NDLI: Treatment of recalcitrant distal tibial nonunion using the descending genicular corticoperiosteal free flap.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Cavadas, Pedro C. Landín, Luis
Description	Country affiliation: Spain Author Affiliation: Cavadas PC ( Division of Hand and Reconstructive Surgery, Clínica Cavadas, Valencia, Spain. pcavadas@telefonica.net)
Abstract	BACKGROUND: Recalcitrant nonunions of the distal tibia without bone defect are severe problems whose treatment is difficult. Stable internal fixation and osteogenetic enhancement are required. The thin corticoperiosteal flap based on the descending genicular artery has been previously described to treat nonunions in the upper extremity without bone defect. The use of this flap to treat distal tibial nonunions is reported in the present article. METHODS: Twenty-five patients with recalcitrant nonunion of the distal tibial metaphysis without segmental bone defect or evidence of infection were treated with revision of the internal fixation and a corticoperiosteal free flap from the medial condyle of the femur. The number of previous surgical procedures was two to five. The flaps were compound, including muscle or fat, for wound coverage in seven cases. RESULTS: All compound flaps survived. Bony union was achieved in all cases, with bone formation at the nonunion site by the fourth month in all cases but one. In this case bone union took 7 months. Donor morbidity was negligible. Two tibiotalar arthrodeses were performed secondarily for posttraumatic osteoarthritis. CONCLUSIONS: Treatment of recalcitrant distal tibial nonunions without bone defect with removal of previous hardware, stable internal fixation, and free corticoperiosteal flap transfer is safe and effective in noninfected cases.
File Format	HTM / HTML
ISSN	00225282
Issue Number	1
Volume Number	64
e-ISSN	15298809
Journal	The Journal of Trauma: Injury, Infection, and Critical Care
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-01-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Surgical Flaps Reoperation Femur Tibial Fractures Humans Middle Aged Male Fractures, Ununited Discipline Traumatology Journal Article Surgery Fracture Fixation, Internal Adult Female Reconstructive Surgical Procedures
Content Type	Text
Resource Type	Article
Subject	Surgery Critical Care and Intensive Care Medicine

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