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Biomedical subjects

C T Price

Publications and source records attributed to C T Price.

At least 19 recordsLinked to original sources
PubMed1996

Pearls and pitfalls of deformity correction and limb lengthening via monolateral external fixation.

In conclusion, monolateral external fixation can be effectively utilized in the management of limb length discrepancy and angular deformity. This manuscript outlines the pertinent theory, application and problems important in these cases. When faced with specific congenital conditions the surgeon is encouraged to reference relevant literature that is more focused than the current paper.

Biomechanical Phenomena↗
PubMed1996

Severe growth retardation following limb lengthening: a case report.

The first limb lengthening was reported by Codivilla in 1905. Common complications reported with this procedure include pain tract infections, angulation deformities, joint contractures, and residual limb length discrepancies. Growth arrest or severe growth retardation in the lengthened bones has rarely been reported. We report a case of a skeletally immature patient with right sided hemihypertrophy who underwent lengthening of the left lower extremity by the method of DeBastiani using Orthofix external fixators. Postoperatively he developed severe growth retardation in the lengthened limb, as evidenced by the Mosely straight line graph, and recurrence of his limb length discrepancy. The reason for this growth retardation remains unknown; however, we hypothesize that premature closure at one or more of the physes occurred because of increased tension across the growth plates. The practice of over-lengthening a congenitally short limb prior to physeal closure should be questioned because resumption of growth after lengthening may be unpredictable.

Adolescent↗
PubMed1996

Familial congenital pseudoarthrosis of the clavicle: case report and literature review.

Congenital pseudoarthrosis of the clavicle (CPC) is a rare condition of unresolved etiology and pathogenesis. Familial occurrence of this anomaly has been documented but the pattern of genetic transmission remains obscure. Two cases involving a father and daughter are presented here with a review of the literature. These cases add support to the genetic basis for CPC.

Child↗
PubMed1994

Unilateral fixators and mechanical axis realignment.

Unilateral fixators have been used successfully for mechanical axis realignment. Immediate correction of angular deformity is usually preferred with monolateral fixation. This article discusses the principles of immediate versus gradual correction and the range of acceptable malalignment. The principles, technique, and results of complex deformity correction also are discussed.

Bone Malalignment↗
PubMed1992

Choosing fusion levels in progressive thoracic idiopathic scoliosis.

The selection of fusion levels in thoracic idiopathic scoliosis was subjected to multicenter retrospective review to test the validity of the classification system and recommendations of King et al. The 253 patients reviewed were treated by posterior fusion and Harrington instrumentation. Bending films were of little help in selecting fusion levels. Standing radiographs alone were usually adequate. King Type II curves may yield better lumbar correction if the lumbar curve is partially included in the fusion. Type IV curves may be safely fused one level proximal to the stable vertebrae.

Adolescent↗
PubMed1992

Recent advances in limb lengthening. Part I: Clinical advances.

The discipline of limb lengthening has undergone numerous advances in recent years. An increased understanding of the biology of distraction osteogenesis, as well as technical advances, has made lengthening more feasible. However, significant problems remain unsolved, and complications--although less severe and long standing--still remain. Little is known about the effect of distraction on soft tissues. Lengthening in skeletally mature patients remains difficult. The myriad of conditions that require lengthening often confounds comparison of techniques. Uniform indications for limb lengthening may never exist, but increasing experience helps guide patient selection.

Bone Lengthening↗
PubMed1992

Recent advances in limb lengthening. Part II: Biological advances.

The most important recent advance in limb lengthening is the recognition that bone will regenerate, under appropriate conditions, within the gap of an osteotomized bone. Although Codivilla recognized this phenomenon, bone formation was inconsistent in his patients. Optimal distraction osteogenesis requires a knowledge of osteotomy techniques, length of latency period, rate and frequency of distraction, and mechanical effects of loading.

Bone Lengthening↗
PubMed1991

The third step of total autologous blood transfusion in scoliosis surgery. Harvesting blood from the postoperative wound.

In a prospective study in scoliosis and kyphosis surgery patients, red blood cells were harvested from the drainage of the postoperative closed wound and returned to the patient. Approximately 1 unit of blood per patient was saved compared with a historically similarly matched group who had no postoperative blood salvage. The authors conclude that the addition of postoperative autologous blood salvage can considerably reduce predeposit autologous blood requirements of patients undergoing Cotrel-Dubousset instrumentation and posterior spine fusion for spinal deformity.

Blood Loss, Surgical↗
PubMed1991

Experience with the Orthofix device for limb lengthening.

The DeBastiani technique is recommended for lengthenings in children and adolescents. The Orthofix device may also be employed for immediate correction of angular and rotational deformities followed by lengthening in pediatric patients. Caution is advised when employing this method in other patients. Lengthening should be avoided through areas of previously damaged or osteoporotic bone. This is especially true in adult patients who have exhibited less than optimal osteogenesis even in the best conditions. Bilevel lengthening or early internal fixation should be considered in adult patients when using this method. Bone formation attained with the DeBastiani method in achondroplastic patients has been encouraging. However, lengthening in achondroplastic patients is rarely indicated owing to the limitation of absolute height gained and the relative complication rate. DeBastiani's callotasis method of lengthening utilizing the Orthofix device offers several advantages when compared with the Wagner and Ilizarov methods. The Orthofix device is a versatile lengthener that offers the best overall biomechanical stability and the capability for dynamization. The application is relatively simple and requires less operative time than that of the circular frames. There is less risk of neurovascular injury with the use of half-pins, and radiographic evaluation is simplified. Bone formation with the Orthofix equals that attained with the Ilizarov device and has significantly diminished the need for bone grafting and internal fixation frequently required using the Wagner method. In children and adolescents, the total number of anesthetics required is reduced using the DeBastiani method owing to a lower complication rate and office pin removal.

Achondroplasia↗
PubMed1990

Nighttime bracing for adolescent idiopathic scoliosis with the Charleston bending brace. Preliminary report.

The authors report their preliminary experience with the Charleston bending brace for the treatment of adolescent idiopathic scoliosis. This brace holds the patient in the position of maximum side bend correction and is worn only at night. Patients in this prospective multicentered study met all the following criteria: skeletal immaturity (Risser 0, 1+, or 2+), curvature greater than 25 degrees before bracing, no prior treatment, and greater than 1-year follow-up since initiation of treatment. There were 191 structural curves in the 139 patients. One hundred fifteen patients (83%) showed improvement or less than 5 degree change in curvature. Twenty-four patients (17%) demonstrated an increase in curvature greater than 5 degrees. Based on these preliminary results, continued use of bending brace treatment at nighttime only is justified for adolescent idiopathic scoliosis. Patients with double curves should be observed closely for increase in compensatory curves.

Adolescent↗
PubMed1990

Limb lengthening by callotasis for children and adolescents. Early experience.

The callotasis technique of De Bastiani was used to perform 11 lower extremity lengthenings in ten pediatric and adolescent patients (aged 8.1-18 years). Average gain in length was 5.0 cm per segment (15% of original bone length). All lengthened segments healed without bone grafting or internal fixation. Healing index was 32 days per centimeter gained. The device was well tolerated and easily removed in the clinic setting. There were 13 minor complications, managed without hospitalization. Three angular deformities required manipulation under anesthesia. One angular deformity remains uncorrected, and one patient lacked 1.1 cm of achieving the desired length. All other patients gained the desired length. There were no refractures, deep infections, or other complications. Limb lengthening by the De Bastiani method is a satisfactory procedure for the pediatric and adolescent patient with moderate limb-length discrepancy.

Adolescent↗
PubMed1990

Correction of distal femoral deformity.

This retrospective study reviews 12 distal femoral osteotomies in nine patients performed for angular and rotational deformities, using the Orthofix external fixator. All osteotomies progressed to solid union with reliable correction of the deformity. Few complications were encountered. Simultaneous lengthening was performed on one patient successfully. This method proved to be a safe and precise means of correcting distal femoral deformity with the option of simultaneous correction of length discrepancy.

Adolescent↗
PubMed1990

Adult scoliosis. Current concepts.

Back pain and increasing deformity of the spine can develop in adults with idiopathic scoliosis. It is known that scoliosis can continue to progress after skeletal maturity and cause problems in adults. Conservative treatment is effective in most cases, but occasionally surgery is necessary. Recent advances in spinal instrumentation have resulted in improved results and fewer complications.

Adult↗
PubMed1989

Metaphyseal and physeal lengthening.

The potential problems associated with physeal distraction and the relative success of callus distraction favor callus distraction as the procedure of choice for equalization of major limb-length discrepancies. Indications for lengthening are the same as in the Wagner procedure. The expected results and soft-tissue complications of callus distraction are similar to those of the Wagner technique. However, the number of procedures required and the osseous complications of lengthening appear to be reduced with these newer methods of limb lengthening.

Bone Lengthening↗
PubMed1987

Osteoid osteoma of the femoral neck: excision through medial approach.

An 11-year-old girl with osteoid osteoma of the medial femoral neck underwent excision of the lesion through a medial adductor approach. A satisfactory result was achieved without unsightly scarring or internal fixation. The medial adductor approach should be considered when osteoid osteoma of the femoral neck is encountered.

Child↗