[Frequency and severity of callus defects. Dorsomedial vs ventrolateral approach for corticotomy in performing callus distraction of the tibia].

BACKGROUND: The purpose of this study was to compare a dorsomedial to the ventrolateral approach for corticotomy in performing callus distraction of the proximal metaphyseal tibia. PATIENTS AND METHODS: A total of 31 callus distractions were performed in 28 humans. The ventrolateral approach was used for 18 and the dorsomedial approach for 13 corticotomies. A scale of four severity grades was used to classify callus defect zones based on their extent as evidenced on serial X-rays. Biopsies were taken from higher-grade defects (grades 3-4).
RESULTS: A total of 13 radiological evaluations revealed 12 defects using the ventrolateral approach. Seven defects (grades 1-2) healed spontaneously, whereas six defects (grades 3-4) required operative intervention as histological tissue examination showed no osteogenic potential.
CONCLUSION: To prevent callus defects of the proximal tibia in the future and to ensure maximal osteogenic potential in the distraction zone, a minimally invasive dorsomedial approach appears to achieve favorable results.