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"4-in-1 Osteosynthesis" for Atrophic-type Congenital Pseudarthrosis of the Tibia
DC Field | Value | Language |
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dc.contributor.author | Choi, In Ho | - |
dc.contributor.author | Lee, Soong Joon | - |
dc.contributor.author | Moon, Hyuk Ju | - |
dc.contributor.author | Cho, Tae-Joon | - |
dc.contributor.author | Yoo, Won Joon | - |
dc.contributor.author | Chung, Chin Youb | - |
dc.contributor.author | Park, Moon Seok | - |
dc.date.accessioned | 2023-05-08T00:51:32Z | - |
dc.date.available | 2023-05-08T00:51:32Z | - |
dc.date.created | 2021-10-14 | - |
dc.date.created | 2021-10-14 | - |
dc.date.issued | 2011-09 | - |
dc.identifier.citation | Journal of Pediatric Orthopaedics, Vol.31 No.6, pp.697-704 | - |
dc.identifier.issn | 0271-6798 | - |
dc.identifier.uri | https://hdl.handle.net/10371/192106 | - |
dc.description.abstract | Background: According to the authors' multi-targeted, fibular status-based algorithmic approach using the Ilizarov technique, ankle stabilization by end-to-end osteosynthesis of the fibula is advocated for mild (type B1), "4-in-1 osteosynthesis" in which all 4 proximal and distal segments of the tibia and fibula are placed in 1 healing mass for moderate (type B2), and distal tibiofibular (TF) fusion for severe (type B3) fibular pseudarthrosis in association with atrophic-type congenital pseudarthrosis of the tibia (CPT). This report describes the indications, operative technique, and outcomes of "4-in-1 osteosynthesis" for atrophic-type CPT associated with type B2 fibular pseudarthrosis. Methods: Thirteen patients presented with atrophic-type CPT associated with type B2 fibular pseudarthrosis underwent Ilizarov osteosynthesis between 1989 and 2007 for atrophic-type CPT. To validate the efficacy of "4-in-1 osteosynthesis" in these patients, fracture risk and ankle function were compared between 2 groups of type B2 patients, namely, 8 patients (mean age, 6.3 y) who underwent "4-in-1 osteosynthesis" according to our current protocol (Group I), and 5 patients (mean age, 3.2 y) treated by other techniques (3 distal TF fusion, 2 failed end-to-end osteosynthesis) during the learning period (Group II). Results: No refracture occurred in Group I, whereas refracture occurred in all except 1 in Group II. Ankles were eventually stabilized by distal TF fusion in all patients in Group II. The Kaplan-Meier method revealed a refracture-free cumulative survival rate of 100% in Group I, whereas in Group II, it dropped progressively and reached 60% at 1.8 years and 20% at 2.7 years. No significant difference in ankle function was evident between the 2 groups (american orthopaedic foot and ankle society (AOFAS) score, 89.25 +/- 7.25 after 7.4 y of follow-up in Group I, and 84.6 +/- 9.53 after 13 y of follow-up in Group II). Conclusions: It is imperative that fibular status be evaluated carefully to enable the planning of the most effective, safe, practical treatment. "4-in-1 osteosynthesis," which is primarily considered for bony union with a large cross-sectional area and ankle stabilization, seems to be a better choice for atrophic-type CPT associated with type B2 fibular pseudarthrosis, in which end-to-end osteosynthesis of the fibula often fails. Level of Evidence: Level III, Retrospective comparative study. | - |
dc.language | 영어 | - |
dc.publisher | Lippincott Williams & Wilkins Ltd. | - |
dc.title | "4-in-1 Osteosynthesis" for Atrophic-type Congenital Pseudarthrosis of the Tibia | - |
dc.type | Article | - |
dc.identifier.doi | 10.1097/BPO.0b013e318221ebce | - |
dc.citation.journaltitle | Journal of Pediatric Orthopaedics | - |
dc.identifier.wosid | 000293831200017 | - |
dc.identifier.scopusid | 2-s2.0-80051979793 | - |
dc.citation.endpage | 704 | - |
dc.citation.number | 6 | - |
dc.citation.startpage | 697 | - |
dc.citation.volume | 31 | - |
dc.description.isOpenAccess | N | - |
dc.contributor.affiliatedAuthor | Choi, In Ho | - |
dc.contributor.affiliatedAuthor | Cho, Tae-Joon | - |
dc.contributor.affiliatedAuthor | Yoo, Won Joon | - |
dc.contributor.affiliatedAuthor | Chung, Chin Youb | - |
dc.contributor.affiliatedAuthor | Park, Moon Seok | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.subject.keywordPlus | INTRAMEDULLARY ROD | - |
dc.subject.keywordPlus | ILIZAROV TECHNIQUE | - |
dc.subject.keywordPlus | PSEUDARTHROSIS | - |
dc.subject.keywordPlus | OSTEOGENESIS | - |
dc.subject.keywordPlus | GROWTH | - |
dc.subject.keywordAuthor | congenital pseudarthrosis of the tibia | - |
dc.subject.keywordAuthor | Ilizarov osteosynthesis | - |
dc.subject.keywordAuthor | fibular pseudarthrosis | - |
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