title: Distal tibial periarticular nonunions: ankle salvage with bone transport.
abstract: A nonunion of the distal tibial metaphysis in close proximity to the articular surface is a challenging clinical problem. Many of the commonly used techniques in a surgeon's treatment armamentarium can be ineffective because of the relative lack of distal bone stock. This study describes a technique of en bloc excision of all infected or nonunited distal tibial bone with an application of a circular external fixator and limb shortening. After treatment with parental antibiotics, when appropriate, and docking of the distal excision site, distraction osteogenesis of the proximal tibia is performed with a second circular frame.
authors.affiliation: Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Schottel
authors.forename: Saravanaraja
authors.initials: S
authors.lastname: Muthusamy
authors.forename: S Robert
authors.initials: SR
authors.lastname: Rozbruch
mesh_terms: D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery; D023821:Limb Salvage / Q000379:methods; D008875:Middle Aged; D019857:Osteogenesis, Distraction; D013978:Tibial Fractures / Q000601:surgery*