case_images: PMC6176307_01
case_images: (a) Leg length view showing 30 degrees varus of tibia and several osteoarthritis left knee. (b) Lateral view showing 20 degrees apex anterior angulation at malunited fracture site.
case_images: CRIOR2018-2632963.001.jpg
case_images: PMC6176307_01_CRIOR2018-2632963.001.jpg
case_images: fig1
case_images: He also had severe tricompartmental osteoarthritis on the left knee (Figures 1(a) and 1(b)).
case_images: CT scan:malunited fracture of the middle third left tibia.
case_images: CRIOR2018-2632963.002.jpg
case_images: PMC6176307_01_CRIOR2018-2632963.002.jpg
case_images: fig2
case_images: A CT scan confirmed the presence of malunion (Figure 2).
case_images: (a, b) Internal fixation after clamshell osteotomy. (b) Blocking screw was used in distal tibia for proper positioning of rod which helped correction of deformity.
case_images: CRIOR2018-2632963.003.jpg
case_images: PMC6176307_01_CRIOR2018-2632963.003.jpg
case_images: fig3
case_images: Tibia was properly aligned and "blocking screw" was placed laterally on the distal fragment to maintain corrected varus position of tibia (Figures 3(a) and 3(b)). Nail was locked with two proximal and two distal locking screws (Figures 3(a) and 3(b)).
case_images: (a-d) Postoperatively showing good healing at fracture site at 6 months.
case_images: CRIOR2018-2632963.004.jpg
case_images: PMC6176307_01_CRIOR2018-2632963.004.jpg
case_images: fig4
case_images: Radiologic healing of fracture was confirmed by three cortices healing on X-ray at 6 months (Figures 4(a)-4(d)).
case_images: Total knee replacement after removing proximal tibial nail screws. Removal of IM nail was not indicated.
case_images: CRIOR2018-2632963.006.jpg
case_images: PMC6176307_01_CRIOR2018-2632963.006.jpg
case_images: fig6
case_images: Postoperative X-rays showed good alignment (Figure 6).