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Limb lengthening

Y H Kou, B G Jiang
Peripheral nerve defects are still a major challenge in clinical practice, and the most commonly used method of treatment for peripheral nerve defects is nerve transplantation, which has certain limitations and shortcomings, so new repair methods and techniques are needed. The peripheral nerve is elongated in limb lengthening surgery without injury, from which we got inspirations and proposed a new method to repair peripheral nerve defects: peripheral nerve elongation. The peripheral nerve could beelongated by a certain percent, but the physiological change and the maximum elongation range were still unknown...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Hamlet A Peterson, William J Shaughnessy, Anthony A Stans
Premature partial physeal arrest without the formation of an osseous bar - physeal bar equivalent (PBE) - is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
L H Dünnweber, R Rödl, G Gosheger, F M Schiedel
Although clear advances have been made during the last 5 years, practical difficulties persist for patients and surgeons in procedures for intramedullary lengthening of long bones. In particular, precise adjustment of the desired amount of lengthening and technically reliable checking of the length actually achieved are problematic. An intramedullary nail with a new type of drive that exploits the shape memory effect has been constructed. The drive technology and the behavior of the intramedullary nail in situ were evaluated in a cadaver experiment...
October 10, 2016: Medical Engineering & Physics
M Laubscher, C Mitchell, A Timms, D Goodier, P Calder
AIMS: Patients undergoing femoral lengthening by external fixation tolerate treatment less well when compared to tibial lengthening. Lengthening of the femur with an intramedullary device may have advantages. PATIENTS AND METHODS: We reviewed all cases of simple femoral lengthening performed at our unit from 2009 to 2014. Cases of nonunions, concurrent deformities, congenital limb deficiencies and lengthening with an unstable hip were excluded, leaving 33 cases (in 22 patients; 11 patients had bilateral procedures) for review...
October 2016: Bone & Joint Journal
Nader S Alkenani, Mariam A Alosfoor, Abdulaziz K Al-Araifi, Hala A Alnuaim
INTRODUCTION: This is a case report of extreme lengthening of the tibia of about 14.5cm using bone transport technique following road traffic accident trauma to the lower limbs. The management of the subsequent massive skeletal defects was challenging to orthopedic surgeons. Based on reported cases, the highest tibial lengthening was 22cm using bifocal transport, while the highest unifocal tibial lengthening reached 14.5cm. CASE PRESENTATION: A 20-year-old male driver was brought to the emergency department after a road traffic accident...
September 3, 2016: International Journal of Surgery Case Reports
Julio J Jauregui, Anthony V Ventimiglia, Preston W Grieco, David B Frumberg, John E Herzenberg
BACKGROUND: Limb lengthening with external fixation is performed to treat patients with leg length discrepancy or short stature. Although the procedure has a high rate of success, one potential drawback from limb lengthening is the amount of time spent in the fixation device while regenerate bone consolidates. Although some studies have assessed different treatment modalities, there has not been a study that has systematically evaluated whether low intensity pulsed ultrasound (LIPUS) or pulsed electromagnetic fields (PEMF) have significant effects on regenerate bone growth...
September 29, 2016: BMC Musculoskeletal Disorders
Daniel L Belavý, Ulf Gast, Dieter Felsenberg
PURPOSE: To investigate atrophy in the deep abdominal muscles, spinal extensors and the impact of high-load resistive exercise with and without whole body vibration following 60d of strict bed-rest. METHODS: 24 subjects underwent 60-days of head-down tilt bed-rest and performed either resistive vibration exercise (RVE), resistive exercise only (RE) or no exercise control (2nd Berlin BedRest Study). The thickness of the transversus abdominis, internal oblique and erector spinae muscles and area of the multifidus muscle were measured bilaterally via real-time ultrasound...
September 28, 2016: Medicine and Science in Sports and Exercise
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
Bruno Dohin, Elie Haddad, Hassan Al Khoury Salem, Mohamed Merhez Kilani
OBJECTIVE: Hip internal rotation (HIR) during gait is one of the main functional disorders related to cerebral palsy (CP) in children. Most of the procedures proposed rotational osteotomy of the femur (FRO), (and/or tibia). However, multilevel surgery (SEMLS) including bone procedure, implicates more difficult and longer rehabilitation. When bone deformity is moderate, the authors hypothesized that FRO could be avoided. They developed a soft tissues procedure to improve HIR. The aim of the study was assessment of the procedure...
September 2016: Annals of Physical and Rehabilitation Medicine
Maud Pradines, Ingrid Masson, Raphaël Portero, Caroline Giroux, Jean-Michel Gracies
OBJECTIVE: To explore changes in muscle architectural parameters of the muscle-tendon unit of soleus and medial gastrocnemius (GM) in patients with chronic hemiparesis, after 1 year of rehabilitation. MATERIAL/PATIENTS AND METHODS: In this prospective study, 20 chronic hemiparetic patients (8W, mean age: 56 [12], time since lesion 9 [8]) were evaluated. Muscle architectural parameters including muscle fascicle length, pennation angle, thickness, tendon and muscle belly lengths were evaluated in vivo using ultrasonography in passive condition (verified by electromyographic recording) in a seated patient with ankle, knee and hip on the paretic side at 90°...
September 2016: Annals of Physical and Rehabilitation Medicine
Nathaly Quintero-Prigent, Caroline Radot, Marion Fiat, Malak Fahny, Naima Brennetot
OBJECTIVE: Fibular hemimelia or longitudinal fibular deficiency is the most frequent congenital malformation of lower limbs. It causes sometimes major limbs shortening. Different treatments could be considered depending on the severity of the malformation: contralateral epiphysiodesis, corrective foot and knee osteotomies, leg-lengthening surgery with external fixation, prosthesis. For the most severe cases (15-20cm bone length discrepancies or unstable knee or foot), leg-lengthening surgery with external fixation is not recommended...
September 2016: Annals of Physical and Rehabilitation Medicine
Jessy Lauer, Stéphane Vigier, Frédéric Delage, Alain Meudec, Jean-Michel Pollet, João Paulo Vilas-Boas, Annie Rouard
OBJECTIVE: Aquatic shoulder exercises are widely implemented into rehabilitation programs to provide early muscle strengthening and improved joint mobility. However, since the drag - the force exerted by the water on the moving segments - is very hard to measure, an in-depth knowledge of internal joint load is lacking, which ultimately prevents healthcare professionals from understanding all clinical implications. For the first time, shoulder joint moment, work, and power were calculated through a novel, validated numerical approach coupling fluid flow simulations and inverse dynamics...
September 2016: Annals of Physical and Rehabilitation Medicine
Saravanaraja Muthusamy, S Robert Rozbruch, Austin T Fragomen
Internal lengthening nail (ILN) is a recent development in limb lengthening and deformity correction specialty. The ILN has the distinct advantage of combining acute deformity correction with gradual lengthening of bone. While using ILN, the short metaphyseal bone fragment may develop a deformity at the time of osteotomy and nail insertion or during bone lengthening because of the wide medullary canal. These deformities are typically predictable, and blocking screws (Poller screws) are helpful in these situations...
September 24, 2016: Strategies in Trauma and Limb Reconstruction
Mahantesh Yellangouda Patil, Srinath Myadam Gupta, Sri Krishna Chaitanya Kurupati, Saumya Agarwal, Vishal Chandarana
INTRODUCTION: Open fractures are treated as surgical emergency and early administration of intravenous antibiotic coupled with early irrigation and debridement decreases the infection rate dramatically. Limb Reconstruction System (LRS) is a unilateral rail system which consists of Shanz pins, rail rods and sliding clamps. It is specifically designed to enable the surgeon to perform simple and effective surgery as it offers rigid fixation of fracture fragments, allowing early weight bearing and reduces economic burden...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Xigong Li, Yang Lu, Junying Sun, Xiangjin Lin, Tiansi Tang
BACKGROUND: The purpose of this study was to evaluate the functional and radiographic results of patients with Crowe type-IV hip dysplasia treated by cementless total hip arthroplasty and double chevron subtrochanteric osteotomy. METHODS: From January 2000 to February 2006, cementless total hip arthroplasty with a double chevron subtrochanteric shortening osteotomy was performed on 18 patients (22 hips) with Crowe type-IV dysplasia. The acetabular cup was placed in the position of the anatomic hip center, and subtrochanteric femoral shortening osteotomy was performed with the use of a double chevron design...
August 10, 2016: Journal of Arthroplasty
Pieter Reynders-Frederix, Cristina Reynders-Frederix, Muhammad Wajid
BACKGROUND: Young patients with a acquired dislocation of the hip with concomitant shortening of the lower limb is a difficult diagnostic problem with few definite treatment options. METHODS: We used the technique, originally described by Ilizarov, with a double femur osteotomy and lengthening the femur. Lengthening was done with a sub muscular placed on-lay femur distraction rod. Distraction of the rod was done by fluid mechanics. After lengthening, the distraction was secured by a parked plate by locking the distal part of the plate...
2016: Open Orthopaedics Journal
Kemal Dogan, Jens Homan, Edo O Aarts, Cees J H M van Laarhoven, Ignace M C Janssen, Frits J Berends
BACKGROUND: The Roux-en-Y gastric bypass (RYGB) still remains the gold standard in bariatric surgery. However, no consensus exists on the optimal limb lengths to induce maximum weight reduction. The aim of the present study was to assess the effect of a longer alimentary limb (AL) length on weight reduction after RYGB. METHODS: A retrospective analysis of a prospectively collected database of patients who underwent a primary laparoscopic RYGB between January 2001 and March 2011 was performed...
August 23, 2016: Surgical Endoscopy
Reggie C Hamdy, Mitchell A Bernstein, Austin T Fragomen, S Robert Rozbruch
No abstract text is available yet for this article.
August 17, 2016: Journal of Bone and Joint Surgery. American Volume
T M Tiefenboeck, L Zak, A Bukaty, G E Wozasek
BACKGROUND: The treatment of leg length discrepancy and deformities has become more common over the last few decades due to newly developed implants. Lengthening using fully implantable intramedullary nails provides many advantages; however, only little data is available. Therefore, we aimed to determine: (1) safety of the implant, (2) the complication rate and (3) functional outcome after magnetic driven intramedullary bone lengthening with a telescopic implant. HYPOTHESES: Automatic bone lengthening with intramedullary nails provide good short-term outcome...
August 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
D Mazzaccaro, M Sciarrini, G Nano
AIM: One of the technical problems which can be encountered during the endovascular repair (EVAR) of abdominal aortic aneurysms, is represented by the challenge of cannulation of the contralateral gate after the opening of the main body of the endograft, especially in case of tortuous aorta-iliac anatomy. Aim of this work is to propose a hypothesis of simplification, verifying the possibility to maximize the area available for the cannulation of the contralateral gate by simulating an oblique distal end of the leg of the most used devices, without affecting the correct sealing between the main body and the iliac extension...
September 2016: Medical Hypotheses
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