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Limb lengthening

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https://www.readbyqxmd.com/read/28074440/distal-femoral-extension-and-shortening-osteotomy-as-a-part-of-multilevel-surgery-in-children-with-cerebral-palsy
#1
Matthias C M Klotz, Klemens Hirsch, Daniel Heitzmann, Michael W Maier, Sebastien Hagmann, Thomas Dreher
BACKGROUND: There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of fl exed knee gait, but investigations analyzing outcome and infl uence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP. Furthermore, it was of interest if an additional patellar tendon advancement (PA) infl uences outcome...
December 23, 2016: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28053384/management-of-complex-femoral-nonunion-with-monorail-external-fixator-a-prospective-study
#2
Hemendra Kumar Agrawal, Mohit Garg, Balvinder Singh, Ashish Jaiman, Vipin Khatkar, Shailender Khare, Sumit Batra, Vinod Kumar Sharma
AIM: To evaluate 30 patients who underwent distraction osteogenesis with monorail external fixator for complex femoral nonunion. METHOD: Complex femoral nonunion includes infective non-union, gap nonunion, and limb-length discrepancy secondary to traumatic bone loss, which needs specialized treatment to ensure the functional integrity of femoral bone. 30 patients, including 28 male and 2 female (aged 22-62 years) patients, underwent surgical debridement followed by bone transport with monorail fixator...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28052378/comparison-of-limb-kinematics-between-collected-and-lengthened-medium-extended-trot-in-two-groups-of-dressage-horses-on-two-different-surfaces
#3
V A Walker, C A Tranquille, J R Newton, S J Dyson, J Brandham, A J Northrop, R C Murray
BACKGROUND: Dressage horses are often asked to work in lengthened paces during training and competition, but to date there is limited information about the biomechanics of dressage-specific paces. Preliminary work has shown increased fetlock extension in extended compared with collected paces, but further investigation of the kinematic differences between collected, medium and extended trot in dressage horses is warranted. OBJECTIVES: Investigation of the effect of collected versus medium/extended trot on limb kinematics of dressage horses...
January 4, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28042118/post-operative-neuropathy-after-total-hip-arthroplasty
#4
E P Su
Nerve palsy is a well-described complication following total hip arthroplasty, but is highly distressing and disabling. A nerve palsy may cause difficulty with the post-operative rehabilitation, and overall mobility of the patient. Nerve palsy may result from compression and tension to the affected nerve(s) during the course of the operation via surgical manipulation and retractor placement, tension from limb lengthening or compression from post-operative hematoma. In the literature, hip dysplasia, lengthening of the leg, the use of an uncemented femoral component, and female gender are associated with a greater risk of nerve palsy...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#5
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/28031510/use-of-a-magnetic-bone-nail-for-lengthening-of-the-femur-and-tibia
#6
Ozgur Karakoyun, Sami Sokucu, Mehmet Fatih Erol, Metin Kucukkaya, Yavuz Selim Kabukçuoğlu
PURPOSE: To report our experience with the PRECICE nail for limb lengthening in 23 patients. METHODS: Records of 15 female and 8 male patients aged 14 to 38 (mean, 23.6) years who underwent lengthening of the tibia (n=6) or femur (n=21) using the PRECICE nail were reviewed. The reasons for lengthening included trauma (n=7), hemihypertrophy (n=2), focal femoral deficiency (n=2), Ellis-van Creveld syndrome (n=1), hip septic arthritis sequelae (n=1), hereditary multiple exostosis (n=1), club foot sequela (n=1), congenital tibial pseudoarthrosis (n=1), fibrous dysplasia (n=1), idiopathic limb length discrepancy (n=7), and cosmetic (n=1)...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28029668/titanium-elastic-nailing-system-tens-for-tibia-fractures-in-children-functional-outcomes-and-complications
#7
K M Kc, P Acharya, A Sigdel
INTRODUCTION: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28009799/percutaneous-hamstring-lengthening-surgery-is-as-effective-as-open-lengthening-in-children-with-cerebral-palsy
#8
Alexander Nazareth, Susan Rethlefsen, Ted C Sousa, Nicole M Mueske, Tishya A L Wren, Robert M Kay
BACKGROUND: Surgical lengthening of the hamstrings is often performed to correct crouch gait in children with cerebral palsy (CP). Previous studies have demonstrated the effectiveness of open hamstring lengthening (oHSL) in improving knee extension static and dynamic range of motion; however, literature regarding percutaneous hamstring lengthening (pHSL) is limited. The purpose of this study was to investigate the effect of open versus pHSL for improving crouch gait and knee function in children with CP...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27990273/advances-in-the-management-of-osteosarcoma
#9
REVIEW
Stefan S Bielack, Stefanie Hecker-Nolting, Claudia Blattmann, Leo Kager
Osteosarcoma, a bone cancer most commonly seen in adolescents and young adults, is usually a high-grade malignancy characterized by a very high risk for the development of pulmonary metastases. High-grade osteosarcomas are usually treated by preoperative and postoperative chemotherapy and surgery, with a very limited number of active agents available. Rarer lower-grade variants such as parosteal and periosteal osteosarcoma or low-grade central osteosarcoma are treated by surgery only. Imaging to search for possible metastases focuses on the lung...
2016: F1000Research
https://www.readbyqxmd.com/read/27923212/comparison-of-diabetic-charcot-patients-with-and-without-foot-wounds
#10
Dane K Wukich, David Sadoskas, Nicholas J Vaudreuil, Mitchell Fourman
BACKGROUND: The primary aim of this study was to evaluate the outcomes of a series of patients with Charcot neuroarthropathy (CN) who were evaluated in a tertiary care setting. We hypothesized that those patients with CN who presented with a Charcot-related foot wound would have lower rates of successful limb salvage than patients who presented without a wound. METHODS: Two hundred forty-five patients (280 feet) were identified with diabetic CN during the time period from January 1, 2005, to June 1, 2015...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27914027/the-role-of-guided-growth-as-it-relates-to-limb-lengthening
#11
REVIEW
Peter M Stevens
For decades, the classic indication for limb lengthening has been reserved for anisomelia that was expected to reach or exceed 5 cm at maturity. Epiphysiodesis was reserved for discrepancies in the 2-5 cm range. With the increasing sophistication of fixators, including rail, hexapod, and hybrid, complex deformities may be corrected simultaneously while moderate to extreme lengthening is achieved. More recently, iterations of telescoping intramedullary rods have further strengthened our armamentarium. Meanwhile, permanent epiphysiodesis techniques, both open and percutaneous, have yielded to more versatile and reversible tethering of one (angle) or both (length) sides of a physis...
December 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#12
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 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909134/what-is-the-morbidity-of-a-non-invasive-growing-prosthesis
#13
M M Gilg, C L Gaston, M C Parry, L Jeys, A Abudu, R M Tillman, S R Carter, R J Grimer
AIMS: Extendible endoprostheses have been available for more than 30 years and have become more sophisticated with time. The latest generation is 'non-invasive' and can be lengthened with an external magnetic force. Early results have shown a worryingly high rate of complications such as infection. This study investigates the incidence of complications and the need for further surgery in a cohort of patients with a non-invasive growing endoprosthesis. PATIENTS AND METHODS: Between 2003 and June 2014, 50 children (51 prostheses) had a non-invasive growing prosthesis implanted for a primary bone sarcoma...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27904734/recurrence-of-a-unicameral-bone-cyst-in-the-femoral-diaphysis
#14
Hyun Se Kim, Kyung Sup Lim, Sung Wook Seo, Seung Pil Jang, Jong Sup Shim
Diaphyseal unicameral bone cysts of the long bone are generally known to originate near the growth plate and migrate from the metaphysis to the diaphysis during skeletal growth. In the case of unicameral bone cysts of diaphyseal origin, recurrence at the same location is extremely rare. We report a case of recurrence of a unicameral bone cyst in the diaphysis of the femur that developed 8 years after treatment with curettage and bone grafting. We performed bone grafting and lengthening of the affected femur with an application of the Ilizarov apparatus over an intramedullary nail to treat the cystic lesion and limb length discrepancy simultaneously...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27878660/residual-bone-growth-after-lengthening-procedures
#15
Pierre Journeau, Pierre Lascombes, Dominique Barbier, Dmitry Popkov
The prognosis of limb length discrepancy is a major subject in paediatric orthopaedic surgery. The strategy depends on the prognosis and must be adapted to each patient. The residual growth of the lengthened segment often remains unknown, but is dependent on age, the percentage of lengthening and other factors. Using a large cohort of 150 children who had undergone bone lengthening procedures, we describe five patterns of post-intervention growth and identify factors that are favourable for normal residual growth...
December 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27866145/cosmetic-limb-lengthening-in-a-patient-of-normal-stature-ethical-considerations
#16
Karthik Vishwanathan, Somashekhar Nimbalkar
Recently, a 23-year-old male patient underwent cosmetic limb lengthening, despite the fact that his height was that of the average Indian male (5 feet 7 inches). The patient's parents and the media criticised the orthopaedic surgeon who had performed the surgery for undertaking an unethical operation. This paper discusses the relevant clinical evidence, ethical aspects and ethical theories surrounding the case. We conclude that the surgeon's decision to perform the surgery seems to be fair and appropriate from the ethical and clinical perspectives...
November 11, 2016: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#17
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27858886/fixator-assisted-tibial-lengthening-over-a-plate-in-a-patient-with-sequelae-of-poliomyelitis
#18
Haci Bayram Tosun, Sancar Serbest, Abuzer Uludag, Seyitali Gumustas, Suat Celik
There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate.Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27848194/intramedullary-lengthening-nails-can-we-also-correct-deformities
#19
REVIEW
U Lenze, A H Krieg
Unlike external fixators, the use of solid intramedullary lengthening nails is restricted to defined anatomical preconditions, such as an adequate bone length. Furthermore, all deformity corrections except the lengthening procedure have to be implemented intraoperatively and cannot be adjusted postoperatively. Conversely, even complex deformity corrections can be performed using intramedullary devices after a thorough preoperative planning. For preparation of the intramedullary cavity as well as positioning of the lengthening nail according to the preoperative planning, reaming the medullary canal with rigid reamers which don't follow the line of least resistance is inevitable...
December 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27848193/from-prevention-of-pin-tract-infection-to-treatment-of-osteomyelitis-during-paediatric-external-fixation
#20
REVIEW
Dimitri Ceroni, Catherine Grumetz, Odile Desvachez, Sophie Pusateri, Pierre Dunand, Eleftheria Samara
Pin-tract infection (PTI) is the most commonly expected problem, or even an almost inevitable complication, when using external fixation. Left unteated, PTI will progress unavoidably, lead to mechanical pin loosening, and ultimately cause instability of the external fixator pin-bone construct. Thus, PTI remains a clinical challenge, specifically in cases of limb lengthening or deformity correction. Standardised pin site protocols which encompass an understanding of external fixator biomechanics and meticulous surgical technique during pin and wire insertion, postoperative pin site care and pin removal could limit the incidence of major infections and treatment failures...
December 2016: Journal of Children's Orthopaedics
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