Management of tibia deformity with fixator assisted nailing technique
10.3760/cma.j.issn.0253-2352.2019.18.003
- VernacularTitle: 单边轨道式外固定支架辅助髓内钉治疗胫骨畸形
- Author:
Shengsong YANG
1
;
Lei HUANG
1
;
Wenzhi ZHAO
2
;
Xing TENG
1
;
Tao WANG
1
;
Wenjie TANG
1
;
Xinbao WU
1
Author Information
1. Orthopedic Trauma Department, Beijing Jishuitan Hospital, Beijing 100035, China
2. Orthopedic Trauma Department, 2nd Affiliated Hospital of Dalian Medical University, Dalian 116023, China
- Publication Type:Clinical Trail
- Keywords:
External fixators;
Internal fixators;
Tibial;
Genu varum;
Osteotomy
- From:
Chinese Journal of Orthopaedics
2019;39(18):1117-1124
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the result of treating tibia deformity with fixator assisted nailing technique (FAN).
Methods:A total of 5 patients with 7 limbs of tibial deformity-were treated with FAN technique. Etiology: 2 patients with bilateral tibial deformity suffered from Ricket's disease, 2 patients were malunion after tibial fracture, 1 patient was congenital pseudoarthrosis of tibia. This is a retrospective study. The unilateral external fixator was mounted on the medial side of tibia, and thenthe minimal invasive osteotomy was performed. After the deformity was corrected, the intramedullary nail was inserted to fix the tibia. None of the patients need bone autograft. The pre-operation and post-operation medial proximal tibia angle (MPTA), mechanical axis deviation (MAD) and range of motion (ROM) were measured and analyzed.
Results:All the 5 patients were followed-up for 12-60 months (average 32 months). The osteotomy site united in 3-5 months (average 4.5 months) post-operatively. According to Paley’s imaging scores, 4 patients were excellent and 1 patient was good. According to Paley's functional result scores, 5 patients were excellent; according to Paley’s bone results evaluation, 4 patients were excellent and 1 patient was good. We achieved desired post-operative MAD (from medial 15 mm-lateral 10 mm) in 6 limbs. The MPTA in 7 limbs was corrected to normal (84°-90°). The ROM was not significantly changed before and after operation. The average ROM of knee before operation was 125°(120°-135°), and average postoperative ROM was 120°(115°-130°), No deep infection or neurovascular injury occurred. All patients were satisfied with the method and results of the operation.
Conclusion:FAN technique combines the advantage of external fixation and intramedullary nail, and it is a good method to treat tibial deformity, the patient should be carefully evaluated and selected for applying this technique.
