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Clinical implication of sagittal translation in lengthening over nail of tibia

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

During the surgery of lengthening over nail (LON), we sometimes observe sagittal translation of proximal tibia (STPT) when the nail is inserted into the canal. We investigated the factors that lead to STPT and its clinical significance.

Methods

We reviewed 35 consecutive patients who underwent bilateral tibial lengthening with LON. The following parameters were assessed to evaluate the factors that can lead to STPT; the level of tibia osteotomy (OT) in sagittal plane, the type of the nail, the nail entry point in sagittal/coronal planes, and the type of the OT. Then, the followings are analyzed to find any possible clinical significance of this phenomenon: the change of posterior proximal tibial angle (PPTA), the cortical healing index, and the translation of the sagittal mechanical axis (SMA) of the lower extremity.

Results

The postoperative STPT was 3.04 ± 2.73 mm, and proximal location of the OT in relation to the nail bending point was found to increase STPT. The nail entry point in sagittal/coronal planes and the type of tibia OT had no significant correlations with STPT. It had no significant relations with the PPTA or cortical healing index. It pushed the SMA posteriorly, but the SMA was always anterior to the center of rotation of the knee joint.

Conclusions

Proximal location of the OT in relation to the nail bending point is related to STPT. However, it does not negatively influence cortical healing, posterior tibial slope, or SMA of the lower extremity.

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Conflict of interest

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Ethical standard

Each author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained.

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Authors and Affiliations

  1. Limb Lengthening and Deformity Reconstruction Service, Department of Orthopaedic Surgery, CHA Bundang Medical Center, 351 Yatap-dong, Bundang-gu, Sung-nam, Kyungki-do, Republic of Korea

    Dong Hoon Lee & Keun Jung Ryu

  2. Department of Orthopaedic Surgery, Institute for Rare Diseases, Korea University Medical Center, Guro Hospital 80, Guro-dong, Guro-gu, Seoul, 152-703, Republic of Korea

    Sang Heon Song, Kwang Won Park & Hae Ryong Song

Authors
  1. Dong Hoon Lee
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  2. Keun Jung Ryu
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  3. Sang Heon Song
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  4. Kwang Won Park
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  5. Hae Ryong Song
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Corresponding author

Correspondence to Hae Ryong Song.

Additional information

This study was approved by the institutional review board of the corresponding author (BD2012-14J, approved on January 4, 2012). The work was performed in the institution of the corresponding author.

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Lee, D.H., Ryu, K.J., Song, S.H. et al. Clinical implication of sagittal translation in lengthening over nail of tibia. Eur J Orthop Surg Traumatol 24, 1579–1585 (2014). https://doi.org/10.1007/s00590-013-1338-3

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  • DOI: https://doi.org/10.1007/s00590-013-1338-3

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