title: Salvage of distal tibia metaphyseal nonunions with the 90 degrees cannulated blade plate.
abstract: Nonunion of distal tibia metaphyseal fractures after trauma is a major problem. Treating these nonunions is made more challenging by the presence of symptomatic ipsilateral tibiotalar arthrosis. The current study examined the use of the 90 degrees cannulated blade plate as an alternative method of stable internal fixation for 13 distal tibia metaphyseal nonunions and simultaneous fusion of three arthritic tibiotalar joints in 13 patients (seven males and six females) with an average age of 42.4 years (range, 21-73 years). Each patient had an average of three prior procedures (range, 2-6). Patients were followed up for an average of 34.2 months (range, 24-55 months). All 13 patients achieved radiographic and clinical union an average of 15.6 weeks (range, 12-20 weeks) from the date of the definitive procedure. There were two broken screws, but no secondary procedures were required to obtain fusion. All patients were ambulatory without support at the last followup. The implant proved effective for stable internal fixation of distal tibia metaphyseal nonunions alone or with simultaneous fusion of the tibiotalar joint.
authors.affiliation: Department of Orthopaedics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. kingsleychin@hotmail.com
authors.forename: Kingsley R
authors.initials: KR
authors.lastname: Chin
authors.forename: Durgesh G
authors.initials: DG
authors.lastname: Nagarkatti
authors.forename: Michael A
authors.initials: MA
authors.lastname: Miranda
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Santoro
authors.forename: Michael R
authors.initials: MR
authors.lastname: Baumgaertner
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Jupiter
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D001860:Bone Plates; D002404:Catheterization / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005599:Fractures, Ununited / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011859:Radiography; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013978:Tibial Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors