Distal Tibial Periarticular Nonunions

Tibial Fractures 03 medical and health sciences 0302 clinical medicine External Fixators Intra-Articular Fractures Fracture Fixation Fractures, Ununited Osteogenesis, Distraction Humans Female Middle Aged Limb Salvage 3. Good health
DOI: 10.1097/bot.0000000000000011 Publication Date: 2013-09-27T22:50:13Z
ABSTRACT
A nonunion of the distal tibial metaphysis in close proximity to the articular surface is a challenging clinical problem. Many of the commonly used techniques in a surgeon's treatment armamentarium can be ineffective because of the relative lack of distal bone stock. This study describes a technique of en bloc excision of all infected or nonunited distal tibial bone with an application of a circular external fixator and limb shortening. After treatment with parental antibiotics, when appropriate, and docking of the distal excision site, distraction osteogenesis of the proximal tibia is performed with a second circular frame.
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