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At least 325 records · Page 18Linked to original sources
PubMed2005

An optimal duration of daily wear for an insole with subtalar strapping in patients with varus deformity osteoarthritis of the knee.

OBJECTIVE: To assess the optimal duration of daily wear for a laterally wedged insole with subtalar strapping in subjects with medial compartment osteoarthritis of the knee (knee OA). DESIGN: The setting was an outpatient clinic. Eighty-one patients with knee OA were prospectively randomized according to birth date and to either 2 weeks of treatment with a lateral wedge with subtalar strapping for less than 5 h (the short group), 5-10 h (the medium group) or greater than 10 h (the long group) each day, or to treatment with a subtalar strapping band without lateral wedge (the placebo group). Standing radiographs were used to analyze the femorotibial angle for each subject, both with and without their respective orthotic device. The remission scores of Lequesne index were compared among the four groups at the conclusion. RESULTS: The short (n=21), medium (n=20) and long (n=18) groups demonstrated a significant greater valgus correction of the femorotibial angle than the placebo group (n=22) (P<0.0001). The remission score was significantly improved in the medium group compared to the placebo (P=0.001) and long (P=0.001) groups. CONCLUSIONS: An optimal duration of insole with subtalar strapping wear for patients with varus deformity knee OA may be between 5 and 10 h each day.

Aged↗
PubMed2005

A 2-year follow-up of a study to compare the efficacy of lateral wedged insoles with subtalar strapping and in-shoe lateral wedged insoles in patients with varus deformity osteoarthritis of the knee.

OBJECTIVE: This study was conducted in order to assess the effect of wearing a lateral wedged insole with a subtalar strap for 2 years in patients with osteoarthritis varus deformity of the knee (knee OA). DESIGN: The setting was an outpatient clinic. The efficacies of the strapped insole and a traditional shoe insert wedged insole (the inserted insole), as a positive control, were compared at the baseline and after 2 years of treatment. Randomization was performed according to birth date. The 61 female outpatients with knee OA who completed a prior 6-month study were asked to wear their respective insoles continuously as treatment during the course of the 2-year study. The femorotibial angle (FTA) was assessed by standing radiographs obtained while the subjects were barefoot and the Lequesne index of the knee OA at 2 years was compared with those at baseline in each insole group. RESULTS: There were 61 patients in the original study, but 13 patients (21.3%) did not want to wear the insole continuously and five (8.2%) withdrew for other reasons. The 42 patients who completed the 2-year study were evaluated. At the 2-year assessment, participants wearing the subtalar strapped insole (n=21) demonstrated significantly decreased FTA (P=0.015), and significantly improved Lequesne index (P=0.031) in comparison with their baseline assessments. These significant differences were not found in the group with the traditional shoe inserted wedged insole (n=21). CONCLUSION: Only those participants using the subtalar strapped insole demonstrated significant change in the FTA in comparison with the baseline assessments. If the insole with a subtalar strap maintains FTA for more than 2 years, it may restrict the progression of degenerative articular cartilage lesions of knee OA.

Aged↗
PubMedDate not supplied

Tardy ulnar nerve palsy in cubitus varus deformity associated with ulnar nerve dislocation in adults.

Seven patients with tardy ulnar nerve palsy from a posttraumatic cubitus varus deformity were reviewed retrospectively. The severity of symptoms was grade I in 3 patients and grade II in 4 patients according to McGowan's classification. The mean internal rotation angle was 30.7 degrees (range, 25 degrees -45 degrees ). The most prominent feature was dislocation of the nerve anterior to the medial epicondyle and entrapment of the nerve by the fibrous band of the flexor carpi ulnaris muscle. Of these 7 patients, 4 were treated by 3-dimensional osteotomy with ulnar nerve transposition, and 3 were treated by anterior transposition of the ulnar nerve. All patients improved clinically, and there was no significant difference between anterior transposition of the nerve in the group with osteotomy and the group without osteotomy. Ulnar nerve instability due to internal rotation deformity and distal entrapment was considered to be the main cause of neuropathy.

Adolescent↗
PubMed2006

Surgical treatment of varus malunion of the proximal humerus with valgus osteotomy.

Among the complications of 2-part fractures of the upper end of the humerus, little attention has been paid to the treatment of the varus malunion. However, this deformity frequently causes pain and disability of the shoulder. To improve this condition, we treated this malunion with a valgus wedge osteotomy. From August 1995 to January 1999, 5 patients with this deformity, all complaining about pain or unsatisfactory function of the shoulder (University of California, Los Angeles score <13), underwent osteotomy and internal fixation with a plate and screws. The mean age was 53 years (range, 25-73 years), there were 4 male patients, and the left side was involved in 4 cases. The mean follow-up was 34 months (range, 22-63 months). Union occurred in all cases by 6 weeks. Three of the results were excellent, and two were good (University of California, Los Angeles score >30). All patients were satisfied with the treatment.

Adult↗
PubMed1996

Gait analysis and motor point block in dynamic varus of the rear foot in a head injured adult.

This clinical note describes a typical case of dynamic varus deformity of the hind part of the foot in a head injured adult. Gait analysis objectified, by kinematic data, the perturbed movement of the rear foot in the frontal plane and identified, by dynamic electromyography, the overactive muscle (posterior tibialis) involved in the deformity. The diagnosis was confirmed by a motor point block of the posterior tibialis muscle with functional improvement. Kinematic data also showed improvement after the block. This case report illustrates the usefulness of gait analysis in diagnosis and management of gait disturbances in adult patients.

Adult↗
PubMedDate not supplied

Lateral closing wedge supracondylar osteotomy of humerus for post-traumatic cubitus varus in children.

Cubitus varus deformity following mal-union of a supracondylar fracture of the humerus in children causes no functional disability, but surgical correction is often requested to improve the appearance of the arm. Maintaining the correction after supracondylar osteotomy is a difficult aspect of the operative treatment and remains controversial. Nine children aged between 6 and 12 years (average 8 years and 11 months) underwent lateral closing wedge supracondylar osteotomy of the humerus, for deformity ranging between 10 and 20 degrees (average 13 degrees). The correction required ranged between 16 and 30 degrees (average 21 degrees). The osteotomy was internally fixed with a two hole marrow plate. At follow-up, which ranged between 3 months and 6 years (average 34 months), six patients were graded as good, two as satisfactory and one as a poor result. One patient had transient radial nerve palsy which recovered completely in 2 months. The patient who was graded poor had undercorrection of the deformity at the original operation. There was no incidence of loss of correction due to implant failure. Complete section of the bone to allow medial displacement of the distal fragment is recommended, thereby avoiding lateral bony prominence at the elbow.

Bone Plates↗
PubMed1987

Medial capsular recession for severe varus deformities.

Medial capsular recession is an effective method of correcting preoperative fixed varus knee deformities at the time of total knee arthroplasty. If the flexion and extension spaces are properly balanced and filled, knee stability is achievable. Sixty-eight knees that had medial capsular recession were followed for at least 2 years after surgery, 19 of them for more than 10 years, with a mean follow-up period of 4.8 years. Of these knees, 73% had less than 5 degrees of postoperative varus/valgus instability with no deterioration during the follow-up period. Attenuation or rupture of the medial flap occurred in only two knees. There was no statistical difference in ultimate range of motion, alignment, or presence of bone-cement radiolucencies between knees with medial recession and those without medial recession.

Aged↗
PubMed1999

Lateral insufficiency fractures of the femur caused by osteopenia and varus angulation: a complication of total hip arthroplasty.

Lateral femoral insufficiency fractures in total hip arthroplasty occur due to osteopenia and varus positioning of the femoral component, the femur itself, or both. The presentation of these fractures can be unclear but usually involves the insidious onset of unexplained thigh or groin pain. The patients are likely to have significant comorbidities as well. Characteristic radiographic findings may be present, depending on when the patient presents. The insufficiency fractures generally occur at the level of the femoral stem tip on the lateral cortex of the femur. If left untreated, pain and loss of function continue. Eventually an insufficiency fracture can progress to a displaced periprosthetic fracture. Nonsurgical treatment is not successful. Recommended treatment involves revision to a long-stem femoral component. The risk of postoperative complications is significant.

Arthroplasty, Replacement, Hip↗
PubMed2000

Assessment of articular cartilage of the lateral tibial plateau in varus osteoarthritis of the knee.

This study describes the soft X-ray examinations of 24 lateral tibial plateaus obtained during total knee arthroplasty for varus osteoarthritis. The average thickness of the articular cartilage was 3.5 min and ranged from 2.1 to 5.0. We considered that 21 out of the 24 lateral tibial plateaus had well preserved articular cartilage. Within the well preserved articular cartilage, bony protuberances of various sizes were found in five cases. All lateral tibial plateaus except one showed osteophyte formation. We considered that 12 of the 24 lateral tibial plateaus had large osteophytes. Ten of these 12 lateral tibial plateaus had well preserved articular cartilage. Large osteophyte formation may not necessarily be a contra-indication of high tibial osteotomy (HTO) or unicompartmental knee arthroplasty (UKA). Cases with a bony protuberance may not be suitable for HTO or UKA, because the overlying articular cartilage is thin and inadequate for supporting load.

Journal Article↗
PubMedDate not supplied

Varus toes: a review and case report.

The authors present an overview of varus or curly toe deformity. This congenital deformity can be seen in many generations of the same family, with no greater incidence in males or females. The hereditary influences on the inheritance of this deformity have not been clearly defined but appear to follow an x-linked or autosomal dominant pattern. The deformity is very often dismissed by physicians, and if left untreated can lead to more serious digital pathology later in life.

Child, Preschool↗
PubMedDate not supplied

The incidence of the intermetatarsal facet of the first metatarsal and its relationship to metatarsus primus varus: a cadaveric study.

The purpose of this study was to determine the incidence of the intermetatarsal facet on the lateral aspect of the base of the first metatarsal and its role in the medial angulation of the proximal metatarsal base as it relates to metatarsus primus varus. A total of 77 human first metatarsals were examined for the presence of the intermetatarsal facet. The intermetatarsal facet was seen on the lateral aspect of the first metatarsal base, superior to the tuberous attachment of the peroneus longus tendon. The obliquity of the first metatarsal base was measured on metatarsals with and without the intermetatarsal facet. The intermetatarsal facet was present on 22 of 77 first metatarsals, or 29% of specimens. The proximal obliquity angle was 2.92 degrees in metatarsals without the facet and 4.63 degrees when the facet was present. This increase in the medial obliquity of the proximal first metatarsal base in the presence of an intermetatarsal facet was statistically significant (P < .002). The intermetatarsal facet between the first and second metatarsals may have a role in an increased medial obliquity of the first metatarsal base and is present in approximately 30% of the population.

Adult↗
PubMed2001

Radiologic analysis of the tibial intramedullary canal in Chinese varus knees: implications in total knee arthroplasty.

Seventy-two lower limb long radiographs were reviewed with respect to mechanical and anatomic axes. A template of an intramedullary tibial guide rod was employed to determine the accuracy of the intramedullary guide in producing ideal tibial cuts (ie, 90 degrees ) and acceptable tibial cuts (ie, 90 degrees +/- 2 degrees ). The mean difference of the angle formed by the 2 axes was 1.84 degrees +/- 1.42 degrees. In our findings, 22.2% of patients would have unacceptable cuts if an intramedullary device were employed for the tibial cut during a total knee arthroplasty. A radiograph showing the whole tibia is required preoperatively to identify varus tibiae that are not suitable for the intramedullary method.

Arthroplasty, Replacement, Knee↗
PubMed2003

Step-by-step measurements of soft tissue balancing during total knee arthroplasty for patients with varus knees.

Using a step-by-step procedure, we measured joint gap during surgery using a simple device with a torque meter in 45 osteoarthritis knee joints (43 patients) with varus deformity. The effects of specific cuts or releases of the anatomic portion on joint gaps were investigated. Each cut or release resulted in various increases in the medial gap from 1.2 to 3.8 mm on average. The final gap measurements averaged 24.1 mm medially and 27.6 mm laterally in extension, and 24.6 mm medially and 27.2 mm laterally in flexion. The results of the measurements showed that each step-by-step procedure had a tendency of gap increase. The results led us to measure soft tissue balancing in a step-by-step procedure during total knee arthroplasty.

Arthroplasty, Replacement, Knee↗
PubMed1996

[Dwyer osteotomy with or without lateral stabilization in calcaneus varus with lateral ligament insufficiency of the upper ankle joint].

Varus deformity is a well known problem in the treatment of chronic lateral ankle instability. Surgical correction is recommended occasionally. The goal of this study was to show the effect of a calcaneal Dwyer osteotomy in patients suffering from a functional instability. We examined 6 patients, who underwent 7 calcaneal osteotomies. Postoperatively all patients maintained stability. No recurrence of a supination trauma was observed.

Adult↗
PubMedDate not supplied

[Reflex studies of the patellar tendon reflex in patients with varus gonarthrosis].

We discuss the role of the neuromuscular system following biomechanical circumstances for the development of osteoarthritis of the knee joint. We examined in 58 patients suffering from osteoarthritis with varus deformity and 22 healthy people the latency and velocity of the patellar tendon reflex. We found with increasing age and by osteoarthritis of the knees shorter reflex latencies, that we see as disintegration of motor system.

Electromyography↗
PubMedDate not supplied

[Osteochondroma as an unusual cause of metatarsus primus varus].

A solitary osteochondroma of the metatarsale II of an adolescent is presented which led to a painful Metatarsus primus varus. After resection of the tumor the patient was free of symptoms, the postoperative resulting form of the foot was normal. One should be aware of a tumor as a possible cause of foot deformities.

Adolescent↗