Biomedical subjects

K N Kuo

Publications and source records attributed to K N Kuo.

26 records · Page 2Linked to original sources

PubMedDate not supplied

Congenital idiopathic clubfoot.

Clubfoot or talipes equinovarus is a complex deformity characterized by three distinct manifestations. The foot is in an equinus position; the forefoot and heel are in varus; and the entire foot is supinated. While the exact etiology of this problem remains unknown, many advancements have been made in the treatment of clubfeet. The surgical procedure is progressive and tailored according the severity of the deformity. Pain management, thorough neurovascular assessments, and education of the family are essential to caring for these patients.

Clubfoot↗

PubMedDate not supplied

Relationship between dynamic deformities and joint moments in children with cerebral palsy.

A relationship between dynamic flexion-extension motion ranges during walking and the magnitude of flexion and extension moments was analyzed for 38 ambulatory children with spastic cerebral palsy. Moments tending to flex the hip and the knee were more than a factor of two times greater than those occurring during normal gait. At the knee, the magnitude of the moments was related to the amount of flexion deformity, whereas at the hip there was no correlation between moment magnitude and extension motion range. The maximum dorsiflexion and plantarflexion ankle moments were of less than normal value in all deformity groupings. An understanding of the longterm influence of these abnormal moments on the terms of the progression or stabilization of the dynamic deformities during walking is an important step toward improving our understanding of and, potentially, our ability to treat patients with cerebral palsy.

Adolescent↗

PubMedDate not supplied

Prognosticating factors in acetabular development following reduction of developmental dysplasia of the hip.

A number of predictors that may influence acetabular development after reduction were studied in 75 hips with developmental dysplasia of the hip (DDH). Seventy-nine percent of the hips had satisfactory results of Severin group I or II, and 21% had unsatisfactory results. The best predictor of success in a unilateral case is the center-head distance discrepancy (CHDD) measurement at 1 year follow-up. Ninety-six percent of hips with a CHDD of < or = 6% had satisfactory results, whereas 78% with a CHDD > 6% had unsatisfactory results. This study also confirms that age at reduction and significant improvement in the acetabular index in the first year after reduction are important predictors.

Acetabulum↗

PubMedDate not supplied

Simultaneous ipsilateral femoral and tibial lengthening with the Ilizarov method.

Eight pediatric patients who underwent nine simultaneous ipsilateral femoral and tibial lengthenings with the Ilizarov external fixator were reviewed. The patient's demographics, diagnoses, corticotomy levels, mechanical axes, healing indices, amounts of lengthening, and complications were recorded. The patients' average age was 8 years 10 months (5 years 4 months-15 years 10 months) with an average follow-up of 49 months (30-88 months). The percentage of femoral lengthening averaged 16.7% (8-23%) with an average healing index of 28 days/cm (20-38 days/cm). The percentage of tibial lengthening averaged 18% (9.6-23.6%) with an average healing index of 29 days/cm (1940 days/cm). Four complications in three patients occurred as a direct result of the lengthening process. Three of the complications involved soft-tissue contractures, which were each successfully treated with one additional surgical procedure, whereas the fourth complication involved poor bone regeneration and required bone grafting and additional immobilization.

Adolescent↗

PubMedDate not supplied

Resistant talipes equinovarus associated with congenital constriction band syndrome.

Thirty-seven clubfeet in 28 patients with concomitant congenital constriction band syndrome were reviewed. The bands were considered to be of significance if located in the calf region (zone 2). The severity of the bands was classified. Grade 1 bands involved subcutaneous tissue, grade 2 bands extended to the fascia, grade 3 bands extended to the fascia and required release, and grade 4 bands were congenital amputations. The patients were divided based on neurologic deficit. Group A consisted of 26 clubfeet without neurologic deficit and had 1.4 surgeries per clubfoot. Group B consisted of 11 clubfeet with neurologic deficit and had 3.7 surgeries per clubfoot. Children with grade 3 bands in zone 2 were most likely to have a neurologic deficit. Twenty-three clubfeet had a good clinical result, seven clubfeet fair, and seven clubfeet poor. Group B had poorer results than Group A. These feet ultimately required numerous and more extensive surgeries to obtain correction, and ultimately had a poorer result.

Amniotic Band Syndrome↗

PubMedDate not supplied

Pseudoaneurysm after foot surgery.

Pseudoaneurysm (PA) is recognized as a rare complication after pediatric foot surgery. We identified the incidence, pertinent clinical features, and response to surgical intervention in PA as a complication of foot surgery. Four PAs were identified after 2,756 foot operations, an overall incidence of 0.14%. These patients typically had symptoms between 2 and 3 months after index operation with an enlarging, pulsatile, compressible mass in the plantar medial aspect of the foot. Arteriography was helpful in planning surgical intervention. Operative treatment consisted of ligation and excision of PA in all patients. Final outcome of foot deformity surgery was not compromised.

Adolescent↗

PubMedDate not supplied

Differential lengthening of the radius and ulna using the Ilizarov method.

Three patients with relative length discrepancy between the radius and ulna and with wrist angular deformity are reported. The Ilizarov apparatus was used for correction of the deformity by differential lengthening of the radius and ulna. The total lengthening percentages ranged from 21 to 52%. All patients obtained a good functional result after surgery with full range of motion of fingers and moderate loss of wrist range of motion in two patients. All patients were able to achieve primary bone healing.

Child↗

PubMedDate not supplied

Rotatory dorsal subluxation of the navicular: a complication of clubfoot surgery.

One hundred fifty-seven patients with 208 idiopathic clubfeet were operated on by a single surgeon (K.K.) from 1976 through 1987. Retrospective analysis was performed with a mean follow-up of 7.3 years on 126 patients with 168 operated-on feet. Twelve (7.1%) of 168 feet developed dorsal subluxation of the tarsal navicular. Six (6.3%) of 95 patients developed subluxation with the posterior medial incision. Six (8.2%) of 78 patients developed subluxation with the Cincinnati incision. Seven (58%) of these 12 feet required additional surgery. An anatomic model was constructed to demonstrate how rotation of the navicular alone mimics the radiographic appearance of dorsal subluxation of the navicular. The navicular dorsal subluxation is a common complication and is associated with a high rate of additional corrective surgery. We suggest that dorsal subluxation of the navicular should be redefined as a rotatory deformity with the medial border of the navicular rotating superiorly in the coronal plane. Attention to the position and rotation of navicular at the time of internal fixation may prevent this complication.

Adolescent↗