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variable diaphyseal fixation depending on the type of pathology and its extent. A similar surgical indication is the treatment of periprosthetic fractures in older patients. There is a renewal of interest in this type of implant in TKA revision surgery
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has spread to the diaphyseal level in order to avoid fractures. Centromedullary osteosynthesis is the main method of fixing such a lesion, and implant failure must be minimized by choosing the correct implant, observing the surgical technique, and
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Longer stems cause tibial pain at the end of the stem in up to 10% of patients, and an off-setting might be required if diaphyseal engagement results in malalignment or a higher risk of fracture, 32 – 35 which is why cementless stems are preferred if
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remove, however, and may increase stress-shielding in the surrounding bone. Press-fit diaphyseal stems with cement in the metaphyseal portion of the implant have also been used. 38 Structural integrity of both the femoral and tibial canals is
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sleeve and cone for bone defection repair, offset adaptor for anatomical connection, and stem extension for metaphyseal or diaphyseal engagement are shown. (B) The design philosophy of offset is the anatomical nonaxial property between the femoral/tibial
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joint linking to the diaphyseal bone. The length of the diaphyseal bone allows an increase in the lever arm of appropriate muscles to improve the power of the joint’s action. The bone contains cells, haemopoietic tissue, and a nerve and blood supply
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surgical control or delayed (secondary) amputations after a failed limb-sparing procedure. Another instance when amputation can be performed is when it serves as a palliative measure for non-resectable tumours complicated with pathological fractures, soft
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tibial nailing . Injury 2000 31 359 – 362 . ( https://doi.org/10.1016/S0020-1383(0000002-4 ) 41. Kapoor SK Kataria H Boruah T Patra SR Chaudhry A Kapoor S . Expandable self-locking nail in the management of closed diaphyseal fractures of
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were not reported. Saw et al. reported a case of a 15-year-old who underwent arthroscopic surgery for a tibial eminence fracture ( 51 ). The patient developed common peroneal nerve palsy that resolved within 1 week. The tourniquet time and pressure
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graft with suction drainage/irrigation. Bone grafts used in cases of nonunion. At least 4 weeks targeted IV antimicrobial therapy. Khan 2012 31 Radical debridement and stabilization of fracture with open reduction and internal fixation (5
