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https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#1
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 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909860/tibial-hemimelia-new-classification-and-reconstructive-options
#2
REVIEW
Dror Paley
Tibial hemimelia is a rare congenital lower limb deficiency presenting with a wide spectrum of associated congenital anomalies, deficiencies and duplications. Reconstructive options have been limited, and the gold standard for treatment has remained amputation with prosthetic fitting. There is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia. Armed with this knowledge, I present here a new classification to guide treatment and prognosis and then discuss new treatment strategies and techniques for limb reconstruction based on this new classification scheme...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27892743/muscle-strength-and-knee-range-of-motion-after-femoral-lengthening
#3
Anil Bhave, Lior Shabtai, Erik Woelber, Arman Apelyan, Dror Paley, John E Herzenberg
Background and purpose - Femoral lengthening may result in decrease in knee range of motion (ROM) and quadriceps and hamstring muscle weakness. We evaluated preoperative and postoperative knee ROM, hamstring muscle strength, and quadriceps muscle strength in a diverse group of patients undergoing femoral lengthening. We hypothesized that lengthening would not result in a significant change in knee ROM or muscle strength. Patients and methods - This prospective study of 48 patients (mean age 27 (9-60) years) compared ROM and muscle strength before and after femoral lengthening...
November 28, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27678508/hip-stability-during-lengthening-in-children-with-congenital-femoral-deficiency
#4
Mark Eidelman, Julio J Jauregui, Shawn C Standard, Dror Paley, John E Herzenberg
BACKGROUND: Congenital femoral deficiency (CFD) is one of the most challenging and complex conditions for limb lengthening. We focused on the problem of hip instability during femoral lengthening because subluxation and dislocation are potentially catastrophic for hip function. METHODS: We assessed for hip stability in 69 children (91 femoral lengthenings) who had CFD Paley type 1a (43 children) and 1b (26 children). The mean age at first lengthening was 6.4 years...
September 27, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/26650581/prophylactic-intramedullary-rodding-following-femoral-lengthening-in-congenital-deficiency-of-the-femur
#5
Amr A Abdelgawad, Julio J Jauregui, Shawn C Standard, Dror Paley, John E Herzenberg
INTRODUCTION: Femoral fracture after lengthening of congenital femoral deficiency (CFD) is a common complication with a high incidence, up to 50%. The purpose of this study is to determine whether prophylactic intramedullary Rush rodding after lengthening for CFD is an effective method to prevent femoral fracture and to assess any complications that may result. METHODS: Forty-five femoral lengthenings (43 CFD patients) were performed using external fixation. At the time of frame removal (except for 3 cases, 8 d later), prophylactic intramedullary Rush rods were inserted...
December 8, 2015: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/26194561/lengthening-with-external-fixation-is-effective-in-congenital-femoral-deficiency
#6
Daniel E Prince, John E Herzenberg, Shawn C Standard, Dror Paley
BACKGROUND: Treatment of congenital femoral deficiency is a complex, multistage protocol and a variety of strategies have been devised to address joint instability, limb length inequality, and deformities. Despite being an important part of the algorithmic approach to the overall treatment of patients with congenital femoral deficiency, a reproducible, safe, and functional treatment for femoral length discrepancy in patients with mild and moderate congenital femoral deficiency has not been reported...
October 2015: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26186317/custom-knee-device-for-knee-contractures-after-internal-femoral-lengthening
#7
Anil Bhave, Lior Shabtai, Peck-Hoon Ong, Shawn C Standard, Dror Paley, John E Herzenberg
The development of knee flexion contractures is among the most common problems and complications associated with lengthening the femur with an internal device or external fixator. Conservative treatment strategies include physical therapy, serial casting, and low-load prolonged stretching with commercially available splinting systems. The authors developed an individually molded, low-cost custom knee device with polyester synthetic conformable casting material to treat knee flexion contractures. The goal of this study was to evaluate the results of treatment with a custom knee device and specialized physical therapy in patients who had knee flexion contracture during femoral lengthening with an intramedullary lengthening femoral nail...
July 1, 2015: Orthopedics
https://www.readbyqxmd.com/read/25692375/precice-intramedullary-limb-lengthening-system
#8
REVIEW
Dror Paley
The PRECICE(®) Intramedullary Limb Lengthening System (Ellipse Technologies Inc., CA, USA) is a remotely controlled, magnetically driven, implantable limb lengthening intramedullary nail system. It has both CE mark and US FDA clearance for its first- (2011) and second-generation (2013) implants. It is indicated for the treatment of limb length discrepancy and short stature. It has been used worldwide in over 1000 cases. Its reported and published results in over 250 cases has been excellent with less pain and lower complication rates than with external fixation methods or previous implantable nail systems...
May 2015: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/24634195/preliminary-experience-with-motorized-distraction-for-tibial-lengthening
#9
Adam S Bright, John E Herzenberg, Dror Paley, Ian Weiner, Rolf D Burghardt
Limb lengthening by callus distraction is commonly performed with the use of external fixation. Lengthening is routinely performed by the patient through small increments throughout the course of a day. Ilizarov has shown that both the rate and frequency of distraction are important factors in the quality of osteogenesis. We report the effect of motorized high frequency distraction for tibial lengthening in comparison with manual low-frequency distraction at the same rate. Manual distraction (0.25 mm four times a day) in a group containing 43 tibiae was compared with motorized distraction (1/1,440 mm 1,400 times a day) in a group containing 27 tibiae...
August 2014: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/24370977/a-comparative-study-of-the-correction-of-femoral-deformity-between-the-ilizarov-apparatus-and-ortho-suv-frame
#10
COMPARATIVE STUDY
Leonid N Solomin, Dror Paley, Elena A Shchepkina, Victor A Vilensky, Petr V Skomoroshko
PURPOSES: This study compared the six-axis external fixator Ortho-SUV Frame (OSF) and the Ilizarov apparatus (IA) in femoral deformity correction. Our specific questions were: (1) which of the fixators (OSF or IA) provides shorter period of femoral deformity correction, and (2) which of the fixators (OSF or IA) provides better accuracy of correction. METHODS: We retrospectively analysed 123 cases of femoral deformities (127 femora): 45 (47) treated with OSF (20 male and 27 female) and 78 (80) with IA (53 male and 27 female)...
April 2014: International Orthopaedics
https://www.readbyqxmd.com/read/22854996/distraction-osteogenesis-for-complex-foot-deformities-u-osteotomy-with-external-fixation
#11
Monique C Gourdine-Shaw, Bradley M Lamm, Dror Paley, John E Herzenberg
BACKGROUND: Certain complex foot deformities can be corrected surgically with a U-osteotomy. This osteotomy is indicated for patients with a uniform deformity of the entire foot relative to the tibia, preexisting stiffness and/or fusion of the subtalar joint, and a pain-free ankle joint. The goal is to create a plantigrade foot through gradual osseous repositioning of the entire foot relative to the tibia by means of external fixation. If needed, foot height can be increased simultaneously...
August 1, 2012: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/22819160/surgery-for-residual-femoral-deformity-in-adolescents
#12
REVIEW
Dror Paley
Abnormalities of the femur frequently accompany acetabular dysplasia as primary or secondary deformities. Femoral surgery is often a component of surgical treatment of acetabular dysplasia either at the onset or to treat a secondary or residual deformity. Proper analysis of the abnormal geometry of the bony femur, as well as the abnormal lever arms around the hip related to the lesser and greater trochanteric positions, is an essential part of a successful surgical plan. An à la carte approach makes the most sense in the treatment of the wide variety of disorders of the upper femur...
July 2012: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/21742151/the-treatment-of-femoral-head-deformity-and-coxa-magna-by-the-ganz-femoral-head-reduction-osteotomy
#13
REVIEW
Dror Paley
The aspherical coxa magna femoral head can be made more spherical by intra-articular osteotomy. The Ganz technique of femoral head reduction osteotomy to reduce the size and restore the spherical shape of the femoral head has been performed in 20 patients over the past 5 years. A good or excellent functional and radiographic result was obtained in 14 of the 20. A fair result (decreased pain but no improvement in range of motion) occurred in 3, and a poor result (stiffness and pain) occurred in 3. The preliminary results of this technique are therefore very promising...
July 2011: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/20864361/a-two-stage-percutaneous-approach-to-charcot-diabetic-foot-reconstruction
#14
Bradley M Lamm, H David Gottlieb, Dror Paley
The goals of Charcot deformity correction are to restore osseous alignment, regain pedal stability, and prevent ulceration. Traditional reconstructive surgical approaches involve large, open incisions to remove bone and the use of internal fixation to attempt to fuse dislocated joints. Such operations can result in shortening of the foot and/or incomplete deformity correction, fixation failure, incision healing problems, infection, and the longterm use of casts or braces. We recommend a minimally invasive surgical technique for the treatment of Charcot deformity, which we performed on 11 feet in 8 patients...
November 2010: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/20019622/femoral-nailing-to-treat-fractures-after-lengthening-for-congenital-femoral-deficiency-in-young-children
#15
John E Herzenberg, Toby Branfoot, Dror Paley, Francisco H Violante
Congenital femoral deficiency in children can be treated with femoral lengthening. A common complication is fracture soon after removal of the external fixator, often despite prophylactic hip spica cast application. These fractures present special challenges because the patients have tight soft tissues and sclerotic intramedullary canals. We treated nine such fractures in eight children (average age, 5.4 years). Most were 'spontaneous' events resulting in transverse fracture through regenerate bone or pin sites...
March 2010: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/19308576/temporary-hemiepiphyseal-arrest-using-a-screw-and-plate-device-to-treat-knee-and-ankle-deformities-in-children-a-preliminary-report
#16
Rolf D Burghardt, John E Herzenberg, Shawn C Standard, Dror Paley
PURPOSE: Traditionally, angular deformities are treated by means of osteotomy. In patients who are skeletally immature, this major intervention can be avoided by influencing or guiding the growth of the affected physis. Recently, a new device was presented as an alternative to the widely used Blount staple. Stevens developed a technique using a two-hole, non-locking plate with two screws to perform temporary hemiepiphysiodesis in children. We studied the effectiveness of this new device in correcting angular deformities in children even younger than 5 years of age...
June 2008: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/18953621/periosteal-grafting-for-congenital-pseudarthrosis-of-the-tibia-a-preliminary-report
#17
Ahmed M Thabet, Dror Paley, Mehmet Kocaoglu, Levent Eralp, John E Herzenberg, Omer Naci Ergin
UNLABELLED: The results of treatment of congenital pseudarthrosis of the tibia (CPT) are frequently unsatisfactory because of the need for multiple operations for recalcitrant nonunion, residual deformities, and limb-length discrepancies (LLD). Although the etiology of CPT is basically unknown, recent reports suggest the periosteum is the primary site for the pathologic processes in CPT. We hypothesized complete excision of the diseased periosteum and the application of a combined approach including free periosteal grafting, bone grafting, and intramedullary (IM) nailing of both the tibia and fibula combined with Ilizarov fixation would improve union rates and reduce refracture rates...
December 2008: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/18800215/tibial-lengthening-extraarticular-calcaneotibial-screw-to-prevent-ankle-equinus
#18
Mohan V Belthur, Dror Paley, Gaurav Jindal, Rolf D Burghardt, Stacy C Specht, John E Herzenberg
UNLABELLED: Between 2003 and 2006, we used an extraarticular, cannulated, fully threaded posterior calcaneotibial screw to prevent equinus contracture in 10 patients (four male and six female patients, 14 limbs) undergoing tibial lengthening with the intramedullary skeletal kinetic distractor. Diagnoses were fibular hemimelia (two), mesomelic dwarfism (two), posteromedial bow (one), hemihypertrophy (one), poliomyelitis (one), achondroplasia (one), posttraumatic limb-length discrepancy (one), and hypochondroplasia (one)...
December 2008: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/18692010/distraction-arthroplasty-of-the-ankle-how-far-can-you-stretch-the-indications
#19
REVIEW
Dror Paley, Bradley M Lamm, Rachana M Purohit, Stacy C Specht
Ankle joint distraction has been shown to be a viable alternative to ankle arthrodesis or ankle replacement. The à la carte approach to ankle joint preservation (resection of blocking osteophytes, release of muscle/joint contractures, and realignment osseous ankle procedures) presented in this article as important for a successful outcome as is the hinged ankle joint distraction technique itself. The authors reviewed 32 patients who underwent this ankle joint distraction technique and found 78% of patients had maintained their ankle range of motion and have no pain to occasional moderate pain that can be managed generally with nonsteroidal anti-inflammatory drugs alone...
September 2008: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/18343295/multiplier-method-for-limb-length-prediction-in-the-upper-extremity
#20
Dror Paley, Amanda Gelman, Mordchai B Shualy, John E Herzenberg
PURPOSE: Limb-length discrepancy occurs in both the upper and lower extremities. Methods of predicting discrepancies at skeletal maturity have generally focused on the lower limbs. Paley et al devised the multiplier method to predict lower-limb-length discrepancy at skeletal maturity. The purpose of this study was to generate a similar methodology applicable for the upper limb. METHODS: Using radiographic, clinical, and anthropologic databases, we divided humeral, radial, and ulnar lengths at skeletal maturity by the humeral, radial, and ulnar lengths at each age and for each percentile given...
March 2008: Journal of Hand Surgery
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