par Simons, Maurice 
;Willems, G;Rocmans, Pierre Arthur ;Delcourt, G.
Référence Acta orthopaedica Belgica (Ed. bilingue), 39, 5, page (919-937)
Publication Publié, 1973
;Willems, G;Rocmans, Pierre Arthur ;Delcourt, G.Référence Acta orthopaedica Belgica (Ed. bilingue), 39, 5, page (919-937)
Publication Publié, 1973
Article révisé par les pairs
| Résumé : | The authors have used the Zanoli operation with success in the treatment of pseudarthrosis of the tibia. The technique consists in joining the fibula and tibia at their proximal and distal metaphyses, so that the fibula takes over the support. The authors extended the method to loss of bony substance of the tibia, the Zanoli operation thus becoming the first stage of the bone repair. This necessitates an intact consolidated or osteosynthetic homolateral fibula. In one case, the authors decided to reconstitute a resected fibular shaft by a 12 cm long iliac graft to treat an infected tibial pseudarthrosis. In a 2nd stage, when the proximal and distal apposition between fibula and tibia are completely solid, and after subsidence of infection, it becomes feasible to reinforce the bony structures. This is done by using the opposite fibula which is inserted into the remaining tibial fragments. After 1 yr excellent ossification, solidity will occur, so that active life can be resumed. The last case was a 5 yr old boy who had lost almost all his tibial diaphysis. The Zanoli operation is contraindicated in young patients because of the risk of injuring the cartilage plates. The authors inspired by this technique, performed a synthesis of the fibula to stabilize the fracture and avoid shortening. In a second stage, they bridged the tibial loss with a long cortical graft from the opposite tibia. Function was normal 3 yr later. |
