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Limb lengthening

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https://www.readbyqxmd.com/read/28819598/two-staged-bilateral-femoral-alignment-osteotomy-with-concomitant-total-knee-arthroplasty-in-an-achondroplasia-patient-a-case-report
#1
Sebastian G Walter, Tobias Schwering, Stefan Preiss
INTRODUCTION: Achondroplasia is the most common form of dwarfism in humans and is orthopedically characterized by shortened extremities and an exaggerated lumbar lordosis. The surgical challenges are maintenance of axial alignment during limb lengthening as well as joint preservation and alignment restoration. CASE REPORT: We present a 46-year-old female suffering from achondroplasia with severe pain in both knees. Severe varus deformities of both femurs and degeneration of both knee joints became apparent on clinical and radiological examination...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28817981/the-use-of-flexible-intramedullary-nails-in-limb-lengthening
#2
Arnold Popkov, Patrick Foster, Alexander Gubin, Dmitry Borzunov, Dmitry Popkov
Lower and upper limb length discrepancy and deformity, congenital or acquired, are amongst the most common conditions in children for orthopaedic referral. Over the last twenty years, surgical techniques have evolved in an attempt to decrease Healing Index and minimise these complications. Areas covered: The flexible intramedullary nailing (FIN) is a minimally invasive intramedullary osteosynthesis. In combination with an external fixator, it is appropriated for pediatric bone lengthenings and lengthening of bones of small diameter in adults...
August 18, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28817162/determining-when-it-is-safe-to-remove-the-external-fixator-results-from-a-survey-of-the-limb-lengthening-and-reconstruction-society
#3
Christopher A Iobst, Waleed Mohammed, Ryan Colley
Thousands of external fixators are applied for distraction osteogenesis each year. Determining when it is safe to remove the fixator can be difficult. The purpose of this study was to survey an international group of external fixation surgeons to determine their current practice patterns surrounding external fixator removal. A 10-question, open-ended survey was emailed to members of the Limb Lengthening and Reconstruction Society. Responses were recorded, and statistical analysis was performed. Pearson's chi-square test and likelihood ratio were used when indicated...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28816903/what-s-new-in-limb-lengthening-and-deformity-correction
#4
Reggie C Hamdy, Mitchell Bernstein, Austin T Fragomen, S Robert Rozbruch
No abstract text is available yet for this article.
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28806980/factors-influencing-outcomes-after-medial-hamstring-lengthening-with-semitendinosus-transfer-in-patients-with-cerebral-palsy
#5
Ki Hyuk Sung, Jaebong Lee, Chin Youb Chung, Kyoung Min Lee, Byung Chae Cho, Seung Jun Moon, Jaeyoung Kim, Moon Seok Park
BACKGROUND: Although several studies have investigated the outcomes after distal hamstring lengthening (DHL), no study has undertaken an approach that included all or most of the important factors that could influence the results. This study was performed to evaluate the outcomes after DHL and analyze the factors that influence the improvement and serial change in knee motion after surgery in patients with cerebral palsy (CP), using a linear mixed model (LMM). METHODS: The study included 314 ambulatory CP patients (594 limbs) with spsastic diplegia who were followed up after undergoing DHL as part of a single-event multilevel surgery and who underwent preoperative and postoperative 3-dimensional (3D) gait analyses...
August 14, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28803367/the-role-of-agonist-and-antagonist-muscles-in-explaining-isometric-knee-extension-torque-variation-with-hip-joint-angle
#6
Theodoros M Bampouras, Neil D Reeves, Vasilios Baltzopoulos, Constantinos N Maganaris
PURPOSE: The biarticular rectus femoris (RF), operating on the ascending limb of the force-length curve, produces more force at longer lengths. However, experimental studies consistently report higher knee extension torque when supine (longer RF length) compared to seated (shorter RF length). Incomplete activation in the supine position has been proposed as the reason for this discrepancy, but differences in antagonistic co-activation could also be responsible due to altered hamstrings length...
August 12, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28803224/broadening-the-argument-on-limb-lengthening
#7
Alok Sarin
No abstract text is available yet for this article.
July 25, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28799987/a-brief-history-of-limb-lengthening
#8
John G Birch
In the last 35 years, orthopaedic surgeons have witnessed 3 major advances in the technique of limb lengthening: "distraction osteogenesis" facilitated by Gavriil Ilizarov method and infinitely-adaptable circular fixator with fine-wire bone fragment fixation; the introduction of the "6-strut" computer program-assisted circular fixators to effect complex deformity correction simultaneously; and the development of motorized intramedullary lengthening nails. However, the principles and associated complications of these techniques are on the basis of observations by Codivilla, Putti, and Abbott from as much as 110 years ago...
September 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28782836/histone-deacetylase-3-deletion-in-mesenchymal-progenitor-cells-hinders-long-bone-development
#9
Marina Feigenson, Lomeli Carpio Shull, Earnest L Taylor, Emily T Camilleri, Scott M Reister, Andre J van Wijnen, Elizabeth W Bradley, Jennifer J Westendorf
Long bone formation is a complex process that requires precise transcriptional control of gene expression programs in mesenchymal progenitor cells. Histone deacetylases (Hdacs) coordinate chromatin structure and gene expression by enzymatically removing acetyl groups from histones and other proteins. Hdac inhibitors are used clinically to manage mood disorders, cancers and other conditions, but are teratogenic to the developing skeleton and increase fracture risk in adults. In this study, the functions of Hdac3, one of the enzymes blocked by current Hdac inhibitor therapies, in skeletal mesenchymal progenitor cells were determined...
August 7, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28746061/lengthening-with-monolateral-external-fixation-versus-magnetically-motorized-intramedullary-nail-in-congenital-femoral-deficiency
#10
Vivian L Szymczuk, Ahmed I Hammouda, Martin G Gesheff, Shawn C Standard, John E Herzenberg
BACKGROUND: Limb lengthening for congenital femoral deficiency (CFD) with or without fibular hemimelia can be performed with both external and internal devices. The purpose of this study is to compare clinical outcomes of femoral lengthening utilizing monolateral external fixation versus a magnetically motorized intramedullary nail in patients with CFD with or without fibular hemimelia. METHODS: This retrospective review included 62 patients with femoral lengthening, 32 patients had monolateral external fixation (group A), 30 patients had internal lengthening nail (group B)...
July 28, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28735102/intra-operatively-measured-spastic-semimembranosus-forces-of-children-with-cerebral-palsy
#11
Can A Yucesoy, Yener Temelli, Filiz Ateş
The knee kept forcibly in a flexed position is typical in cerebral palsy. Using a benchmark, we investigate intra-operatively if peak spastic hamstring force is measured in flexed knee positions. This tests the assumed shift of optimal length due to adaptation of spastic muscle and a decreasing force trend towards extension. Previously we measured spastic gracilis (GRA) and semitendinosus (ST) forces. Presently, we studied spastic semimembranosus (SM) and tested the following hypotheses: spastic SM forces are (1) high in flexed and (2) low in extended positions...
July 12, 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/28706382/cementless-acetabular-component-with-or-without-upward-placement-in-dysplasia-hip-early-results-from-a-prospective-randomised-study
#12
Zhiqi Zhang, Peihui Wu, Zhiyu Huang, Baoxi Yu, Hong Sun, Ming Fu, Yan Kang, Weiming Liao
BACKGROUND: Total hip arthroplasty (THA) in developmental dysplasia of hip (DDH) is difficult for the abnormal acetabulum. The purpose of this study was to evaluate the difference of anatomic and upward placement of acetabular component during early stage. METHODS: From April 2014 through June 2015, forty DDH patients (Crowe I to III, 42 hips) were prospectively randomized to either anatomic or upward group. Patient recorded diaries were collected. Radiographs were reviewed...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28704303/gain-of-length-loss-of-strength-alteration-in-muscle-strength-after-femoral-leg-lengthening-in-young-patients-a-prospective-longitudinal-observational-study
#13
Andreas H Krieg, Sebastian Gehmert, Olivia L Neeser, Xaver Kaelin, Bernhard M Speth
This study aimed to determine the alteration in maximum isokinetic torque in patients after intramedullary femoral leg lengthening. Thirty patients with a median leg-length discrepancy of 3.0 cm underwent femoral limb lengthening with an intramedullary motorized device. Maximum isokinetic, concentric torque of the extensors, and flexors of the knee was measured before (n=30) and 2 years after surgery (n=21). Postoperatively, a significant difference remained for the maximum isokinetic torque of the extensors (22%) between the lengthened and the normal leg, which might have been caused by muscle response to the distraction procedure itself in the form of higher stiffness, less immediate displacement, and inconsistent force relaxation properties...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28690469/ankle-reconstruction-in-fibular-hemimelia-new-approach
#14
Hany Hefny, ElHussein M Elmoatasem, Mahmoud Mahran, Tamer Fayyad, Mohamed A Elgebeily, Ahmed Mansour, Mamdouh Hefny
BACKGROUND: Fibular hemimelia is a congenital disorder that is characterized by the absence of the fibula that could be either partial or complete. Successful management aims to restore normal weight bearing and normal limb length. The introduction of the Ilizarov method of limb lengthening has provided an attractive alternative to amputation. During lengthening, the tight posterolateral soft-tissue structures, the thick fibrous fibular band, and the shortened Achilles tendon become tighter and transfer a valgus force to the talus and calcaneus, further aggravating the deformity...
July 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28674737/systematic-review-of-the-outcome-of-total-hip-arthroplasty-in-patients-with-sequelae-of-legg-calv%C3%A3-perthes-disease
#15
Sammy A Hanna, Khaled M Sarraf, Manoj Ramachandran, Pramod Achan
BACKGROUND: Total hip arthroplasty (THA) in patients with sequelae of Legg-Calvé-Perthes disease (LCP) is technically demanding because of the disease related deformities occuring in the proximal femur and/or the multiplanar deformities secondary to corrective osteotomies in childhood. Little is known about the long-term outcome of the procedure in this challenging group of patients. METHODS: We carried out a systematic review of the literature to determine the functional outcome, complications and revision rate of THA in patients with sequelae of LCP disease...
August 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28649479/functional-outcomes-of-childhood-selective-dorsal-rhizotomy-20-to-28-years-later
#16
T S Park, Jenny L Liu, Caleb Edwards, Deanna M Walter, Matthew B Dobbs
BACKGROUND: Selective dorsal rhizotomy (SDR) is a surgical method used to treat childhood spastic cerebral palsy (CP). However, the effects of early SDR on functional outcomes and quality of life decades later in adulthood remains to be elucidated. OBJECTIVES: To evaluate the long-term outcomes in terms of satisfaction and mobility of adult patients who received childhood SDR. METHODS: Adult patients who received SDR in childhood were surveyed...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28639009/chipping-and-lengthening-over-nailing-technique-for-femoral-shaft-nonunion-with-shortening
#17
Gen Sasaki, Yoshinobu Watanabe, Motoyuki Takaki, Youichi Yasui, Wataru Miyamoto, Hirotaka Kawano, Takashi Matsushita
PURPOSE: Chipping and lengthening over nailing (CLON) technique was developed to treat femoral shaft nonunion with shortening more than 10 mm. The purpose of the current retrospective case series was to clarify the effectiveness of the CLON technique on the femoral shaft nonunion following intramedullary nailing. METHODS: Clinical and radiological outcomes in the patients receiving operative treatment for femoral shaft nonunion between August 2012 and December 2016 were retrospectively reviewed using the Refractory Fracture Data Registry at the authors' institution...
June 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28629941/does-patella-lowering-improve-crouch-gait-in-cerebral-palsy-comparative-retrospective-study
#18
E Desailly, C Thévenin-Lemoine, N Khouri
BACKGROUND: Patella lowering aims to improve quadriceps function as a means of correcting crouch gait in patients with cerebral palsy. Few studies have assessed the effects of patella lowering as a component of multilevel surgery. HYPOTHESIS: Including patella lowering into the components of multilevel surgery is beneficial in patients with crouch gait and patella alta. MATERIAL AND METHODS: In 12 lower limbs with patella alta (Caton-Deschamps index>1...
June 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28611857/chronic-achilles-tendon-rupture-reconstruction-using-the-lindholm-method-and-the-vulpius-method
#19
Firat Ozan, Fatih Dogar, Kaan Gurbuz, Yakup Ekinci, Semmi Koyuncu, Hazim Sekban
BACKGROUND: We investigated the clinical and functional outcomes of chronic Achilles tendon rupture reconstruction via the Lindholm technique and via the Vulpius' lengthening of the gastrocnemius. METHODS: We evaluated 15 patients with chronic Achilles tendon rupture (Lindholm technique in eight patients and primary repair with the Vulpius technique in seven patients). In the final follow-up, the Hooker scale was used to measure the ankle functional capacity in all patients...
July 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28607872/vascularized-fibula-based-physis-transfer-a-follow-up-study-of-longitudinal-bone-growth-and-complications
#20
Ronnie L Shammas, Yash J Avashia, Alfredo E Farjat, Anthony A Catanzano, L Scott Levin, William C Eward, Brian E Brigman, Detlev Erdmann
BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up of longitudinal growth patterns and outcomes after free fibula epiphyseal transfer in upper extremity reconstruction. METHODS: A retrospective review of 4 patients who underwent free fibula epiphyseal transfer after oncologic resection of the proximal humerus for osteosarcoma was performed...
May 2017: Plastic and Reconstructive Surgery. Global Open
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