Proximal tibia resection / f / 16yo
Transcript of Proximal tibia resection / f / 16yo
![Page 1: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/1.jpg)
Proximal tibia resection / f / 16yo
♀ 16 yo 1st referral: 05.07.2012
HPI:
•Knee pain since July 2011
•No recovery after physiotherapy and orthopedic arch support
•Third consultation and increasing pain: MRI
PMH:
n.c.
Family history: grandmother breast cancer; grandfather lung cancer; uncle: lung cancer and gastric cancer
![Page 2: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/2.jpg)
Clinical Exam:
Local swelling, warmth, F/E 140/0/0
Proximal tibia resection / f / 16yo
![Page 3: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/3.jpg)
Proximal tibia resection / f / 16yo
![Page 4: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/4.jpg)
Proximal tibia resection / f / 16yo
![Page 5: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/5.jpg)
small nodulus
Proximal tibia resection / f / 16yo
![Page 6: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/6.jpg)
Jamshidi Biopsy and Hohlbohrer
5. July 2012
Proximal tibia resection / f / 16yo
![Page 7: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/7.jpg)
Proximal tibia resection / f / 16yo
![Page 8: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/8.jpg)
Proximal tibia resection / f / 16yo
![Page 9: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/9.jpg)
EURAMOS
Proximal tibia resection / f / 16yo
![Page 10: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/10.jpg)
July 5, 2012
Proximal tibia resection / f / 16yo
![Page 11: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/11.jpg)
October 05, 2012
Proximal tibia resection / f / 16yo
![Page 12: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/12.jpg)
Vastus medialis muscle
Tibial artery and vein
Pes anserinus superficialis
(blue fibre)
Pes anserinus
profundus (blue fibre)
Anterior tibial artery
Proximal tibia resection / f / 16yo
![Page 13: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/13.jpg)
Extensor muscles Fibula/mobilized
peroneal nerve
Proximal tibia resection / f / 16yo
![Page 14: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/14.jpg)
Proximal tibia resection / f / 16yo
![Page 15: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/15.jpg)
Tibial artery and vein and nerve
Tibial osteotomy
Fibular osteotomy Tendon of biceps femoris
muscle (blue fibre)
Proximal tibia resection / f / 16yo
![Page 16: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/16.jpg)
Proximal tibia resection / f / 16yo
![Page 17: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/17.jpg)
Proximal tibia resection / f / 16yo
![Page 18: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/18.jpg)
Proximal tibia resection / f / 16yo
![Page 19: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/19.jpg)
Proximal tibia resection / f / 16yo
![Page 20: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/20.jpg)
Vastus medialis muscle Medial head gastrocnemius
muscle flap
Proximal tibia resection / f / 16yo
![Page 21: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/21.jpg)
Proximal tibia resection / f / 16yo
![Page 22: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/22.jpg)
Proximal tibia resection / f / 16yo
![Page 23: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/23.jpg)
Proximal tibia resection / f / 16yo
![Page 24: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/24.jpg)
Proximal tibia resection / f / 16yo
![Page 25: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/25.jpg)
Postoperative x-rays: October 05, 2012
Proximal tibia resection / f / 16yo
![Page 26: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/26.jpg)
Postoperative x-rays: October 05, 2012
Proximal tibia resection / f / 16yo
![Page 27: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/27.jpg)
Proximal tibia resection / f / 16yo
![Page 28: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/28.jpg)
Proximal tibia resection / f / 16yo
![Page 29: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/29.jpg)
Proximal tibia resection / f / 16yo
![Page 30: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/30.jpg)
Proximal tibia resection / f / 16yo
![Page 31: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/31.jpg)
Proximal tibia resection / f / 16yo
![Page 32: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/32.jpg)
Proximal tibia resection / f / 16yo
![Page 33: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/33.jpg)
Vorläufige Beurteilung (drei Schnittpräparate entkalken noch!)
Proximal tibia resection / f / 16yo
![Page 34: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/34.jpg)
- Start of adjuvant chemotherapy in
KiSpi
- CT of the lung is planned
- Follow-up's every 3 months
Proximal tibia resection / f / 16yo
![Page 35: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/35.jpg)
October 22, 2012
Proximal tibia resection / f / 16yo
![Page 36: Proximal tibia resection / f / 16yo](https://reader031.fdocuments.net/reader031/viewer/2022013018/61d0f8c03879745e7472cbc5/html5/thumbnails/36.jpg)