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Limb lengthening

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https://www.readbyqxmd.com/read/29397412/resection-arthrodesis-using-distraction-osteogenesis-then-plating-as-a-hybrid-surgical-technique-for-the-management-of-bone-sarcomas-of-the-distal-tibia
#1
Teng-Fei Lou, Hua Li, Yi-Min Chai, Chun-Yang Wang, Sheng-He Liu, Musha Hamushan, Fan Wu, Wei-Jie Cai, Pei Han
PURPOSE: We report the oncological and functional results of limb salvage for bone sarcomas involving the distal tibia using hybrid surgical technique of resection arthrodesis by bone transport then plating. METHODS: Five patients (mean age 18.6 years) with primary distal tibial sarcomas (two Ewing's sarcomas and three osteosarcomas) were treated by this method. The average duration of follow-up is 53 months. All patients accepted distraction osteogenesis with a standard technique using external fixator after wide (four cases) or marginal (one case) resection in the first operation...
February 3, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29389718/rectus-femoris-transfer-versus-rectus-intramuscular-lengthening-for-the-treatment-of-stiff-knee-gait-in-children-with-cerebral-palsy
#2
Matthew D Ellington, Allison C Scott, Judith Linton, Elroy Sullivan, Douglas Barnes
BACKGROUND: Rectus femoris transfer (RFT) is used to treat stiff knee gait in spastic cerebral palsy. Recently, rectus femoris lengthening has been reported as treatment for stiff knee gait. The purpose of this study was to compare short-term outcomes of 2 surgical procedures. METHODS: A retrospective chart review of 23 patients (42 limbs) with diplegic spastic cerebral palsy who had undergone rectus femoris intramuscular lengthening for treatment of stiff knee gait with a Gross Motor Function Classification System level I, II, or III was completed...
January 31, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29385865/three-dimensional-limb-lengthening-after-total-knee-arthroplasty-in-a-simulation-study
#3
Takaaki Ohmori, Tamon Kabata, Yoshitomo Kajino, Daisuke Inoue, Tadashi Taga, Takashi Yamamoto, Tomoharu Takagi, Junya Yoshitani, Takuro Ueno, Ken Ueoka, Hiroyuki Tsuchiya
OBJECTIVES: Limb lengthening after total knee arthroplasty (TKA) has been reported in some cases, all of which were evaluated using 2-dimensional images. To our knowledge, no case has been evaluated using 3-dimensional (3D) images. We investigated 3D limb lengthening after TKA. METHODS: We simulated 100 varus knees using 3D templating software. Virtual TKA was performed to maintain the original joint line by conducting a measured-resection technique. We examined the relationships of 3D distance between the femoral head center and ankle center before and after TKA, degree of hip-knee-ankle angle (HKA) improvement, and degree of flexion contracture angle improvement...
February 1, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29352575/double-plication-for-spring-mediated-intestinal-lengthening-of-a-defunctionalized-roux-limb
#4
Genia Dubrovsky, Nhan Huynh, Anne-Laure Thomas, Shant Shekherdimian, James C Y Dunn
BACKGROUND: Spring-mediated distraction enterogenesis has been shown to increase the length of an intestinal segment. The goal of this study is to use suture plication to confine a spring within an intestinal segment while maintaining luminal patency to the rest of the intestine. METHODS: Juvenile mini-Yucatan pigs underwent placement of nitinol springs within a defunctionalized Roux limb of jejunum. A 20 French catheter was passed temporarily, and sutures were used to plicate the intestinal wall around the catheter at both ends of the encapsulated spring...
December 26, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29299643/body-foot-geometries-as-revealed-by-perturbed-obstacle-position-with-different-time-constraints
#5
Louis-Philippe Dugas, Laurent J Bouyer, Bradford J McFadyen
This study examined the geometrical relationships between the feet, pelvis and an environmental obstruction when crossing an obstacle with unexpected changes to its position. Nine healthy young adults stepped over an obstacle 19 cm high with their right leg leading. The obstacle could be static or advanced at either lead (early detection) or trail (late detection) foot contact prior to clearance to force an adaptive reorganization of body-foot geometry and foot proximity to the obstacle. Stride length, minimum foot clearance over the obstacle, and foot-obstacle horizontal proximity before and after clearance were measured along with the relative position of the pelvis to each foot at eight points (four for each foot) during approach and clearance: heel contacts before and after crossing the obstacle, maximum foot heights and foot clearances...
January 4, 2018: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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