OBJECTIVE: To investigate the position change of the fibular bone after maxillary reconstruction by free fibular flap and to analyze the factors affecting the position change. METHODS: Patients who underwent maxillary reconstruction by free fibular flap in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from November 2012 to November 2016 were enrolled in this study. CT scans 1 week and 1 year postoperatively were collected and stored in DICOM format. The ProPlan CMF software was used to reconstruct the CT scans and separate the maxilla and each segment of the fibular flap. The Geomagic Control software was used to measure the long axis direction vector of each fibular segment. And the position change direction was recorded. The patients were divided into groups according to the use of the fibula or titanium plate to reconstruct the zygomaticmaxillary buttress. RESULTS: A total of 32 patients were enrolled. Among them, 21 were in the titanium plate group and 11 in the fibula bone group. The angle between the long axis of the fibular segment and the X axis in the X-Y plane was 95.65°±53.49° and 95.53°±52.77°, 1 week and 1 year postoperatively, and there was no statistical difference (P>0.05). The angle between the long axis of the fibular segment and the X axis in the X-Z plane was 96.88°±69.76° and 95.33°±67.42°, respectively, with statistical difference (P=0.0497). The angular changes of the long axis of the fibular segment in the titanium plate group and the fibular bone group were 3.23°±3.93° and 1.94°±1.78°, respectively, and the angular changes in the X-Z plane were 6.02°±9.89° and 3.27°±2.31°, respectively. There was no significant difference between the groups (P>0.05). The long axis changes of the fibular segment in the X-Y plane for reconstruction of the anterior alveolar, posterior alveolar, and buttress were 3.13°±3.78°, 2.56°±3.17°, and 5.51°±4.39°, respectively. There was a statistical difference (P = 0.023) between the posterior and buttress. In the X-Z plane, theses were 4.94°±4.75°, 5.26°±10.25°, 6.69°±6.52°, respectively. There was no statistical difference among the three groups (P>0.05). The main positional deviation directions of the titanium plate group and the fibular bone group were interior and superior sides, and there was no statistical difference between the two groups (P>0.05). CONCLUSION One year postoperatively, the position of the free fibular flap was changed compared with 1 week postoperatively. The position of the free fibular flap was mainly changed to the interior and superior sides.
Bone Transplantation ; Fibula/diagnostic imaging* ; Free Tissue Flaps ; Humans ; Mandibular Reconstruction ; Maxilla/surgery*

Hoffa's fracture is an uncommon fracture of the femoral condyle with coronal orientation of the fracture line. The mechanism of injury in pediatric Hoffa's fracture is road traffic accident, sports injury, and trivial injury. Clinical examination and proper imaging is important for diagnosis of pediatric Hoffa's fracture because of high chances of missing these injuries which can lead to nonunion and malunion at the fracture site. Open reduction and anatomical reduction of intraarticular fragment is the gold standard treatment of these fractures. We present a rare case of Hoffa's fracture in a 16-year-old girl with asso ciated ipsilateral fibular fracture.
Adolescent ; Female ; Femoral Fractures ; diagnostic imaging ; therapy ; Fibula ; injuries ; Humans ; Knee Joint ; diagnostic imaging

This report describes a rare case of parosteal ossifying lipoma of the fibula. Very few reports have described the magnetic resonance (MR) imaging features with gadolinium enhancement of this neoplasm. In this case, low-signal-intensity strands within the lipomatous mass on T1-weighted image with varying degrees of enhancement were detected. Thus, parosteal ossifying lipoma should be included within the group of gadolinium-enhanced benign lipomatous tumours that may mimic liposarcoma on MR imaging. However, the characteristic radiographic appearance, together with computed tomography or MR imaging features, should aid in the correct diagnosis of this condition.
Adult ; Bone Neoplasms ; diagnosis ; Diagnosis, Differential ; Female ; Fibula ; diagnostic imaging ; pathology ; Gadolinium ; Humans ; Lipoma ; diagnosis ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

Adult ; Female ; Fibula ; transplantation ; Free Tissue Flaps ; Humans ; Imaging, Three-Dimensional ; Maxilla ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tomography, X-Ray Computed

OBJECTIVETo explore the characteristics, diagnosis and treatment on traumatic dislocation.

METHODSFrom April 2000 to August 2010, 12 patients with acute traumatic dislocation of superior tibiofibular joint were treated including 10 males and 2 females with an average age of 30.6 years old ranging from 18 to 60 years. According to Ogden classification, 8 cases were the anterolateral dislocation, 2 were posterior-medial dislocation, and 2 were upward dislocation. All patients had swelling in lateral-inferior of knee, fibular head prominent, fibular head pain, floating feeling in head of fibula. One case was treated by conservative treatment, and the remaining 11 cases by surgical treatment.

RESULTSAll patients were followed-up for 10 months to 3 years (means 18 months). Evaluation by Lysholm scoring,the total scores were 95.08 +/- 2.02, involving limbing 4.92 +/- 0.28, support 4.92 +/- 0.28, interlocking 15.00 +/- 0.00, instability 24.58 +/- 0.79, pain 22.50 +/- 1.24, swell 8.50 +/- 0.90, climbing stairs 9.75 +/- 0.62, squatting 4.92 +/- 0.28; 11 cases achieved excellent results and 1 good. Nerve functional recovered. X-ray was no longer dislocation.

CONCLUSIONThe diagnosis of traumatic dislocation is easy misseddiagnosis, surgery is the main treatment method, the prognosis is good.

Adolescent ; Adult ; Arthrography ; Female ; Fibula ; Humans ; Joint Dislocations ; diagnostic imaging ; therapy ; Joints ; injuries ; Male ; Middle Aged ; Tibia ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

A 48-year-old man sustained a traffic accident injury to his left leg. It was an open fracture of the left tibia and fibula accompanied by a large soft tissue defect (27 cm multiply 7 cm). Doppler examination revealed the posterior tibial artery was occluded due to thrombosis. Three weeks after injury, the latissimus dors myocutaneous flap was elevated with a T-shaped vascular pedicle and was interposed between the two vascular ends of the posterior tibial vessel of the contralateral leg. Two end to end anastomoses were performed between the two vascular ends of the posterior tibial vessel of the contralateral leg and the latissimus dors myocutaneous flap's T-shaped vascular pedicle. The latissimus dorsi myocutaneous flap was used for repair of a large soft tissue defect of the left leg. The vascular pedicle was cut off after 28 days and the flap survived completely. After 3-years'follow-up postoperatively, a good contour was confirmed at the recipient area. The right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was demonstrated patent by clinical and Doppler examinations.
Accidents, Traffic ; Anastomosis, Surgical ; Fibula ; diagnostic imaging ; injuries ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Soft Tissue Injuries ; diagnostic imaging ; surgery ; Superficial Back Muscles ; transplantation ; Surgical Flaps ; Thrombosis ; diagnostic imaging ; Tibial Arteries ; diagnostic imaging ; Tibial Fractures ; diagnostic imaging ; surgery ; Ultrasonography, Doppler

OBJECTIVETo explore the methods and therapeutic effects of trans-fibular anterior-lateral approach combined with external fixation in the treatment of Gustilo III distal tibiofibula fractures.

METHODSFrom 2007 to 2010,9 patients including 7 males and 2 females with the mean age of 40 years(ranging from 29 to 51 years). All patients received internal fixation of fibula after debridement on the first phase, external fixator were used to fix tibia across ankle joint, and removed after successful skin graft; The second phase tibia was used to fix through the lateral incision used in phase I. Early functional exercise was encouraged ,the union condition and functional results of the ankle joint was evealuated. The criteria of the AOFAS Foot and Ankle Surgery was used to evaluate the effects.

RESULTSAll patients were followed up,and the duration ranged for 8 to 37 months(averaged 21 months). Nine patients were achieved bony union, the average healing time was 24 weeks. No plate rupture or screw loosening was found. According to the AOFAS Foot and Ankle Surgery evaluation system, 3 cases got excellent results, 4 good cases and 2 fair.

CONCLUSIONTrans-fibular anterior-lateral approach combined with external fixation for Gustilo III distal tibiofibula fractures can receive satisfactory reset, debond ankle joint eralier and imporove the clinical effects.

Adult ; Female ; Fibula ; Fracture Fixation ; methods ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Tibia ; Treatment Outcome

OBJECTIVE: To derive regression formulae for stature estimation using forensic radiography from the tibia and fibula of Chinese Han teenagers in Sichuan Province. METHODS: To construct equations, measurements were conducted on the training sample (412 adults, 201 males and 211 females). The whole length of the fibula and four measurements of tibia were determined using CR radiography, rectified through theoretical magnification. The regression formulae were relatively constructed to the real stature measured in an erect position. Through using the testing sample (40 adults) for the regression formulae, the reliability of the regression formulae was assessed. RESULTS: The range of correlation coefficients of four measurements for tibia was 0.880-0.895 in the sex-unknown group, 0.869-0.893 in the male, and 0.845-0.855 in the female. The five measurements were found to be better correlated with stature in the male than in the female. CONCLUSION The digital X-ray of the tibia and fibula for stature estimation is proved to be effective in forensic individual identification; therefore, these equations can be of great assistance to the stature estimation of the contemporary Chinese Han teenagers.
Adolescent ; Adult ; Anthropometry ; Asian People/ethnology* ; Body Height ; Bone and Bones/diagnostic imaging* ; China ; Female ; Fibula/diagnostic imaging* ; Forensic Anthropology ; Humans ; Male ; Regression Analysis ; Sex Characteristics ; Tibia/diagnostic imaging* ; Tomography, X-Ray Computed/methods* ; Young Adult

OBJECTIVETo investigate the clinical effects of manipulative reduction and percutaneous locking compression plate internal fixation for the treatment of mid-distal tibiofibula shaft fractures.

METHODSFrom January 2006 to October 2009,46 patients suffering from mid-distal tibiofibula shaft fractures were treated with closed manipulative reduction and LCP, involved 27 males and 19 females with an average age of 39 years old ranging from 17 to 56 years. According to AO classification, there were 12 cases of type A, 24 of type B, 10 of type C. The duration of visiting hospital were from 2 hours to 3 days after being injured for these patients. The injured limbs of the patients were swollen and painful,even with bony crepitus. The wound, function of the injured limb and union of fractures were observed after operation.

RESULTSAll the patients were followed up from 12 to 18 months (averaged 15 months). It was found that the wound of all patients had primary healing without any infection. The fracture healing time was 12 to 18 weeks (means 14 weeks). The results were excellent in 40 cases,good in 4 and fair in 2.

CONCLUSIONLess invasive, more stable fixation, shorter healing time and better functional rehabilitation are observed in the treatment of mid-distal tibiofibula shaft fractures after manipulative reduction and percutaneous locking compression plate internal fixation.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fibula ; diagnostic imaging ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; methods ; Tibia ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed ; Young Adult

Adult ; Female ; Femoral Fractures ; diagnostic imaging ; physiopathology ; surgery ; Fibula ; transplantation ; Humans ; Male ; Middle Aged ; Time Factors ; Tomography, X-Ray Computed ; Transplantation, Autologous