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https://www.readbyqxmd.com/read/28925669/lower-extremity-abnormalities-in-children
#1
Caitlyn M Rerucha, Caleb Dickison, Drew C Baird
Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing is less common than intoeing and occurs more often in older children. Out-toeing is caused by external tibial torsion and femoral retroversion. Angular problems include genu varum (bowleg) and genu valgum (knock knee). With pes planus (flatfoot), the arch of the foot is usually flexible rather than rigid...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28904628/tibial-derotational-osteotomies-in-two-neuromuscular-populations-comparing-cerebral-palsy-with-myelomeningocele
#2
R M Thompson, S Ihnow, L Dias, V Swaroop
PURPOSE: To review the outcomes of tibial derotational osteotomies (TDOs) as a function of complication and revision surgery rates comparing a cohort of children with myelodysplasia to a cohort with cerebral palsy (CP). METHODS: A chart review was completed on TDOs performed in a tertiary referral centre on patients with myelodysplasia or CP between 1985 and 2013 in patients aged > 5 years with > 2 years follow-up. Charts were reviewed for demographics, direction/degree of derotation, complications and need for re-derotation...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28869487/rhbmp-2-in-an-injectable-gelfoam-carrier-enhances-consolidation-of-the-distracted-callus-in-a-sheep-model
#3
T Floerkemeier, F Thorey, M Wellmann, C Hurschler, S Budde, H Windhagen
BACKGROUND: A major problem associated with distraction osteogenesis is the long time required for consolidation. OBJECTIVE: The goal of this study was to determine whether a percutaneous injection of recombinant human bone morphogenetic protein-2 (rhBMP-2) in a Gelfoam carrier would enhance bone consolidation following distraction. METHODS: A unilateral tibial osteotomy combined with external stabilization was performed in 14 adult sheep...
August 26, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28865572/torsional-appearance-of-the-anterior-cruciate-ligament-explaining-ribbon-and-double-bundle-concepts-a-cadaver-based-study
#4
Thibaut Noailles, Philippe Boisrenoult, Matthieu Sanchez, Philippe Beaufils, Nicolas Pujol
PURPOSE: To investigate the effect of the anterior cruciate ligament (ACL) torsion in 90° knee flexion on the morphological appearance of the ACL. METHODS: Sixty knees from fresh frozen anatomical specimens were dissected. Eighteen knees were excluded according to selection criteria (torn ACL, mucoid degeneration of the ACL, arthritic lesions of the notch, or knees harboring synovial inflammatory pathologies). After the removal of the synovial membrane, the morphology of the ligamentous fibers of the ACL and the twist were analyzed...
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28855192/the-effect-of-implant-position-on-bone-strain-following-lateral-unicompartmental-knee-arthroplasty-a-biomechanical-model-using-digital-image-correlation
#5
A M Ali, S D S Newman, P A Hooper, C M Davies, J P Cobb
OBJECTIVES: Unicompartmental knee arthroplasty (UKA) is a demanding procedure, with tibial component subsidence or pain from high tibial strain being potential causes of revision. The optimal position in terms of load transfer has not been documented for lateral UKA. Our aim was to determine the effect of tibial component position on proximal tibial strain. METHODS: A total of 16 composite tibias were implanted with an Oxford Domed Lateral Partial Knee implant using cutting guides to define tibial slope and resection depth...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28802221/in-vivo-mechanical-behaviour-of-the-anterior-cruciate-ligament-a-study-of-six-daily-and-high-impact-activities
#6
Elisa Roldán, Neil D Reeves, Glen Cooper, Kirstie Andrews
The anterior cruciate ligament (ACL) plays a key role in the stability of the knee joint restricting the rotation and anterior tibial translation. However, there is a lack of knowledge of the in vivo ACL mechanical behaviour during high impact manoeuvres. The motion of 12 young participants with healthy knees was captured while they performed the following activities: walking, running, cross-over cutting, sidestep cutting, jumping and jumping with one leg. The in vivo ACL length and strain were estimated using experimental kinematic data and three degree of freedom (DOF) knee model...
August 1, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28777285/3d-modeling-of-lower-extremities-with-biplanar-radiographs-reliability-of-measures-on-subsequent-examinations
#7
David E Westberry, Ashley M Carpenter
BACKGROUND: Biplanar radiography with 3-dimensional (3D) modeling (EOS) provides a comprehensive assessment of lower limb alignment in an upright weight-bearing position with less radiation than conventional radiography. A study was performed to assess the consistency and reliability of 2 lower extremity 3D biplanar radiograph models created at least 1 year apart in a pediatric population. METHODS: All patients who had 2 lower extremity radiographic evaluations with EOS performed at visits a minimum of 1 year apart were reviewed...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28758082/a-new-instrument-for-measuring-tibial-torsion-in-pediatric-patients
#8
Ji Hyun Jeon, Yong-Soon Yoon, Kwang Jae Lee, Ki Pi Yu, Jong Hoo Lee, Tae Yong Seog, EunJi Son
OBJECTIVE: To develop and test the validity and reliability of a new instrument for measuring the thigh-foot angle (TFA) for the patients with in-toeing and out-toeing gait. METHODS: The new instrument (Thigh-Foot Supporter [TFS]) was developed by measuring the TFA during regular examination of the tibial torsional status. The study included 40 children who presented with in-toeing and out-toeing gaits. We took a picture of each case to measure photographic-TFA (P-TFA) in the proper position and to establish a criterion...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28734986/exogenous-hedgehog-antagonist-delays-but-does-not-prevent-fracture-healing-in-young-mice
#9
Xiaochen Liu, Jennifer A McKenzie, Clayton W Maschhoff, Michael J Gardner, Matthew J Silva
Fracture healing recapitulates many aspects of developmental osteogenesis. The hedgehog (Hh) signaling pathway, essential to skeletal development, is upregulated during fracture healing, although its importance is unclear. Our goal was to assess the functional importance of Hh signaling in endochondral fracture healing. We created closed, transverse diaphyseal femur fractures in mice, stabilized with an intramedullary pin, and administered a systemic Hh inhibitor or vehicle. Because Hh pathway activation is mediated by the receptor Smoothened (Smo), we used the Smo antagonist GDC-0449 (GDC, 50mg/kg, twice daily) to target the pathway...
October 2017: Bone
https://www.readbyqxmd.com/read/28715039/erratum-to-computed-tomographic-evaluation-of-femoral-and-tibial-conformation-in-english-staffordshire-bull-terriers-with-and-without-congenital-medial-patellar-luxation
#10
Mark Newman, Katja Voss
OBJECTIVE: To compare hindlimb conformation of English Staffordshire Bull Terriers with and without medial patellar luxation using computed tomography. METHODS: Hindlimb computed tomography (CT) was performed on six English Staffordshire Bull Terriers with grade II or III medial patellar luxation, and six without medial patellar luxation. Inclination angle, femoral condyle trochanteric angle, anteversion angle (AA), distal anteversion angle (DAA), proximal anteversion angle (PAA), femoral varus angle (FVA), tibial valgus angle (TVA), and tibial torsion angle (TTA) were measured...
July 10, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28668738/correlation-of-the-torsion-values-measured-by-rotational-profile-kinematics-and-ct-study-in-cp-patients
#11
Ha Yong Kim, Yong Han Cha, Young Sub Chun, Hyuck Soo Shin
BACKGROUND: The purpose of study was to analyze correlations between bony torsions measured by Staheli's rotation profile, computed tomography (CT) torsional study, and gait analysis in patients with cerebral palsy (CP). MATERIALS & METHOD: The study group comprised of 26 children with CP (spastic diplegia, Gross Motor Function Classification System (GMFCS) 1-2, mean age 12.6 years) with torsional deformities. All subjects were assessed by examining: 1) rotational profile [internal rotation (IR) and external rotation (ER)], 2) CT torsional profile [femoral anteversion (FAV) and tibial torsion (TT)], and 3) gait analysis [mean hip rotation (HR) and mean knee rotation (KR)]...
June 22, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28646823/does-the-surgical-correction-of-tibial-torsion-with-genu-varum-produce-outcomes-similar-to-those-in-varus-correction-alone
#12
Austin T Fragomen, Matthew Meade, Eugene Borst, Joseph Nguyen, S Robert Rozbruch
No abstract text is available yet for this article.
June 24, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28636055/effect-of-headless-compression-screw-on-construct-stability-for-centre-of-rotation-and-angulation-based-levelling-osteotomy-biomechanical-testing-in-flexion-and-torsion
#13
Michelle R Meyer, Mireya A Perez, Mohammad S Hossain, Edward B Silverman, Randall B Fitch, Ryan B Wicker
OBJECTIVE: To compare the biomechanical properties of bone and implant constructs when used for the centre of rotation and angulation (CORA) based levelling osteotomy, with and without implantation of a trans-osteotomy headless compression screw tested under three-point flexural and torsional forces; thereby determining the contribution of a trans-osteotomy headless compression screw with regards to stability of the construct. METHODS: Experimental biomechanical study utilizing 12 pairs of cadaveric canine tibias...
June 21, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28533596/the-ratio-of-medial-and-lateral-hamstring-muscle-thickness-does-not-correlate-with-the-lateral-tibial-rotation-angle-in-the-standing-position-in-healthy-young-adults
#14
Dong-Soo Lee, Sung-Dae Choung, Seung-Won Lee, Hye Rim Suh, Jae-Hoon Shim
[Purpose] To investigate the relationship between the lateral tibial rotation angle during knee joint flexion and the medial and lateral hamstring muscle thickness ratio during knee joint extension while resting, doing nothing, in upright standing position. The lateral tibial torsion is an important factor of orthopedic knee joint diseases as well as other weight bearing joint diseases such as osteoarthritis, meniscus syndrome, anterior cruciate ligament rupture, etc. [Subjects and Methods] Thirty healthy young adults participated in this study...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28474728/pelvic-limb-alignment-measured-by-computed-tomography-in-purebred-english-bulldogs-with-medial-patellar-luxation
#15
Filippo Lusetti, Andrea Bonardi, Chadi Eid, Anna Brandstetter de Belesini, Filippo Maria Martini
OBJECTIVES: The aim of the study was to describe the differences in pelvic limb alignment between healthy purebred English Bulldogs and those with medial patellar luxation through the measurement of femoral and tibial angles on computed tomography images in multiplanar reconstruction modality (MPR-CT). METHODS: Twenty-one purebred English Bulldogs were included and divided into two groups: one including healthy dogs (15 limbs) and the other including those with medial patellar luxation (24 limbs)...
May 10, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28471818/spectrum-of-diagnosis-and-disposition-of-patients-referred-to-a-pediatric-orthopaedic-center-for-a-diagnosis-of-intoeing
#16
Shawne Faulks, Kaitlyn Brown, John G Birch
BACKGROUND: Orthopaedic surgeons frequently evaluate otherwise healthy children for concern of intoed gait. Intoeing in otherwise healthy young children due to metatarsus adductus, internal tibial torsion, and increased femoral anteversion do not typically require orthopaedic treatment. This study reviewed the actual diagnosis, management, and disposition of patients referred to a pediatric orthopaedic specialty hospital for a diagnosis of intoeing; the efficacy of an Advanced Practice Provider (APP) assessment program to screen and triage patients with a primary complaint of intoeing; and parental satisfaction with that program...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28470694/a-comparison-of-three-methods-of-measuring-tibial-torsion-in-children-with-myelomeningocele-and-normally-developing-children
#17
Cassie N Borish, Nicole M Mueske, Tishya A L Wren
Abnormal tibial torsion is a common pediatric problem, and there are many existing measurement methods. The purpose of this study was to compare three methods of measuring tibial torsion for its evaluation: computed tomography, physical examination, and motion capture. Twenty healthy children and 20 children with myelomeningocele underwent measures of tibial torsion bilaterally. Measurements were compared using correlation and Bland-Altman plots of the difference between measurements. All three measurements were moderately correlated in controls (r ≥ 0...
May 3, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28467582/minimal-invasive-fixation-of-distal-tibial-fractures-does-not-result-in-rotational-malalignment-a-report-of-24-cases-with-ct-imaging
#18
Mehmet Mesut Sönmez, Deniz Gülabi, Meriç Uğurlar, Metin Uzun, Sezgin Sarban, Ali Şeker
BACKGROUND: Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. METHODS: Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28331928/computed-tomographic-evaluation-of-femoral-and-tibial-conformation-in-english-staffordshire-bull-terriers-with-and-without-congenital-medial-patellar-luxation
#19
Mark Newman, Katja Voss
OBJECTIVE: To compare hindlimb conformation of English Staffordshire Bull Terriers with and without medial patellar luxation using computed tomography. METHODS: Hindlimb computed tomography (CT) was performed on six English Staffordshire Bull Terriers with grade II or III medial patellar luxation, and six without medial patellar luxation. Inclination angle, femoral condyle trochanteric angle, anteversion angle (AA), distal anteversion angle (DAA), proximal anteversion angle (PAA), femoral varus angle (FVA), tibial valgus angle (TVA), and tibial torsion angle (TTA) were measured...
May 22, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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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