title: [Simultaneous transarticular intramedullary nailing of the tibia and total knee replacement in tibial nonunion and osteoarthrosis].
abstract: The combined manifestation of a nonunion of the proximal tibia and an osteoarthrosis of both knee joints is not very common. Yet, this was a kind of "unhappy triad" for a 86 year old lady suffering from a nonunion after one year of conservative treatment of a proximal tibial shaft fracture. Her quality of life has already been reduced by a loss of visual power and she was completely invalidized. She was unable to walk and she was hospitalized for the whole period of time. The operative treatment consisted in an intramedullary tibial nailing through the resected tibial joint surface using an IMSC-nail and, simultaneously through the same surgical approach, in a partially cemented total knee joint replacement. After 5 months a replacement of the second knee joint also was performed and 6 weeks later the almost blind patient could be discharged for home again. After another 7 months a proximal femoral fracture of the first side was repaired using a proximal femural nail. Four years later she still is able to live on her own and runs her flat with only little external help. She can walk as far as 3 km and enjoys a good knee function.
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie, Lukas-Krankenhaus Bünde. kiefer@owl-online.de
authors.forename: H
authors.initials: H
authors.lastname: Kiefer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D007720:Knee Prosthesis; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*