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Limb length discrepancy

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https://www.readbyqxmd.com/read/28208960/functional-outcome-of-conservatively-treated-bilateral-neck-of-femur-fracture-in-an-elderly-a-case-report
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28152452/upper-extremity-motion-during-gait-in-adolescents-with-structural-leg-length-discrepancy-an-exploratory-study
#4
Fabiola Angelico, Marie Freslier, Jacqueline Romkes, Reinald Brunner, Stefan Schmid
BACKGROUND AND PURPOSE: Depending on the extent of a structural leg length discrepancy (LLD), several compensatory mechanisms take place in order to maintain function and to optimize energy consumption during gait. However, studies describing the influence of a structural LLD on upper limb motion are lacking. The current study therefore aimed at the evaluation of upper limb motion during gait in LLD patients compared to healthy controls. METHODS: Motion capture data from 14 patients with structural LLD and 15 healthy controls that were collected during barefoot walking at a self-selected speed were retrospectively analyzed...
January 4, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28148662/intra-articular-corrective-osteotomies-combined-with-the-ilizarov-technique-for-the-treatment-of-deformities-of-the-knee
#5
J Xu, Y Jia, Q Kang, Y Chai
AIMS: To present our experience of using a combination of intra-articular osteotomy and external fixation to treat different deformities of the knee. PATIENTS AND METHODS: A total of six patients with a mean age of 26.5 years (15 to 50) with an abnormal hemi-joint line convergence angle (HJLCA) and mechanical axis deviation (MAD) were included. Elevation of a tibial hemiplateau or femoral condylar advancement was performed and limb lengthening with correction of residual deformity using a circular or monolateral Ilizarov frame...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28144605/limb-lengthening-using-the-precice-tm-nail-system-complications-and-results
#6
Ulrich Wiebking, Emmanouil Liodakis, Mohamed Kenawey, Christian Krettek
BACKGROUND: Three types of telescopic nails are mainly used for intramedullary limb lengthening nowadays. Despite some important advantages of this new technology (e.g. controlled distraction rate, not restricted availability, possibility to perform accordion maneuvers), few articles exist on clinical results and complications after lengthening with the PRECICE(TM) nail (Ellipse, USA). OBJECTIVES: The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICE(TM) nail...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28141693/time-to-return-to-school-after-10-common-orthopaedic-surgeries-among-children-and-adolescents
#7
Samuel C Willimon, Marjorie M Johnson, Mackenzie M Herzog, Michael T Busch
BACKGROUND: Return to school among adolescents is often overlooked in orthopaedic outcome studies. The purpose was to measure the time missed from school after 10 common orthopedic surgeries. METHODS: Patients, 5 to 19 years old enrolled in elementary, middle, or high school, who underwent treatment for fixation of type III supracondylar humerus fracture, midshaft femur fracture fixation, isolated anterior cruciate ligament reconstruction, isolated partial menisectomy, adolescent idiopathic scoliosis fusion, closed reduction of both-bone forearm fracture, arthroscopic Bankart repair, hip arthroscopy with femoroacetabular impingement correction, limb length discrepancy correction, or surgical fixation of slipped capital femoral epiphysis during the 2014/2015 and 2015/2016 school years were identified for this Institutional Review Board-approved study...
January 30, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28141690/predicting-late-follow-up-and-understanding-its-consequences-in-growth-modulation-for-pediatric-lower-limb-deformities
#8
Cheryl Lawing, Adam Margalit, Gift Ukwuani, Paul D Sponseller
BACKGROUND: Growth modulation with implants facilitates correction of angular deformities and limb-length discrepancies (LLDs) in children. Close follow-up is necessary when using growth modulation to prevent overcorrection. We examined factors associated with late follow-up and overcorrection rates in patients with late versus timely follow-up. METHODS: This was a retrospective review of growth modulation procedures in children at 1 institution from 2000 through 2014...
January 30, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28070823/relationship-between-postoperative-complications-and-fibular-integrity-in-congenital-pseudarthrosis-of-the-tibia-in-children
#9
Yao-Xi Liu, Hai-Bo Mei, Guang-Hui Zhu, Rong-Guo He, Kun Liu, Jin Tang, Jiang-Yan Wu, Wei-Hua Ye, Xin Hu, Qian Tan, An Yan, Sheng-Xiang Huang, Xiao-Qian Tan, Ting Lei
BACKGROUND: This study aimed to investigate the relationship between postoperative complications and fibular integrity in congenital pseudarthrosis of the tibia (CPT) in children. METHODS: A retrospective study was performed in 59 patients with Crawford type IV CPT who were treated with combined surgical technique from 2007 to 2011. The patients were divided into two groups, the CPT with fibular pseudarthrosis (group A) and CPT with intact fibula groups (group B), on the basis of fibula status after the union of CPT...
December 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28053384/management-of-complex-femoral-nonunion-with-monorail-external-fixator-a-prospective-study
#10
Hemendra Kumar Agrawal, Mohit Garg, Balvinder Singh, Ashish Jaiman, Vipin Khatkar, Shailender Khare, Sumit Batra, Vinod Kumar Sharma
AIM: To evaluate 30 patients who underwent distraction osteogenesis with monorail external fixator for complex femoral nonunion. METHOD: Complex femoral nonunion includes infective non-union, gap nonunion, and limb-length discrepancy secondary to traumatic bone loss, which needs specialized treatment to ensure the functional integrity of femoral bone. 30 patients, including 28 male and 2 female (aged 22-62 years) patients, underwent surgical debridement followed by bone transport with monorail fixator...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28040089/success-rate-and-risk-factors-of-failure-of-the-induced-membrane-technique-in-children-a-systematic-review
#11
Jean-Charles Aurégan, Thierry Bégué, Guillaume Rigoulot, Christophe Glorion, Stéphanie Pannier
The induced membrane technique was designed by Masquelet et al. to address segmental bone defects of critical size in adults. It has been used after bone defects of traumatic, infectious and tumoral origin with satisfactory results. Recently, it has been used in children but, after an initial enthusiasm, several cases of failure have been reported. The purpose of this study was to assess the success rate and the risk factors of failure of the induced membrane for children. We conducted a systematic review of all the studies reporting the results of the induced membrane technique to address bone defects of critical size in children...
December 2016: Injury
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#12
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28040087/femoral-non-union-with-malalignment-reconstruction-and-biological-stimulation-with-the-chipping-technique
#13
Yoshinobu Watanabe, Takashi Matsushita
INTRODUCTION: The purpose of this study was to investigate the effectiveness of the chipping technique for the treatment of femoral non-unions associated with malalignment. PATIENTS AND METHODS: A total of 21 femoral non-unions were managed with the chipping procedure and re-fixation. 15 of them had malalignment (angular or rotational deformity or limb length discrepancy). The deformities were simultaneously corrected by a combination of chipping and temporal external fixator...
December 2016: Injury
https://www.readbyqxmd.com/read/28031510/use-of-a-magnetic-bone-nail-for-lengthening-of-the-femur-and-tibia
#14
Ozgur Karakoyun, Sami Sokucu, Mehmet Fatih Erol, Metin Kucukkaya, Yavuz Selim Kabukçuoğlu
PURPOSE: To report our experience with the PRECICE nail for limb lengthening in 23 patients. METHODS: Records of 15 female and 8 male patients aged 14 to 38 (mean, 23.6) years who underwent lengthening of the tibia (n=6) or femur (n=21) using the PRECICE nail were reviewed. The reasons for lengthening included trauma (n=7), hemihypertrophy (n=2), focal femoral deficiency (n=2), Ellis-van Creveld syndrome (n=1), hip septic arthritis sequelae (n=1), hereditary multiple exostosis (n=1), club foot sequela (n=1), congenital tibial pseudoarthrosis (n=1), fibrous dysplasia (n=1), idiopathic limb length discrepancy (n=7), and cosmetic (n=1)...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28029668/titanium-elastic-nailing-system-tens-for-tibia-fractures-in-children-functional-outcomes-and-complications
#15
K M Kc, P Acharya, A Sigdel
INTRODUCTION: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28028968/the-use-of-3d-printing-technology-in-the-ilizarov-method-treatment-pilot-study
#16
Karolina Burzyńska, Piotr Morasiewicz, Jarosław Filipiak
BACKGROUND: Significant developments in additive manufacturing technology have occurred in recent years. 3D printing techniques can also be helpful in the Ilizarov method treatment. OBJECTIVES: The aim of this study was to evaluate the usefulness of 3D printing technology in the Ilizarov method treatment. MATERIAL AND METHODS: Physical models of bones used to plan the spatial design of Ilizarov external fixator were manufactured by FDM (Fused Deposition Modeling) spatial printing technology...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/27998211/axial-and-appendicular-body-proportions-for-evaluation-of-limb-and-trunk-asymmetry
#17
Douglas S Weinberg, Raymond W Liu, Samuel Q Li, James O Sanders, Daniel R Cooperman
Background and purpose - When children with irregular body proportions or asymmetric limbs present, it may be unclear where the pathology is located. An improved understanding of the clinical ratio between upper extremity, lower extremity, and spine length may help elucidate whether there is disproportion between the trunk and limbs, and whether there is a reduction deficit of the shorter limb rather than hypertrophy of the longer limb. Patients and methods - We used the Brush Foundation study of child growth and development, which was a prospective, longitudinal study of healthy children between the 1930s and the 1950s, and we collected serial clinical measurements for 290 children at 3,326 visits...
December 21, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27923597/long-term-results-of-cementless-total-hip-arthroplasty-with-subtrochanteric-shortening-osteotomy-in-crowe-type-iv-developmental-dysplasia
#18
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
#19
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 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#20
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 2016: Journal of Children's Orthopaedics
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