Cases reported "Tibial Fractures"

Filter by keywords:



Filtering documents. Please wait...

1/26. Salvage of open tibial fracture with segmental loss of tibial nerve: case report and review of the literature.

    We report a case history, treatment, and follow-up of an open comminuted distal tibial fracture with significant soft tissue loss and segmental loss of the tibial nerve and posterior tibial artery. This constellation of injuries with an insensate plantar foot has often been an indication for amputation. In this instance, a functional distal extremity was salvaged with the use of Ilizarov fixation, delayed primary tibial nerve cable grafting, and staged soft tissue coverage. Clinical follow-up and review of the literature on the techniques used are offered for consideration.
- - - - - - - - - -
ranking = 1
keywords = nerve
(Clic here for more details about this article)

2/26. Successful free flap transfer following venous thrombectomy in recipient vessel.

    We report the case of a 53-year-old male patient who suffered a high velocity multiple trauma with bilateral open tibial fractures. At definitive orthopaedic and plastic surgical reconstruction 5 days post initial trauma, he was found peroperatively to have an existing deep venous thrombosis in his popliteal vein on one side. He underwent venous thrombectomy and had subsequent successful latissimus dorsi flap transfer using the unblocked popliteal vein as a recipient vessel.
- - - - - - - - - -
ranking = 0.058104385573451
keywords = block
(Clic here for more details about this article)

3/26. Tibial plateau fracture after arthroscopic anterior cruciate ligament reconstruction.

    Complications have been described with each technique for reconstruction of the anterior cruciate ligament (ACL) in the knee, both open and arthroscopically assisted. The authors describe a case of tibial plateau fracture occurring 7 months after an ACL reconstruction using the half tunnel technique. The fracture occurred at the tibial fixation site and required open reduction with internal fixation. To our knowledge, only 2 cases of proximal tibial fracture after patellar tendon autograft ACL reconstruction have been previously reported. The authors hypothesize that patellar tendon harvesting with bone blocks and transosseous tibial tunnel can produce a "stress riser" effect and somehow act synergistically to create decreased strength at the level of proximal tibial metaphysis.
- - - - - - - - - -
ranking = 0.058104385573451
keywords = block
(Clic here for more details about this article)

4/26. Displacement of the common peroneal nerve associated with upper tibial fracture: implications for fine wire fixation.

    The constant anatomic position of the common peroneal nerve is relied on when performing fine wire external fixation in the upper tibia. We report the case of a sixty-two-year-old woman with a Schatzker Type V fracture of her right tibial plateau and upper-third diaphyseal fracture associated with displacement and shortening of the upper tibia. She was treated by minimal internal fixation of the intraarticular fracture and application of a Sheffield Hybrid External Fixator. During percutaneous insertion of the reference wire in the fibular head, a distal muscle twitch alerted the surgeon, and the common peroneal nerve was duly explored and found displaced forward over the fibular head, dangerously close to the wire. It is postulated that at the time of injury, the common peroneal nerve was displaced anteriorly and that despite reduction of the tibial fractures, it had failed to return to its original position.The mechanism of this was confirmed by an anatomic study on an above-the-knee amputation specimen in which the metaphyseal-diaphyseal element of the fracture was reproduced. We recommend insertion of the reference fibular wire with the knee in flexion. Open insertion of this wire, with an incision down to bone and exposure of the fibular head, is recommended in cases in which severe trauma with shortening of the upper tibia, with possible disruption of the tibiofibular joint, puts the nerve in danger of injury.
- - - - - - - - - -
ranking = 1.3333333333333
keywords = nerve
(Clic here for more details about this article)

5/26. Fracture of the tibial tubercle following anterior cruciate ligament reconstruction.

    A case is presented of a traumatic avulsion fracture of part of the tibial tubercle after harvesting of the central third of the patellar tendon, with bone blocks, for anterior cruciate ligament (ACL) reconstruction. The literature is reviewed. This injury has not been reported previously.
- - - - - - - - - -
ranking = 0.058104385573451
keywords = block
(Clic here for more details about this article)

6/26. Osseous integration of hydroxyapatite grafts in metaphyseal bone defects of the proximal tibia (CT-study).

    PURPOSE OF THE STUDY: The purpose of the study was the examination of the osseous integration of hydroxyapatite grafts used for the filling of metaphyseal bone defects in tibia head fractures. MATERIAL: Four patients with lateral tibia plateau fractures AO-type B3 (12) were included in the study. patients were treated by arthroscopically assisted reduction and percutaneous screw fixation. The metaphyseal bone defects were filled with prepared solid hydroxyapatite graft blocks (Endobon Fa. Merk Darmstadt, germany). In all of the patients a CT study for the osseous integration of hydroxyapatite grafts used for the filling of metaphyseal bone defects in tibial head fractures was performed. Measurements of density were performed of the implant region, the periimplant region, the distant periimplant region and the fibula bone. Follow-up CT examinations of these specific regions were performed 6 and 12 months postoperative. RESULTS: In all cases an increase of density of the hydroxyapatite graft after 6 months and 12 months follow-up was detected. The periimplant region showed in all cases a decrease of density. A progressive decrease of the periimplant and the distant cancellous tibial bone region was also detectable after 6 and 12 months post-op. A similar decrease of density was visible in the region of the cancellous bone of the fibula. In the interface region a direct bone formation between the hydroxyapatite graft and the adjected cancellous bone was visible in all cases during follow-up. CONCLUSION: The increase of density of the hydroxyapatite grafts and the direct bone formation in the interface region between the hydroxyapatite graft and the adjacent cancellous bone are clear radiomorphological signs for an osteointegration of hydroxyapatite grafts in the metaphyseal region.
- - - - - - - - - -
ranking = 0.058104385573451
keywords = block
(Clic here for more details about this article)

7/26. Unimuscular neuromuscular insult of the leg in partial anterior compartment syndrome in a patient with combined fractures.

    A complicated case of ipsilateral fractures of the left femur and tibia after a road traffic accident is reported. The patient presented with numbness of the first web of his left foot and contracture of the extensor hallucis longus muscle, with fixed length deformity after intramedullary nailing of the femur and tibia. The extensor digitorum longus and tibialis anterior muscles were spared. Tinel's sign could be elicited at the mid-portion of the anterior compartment of the injured leg. This indicated that the distal half of the anterior tibial nerve (deep peroneal nerve), together with the extensor hallucis muscle of the anterior compartment of the leg, had been damaged. The subsequent management of this patient is described.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = nerve
(Clic here for more details about this article)

8/26. Single-stage achilles tendon reconstruction using a composite sensate free flap of dorsalis pedis and tendon strips of the extensor digitorum longus in a complex wound.

    The reconstruction of the posterior heel including a wide defect of the Achilles tendon is difficult as a result of complicated infection, deficient soft tissue for coverage, and functional aspects and defects of the tendon itself. As a single-stage procedure, various methods of tendon transfer and tendon graft have been reported along with details of local flaps or island flaps for coverage. With advances in microsurgical techniques and subsequent refinements, several free composite flaps, including tendon, fascia, or nerve, have been used to reconstruct large defects in this area without further damaging the traumatized leg. The authors report such a single-stage reconstruction of a composite achilles tendon defect using the extensor digitorum longus tendon of the second to fourth toe in combination with a dorsalis pedis flap innervated by the superficial peroneal nerve. The follow-up of this case has proved a satisfactory outcome to date.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = nerve
(Clic here for more details about this article)

9/26. Composite vascularised osteocutaneous fibula and sural nerve graft for severe open tibial fracture--functional outcome at one year: a case report.

    Management of severe open tibial fracture with neurovascular injury is difficult and controversial. Primary amputation is an acceptable option as salvaging the injured, insensate, and ischaemic limb may result in chronic osteomyelitis and non-functional limb. We report a case of open tibial fracture associated with segmental bone and soft tissue loss, posterior tibial nerve and artery injuries, which was further complicated by chronic osteo-myelitis treated with composite vascularised osteocutaneous fibula and sural nerve graft. Functional outcome of the injured limb at one-year follow-up was satisfactory: the patient was capable of achieving full weightbearing and was able to appreciate crude touch, pain, proprioception, and temperature at the plantar aspect of the foot. There was no pressure sore or ulceration.
- - - - - - - - - -
ranking = 1
keywords = nerve
(Clic here for more details about this article)

10/26. Ultrasound guidance for a lateral approach to the sciatic nerve in the popliteal fossa.

    Descriptions of the use of ultrasound for nerve location have focused on upper limb blocks. We present a case in which ultrasound imaging was used for a lateral approach to the sciatic nerve in the popliteal fossa. Ultrasound images taken proximal to the popliteal crease showed tibial and common peroneal nerves as round hyperechoic structures superficial and lateral to the tibial artery. Under direct ultrasound guidance, we placed a block needle close to the tibial nerve and confirmed its position with nerve stimulation. Injected local anaesthetic was seen on ultrasound as it spread around both tibial and common peroneal nerves.
- - - - - - - - - -
ranking = 1.7828754378136
keywords = nerve, block
(Clic here for more details about this article)
| Next ->


Leave a message about 'Tibial Fractures'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.