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Limb length discrepancy

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https://www.readbyqxmd.com/read/28428035/evaluation-of-the-external-fixator-truelok-hexapod-system-for-tibial-deformity-correction-in-children
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28379937/treatment-of-post-traumatic-femoral-discrepancy-with-precice-magnetic-powered-intramedullary-lengthening-nails
#6
Ahmed I Hammouda, Julio J Jauregui, Martin G Gesheff, Shawn C Standard, Janet D Conway, John E Herzenberg
OBJECTIVE: Post traumatic limb length discrepancy (LLD) may present secondary to fracture shortening, malunion, or epiphyseal growth arrest. The purpose of this study was to evaluate the outcomes of lengthening post-traumatic femoral segments utilizing a recently available magnetic intramedullary (IM) lengthening system. DESIGN: Retrospective cohort study SETTING:: Urban Level II Trauma CenterPatients/Participants: This study was performed to review post-traumatic patients treated for femoral shortening at our institution between 2011 and 2015...
April 20, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28342821/correction-of-axial-deformity-during-lengthening-in-fibular-hypoplasia-hexapodal-versus-monorail-external-fixation
#7
Antoine Chalopin, Loïc Geffroy, Sébastien Pesenti, Antoine Hamel, Franck Launay
INTRODUCTION: Childhood fibular hypoplasia is a rare pathology which may or may not involve limb-length discrepancy and axial deformity in one or more dimensions. The objective of the present study was to compare the quality of the axial correction achieved in lengthening procedures by hexapodal versus monorail external fixators. The hypothesis was that the hexapodal fixator provides more precise correction. MATERIAL AND METHODS: A retrospective multicenter study included 52 children with fibular hypoplasia...
March 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28341498/natural-history-of-iatrogenic-pediatric-femoral-artery-injury
#8
Elizabeth A Andraska, Tatum Jackson, Huiting Chen, Katherine A Gallagher, Jonathan L Eliason, Dawn M Coleman
INTRODUCTION: Iatrogenic femoral artery trauma complicates the course of critically-ill neonates and children. Complications from persistent arterial occlusion include claudication and limb length discrepancies. Data supporting risk factors for such and need for revascularization are lacking. METHODS: Review of a prospectively maintained database at a tertiary institution of iatrogenic pediatric femoral artery injuries incurred between 2013-2014 was performed. Additional injuries were identified by review of pediatric arterial duplex performed between 2008-2013...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28303481/morphea-and-eosinophilic-fasciitis-an-update
#9
REVIEW
Jorre S Mertens, Marieke M B Seyger, Rogier M Thurlings, Timothy R D J Radstake, Elke M G J de Jong
Morphea, also known as localized scleroderma, encompasses a group of idiopathic sclerotic skin diseases. The spectrum ranges from relatively mild phenotypes, which generally cause few problems besides local discomfort and visible disfigurement, to subtypes with severe complications such as joint contractures and limb length discrepancies. Eosinophilic fasciitis (EF, Shulman syndrome) is often regarded as belonging to the severe end of the morphea spectrum. The exact driving mechanisms behind morphea and EF pathogenesis remain to be elucidated...
March 16, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28295122/epiphysiodesis-screw-bending
#10
Brett M Normandin, David J Tennent, Todd H Baldini, Alesia M Blanchard, Jason T Rhodes
Percutaneous epiphysiodesis using transphyseal screws is a common method for treatment of limb length discrepancy and angular deformity. The authors report 3 cases of a previously unreported complication following treatment with percutaneous epiphysiodesis using transphyseal screws: bending of the transphyseal screw. In each case, this rare complication was associated with difficult removal of the screw. This retrospective case report accessed the medical records of 3 children, 2 boys and 1 girl, 9 to 14 years old...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28261423/cementless-total-hip-arthroplasty-involving-trochanteric-osteotomy-without-subtrochanteric-shortening-for-high-hip-dislocation
#11
Soong Joon Lee, Jeong Joon Yoo, Hee Joong Kim
BACKGROUND: Total hip arthroplasty with subtrochanteric shortening osteotomy is widely performed for high hip dislocation. However, suboptimal leg length discrepancy correction and nonunion of the osteotomy site remain concerns. Although total hip arthroplasty using trochanteric osteotomy without subtrochanteric osteotomy was introduced, cemented implants have been more commonly used than contemporary cementless implants in this procedure. We evaluated the long-term results of cementless total hip arthroplasty with trochanteric osteotomy without subtrochanteric osteotomy for high hip dislocation...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28254154/total-hip-arthroplasty-with-step-cut-subtrochanteric-femoral-shortening-osteotomy-in-high-riding-hip-dislocated-patients-with-previous-femoral-osteotomy
#12
Vahit Emre Ozden, Goksel Dikmen, Burak Beksac, Ismail Remzi Tozun
BACKGROUND: To evaluate the long-term clinical and radiological outcomes of cementless total hip arthroplasty (THA) in high riding hip dislocated patients with previous proximal femoral osteotomy. METHODS: Twenty-one consecutive patients with a mean age forty-two years were treated with cementless THA Step-cut subtrochanteric femoral osteotomy was performed in all twenty-eight hips. Metal on polyethylene (MoP) and ceramic on ceramic (CoC) bearings were used in two different consecutive time periods...
February 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28253948/-long-term-outcomes-of-the-treatment-of-pediatric-femoral-shaft-fractures-treated-with-bryant-s-vertical-traction
#13
J Urban, P Toufar, M Kloub
PURPOSE OF THE STUDY The paper aimed to evaluate the long-term outcomes of the treatment of diaphyseal femur fractures in children treated with Bryant's vertical traction. Moreover, we also assessed the size of overgrowth in the injured femur. MATERIAL AND METHODS The study included 23 patients with 23 femoral shaft fractures treated with Bryant's vertical traction at our department in 2009-2014. The following parameters were assessed: sex, ïnjured side, weight, age, mechanism of injury, potential abuse, type of fracture, duration of traction, and total length of hospital stay...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28251066/titanium-elastic-nailing-in-diaphyseal-femoral-fractures-of-children-below-six-years-of-age
#14
Fabrizio Donati, Giuseppe Mazzitelli, Marco Lillo, Amerigo Menghi, Carla Conti, Antonio Valassina, Emanuele Marzetti, Giulio Maccauro
AIM: To report the clinical and radiographic results of titanium elastic nail (TEN) in diaphyseal femoral fractures of children below age of six years. METHODS: A retrospective analysis of 27 diaphyseal femoral fractures in children younger than six years treated with TEN between 2005 and 2015 was conducted. Patients were immobilized in a cast for 5 wk and the nails were removed from 6 to 12 wk after surgery. Twenty-four cases were clinically and radiographically re-evaluated using the Flynn's scoring criteria, focusing on: Limb length discrepancy, rotational deformity, angulation, hip and knee range of motion (ROM), functional status, complications, and parent's satisfaction...
February 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28244924/humerus-lengthening-with-the-precice-internal-lengthening-nail
#15
Anton M Kurtz, S Robert Rozbruch
BACKGROUND: Deformity and growth arrest of the humerus in children may result as sequelae of proximal humerus fractures and unicameral bone cysts, or as complications of their treatment. As approximately 80% of the growth of the humerus arises from the proximal physis, the resultant upper limb-length discrepancy can be substantial. Benefits to lengthening the shortened arm have been previously demonstrated with the use of external fixation devices. To our knowledge, no reports have been published on the use of intramedullary implants for this purpose...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28231063/bone-age-in-unilateral-spastic-cerebral-palsy-is-there-a-correlation-with-hand-function-and-limb-length
#16
Je-Sang Lee, Im Jeong Choi, Myung Jun Shin, Jin-A Yoon, Sung Hwa Ko, Yong Beom Shin
BACKGROUND: The purpose of this study was to analyze the bone age and the upper extremity segmental lengths between the affected and the unaffected side and to reveal the correlation between the difference of bone age and the upper limb length discrepancy in the unilateral spastic cerebral palsy (CP). We also evaluated the relationship between difference of bone age and hand function. METHODS: Seventy-eight patients participated in this study. The bone ages of hand-wrists of the patients were determined by the Greulich and Pyle atlas...
March 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28220260/three-stage-treatment-protocol-for-recalcitrant-distal-femoral-nonunion
#17
Ching-Hou Ma, Yen-Chun Chiu, Yuan-Kun Tu, Cheng-Yo Yen, Chin-Hsien Wu
INTRODUCTION: In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. MATERIALS AND METHODS: We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft...
April 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28208960/functional-outcome-of-conservatively-treated-bilateral-neck-of-femur-fracture-in-an-elderly-a-case-report
#18
Prateek Sunil Joshi
Bilateral Neck of Femur (NOF) fractures is relatively rare. Surgery, either osteosynthesis or hemireplacement arthroplasty, is the mainstay of treatment. Significant complications are known to occur in such cases. In this case report, we present the functional outcome of a conservatively treated bilateral NOF fracture at one year, in a 93-year-old man. Our patient, a 93-year-old gentleman, sustained right side NOF fracture in May 2014 and left side NOF fracture in May 2015, both after trivial fall. He did not give consent for surgery considering high operative risk...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#19
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28159052/complex-ankle-arthrodesis-with-step-cut-osteotomy-in-charcot-arthropathy-with-bone-loss
#20
Sean Booth, Moez Ballal, Anand Pillai
We report a case of a complex limb salvage ankle arthrodesis in a patient with Charcot arthropathy. A step-cut osteotomy was performed in order to tackle the issues of anterior tibial bone loss; worsening leg length discrepancy; soft tissue contraction; joint instability and high risk of non-union. The construct formed by the step-cut allowed for the preservation of good bone stock; avoidance of further limb shortening; increased torsional stability and increased surface area for bony union. This resulted in a patient with a stable, plantigrade foot appropriate for footwear...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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