keyword
https://read.qxmd.com/read/38070015/towards-a-better-understanding-of-knee-angular-deformities-discrepancies-between-clinical-examination-and-2d-3d-assessments
#21
JOURNAL ARTICLE
Diane Ghanem, Ali Ghoul, Ayman Assi, Ismat Ghanem
INTRODUCTION: Discrepancy between the clinical examination and the 2D/3D radiographs is a common concern in patients with angular or rotational deformities of the lower limbs, as it may alter clinical judgment and subsequent treatment. The aim was to identify such discrepancies and assess determinants that may contribute to their existence. MATERIALS AND METHODS: A retrospective chart review was conducted on 329 consecutive patients (658 lower limbs) who underwent physical examination and long-leg biplanar radiographs in our institution between 2013 and 2018 for limb length discrepancy or angular deformity of the knees (varus/valgus)...
December 9, 2023: Archives of Orthopaedic and Trauma Surgery
https://read.qxmd.com/read/38033528/biomechanical-analysis-of-bridge-combined-fixation-system-as-a-novel-treatment-for-the-fixation-of-type-a3-distal-femoral-fractures
#22
JOURNAL ARTICLE
Jianke Liu, Zhaozhao Huang, Yubin Qi, Yuntao Long, Yanhui Zhang, Na Liu, Guilai Zuo, Wen Wang
BACKGROUND: To compare the biomechanical parameters of AO/OTA type A3 distal femoral fractures fixed bilaterally with a bridge combined fixation system (BCFS) and lateral locking compression plate + locking reconstruction plate (LCP + LRP). METHODS: Twelve A3 distal femoral fracture models with medial cortical defects of the distal femur were created using synthetic femoral Sawbones. BCFS and LCP + LRP were used for bilateral fixation, with six in each group...
2023: Frontiers in Surgery
https://read.qxmd.com/read/38026862/biomechanical-evaluation-of-three-implants-for-treating-unstable-femoral-intertrochanteric-fractures-finite-element-analysis-in-axial-bending-and-torsion-loads
#23
JOURNAL ARTICLE
HuanAn Bai, Lu Liu, Ning Duan, HanZhong Xue, Liang Sun, Ming Li, Zhong Li, Kun Zhang, Qian Wang, Qiang Huang
Purpose: How to effectively enhance the mechanical stability of intramedullary implants for unstable femoral intertrochanteric fractures (UFIFs) is challenging. The authors developed a new implant for managing such patients. Our aim was to enhance the whole mechanical stability of internal devices through increasing antirotation and medial support. We expected to reduce stress concentration in implants. Each implant was compared to proximal femoral nail antirotation (PFNA) via finite element method. Methods: Adult AO/OTA 31-A2...
2023: Frontiers in Bioengineering and Biotechnology
https://read.qxmd.com/read/37993038/intramedullary-implant-stability-affects-patterns-of-fracture-healing-in-mice-with-morphologically-different-bone-phenotypes
#24
JOURNAL ARTICLE
Vaida Glatt, Nicole Bartnikowski, Michal Bartnikowski, Leonardo Aguilar, Michael Schuetz, Kevin Tetsworth
Almost all prior mouse fracture healing models have used needles or K-wires for fixation, unwittingly providing inadequate mechanical stability during the healing process. Our contention is that the reported outcomes have predominantly reflected this instability, rather than the impact of diverse biological conditions, pharmacologic interventions, exogenous growth factors, or genetic considerations. This important issue becomes obvious upon a critical review of the literature. Therefore, the primary aim of this study was to demonstrate the significance of mouse-specific implants designed to provide both axial and torsional stability (Screw and IM Nail) compared to conventional pins (Needle and K-wires), even when used in mice with differently sized marrow canals and diverse genetic backgrounds...
November 20, 2023: Bone
https://read.qxmd.com/read/37975265/is-augmented-femoral-lateral-plating-with-helically-shaped-medial-plates-biomechanically-advantageous-over-straight-medial-plates
#25
JOURNAL ARTICLE
Torsten Pastor, Ivan Zderic, Ludmil Drenchev, Hristo Kostov Skulev, Till Berk, Frank J P Beeres, Björn-Christian Link, Boyko Gueorguiev, Karl Stoffel, Matthias Knobe
BACKGROUND: Dual plating of comminuted distal femoral fractures allows for early patient mobilization. An additional helically shaped medial plate avoids the medial vital structures of the thigh. AIM: to investigate the biomechanical competence of augmented lateral locking compression plate distal femur (LCP-DF) using an additional straight versus a helically shaped medial LCP of the same length. METHODS: Ten pairs of human cadaveric femora were instrumented with a lateral anatomical 15-hole LCP-DF...
November 17, 2023: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://read.qxmd.com/read/37954430/analysis-of-lower-extremity-alignment-lea-in-children-with-recurrent-patellar-dislocation-by-eos-system
#26
JOURNAL ARTICLE
Mingyuan Miao, Haiqing Cai, Li Zhang, Haoqi Cai
OBJECTIVES: Recurrent patellar dislocation (RPD) greatly affects active young individuals, necessitating the identification of risk factors for a better understanding of its cause. Previous research has connected RPD to lower limb alignment (LEA) abnormalities, such as increased femoral anteversion, tibial external rotation, knee valgus, and flexion. This study aims to use EOS technology to detect RPD-related LEA anomalies, enabling three-dimensional assessment under load conditions. METHODS: A total of 100 limbs (50 in the RPD group, 50 in the control group) were retrospectively analyzed...
2023: Frontiers in Pediatrics
https://read.qxmd.com/read/37947855/-corrective-osteotomies-around-the-knee-joint-using-hexapods
#27
REVIEW
Jörg Dickschas
OBJECTIVE: Correction of deformities around the knee joint in the frontal and sagittal axis, torsion, length and translation. INDICATIONS: Complex deformities of the proximal tibia, and to a lesser extent of the distal femur, which cannot be treated with acute correction using plate or nail osteosynthesis. CONTRAINDICATIONS: Nicotine abuse, soft tissue problems, lack of patient compliance. SURGICAL TECHNIQUE: First, mounting of the proximal ring of the ring fixator strictly parallel to the joint line in 2 planes, fixation with 3 or 4 pins or wires...
November 10, 2023: Operative Orthopädie und Traumatologie
https://read.qxmd.com/read/37936394/additional-plate-fixation-of-hinge-fractures-after-varisation-distal-femoral-osteotomies-provides-favorable-torsional-stability-a-biomechanical-study
#28
JOURNAL ARTICLE
Christian Peez, Arian Grosse-Allermann, Adrian Deichsel, Michael J Raschke, Johannes Glasbrenner, Thorben Briese, Jens Wermers, Elmar Herbst, Christoph Kittl
BACKGROUND: Hinge fractures are considered risk factors for delayed or nonunion of the osteotomy gap in distal femoral osteotomies (DFOs). Limited evidence exists regarding the treatment of hinge fractures after DFO, which could improve stability and thus bone healing. PURPOSE: To (1) examine the effect of hinge fractures on the biomechanical properties of the bone-implant construct, (2) evaluate the biomechanical advantages of an additional fixation of a hinge fracture, and (3) test the biomechanical properties of different types of varisation DFOs...
December 2023: American Journal of Sports Medicine
https://read.qxmd.com/read/37901836/lower-limb-internal-loading-and-potential-consequences-for-fracture-healing
#29
JOURNAL ARTICLE
Mark Heyland, Dominik Deppe, Marie Jacqueline Reisener, Philipp Damm, William R Taylor, Simon Reinke, Georg N Duda, Adam Trepczynski
Introduction: Mechanical loading is known to determine the course of bone fracture healing. We hypothesise that lower limb long bone loading differs with knee flexion angle during walking and frontal knee alignment, which affects fracture healing success. Materials and methods: Using our musculoskeletal in silico modelling constrained against in vivo data from patients with instrumented knee implants allowed us to assess internal loads in femur and tibia. These internal forces were associated with the clinical outcome of fracture healing in a relevant cohort of 178 extra-articular femur and tibia fractures in patients using a retrospective approach...
2023: Frontiers in Bioengineering and Biotechnology
https://read.qxmd.com/read/37878013/distal-femoral-torsion-is-correlated-with-higher-grade-trochlear-dysplasia-and-shorter-anterior-condyles-in-patients-with-patellar-dislocation-and-increased-femoral-torsion
#30
JOURNAL ARTICLE
Kuo Hao, Yingzhen Niu, Zhenhui Huo, Fei Wang
PURPOSE: To describe the characteristics of femoral torsion in patients with different segmental torsion types and to evaluate the correlations between segmental torsion and the morphology of the femoral condyles and trochlea in patients with patellar dislocation and increased femoral torsion. METHODS: Between January 2021 and March 2023, 69 patients were included and classified into two groups according to the femoral segment contributing the most to total torsion: 32 patients in Group A (femoral neck and shaft torsion) and 37 patients in Group B (distal torsion)...
October 25, 2023: Knee Surgery, Sports Traumatology, Arthroscopy
https://read.qxmd.com/read/37866875/editorial-commentary-evaluation-of-patellofemoral-instability-is-complex-and-multifactorial
#31
EDITORIAL
Seth L Sherman, Andrew Gudeman
The work-up of patellofemoral instability is complex and multifactorial. Patient factors (i.e., age, activity demand, goals/expectations), clinical presentation (pain, instability, or both), and physical examination (i.e., J-sign, apprehension into flexion), must be correlated with imaging findings (radiographs, magnetic resonance imaging, computed tomography) and anatomic risk factors, including patella alta, trochlear dysplasia, patellar tilt, lateralized force vector, valgus, femoral anteversion, and tibial torsion...
November 2023: Arthroscopy
https://read.qxmd.com/read/37840102/hip-mri-in-flexion-abduction-external-rotation-for-assessment-of-the-ischiofemoral-interval-in-patients-with-hip-pain-a-feasibility-study
#32
JOURNAL ARTICLE
Alexander F Heimann, Jonas Walther, Moritz Tannast, Joseph M Schwab, Moritz Wagner, Alexander Brunner, Till D Lerch, Simon D Steppacher, Peter Vavron, Ehrenfried Schmaranzer, Florian Schmaranzer
OBJECTIVES: To assess the feasibility of flexion-abduction-external rotation (FABER) magnetic resonance imaging (MRI) of the hip to visualize changes in the ischiofemoral interval and ability to provoke foveal excursion over the acetabular rim. METHODS: IRB-approved retrospective single-center study. Patients underwent non-contrast 1.5-T hip MRI in the neutral and FABER position. Two readers measured the ischiofemoral interval at three levels: proximal/distal intertrochanteric distance and ischiofemoral space...
October 15, 2023: Insights Into Imaging
https://read.qxmd.com/read/37832469/medial-helical-versus-straight-lateral-plating-of-distal-femoral-fractures-a-biomechanical-comparative-study
#33
JOURNAL ARTICLE
Torsten Pastor, Ivan Zderic, Firas Souleiman, Ludmil Drenchev, Hristo Kostov Skulev, Till Berk, Boyko Gueorguiev, Matthias Knobe
BACKGROUND: Distal femoral fractures are commonly treated with lateral straight plates. However, the lateral approach may not always be desirable, and 180°-helical plates may be an alternative. AIM: To investigate the biomechanical competence of 180°-helical plating versus standard straight lateral plating of unstable fractures at the distal femur. METHODS: Twelve left artificial femora were instrumented with a 15-hole Locking Compression Plate-Distal Femur, using either 180°-helical plates (group 1) or conventional straight lateral plates (group 2)...
October 5, 2023: Clinical Biomechanics
https://read.qxmd.com/read/37823742/biomechanical-comparison-of-fixation-methods-on-third-generation-femoral-composite-bone-models-in-pauwels-type-3-femoral-neck-fractures-contribution-of-the-medial-buttress-plate-to-fixation
#34
JOURNAL ARTICLE
Feyzi Kılıç, Abdulkadir Polat, Fatih Yamak, Ergün Bozdag, Fırat Fidan, Hakan Başar
OBJECTIVE: To compare the use of cannulated screws in an inverted triangular configuration, medial buttress plates, and the combination of these 2 fixation methods in the treatment of Pauwels type 3 femoral neck fractures. METHODS: Twenty-eight anatomical composite third-generation femoral bone models were divided into 4 groups. The control group (group 1) was formed with 7 third-generation intact bone models. The fracture model was created with a 70° cutting block to fit 21 Pauwels type 3 fracture configurations...
September 2023: Acta Orthopaedica et Traumatologica Turcica
https://read.qxmd.com/read/37817247/miserable-malalignment-syndrome-associated-knee-pain-a-case-for-infra-tubercle-tibial-de-rotation-osteotomy-using-an-external-fixator
#35
JOURNAL ARTICLE
Ahmed A Elsheikh, George W V Cross, Jonathan Wright, William David Goodier, Peter Calder
INTRODUCTION: Miserable malalignment syndrome is a complex torsional lower limb deformity with limited consensus on surgical treatment. We present the outcome of de-rotation of the tibia alone using an external fixator. METHODS: Fifteen patients (22 segments) were operated on between 2012 and 2020; 13 presented with anterior knee pain, and two presented with out-toeing. Gait analysis was done in nine patients, and CT scan rotational profile, including tibial tubercle-trochlear groove distance, femoral version, and tibial torsion, were calculated...
October 11, 2023: Journal of Orthopaedic Surgery and Research
https://read.qxmd.com/read/37783426/biomechanical-comparison-of-distal-femoral-fracture-fixation-polyaxial-vs-uniaxial-locking-screws-with-different-blocking-screw-configurations-in-retrograde-femoral-nailing
#36
JOURNAL ARTICLE
Suat Batar, Mehmet Salih Söylemez, S Ergün Bozdağ, Enis Yaman, Bahattin Kemah, Oğuz S Poyanlı
INTRODUCTION: Clinical studies have indicated reduced reliance on blocking screws with the introduction of polyaxial locking nails, yet the biomechanical superiority of polyaxial locking over blocking screws remains unverified, specifically for distal dia-metaphyseal femur fractures. HYPOTHESIS: We hypothesized that the combination of multiaxial locking using three screws and parallel locking reinforced by two blocking screws would result in superior outcomes compared to utilizing only parallel locking with two screws and one blocking screw...
September 30, 2023: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://read.qxmd.com/read/37751370/drop-landing-analysis-of-rotational-osteotomies
#37
JOURNAL ARTICLE
Peter M Stevens, Olivia F Grothaus, Bruce A MacWilliams
Pathomechanics resulting from rotational deformities of the long bones in an idiopathic population have not been extensively studied, and are chiefly limited to level over ground walking. Thirty-five adolescents with excessive idiopathic outward tibial torsion (TT), femoral rotation, or both (pan genu) were studied both before and after corrective surgery. Data collected included computational motion analysis of a drop jump and patient-reported outcomes consisting of PODCI and Goal Attainment Scores. Results were compared to an age-matched typically developing cohort (n = 25)...
September 22, 2023: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/37740782/virtual-3d-femur-model-to-assess-femoral-version-comparison-to-the-2d-axial-slice-approach
#38
JOURNAL ARTICLE
Jade Iwasaka-Neder, Sarah D Bixby, M Alejandra Bedoya, Enju Liu, Delma Y Jarrett, Donna Agahigian, Andy Tsai
BACKGROUND: Quantifying femoral version is crucial in diagnosing femoral version abnormalities and for accurate pre-surgical planning. There are numerous methods for measuring femoral version, however, reliability studies for most of these methods excluded children with hip deformities. OBJECTIVE: To propose a method of measuring femoral version based on a virtual 3D femur model, and systematically compare its reliability to the widely used Murphy's 2D axial slice technique...
September 23, 2023: Pediatric Radiology
https://read.qxmd.com/read/37730490/biomechanical-performance-of-talon-cannulated-compression-device-in-pauwels-type-iii-fractures-a-comparative-study
#39
JOURNAL ARTICLE
Hayri Can Taşkent, Kadir Bahadır Alemdaroğlu, Yunus Uslan, Niyazi Ercan, Teyfik Demir
INTRODUCTION: Pauwels Type III fractures are unstable and frequently treated with cannulated screws (CS) or dynamic hip screws (DHS). The newly developed talon-cannulated compression devices (TCCD) have the potential to provide rotational stability, mainly through their talon. The study investigates whether TCCD has mechanical advantages over conventional screws or can be as stable as DHS in a reverse triangle configuration for an unstable femoral neck fracture. MATERIAL AND METHODS: After creating a standard Pauwels Type III unstable femoral neck fracture in 36 synthetic femur bones in cortical/hard cancellous bone density, 18 were reserved for dynamic-static tests, and 18 were used for torsional tests...
September 9, 2023: Injury
https://read.qxmd.com/read/37721931/comparative-analysis-of-physical-examination-ct-scan-and-three-dimensional-gait-analysis-in-evaluating-lower-extremity-torsion-deformities-in-children-with-cerebral-palsy
#40
JOURNAL ARTICLE
Sheng Jin, Chunxin Xu, Haiqing Cai, Cen Chen, Yangyang Lu, Zhigang Wang, Min Shen
BACKGROUND The aim of this study was to analyze the correlation and the accuracy of lower-extremity torsion deformities measured by physical examination, CT scan, and three-dimensional gait analysis in children with CP. MATERIAL AND METHODS The study group included 72 children with CP with lower-extremity torsion deformities. All subjects were assessed by: 1. physical examination: maximum internal rotation (MIR), maximum external rotation (MER) for hip joint torsion, and transmalleolar axis (TMA) for tibial torsion; 2...
September 18, 2023: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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