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Evans osteotomy

Federico Canavese, Alain Dimeglio, François Bonnel
BACKGROUND: Several anatomical studies have shown that the articular facets of the calcaneus can present with different anatomy. This study assessed the 3D anatomy of lateral calcaneal lengthening (LCL) osteotomy in relation to the anterior and middle facet of the calcaneus in a group of skeletally immature patients treated for symptomatic flatfoot deformity. METHODS: During the study period, 14 consecutive patients (10 males, 4 females) presenting symptomatic flatfoot (20 feet) with different aetiologies underwent LCL osteotomy and CT scan with 3D reconstruction of the operated feet...
June 3, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Andrew J Meyr, Laura E Sansosti, Sayed Ali
This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for elective reconstruction of the midfoot and rearfoot with focus on the flatfoot deformity. Our goal is to demonstrate objective radiographic parameters that surgeons utilize to initially define the deformity, lead to procedure selection, and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries...
June 2017: Journal of Radiology Case Reports
Jaiben George, Evan M Miller, Carlos A Higuera, Thomas E Kuivila, Michael A Mont, Ryan C Goodwin
BACKGROUND: As the indications for total hip arthroplasty (THA) have expanded, this procedure is being increasingly performed in young patients. Oftentimes, this population has undergone one or more salvage procedures in an attempt to delay or forestall a THA. However, it is unclear whether patients with prior salvage procedure have higher risk of adverse events. METHODS: From 2004 to 2014, 215 THAs performed in patients less than 30 years at a single institution were identified...
November 13, 2017: Journal of Arthroplasty
Eric So, Vincent H Mandas, Lee Hlad
Treatment of large osseous defects remains a difficult surgical challenge. Autografts and allografts have been known to undergo late collapse, because these options are not specifically designed to withstand the high loads of the foot and ankle. The inability to achieve the correct shape for reconstruction further limits their application. Large osseous defects will result during salvage after failed Lapidus bunionectomy, explantation of failed total ankle replacements, and nonunion of Evans calcaneal osteotomy...
January 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Stuart M Saunders, Scott J Ellis, Constantine A Demetracopoulos, Anca Marinescu, Jayme Burkett, Jonathan T Deland
BACKGROUND: The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy. METHODS: We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years...
January 2018: Foot & Ankle International
Khalid M S Mohamed, Christopher Fenelon, John G Galbraith, Lester G D'Souza
Lateral column lengthening osteotomy is very useful surgical technique in treating stage II of pes planovalgus deformity of the foot. Either autograft from the iliac crest or allograft can be used for this purpose. In our technique we describe a novel method of obtaining bone graft locally from the calcaneus and therefore avoiding complications and morbidity associated with iliac crest graft.
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Marcelo E Jara
In 1975, Evans published an article describing the surgical management of the "calcaneo-valgus deformity," pointing out that the deformity was due to relative shortening of the lateral column of the foot. Correction involved "equalizing" both columns by performing an osteotomy in the neck of the calcaneus 1.5 cm from the calcaneocuboid joint, where a trapezoidal wedge of tricortical bone was placed. Although it was considered a success, there were complications, including sural nerve injury, surgical wound dehiscence, undercorrection, and graft subsidence...
September 2017: Foot and Ankle Clinics
Jonathan Morris, Rui Yang, Michael Roth, Jonathan Gill, Richard Gorlick, Yungtai Lo, Bang H Hoang, Evan Garfein, David S Geller
INTRODUCTION: The vascularized fibular graft prosthetic composite (VFGPC) is used for reconstruction after internal hemipelvectomy. The purpose of this study was to create a mathematical model that calculates the mechanical effects of the vascularized fibular graft on the VFGPC. METHODS: The effects of the VFG positioning were calculated based on three-dimensional static analyzes to determine the direction, magnitude, and distribution of the forces through the prosthesis and VFG...
May 22, 2017: Journal of Surgical Oncology
Kevin M Neal, Evan Siegall
Management of large, severe, stiff spinal deformities in children can be challenging. Adjunctive treatments used in conjunction with spinal osteotomy, instrumentation, and fusion can improve the ultimate degree of deformity correction. These adjunctive treatments include preoperative halo-gravity traction, intraoperative halo-femoral traction, temporary internal spinal distraction, and anterior spinal release. Each of these techniques has unique indications and individual risks. When the appropriate protocols are followed, these techniques can be safe and efficacious...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
Roman H Khonsari, Benjamin Way, Johan Nysjö, Guillaume A Odri, Raphaël Olszewski, Robert D Evans, David J Dunaway, Ingela Nyström, Jonathan A Britto
A major concern in FGFR2 craniofaciosynostosis is oculo-orbital disproportion, such that orbital malformation provides poor accommodation and support for the orbital contents and peri-orbita, leading to insufficient eyelid closure, corneal exposure and eventually to functional visual impairment. Fronto-facial monobloc osteotomy followed by distraction osteogenesis aims to correct midfacial growth deficiencies in Crouzon-Pfeiffer syndrome patients. Fronto-facial bipartition osteotomy followed by distraction is a procedure of choice in Apert syndrome patients...
October 2016: Journal of Cranio-maxillo-facial Surgery
Brian A Smith, Robert S Adelaar, Jennifer S Wayne
Several surgically corrective procedures are considered to treat Adult Acquired Flatfoot Deformity (AAFD) patients, relieve pain, and restore function. Procedure selection is based on best practices and surgeon preference. Recent research created patient specific models of AAFD to explore their predictive capabilities and examine effectiveness of the surgical procedure used to treat the deformity. The models' behavior was governed solely by patient bodyweight, soft tissue constraints, muscle loading, and joint contact without the assumption of idealized joints...
July 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Nathan Patrick, Gregory S Lewis, Evan P Roush, Allen R Kunselman, Jarrett D Cain
Medial displacement calcaneal osteotomies have been shown to be successful in the surgical management of adult acquired flatfoot, in particular, stage 2 deformity. Classically, the medial displacement calcaneal osteotomy technique has been performed. However, a calcaneal Z osteotomy has been more recently described and applied in the surgical management of flatfoot deformity. Although the potential advantages of the calcaneal Z technique have been reported, data on its effect on the subtalar joint are lacking...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Evan Lederman, Jonathan Streit, John Idoine, Yousef Shishani, Reuben Gobezie
Secure subscapularis repair is an essential element of total shoulder arthroplasty. Some surgeons prefer subscapularis peel because of ease of use, but some evidence suggests that lesser tuberosity osteotomy provides better fixation. The authors developed a novel, through-implant repair technique and performed a biomechanical study of its strength with cadaveric specimens. The authors obtained 20 matched pairs of cadaveric shoulders and inserted an uncemented short-stemmed humeral prosthesis that facilitates through-implant repair in all specimens...
September 1, 2016: Orthopedics
Jason Rhodes, Alfred Mansour, Allison Frickman, Breanna Pritchard, Katherine Flynn, Zhaoxing Pan, Frank Chang, Nancy Miller
BACKGROUND: The Evan's calcaneal lengthening osteotomy is a treatment method for spastic flatfoot deformity in patients with cerebral palsy that fail nonoperative measures. Autograft and allograft have been reported as potential graft choices. Bovine xenograft has been introduced as an alternative, but limited human data exists supporting its efficacy. This study compares the long-term results of allograft versus xenograft in isolated Evan's procedure performed for correction of flexible spastic flatfoot deformity...
April 2017: Journal of Pediatric Orthopedics
Umur Aydogan, Evan P Roush, Blake E Moore, Seth H Andrews, Gregory S Lewis
Destruction of the normal metatarsal arch by a long metatarsal is often a cause for metatarsalgia. When surgery is warranted, distal oblique, or proximal dorsiflexion osteotomies of the long metatarsal bones are commonly used. The plantar fascia has anatomical connection to all metatarsal heads. There is controversial scientific evidence on the effect of plantar fascia release on forefoot biomechanics. In this cadaveric biomechanical study, we hypothesized that plantar fascia release would augment the plantar metatarsal pressure decreasing effects of two common second metatarsal osteotomy techniques...
April 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Alan Edwards, Evan Larson, Mitchell Beckert, Nikhil Sahai, John P Albright
BACKGROUND: Tibial tubercle-trochlear groove (TT-TG) distance is currently used at our institution to determine tibial tubercle medialization required in Fulkerson osteotomies. If the correlation between a modified lateral patellar edge (LPE) and the transfer distance was found to be stronger than its correlation with TT-TG, it would suggest that the best measurement to use is actually modified LPE. METHODS: The electronic medical records of 32 patients who underwent Fulkerson osteotomy procedures with femoral nerve stimulation were reviewed and measured...
August 2016: Knee
Mark Sheldon Lloyd, Desi Rodrigues, Hiroshi Nishikawa, Nicholas White, Gurish Solanki, Peter Noons, Martin Evans, Stephen Dover
INTRODUCTION: Due to the rarity of isolated frontosphenoidal suture synostosis clinical diagnosis can be challenging. This study of 6 patients aims to review the clinical, radiological findings, and operative techniques used to correct the underlying pathology. METHODS: Patients with isolated frontosphenoidal suture craniosynostosis were selected from a retrospective review of 88 patients with unicoronal synostosis treated during a 3-year period. Two-dimensional photography of patients' soft tissue morphology from the vertex view allowed assessment of the following morphology: frontal bossing, brow depression, nasal tip deviation, and ear position...
June 2016: Journal of Craniofacial Surgery
Pradeep Mettu, M Tariq Bhatti, Mays A El-Dairi, Evan B Price, Amy Y Lin, Ali Alaraj, Pete Setabutr, Heather E Moss
We describe 2 unique cases of visual symptoms occurring during mastication in patients with lateral orbital wall defects. A 57-year-old man reported intermittent double vision and oscillopsia after a right fronto-temporal-orbito-zygomatic craniotomy with osteotomy of the lesser wing of the sphenoid for a complex invasive pituitary adenoma. Proptosis of the right globe was present only during mastication. Computed tomography (CT) revealed a bony defect in the right lateral orbital wall. A 48-year-old man presented with transient diplopia and scotoma in the right eye elicited by chewing...
September 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Umur Aydogan, Blake Moore, Seth H Andrews, Evan P Roush, Allen R Kunselman, Gregory S Lewis
BACKGROUND: The optimal surgery for reducing pressure under the second metatarsal head to treat metatarsalgia is unknown. We tested our hypothesis that a proximal oblique dorsiflexion osteotomy of the second metatarsal would decrease second-metatarsal plantar pressures in a cadaver model with varying Achilles tendon tension. We also tested the plantar pressure effects of two popular techniques of distal oblique osteotomy. METHODS: Twelve fresh-frozen feet from six cadavers were randomly assigned to either the distal osteotomy group (a classic distal oblique osteotomy followed by a modified distal oblique osteotomy) or proximal metatarsal osteotomy group...
December 2, 2015: Journal of Bone and Joint Surgery. American Volume
Alexander S McLawhorn, Ashley E Levack, Kara G Fields, Evan D Sheha, Kathryn R DelPizzo, Ernest L Sink
BACKGROUND: Periacetabular osteotomy (PAO) reorients the acetabular cartilage through a complex series of pelvic osteotomies, which risks significant blood loss often necessitating blood transfusion. Therefore, it is important to identify effective strategies to manage blood loss and decrease morbidity after PAO. The purpose of this study was to determine the association of epsilon-aminocaproic acid (EACA), an antifibrinolytic agent, with blood loss from PAO. METHODS: Ninety-three patients out of 110 consecutive patients that underwent unilateral PAO for acetabular dysplasia met inclusion criteria...
March 2016: Journal of Arthroplasty
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