Valgus Deformity After Fibular Resection in Children

González-Herranz, P.; Río, Angel del; Burgos, Jesús; López-Mondejar, J A; Rapariz, J. M.

doi:10.1097/01241398-200301000-00011

Cited by 48 publications

(47 citation statements)

References 16 publications

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“…In the only study analyzing the morphologic adaptation of the donor-side tibia in humans [14], thickening on the lateral aspect was observed. This is consistent with our results because the newly formed bone in the interosseous space would appear predominantly on the lateral aspect of the tibia when imaged with planar radiography.…”

Section: Discussionmentioning

confidence: 99%

“…Questionnaire results [1,3,30,36], disability scales [1,10,25], or gait analyses [3,25] have been reported in some studies, and disabilities such as pain, ankle instability, and inability to run have been described [1,3,10,18,25,30,32,36]. Other studies have attempted quantitative analyses of long-term side effects based on radiographs [2,10,14,28,30]. Most of these studies, however, focused on ankle deformities [2,10,28,30], and only one described thickening of the tibial lateral cortex [14].…”

Section: Introductionmentioning

confidence: 99%

“…Other studies have attempted quantitative analyses of long-term side effects based on radiographs [2,10,14,28,30]. Most of these studies, however, focused on ankle deformities [2,10,28,30], and only one described thickening of the tibial lateral cortex [14]. In contrast, experimental studies performed on animals have reported quantitative analyses of radius adaptation after ulna resection for pigs [15] and sheep [23,26].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Taddei

Balestri

Rimondi

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Absence of the fibula after harvesting to reconstruct an upper-limb segment increases loads on the donor-side tibia and thereby provides a unique opportunity to analyze the bone adaptation process in humans. We therefore quantified densitometric and morphologic changes of the donor-side tibia in three young patients (ages 8, 13, 16 years), on the basis of computed tomography (CT) examinations of both legs (one preoperatively and two postoperatively). The range of final followup was 27-43 months. Three-dimensional models of shank bones were generated from CT data and used to measure crosssectional area, diaphyseal cortical thickness, and crosssectional moment of inertia. In addition, density of the newly formed bone was evaluated. The donor-side tibia showed morphologic and density adaptation with time.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Taddei

Balestri

Rimondi

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…With disruption of the nutrient artery through removal of a fibular segment, the main source of blood supply to the periosteum is disrupted, and ischemia of the periosteum can lead to failure of regeneration of the fibular defect [15] . The possibility of fibular pseudoarthrosis must always be kept in mind and reconstructive methods must be used to prevent valgus deformity [16] . There are conflicting data in literature regarding the prevention of ankle valgus using a syndesmotic screw.…”

Section: Discussionmentioning

confidence: 99%

Chronic haematogenous osteomyelitis of fibula diaphysis with pathological fracture and review of literature

Patil¹,

Patel²,

Baviskar³

et al. 2017

Int. J. Orthop. Sci.

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Introduction: Management of fibular osteomyelitis presents various challenges with respect to stability of ankle mortise, poor quality of periosteum and fibular pseudoarthrosis. Case History: We present a case of a 6 year male child with chronic osteomyelitis of fibula and pathological fracture, who was operated with resection of fibula with proximal and distal tibio-fibular syndesmotic fixation. Patient was followed up for One year and was noted to have fibular pseudoarthrosis and 5 valgus deformity of ankle. Discussion: Progressive valgus deformity at the ankle is a known complication that can occur many years after index fibular resection. We noticed a ankle valgus deformity at 3 month post-op which was non-progressive till 1 year follow-up. The valgus was traced retrospectively to be due to syndesmotic fixation of the fibular remnant after fibular resection, thereby adding a valgus force to ankle mortice. This could have been avoided by inserting the syndesmotic screw before fibular resection. This cause should also be kept in mind while evaluating such patients. These patients should also be followed up to detect fibular pseudoarthrosis and progressive valgus ankle deformity.

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“…Among the early complications is devascularisation of the donor leg due to a peronea magna artery [13,18]. Of the late complications, valgus ankle deformity is the most common in the growing child, and some authors advise distal tibiofibular joint arthrodesis or reconstruction of fibula using a tibial autograft as surgical prevention procedures [1,8,11,15].…”

Section: Introductionmentioning

confidence: 99%

Vascularised fibular graft for the treatment of congenital pseudarthrosis of the tibia: long-term complications in the donor leg

Iamaguchi

Fucs

Costa

et al. 2010

International Orthopaedics (SICOT)

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Treatment of congenital pseudarthrosis of the tibia is still controversial, and vascularised fibula graft is a reliable method for consolidation, although complications can occur in the donor leg after fibula grafting. This study evaluates 16 patients with congenital pseudarthrosis of the tibia (CPT) treated with contralateral fibular graft, with regard to complications in the donor leg, and assesses the influence of distal tibiofibular joint arthrodesis in these complications. All patients with CPT were consecutively submitted to surgical treatment with contralateral fibular graft. The mean follow-up was 94 months, varying from 44 to 162 months. The long-term effects in the donor leg were determined, and 12 cases with distal tibiofibular arthrodesis (group 1) were compared with a group without arthrodesis (group 2). Half of the patients had proximal migration of the lateral malleolus. Eight patients had ankle valgus. Group 1 had an average valgus tilt angle of 5.8°, while group 2 had an average angle of 1.5°. There was no significant difference between the patients with or without distal tibiofibular joint arthrodesis. The patients with a distal fibula remnant smaller than 5 cm had greater valgus tilt angle measurements. Distal tibiofibular arthrodesis was not effective in preventing all the complications in the donor leg; however, it can lessen the severity of the complications. Our results show that a distal fibular remnant greater than 5 cm should be retained to prevent ankle valgus.

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Valgus Deformity After Fibular Resection in Children

Cited by 48 publications

References 16 publications

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Chronic haematogenous osteomyelitis of fibula diaphysis with pathological fracture and review of literature

Vascularised fibular graft for the treatment of congenital pseudarthrosis of the tibia: long-term complications in the donor leg

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