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Limb lengthening

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https://www.readbyqxmd.com/read/29245094/concomitant-rhomboid-shaped-tibiae-and-fibulae-finger-like-projections-and-orthopedic-management-in-a-new-variant-of-nievergelt-syndrome-a-case-report
#1
Tuna Pehlivanoğlu, Mehmet Demirel, Yavuz Sağlam, Halil İbrahim Balci, Hayati Durmaz
INTRODUCTION: The rare Nievergelt syndrome (NS) is the most severe form of mesomelic dysplasia and is characterized by disproportionate shortness of the limbs. The aim of this case report was to describe the clinical and radiological features of a rare case of NS. PRESENTATION OF CASE: Here we describe a female patient originally presenting with bilateral hand, lower leg, and foot deformities at the age of 10 years old. In addition to the characteristic features of NS, this patient presented with finger-like projections on her heels, bilateral hand anomalies, and atypical facial features...
December 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29241817/salvage-of-congenital-pseudarthrosis-of-the-tibia-by-the-induced-membrane-technique-followed-by-a-motorised-lengthening-nail
#2
T Pollon, J Sales de Gauzy, T Pham, C Thévenin Lemoine, F Accadbled
An 18-year-old male with neurofibromatosis type I was treated for congenital pseudarthrosis of the tibia using the Masquelet induced-membrane technique with internal fixation by retrograde implantation of a transplantar intramedullary nail. Bone healing was obtained at the expense of malunion with external rotation and 5.5cm of lower limb shortening. A motorised intramedullary lengthening nail (Fitbone®, Wittenstein, Igersheim, Germany) was implanted. This treatment was successful in correcting the rotational malalignment and limb length discrepancy...
December 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29228043/novel-systems-for-the-application-of-isolated-tensile-compressive-and-shearing-stimulation-of-distraction-callus-tissue
#3
Nicholaus Meyers, Julian Schülke, Anita Ignatius, Lutz Claes
BACKGROUND: Distraction osteogenesis is a procedure widely used for the correction of large bone defects. However, a high complication rate persists, likely due to insufficient stability during maturation. Numerical fracture healing models predict bone regeneration under different mechanical conditions allowing fixation stiffness optimization. However, most models apply a linear elastic material law inappropriate for the transient stresses/strains present during limb lengthening or segment transport...
2017: PloS One
https://www.readbyqxmd.com/read/29214392/modulation-of-specific-inhibitory-networks-in-fatigued-locomotor-muscles-of-healthy-males
#4
Stuart Goodall, Glyn Howatson, Kevin Thomas
Reduced maximal force capability of skeletal muscle, as a consequence of exercise, can be due to peripheral or central fatigue mechanisms. In upper-limb muscles, neuromuscular fatigue is concurrent with reduced corticospinal excitability and increased inhibition (lengthened corticospinal silent period [CSP]; reduced short-interval intracortical inhibition [SICI] ratio). However, it is unclear whether these adjustments occur in response to fatiguing exercise of locomotor muscles. This study examined the effect of fatiguing, maximal, knee-extensor exercise on motor cortical excitability and inhibition...
December 6, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/29209417/do-athletes-alter-their-running-mechanics-after-an-achilles-tendon-rupture
#5
Daniel Jandacka, Julia Freedman Silvernail, Jaroslav Uchytil, David Zahradnik, Roman Farana, Joseph Hamill
Background: Over the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population. The purpose of this study was to compare the lower extremity mechanics of Achilles tendon ruptured runners with healthy controls. Methods: The participants with a past history of an Achilles tendon repair (n = 11) and healthy control (n = 11) subgroups were matched on sex, age, type of regular physical activity, mass, height, footfall pattern and lateral dominancy...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29208195/-treatment-principles-in-bone-reconstruction-and-limb-lengthening-of-the-lower-extremity
#6
Ulrik Kæhler Olesen, Tobias Nygaard, Søren V Kold, Adam Hede
Limb length discrepancies, axis deviations and bone loss on a congenital, traumatic or infectious basis are treated with restoration of axis and bone elongation. The intention is to improve gait and function, to relieve pain caused by imbalance in the musculoskeletal system and to prevent degenerative joint disease. Modern motorized intramedullary nails spare the patients for external fixators, and thus complications are being reduced. X-ray, CT-based planning and a thorough clinical examination is essential for a good result...
November 20, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29182122/complications-associated-with-bone-lengthening-of-the-lower-limb-by-callotasis
#7
S Castelein, P-L Docquier
The present study aims to assess the incidence of complications related to bone lengthening procedures and to identify factors that may predict these complications. We retrospectively studied 51 lengthening procedures in 39 patients (mean age 13 years) from 2001 to 2015. A circular external fixator was used in 37 procedures and a monolateral fixator in 14 procedures. Duration of distraction, fixator's time, days of treatment, lengthening percentage, bone healing index, distraction regenerate length, distraction index, risk factors and complications were evaluated...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29182121/primary-epiphyseal-and-metaepiphyseal-tubercular-osteomyelitis-in-children-a-series-of-8-case
#8
A Agarwal, N Gupta, M Mishra, N Agrawal, D Kumar
Clinical series of primary epiphyseal and metaepiphyseal tubercular osteomyelitis are few. The purpose of our study was to retrospectively review the presentation, healing response and functional results of 8 such cases in children. MATERIAL AND METHODS: The patients were evaluated for pain, deformity, range of motion, limb length discrepancy (if any) and recurrence. Serial radiographs of the region were studied to see remineralization, obliteration of radiological lesions, status of physis and remodeling of the growth plate...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29176457/a-frame-free-vascularized-fibular-graft-and-femoral-lengthening-for-osteosarcoma-pediatric-patients
#9
Megan Cashin, Christopher Coombs, Ian Torode
BACKGROUND: Pediatric limb reconstruction after resection of a malignant tumor presents specific challenges. Multiple surgical techniques have been used to treat these patients. This paper describes a staged surgical technique for the reconstruction of large distal femoral defects due to tumor resection in skeletally immature patients. METHODS: Three pediatric patients with osteosarcoma of the distal femur underwent staged reconstruction. Neoadjuvant chemotherapy was followed by en bloc tumor resection and immediate reconstruction of the distal femoral defect with a vascularized free fibular autograft utilizing a unique A-frame construct combined with intramedullary nail fixation...
November 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29172758/deformity-and-clinical-outcomes-following-operative-correction-of-charcot-foot-a-new-classification-with-implications-for-treatment
#10
Michael S Pinzur, Adam P Schiff
BACKGROUND: The historic treatment of Charcot foot arthropathy has been immobilization during the active phase of the disease process, followed by accommodative bracing of the acquired deformity. Evidence derived from modern patient-reported outcomes investigations has convinced many surgeons to attempt operative correction of the acquired deformity with a goal of improving quality of life. METHODS: Over a 12-year period, 214 patients (9 bilateral) underwent reconstruction of the acquired deformity associated with midtarsal Charcot foot arthropathy...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29155725/an-efficient-and-reproducible-protocol-for-distraction-osteogenesis-in-a-rat-model-leading-to-a-functional-regenerated-femur
#11
Martine Pithioux, Flavy Roseren, Christian Jalain, Franck Launay, Philippe Charpiot, Patrick Chabrand, Sandrine Roffino, Edouard Lamy
This protocol describes the use of a newly developed external fixator for distraction osteogenesis in a rat femoral model. Distraction osteogenesis (DO) is a surgical technique leading to bone regeneration after an osteotomy. The osteotomized extremities are moved away from each other by gradual distraction to reach the desired elongation. This procedure is widely used in humans for lower and upper limb lengthening, treatment after a bone nonunion, or the regeneration of a bone defect following surgery for bone tumor excision, as well as in maxillofacial reconstruction...
October 23, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29145886/are-mice-good-models-for-human-neuromuscular-disease-comparing-muscle-excursions-in-walking-between-mice-and-humans
#12
Xiao Hu, James P Charles, Turgay Akay, John R Hutchinson, Silvia S Blemker
BACKGROUND: The mouse is one of the most widely used animal models to study neuromuscular diseases and test new therapeutic strategies. However, findings from successful pre-clinical studies using mouse models frequently fail to translate to humans due to various factors. Differences in muscle function between the two species could be crucial but often have been overlooked. The purpose of this study was to evaluate and compare muscle excursions in walking between mice and humans. METHODS: Recently published musculoskeletal models of the mouse hindlimb and human lower limb were used to simulate muscle-tendon dynamics during mouse and human walking, a key daily activity...
November 16, 2017: Skeletal Muscle
https://www.readbyqxmd.com/read/29130046/a-comparison-of-the-device-related-complications-of-intramedullary-lengthening-nails-using-a-new-classification-system
#13
Dong Hoon Lee, Sungmin Kim, Jung Woo Lee, Hoon Park, Tae Yoon Kim, Hyun Woo Kim
The purpose of this study was to understand the pros and cons of the lengthening nails which have their own mechanical mechanism; we propose a classification for "device-related complications" arising from mechanical properties of the nail itself. From March 2010 to March 2014, 115 segments of lower limb lengthening were performed using intramedullary lengthening nails (35 ISKD, 34 PRECICE1, and 46 PRECICE2). Device-related complications were sorted into three categories according to a new classification: distraction control-related (type I), stability related (type II), and other device-related (type III); these were subdivided using Paley's concept of problems (a), obstacles (b), and sequel (c)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29081849/physical-function-and-health-related-quality-of-life-in-young-adults-with-unilateral-congenital-lower-limb-deficiencies
#14
T S Kaastad, A T Tveter, H Steen, I Holm
PURPOSE: The primary aim was to examine if there were differences in physical function and health-related quality of life (HRQoL) between young adults (18 to 35 years) with unilateral congenital lower-limb deficiency (CLLD) who had been surgically lengthened (Surg) and those using lengthening prostheses (Pros). Second, we wanted to compare their health status with an age- and gender-matched reference group (Ref) without CLLD. METHODS: Cross-sectional study including a study-specific questionnaire, clinical examination, two field tests evaluating physical function (the six-minute walk test and the Stair test) and HRQoL questionnaires (Short Form (SF)-36 and EuroQol (EQ)-5D-3L)...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29027186/novel-technique-for-intraoperative-sciatic-nerve-assessment-in-complex-primary-total-hip-arthroplasty-a-pilot-study
#15
Shai S Shemesh, Jonathan Robinson, Samuel Overley, Michael J Bronson, Calin S Moucha, Darwin Chen
INTRODUCTION: Sciatic nerve injury (SNI) is a potentially devastating complication after total hip arthroplasty (THA). Intraoperative neural monitoring has been found in several studies to be useful in preventing SNI, but can be difficult to implement. In this study, we examine the results of using a handheld nerve stimulator for intraoperative sciatic nerve (SN) monitoring during complex THA requiring limb lengthening and/or significant manipulation of the SN. METHODS: A consecutive series of 11 cases (9 patients, 11 hips) with either severe developmental dysplasia of the hip (Crowe 3-4) or other underlying conditions requiring complex hip reconstruction involving significant leg lengthening and/or nerve manipulation...
October 9, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28967055/clinical-and-functional-outcomes-after-augmented-hip-abductor-tendon-repair
#16
Jay R Ebert, Thomas A Bucher, Conor J Mullan, Gregory C Janes
INTRODUCTION: Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome. Surgical studies are often reported in small cohorts and with limited information on functional improvement. This study reports the clinical and functional outcomes after HAT repair. METHODS: 112 patients with symptomatic HAT tears, diagnosed via magnetic resonance imaging, underwent open bursectomy, V-Y lengthening of the iliotibial band, debridement of the diseased tendon, decortication of the trochanteric foot-plate and reattachment of the tendon with suture anchors, augmented with a LARS ligament through a trans-osseous tunnel...
September 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28965313/significant-liver-related-morbidity-after-bariatric-surgery-and-its-reversal-a-case-series
#17
Magdalena Eilenberg, Felix B Langer, Andrea Beer, Michael Trauner, Gerhard Prager, Katharina Staufer
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) occurs in up to 80% of patients with obesity. Current data suggest an improvement of NAFLD after established bariatric procedures. OBJECTIVES: This study investigated liver function impairment after Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB). SETTING: University Hospital, Bariatric Surgery Unit METHODS: In this single-center case series, consecutive in- and outpatients after bariatric surgery who presented with severe liver dysfunction from March 2014 to February 2017 were included and followed until March 2017...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28965167/laparoscopic-reversal-of-the-biliopancreatic-diversion-with-duodenal-switch-a-step-by-step-video-case
#18
Hamzeh M Halawani, Gintaras Antanavicius
BACKGROUND: Despite the success of the Biliopancreatic Diversion with Duodenal Switch procedure (BPD-DS) in weight loss and comorbidities resolution, reversal of BPD-DS is necessary in 0.2-0.6% of BPD-DS cases for vitamin, protein, and other micronutrient deficiencies. Different techniques are available to reverse the malabsorptive component of the BPD-DS. METHODS: A retrospective chart review for a 37-year-old female patient who presented with lower leg edema and signs of malnutrition 5 years after a BPD/DS...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28945740/force-encoding-in-muscle-spindles-during-stretch-of-passive-muscle
#19
Kyle P Blum, Boris Lamotte D'Incamps, Daniel Zytnicki, Lena H Ting
Muscle spindle proprioceptive receptors play a primary role in encoding the effects of external mechanical perturbations to the body. During externally-imposed stretches of passive, i.e. electrically-quiescent, muscles, the instantaneous firing rates (IFRs) of muscle spindles are associated with characteristics of stretch such as length and velocity. However, even in passive muscle, there are history-dependent transients of muscle spindle firing that are not uniquely related to muscle length and velocity, nor reproduced by current muscle spindle models...
September 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28938286/optimizing-bone-defect-reconstruction-balanced-cable-transport-with-circular-external-fixation
#20
Stephen Matthew Quinnan, Charles Lawrie
Distraction osteogenesis has proven effective in the management of tibial bone loss from severe trauma and infection. Unfortunately, pain and scarring from wires and half pins dragging through the skin and the required prolonged time in the external fixator make treatment difficult. Cable bone transport has been shown to improve cosmesis and decrease pain during transport. However, the published methods have limitations in that they have poor control of transport segment alignment, do not allow for lengthening of the limb, and do not permit weight bearing during the treatment process...
October 2017: Journal of Orthopaedic Trauma
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