Management of tibia deformity with fixator assisted nailing technique / 中华骨科杂志

ABSTRACT

To discuss the result of treating tibia deformity with fixator assisted nailing technique (FAN). Methods A total of 5 patients with 7 limbs of tibial deformity?were treated with FAN technique. Etiology 2 patients with bilater?al tibial deformity suffered from Ricket's disease, 2 patients were malunion after tibial fracture, 1 patient was congenital pseudoar?throsis of tibia. This is a retrospective study. The unilateral external fixator was mounted on the medial side of tibia, and thenthe minimal invasive osteotomy was performed. After the deformity was corrected, the intramedullary nail was inserted to fix the tibia. None of the patients need bone autograft. The pre?operation and post?operation medial proximal tibia angle (MPTA), mechanical axis deviation (MAD) and range of motion (ROM) were measured and analyzed. Results All the 5 patients were followed?up for 12-60 months (average 32 months). The osteotomy site united in 3-5 months (average 4.5 months) post?operatively. According to Paley’s imaging scores, 4 patients were excellent and 1 patient was good. According to Paley's functional result scores, 5 patients were excellent; according to Paley’s bone results evaluation , 4 patients were excellent and 1 patient was good. We achieved de?sired post?operative MAD (from medial 15 mm-lateral 10 mm) in 6 limbs. The MPTA in 7 limbs was corrected to normal (84°-90°). The ROM was not significantly changed before and after operation. The average ROM of knee before operation was 125° (120°-135°),and average postoperative ROM was 120°(115°-130°),No deep infection or neurovascular injury occurred. All pa?tients were satisfied with the method and results of the operation. Conclusion FAN technique combines the advantage of exter?nal fixation and intramedullary nail, and it is a good method to treat tibial deformity, the patient should be carefully evaluated and selected for applying this technique.