PURPOSE: To present tibial axis-talar ratio and tibia-ankle surface angle in lateral measured on standing ankle lateral radiographs of adults who did not have specific ankle pathology. MATERIALS AND METHODS: On Fifty-six radiographs without ankle osteoarthritis and malalignment, radiographic measures were performed with use of a custom dizitizing program based on PV-WAVE(R). AP ankle alignment was quantified by tibia axis-talar ratio (TTR) and tibia ankle surface angle in lateral (TLS angle). The data was compared with previously reported american data and analyzed using a t-test. RESULTS: The average TTR and TLS angle of our series were 33.9+/-3.3%, and no significant difference compared with reported american adults (p=0.152). CONCLUSION: The T-T ratio and TLS angle measured on standing ankle lateral radiographs of our series were 33.9+/-3.3% and 80.4+/-3.3 degrees. This measures appear to be a useful measure for determining AP ankle alignment.
Adult ; Ankle* ; Humans ; Osteoarthritis ; Pathology ; Tibia

Background: Bone marrow stem cells with their plasticity can be used to replace and repair the other damaged organs and tissues, so they can also be used to obtain bone healing of nonunions. Objective: to evaluate the results of percutaneous autologous bone marrow grafting to treat the tibia diaphyseal nonunions. Subjects and methods: 12 patients with noninfected nonunion of the tibia were diagnosed and treated in Viet Duc Hospital. About 250mL of marrow was aspirated, then separated and concentrated by density gradient centrifugation. The final mononuclear cell mass containing stem cells and progenitors was washed in 30ml of 0.9% NaCL and then injected into the damaged sites. Patients were evaluated by clinical and X-rays examinations with at least 6 months follow-up. Results: None of the patients had post - op complications. Bone union was obtained in eleven of the twelve patients (91,7%) at an average of 15,3 weeks (range, 9 - 30 weeks), the bone marrow grafts used for these patients who had bone union contained a mean of 5,65 \xb1 3,74 x 106 (0,95 - 11,73 x 106) CD34(+) stem cells in total. Conclusions: Percutaneous autologous bone - marrow grafting is a minimally invasive alternative and a simple, effective, safe method for the treatment of the tibia diaphyseal nonunions with the comparative bone healing rate. \r\n', u'\r\n', u'
Tibia/ pathology ; Bone Marrow/ anatomy & ; histology ; surgery

BACKGROUND: The aim of the present study was to prepare hydroxyapatite (HA) and then characterize its effect on bone integration in a rabbit tibial defect model. The bone formation with different designs of HA was compared and the bony integration of several graft materials was investigated qualitatively by radiologic and histologic study. METHODS: Ten rabbits were included in this study; two holes were drilled bilaterally across the near cortex and the four holes in each rabbit were divided into four treatment groups (HAP, hydroxyapatite powder; HAC, hydroxyapatite cylinder; HA/TCP, hydroxyapatite/tri-calcium phosphate cylinder, and titanium cylinder). The volume of bone ingrowth and the change of bone mineral density were statistically calculated by computed tomography five times for each treatment group at 0, 2, 4, 6, and 8 weeks after grafting. Histologic analysis was performed at 8 weeks after grafting. RESULTS: The HAP group showed the most pronounced effect on the bone ingrowth surface area, which seen at 4, 6, and 8 weeks after graft (p < 0.05). On comparing the change of bone mineral density the bone ingrowth surface area among the 4 groups, there were no statistically significant differences among the groups found for any period (p > 0.05). On histological examination, the HAP group revealed well-recovered cortical bone, but the bone was irregularly thickened and haphazardly admixed with powder. The HAC group showed similar histological features to those of the HA/TCP group; the cortical surface of the newly developed bone was smooth and the bone matrix on the surface of the cylinder was regularly arranged. CONCLUSIONS: We concluded that both the hydroxyapatite powder and cylinder models investigated in our study may be suitable as a bone substitute in the rabbit tibial defect model, but their characteristic properties are quite different. In contrast to hydroxyapatite powder, which showed better results for the bone ingrowth surface, the hydroxyapatite cylinder showed better results for the sustained morphology.
Animals ; *Bone Substitutes ; *Durapatite ; *Osseointegration ; Rabbits ; Tibia/pathology/radiography/*surgery

Adult ; Diagnosis, Differential ; Female ; Humans ; Skin ; pathology ; Skin Neoplasms ; pathology ; Skin Ulcer ; pathology ; Tibia

We present a case of medullary sclerosis of the appendicular skeleton in a patient with chronic renal insufficiency for whom MR imaging findings were char-acteristic. T1- and T2-weighted MR images showed multiple vertical lines (medullary streaks) of low signal intensity in the metaphyses and diaphyses of the distal femur and proximal tibia.
Adult ; Case Report ; Femur/pathology ; Human ; Kidney Failure, Chronic/complications ; *Magnetic Resonance Imaging ; Male ; Osteosclerosis/*pathology ; Tibia/pathology

Telangiectatic osteosarcoma is a rare and special variant of osteogenic sarcoma with distinct radiologic, gross and microscopic features. This tumor is predominantly lytic, destructive tumor without sclerosis on roentgenogram, and is soft and cystic on gross examination. Histologically aneurysmally dilated spaces lined or traversed by stromal cells producing osteoid are noted. This report concerns a case of telangiectatic osteosarcoma occurring in a 7 years old boy. He presented with pathologic fracture of the right distal tibia, followed by a purely lytic lesion on X-ray examination. This lesion recurred five times during a span of one year. Microscopic features of the biopsy specimen was difficult to differentiate from aneurysmal bone cyst because of prominant blood-filled cyst formation. It was finally identified as osteosarcoma from the below-knee amputation specimen through the close examination for anaplastic osteoid-producing stromal cells in the septa that separate the blood cysts.
Aneurysm/complications/diagnosis ; Child ; Diagnosis, Differential ; Humans ; Male ; Neoplasm Recurrence, Local ; Osteosarcoma/complications/*pathology ; Tibia

Brodie's abscess is a form of subacute osteomyelitis, which typically involves the metaphyses of the long tubular bones, particularly in the tibia. The diagnosis is usually made incidentally, as there are no accompanying symptoms or laboratory studies. Bilateral involvement at the proximal tibia is unusual. However, orthopaedic surgeons should be aware of this entity, as it may present without symptoms. Checking the contralateral limb for concomitant Brodie's abscess is recommended.
Abscess ; diagnosis ; Adult ; Female ; Humans ; Osteomyelitis ; complications ; diagnosis ; Radiography ; Tibia ; diagnostic imaging ; pathology

OBJECTIVETo compare the differences in damage degree, healing time and healing process between two animal models of defection fracture and provide the research data for the establishment of a new animal model.

METHODSSixty male SPF Spragur-Dawley rats were divided randomly into control group, sawing group and drilling hole group, with 20 rats in each group. Animals of drilling hole group were treated with hone drill and made an 1 mm hole on tibial plateau animals of sawing group were treated with saw and made an 3 mm defection on tibial plateau; nothing to do in animals of control group. The rats were respectively killed at 2nd, 4th weeks after operation, bone density, bone ash quantity, contents of bone Ca, P were detected.

RESULTSAt the 2nd week after operation, bone density, bone ash quantity, contents of bone Ca, P in drilling hole group and sawing group were significantly lower than that of the control group (P < 0.05 or P < 0.01). Two animal models of drilling hole group and sawing group were similar in X-ray films and pathology investigations. At the 4th week after operation, there were no significant defference in bone density and bone ash quantity among three groups (P > 0.05). Rats of sawing group showed more poroma and inflammatory infiltration in histological examination.

CONCLUSIONDrilling hole method and sawing method could be used to make animal model of defection fracture, two methods showed similar damage degree, healing time and healing process, hut drilling hole method have advantages of simple operation, easily control damage degree and less inflammatory infiltration and bone disunion.

Animals ; Bone Density ; Disease Models, Animal ; Male ; Rats ; Rats, Sprague-Dawley ; Tibia ; pathology ; Tibial Fractures ; etiology

OBJECTIVETo explore a new method for finite element modeling to achieve material property assignment based on in situ CT gray value in simulated osteotomies for deformities.

METHODSA CT scan dataset of the lower limb of a patient with extorsion deformity was obtained for three-dimensional reconstruction using Mimics software and preparing a solid model. In the CAD software, the parameters for osteotomy simulation were defined including the navigation axis, rotation angle and reference plane. The tibia model was imported to the FEA pre-processing software for meshing procedure and then exported to Mimics. All the segments of the tibia meshed model were assigned uneven material properties based on the relationship between CT gray values and material properties in the Mimics software. Finally, all the segments of the tibia model, reference axis and reference plane were assembled in the pre-processing software to form a full finite element model of a corrected tibia, which was submitted to resolver for biomechanical analysis.

RESULTSThe tibia model established using our modeling method had inhomogeneous material properties based on CT gray values, and was available for finite element analysis for the simulation of osteotomy.

CONCLUSIONSThe proposed finite element modeling method, which retains the accuracy of the material property assignment based on CT gray value, can solve the reposition problem commonly seen in modeling via the routine method of property assignment and provides an efficient, flexible and accurate computational biomechanical analysis method for orthopedic surgery.

Finite Element Analysis ; Humans ; Models, Anatomic ; Osteotomy ; Software ; Tibia ; pathology ; Tomography, X-Ray Computed

PURPOSE: To establish the basis for a non-invasive and non-destructive assessment of the mechanical properties during natural fracture healing by analyzing the vibrational property of the fracture healing and comparing the vibrational property, the bone healing status (as determined by X-ray) and the mechanical strength parameters. MATERIALS AND METHODS: The tibial shafts of rabbits were broken under general anesthesia. The rabbits were sacrificed at 2, 4, 6 weeks after the fracture, then X-rays of the fractured tibias were sequentially taken to detect the fracture healing. The vibration mode and the biomechanical strength were measured. RESULTS: According to the results of a multiple regression analysis, the standardized coefficients of callus, apposition, lateral angulation, DAMP1, FREQ1 in the fractured tibias, were -0.80, -0.23, -0.21, -0.25, -0.25. In normal contralateral tibias, the standardized coefficients of the area, FREQ1, DAMP1, FREQ2, DAMP3 were -0.73, 0.28, 0.41, 0.39, -0.25. CONCLUSION: A monitoring of the fracture healing process that utilizes the frequency response function is thought to be useful in detecting the early phase of healing within 4 weeks. Additional studies on the vibrational characteristics of the healing bones after a clinical union or after simillar pathologies should be pursued so that future diagnostic applications ca be made.
Anesthesia, General ; Bony Callus ; Fracture Healing ; Fractures, Bone* ; Pathology ; Rabbits ; Tibia ; Vibration