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Patterns of healing: a comparison of two proximal tibial osteotomy techniques.

Peek AC, Timms A, Chin KF, Calder P, Goodier D - Strategies Trauma Limb Reconstr (2016)

Bottom Line: The time to consolidation of the anterior, posterior, medial and lateral cortices was compared.This was not a significant difference.Both Gigli saw and De Bastiani corticotomy techniques result in good bone formation following distraction osteogenesis.

View Article: PubMed Central - PubMed

Affiliation: Royal National Orthopaedic Hospital, Stanmore, UK. anna.peek@rnoh.nhs.uk.

ABSTRACT
Several low-energy osteotomy techniques are described in the literature, but there is limited evidence comparing them. Our study evaluates the patterns of regenerate formation using two different osteotomy techniques. Two cohorts of patients underwent osteotomy of the tibia using a Gigli saw (n = 15) or De Bastiani corticotomy (n = 12) technique. The patient radiographs were assessed by the two senior authors who were blinded to the osteotomy type. Regenerate quality was assessed along the anterior, posterior, medial and lateral cortices, graded 1-5 from absent to full consolidation over time. The time to 3 cortices healed/regenerate length was calculated. The time to consolidation of the anterior, posterior, medial and lateral cortices was compared. The mean 3 cortices index in the Gigli group was 2.0 months/cm and in the De Bastiani group 1.8 months/cm. This was not a significant difference. In both groups, anterior bone formation was slower, and anterior cortical deficiency with a scalloped appearance was seen in 25 % of cases overall with no statistically significant difference between the two groups. Both Gigli saw and De Bastiani corticotomy techniques result in good bone formation following distraction osteogenesis. The anterior tibial cortex consolidates more slowly than the other cortices in both groups. This is likely due to deficient soft tissue cover and direct periosteal damage at time of osteotomy.

No MeSH data available.


Related in: MedlinePlus

Illustrations of the scoring system
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Fig1: Illustrations of the scoring system

Mentions: The bone quality of the regenerate was recorded along the anterior, posterior, medial and lateral cortices. This was graded 1–5, from absent to full consolidation over time in frame. Each cortex was graded independently (Table 2; Fig. 1).Table 2


Patterns of healing: a comparison of two proximal tibial osteotomy techniques.

Peek AC, Timms A, Chin KF, Calder P, Goodier D - Strategies Trauma Limb Reconstr (2016)

Illustrations of the scoring system
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4814378&req=5

Fig1: Illustrations of the scoring system
Mentions: The bone quality of the regenerate was recorded along the anterior, posterior, medial and lateral cortices. This was graded 1–5, from absent to full consolidation over time in frame. Each cortex was graded independently (Table 2; Fig. 1).Table 2

Bottom Line: The time to consolidation of the anterior, posterior, medial and lateral cortices was compared.This was not a significant difference.Both Gigli saw and De Bastiani corticotomy techniques result in good bone formation following distraction osteogenesis.

View Article: PubMed Central - PubMed

Affiliation: Royal National Orthopaedic Hospital, Stanmore, UK. anna.peek@rnoh.nhs.uk.

ABSTRACT
Several low-energy osteotomy techniques are described in the literature, but there is limited evidence comparing them. Our study evaluates the patterns of regenerate formation using two different osteotomy techniques. Two cohorts of patients underwent osteotomy of the tibia using a Gigli saw (n = 15) or De Bastiani corticotomy (n = 12) technique. The patient radiographs were assessed by the two senior authors who were blinded to the osteotomy type. Regenerate quality was assessed along the anterior, posterior, medial and lateral cortices, graded 1-5 from absent to full consolidation over time. The time to 3 cortices healed/regenerate length was calculated. The time to consolidation of the anterior, posterior, medial and lateral cortices was compared. The mean 3 cortices index in the Gigli group was 2.0 months/cm and in the De Bastiani group 1.8 months/cm. This was not a significant difference. In both groups, anterior bone formation was slower, and anterior cortical deficiency with a scalloped appearance was seen in 25 % of cases overall with no statistically significant difference between the two groups. Both Gigli saw and De Bastiani corticotomy techniques result in good bone formation following distraction osteogenesis. The anterior tibial cortex consolidates more slowly than the other cortices in both groups. This is likely due to deficient soft tissue cover and direct periosteal damage at time of osteotomy.

No MeSH data available.


Related in: MedlinePlus