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Carlos Augusto Malheiros Luzo, Roberto Guarniero, Nei Botter Montenegro, Rui Maciel de Godoy Junior
OBJECTIVE: To present the preliminary results from treating patients with Legg-Calvé-Perthes Disease (LCPD) by means of hip arthrodiastasis using a monolateral external fixator applied to the hip and to succinctly describe the surgical technique used, in a prospective study. METHODS: Prospective study on 18 patients with LCPD who underwent surgical treatment by means of the hip arthrodiastasis technique using a monolateral external fixator. There were 13 male and five female patients of mean age 8...
May 2016: Revista Brasileira de Ortopedia
I Aguado-Maestro, J C Abril, A Bañuelos Diaz, M García Alonso
INTRODUCTION AND OBJECTIVE: Arthrodiastasis consists of the mobilisation of the hip while distracted by a hinged distractor. The aim of our study is to show the results of the treatment of late-onset Perthes disease with this technique in our institution. MATERIAL AND METHODS: Ambispective review of all the cases that underwent this surgery in our Department of Paediatric Orthopaedics between 2010 and 2014 with the following inclusion criteria: patients over 8 years old, with minimal deformity, and poor prognosis...
July 2016: Revista Española de Cirugía Ortopédica y Traumatología
Francesco Castagnini, Camilla Pellegrini, Luca Perazzo, Francesca Vannini, Roberto Buda
Ankle osteoarthritis (AOA) is a severe pathology, mostly affecting a post-traumatic young population. Arthroscopic debridement, arthrodiastasis, osteotomy are the current joint sparing procedures, but, in the available studies, controversial results were achieved, with better outcomes in case of limited degeneration. Only osteotomy in case of malalignment is universally accepted as a joint sparing procedure in case of partial AOA. Recently, the biological mechanism of osteoarthritis has been intensively studied: it is a whole joint pathology, affecting cartilage, bone and synovial membrane...
December 2016: J Exp Orthop
Amol Saxena, Magali Fournier
Tarsal coalitions are an abnormal union between 2 tarsal bones. They occur most commonly between the calcaneus and talus or the calcaneus and navicular but can also arise from other joints in the foot. Isolated cases of coalitions between the medial cuneiform and navicular are extremely rare, and only a few cases have been reported. Treatment recommendations are, therefore, sparse, and no long-term follow-up data have been reported. We present the case of 2 sisters, each diagnosed with a symptomatic naviculocuneiform coalition...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Ajai Singh, Rajeshwar N Srivastava, Prashant Shukla, Amit Pushkar, Sabir Ali
Background. Hip distraction in Perthes' disease unloads the joint, which negates the harmful effect of the stresses on the articular surfaces, which may promote the sound healing of the area of necrosis. We have examined the effect of arthrodiastasis on the preservation of the femoral head in older children with Perthes' disease. Methods and Materials. Twelve children with age more than 8 years with Perthes' disease of less than one year were treated with hip distraction by a hinged monolateral external fixator...
2014: Advances in Orthopedics
Gregory C Berlet, Christopher F Hyer, Ryan T Scott, Melissa M Galli
Correction of valgus hindfoot deformity can be successfully achieved with arthrodesis of the subtalar and talonavicular joints through a single medial based incision. The advantages of medial double arthrodesis compared with the standard triple arthrodesis 2-incision approach include the absence of a lateral incision and a few degrees of residual mobility through the unfused calcaneocuboid joint (CCJ). The CCJ has often been noted to distract and decompress with the abduction correction achieved through medial double fusion...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Melissa M Galli, Nicole M Protzman, Stephen A Brigido
Arthrodiastasis of the calcaneocuboid joint after medial double arthrodesis has been described, but the extent remains unreported. We present our comparative findings after medial double and Lapidus fusion on the effects of the calcaneocuboid joint. Adults undergoing medial column fusion with internal fixation and a minimal clinical and radiographic follow-up period of 3 months were included. Subjects were excluded for Charcot deformity, previous arthrodesis surgery, and history of calcaneocuboid joint trauma or surgery...
May 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
John J Stapleton, Thomas Zgonis
Numerous techniques have been described for posttraumatic ankle arthritis with or without an associated lower extremity deformity in the adult population. These surgical procedures may include, but are not limited to, ankle exostectomy with joint resurfacing, ankle arthrodiastasis, ankle arthroplasty, and ankle arthrodesis. Associated deformities may also be addressed with supramalleolar osteotomies, tibia or fibular lengthening, and calcaneal osteotomies. In juvenile patients, surgical treatment options for posttraumatic ankle arthritis can be challenging, especially when an associated deformity is present...
October 2014: Clinics in Podiatric Medicine and Surgery
M Galán, R Seijas, M Aguirre, O Ares, X Cuscó, R Cugat
BACKGROUND: The prognosis of late onset Perthes cases is usually poor and the proposed treatments vary based on the surgeon's preferences and experience, as well as on the available resources. Most of them are salvage procedures with a short follow-up and non-standardized application criteria. METHODS: Hip arthroscopy and arthrodiastasis with external fixator are indicated for certain situations in Perthes disease. Based on the results obtained with each of these techniques separately, both of them were used to treat a case of Perthes disease involving a poor prognosis...
November 2013: Acta Ortopédica Mexicana
Shuhei Ugaji, Koji Watanabe, Hidenori Matsubara, Issei Nomura, Takao Aikawa, Hiroyuki Tsuchiya
We here report a case of a 50-year-old male with ankle osteoarthritis and lower limb deformity, for which simultaneous deformity correction and arthrodiastasis were performed. The patient initially experienced an open fracture on the left tibia at 19 years, but it was malunited. The Japanese Society for Surgery score of the foot for the left ankle was 53 points. X-ray and CT imaging showed rotational and angular tibial deformities with shortening by 1.6cm and end-stage osteoarthritis of the left ankle. An external fixator was applied to correct the lower limb deformity, and ankle arthrodiastasis was performed...
March 2014: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
M Herrera-Pérez, J L Pais-Brito, J de Bergua-Domingo, M Aciego de Mendoza, A Guerra-Ferraz, P Cortés-García, B Déniz-Rodríguez
INTRODUCTION: The most common cause of osteoarthritis of the ankle is post-traumatic, and although tibiotalar arthrodesis remains the surgical gold standard, a number of techniques have been described to preserve joint mobility, such as joint distraction arthroplasty or arthrodiastasis. OBJECTIVE: To evaluate the functional outcome and changes in Visual Analogue Scale (VAS) for pain after the application of the distraction arthroplasty for post-traumatic ankle osteoarthritis...
November 2013: Revista Española de Cirugía Ortopédica y Traumatología
I Georgescu, C Vlad, T Ş Gavriliu, S Dan, A A Pârvan
INTRODUCTION: Osteogenesis imperfecta (OI) is a very rare disease compared to other afflictions, running the risk of social isolation for children and their parents, due to the problems specific to the disease. All the social, psychological and physical disadvantages must be removed or at least mitigated, all within the society's limited resources. In Romania, this situation has led in the last couple of years to the selection of a number of extremely severe cases, which could not be solved by orthopedic and classic surgical treatment methods...
June 15, 2013: Journal of Medicine and Life
Amol Saxena, Brian W Fullem
Surgery in the athlete can present unique challenges, particularly when articular damage and osteoarthritic changes are noted. To allow athletes to return to their desired activity level, an alternative to the traditional approach of fusion must be developed. We prospectively reviewed 3 cases of osteochondral lesions and degenerative changes of the tarsal navicular joint involving a unique surgical approach consisting of microfracture of the lesions with concomitant arthrodiastasis. All 3 patients were treated with a miniexternal fixator to provide distraction for 4 weeks...
March 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Bryan A Sagray, Bradley A Levitt, Thomas Zgonis
Arthrosis of the ankle joint, typically posttraumatic in nature, can affect younger and older populations alike. A multitude of procedures exist for treatment, such as arthrodesis, total joint replacement, arthrodiastasis, and articular repair. Current literature has demonstrated success in articular surface repair and arthrodiastasis as separate procedures. This article reviews the technique of ankle arthrodiastasis and interpositional ankle exostectomy, consisting of background, mechanism of action, indications, patient selection criteria, complications, and advantages in the current literature...
October 2012: Clinics in Podiatric Medicine and Surgery
Albert M D'Angelantonio, Faith A Schick
There are many treatment options for patients with ankle osteochondral defects and subsequent osteoarthritis. Although ankle arthrodesis remains the gold standard to definitive treatment of this condition, its permanent sequelae demands an alternative. In this article we discuss a case report from a 61-year-old woman with a history of a previous ankle sprain resulting in an osteochondral defect that progressed to develop ankle osteoarthritis. After multiple attempts at conservative management, the patient underwent placement of an articulating external ring fixator for arthrodiastasis, as well as ankle joint resurfacing using allograft...
January 2013: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Lawrence A DiDomenico, Nik Gatalyak
End-stage ankle arthritis is a debilitating condition that leads to pain and swelling in the ankle joint, with symptoms aggravated by standing and ambulation. Ankle arthritis commonly results from a history of trauma, or a series of recurrent injuries to the ankle. However, it may develop from other causes such as uneven loading of the ankle joint caused by an alignment deformity or from inflammatory arthritis such as rheumatoid arthritis, gout, or secondary to a serious joint infection. Patients with severe ankle arthritis often have limited ankle motion with an antalgic gait...
July 2012: Clinics in Podiatric Medicine and Surgery
Mohamed Abdel-Rehim Laklouk, Gamal Ahmed Hosny
The aim of this work is to determine the effect of this type of treatment on the shape of the femoral head, the range of motion (ROM), radiological changes in the femoral head, and the prognosis of Perthes disease at skeletal maturity. From 1998 to 2007, 53 patients with Perthes disease were treated with a combination of soft tissue release and joint distraction with a hinged monolateral external fixator in 32 patients and by Ilizarov external fixator in 21 patients. Nineteen of our 53 patients attained skeletal maturity and were evaluated in our study...
September 2012: Journal of Pediatric Orthopedics. Part B
Crystal L Ramanujam, Steven Kissel, Alex Stewart, Thomas Zgonis
The primary goal in the treatment of arthritic joints is elimination of pain associated with limited motion. Several surgical techniques have been developed to treat varying degrees of hallux rigidus of any cause. This case report details an alternative surgical approach to address hallux rigidus and associated hallux valgus deformity through a combination of joint debridement, resurfacing, and arthrodiastasis.
January 2012: Clinics in Podiatric Medicine and Surgery
Abdel Rahman Abdel Latif Amer, Ashraf A Khanfour
Perthes' disease (Legg-Calvé-Perthes' disease) is relatively common in childhood, affecting 0.8/100.000 children. Late onset Perthes' disease, older than 8 years of age, constitutes about 20% of cases and is known for its aggressive course and poor outcome with chronic hip pain and stiffness. Although containment of the head in the acetabulum is the usual treatment for early cases, its results in treating late-onset cases are universally poor, so that many authors conclude that there is an upper age limit for effectiveness of containment treatment...
August 2011: Acta Orthopaedica Belgica
Gamal Ahmed Hosny, Khamis El-Deeb, Mohamed Fadel, Mohamed Laklouk
BACKGROUND: Hip distraction in Legg-Calvé-Perthes disease unloads the joint, which negates the harmful effect of the stresses on the articular surface, which may promote the sound healing of the areas of necrosis. METHODS: Nonarticulated arthrodiastasis without soft tissue release using an Ilizarov external fixator was applied to 29 patients with Legg-Calvé-Perthes disease (older than 8 y at onset and lateral pillar type C or B). RESULTS: Follow-up period ranged from 2...
September 2011: Journal of Pediatric Orthopedics
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