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Limb length discrepancy

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https://www.readbyqxmd.com/read/28913399/reactive-scoliosis-a-challenging-phenomenon-in-adolescent-patients-with-hip-arthritis
#1
Madhav Chowdhry, Laura Matsen Ko, Corinna Franklin, Javad Parvizi
Functional limb length discrepancy (LLD) in adolescents can result from soft tissue contracture following long-standing hip disease. We present a case of a 13-year-old girl with difficulty in ambulation due to right hip pain and LLD. Radiographs revealed severe arthritis of right hip with signs of avascular necrosis of the femoral head. The patient had developed reactive scoliosis of lumbar spine along with pelvic obliquity. After failing conservative management, total hip arthroplasty (THA) without attempting to equalize LLD was performed...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28888389/scheuermann-s-disease-in-a-juvenile-male-from-the-late-roman-necropolis-of-torrenueva-3rd-4th-century-ce-granada-spain
#2
Joan Viciano, Sandra López-Lázaro, Ángela Pérez-Fernández, Anabel Amores-Ampuero, Ruggero D'Anastasio, José Miguel Jiménez-Triguero
This study details a severe case of Scheuermann's disease (SD) in a well-preserved skeleton of a juvenile male (designated TOR302), dated to 3rd-4th century CE, from the late Roman necropolis of Torrenueva (Granada, Spain). Individual TOR302 shows an evident kyphotic curve in the thoraco-lumbar spine, which is characterised by: (i) vertebral bodies of thoracic vertebra T2, thoracic segment T4-T9, and thoraco-lumbar segment T12-L2 wedged at >5°; (ii) slight anterior extensions of the epiphyseal ring; (iii) Schmorl's nodes on the superior and/or inferior plates; and (iv) a Cobb angle of 75°, derived from thoracic segments T4-T9...
September 2017: International Journal of Paleopathology
https://www.readbyqxmd.com/read/28880604/a-novel-technique-to-determine-foot-contribution-to-limb-length-discrepancy
#3
George Lane
Evaluation for limb-length discrepancy is an important part of the biomechanical work-up in the podiatric musculoskeletal exam. By understanding the foot's contribution to such a discrepancy, the podiatric clinician will have better insight regarding treatment strategy. This technique will provide the clinician with a simple method to gain such insight.
July 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28875130/ipsilateral-femur-and-tibia-fractures-in-pediatric-patients-a-systematic-review
#4
Jason B Anari, Alexander L Neuwirth, B David Horn, Keith D Baldwin
AIM: To better understand how pediatric floating knee injuries are managed after the wide spread use of new orthopaedic technology. METHODS: We searched EMBASE, COCHRANE and MEDLINE computerized literature databases from the earliest date available in the databases to February 2017 using the following search term including variants and pleural counterparts: Pediatric floating knee. All studies were thoroughly reviewed by multiple authors. Reference lists from all articles were scrutinized to identify any additional studies of interest...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28861191/porous-femoral-fixation-in-total-hip-arthroplasty-with-short-anatomical-stem-radiographic-evaluation
#5
Suresh Patil, Carrilero Luis, Henry Finn
BACKGROUND: Hip prostheses with short anatomical stems were designed for metaphyseal fixation and to spare bone stock. We present a study of a short anatomical femoral stem used in all age groups of patients with Dorr A and B type of femora. METHODS: We reviewed radiographs of 85 hips in 74 patients who had a cementless total hip arthroplasty with a short anatomical 80 mm femoral stem designed to achieve pure metaphyseal fixation. A ream-only technique was used for femoral canal preparation in all patients...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28837601/age-and-severity-adjusted-treatment-of-proximal-humerus-fractures-in-children-and-adolescents-a-systematical-review-and-meta-analysis
#6
Lisa Hohloch, Helge Eberbach, Ferdinand C Wagner, Peter C Strohm, Kilian Reising, Norbert P Südkamp, Jörn Zwingmann
BACKGROUND: Fractures of the proximal humerus in patients under the age of 18 years show a low incidence; existing clinical studies only comprise small patient numbers. Different treatment methods are mentioned in the literature but a comparison of the outcome of these methods is rarely made. Up to now, no evidence-based algorithm for conservative and operative treatment is available. The aim of this systematic review with meta-analysis was therefore to gather the best evidence of different treatment methods and their associated functional outcome, complication rates, rates of limb length discrepancies and radiological outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28817981/the-use-of-flexible-intramedullary-nails-in-limb-lengthening
#7
Arnold Popkov, Patrick Foster, Alexander Gubin, Dmitry Borzunov, Dmitry Popkov
Lower and upper limb length discrepancy and deformity, congenital or acquired, are amongst the most common conditions in children for orthopaedic referral. Over the last twenty years, surgical techniques have evolved in an attempt to decrease Healing Index and minimise these complications. Areas covered: The flexible intramedullary nailing (FIN) is a minimally invasive intramedullary osteosynthesis. In combination with an external fixator, it is appropriated for pediatric bone lengthenings and lengthening of bones of small diameter in adults...
August 18, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28803814/revision-total-hip-arthroplasty-with-a-monoblock-splined-tapered-grit-blasted-titanium-stem
#8
Michael D Hellman, Sean M Kearns, Daniel D Bohl, Bryan D Haughom, Brett R Levine
BACKGROUND: In revision total hip arthroplasty (THA), proximal femoral bone loss creates a challenge of achieving adequate stem fixation. The purpose of this study was to examine the outcomes of a monoblock, splined, tapered femoral stem in revision THA. METHODS: Outcomes of revision THA using a nonmodular, splined, tapered femoral stem from a single surgeon were reviewed. With a minimum of 2-year follow-up, there were 68 cases (67 patients). Paprosky classification was 3A or greater in 85% of the cases...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803367/the-role-of-agonist-and-antagonist-muscles-in-explaining-isometric-knee-extension-torque-variation-with-hip-joint-angle
#9
Theodoros M Bampouras, Neil D Reeves, Vasilios Baltzopoulos, Constantinos N Maganaris
PURPOSE: The biarticular rectus femoris (RF), operating on the ascending limb of the force-length curve, produces more force at longer lengths. However, experimental studies consistently report higher knee extension torque when supine (longer RF length) compared to seated (shorter RF length). Incomplete activation in the supine position has been proposed as the reason for this discrepancy, but differences in antagonistic co-activation could also be responsible due to altered hamstrings length...
August 12, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28793888/does-structural-leg-length-discrepancy-affect-postural-control-preliminary-study
#10
Małgorzata Eliks, Wioleta Ostiak-Tomaszewska, Przemysław Lisiński, Paweł Koczewski
BACKGROUND: Leg-length inequality results in an altered position of the spine and pelvis. Previous studies on the influence of leg asymmetry on postural control have been inconclusive. The purpose of this paper was to investigate the effect of structural leg-length discrepancy (LLD) on the control of posture. METHODS: We studied 38 individuals (19 patients with structural LLD, 19 healthy subjects). The examination included measurement of the length of the lower limbs and weight distribution as well as a static posturography...
August 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28767173/prevalence-presentation-and-treatment-of-lower-limb-pathologies-in-juvenile-idiopathic-arthritis-a-narrative-review
#11
REVIEW
Antoni Fellas, Fiona Hawke, Derek Santos, Andrea Coda
Juvenile idiopathic arthritis is a chronic, autoimmune, inflammatory joint disease. It is the most common arthritis in children and adolescents. This paper reviews the presentation and treatment of lower limb pathologies in juvenile idiopathic arthritis from an allied health perspective. Common lower limb pathologies include: synovitis causing swelling, tenderness and pain; persistent inflammation leading to flexion contractures; limb length discrepancies; muscle atrophy; enthesopathies such as plantar fasciitis and Achilles tendonitis; and tenosynovitis...
August 2, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28756873/accordion-technique-combined-with-minimally-invasive-percutaneous-decortication-for-the-treatment-of-bone-non-union
#12
Qun Zhang, Wei Zhang, Zhuo Zhang, Peifu Tang, Lihai Zhang, Hua Chen
BACKGROUND: A variety of approaches have been used to treat oligotrophic or atrophic non-union. Conventional methods are often associated with great operative trauma, increased blood loss, a risk of re-infection, higher medical costs, and complications at the donor site. This study aimed to assess the clinical efficacy of the accordion technique combined with Minimally Invasive Percutaneous Decortication (MIPD) for these types of bone non-union. METHODS: From January 2010 to December 2015, 20 patients with long bone aseptic non-unions of the lower extremities without bone defects who were treated with the accordion technique combined with MIPD...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28714636/-corrective-surgery-for-lower-limb-length-discrepancy-and-malalignment-in-paediatric-orthopaedics
#13
Dimitri Ceroni, Raimonda Valaikaite, Catherine Grumetz, Odile Desvachez, Sophie Pusateri, Pierre Dunand, Vasiliki Spyropoulou, Eleftheria Samara
Lower limb length discrepancy and malalignment in paediatric orthopaedics constitute a set of acquired or malformative structural pathologies. These anomalies, which may alter statics of lower limbs, are susceptible to engender an asymmetry of mechanical constraints' distribution across joints, and thus to promote the onset of arthritic phenomenons. The purpose of this review's article is to define the limits of tolerance of the various malformations and describe the innovative techniques available in order to correct them...
February 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28706382/cementless-acetabular-component-with-or-without-upward-placement-in-dysplasia-hip-early-results-from-a-prospective-randomised-study
#14
Zhiqi Zhang, Peihui Wu, Zhiyu Huang, Baoxi Yu, Hong Sun, Ming Fu, Yan Kang, Weiming Liao
BACKGROUND: Total hip arthroplasty (THA) in developmental dysplasia of hip (DDH) is difficult for the abnormal acetabulum. The purpose of this study was to evaluate the difference of anatomic and upward placement of acetabular component during early stage. METHODS: From April 2014 through June 2015, forty DDH patients (Crowe I to III, 42 hips) were prospectively randomized to either anatomic or upward group. Patient recorded diaries were collected. Radiographs were reviewed...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28704303/gain-of-length-loss-of-strength-alteration-in-muscle-strength-after-femoral-leg-lengthening-in-young-patients-a-prospective-longitudinal-observational-study
#15
Andreas H Krieg, Sebastian Gehmert, Olivia L Neeser, Xaver Kaelin, Bernhard M Speth
This study aimed to determine the alteration in maximum isokinetic torque in patients after intramedullary femoral leg lengthening. Thirty patients with a median leg-length discrepancy of 3.0 cm underwent femoral limb lengthening with an intramedullary motorized device. Maximum isokinetic, concentric torque of the extensors, and flexors of the knee was measured before (n=30) and 2 years after surgery (n=21). Postoperatively, a significant difference remained for the maximum isokinetic torque of the extensors (22%) between the lengthened and the normal leg, which might have been caused by muscle response to the distraction procedure itself in the form of higher stiffness, less immediate displacement, and inconsistent force relaxation properties...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28704298/titanium-mesh-cage-as-an-alternative-reconstruction-method-for-epiphyseal-sparing-tumour-resections-in-children
#16
Mehmet Ayvaz, Senol Bekmez, Altug Yucekul, Musa U Mermerkaya, A Mazhar Tokgozoglu
In this study, we introduced an alternative reconstruction option for epiphysis-sparing tumour resection in children. Eight patients with a malignant tumour in the diaphysis or metaphysis-diaphysis junction of a long bone underwent epiphysis-sparing intercalary resection. Reconstruction was performed using a titanium mesh cage filled with impacted cancellous bone allograft and autograft. A plate and screws were used to supplement the fixation. At the last follow-up, union was achieved in seven patients. Limb-length discrepancy occurred in three patients...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28692359/prevention-of-limb-length-discrepancy-in-total-hip-arthroplasty
#17
Babar Kayani, Jurek Pietrzak, Fahad S Hossain, Sujith Konan, Fares S Haddad
Total hip arthroplasty is a highly effective and cost-efficient procedure but postoperative limb length discrepancy is a common source of patient dissatisfaction and litigation. This article provides a systematic, stepwise approach for identifying and proactively managing risk factors associated with limb length discrepancy following total hip arthroplasty. This review explores preoperative history taking, clinical examination, radiological templating, implant positioning, soft tissue balancing, and intraoperative surgical techniques for minimizing leg length discrepancy while maintaining stability and restoring mechanical function following total hip arthroplasty...
July 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28690469/ankle-reconstruction-in-fibular-hemimelia-new-approach
#18
Hany Hefny, ElHussein M Elmoatasem, Mahmoud Mahran, Tamer Fayyad, Mohamed A Elgebeily, Ahmed Mansour, Mamdouh Hefny
BACKGROUND: Fibular hemimelia is a congenital disorder that is characterized by the absence of the fibula that could be either partial or complete. Successful management aims to restore normal weight bearing and normal limb length. The introduction of the Ilizarov method of limb lengthening has provided an attractive alternative to amputation. During lengthening, the tight posterolateral soft-tissue structures, the thick fibrous fibular band, and the shortened Achilles tendon become tighter and transfer a valgus force to the talus and calcaneus, further aggravating the deformity...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28674737/systematic-review-of-the-outcome-of-total-hip-arthroplasty-in-patients-with-sequelae-of-legg-calv%C3%A3-perthes-disease
#19
Sammy A Hanna, Khaled M Sarraf, Manoj Ramachandran, Pramod Achan
BACKGROUND: Total hip arthroplasty (THA) in patients with sequelae of Legg-Calvé-Perthes disease (LCP) is technically demanding because of the disease related deformities occuring in the proximal femur and/or the multiplanar deformities secondary to corrective osteotomies in childhood. Little is known about the long-term outcome of the procedure in this challenging group of patients. METHODS: We carried out a systematic review of the literature to determine the functional outcome, complications and revision rate of THA in patients with sequelae of LCP disease...
August 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28639009/chipping-and-lengthening-over-nailing-technique-for-femoral-shaft-nonunion-with-shortening
#20
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
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