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https://www.readbyqxmd.com/read/28550143/kicked-to-touch-hoodwinked-by-torticollis
#1
Ciaran K Mc Donald, Niall Mc Goldrick, Cliodhna Ni Fhoghlu, Fintan Shannon
A 2-year-old girl presented to the emergency department with a 3-day history of a painful stiff neck after getting a kick to her head from her older brother. Her general practitioner had recently started her on oral antibiotics for otitis media. Plain film imaging of her cervical spine on admission revealed anterior subluxation of C2 on C3 suggestive of bifacetal dislocation. Subsequent CT imaging confirmed malalignment of the upper cervical spine. The patient was admitted and worked up with MRI of the cervical spine which unexpectedly revealed a large 4×2 cm retropharyngeal abscess extending from C1 to C4...
May 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28547676/femoral-malrotation-after-surgical-treatment-of-femoral-shaft-fractures-in-children-a-retrospective-ct-based-analysis
#2
Christian Zeckey, Fergal Monsell, Mark Jackson, Philipp Mommsen, Musa Citak, Christian Krettek, Mohamed Omar
BACKGROUND: Rotational malalignment is an important and not always avoidable complication after surgical treatment of femoral shaft fractures. The purpose of this study was to determine the incidence of rotational malalignment in children after surgical treatment of femoral shaft fractures and to identify potential patient- and treatment-related risk factors based on data obtained from CT scans. METHODS: We conducted a retrospective analysis of all patients aged less than 15 years with femoral shaft fractures admitted to our level 1 trauma centre between January 2004 and July 2014...
May 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28542101/clinical-impact-of-t1-slope-minus-cervical-lordosis-following-multilevel-posterior-cervical-fusion-surgery-a-minimum-2-year-follow-up-data
#3
Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
STUDY DESIGN: Retrospective study. OBJECTIVE: To assess the longer term relationship between sagittal alignment of the cervical spine and patient-reported health-related quality-of-life (HRQOL) scores following multilevel posterior cervical fusion, and to explore whether an analog of T1 slope - C2-C7 lordosis ('T1S-CL') impacts on patients' clinical outcomes. SUMMARY OF BACKGROUND DATA: A 6-month follow-up study demonstrated that, similar to the thoracolumbar spine, the severity of disability increases with sagittal malalignment following cervical reconstruction surgery...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28542100/global-spinal-alignment-in-patients-with-cervical-spondylotic-myelopathy
#4
Go Yoshida, Abdulmajeed Alzakri, Vincent Pointillart, Louis Boissiere, Ibrahim Obeid, Yukihiro Matsuyama, Jean Marc Vital, Olivier Gille
STUDY DESIGN: Prospective radiographic analysis of cervical spondylotic myelopathy (CSM) OBJECTIVE.: To clarify the pathophysiology of CSM, and use the characteristic of global spinal alignment for determining the surgical strategy. SUMMARY OF BACKGROUND DATA: Radiographic evaluation of CSM, in general, comprises cervical magnetic resonance imaging (MRI) and regional cervical radiography, which cannot distinguish between cervical hyperlodorsis with spinopelvic compensation and cervical lordorsis with normal global alignment...
May 24, 2017: Spine
https://www.readbyqxmd.com/read/28527756/radiological-lumbar-stenosis-severity-predicts-worsening-sagittal-malalignment-on-full-body-standing-stereoradiographs
#5
Aaron J Buckland, Subaraman Ramchandran, Louis Day, Shay Bess, Themistocles Protopsaltis, Peter G Passias, Bassel G Diebo, Renaud Lafage, Virginie Lafage, Akhila Sure, Thomas J Errico
BACKGROUND CONTEXT: Patients with degenerative lumbar stenosis (DLS) adopt a forward flexed posture in an attempt to decompress neural elements. The relationship between sagittal alignment and severity of lumbar stenosis has not previously been studied. PURPOSE: We hypothesized that patients with increasing radiological severity of lumbar stenosis will exhibit worsening sagittal alignment. STUDY DESIGN: This is a cross-sectional study. PATIENT SAMPLE: Our sample consists of patients who have DLS...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28523427/-total-ankle-arthroplasty-with-simultaneous-subtalar-fusion
#6
J Mainzer, P Rippstein
OBJECTIVE: Pain free weight bearing ability with orthograde hindfoot position and preserved tibiotalar motion. INDICATIONS: Symptomatic arthritis of the ankle and subtalar joint, additional subtalar hindfoot malalignment. CONTRAINDICATIONS: Absolute: acute infection, noncorrectable ligamentous instability or bony defects, restricted perfusion, diabetic foot syndrome. Relative: inability to comply with postoperative partial weight bearing, only moderate symptoms of subtalar arthritis, smoking, intricate soft tissue situation...
May 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28503753/distal-forearm-fracture-open-reduction-internal-fixation-sonographic-detection-of-hardware-malalignment-and-associated-tendon-injuries-missed-by-radiography
#7
Tara A Morgan, Samantha L Piper, Lisa L Lattanza, Ruth B Goldstein, Thomas Link, Daria Motamedi
Tendon injury is a known complication of distal radius fracture plate and screw fixation. Targeted musculoskeletal sonography is uniquely capable of assessing both tendon integrity and hardware abnormalities not recognized on radiographs. Each of the 3 patients described presented with pain after an open reduction-internal fixation following a distal forearm fracture. In each patient, radiographic findings, specifically the hardware position, were interpreted as normal. Important radiographically occult observations were subsequently made with sonography, including 3 proud screws and tendon injuries, all of which required surgical treatment...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28502357/experience-with-navigation-in-total-ankle-arthroplasty-is-it-worth-the-cost
#8
REVIEW
Christopher W Reb, Gregory C Berlet
Optimal placement of correctly sized total ankle replacement (TAR) implants is elemental to prolonging the working life. The negative mechanical effects of implant malalignment are well characterized. There is one FDA-approved navigated TAR system with limited but encouraging outcomes data. Therefore, its value can be estimated only based on benefits other than a proven clinical outcomes improvement over conventional systems. These include unique preoperative planning through 3-dimensional templating and virtual surgery and the patient-specific cut guides, which also reduce overall instrumentation needed for the case...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28502351/malalignment-correction-of-the-lower-limb-before-during-and-after-total-ankle-arthroplasty
#9
REVIEW
Taggart T Gauvain, Michael A Hames, William C McGarvey
One of the main challenges in ankle replacement is correction of any deformities in the operative limb. Deformity can be found proximal and distal to the ankle joint as well as in the ankle joint. There are static and dynamic deformities that can create unbalanced ankle joints causing early and often catastrophic failure. Surgeons must recognize the deformities that are present and use sound judgment to balance the ankle joint with procedures before, during, or after total ankle implantation. This article helps clinicians to identify deformity and provides a basic template to consider how to address each challenge...
June 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28501956/an-in-vitro-evaluation-of-sagittal-alignment-in-the-cervical-spine-after-insertion-of-supraphysiologic-lordotic-implants
#10
Donald J Blaskiewicz, Jeffrey E Harris, Patrick P Han, Alexander W Turner, Gregory M Mundis
PURPOSE: Cervical spine malalignment can develop as a consequence of degenerative disc disease or following spinal surgery. When normal sagittal alignment of the spine is disrupted, further degeneration may occur adjacent to the deformity. The purpose of this study was to investigate changes in lordosis and sagittal alignment in the cervical spine after insertion of supraphysiologic lordotic implants. METHODS: Eight cadaveric cervical spines (Occiput-T1) were tested...
May 13, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28499396/averaging-rotational-landmarks-during-total-knee-arthroplasty-reduces-component-malrotation-caused-by-femoral-asymmetry
#11
Tat Woon Chao, Liam Geraghty, Pandelis Dimitriou, Simon Talbot
BACKGROUND: Femoral component malrotation is a common cause of patient dissatisfaction after total knee arthroplasty. The sulcus line (SL) is more accurate than Whiteside's line as it corrects for variation in the coronal orientation of the groove. The hypothesis is that averaging the SL and posterior condylar axis (PCA) will reduce femoral malrotation. METHODS: The component was inserted at a position between the SL and PCA in 91 patients. An intraoperative photograph was taken showing the landmarks...
May 12, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28492130/osteogenesis-imperfecta-type-3-in-south-africa-causative-mutations-in-fkbp10
#12
Alvera Vorster, Peter Beighton, Manogari Chetty, Yasmeen Ganie, Bertram Henderson, Engela Honey, Piet Maré, David Thompson, Karen Fieggen, Denis Viljoen, Rajkumar Ramesar
BACKGROUND: A relatively high frequency of autosomal recessively inherited osteogenesis imperfecta (OI) type 3 (OI-3) is present in the indigenous black southern African population. Affected persons may be severely handicapped as a result of frequent fractures, progressive deformity of the tubular bones and spinal malalignment. OBJECTIVE: To delineate the molecular basis for the condition. METHODS: Molecular investigations were performed on 91 affected persons from seven diverse ethnolinguistic groups in this population...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28488001/lateral-displacement-sulcus-angle-and-trochlear-angle-are-associated-with-early-patellofemoral-osteoarthritis-following-anterior-cruciate-ligament-reconstruction
#13
Erin M Macri, Adam G Culvenor, Hayden G Morris, Timothy S Whitehead, Trevor G Russell, Karim M Khan, Kay M Crossley
PURPOSE: Patellofemoral osteoarthritis (PFOA) occurs in approximately half of anterior cruciate ligament (ACL)-injured knees within 10-15 years of trauma. Risk factors for post-traumatic PFOA are poorly understood. Patellofemoral alignment and trochlear morphology may be associated with PFOA following ACL reconstruction (ACLR), and understanding these relationships, particularly early in the post-surgical time period, may guide effective early intervention strategies. In this study, patellofemoral alignment and trochlear morphology were investigated in relation to radiographic features of early PFOA 1-year post-ACLR...
May 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28486287/controlled-compression-nailing-for-at-risk-humeral-shaft-fractures
#14
J Tracy Watson, Roy W Sanders
Compression techniques seem to be the primary factor in determining the success of both plating and nailing techniques for the management of acute fractures and for delayed and nonunion management of these fractures. An intramedullary nail that can provide continual compression (like a plate) and mechanical manipulation of the callous throughout the course of treatment is an ideal device that provides all the advantages of plating and nailing and avoids the noted limitations of both. The UNYTE compression humeral nail is based on the PRECICE intramedullary limb lengthening system...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28484794/femoral-head-retroposition-as-a-potential-compensatory-mechanism-in-patients-with-a-severe-mismatch-between-pelvic-incidence-and-lumbar-lordosis
#15
Xiaofei Cheng, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Jie Zhao
OBJECTIVE: Severe mismatch between pelvic incidence (PI) and lumbar lordosis (LL) leads to extra anterior displacement of the gravity line. The objective of this study is to investigate whether femoral head retroposition is a separate compensatory mechanism responsible for the extra anterior displacement. SUBJECTS AND METHODS: Based on the values of PI and LL, 94 patients were divided into the PI-LL match group (PI-LL ≤ 0°), the mild PI-LL mismatch group (20°> PI-LL >0°), and the severe PI-LL mismatch group (PI-LL ≥ 20°)...
May 9, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28482200/analysis-of-compensatory-mechanisms-in-the-pelvis-and-lower-extremities-in-patients-with-pelvic-incidence-and-lumbar-lordosis-mismatch
#16
Xiaofei Cheng, Kai Zhang, Xiaojiang Sun, Changqing Zhao, Hua Li, Jie Zhao
The objective was to analyze the compensatory effect of the pelvis and lower extremities on sagittal spinal malalignment in patients with pelvic incidence (PI) and lumbar lordosis (LL) mismatch. A series of parameters including PI, LL, PI-LL, thoracic kyphosis (TK), pelvic tilt (PT), sacral slope (SS), knee flexion angle (KFA), tibial obliquity angle (TOA), femoral obliquity angle (FOA), femur pelvis angle (FPA) and pelvic shift (PS) were measured. Patients with PI-LL mismatch were divided into pelvic retroversion group and pelvic retroposition group based on their PT and PS, and then the parameters were compared within the two groups and with the control group...
May 1, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28467582/minimal-invasive-fixation-of-distal-tibial-fractures-does-not-result-in-rotational-malalignment-a-report-of-24-cases-with-ct-imaging
#17
Mehmet Mesut Sönmez, Deniz Gülabi, Meriç Uğurlar, Metin Uzun, Sezgin Sarban, Ali Şeker
BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. METHODS: Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28460410/comparative-study-for-alignment-of-extramedullary-guides-versus-portable-accelerometer-based-navigation-in-total-knee-arthroplasty
#18
Kazu Matsumoto, Hiroyasu Ogawa, Masashi Fukuta, Nobuyuki Mori, Haruhiko Akiyama
The use of portable, accelerometer-based navigation (PN) devices for positioning of the components of total knee arthroplasty (TKA) is emerging as an alternative to standard extramedullary (EM) systems, which was needed to the image intensifier. The aim of our study was to compare the accuracy of component positioning in TKA using an EM and PN systems. Data from 100 consecutive primary TKAs, performed by multiple surgeons in 87 patients between October 2010 and June 2015, were analyzed. Coronal and sagittal plane alignments of the TKA components, relative to the mechanical axis of the limb, were evaluated by radiography...
May 1, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28459750/when-and-how-far-to-move-the-tibial-tuberosity-in-patients-with-patellar-instability
#19
Taylor D'Amore, Miho J Tanaka, Andrew J Cosgarea
The many factors contributing to patellar instability have led to various surgical techniques that are used commonly today. When surgery is deemed necessary, the operation should be tailored to the patient's specific pathoanatomy. Patients with malalignment can often be stabilized by moving the tibial tuberosity to a more medial, anteromedial, or distal position. Subsequent changes in the forces acting on the patellofemoral joint will depend on the direction and distance of the tuberosity repositioning. When planning tuberosity osteotomies, it is crucial to understand how to use clinical and imaging modalities to measure and quantify tuberosity position accurately to achieve the desired degree of realignment...
June 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28459748/diagnosis-and-characterization-of-patellofemoral-instability-review-of-available-imaging-modalities
#20
Arya Haj-Mirzaian, Gaurav K Thawait, Miho J Tanaka, Shadpour Demehri
Patellofemoral instability (PI) is defined as single or multiple episodes of patellar dislocation. Imaging modalities are useful for characterization of patellar malalignment, maltracking, underlying morphologic abnormalities, and stabilizing soft-tissue injuries. Using these findings, orthopedic surgeons can decide when to operate, determine the best operation, and measure degree of correction postoperatively in PI patients. Also, these methods assist with PI diagnosis in some suspicious cases. Magnetic resonance imaging is the preferred method especially in the setting of acute dislocations...
June 2017: Sports Medicine and Arthroscopy Review
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