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Limb lengthening

Holly L Racine, Chad A Meadows, Gabriela Ion, Maria A Serrat
Limb length inequality results from many types of musculoskeletal disorders. Asymmetric weight bearing from a limb length discrepancy of less than 2% can have debilitating consequences such as back problems and early-onset osteoarthritis. Existing treatments include invasive surgeries and/or drug regimens that are often only partially effective. As a noninvasive alternative, we previously developed a once daily limb-heating model using targeted heat on one side of the body for 2 weeks to unilaterally increase bone length by up to 1...
2018: Frontiers in Endocrinology
Konstantin Igorevich Novikov, Koushik Narayan Subramanyam, Sergey V Kolesnikov, Oleg K Chegurov, Elina S Kolesnikova, Abhishek V Mundargi
Ilizarov is an accepted technique for lengthening short amputation stumps to improve prosthetic function and rehabilitation. The relation of stump lengthening and phantom limb pain (PLP) has not been reported in literature. We present here a case report of a transfemoral amputee who had a flare up of PLP following stump lengthening. He responded well to a combination of pharmacological therapy and soft tissue manipulative techniques and desired length was achieved. This report alerts the possibility of aggravation of PLP following stump lengthening and discusses its management...
May 2018: Archives of Bone and Joint Surgery
A N Ahn, N Konow, C Tijs, A A Biewener
To relate in vivo behavior of fascicle segments within a muscle to their in vitro force-length relationships, we examined the strain behavior of paired segments within each of three vertebrate muscles. After determining in vivo muscle activity patterns and length changes of in-series segments within the semimembranosus muscle in the American Toad (Bufo americanus) during hopping and within the sternohyoid muscle in the rat (Rattus rattus) during swallowing, and of spatially separated fascicles within the medial gastrocnemius muscle in the rat during trotting, we measured their corresponding in vitro (toad) or in situ (rat) force-length relationships...
June 7, 2018: Integrative and Comparative Biology
Izumi Kadono, Hiroshi Kitoh, Kenichi Mishima, Masaki Matsushita, Koji Sato, Masato Kako, Naoki Ishiguro
Increase in the magnitude of lengthening during the limb lengthening procedure involves a high risk of decreased range of motion (ROM) in adjacent joints. Even though patients with achondroplasia can tolerate a relatively larger amount of lengthening owing to its inherent soft-tissue laxity, they often exhibit significant joint contractures during extensive lengthening. In the present study, we evaluated temporal changes in the ROM of the hip, knee, and ankle joints throughout the treatment period in 12 limbs of six patients with achondroplasia who had undergone extensive tibial lengthening...
June 6, 2018: Journal of Pediatric Orthopedics. Part B
Akihiko Takeuchi, Norio Yamamoto, Katsuhiro Hayashi, Hidenori Matsubara, Hiroaki Kimura, Shinji Miwa, Takashi Higuchi, Kensaku Abe, Yuta Taniguchi, Hiroyuki Tsuchiya
BACKGROUND: Epiphyseal-preservation surgery for osteosarcoma is an alternative method which has been indicated carefully to selected patients. The tumor-devitalised autograft treated with liquid nitrogen procedure is one of the biological reconstruction method to reconstruct the defect after tumor excision. The limb length discrepancy is usually appeared in children with their growth after limb-sparing surgery. This study was aimed to investigated the growth of residual epiphysis following epiphyseal-preservation surgery for childhood osteosarcoma around the knee joint...
June 6, 2018: BMC Musculoskeletal Disorders
Zhimin Guo, Lingling Shi, Sheng Tian, Wei Chen, Bin Lin
Objective: To evaluate the limbs shortening and re-lengthening in the treatment of tibial infectious bone defect and chronic osteomyelitis. Methods: Between January 2011 and April 2016, 19 cases of tibial infectious bone defect and chronic osteomyelitis were treated with the limbs shortening and re-lengthening technique. There were 13 males and 6 females, aged from 22 to 62 years (mean, 44 years). The causes of injury included traffic accident injury in 16 cases, crush injury in 1 case, and falling from height in 2 cases...
August 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Shuqiang Xie, Jianxi Hou, Qiqiang Dong, Huafeng Zhang, Hongxin Wang, Chaofan Yang
Objective: To investigate the effectiveness and technical points of shortened replantation combined with limb lengthening in the treatment of severe amputation of middle and distal lower leg. Methods: Twelve cases of severe amputation of middle and distal lower leg were treated with shortened replantation at the 1st stage and limb lengthening at the 2nd stage between April 2009 and May 2016. There were 9 males and 3 females with an average age of 28 years (range, 16-32 years)...
August 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Tao Ji, Wei Guo, Rongli Yang, Xiaodong Tang, Dasen Li, Yi Yang
Objective: To investigate the surgical characteristics and preliminary effectiveness of Orthofix unilateral external fixator in the treatment of musculoskeletal tumors. Methods: Twenty-two patients received Orthofix unilateral external fixator treatment for bone defect after tumor excision or complications after limb salvage surgery between June 2011 and March 2016. There were 11 males and 11 females with a median age of 23.5 years (range, 4-57 years). The bone defect or limb length discrepancy after tumor resection was at proximal femur in 6 cases, distal femur in 8 cases, diaphysis of femur in 3 cases, proximal tibia in 2 cases, and diaphysis of tibia in 3 cases...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Petr Stastny, Michal Lehnert, James J Tufano
Many hamstring injuries that occur during physical activity occur while the muscles are lengthening, during eccentric hamstring muscle actions. Opposite of these eccentric hamstring actions are concentric quadriceps actions, where the larger and likely stronger quadriceps straighten the knee. Therefore, to stabilize the lower limbs during movement, the hamstrings must eccentrically combat against the strong knee-straightening torque of the quadriceps. As such, eccentric hamstring strength expressed relative to concentric quadricep strength is commonly referred to as the "functional ratio" as most movements in sports require simultaneous concentric knee extension and eccentric knee flexion...
May 1, 2018: Journal of Visualized Experiments: JoVE
Emmanuel Dahan, Camilo Chaves, Manon Bachy, Frank Fitoussi
Congenital muscle hypertrophy of the upper limb is a very rare condition with unknown aetiology. This descriptive observational and retrospective series included eight children followed by a multidisciplinary team from 2005 to 2017. The diagnosis was based on a cluster of clinical and radiological characteristics after elimination of differential diagnoses. Patients were categorized according to: anomalies of the wrist, anomalies of long fingers of intrinsic or extrinsic origin; and anomalies of the thumb with or without first web space contracture...
January 1, 2018: Journal of Hand Surgery, European Volume
J Wright, R A Hill, D M Eastwood, A Hashemi-Nejad, P Calder, S Tennant
Purpose: To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. Patients and Methods: In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures...
April 1, 2018: Journal of Children's Orthopaedics
Piotr Morasiewicz, Karolina Burzyńska, Wiktor Orzechowski, Szymon Łukasz Dragan, Szymon Feliks Dragan, Jarosław Filipiak
BACKGROUND: Treatment of multiplanar deformities, especially in younger children, requires construction of a complex Ilizarov fixator, frequently with small dimensions. The aim of this study is to verify clinical application of a3D-printed bone model in treatment with the Ilizarov method. METHODS: The study involved a 6-year-old child in whom clinical and radiological examination revealed multiplanar deformity of the right leg. Then, 3D models of individual bones were printed by means of additive manufacturing and were used as a scaffold to install the Ilizarov apparatus...
July 2018: Medical Engineering & Physics
Adam E M Eltorai, Carolina Fuentes
Purpose: To examine distraction-based methods for treatment of early onset scoliosis (EOS), focusing on the magnetically controlled growing rod system (MCGR) relative to traditional growing rod system (TGR). To briefly discuss internal magnetically controlled nails for bone lengthening as another application of magnetic growth modulation. Results: Relative to TGR, MCGR involves fewer complications related to infection and general anesthesia because of fewer successive surgeries required...
March 2018: Journal of Orthopaedics
Yasser Elbatrawy
This article summarizes the content of this special issue of the journal about: deformity correction, limb lengthening and reconstruction.
2018: SICOT-J
Gaurav Garg, Rajat Malot
Introduction: Proximal femur is the common site for localization of benign bone lesions, and the diagnosis is often delayed and potentially challenging due to their atypical presentations. Early diagnosis is difficult as intra-articular lesions often present with clinical and radiological features of inflammatory synovitis in the joint. Case Report: Two patients of intra-articular osteoid osteoma in proximal femoral presented with atypical features limb lengthening, minimal reactive bone sclerosis, and multifocal nidus...
November 2017: Journal of Orthopaedic Case Reports
Emily I McIntosh, Geoffrey A Power, Brian H Dalton
The purpose was to investigate whether exercise-induced muscle weakness of the plantar and dorsiflexors through high-intensity lengthening contractions increases the vestibulomyogenic balance response. Nine males (∼25 years) participated in three experimental testing days to evaluate the vestibular control of standing balance and neuromuscular function of the plantar and dorsiflexors pre- and post (30 min, and 1 and 7 days) high-intensity lengthening plantar and dorsiflexions. To evaluate the vestibular-evoked balance response, participants stood quietly on a force plate while exposed to continuous, random electrical vestibular stimulation (EVS) for two 90-s trials...
May 14, 2018: Neuroscience Letters
Yuki Mataki, Hiroshi Kamada, Hirotaka Mutsuzaki, Yukiyo Shimizu, Ryoko Takeuchi, Masafumi Mizukami, Kenichi Yoshikawa, Kazushi Takahashi, Mayumi Matsuda, Nobuaki Iwasaki, Hiroaki Kawamoto, Yasuyoshi Wadano, Yoshiyuki Sankai, Masashi Yamazaki
BACKGROUND: The Hybrid Assistive Limb (HAL® ) is an exoskeleton wearable robot suit that assists in voluntary control of knee and hip joint motion. There have been several studies on HAL intervention effects in stroke, spinal cord injury, and cerebral palsy. However, no study has investigated HAL intervention for patients with cerebral palsy after surgery. CASE PRESENTATION: We report a case of using HAL in a postoperative patient with cerebral palsy. A 15-year-old boy was diagnosed with spastic diplegia cerebral palsy Gross Motor Function Classification System level IV, with knee flection contracture, equinus foot, and paralysis of the right upper extremity with adduction contracture...
March 27, 2018: BMC Research Notes
Piotr Morasiewicz, Wiktor Urbański, Mirosław Kulej, Szymon Łukasz Dragan, Szymon Feliks Dragan, Łukasz Pawik
INTRODUCTION: Normal balance and symmetric distribution of lower limb loads are associated with adequate muscle strength, joint mobility and proprioception. The aim of this study was to analyze the distribution of lower limb loads and balance prior to and after axis correction and lengthening with Ilizarov method. MATERIALS AND METHODS: The prospective analysis included 20 patients from our clinic, who have been subjected to distraction-corrective lower limb corticotomies with the Ilizarov method in 2014-2015...
April 2018: Injury
Saber Ghiassi, Kelvin Higa, Steven Chang, Pearl Ma, Aaron Lloyd, Keith Boone, Eric J DeMaria
BACKGROUND: Standard proximal Roux-en-Y gastric bypass (RYGB) fails to achieve long-term weight maintenance and/or control of metabolic syndrome in up to 35% of patients. OBJECTIVES: To improve the performance of the standard proximal gastric bypass by increasing the biliopancreatic limb length at the expense of the common channel. SETTINGS: Academic-affiliated private practice. METHODS: A retrospective review of all patients who underwent conversion to distal RYGB from 2010 to 2016 was performed...
May 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Seung Yeol Lee, Soon-Sun Kwon, Chin Youb Chung, Kyoung Min Lee, Ki Hyuk Sung, Sangwoo Kim, Moon Seok Park
BACKGROUND: Simultaneous motion of the knee and ankle joints is required for many activities including gait. We aimed to evaluate the influence of surgery involving tendons around the knee on ankle motion during gait in the sagittal plane in cerebral palsy patients. METHODS: We included data from 55 limbs in 34 patients with spastic cerebral palsy. Patients were followed up after undergoing only distal hamstring lengthening with or without additional rectus femoris transfer...
March 15, 2018: BMC Musculoskeletal Disorders
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