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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: Tibia; Tibial Fractures
Morphological re-description of Cochlochila bullita (Stål) (Heteroptera: Tingidae), a potential pest of Orthosiphon aristatus Blume Miq. (Lamiales: Lamiaceae) in Malaysia

Peng TL, Sajap AS, Jeen LH, Lee SH, Lum WC

Pak J Biol Sci, 2013 Dec 01;16(23):1786-90.
PMID: 24506049

One species of lace bug Cochlochila bullita Stål (Heteroptera: Tingidae) was found heavily infested Orthosiphon aristatus Blume Miq., an important medicinal plant in Malaysia. A morphological re-description of C. bullita was done in order to facilitate the identification of this oligophagous insect pest. Five variables, body length and width, antenna length, tibia length and head width were measured from 15 samples from each stage. Among these variables, body length and width were used to construct the ratio for species identification; while body lengths with the other three variables were used to distinguish the nymphs from each developmental stage. The measurements of four traits except the antenna length showed significant differences between the development stages. And thus suggest the body width, tibia length and head width were suitable parameters used to distinguish the nymphal stages. However, the result on the growth factor showed only the sizes of the head followed a more constant growth rate with growth ratios (1.21-1.39) lie between the Dyar's ratio. Body length and width ratio for the adult female and male was 1.51 +/- 0.00 and 1.59 +/- 0.01, respectively. These data are pertinent for identifying developmental stages and to distinguish the species of the lace bug.

Matched MeSH terms: Tibia/growth & development
Stable Incretin Mimetics Counter Rapid Deterioration of Bone Quality in Type 1 Diabetes Mellitus

Mansur SA, Mieczkowska A, Bouvard B, Flatt PR, Chappard D, Irwin N, et al.

J Cell Physiol, 2015 Dec;230(12):3009-18.
PMID: 26016732 DOI: 10.1002/jcp.25033

Type 1 diabetes mellitus is associated with a high risk for bone fractures. Although bone mass is reduced, bone quality is also dramatically altered in this disorder. However, recent evidences suggest a beneficial effect of the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) pathways on bone quality. The aims of the present study were to conduct a comprehensive investigation of bone strength at the organ and tissue level; and to ascertain whether enzyme resistant GIP or GLP-1 mimetic could be beneficial in preventing bone fragility in type 1 diabetes mellitus. Streptozotocin-treated mice were used as a model of type 1 diabetes mellitus. Control and streptozotocin-diabetic animals were treated for 21 days with an enzymatic-resistant GIP peptide ([D-Ala(2) ]GIP) or with liraglutide (each at 25 nmol/kg bw, ip). Bone quality was assessed at the organ and tissue level by microCT, qXRI, 3-point bending, qBEI, nanoindentation, and Fourier-transform infrared microspectroscopy. [D-Ala2]GIP and liraglutide treatment did prevent loss of whole bone strength and cortical microstructure in the STZ-injected mice. However, tissue material properties were significantly improved in STZ-injected animals following treatment with [D-Ala2]GIP or liraglutide. Treatment of STZ-diabetic mice with [D-Ala(2) ]GIP or liraglutide was capable of significantly preventing deterioration of the quality of the bone matrix. Further studies are required to further elucidate the molecular mechanisms involved and to validate whether these findings can be translated to human patients.

Matched MeSH terms: Tibia/drug effects*; Tibia/metabolism; Tibia/physiopathology; Tibia/radiography
Fulltext A Comparison of Plain Radiography with Computer Tomography in Determining Coronal and Sagittal Alignments following Total Knee Arthroplasty

Solayar GN, Chinappa J, Harris IA, Chen DB, Macdessi SJ

Malays Orthop J, 2017 Jul;11(2):45-52.
PMID: 29021879 MyJurnal DOI: 10.5704/MOJ.1707.006

Introduction: Optimal coronal and sagittal component positioning is important in achieving a successful outcome following total knee arthroplasty (TKA). Modalities to determine post-operative alignment include plain radiography and computer tomography (CT) imaging. This study aims to determine the accuracy and reliability of plain radiographs in measuring coronal and sagittal alignment following TKA. Materials and Methods: A prospective, consecutive study of 58 patients undergoing TKA was performed comparing alignment data from plain radiographs and CT imaging. Hip-knee-angle (HKA), sagittal femoral angle (SFA) and sagittal tibial angle (STA) measurements were taken by two observers from plain radiographs and compared with CT alignment. Intra- and inter-observer correlation was calculated for each measurement. Results: Intra-observer correlation was excellent for HKA (r>0.89) with a mean difference of <1.9°. The least intra-observer correlation was for SFA (mean r=0.58) with a mean difference of 8°. Inter-observer correlation was better for HKA (r>0.95) and STA (r>0.8) compared to SFA (r=0.5). When comparing modalities (radiographs vs CT), HKA estimations for both observers showed the least maximum and mean differences while SFA observations were the least accurate. Conclusion: Radiographic estimation of HKA showed excellent intra- and inter-observer correlation and corresponds well with CT imaging. However, radiographic estimation of sagittal plane alignment was less reliably measured and correlated less with CT imaging. Plain radiography was found to be inferior to CT for estimation of biplanar prosthetic alignment following TKA.

Matched MeSH terms: Tibia
Fulltext Chronic tibial osteomyelitis in children. A case review at hospital tengku ampuan afzan, kuantan

Shukrimi A, Ariff MS, Zamzuri Z, Mai Ashikin NT

Med J Malaysia, 2015 Feb;70(1):48-51.
PMID: 26032532 MyJurnal

Osteomyelitis in children has various clinical manifestations causing diagnostic and therapeutic difficulties. Inappropriate treatment of acute osteomyelitis may lead to chronic, serious and complicated condition. Chronic osteomyelitis continues to be a major cause of morbidity and disability in children living in developing countries. We present three cases of tibial osteomyelitis that have different presentations and sequalae. Our intention is to alert our colleagues, particularly primary physicians, regarding the variety of presentation and the important of early diagnosis and treatment to reduce the risk of morbidity following osteomyelitis.

Matched MeSH terms: Tibia
Fulltext Avoiding diagnostic pitfalls in mimics of neoplasia: the importance of a comprehensive diagnostic approach

Samsudin EZ, Kamarul T, Mansor A

Singapore Med J, 2015 May;56(5):e92-5.
PMID: 26034328 DOI: 10.11622/smedj.2015082

Any medical diagnosis should take a multimodal approach, especially those involving tumour-like conditions, as entities that mimic neoplasms have overlapping features and may present detrimental outcomes if they are underdiagnosed. These case reports present diagnostic pitfalls resulting from overdependence on a single diagnostic parameter for three musculoskeletal neoplasm mimics: brown tumour (BT) that was mistaken for giant cell tumour (GCT), methicillin-resistant Staphylococcus aureus osteomyelitis mistaken for osteosarcoma and a pseudoaneurysm mistaken for a soft tissue sarcoma. Literature reviews revealed five reports of BT simulating GCT, four reports of osteomyelitis mimicking osteosarcoma and five reports of a pseudoaneurysm imitating a soft tissue sarcoma. Our findings highlight the therapeutic dilemmas that arise with musculoskeletal mimics, as well as the importance of thorough investigation to distinguish mimickers from true neoplasms.

Matched MeSH terms: Tibia/pathology
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: Tibia/injuries; Tibia/pathology; Tibia/radiography; Tibial Fractures/etiology; Tibial Fractures/radiography; Tibial Fractures/surgery
Fulltext Minimally Invasive Plate Osteosynthesis with Conventional Compression Plate for Diaphyseal Tibia Fracture

Anuar-Ramdhan IM, Azahari IM, Med Orth M

Malays Orthop J, 2014 Nov;8(3):33-6.
PMID: 26401234 MyJurnal DOI: 10.5704/MOJ.1411.008

The diaphyseal tibia fracture is best treated with intramedullary nail but in some cases where the nail is not applicable, plate fixation will be the next option of fixation. The extensile anterior approach is normally used for conventional compression plate fixation in tibia shaft fractures. The extensive surgical dissection may devitalizes the bony fragments and interfere with the fracture union as well as soft tissue healing. Minimally Invasive Plate Osteosynthesis (MIPO) provides good preservation of blood supply and fracture hematoma at the fracture site thus promotes biological bone healing. The use of indirect reduction techniques and small skin incisions to introduce the plate is technically demanding and requires fluoroscopy exposures throughout the surgery, being some of its drawbacks. We recommend MIPO for conventional compression plate fixation in tibial shaft fractures in view of the reduced surgical trauma to the surrounding soft tissue and good functional outcome.

Matched MeSH terms: Tibia; Tibial Fractures
Fulltext Effects of honey supplementation combined with different jumping exercise intensities on bone mass, serum bone metabolism markers and gonadotropins in female rats

Mosavat M, Ooi FK, Mohamed M

BMC Complement Altern Med, 2014;14:126.
PMID: 24708608 DOI: 10.1186/1472-6882-14-126

The effects of high and low jumping exercise intensities combined with honey on bone and gonadotrophins were investigated in eighty four 9 week-old female rats.

Matched MeSH terms: Tibia/growth & development*; Tibia/metabolism; Tibia/chemistry
Fulltext Vitamin E improved bone strength and bone minerals in male rats given alcohol

Zakaria S, Mat-Husain SZ, Ying-Hwey K, Xin-Kai K, Mohd-Badawi A, Abd-Ghani NA, et al.

Iran J Basic Med Sci, 2017 Dec;20(12):1360-1367.
PMID: 29238472 DOI: 10.22038/IJBMS.2017.9610

Objectives: Alcohol consumption induces oxidative stress on bone, which in turn increases the risk of osteoporosis. This study determined the effects of vitamin E on bone strength and bone mineral content in alcohol-induced osteoporotic rats.
Materials and Methods: Three months old Sprague Dawley male rats were randomly divided into 5 groups: (I) control group; (II) alcohol (3g/kg) + normal saline; (III) alcohol (3g/kg) + olive oil; (IV) alcohol (3g/kg) + alpha-tocopherol (60mg/kg) and (V) alcohol (3g/kg) + palm vitamin E (60mg/kg). The treatment lasted for three months. Following sacrifice, the right tibia was subjected to bone biomechanical test while the lumbar (fourth and fifth lumbar) and left tibia bones were harvested for bone mineral measurement.
Results: Alcohol caused reduction in bone biomechanical parameters (maximum force, ultimate stress, yield stress and Young's modulus) and bone minerals (bone calcium and magnesium) compared to control group (P<0.05). Palm vitamin E was able to improve bone biomechanical parameters by increasing the maximum force, ultimate stress and Young's modulus (P<0.05) while alpha-tocopherol was not able to. Both alpha-tocopherol and palm vitamin E were able to significantly increase tibia calcium and magnesium content while only alpha-tocopherol caused significant increase in lumbar calcium content (P<0.05).
Conclusion: Both palm vitamin E and alpha-tocopherol improved bone mineral content which was reduced by alcohol. However, only palm vitamin E was able to improve bone strength in alcohol treated rats.

Matched MeSH terms: Tibia
Fulltext V-Shaped Bending Support helps in 3-Point Bending Test experiment for small mice bone

Noor Shafini Mohamad, Mohd Hafizi Mahmud

Jurnal Inovasi Malaysia, 2020;4(1):1-14.
MyJurnal

Three-point bending test is one of the main methods used in long bones to characterise bone material and determine the biomechanical properties. We have examined the mechanical competencies of the mouse bones at four-week-old by using a three-point bending jig so that the potential genotype-related deficiencies in mechanical properties of bones explored. The available bending jig was not suitable for small animal model and may cause slippage when applying the load. The tibial gross length measurements of the four-week-old mouse measured using the proximal anatomical point of the centre of the condyles to the distal anatomical significance of the medial malleolus (~16 mm). The mid tibia diameter measurement is taken at the middle tibia (~1 mm) and metaphyseal diameter (~3 mm). The bending jig was custom-made, where both ends support were cut in a v-shape to provide stability. The tibias were mechanically tested with the v-shape support under three-point bending using a Bose ElectroForce® 3200 until failure. The test revealed a significant result of flexural strength, work-to-fracture and strain to failure obtained from the load-displacement curves. The finding may be useful in the studies of quantitative assessments of the strength and toughness of small animal bones.

Matched MeSH terms: Tibia
Fulltext Chronic Osteomyelitis Revisited: A Case Report

Chuah SK, Bajuri MY, Mohd Nor F

Cureus, 2019 Jun 28;11(6):e5023.
PMID: 31501722 DOI: 10.7759/cureus.5023

Chronic osteomyelitis treatment is always a challenge to orthopaedic surgeons which requires great dedication and perseverance. We report a successful limb salvage case of a 46-year-old man who suffered from a left tibia chronic osteomyelitis with soft tissue defect. The treatment approach was a thorough wound debridement of devitalized tissues and necrotized bone, commencement of culture-directed antibiotics, reconstruction with vascularized osteomyocutaneous fibula flap, and skeletal stabilization with internal fixation. As compared to below knee amputation, the result we obtained in this case is more promising with regard to mobility and function.

Matched MeSH terms: Tibia
Fulltext Surgical Management of Distal Tibia Fracture: Towards An Outcome-based Treatment Algorithm

Rushdi I, Che-Ahmad A, Abdul-Ghani K, Mohd-Rus R

Malays Orthop J, 2020 Nov;14(3):57-65.
PMID: 33403063 DOI: 10.5704/MOJ.2011.010

Introduction: Distal tibia fractures are frequently associated with an extensive soft tissue injury which then leads to a higher risk of complications such as infection, non-union and eventually poor overall outcome. The purpose of this study is to measure the outcome of distal tibia fractures treated with internal fixation, external fixator or Ilizarov external fixator(IEF). We aim to propose an algorithm for management of distal tibia fractures by evaluating the treatment options, outcomes and risk factors present.
Material and Methods: This study is a cross-sectional study of all distal tibia fractures treated surgically in Tengku Ampuan Rahimah Hospital, Klang from 1st January 2016 till 30th June 2018. Patient records were reviewed to analyse the outcomes of surgical treatment and risk factors associated with it.
Results: Ninety-one patients were included with a mean age of 41.5 years (SD = 16.4). Thirty-nine cases (42.9%) were open fractures. Thirty-eight patients (41.8%) were treated with internal fixation, 27 patients (29.7%) were treated with IEF and 26 patients (28.6%) were treated with an external fixator. Among open fractures cases, no significant finding can be concluded when comparing each surgical option and its outcome, although one option was seen better than the other in a particular outcome. Initial skeletal traction or temporary spanning external fixator in close fractures reduced the risk of mal-alignment (p value=0.001). Internal fixation is seen superior to IEF and external fixator in close fractures in term of articular surface reduction (p value = 0.043) and risk of mal-alignment (p value = 0.007).
Conclusion: There is no single method of fixation that is ideal for all pilon fractures and suitable for all patients. This proposed algorithm can help surgeons in deciding treatment strategies in the challenging management of distal tibia fractures to reduce associated complications.

Matched MeSH terms: Tibia; Tibial Fractures
Non-uniform decay in jumping exercise-induced bone gains following 12 and 24 weeks of cessation of exercise in rats

Ooi FK, Singh R, Singh HJ, Umemura Y, Nagasawa S

J Physiol Sci, 2011 Nov;61(6):487-95.
PMID: 21870136 DOI: 10.1007/s12576-011-0169-4

The effects of deconditioning on exercise-induced bone gains in rats were investigated in 12-week-old female WKY rats performing a standard jumping exercise regimen for either 8, 12 or 24 weeks, followed by sedentary periods of either 24, 12 or 0 weeks, respectively. Age-matched controls received no exercise over the same period. At the end of the training/sedentary period, the tibiae were harvested for analyses of bone parameters. Gains in tibial fat-free dry weight decayed within 12 weeks of deconditioning, but gains in tibial ultimate bending force (strength), maximum diameter and cortical area were still present at 12 weeks of deconditioning. With the exception of cortical area, all other exercise-induced bone gains decayed by the 24th week of deconditioning. It appears that the decay in exercise-induced bone gains in strength, physical and morphological properties is not uniform, and that gains in fat-free dry weight seem to decay earlier.

Matched MeSH terms: Tibia/metabolism; Tibia/physiology*
Fulltext 15 years review of Gastrocnemius flap done in department of orthopaedics, Hospital Tengku Ampua Afzan, Kuantan

Nazri Mohd Yusof

International Medical Journal Malaysia, 2017;16(11):10-10.
MyJurnal

Gastrocnemius flap is the workhorse for wound coverage in the proximal
tibia. It can be perform by general orthopaedic surgeon because it is done without the
need of microscopic instrumentation. Its coverage can be extended to cover the knee
and midshaft of tibia when skin overlying it is included in the flap. (Copied from article).

Matched MeSH terms: Tibia
Fulltext Stage protocol in the management of infection following plating of the Tibia

Nazri, M.Y.

International Medical Journal Malaysia, 2012;11(1):41-46.
MyJurnal

Introduction: Anterior border of the tibia is covered only by a thin layer of protective tissue. Plating of the tibia often results in wound complication and infection if the injury to this area is not recognized. We review our results of managing infection following plating of the tibia using a protocol base on the status of bone healing and the presence of bone or soft-tissue defect. Methods: Eight cases of infection following plating of the tibia were managed according to stage procedures protocols and classification, which is based on the state of bony union and the defect following wound debridement. The soft-tissue defects were managed with local flaps, and the bone defects were managed with Illizarov bone transport. Results: Three patients had more than one bacterium isolated. Gram negative organisms were isolated from seven patients. Methicillineresistant Staphylococcus aureus was isolated in two patients. All patients achieved union with a mean union
time of seven months. The infections were controlled in seven patients. One patient had minimal sinus discharge but refused further treatment. Conclusions: The stage protocol for the management of infection following plating of the tibia is practical and produces excellent results.

Matched MeSH terms: Tibia
Fulltext Stature approximation of Malays, Chinese and Indian in Malaysia using radiographs of femur, tibia and fibula

Amal Hayati Zainal Abidin, Khairul Osman, Sri Pawita Albakri Amir Hamzah, Noor Hazfalinda Hamzah, Ab Halim Mansar, Normaizatul Afizah Ismail

Jurnal Sains Kesihatan Malaysia, 2011;9(1):45-50.
MyJurnal

The study was conducted to create specific formulae for stature estimation of adult male population in Malaysia based on measurements of femur, tibia and fibula lengths using radiographic method. A number of thirty two Malaysians from hospitals involved as subjects in this study. The subjects were Malays (14), Chinese (8) and Indians (10) from 25-45 years old. The standing height of the subject was recorded before femur, tibia and fibula were scanned with an x-ray
machine. The bones length was measured on the x-ray film in centimetres (cm) and analysed using Statistical Package for Social Sciences (SPSS) version 19.0 for Windows. The results showed a significant relationship (p < 0.05) between stature and measurements of length of femur, tibia and fibula. Stature of Malays and Indians were significant (p < 0.05) with measurements of length of femur, tibia and fibula but insignificant in Chinese. Simple Linear Regression Analysis was used to derive regression equation for single bone and Multiple Linear Regression Analysis was used to derive regression equation for combination of femur, tibia and fibula. Six formulae for stature estimation of adult male population in Malaysia were derived. The formulae consist of three formulae for single bone, a formulae for combination bones with unknown race, a formulae for combination bones of Malays population and a formulae for combination bones of Indians population. Formulae for combination bones had the highest correlation coefficient compared to the formula using a single bone. Standard error was found to be high in all the formulae due to small sample size. Extension for this study is essential to provide Malaysia with accurate formulae.

Matched MeSH terms: Tibia
Fulltext The morphology of proximal tibia geometry amongst the Igbos of South East Nigeria and its implication in total knee replacement

Katchy AU, Agu AU, Ikele IT, Esom E, Nto NJ

Niger J Clin Pract, 2019 Oct;22(10):1423-1429.
PMID: 31607734 DOI: 10.4103/njcp.njcp_93_19

Background: The morphological parameters of the proximal tibia play a major role in total knee replacement and there are ethnic and gender variations to these parameters.
Aim: To evaluate parameters of the proximal tibia geometry amongst the Igbos of South Eastern Nigeria and discuss the clinical implications in total knee replacement.
Methods: The proximal tibia parameters of 558 adult tibiae bones, 300 right-sided and 258 left-sided, collected from the osteological unit of the department of anatomy University of Nigeria Enugu campus were measured using a Venier calipers.
Results: The values of the determined parameters are as follows: anterior posterior dimension (APD): 5.50 cm, medial lateral dimension (MLD):7.53 ± 5.56 cm, proximal length (PL): 7.32 ± 0.67 cm, proximal width (PW) CM: 4.10 ± 0.30 cm, medial tibia posterior slope (MTPS):11.36 ± 4.15° and lateral tibia posterior slope (LTPS):5.65 ± 2.72°. The correlation test between these parameters of the proximal tibia shows a strong significant correlation between LPTS and MPTS (r =0.814, P < .001). The comparison of the means of the MPTS of both sides using independent samples t test shows a mean difference that is not significant (p =0.628). A comparison of the values with other populations shows significant mean difference for MLD with that of Chinese and American populations (p < .05). The mean difference between the APD of this study and the Chinese is significant (p =0.007). A comparison of MPTS and LPTS for Malaysian, Chinese, and white Americans shows a significance difference for all the three populations (p tibia surface coverage in total knee replacement amongst the Igbo population.

Matched MeSH terms: Tibia/anatomy & histology*; Tibia/surgery
Fulltext Repeat rate analysis of lower limb radiograph for digital radiography in general radiography at Pantai Klang hospital Selangor

Nur Aishah Jusnaidi, Nurul Fadhlina Ismail

Malaysian Journal of Applied Sciences, 2020;5(2):112-116.
MyJurnal

Assessing the repeat rate is crucial to reduce unnecessary dose to the patient by identifying the major cause for repeating the x-rays exposure to the patient and apply corrective measures. To analyse the repeat rate of routine lower limb projections in direct digital radiography (DR) from general radiology department of Pantai Klang Hospital. 26 months retrospective repeated radiograph was acquired from Picture Archiving and Communication System (PACS) at Hospital Pantai Klang. The retrieved radiographs were grouped based on the reason for the i radiographs being rejected which are incorrect positioning, incorrect collimation, patient movement, incorrect exposure factors, artefact, and other reasons. Total repeated radiographs retrieved for basic lower limbs projections were 13616. Knee was the highest repeted examination and the lowest repeat rate was tibia fibula. (repeat rate: knee = 1.04%, tibia fibula = 0.57%). incorrect positioning is the major causes for repeat exposure for all examinations type, followed by incorrect collimation, other categories, centring ray error, incorrect exposure factors and artifact.

Matched MeSH terms: Tibia
Fulltext Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report

Malhotra R, Chua WL, O'Neill G

Malays Orthop J, 2016 Nov;10(3):49-51.
PMID: 28553450 DOI: 10.5704/MOJ.1611.014

We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

Matched MeSH terms: Tibia

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