Bone Defect of the Tibia: A Case Report

Authors

  • Andriessanto Lengkong Universitas Sam Ratulangi
  • Djarot Noersasongko Universitas Sam Ratulangi
  • Haryanto Sunaryo Universitas Sam Ratulangi
  • Tommy Suharso Universitas Sam Ratulangi
  • Rangga Rawung Universitas Sam Ratulangi
  • Stefan Kambey Universitas Sam Ratulangi
  • Nurmalasari Amira Universitas Sam Ratulangi

DOI:

https://doi.org/10.35790/msj.v5i1.44238

Abstract

Abstract: Defects in long bones including tibia are still difficult problems in orthopaedic field for both the physician and the patient. We reported a case of a 56-year-old woman who came to the hospital with the chief complaint of being unable to walk since she was nine years old after getting a motorcycle accident. The patient complained that her leg did not grow since then. The patient was fully conscious and hemodynamically stable. Physical examination revealed that there was a deformity of the left lower leg with shortening of the lower leg and absence of the tibial bone. The patient was diagnosed with left tibia bone defect, therefore, above-the-knee amputation was performed. The amputation must be viewed as an opportunity to re-establish or enhance the patient’s functional level and facilitate a return to near normal locomotion using a prosthesis after amputation. Soft tissue and muscle quality, bone condition, neurovascular conditions and function of the limb can be considered in the selection of therapy in bone defect. The level of amputation can be determined by assessing the bone condition, neurovascular condition, and the ability of muscle and skin flaps to close the wound. In conclusion, amputation can be the treatment of choice for patient with bone defect. Improving lower limb function is proven to maximize the patient quality of life.

Keywords: bone defect tibia; above-the-knee amputation; transfemoral amputation

Author Biographies

Andriessanto Lengkong, Universitas Sam Ratulangi

Division of Orthopaedic Surgery, Department of Surgery, Medical Faculty, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Djarot Noersasongko, Universitas Sam Ratulangi

Division of Orthopaedic Surgery, Department of Surgery, Medical Faculty, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Haryanto Sunaryo, Universitas Sam Ratulangi

Division of Orthopaedic Surgery, Department of Surgery, Medical Faculty, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Tommy Suharso, Universitas Sam Ratulangi

Division of Orthopaedic Surgery, Department of Surgery, Medical Faculty, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Rangga Rawung, Universitas Sam Ratulangi

Division of Orthopaedic Surgery, Department of Surgery, Medical Faculty, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Stefan Kambey, Universitas Sam Ratulangi

Division of Orthopaedic Surgery, Department of Surgery, Medical Faculty, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou Hospital, Manado, Indonesia

Nurmalasari Amira, Universitas Sam Ratulangi

Department of Surgery, Medical Faculty, Universitas Sam Ratulangi, Manado, Indonesia

References

Wiese A, Pape HC. Bone defects caused by high-energy injuries, bone loss, infected nonunions, and nonunions. Orthop Clin N Am [Internet]. 2010;41(1):1-4. Available from: doi:10.1016/j.ocl.2009. 07.003

Donaldson LH, Brooke K, Faux SG. Orthopaedic trauma from road crashes: is enough being done? Aust Health Rev. 2009;33(1):72–83.

David GA. Amputations of the lower extremity. In: Terry C, James H, Frederick MA, editors. Campbell’s Operative Orthopaedics (13th ed). Canada: Elsevier; 2017. p. 674-85.

Berke GM, Buell NC, Fergason JR, Gailey RS, Hafner BJ, Hubbard SN, et al. Transfemoral Amputation: The Basics and Beyond. Prosthetics Research Study (PRS): Otto Bock Healthcare; 2005. p. 1-3. Available from: www.oandplibrary.org/assets/pdf/TransfemoralAmputationtheBasicsandBeyond. pdf.

Muller MD. Transfemoral amputation: prosthetic management. In: Krajbich JI, Pinzur MS, Potter BK, Stevens PM, eds. Atlas of Amputations and Limb Deficiencies (4th ed). American Academy of Orthopaedic Surgeons; 2016. p. 537.

Dragica S, Primoz R, Matjaz V, Borut G. Treatment of Bone Defects - Allogenic Platelet Gel and Autologous Bone Technique [Internet]. Spain; 2013. Doi: 10.5772/55987.

Ashman O, Phillips AM. Treatment of non-unions with bone defects: which option and why? Injury. 2013;44 Suppl 1:S43-5. Doi: 10.1016/S0020-1383(13)70010-X.

Seo I, Chang W, Joon WK, Kyeong HP. Bone transport over the plat for the segmental bone defect of tibia. J Trauma Inj [Internet]. 2018;31(2):107-11. Available from: http://doi.org/10.20408/jti.2018. 31.2. 107.

Selvadurai N, David N. Orthopaedic operations. In: Louis S, David M, Selvadurai N, editors. Apley’s: System of Orthopedics and Fractures (9th ed). London: Hodder Arnold; 2010. p. 325-7.

Sarin S, Shami S, Shields DA, Scurr JH, Smith PD. Selection of amputation level: a review. Eur J Vasc Surg. 1991;5(6):611-20. Doi: 10.1016/s0950-821x(05)80894-1.

Gayito RC, Priuli G, Traore SY, Barbier O, Docquier P-L.Treatment of large diaphyseal bone defect of the tibia by the "fibula pro tibia" technique: application in developing countries. Acta Orthop Belg. 2015 Mar;81(1):17-22.

Katsamouris A, Brewster DC, Megerman J, Cina C, Darling RC, Abbott WM. Transcutaneous oxygen tension in selection of amputation level. Am J Surg. 1984;147(4):510-7. Doi: 10.1016/0002-9610(84)90014-x.

Wyss CR, Harrington RM, Burgess EM, Matsen FA 3rd. Transcutaneous oxygen tension as a predictor of success after an amputation. J Bone Joint Surg Am. 1988;70(2):203-7.

Esquenazi A, Meier RH. Rehabilitation in limb deficiency. 4. Limb amputation. Archives of Physical Medicine and Rehabilitation. 1996;77(3 Suppl):S18-28

Misuri A, Lucertini G, Nanni A, Viacava A, Belardi P. Predictive value of transcutaneous oximetry for selection of the amputation level. J Cardiovasc Surg (Torino). 2000;41(1):83-7.

Parmaksızoğlu F, Cansü E, Unal MB, Ince AY. Acute emergency tibialization of the fibula: reconstruction of a massive tibial defect in a type IIIC open fracture. Strategies Trauma Limb Reconstr. 2013;8(2):127-31. Doi: 10.1007/s11751-013-0167-6. Epub 2013 Jul 27.

Kanneth R, Woodburn MB, Benjamin L. Amputation. In: Hallett JW, Mills JL, Earnshaw JJ, Reekers JA, Rooke TW, editors. Comprehensive Vascular and Endovascular Surgery (2nd ed). Elsevier; 2009. p. 229-39. Available from: https://mayoclinic.pure.elsevier.com/en/publications/ comprehensive-vascular-and-endovascular-surgery-second-edition

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Published

2023-04-21

How to Cite

Lengkong, A., Noersasongko, D., Sunaryo, H., Suharso, T., Rawung, R., Kambey, S., & Amira, N. (2023). Bone Defect of the Tibia: A Case Report. Medical Scope Journal, 5(1), 9–13. https://doi.org/10.35790/msj.v5i1.44238