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Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report

Osteonecrosis is a disruption of blood supply to the bone which results in bone cell death. Post-traumatic osteonecrosis of distal tibia rarely happens as compared to osteonecrosis which affects other parts of the musculoskeletal system. We report a case of osteonecrosis of distal tibia in an adult...

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Autores principales: Mazli, Norliyana, Bajuri, Mohd Yazid, Nik Abdullah, Nik Alif
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693789/
https://www.ncbi.nlm.nih.gov/pubmed/38050520
http://dx.doi.org/10.7759/cureus.48214
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author Mazli, Norliyana
Bajuri, Mohd Yazid
Nik Abdullah, Nik Alif
author_facet Mazli, Norliyana
Bajuri, Mohd Yazid
Nik Abdullah, Nik Alif
author_sort Mazli, Norliyana
collection PubMed
description Osteonecrosis is a disruption of blood supply to the bone which results in bone cell death. Post-traumatic osteonecrosis of distal tibia rarely happens as compared to osteonecrosis which affects other parts of the musculoskeletal system. We report a case of osteonecrosis of distal tibia in an adult male following an open fracture dislocation of the right ankle. Initial surgery of wound debridement with a temporary external fixator was performed for ankle stabilization. The patient underwent internal fixation once the subcutaneous tissue was deemed suitable. A year later, he had worsening ankle pain which affected his daily activities. Magnetic resonance imaging showed osteonecrosis of the distal tibia, osteochondral injury of the medial tibial plafond, and medial talus with lateral ligament complex injuries. Autologous iliac bone grafting was applied to the distal tibia and a cell-free hyaluronic acid-based scaffold (Hyalofast®) was used to address the bone osteonecrosis and osteochondral injury respectively. Visual analog score (VAS), AOFAS hindfoot score, and ankle range of motion improved at three months and significantly increased after six months and one year post-operatively.
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spelling pubmed-106937892023-12-04 Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report Mazli, Norliyana Bajuri, Mohd Yazid Nik Abdullah, Nik Alif Cureus Orthopedics Osteonecrosis is a disruption of blood supply to the bone which results in bone cell death. Post-traumatic osteonecrosis of distal tibia rarely happens as compared to osteonecrosis which affects other parts of the musculoskeletal system. We report a case of osteonecrosis of distal tibia in an adult male following an open fracture dislocation of the right ankle. Initial surgery of wound debridement with a temporary external fixator was performed for ankle stabilization. The patient underwent internal fixation once the subcutaneous tissue was deemed suitable. A year later, he had worsening ankle pain which affected his daily activities. Magnetic resonance imaging showed osteonecrosis of the distal tibia, osteochondral injury of the medial tibial plafond, and medial talus with lateral ligament complex injuries. Autologous iliac bone grafting was applied to the distal tibia and a cell-free hyaluronic acid-based scaffold (Hyalofast®) was used to address the bone osteonecrosis and osteochondral injury respectively. Visual analog score (VAS), AOFAS hindfoot score, and ankle range of motion improved at three months and significantly increased after six months and one year post-operatively. Cureus 2023-11-03 /pmc/articles/PMC10693789/ /pubmed/38050520 http://dx.doi.org/10.7759/cureus.48214 Text en Copyright © 2023, Mazli et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Orthopedics
Mazli, Norliyana
Bajuri, Mohd Yazid
Nik Abdullah, Nik Alif
Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report
title Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report
title_full Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report
title_fullStr Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report
title_full_unstemmed Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report
title_short Treatment of Post-traumatic Osteonecrosis in the Distal Tibia With Autologous Bone Grafting: A Case Report
title_sort treatment of post-traumatic osteonecrosis in the distal tibia with autologous bone grafting: a case report
topic Orthopedics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693789/
https://www.ncbi.nlm.nih.gov/pubmed/38050520
http://dx.doi.org/10.7759/cureus.48214
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