing. The aim of this study was to evaluate the functional outcome following hybrid external fixation in the management of Schatzkers type V and VI fractures.

Materials and Methods: A total of 30 patients with type V and VI proximal tibial fractures who presented between January 2012 to January 2015 were managed with hybrid external fixation and were followed-up for a period of 3 years.

Results: The mean age of the patients was 42.26 years with the left knee being more commonly affected. Schatzkers type V was the more common fracture type seen. The mean time to union was 12.06 weeks and the average range of motion achieved was 0 to 100°. The mean Rasmussens functional score was 25.4 at last follow-up and we had excellent results in 5 patients and good results in 22 patients.

Conclusion: Through this study, we conclude that the hybrid external fixation is an excellent option in the type V and VI fractures with extensive soft tissue compromise. It is easy to apply, facilitates early mobilisation of the joint and gives good functional results.

Matched MeSH terms: Tibial Fractures

Fulltext 13-year-old exposed interlocking nail: a case report

Chua, Y.C.J., Lim, L.A., Hudzairy, A.

Malays Orthop J, 2009;3(1):91-94.

MyJurnal

We are reporting a case of post-traumatic chronic osteomyelitis of the tibia with an open wound exposing an intra medullar nail implant for 13 years. The patient presented with fresh ipsilateral tibia plateau fracture. He was treated by removal of the implant, debridement and local placement of Gentamicin-impregnated PMMA beads according to guidelines of two-stage Belfast technique . After five months of wound treatment, the exposed bone was covered by healthy granulation tissue and the patient was able to fully bear weight.

Matched MeSH terms: Tibial Fractures

Displaying publications 21 - 40 of 48 in total