Study of secondary changes in patients tissues after posttraumatic extraarticular femur and tibia deformities

Konstantin Romanenko, Yaroslav Doluda, Ruslan Zlatnyk, Svetlana Yakovenko, Olena Karpinska, Dmytro Prozorovsky, Karolina Poplavska


One of complications after shaft fractures is formation of angular deformities. Clinical significance of axial infringement can influence on the leg function.

Objective: to study the changes which occur in the tissues of injured segments, they have influence on the method of treatment in patients with posttraumatic extraarticular deformities of femur and tibia.

Methods: we analyzed the results of treatment of 38 patients with posttraumatic extraarticular deformities of femur and tibia. All patients were examined with complex clinical, radiologic methods according to suggested plan. It included the analysis of general patient state and injured leg; X-rays with comparative evaluation of joints, localization and severity of deformity, state of regeneration process and bone state; ultrasound examination of soft tissues (ligaments, muscles); biomechanical studies.

Results: all methods of examination are described. The most significant secondary changes of injured leg are pointed out: the magnitude, type and localization of deformity; regeneration process and bone state; arthritis changes in the joints; infringement of soft tissues; changes in podogramme.

Conclusions: usage of suggested plan of examination of patients with extraarticular deformities of the tibia and femur allowed us to determine parameters of anamnesis, general and local status, secondary changes in soft tissues which have influence on the choice of method of treatment.


deformity; femur; tibia; plan of examination; secondary changes


Fayaz, H. C., Giannoudis, P. V., Vrahas, M. S., Smith, R. M., Moran, C., Pape, H. C., … Jupiter, J. B. (2011). The role of stem cells in fracture healing and nonunion. International Orthopaedics, 35(11), 1587-1597. doi:10.1007/s00264-011-1338-z

Popsuishapka, O., Uzhigova, O., & Litvishko, V. (2013). Rate of nonunion and delayed union of fragments in isolated diaphyseal fractures of long bones of the extremities. Orthopaedics, traumatology and prosthetics, 1, 39–43. doi:10.15674/0030-59872013139-43 (in Russian)

Engsberg, J., Leduc, S., Ricci, W., & Borrelli Jr, J. (2014). Improved function and joint kinematics after correction of tibial malalignment. American journal of orthopedics, 43(12), E313–318.

Marti, R. K., & Heerwaarden, R. J. (2008). Osteotomies for posttraumatic deformities. Basel: Thieme.

Paley, D. (2002). Principles of deformity correction: Exercise workbook. Berlin: Springer.

Korzh, M., Romanenko, K., Karpinsky, M., Prozorovsky, D., & Yaresko, O. (2015). Mathematic modeling of the influence of femur malalignment on the bearing of lower extremity joints. Orthopaedics, traumatology and prosthetics, 4, 25-30. doi:10.15674/0030-59872015425-30 (in Ukrainian)

Romanenko, K., Ashukina, N., Batura, I., & Prozorovsky, D. (2017). Morphology of the articular cartilage of the knee joint in rats with extraarticular femoral bone deformity. Orthopaedics, traumatology and prosthetics, 1, 63-71. doi:10.15674/0030-59872017163-71. (in Ukrainian)

Fan, C. H. (2014). One-stage femoral osteotomy and computer-assisted navigation total knee arthroplasty for osteoarthritis in a patient with femoral subtrochanteric fracture malunion. Case Reports in Orthopedics, 2014, 1-4. doi:10.1155/2014/645927

Lonner, J. H., Siliski, J. M., & Lotke, P. A. (2000). Simultaneous femoral osteotomy and total knee arthroplasty for treatment of osteoarthritis associated with severe extra-articular deformity. The Journal of Bone and Joint Surgery-American Volume, 82(3), 342-348. doi:10.2106/00004623-200003000-00005

Xiao-Gang, Z., Shahzad, K., & Li, C. (2012). One-stage total knee arthroplasty for patients with osteoarthritis of the knee and extra-articular deformity. International Orthopaedics, 36(12), 2457-2463. doi:10.1007/s00264-012-1695-2

Romanenko, К. К., Goridova, L., & Prozorovskiy, D. (2005). Clinical-diagnostic algorithm in the case of posttraumatic long bones deformity – a basis of treatment tactics (reporting #1). Ukrainian Medical Almanac, 8(2 suppl.), 115–117. (in Russian)

Gaiko, O. (2013). Structure-functional abnormalities in muscles of patients with extremities damage (diagnostics, monitoring, development forecasting): doctoral thesis in medical science. Traumatology and Orthopedics. Kyiv. (in Ukrainian)

Romanenko, K., Doluda, Y., Karpinsky, M., & Prozorovsky, D. (2017). Weight-bear specifics in patients with post traumatic extraarticular femoral and tibial fractures (statographic research). Orthopaedics, traumatology and prosthetics, 2, 35-44. doi:10.15674/0030-59872017235-44 (in Ukrainian)

Tyazhelov, O., Karpinsky, M., Karpinska, O., & Yaremin, S. (2014). Justification and analysis of geometric parameters of statographic data for evaluation the musculoskeletal system of human. Orthopaedics, traumatology and prosthetics, 3, 62-67. doi:10.15674/0030-59872014362-67 (in Ukrainian)

Nasledov, A. (2011). SPSS 19: professional statistic data analysis. St Petersburg: Piter. (in Russian)

Korzh, N., Goridova, L., & Romanenko, K. (2004). The principles of treatment of different disorders of reparative osteogenesis, that developed after diaphyseal tibia fractures. Aktualʹni pytannya suchasnoyi ortopedii ta travmatolohii (pp. 267–273). Kyiv. (in Russian)

Romanenko, K. (2002). Ununited diaphyseal fractures of long bones (risk factors, diagnostics, treatment): thesis for a candidate degree in medical science. Traumatology and orthopedics. Kharkiv. (in Russian)

Tyazhelov, O., Poletaeva, N., Romanenko, K., Goridova, L., & Prozorovsky, D. (2010). Mathematical modelling of diaphyseal deformities of the long bones. Orthopaedics, traumatology and prosthetics,, 3, 61-63. doi:10.15674/0030-59872010361-63 (in Ukrainian)

Korzh, М., Romanenko, К., Goridova, L., & Prozorovskiy, D. (2011). Tactical approaches to the treatment of posttraumatic diaphyseal defromities of bones. Papers presented at the IV Poland-Ukraine conference of orthopedists, Zamost, 11–12 of June, 2011. (in Ukrainian)

Korzh, М., Romanenko, К., Goridova, L., & Prozorovskiy, D. (2013). Preoperative planning in the treatment of posttraumatic extraarticular deformities of femur and tibia. Papers presented at XVI Congress of Ukrainian orthopedists and traumatology, Kharkiv, 3–5 Oct 2013. (in Russian)

Copyright (c) 2018 Kostiantin Romanenko, Yaroslav Doluda, Ruslan Zlatnik, Svetlana Yakovenko, Olena Karpinska, Dmytro Prozorovskiy, Karolina Poplavska

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.