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 Отправлено William J. Smith 08 Февраль 2005, 17:55
Dear List,I wish to solicit advice from the list to manage a patient with a shortened tibia.
She complains of vague knee and back pain, which worsen with activity or prolonged standing. She is now 55, recently retired, but otherwise healthy and desires to hike, ski and exercise. She was injured 20 years earlier after being struck by a car. Other injuries included a ruptured spleen, and an early post-injury pulmonary embolism. Her tib-fib fx was treated in a cast. Her tibial shortening measures 2.5 cm on scanogram. Attached are today's films.
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Re: tibial malunion
Alexander Chelnokov 08 Февраль 2005, 21:19
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I would perform perQ corticotomy/osteotomy of the both bones, gradual lengthening by ex-fix then conversion to a locked nail. I would perform transverse corticotomy below the union rather than longitudinal splitting of the fragments.
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Re: tibial malunion
V. M. Iyer 08 Февраль 2005, 23:36
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Dr Smith.
The shortening is 2.5 cm. Shoe raise of 2cm half inside and half outside.
Will she not be happy with that? She can trek, ski and exercise with that.
If she has not been wearing compensation all these years that may be the reason for her present complaints.
If she insists on limb length equalisation, lengthening of a short leg will be ? ? at this age. The opposite may be possible. I will refer her to my rival orthopaedic surgeon for any surgery Regards
V M Iyer
. Iyer Orthopaedic Centre,
103,Railway lines Solapur India.
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Re: tibial malunion
Dr. Castro 09 Февраль 2005, 01:04
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By my opinion, 20 years old malunoin, with 2.5 cm. Shortening, in 55 years old person, are not a ⌠classic■ indications for limb lengthening!
Dr. Castro
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tibial malunion
