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Rajesh Malhotra, Deepak Gautam, Bhavuk Garg, Anjan Trikha
We wish to present a case of 47-year-old patient with Juvenile Rheumatoid Arthritis and ankylosis of both hips and both knees treated by bilateral hip and knee arthroplasty in a single anaesthesia i.e. Quadruple joint replacement in single sitting. He was back on his feet from his bed-ridden state within the fortnight following surgery. He has been followed up for four years and has been performing his activities of daily living independently. We discuss the preoperative planning, surgical details and post-operative rehabilitation and unique challenges pertaining to this case...
May 2018: Archives of Bone and Joint Surgery
Hua-Lun Wang, Pei-Pei Zhang, Li Meng, Su-Xia Liang, Hao Liu, Ying-Bin Yan
PURPOSE: The aim of this experimental study was to investigate the role of the fibrous layer of the condylar head in the formation of temporomandibular joint (TMJ) ankylosis in a sheep model of intracapsular condylar fracture. MATERIALS AND METHODS: Six growing Xiao-wei Han sheep were used in the study, and bilateral TMJ surgery was performed in each sheep. In the left TMJ, sagittal fracture of the condyle, removal of the fibrous layer of the condylar head, excision of two thirds of the disc, and removal of the fibrous zone of the glenoid fossa were performed...
May 24, 2018: Journal of Oral and Maxillofacial Surgery
Pamela F Weiss, Walter P Maksymowych, Robert G Lambert, Jacob L Jaremko, David M Biko, Joel Paschke, Timothy G Brandon, Rui Xiao, Nancy A Chauvin
OBJECTIVE: There is a critical need for measures to evaluate structural progression in the pediatric sacroiliac joint (SIJ). We aimed to evaluate the construct validity and reliability of the Spondyloarthritis Research Consortium of Canada SIJ Structural Score (SSS) in children with suspected or confirmed juvenile spondyloarthritis. METHODS: The SSS assesses structural lesions of the SIJ on magnetic resonance imaging (MRI) through the cartilaginous part of the joint...
June 15, 2018: Journal of Rheumatology
Sanjay Rastogi, Ashish Sharma, Nandani Kumari, Rupshikha Choudhury, Siddhi Tripathi, Ankit Kumar, Pranshu Chauhan, Kaustuv Kumar Das
PURPOSE: The objective of the study was to compare the deep subfascial approach to subfascial approach in terms of facial nerve injury and quality of life. MATERIALS AND METHODS: A randomized study was performed from August 2013 to March 2017 on 24 patients with unilateral TMJ ankylosis. The subjects were randomly allotted to either Group I (12, Deep Subfascial) or Group II (12, Subfascial). All patients were evaluated objectively for facial nerve injury post-operatively and subjectively for quality of life in the form of a questionnaire post-operatively for 6 months...
April 20, 2018: Journal of Cranio-maxillo-facial Surgery
Byung-Ho Yoon, In Keun Park, Yerl-Bo Sung
Purpose: Neurogenic myositis ossificans (NMO) in patients with traumatic spinal cord or brain injuries can cause severe joint ankylosis or compromise neurovascularture. The purpose of this study was to evaluate the clinical and radiological outcomes of and review considerations relevant to surgical resection of NMO of the hip joint. Materials and Methods: Six patients (9 hips) underwent periarticular NMO resection between 2015 and 2017. The medical records of these patients were retrospectively reviewed...
June 2018: Hip & Pelvis
Tabishur Rahman
We describe a case of maxillofacial trauma in a pediatric patient in whom the mandibular condyle was superolaterally displaced into the temporal fossa, medial to the zygomatic arch which was intact. In addition, there was an associated mandibular symphyseal fracture. To our knowledge, this case is the first of its kind to be reported in the literature. We also observed a complication in the form of development of ankylosis in the involved joint which required another surgery.
June 2018: Craniomaxillofacial Trauma & Reconstruction
S R Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury...
May 2018: Indian Journal of Orthopaedics
R Y Bi, X T Luo, N Jiang, S S Zhu, Y F Li
Mandibular distraction osteogenesis (DO) has been shown to lead to considerable improvement in obstruction of the posterior airway space in patients with ankylosis of the temporomandibular joint (TMJ), and our objective was to find out if we could confirm these findings. Seventeen patients had spiral computed tomographic (CT) scans before and after DO. After treatment, the overall posterior airway space was enlarged in all three sections of the airway (oropharyngeal, glossopharyngeal, and laryngeal). We then compared rates of change in the airway among the sections using 2-dimensional and 3-dimensional assessments, and found that the rate of change in 3-dimensional assessment of volume was significantly higher than that in the 2-dimensional (62% compared with 34%)...
June 7, 2018: British Journal of Oral & Maxillofacial Surgery
Sungsin Jo, Sung Eun Wang, Young Lim Lee, Suman Kang, Bitnara Lee, Jinil Han, Il-Hoon Sung, Ye-Soo Park, Sang-Cheol Bae, Tae-Hwan Kim
BACKGROUND: IL-17A has recently emerged as a potential target that regulates the extensive inflammation and abnormal bone formation observed in ankylosing spondylitis (AS). Blocking IL-17A is expected to inhibit bony ankylosis. Here, we investigated the effects of anti IL-17A agents in AS. METHODS: TNFα, IL-17A, and IL-12/23 p40 levels in serum and synovial fluid from patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), osteoarthritis (OA), or healthy controls (HC) were measured by ELISA...
June 7, 2018: Arthritis Research & Therapy
Désirée van der Heijde, Jürgen Braun, Atul Deodhar, Xenofon Baraliakos, Robert Landewé, Hanno B Richards, Brian Porter, Aimee Readie
In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural damage is currently assessed by conventional radiography and scoring systems that reliably assess radiographic structural damage are needed to capture the differential effects of drugs on structural damage progression. The validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the effect of AS treatments on radiographic progression rates was assessed in this review...
May 30, 2018: Rheumatology
Cory M Resnick, Joshua Genuth, Carly E Calabrese, Amir Taghinia, Brian I Labow, Bonnie L Padwa
PURPOSE: Patients with hemifacial microsomia (HFM) and Kaban-Pruzansky type III mandibular deformities require ramus construction with autologous tissue. The free fibula flap, an alternative to the costochondral graft, has favorable characteristics for this construction but may be associated with temporomandibular joint ankylosis. The purposes of this study were to present a series of patients with HFM who underwent free fibula flap ramus construction, to determine the incidence of ankylosis, and to identify perioperative factors associated with ankylosis...
May 28, 2018: Journal of Oral and Maxillofacial Surgery
Aleksandra Konarzewska, Anna Korzon-Burakowska, Ludomira Rzepecka-Wejs, Iwona Sudoł-Szopińska, Edyta Szurowska, Michał Studniarek
One of significant challenges faced by diabetologists, surgeons and orthopedists who care for patients with diabetic foot syndrome is early diagnosis and differentiation of bone structure abnormalities typical of these patients, i.e. osteitis and Charcot arthropathy. In addition to clinical examination, the patient's medical history and laboratory tests, imaging plays a significant role. The evaluation usually begins with conventional radiographs. In the case of osteomyelitis, radiography shows osteopenia, lytic lesions, cortical destruction, periosteal reactions as well as, in the chronic phase, osteosclerosis and sequestra...
March 2018: Journal of Ultrasonography
Alberto Consolaro, Paulo Domingos Ribeiro Júnior, Maurício A Cardoso, Dario A Oliveira Miranda, Monica Salfatis
Dental arches areas with teeth presenting dentoalveolar ankylosis and replacement root resorption can be considered as presenting normal bone, in full physiological remodeling process; and osseointegrated implants can be successfully placed. Bone remodeling will promote osseointegration, regardless of presenting ankylosis and/or replacement root resorption. After 1 to 10 years, all dental tissues will have been replaced by bone. The site, angulation and ideal positioning in the space to place the implant should be dictated exclusively by the clinical convenience, associated with previous planning...
January 2018: Dental Press Journal of Orthodontics
Jorge Chaurand
Temporomandibular joint (TMJ) ankylosis is a complex entity that requires accurate diagnosis and prompt treatment. Multiple surgical modalities have been proposed to treat TMJ ankylosis, including gap arthroplasty, interpositional arthroplasty, and total joint reconstruction. This article is to report one treated with patient specific implants due to its complexity, technical considerations are presented and could be an option for patients with similar conditions requiring this type of complicated treatment...
May 16, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
Deepika Pai, Abhay T Kamath, Pushpa Kini, Manish Bhagania, Saurabh Kumar
Klippel-Feil syndrome (KFS) is classically characterized by fusion of any of the two of seven cervical vertebrae. It is identified by the presence of a triad of clinical signs including short neck, limitation of head and neck movements and low posterior hairline. Unusual bony malformations leading to facial asymmetry is the most common oral manifestation associated with KFS. Such maxillomandibular fusion can also result in restricted mouth opening in children. It's a challenge to provide complete rehabilitation in such children...
May 15, 2018: Journal of Clinical Pediatric Dentistry
Yiu Yan Leung, Karen Kar Yan Lai
PURPOSE OF REVIEW: This article reviews the current literature on the use of distraction osteogenesis as a treatment for patients with obstructive sleep apnoea (OSA). We reviewed the indications, surgical protocols and outcomes for distraction osteogenesis in paediatric and adult OSA cases described in the literature. RECENT FINDINGS: There is evidence that distraction osteogenesis is effective in treating children with OSA as a result of underdevelopment of jaws such as those with craniofacial syndromes...
May 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Maria Clara Rodrigues Pinheiro, Maria das Graças Rodrigues Pinheiro, Lucas Rodrigues Pinheiro, Sergio de Melo Alves-Junior, Joao de Jesus Viana Pinheiro, Andre Luis Ribeiro Ribeiro
No abstract text is available yet for this article.
May 8, 2018: Journal of Craniofacial Surgery
Mohamed Hazem Abdelazeem, Özgür Erdogan, Tarek Ahmed Awad
Surgical management of temporomandibular joint (TMJ) ankylosis in children is often challenging and may result in various complications such as facial nerve injury and visible scar. In this clinical report, the authors present minimally invasive management of a 9-year-old boy with bilateral post-traumatic TMJ ankylosis. The ankylotic TMJs were addressed and gap arthoplasties were performed by endoscopically assisted transoral approach. The risk of facial nerve injury is minimized and facial scar was prevented by avoiding extraoral incision...
May 8, 2018: Journal of Craniofacial Surgery
L Fath, H Cebula, M N Santin, A Coca, C Debry, F Proust
INTRODUCTION: Grisel's syndrome consists in rotational subluxation of C1-C2 following ENT infection or surgery. There is no consensus on management. We present 2 cases requiring surgical treatment in our center. CASE REPORTS: Two 10-year-old patients presented torticollis with cervical pain resistant to medical treatment, with onset a few months after tonsillectomy. In both cases, radiological assessment, comprising CT scan and MRI, showed Fielding-Hawkins type-3 C1-C2 rotational subluxation, without ligament lesion...
May 3, 2018: Neuro-Chirurgie
Franciny Querobim Ionta, Priscilla Santana Pinto Gonçalves, Heitor Marques Honório, Gabriela Cristina de Oliveira, Catarina Ribeiro Barros de Alencar, Natália Mello Santos, Thais Marchini de Oliveira, Daniela Rios
This case report describes the consequences of delayed (24 hours) reimplantation of an avulsed maxillary central incisor, findings over a 4-year follow-up period, and the management of ankylosis during facial growth. After a traumatic event, a 10-year-old boy was taken to a hospital emergency department due to injuries to his face, including avulsion of the maxillary left central incisor. Despite the short amount of time before arriving at the hospital (10 minutes) and use of the correct storage medium (milk), the tooth was not reimplanted, and the parents did not receive instructions to seek dental treatment...
May 2018: General Dentistry
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