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Evans osteotomy

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...
August 24, 2016: 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...
July 2, 2016: 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...
June 9, 2016: 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
T Woodacre, M Ricketts, J T Evans, G Pavlou, P Schranz, M Hockings, A Toms
BACKGROUND: Complication rates following opening wedge high tibial osteotomy (OWHTO) is an issue that has not been comprehensively addressed in current literature. METHODS: We performed a retrospective study of local patients who underwent OWHTO for isolated medial compartment knee osteoarthritis from 1997 to 2013. We analysed survivorship and complication rates and compared this to a literature review of previously reported data. RESULTS: One hundred and fifteen patients met the inclusion criteria...
March 2016: Knee
Jeremy Y Chan, Stephen T Greenfield, Dylan S Soukup, Huong T Do, Jonathan T Deland, Scott J Ellis
BACKGROUND: Correction of forefoot abduction in stage IIb adult acquired flatfoot likely depends on the amount of lateral column lengthening (LCL) performed, although this represents only one aspect of a successful reconstruction. The purpose of this study was to evaluate the correlation between common reconstructive variables and the observed change in forefoot abduction. METHODS: Forty-one patients who underwent flatfoot reconstruction involving an Evans-type LCL were assessed retrospectively...
December 2015: Foot & Ankle International
Nicole M Protzman, Garrett M Wobst, Eric C Storts, Jennifer L Mulhern, Raymond E McCarroll, Stephen A Brigido
Evans calcaneal osteotomy remains a cornerstone in the correction of the flexible flatfoot. Although multiple techniques have been used to maintain the length of the lateral column, a low profile wedge locking plate was recently introduced as an alternative to the traditional tricortical allograft wedge. We hypothesized that the wedge locking plate would better maintain the mid-calcaneal length compared with the tricortical allograft wedge. To test this hypothesis, after Evans osteotomy, the mid-calcaneal length was measured in the immediate postoperative period and again at 3 and 6 months...
September 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jacob Ruzevick, Shaan M Raza, Pablo F Recinos, Kaisorn Chaichana, Gustavo Pradilla, Jennifer E Kim, Alessandro Olivi, Jon Weingart, James Evans, Alfredo Quinones-Hinojosa, Michael Lim
BACKGROUND: The orbitozygomatic craniotomy is a fundamental procedure in neurosurgery, allowing access to orbital and skull base pathology. OBJECTIVE: Determine the feasibility of using an ultrasonic osteotome to safely perform orbitozygomatic osteotomies in patients with intracranial pathology. METHODS: The medical records of patients undergoing orbitozygomatic craniotomy using an ultrasonic osteotome (Aesculap BoneScalpel™) for tumor resection at Johns Hopkins Hospital between November 2009 and March 2013 were retrospectively reviewed...
July 2015: Clinical Neurology and Neurosurgery
Patrick G Marinello, Sebastian Peers, Joseph Styron, Khurram Pervaiz, Peter J Evans
During a posterior approach to the elbow, the triceps muscle body and tendon insertion must be addressed during exposure. Several methods exist including performing an olecranon osteotomy. The triceps fascial tongue exposure, originally described by Van Gorder in 1940, provides an excellent view of the joint while causing minimal trauma to the extensor mechanism facilitating tendon healing, and easy intraoperative conversion from fracture fixation to a total elbow arthroplasty if a fracture is not able to be reconstructed...
June 2015: Techniques in Hand & Upper Extremity Surgery
Jenny M Frances, David S Feldman
Flatfoot in a child may be normal before development of the arch, but the prevalence decreases with age. Treatment is indicated only in the presence of pain and should begin with nonsurgical management options such as stretching of the Achilles tendon and the use of soft shoe orthotics. If pain persists, a modified Evans procedure, together with additional procedures to address forefoot supination, can be successful in correcting deformity and addressing pain. A thorough understanding of the pathology and correction desired will help minimize complications and recurrence...
2015: Instructional Course Lectures
Constantine A Demetracopoulos, Pallavi Nair, Andrew Malzberg, Jonathan T Deland
BACKGROUND: Lateral column lengthening is used to correct abduction deformity at the midfoot and improve talar head coverage in patients with flatfoot deformity. It was our hypothesis that following a stepcut lengthening calcaneal osteotomy (SLCO), patients would have adequate correction of the deformity, a high union rate of the osteotomy, and improvement in clinical outcome scores. METHODS: We retrospectively reviewed 37 consecutive patients who underwent SLCO for the treatment of stage IIB flatfoot deformity with a minimum 2-year follow-up...
July 2015: Foot & Ankle International
Shitian Tang, Gang Liu, Dingwei Zhang, Jun Wang, Fuguo Huang
OBJECTIVE: To evaluate the long-term effectiveness of lunate excision and vascularized capitate osteotomy transposition for advanced Kienböck's disease. METHODS: Between June 2004 and January 2008, 16 patients with Kienböck disease in Lichtman stages IIIB-IV were treated with lunate excision and vascularized capitate osteotomy transposition. There were 10 males and 6 females at the age of 27-59 years (mean, 38.8 years). The disease was caused by trauma in 10 cases, and unknown reason in 6 cases...
August 2014: Chinese Journal of Reparative and Reconstructive Surgery
William Breakey, Chris Abela, Robert Evans, Owase Jeelani, Jonathan Britto, Richard Hayward, David Dunaway
OBJECTIVE: Hypertelorism may be corrected by either transcranial box osteotomy or facial bipartition. Despite radical bony resection, the associated soft tissue translation often seems disproportionate. The purpose of this study was to review bony and soft tissue movements in a series of 15 consecutive hypertelorism correction cases. METHODS: Two surgical residents in training independently analyzed preoperative and postoperative axial and three-dimensional reconstructed computed tomography data from 15 consecutive patients undergoing facial bipartition (n = 7) or transcranial box osteotomy correction (n = 8) between 2001 and 2010...
January 2015: Journal of Craniofacial Surgery
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