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Limb length discrepancy

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https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#1
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29776983/robotic-assisted-compared-with-conventional-total-hip-arthroplasty-systematic-review-and-meta-analysis
#2
Xi Chen, Jianping Xiong, Peipei Wang, Shibai Zhu, Wenting Qi, Huiming Peng, Lingjia Yu, Wenwei Qian
BACKGROUND: Robotic-assisted total hip arthroplasty (THA) allows for accurate preoperative planning and component positioning, potentially enhancing implant survival and long-term outcomes. The relative efficacy and safety of robotic-assisted and conventional THA, however, are unclear. This systematic review and meta-analysis compared the safety and efficacy of robotic-assisted and conventional THA. METHODS: Medline, Embase and the Cochrane Library were comprehensively searched in September 2017 to identify studies comparing the safety and efficacy of robotic-assisted and conventional THA...
May 18, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29721550/evaluation-of-functional-and-structural-leg-length-discrepancy-in-patients-with-adolescent-idiopathic-scoliosis-using-the-eos-imaging-system-a-prospective-comparative-study
#3
Tatsuhiro Sekiya, Yoichi Aota, Katsutaka Yamada, Kanichiro Kaneko, Manabu Ide, Tomoyuki Saito
Background: To our knowledge, no studies have reported the exact structural leg length discrepancies (LLDs) in patients with adolescent idiopathic scoliosis (AIS). Therefore, this study aimed to evaluate the differences between functional and structural LLDs and to examine the correlations between LLDs and spinopelvic parameters in patients with AIS using an EOS imaging system, which permits the three-dimensional reconstruction of spinal and lower-limb bony structures. Methods: Eighty-two consecutive patients with AIS underwent whole-body EOS radiography in a standing position between August 2014 and March 2016...
2018: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/29707059/posteromedial-bowing-of-the-tibia-a-benign-condition-or-a-case-for-limb-reconstruction
#4
J Wright, R A Hill, D M Eastwood, A Hashemi-Nejad, P Calder, S Tennant
Purpose: To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. Patients and Methods: In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures...
April 1, 2018: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29705080/no-relationship-between-mild-limb-length-discrepancy-and-spine-hip-or-knee-degenerative-disease-in-a-large-cadaveric-collection
#5
Raymond W Liu, Jonathan J Streit, Douglas S Weinberg, Jeremy D Shaw, Elyse LeeVan, Daniel R Cooperman
BACKGROUND: Although asymptomatic mild limb length discrepancy (LLD) in children is generally treated non-operatively, there is limited high quality follow up data to support this recommendation. HYPOTHESIS: We hypothesized that there would be no association between LLD and arthritic changes with mild limb length discrepancy. MATERIALS AND METHODS: We studied 576 well-preserved cadaveric skeletons ranging from 40 to 79 years of age. Limb length discrepancy was based on combined femoral and tibial lengths measured using digital calipers...
April 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29701099/management-of-extra-articular-segmental-defects-in-long-bone-using-a-titanium-mesh-cage-as-an-adjunct-to-other-methods-of-fixation
#6
N Attias, A M Thabet, G Prabhakar, J A Dollahite, R J Gehlert, T A DeCoster
Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to intramedullary nail or plate reconstruction of an extra-articular segmental long bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years) treated for a segmental long bone defect by nail or plate fixation and an adjunctive TMC were included. The bone defects treated were in the tibia (nine), femur (six), radius (one), and humerus (one). The mean length of the segmental bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was 8...
May 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29689742/microsurgical-repair-of-neonatal-iliac-artery-injuries-with-saphenous-vein-grafts
#7
Karri A Adamson, Matthew E Braza, John A LoGiudice, William W Dzwierzynski
Two neonates with congenital heart disease, one and thirty-one days old respectively, suffered inadvertent arterial injury from cardiac catheterization. Both insults resulted in unrecognized avulsion of the external iliac artery from its origin. The patients quickly decompensated, with their right lower extremities becoming critically ischemic. In both cases, segments of reversed greater saphenous vein were used as interposition grafts from the common iliac artery to the common femoral artery. Reperfusion of the right foot was immediate for the one-day-old...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29678653/continued-ultrasound-surveillance-required-after-hand-ischemia-associated-with-trauma-in-children
#8
Melissa L Kirkwood, Khalil H Chamseddin, Brianne Hanson, Carlos H Timaran, Mujtaba Ali, Alexis D Jacob, John E Rectenwald
BACKGROUND: Hand ischemia following trauma in children is rare and the natural history after upper extremity arterial bypass in children is unknown. We hypothesize children with brachial artery repair are at long term risk of developing aneurysmal degeneration or Thrombosis thus necessitating annual duplex ultrasonography and physical examination. STUDY DESIGN: A retrospective review of children who had brachial artery repair (bypass or vein patch) for hand ischemia secondary to trauma at a level I trauma pediatric hospital was performed...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29674772/total-hip-arthroplasty-for-patients-with-residual-poliomyelitis-at-a-mean-eight-years-of-follow-up
#9
Mayumi Sonekatsu, Motoki Sonohata, Masaru Kitajima, Shunsuke Kawano, Masaaki Mawatari
In patients with poliomyelitis, degenerative arthritis of the hip may be encountered in the paralytic or normal contralateral limb because of leg length discrepancy, pelvic obliquity, or severe deformities of the affected hip. Although total hip arthroplasty (THA) is one of the most common orthopedic procedures, there are few reports of THA in adult patients with residual poliomyelitis. From March 2001 to January 2011, 5 patients with residual poliomyelitis (6 hips) underwent THA using uncemented implants at our hospital...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29666111/decreasing-an-offloading-device-s-size-and-offsetting-its-imposed-limb-length-discrepancy-lead-to-improved-comfort-and-gait
#10
Ryan T Crews, Joseph Candela
OBJECTIVE: Patient adherence is a challenge in offloading diabetic foot ulcers (DFUs) with removable cast walkers (RCWs). The size and weight of an RCW, changes to gait, and imposed limb length discrepancies may all discourage adherence. This study sought to determine whether RCW size and provision of a contralateral limb lift affected users' comfort and gait. RESEARCH DESIGN AND METHODS: Twenty-five individuals at risk for DFUs completed several 20-m walking trials under five footwear conditions: bilateral standardized shoes, a knee-high RCW with shoe with or without an external shoe lift contralaterally, and an ankle-high RCW with shoe with or without an external shoe lift contralaterally...
April 17, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29657455/dynamic-leg-length-asymmetry-during-gait-is-not-a-valid-method-for-estimating-mild-anatomic-leg-length-discrepancy
#11
Gustavo Leporace, Luiz Alberto Batista, Raphael Serra Cruz, Gabriel Zeitoune, Gabriel Armondi Cavalin, Leonardo Metsavaht
The purpose of this study was to test the validity of dynamic leg length discrepancy (DLLD) during gait as a radiation-free screening method for measuring anatomic leg length discrepancy (ALLD). Thirty-three subjects with mild leg length discrepancy walked along a walkway and the dynamic leg length discrepancy (DLLD) was calculated using a motion analysis system. Pearson correlation and paired Student t -tests were applied to calculate the correlation and compare the differences between DLLD and ALLD (α = 0...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29655809/acute-limb-ischemia-in-an-8-year-old-patient-case-report
#12
Young Erben, Samuel M Miller, Brandon J Sumpio, Brian J Dillon, Alfred I Lee, Peter Blume, Bauer E Sumpio, Carlos Mena-Hurtado
We report the case of an 8-year-old patient with a history of nephrotic syndrome (NS), who presented to the emergency department (ED) with right foot pain. The patient's mother described intermittent pain that woke her son from sleep and was accompanied by the foot turning purple and becoming cold to touch. Physical exam revealed capillary refill of over ten seconds in the right and less than two seconds in the left foot. Ankle-brachial indices (ABI) were 0.0 on the right and 0.96 on the left. The patient was admitted and started on therapeutic intravenous heparin...
April 12, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29615012/how-does-iliosacral-bone-tumor-resection-without-reconstruction-affect-the-ipsilateral-hip-joint
#13
Tao Jin, Weifeng Liu, Hairong Xu, Yuan Li, Lin Hao, Xiaohui Niu
BACKGROUND: Whether reconstruction is more beneficial after iliosacral bone tumor resection remains controversial. Because of high rates of complications and recurrence, few patients benefit from reconstruction. The aim of this study is to assess functional outcomes and to reveal changes in the ipsilateral hip joint after partial iliosacral resection. METHODS: From 1998 to 2016, 21 patients aged 20-66 years underwent iliosacral resection, 18 without reconstruction (group 1) and 3 with reconstruction (group 2)...
April 4, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29589084/soft-tissue-tension-is-four-times-lower-in-the-unstable-primary-total-hip-arthroplasty
#14
Takeshi Ogawa, Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
PURPOSE: The aim was to compare patients who suffered recurrent dislocation following total hip arthroplasty (THA) with those who did not to clarify the degree of soft tissue tension in dislocation patients. METHODS: The subjects were 18 hips with recurrent dislocation (unstable THA group) and 37 hips without dislocation (stable THA group). To evaluate soft tissue tension, radiographs were taken while applying distal traction at traction forces of 40, 30, and 20% of the body weight (BW) and femoral head displacement was measured...
March 27, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29576639/total-hip-arthroplasty-by-the-direct-anterior-approach-using-a-neck-preserving-stem-safety-efficacy-and-learning-curve
#15
Aditya Khemka, Omar Mograby, Sarah J Lord, Zelda Doyle, Munjed Al Muderis
Background: The concept of femoral neck preservation in total hip replacement (THR) was introduced in 1993. It is postulated that retaining cortical bone of the femoral neck offers triplanar stability, uniform stress distribution, and accommodates physiological anteversion. However, data on safety, efficacy and learning curve are lacking. Materials and Methods: We prospectively assessed all patients who were operated for a THR with a short neck preserving stem (MiniHip) between 2012 and 2014...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29549568/cozen-s-deformity-resolved-by-guided-growth
#16
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
March 16, 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29547071/free-functioning-gracilis-transfer-for-reanimation-of-elbow-and-hand-in-total-traumatic-brachial-plexopathy-in-children
#17
Tomas Madura, Kazuteru Doi, Yasunori Hattori, Sotetsu Sakamoto, Takashi Shimoe
The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3-17) who were followed-up over a mean period of 6 years (range 2-16). The transferred gracilis delivered a stable elbow flexion with a useful power, as well as reconstructed active finger motion. In 3-11-year-old patients we noted a tendency towards developing a progressive flexion contracture of the elbow...
January 1, 2018: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/29544973/measurement-of-patient-s-perception-on-limb-length-discrepancy-compared-with-weight-bearing-orthoroentgenography-in-total-hip-arthroplasty-a-prospective-study
#18
Kriangsak Piyakunmala, Thananit Sangkomkamhang
BACKGROUND: Aims of this study included providing a comparison of the measurement of limb-length discrepancy after primary total hip arthroplasty between patient's perception and weight-bearing orthoroentgenographic measurement. A comparison between patient's perception and pelvic radiographic measurement was examined as well. METHODS: This prospective study comprised patients who had already undergone total hip arthroplasty and were receiving postoperative outpatient care between April 2017 and July 2017...
February 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29541207/novel-exostosin-2-mutation-identified-in-a-chinese-family-with-hereditary-multiple-osteochondroma
#19
Weiwei Ruan, Li Cao, Zhonghua Chen, Mingxiang Kong, Qing Bi
Hereditary multiple osteochondroma (HMO) is an autosomal dominant genetic disorder characterized by multiple outgrowing bony tumors capped by cartilage, generally affecting the metaphyses. The disease is known as hereditary multiple exostoses, familial exostosis, multiple cartilaginous exostoses or hereditary malformation of cartilage. The prevalence of HMO in Europe and the Unites States is ~1:100,000, although it has not been reported in China. The disease is often accompanied by pain, asymmetry and skeletal malformations, including forearm and leg bending deformities, limb length discrepancies, and knee internal and external rotation abnormalities...
April 2018: Oncology Letters
https://www.readbyqxmd.com/read/29536681/-effect-of-ceramic-on-ceramic-total-hip-arthroplasty-in-crowe-iv-developmental-dysplasia-of-the-hip
#20
Jing-Yang Sun, Yong-Gang Zhou, Yin-Qiao Du, Shang Piao, Sen Wang, Zhi-Sen Gao, Wen-Ming Wu, Hai-Yang Ma
OBJECTIVE: To observe the clinical effect of ceramic on ceramic total hip arthroplasty(THA)in Crowe IV developmental dysplasia of the hip(DDH). METHODS: From April 2008 to December 2015, 137 hips of 111 Crowe IV DDH patients received THA using Forte or Delta ceramic on ceramic by one senior surgeon, which consists of 85 unilateral hips and 26 bilateral hips. The average age of the patients was(38.88±10.83) years old ranging from 18 to 68 years old. The mean follow-up was(41...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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