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Limb length discrepancy

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https://www.readbyqxmd.com/read/27923597/long-term-results-of-cementless-total-hip-arthroplasty-with-subtrochanteric-shortening-osteotomy-in-crowe-type-iv-developmental-dysplasia
#1
Duan Wang, Ling-Li Li, Hao-Yang Wang, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: When surgeons reconstruct hips with a high dislocation related to severe developmental dysplasia of the hip (DDH) in total hip arthroplasty (THA), archiving long-term stable implant fixation and improving patient function and satisfaction remain challenging. The purpose of this study was to evaluate the 10-year outcomes of transverse subtrochanteric shortening osteotomy in cementless, modular THA in Crowe type IV-Hartofilakidis type III DDH. METHODS: We reviewed 62 patients (76 hips) who underwent cementless THA with transverse subtrochanteric shortening osteotomy from 2002-2010...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27914027/the-role-of-guided-growth-as-it-relates-to-limb-lengthening
#2
REVIEW
Peter M Stevens
For decades, the classic indication for limb lengthening has been reserved for anisomelia that was expected to reach or exceed 5 cm at maturity. Epiphysiodesis was reserved for discrepancies in the 2-5 cm range. With the increasing sophistication of fixators, including rail, hexapod, and hybrid, complex deformities may be corrected simultaneously while moderate to extreme lengthening is achieved. More recently, iterations of telescoping intramedullary rods have further strengthened our armamentarium. Meanwhile, permanent epiphysiodesis techniques, both open and percutaneous, have yielded to more versatile and reversible tethering of one (angle) or both (length) sides of a physis...
December 2, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#3
REVIEW
Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909134/what-is-the-morbidity-of-a-non-invasive-growing-prosthesis
#4
M M Gilg, C L Gaston, M C Parry, L Jeys, A Abudu, R M Tillman, S R Carter, R J Grimer
AIMS: Extendible endoprostheses have been available for more than 30 years and have become more sophisticated with time. The latest generation is 'non-invasive' and can be lengthened with an external magnetic force. Early results have shown a worryingly high rate of complications such as infection. This study investigates the incidence of complications and the need for further surgery in a cohort of patients with a non-invasive growing endoprosthesis. PATIENTS AND METHODS: Between 2003 and June 2014, 50 children (51 prostheses) had a non-invasive growing prosthesis implanted for a primary bone sarcoma...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27904734/recurrence-of-a-unicameral-bone-cyst-in-the-femoral-diaphysis
#5
Hyun Se Kim, Kyung Sup Lim, Sung Wook Seo, Seung Pil Jang, Jong Sup Shim
Diaphyseal unicameral bone cysts of the long bone are generally known to originate near the growth plate and migrate from the metaphysis to the diaphysis during skeletal growth. In the case of unicameral bone cysts of diaphyseal origin, recurrence at the same location is extremely rare. We report a case of recurrence of a unicameral bone cyst in the diaphysis of the femur that developed 8 years after treatment with curettage and bone grafting. We performed bone grafting and lengthening of the affected femur with an application of the Ilizarov apparatus over an intramedullary nail to treat the cystic lesion and limb length discrepancy simultaneously...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27878660/residual-bone-growth-after-lengthening-procedures
#6
Pierre Journeau, Pierre Lascombes, Dominique Barbier, Dmitry Popkov
The prognosis of limb length discrepancy is a major subject in paediatric orthopaedic surgery. The strategy depends on the prognosis and must be adapted to each patient. The residual growth of the lengthened segment often remains unknown, but is dependent on age, the percentage of lengthening and other factors. Using a large cohort of 150 children who had undergone bone lengthening procedures, we describe five patterns of post-intervention growth and identify factors that are favourable for normal residual growth...
November 23, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27876520/explaining-endograft-shortening-during-endovascular-repair-of-abdominal-aortic-aneurysms-in-severe-aortoiliac-tortuosity
#7
Kevin Lee, Sajjid Hossain, Maher Sabalbal, Luc Dubois, Audra Duncan, Guy DeRose, Adam H Power
OBJECTIVE: During endovascular aneurysm repair (EVAR), severely tortuous aortoiliac anatomy can alter the deployment and conformability of the endograft. The accuracy of treatment length measurements is commonly recognized to be affected by severe tortuosity. However, the exact mechanism of the postintervention length discrepancy is poorly understood. The objective of this study was to determine the mechanism of how severe aortoiliac tortuosity influences the endograft and native aorta during EVAR and its impact on the distal sealing zone...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27871660/management-of-the-anterior-cruciate-ligament-injured-knee-in-the-skeletally-immature-athlete
#8
REVIEW
Christian N Anderson, Allen F Anderson
Intrasubstance tears of the anterior cruciate ligament (ACL) are being diagnosed with increasing frequency in the skeletally immature. Management options include nonoperative/ early surgical, or delayed surgical reconstruction. Nonoperative/delayed reconstruction results in worse functional outcomes than early reconstruction. Physicians are faced with a treatment dilemma; clinical and basic science studies have demonstrated risk of limb-length discrepancy and angular deformity with ACL reconstruction. Vertical drill tunnels decrease physeal damage and minimize growth deformity; however, this technique results in nonanatomic ACL graft placement...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27861256/nonmodifiable-risk-factors-for-anterior-cruciate-ligament-injury
#9
Meghan J Price, Maria Tuca, Frank A Cordasco, Daniel W Green
PURPOSE OF REVIEW: As anterior cruciate ligament (ACL) injury is becoming increasingly prevalent in the population of active children and young adolescents, it is crucial to be aware of both the modifiable and nonmodifiable factors that place this population at increased ACL injury risk. Historically, there has not been a definitive consensus on all of these risk factors-particularly the nonmodifiable ones. RECENT FINDINGS: The present review has accumulated the most recent evidence for the nonmodifiable risk factors in ACL injury focusing particularly on female gender, generalized joint laxity, knee recurvatum, increased lateral tibial slope, decreased intercondylar notch width, structural lower extremity valgus, limb length discrepancy, family history, and history of contralateral knee ACL injury...
November 16, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27858886/fixator-assisted-tibial-lengthening-over-a-plate-in-a-patient-with-sequelae-of-poliomyelitis
#10
Haci Bayram Tosun, Sancar Serbest, Abuzer Uludag, Seyitali Gumustas, Suat Celik
There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate.Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27847854/spinopelvic-fixation-of-sacroiliac-joint-fractures-and-fracture-dislocations-a-clinical-8-years-follow-up-study
#11
Mohammad R Sobhan, Seyed Mohammad J Abrisham, Mahmood Vakili, Saeed Shirdel
BACKGROUND: Pelvic ring injuries and sacroiliac dislocations have significant impacts on patient's quality of life. Several techniques have been described for posterior pelvic fixation. The current study has been designed to evaluate the spinopelvic method of fixation for sacroiliac fractures and fracture-dislocations. METHODS: Between January 2006 and December 2014, 14 patients with sacroiliac joint fractures, dislocation and fracture-dislocation were treated by Spinopelvic fixation at Shahid Sadoughi Training Hospital, Yazd, Iran...
October 2016: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/27845969/closing-the-growth-plate-a-review-of-indications-and-surgical-options
#12
Joseph J Ruzbarsky, Christine Goodbody, Emily Dodwell
PURPOSE OF REVIEW: The purpose is to review the indications for epiphysiodesis in the treatment of pediatric limb length discrepancies; provide an update on current diagnostic, planning, and surgical techniques; and to introduce possible future alternatives. RECENT FINDINGS: Retrospective comparative studies have failed to demonstrate superiority of one epiphysiodesis technique over the others. EOS low-dose biplanar X-ray and smartphone growth prediction applications are improving our ability to diagnose and plan treatment for leg length discrepancy...
November 14, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27832012/paediatric-lower-limb-deformity-correction-with-the-eight-plate-adverse-events-and-correction-outcomes-of-126-patients-from-an-international-multicentre-study
#13
Alexander Joeris, Leonhard Ramseier, Micha Langendörfer, Michael von Knobloch, Sandeep Patwardhan, Jonathan Dwyer, Theddy Slongo
No large multicentre studies have yet been published on tension-band-like implants such as the Eight Plate to treat limb-length discrepancies and varus valgus deformities in children. Therefore, we carried out a retrospective international multicentre study including 126 patients to assess outcomes and to reliably quantify the incidence of implant-related and growth-plate related adverse events (AEs). Correction was achieved in 66% of varus valgus deformities and in 59% of limb-length discrepancies and maintained in 85%...
November 9, 2016: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27826905/current-approaches-to-flexible-intramedullary-nailing-for-bone-lengthening-in-children
#14
REVIEW
Dmitry Popkov, Pierre Lascombes, Pierre Journeau, Arnold Popkov
Limb-length discrepancies and extremity deformities are among the most common non-traumatic orthopaedic conditions for which children are hospitalised. There is a need to develop new treatment options for lower-limb length discrepancy in order to ameliorate treatment outcomes, avoid or reduce rates of complication and provide early rehabilitation. The authors report on the basic principles, experimental and clinical data, advantages, problems and complications of a combined technique associating the Ilizarov method and flexible intramedullary nailing (FIN) in limb lengthening and deformity correction in children...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27817994/favorable-early-results-of-impaction-bone-grafting-with-reinforcement-mesh-for-the-treatment-of-paprosky-3b-acetabular-defects
#15
Bradford S Waddell, Friedrich Boettner, Alejandro Gonzalez Della Valle
BACKGROUND: We present the early institutional experience with the use of impaction bone grafting, mesh augmentation, and cement fixation of an all-polyethylene cup for the treatment of Paprosky 3B acetabular defects during revision total hip arthroplasty. METHODS: Between 2005 and 2014, 21 patients (9 men, 12 women) with Paprosky 3B acetabular defects who underwent revision total hip arthroplasty using this technique were reviewed clinically and radiographically...
October 5, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27770774/combination-of-intramedullary-rod-wrapping-bone-grafting-and-ilizarov-s-fixator-for-the-treatment-of-crawford-type-iv-congenital-pseudarthrosis-of-the-tibia-mid-term-follow-up-of-56-cases
#16
Guang-Hui Zhu, Hai-Bo Mei, Rong-Guo He, Yao-Xi Liu, Kun Liu, Jin Tang, Jiang-Yan Wu
BACKGROUND: The purpose of this study was to investigate the initial union rate, refracture rate and residual deformities of congenital pseudarthrosis of the tibia (CPT), using combined surgery including pseudarthrosis resection, intramedullary rodding, autogenous iliac bone grafting and Ilizarov's fixator, with a mean 5.2 years follow-up. METHODS: We retrospectively reviewed the records and diagrams of patients with Crawford type IV congenital pseudarthrosis of the tibia between February 2007 and March 2010...
October 22, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27748675/physeal-bar-equivalent
#17
Hamlet A Peterson, William J Shaughnessy, Anthony A Stans
Premature partial physeal arrest without the formation of an osseous bar - physeal bar equivalent (PBE) - is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27733883/lower-limbs-alignment-in-patients-with-a-unilateral-completely-dislocated-hip
#18
Shinsuke Someya, Motoki Sonohata, Shuya Ide, Satomi Nagamine, Tomonori Tajima, Masaaki Mawatari
BACKGROUND: Severe hip osteoarthritis is known to lead to secondary osteoarthritis of the knee joint. It is not clear whether contracture or a leg length discrepancy is more important in determining the knee alignment. METHODS: In this study, 48 hips in 48 patients with a unilateral completely dislocated hip (Crowe IV) were recruited. The patients were divided into two groups (Crowe IVa and IVb). The Crowe IVa group had completely dislocation with psudo-articulation, and the Crowe IVb group had completely dislocation without psudo-articulation...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27686373/regenerate-bone-stimulation-following-limb-lengthening-a-meta-analysis
#19
Julio J Jauregui, Anthony V Ventimiglia, Preston W Grieco, David B Frumberg, John E Herzenberg
BACKGROUND: Limb lengthening with external fixation is performed to treat patients with leg length discrepancy or short stature. Although the procedure has a high rate of success, one potential drawback from limb lengthening is the amount of time spent in the fixation device while regenerate bone consolidates. Although some studies have assessed different treatment modalities, there has not been a study that has systematically evaluated whether low intensity pulsed ultrasound (LIPUS) or pulsed electromagnetic fields (PEMF) have significant effects on regenerate bone growth...
September 29, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27676749/orthopedic-treatment-vs-surgery-for-longitudinal-fibular-deficiency
#20
Nathaly Quintero-Prigent, Caroline Radot, Marion Fiat, Malak Fahny, Naima Brennetot
OBJECTIVE: Fibular hemimelia or longitudinal fibular deficiency is the most frequent congenital malformation of lower limbs. It causes sometimes major limbs shortening. Different treatments could be considered depending on the severity of the malformation: contralateral epiphysiodesis, corrective foot and knee osteotomies, leg-lengthening surgery with external fixation, prosthesis. For the most severe cases (15-20cm bone length discrepancies or unstable knee or foot), leg-lengthening surgery with external fixation is not recommended...
September 2016: Annals of Physical and Rehabilitation Medicine
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