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Rotational femoral osteotomy

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https://www.readbyqxmd.com/read/28537994/changes-in-gait-parameters-after-femoral-derotational-osteotomy-in-cerebral-palsy-patients-with-medial-femoral-torsion
#1
Ha Yong Kim, Yong Han Cha, Jae Yong Byun, Young Sub Chun, Won Sik Choy
Medial femoral torsion (MFT) is a common pathologic gait in cerebral palsy (CP) children that can be corrected by femoral derotational osteotomy (FDO). It is not clearly known as to how much various gait parameters change after FDO. The aim of this study was to quantify changes in gait parameters after FDO. The study group included 19 young CP patients (28 limbs, age<20 years, average age: 13.2 years) with symptomatic MFT, treated with distal FDO. The study group was divided into two groups: the unilateral FDO group (UG) and the bilateral FDO group (BG)...
May 19, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28529663/the-modified-dunn-procedure-for-slipped-capital-femoral-epiphysis-the-bernese-experience
#2
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529661/slipped-capital-femoral-epiphysis-management-and-the-arthroscope
#3
F Accadbled, O May, C Thévenin-Lemoine, J Sales de Gauzy
BACKGROUND: In situ pinning of slipped capital femoral epiphysis (SCFE) results in various degrees of deformity of the femoral head-neck junction. Repetitive trauma from cam-type femoroacetabular impingement (FAI) can lead to labral tears and injury to the articular cartilage causing loss of function. Arthroscopic osteoplasty is an alternative to open procedure and to Southwick/Imhäuser-type osteotomies in symptomatic selected cases. SURGICAL TECHNIQUE: The amount of bone to be resected has to be carefully planned pre-operatively...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529111/the-results-of-total-hip-arthroplasty-after-sugioka-transtrochanteric-anterior-rotational-osteotomy-for-osteonecrosis
#4
Takeshi Utsunomiya, Goro Motomura, Satoshi Ikemura, Satoshi Hamai, Jun-Ichi Fukushi, Yasuharu Nakashima
BACKGROUND: Since Sugioka transtrochanteric anterior rotational osteotomy (ARO) for osteonecrosis of the femoral head (ONFH) changes the morphology of the proximal femur, total hip arthroplasty (THA) after previous ARO is considered a technically demanding procedure. The purpose of this study was to compare the clinicoradiologic outcomes of THA after ARO with those of THA without any antecedent surgery for ONFH. METHODS: Twenty-four hips in 20 patients who underwent cementless THA after ARO (postosteotomy group) were retrospectively reviewed and compared with patients who underwent cementless THA without any antecedent surgery for ONFH during the same period (primary group)...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28521149/long-term-outcomes-of-external-femoral-derotation-osteotomies-in-children-with-cerebral-palsy
#5
Sylvia Õunpuu, Matthew Solomito, Katharine Bell, Kristan Pierz
External femoral derotation osteotomy (FDO) is an orthopaedic intervention to correct increased femoral anteversion and associated excessive internal hip rotation and internal foot progression during gait in children with cerebral palsy. The resulting functional issues may include clearance problems and hip abductor lever-arm dysfunction. The purpose of this study was to evaluate long-term gait outcomes of FDO. Twenty ambulatory patients (27 sides) with cerebral palsy who underwent pre-operative (P0) and a one year post-operative (P1) gait analysis as part of the standard of care had a second post-operative analysis (P2) approximately 11 years post-surgical intervention...
April 29, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28439311/treatment-of-shepherd-s-crook-deformity-in-patients-with-polyostotic-fibrous-dysplasia-using-a-new-type-of-custom-made-retrograde-intramedullary-nail-a-technical-note
#6
F Hefti, L Donnan, A H Krieg
AIMS: The severe form of coxa vara, the 'shepherd's crook deformity', is always a consequence of a locally extensive form of polyostotic fibrous dysplasia (or McCune-Albright syndrome). Treatment of this deformity is a challenge. The soft bone does not tolerate any implant that depends on the stability of the cortical bone (like plates or external fixators). Intramedullary nails are the most appropriate implants for stabilisation, but if they are inserted from the greater trochanter, they cannot correct the varus deformity enough...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28419537/electromagnetic-tracking-for-femoral-derotation-osteotomy-an-in-vivo-study
#7
Andreas Geisbüsch, Christoph Auer, Hartmut Dickhaus, Cornelia Putz, Thomas Dreher
Femoral derotation osteotomy delivers good to excellent results in the treatment of rotational gait abnormalities and especially in internal rotation gait. The outcome of the procedure has been evaluated in numerous short- and long-term studies. Although reasons for recurrence and over-/under-correction have been unveiled in earlier studies the mechanisms are still not fully understood. False intra-operative assessment of the derotation angle may contribute to imprecise outcomes. In a recent saw-bone study we evaluated an electromagnetic tracking system in comparison to conventional goniometer measurement and a CT reference measurement and found it to be extremely accurate, whereas the use of a conventional goniometer for derotation measurement showed a high inter- and intra-rater variability...
April 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28377262/evaluation-of-malrotation-following-intramedullary-nailing-in-a-femoral-shaft-fracture-model-can-a-3d-c-arm-improve-accuracy
#8
Austin J Ramme, Jonathan Egol, Gregory Chang, Roy I Davidovitch, Sanjit Konda
INTRODUCTION: Difficulty determining anatomic rotation following intramedullary (IM) nailing of the femur continues to be problematic for surgeons. Clinical exam and fluoroscopic imaging of the hip and knee have been used to estimate femoral version, but are inaccurate. We hypothesize that 3D c-arm imaging can be used to accurately measure femoral version following IM nailing of femur fractures to prevent rotational malreduction. METHODS: A midshaft osteotomy was created in a femur Sawbone to simulate a transverse diaphyseal fracture...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28365906/error-range-in-proximal-femoral-osteotomy-using-computer-tomography-based-navigation
#9
Masaki Takao, Takashi Sakai, Hidetoshi Hamada, Nobuhiko Sugano
PURPOSE  : The purpose of this preliminary study was to determine the error range compared with preoperative plans in proximal femoral osteotomy conducted using a computed tomography (CT)-based navigation system. METHODS  : Four patients (four hips) underwent transtrochanteric rotational osteotomy (TRO), and three patients (four hips) underwent curved varus osteotomy (CVO) using CT-based navigation. Volume registration of pre- and postoperative CT was performed for error assessment. RESULTS  : In TRO, the mean osteotomy angle error was [Formula: see text] (range [Formula: see text]) in the valgus direction and [Formula: see text] (range [Formula: see text]) in the retroversion direction...
April 1, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28331928/computed-tomographic-evaluation-of-femoral-and-tibial-conformation-in-english-staffordshire-bull-terriers-with-and-without-congenital-medial-patellar-luxation
#10
Mark Newman, Katja Voss
OBJECTIVE: To compare hindlimb conformation of English Staffordshire Bull Terriers with and without medial patellar luxation using computed tomography. METHODS: Hindlimb computed tomography (CT) was performed on six English Staffordshire Bull Terriers with grade II or III medial patellar luxation, and six without medial patellar luxation. Inclination angle, femoral condyle trochanteric angle, anteversion angle (AA), distal anteversion angle (DAA), proximal anteversion angle (PAA), femoral varus angle (FVA), tibial valgus angle (TVA), and tibial torsion angle (TTA) were measured...
March 23, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28322290/3d-printed-navigation-template-in-proximal-femoral-osteotomy-for-older-children-with-developmental-dysplasia-of-the-hip
#11
Pengfei Zheng, Peng Xu, Qingqiang Yao, Kai Tang, Yue Lou
To explore the feasibility of 3D-printed navigation template in proximal femoral varus rotation and shortening osteotomy for older children with developmental dysplasia of the hip (DDH). Between June 2014 and May 2015, navigation templates were designed and used for 12 DDH patients. Surgical information and outcomes were compared to 13 patients undergoing the same surgery but without navigation template. In template-guided patient group, operation time (21.08 min vs. 46.92 min), number of X-ray exposures (3...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28278135/the-influence-of-the-unaffected-hip-on-gait-kinematics-in-patients-with-hemiplegic-cerebral-palsy
#12
Mikhail Tretiakov, Khanh P Do, Michael Aiona
BACKGROUND: Hemiplegic cerebral palsy (HCP) patients have transverse-plane gait deviations that may include the "uninvolved" side. The aim of this study is to quantify the static rotational profile, the dynamic position during gait and determine whether any correlations between the involved and uninvolved side exist. METHODS: A total of 171 subjects that met the inclusion criteria of HCP and no prior history of bony surgery were reviewed. Clinical and gait measurements were analyzed and compared between subjects and a population of typically developing (TD) children...
April 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28261424/healing-process-of-osteonecrotic-lesions-of-the-femoral-head-following-transtrochanteric-rotational-osteotomy-a-computed-tomography-based-study
#13
Devendra Lakhotia, Siva Swaminathan, Won Yong Shon, Jong Keon Oh, Jun Gyu Moon, Chirayu Dwivedi, Suk Joo Hong
BACKGROUND: Transtrochanteric rotational osteotomy (TRO) is a controversial hip-preserving procedure with a variable success rate. The healing process of femoral head osteonecrosis after TRO has been poorly explained till now. This study aimed to evaluate the healing process of previously transposed necrotic lesion after a TRO for nontraumatic osteonecrosis of the femoral head using computed tomography (CT). METHODS: Among 52 patients (58 hips) who had preserved original femoral head after TRO, we retrospectively reviewed 27 patients (28 hips) who had undergone sequential CT scans and had no major complication following TRO...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28229355/femoral-shaft-osteotomy-for-obligate-outward-rotation-due-to-scfe
#14
Peter M Stevens, Lucas Anderson, Bruce A MacWilliams
Slipped capital femoral epiphysis (SCFE) is an adolescent disease that leads to retroversion of the femoral neck and shaft, relative to the head. Observing that patients with SCFE must walk with an outward foot progression angle and externally rotate the leg in order to flex the hip, we have been performing a femoral shaft rotational osteotomy wherein we rotate the lower femur 45° inward, relative to the upper femur. By correcting retroversion, our goal is to improve functional hip and knee motion, thereby mitigating the effects of SCFE impingement...
April 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28197751/rotational-acetabular-osteotomy-for-acetabular-dysplasia-and-osteoarthritis-a-mean-follow-up-of-20%C3%A2-years
#15
Takahito Yuasa, Katsuhiko Maezawa, Kazuo Kaneko, Masahiko Nozawa
INTRODUCTION: Rotational acetabular osteotomy (RAO), a joint-conserving surgery in which the femoral head coverage by autologous cartilage is improved to achieve joint stability, is one of the most common joint-conserving surgeries for acetabular dysplasia of the hip in adult patients. Favorable outcome of RAO for pre- and initial coxarthrosis has been reported with middle- to long-term observation; however, surgery should be selected for advanced coxarthrosis. The objective of this study was to investigate the long-term clinical outcomes and radiological arthritis changes in patients who were treated with RAO and could be followed for 15 years or longer, and to investigate the joint conservation rate by preoperative arthritis stage...
February 14, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28148658/long-term-outcomes-of-transtrochanteric-rotational-osteotomy-for-non-traumatic-osteonecrosis-of-the-femoral-head
#16
D Morita, Y Hasegawa, T Okura, Y Osawa, N Ishiguro
AIMS: Transtrochanteric rotational osteotomy (TRO) is performed for young patients with non-traumatic osteonecrosis of the femoral head (ONFH) to preserve the hip. We aimed to investigate the long-term outcomes and the risk factors for failure 15 years after this procedure. PATIENTS AND METHODS: This study included 95 patients (111 hips) with a mean age of 40 years (21 to 64) who underwent TRO for ONFH. The mean follow-up was 18.2 years (3 to 26). Kaplan-Meier survivorship analyses were performed with conversion to total hip arthroplasty (THA) and radiological failure due to secondary collapse of the femoral head or osteoarthritic changes as the endpoint...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28122388/clinical-study-of-3d-imaging-and-3d-printing-technique-for-patient-specific-instrumentation-in-total-knee-arthroplasty
#17
Bing Qiu, Fei Liu, Bensen Tang, Biyong Deng, Fang Liu, Weimin Zhu, Dong Zhen, Mingyuan Xue, Mingjiao Zhang
Patient-specific instrumentation (PSI) was designed to improve the accuracy of preoperative planning and postoperative prosthesis positioning in total knee arthroplasty (TKA). However, better understanding needs to be achieved due to the subtle nature of the PSI systems. In this study, 3D printing technique based on the image data of computed tomography (CT) has been utilized for optimal controlling of the surgical parameters. Two groups of TKA cases have been randomly selected as PSI group and control group with no significant difference of age and sex (p > 0...
January 25, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28094687/successful-management-of-femoral-trauma-in-a-through-knee-amputee-with-a-previous-malunited-fracture-implications-and-functional-outcome
#18
Beth Lineham, Paul Harwood, Peter Giannoudis
BACKGROUND: After amputation patients are more likely to injure their residual limb. An injury of a previously amputated limb, especially if the residuum is not anatomically normal, poses a dilemma for management. Case Description and Methods: This case report discusses a femoral fracture sustained proximal to a through-knee amputation. Findings and outcomes: The fracture was at the site of a malunited fracture. A shortening osteotomy with bone graft was undertaken to improve alignment and prosthetic fit and remove poor-quality bone...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28060234/reorientational-proximal-femoral-osteotomies-for-arthrogrypotic-hip-contractures
#19
COMPARATIVE STUDY
Harold Jacob Pieter van Bosse, Roger E Saldana
BACKGROUND: Severe hip contractures in arthrogrypsosis are multiplanar, which can preclude or can greatly complicate sitting and ambulation. The reorientational osteotomy at the intertrochanteric level preserves preoperative hip motion but moves it to a more functional domain. We retrospectively compared preoperative and postoperative hip motion and evaluated the ambulatory abilities of patients who underwent the procedure. METHODS: Since 2008, 65 patients with arthrogryposis had 119 reorientational proximal femoral osteotomies with a minimum follow-up of 2 years...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28017874/factors-influencing-progressive-collapse-of-the-transposed-necrotic-lesion-after-transtrochanteric-anterior-rotational-osteotomy-for-osteonecrosis-of-the-femoral-head
#20
Y Kubo, G Motomura, S Ikemura, K Sonoda, T Yamamoto, Y Nakashima
BACKGROUND: Transtrochanteric anterior rotational osteotomy (ARO) for osteonecrosis of the femoral head (ONFH) can preserve for a long-time collapsed femoral head. Progressive collapse of anteriorly-transposed necrotic lesion leads to secondary arthritic changes and clinical failure. Critical factors influencing collapse of the transposed necrotic lesion after ARO remain largely unknown. Therefore, we performed a retrospective study of ARO to determine: (1) if preoperative collapse influences collapse of the transposed necrotic area, (2) if any other factor may influence collapse of the transposed necrotic area...
April 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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