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Limb length discrepancy

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https://www.readbyqxmd.com/read/28639009/chipping-and-lengthening-over-nailing-technique-for-femoral-shaft-nonunion-with-shortening
#1
Gen Sasaki, Yoshinobu Watanabe, Motoyuki Takaki, Youichi Yasui, Wataru Miyamoto, Hirotaka Kawano, Takashi Matsushita
PURPOSE: Chipping and lengthening over nailing (CLON) technique was developed to treat femoral shaft nonunion with shortening more than 10 mm. The purpose of the current retrospective case series was to clarify the effectiveness of the CLON technique on the femoral shaft nonunion following intramedullary nailing. METHODS: Clinical and radiological outcomes in the patients receiving operative treatment for femoral shaft nonunion between August 2012 and December 2016 were retrospectively reviewed using the Refractory Fracture Data Registry at the authors' institution...
June 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28622842/two-stage-knee-arthrodesis-with-a-modular-intramedullary-nail-due-to-septic-failure-of-revision-total-knee-arthroplasty-with-extensor-mechanism-deficiency
#2
Max J Friedrich, Jan Schmolders, Matthias D Wimmer, Andreas C Strauss, Milena M Ploeger, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
BACKGROUND: Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28601180/musculoskeletal-traumatic-injuries-in-children-characteristic-imaging-findings-and-mimickers
#3
REVIEW
Victor M Ho-Fung, Matthew A Zapala, Edward Y Lee
Musculoskeletal traumatic injuries in children demonstrate characteristic imaging findings. The physis is the most susceptible structure to traumatic injury. The periosteum in children plays a key role in rapid bone healing and stability. The main complications of fractures in children are premature physeal closure, potential limb length discrepancy, and angular deformities. Understanding the normal bone growth, healing, and complications of pediatric fractures is crucial for appropriate imaging diagnosis. This article discusses currently available imaging modalities with up-to-date techniques, underlying mechanisms, and characteristic imaging findings of musculoskeletal traumatic injuries and mimickers encountered in daily clinical practice...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28600975/relationship-and-significance-of-gait-deviations-associated-with-limb-length-discrepancy-a-systematic-review
#4
REVIEW
Sam Khamis, Eli Carmeli
Controversy still exists as to the clinical significance of leg length discrepancy (LLD) in spite of the fact that further evidence has been emerging regarding the relationship between several clinical conditions and LLD. The objectives of our study were to review the available research with regard to LLD as a cause of clinically significant gait deviations, to determine if there is a relationship between the magnitude of LLD and the presence of gait deviations and to identify the most common gait deviations associated with LLD...
May 31, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28578843/total-hip-arthroplasty-in-patients-with-multifactorial-perceived-limb-length-discrepancy
#5
Amgad M Haleem, Kevin F Wiley, Raul Kuchinad, S Robert Rozbruch
BACKGROUND: Patients with advanced hip arthritis can present with multifactorial limb length discrepancies (LLDs) owing to bony shortening from growth arrest, proximal hip migration, soft-tissue contractures, and pelvic obliquity. The patient perceives an LLD that is a combination of true LLD and apparent LLD. METHODS: We retrospectively reviewed 7 cases with multifactorial mean perceived LLD of 7.7 cm (range, 3.6-11 cm) that underwent primary total hip arthroplasty and auxiliary soft-tissue procedures...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28567217/comparison-of-surgical-parameters-and-results-between-curved-varus-osteotomy-and-rotational-osteotomy-for-osteonecrosis-of-the-femoral-head
#6
Young-Kyun Lee, Chan Ho Park, Yong-Chan Ha, Do-Yeon Kim, Sung-Hwa Lyu, Kyung-Hoi Koo
BACKGROUND: Various osteotomies have been introduced to treat osteonecrosis of the femoral head. The purpose of this study was to compare surgical parameters, postoperative limb length discrepancy, and minimum 5-year clinical and radiological results between transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head. METHODS: From 2004 to 2009, 103 consecutive TROs (97 patients) followed by 72 consecutive TCVOs (64 patients) were performed for the treatment of osteonecrosis of the femoral head...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28567150/cortical-fenestration-for-megaprosthesis-stem-revision
#7
Vincent Y Ng, Philip Louie, Stephanie Punt, Ernest U Conrad Iii
BACKGROUND: The most common modes of failure for megaprostheses are aseptic loosening followed by periprosthetic infection and stem fracture. Surgical technique for bone and implant exposure is controversial and may influence the success of revision and the need for additional future revisions. The purpose of this study was to evaluate the effectiveness of cortical fenestration for megaprosthesis revision, particularly for stem fracture. METHODS: From 1985-2014, 196 adult and pediatric patients underwent limb salvage with a distal femoral or proximal tibial megaprosthesis (109 cemented, 87 pressfit)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28562492/congenital-pseudarthrosis-of-the-tibia-in-children-should-we-defer-surgery-until-3-years-old
#8
Yaoxi Liu, Haibo Mei, Guanghui Zhu, Kun Liu, Jiangyan Wu, Jin Tang, Rongguo He
Currently, the timing of surgery for congenital pseudarthrosis of the tibia (CPT) remains controversial. The aim of this study was to investigate the results of treatment of pseudarthrosis of the tibia in children younger than 3 years of age. A retrospective study was carried out to explore the relationship between postoperative complications and the age of surgery in children with CPT. The analysis was carried out on 42 patients with Crawford type IV CPT treated with a combined surgical technique between 2008 and 2012...
May 30, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28559144/vascularised-fibula-or-induced-membrane-to-treat-congenital-pseudarthrosis-of-the-tibia-a-multicentre-study-of-18-patients-with-a-mean-9-5-year-follow-up
#9
F Vigouroux, G Mezzadri, R Parot, A Gazarian, S Pannier, F Chotel
BACKGROUND: The objective of this study was to compare outcomes of two surgical techniques used to treat congenital pseudarthrosis of the tibia (CPT), the induced membrane technique (IM) and the transfer of the contralateral vascularised fibula (VF). HYPOTHESIS: The IM technique produces similar outcomes to those of VF grafting in terms of healing and function, while being simpler and having a lower complication rate. MATERIAL AND METHOD: This retrospective multicentre study included 18 patients with a mean age of 2...
May 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28557815/use-of-paley-classification-and-superankle-procedure-in-the-management-of-fibular-hemimelia
#10
Ruta M Kulkarni, Nitish Arora, Sagar Saxena, Sujay M Kulkarni, Yadwinder Saini, Rajiv Negandhi
BACKGROUND: Fibular hemimelia is the most common deficiency involving the long bones. Paley classification is based on the ankle joint morphology, identifies the basic pathology, and helps in planning the surgical management. Reconstruction surgery encompasses foot deformity correction and limb length equalization. The SUPERankle procedure is a combination of bone and soft tissue procedures that stabilizes the foot and addresses all deformities. METHODS: We retrospectively reviewed 29 consecutive patients (29 limb segments), surgically treated between December 2000 and December 2014...
May 26, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28506314/application-of-intraoperative-limb-length-measurement-by-a-new-osteotomy-device-in-hemiarthroplasty-for-treating-femoral-neck-fracture
#11
Zhanle Zheng, Lei Yang, Yanling Su, Xian Yu, Zhiyong Hou, Yingze Zhang
BACKGROUND: Limb length discrepancy is one of the most common complications after hip arthroplasty. We developed a device - intraoperative limb-length measurement and osteotomy device (ILMOD), and applied it to patients who were treated with hemiarthroplasty for femoral neck fracture to improve limb length discrepancy by providing an accurate osteotomy during hemi-arthroplasty. METHODS: Between April 2012 and October 2013, 65 patients were treated with hip hemiarthroplasty for femoral neck fracture at our trauma center...
May 15, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28495173/late-treatment-of-obstetrical-brachial-plexus-palsy-by-humeral-rotational-osteotomy-and-lengthening-with-an-intramedullary-elongation-nail
#12
Ahmet Emrah Acan, Onur Gursan, Nihat Demirhan Demirkiran, Hasan Havitcioglu
To date, all the authors who have recommended external rotation osteotomy (ERO) in the late treatment of obstetrical brachial plexus palsy (OBPP), have neglected upper limb length discrepancy, which is an another sequelae of OBPP. In this paper, a new technique is reported for the late treatment of OBPP patients with upper limb length discrepancy, in which both humeral external rotation osteotomy (ERO) and lengthening are applied with an intramedullary elongation nail. With this technique, upper limb function is improved through re-orientation of the shoulder arc to a more functional range, and further improvements will be seen in the appearance of the upper limb with the elimination of length discrepancy...
May 8, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28489628/lengthening-of-newly-formed-humerus-after-autologous-fibula-graft-transplantation-following-intercalary-tumor-resection
#13
Hakan Pilge, Martin Ruppert, Bernd Bittersohl, Bettina Westhoff, Rüdiger Krauspe
Secondary limb lengthening after intercalary bone resection in pediatric patients is still challenging. After the resection, a free fibula autograft can be used to reconstruct the osseous gap. However, in particular in young pediatric patients, insufficient growth of the epiphyseal plate after transplantation may lead to a significant limb-length discrepancy (LLD). In this case, the autograft was used for limb lengthening. We report on the lengthening of a humerus regenerate after fibula autograft transplantation into a humeral defect in a pediatric/young adolescent patient...
May 5, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28483212/predictors-and-functional-implications-of-change-in-leg-length-after%C3%A2-total-knee-arthroplasty
#14
Jason Chinnappa, Darren B Chen, Ian A Harris, Samuel J MacDessi
BACKGROUND: Leg lengthening occurs in 83% of primary total knee arthroplasty (TKA). The effects of leg length discrepancy (LLD) on THA patients are well established. However, patient function and satisfaction associated with LLD after primary TKA has not been analyzed. This study aimed to quantify the magnitude of limb lengthening, identify radiographic and perceived LLD, and correlate these with predictive factors and functional outcomes in a series of TKA patients. METHODS: Patients undergoing primary TKA who met inclusion criteria were prospectively enrolled in this study...
April 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28447315/neglected-hip-dislocation-an-unusual-presentation-its-management-and-review-of-the-literature
#15
Sandeep Kumar, Anshul Dahuja, M S Narula, Sangam Garg, Rashmeet Kaur
Neglected traumatic posterior hip dislocation is not an uncommon condition seen in developing countries. Its treatment is fraught with great difficulties and controversies. Here we present a 31-year-old female patient presented to our hospital 2 years after sustaining an accident. She had gone through multiple treatments for her dislocated hip without any success. After arrival to our hospital, patient managed by constrained total hip replacement (THR). Her Harris hip score improved from 48 (preoperative) to 81 (postoperative)...
April 26, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28428035/evaluation-of-the-external-fixator-truelok-hexapod-system-for-tibial-deformity-correction-in-children
#16
Sébastien Pesenti, Christopher A Iobst, Franck Launay
BACKGROUND: Tibial deformities are common in paediatric orthopaedic practice. Correcting multiplanar tibial deformities associated with lower limb length discrepancycan be challenging. Hexapod external fixation with gradual correction has been proven effective in this situation. OBJECTIVE: To assess clinical and radiological outcomes of gradual tibial deformity correction using the external fixator TL-HEX(TM)(Orthofix) in children. HYPOTHESIS: TL-HEX™ is effective in correcting tibial deformities in children...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28408083/masquelet-technique-versus-ilizarov-bone-transport-for-reconstruction-of-lower-extremity-bone-defects-following-posttraumatic-osteomyelitis
#17
Kai Tong, Ziyi Zhong, Yulan Peng, Chuangxin Lin, Shenglu Cao, YunPing Yang, Gang Wang
OBJECTIVE: This study was to compare the effectiveness of Masquelet technique versus Ilizarov bone transport in the treatment of lower extremity bone defects following posttraumatic osteomyelitis. PATIENTS AND METHODS: We retrospectively reviewed 39 patients who had been treated at our department for lower extremity bone defects following posttraumatic osteomyelitis. They were 30 males and 9 females with a mean age of 39.18 (range, 12-63 years). The infected bone defects involved 26 tibias and 13 femurs...
April 4, 2017: Injury
https://www.readbyqxmd.com/read/28400661/intraoperative-measurement-of-limb-lengthening-during-total-hip-arthroplasty
#18
Dimitrios Vasileiou Papadopoulos, Panagiotis Koulouvaris, Georgios Charalambos Aggelidakis, Andreas Georgios Tsantes, Marios Georgios Lykissas, Alexandros Mavrodontidis
BACKGROUND: Limb length discrepancy (LLD) after total hip arthroplasty (THA) is a common problem which cannot be completely resolved. Many techniques have been described in order to minimize postoperative LLD, but most of these techniques are difficult to apply. Ideal technique must be simple and accurate. The most simple technique using a suture tied on the skin has well-known limitations, but its accuracy has not been evaluated before. MATERIALS AND METHODS: Sixty THAs in sixty patients (mean age 71 years, 1:1 male to female ratio) with hip osteoarthritis (37 cases in the right, and 23 cases in the left side) were studied in this prospective study...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28383440/cementless-total-hip-arthroplasty-with-extended-sliding-trochanteric-osteotomy-for-high-congenital-hip-dislocation-a-retrospective-study
#19
Zhengliang Luo, Min Chen, Fei Hu, Zhe Ni, Xiaofeng Ji, Xiaoqi Zhang, Peng Cheng, Xifu Shang
Total hip arthroplasty (THA) for high congenital hip dislocation (CHD) is technically demanding. The purpose of this retrospective study was to evaluate the results of cementless THA combined with extended sliding trochanteric osteotomy. We also assessed whether chronic low back pain was relieved after surgery.The study included 19 patients (23 hips) with high CHD treated with cementless THA using extended sliding trochanteric osteotomy technique. Clinical and radiographic outcomes were evaluated.Harris Hip Score, WOMAC score, visual analog scale for low back pain and Trendelenburg sign were significantly improved (P < 0...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28381356/blocking-screws-for-alignment-control-in-intramedullary-limb-lengthening
#20
Julian Fürmetz, Stefan Bösl, James Schilling, Florian Wolf, Nikolaus Degen, Peter H Thaller
Simultaneous deformity correction in the frontal and sagittal plane becomes more and more an important part of intramedullary lengthening to avoid further operative procedures. Such as in fracture treatment blocking screws can be used for alignment control if osteotomy is performed in the metaphyseal bone. 31 intramedullary lengthening procedures between 2009 and 2011 were retrospectively analysed for precision of simultaneous deformity correction. The average planned correction to the HKA was 2.4° (0.1°-8...
March 31, 2017: Injury
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