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At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[Treatment of varus gonarthrosis using Coventry's modified technic].

A high plane femoral head osteotomy technique after Coventry, modified by Blauth, is described; during the last 10 years it has been used in over 200 cases at Kiel University Orthopedic Clinic. In the present paper the mid-term findings in follow-ups of 100 osteotomies in 86 patients are analyzed. Of these interventions, 83% resulted in a significant reduction in complaints at rest and on loadbearing, a considerable improvement in walking ability, and clinically a strengthening of the ligamentous apparatus as well as a reduction in irritation. The 17% poor results were mainly patients with advanced panarthroses, knee-bending contractures and increased loosening of the ligaments. In almost all of these cases, the axial error was insufficiently corrected, while the good results were usually associated with over-correction. In cases of varus gonarthrosis we therefore aim for 5 degrees overcorrection. With the exception of a motoric paresis of the peroneal nerve and a deep infection which healed without sequelae, there were no serious complications. This method can thus be recommended as a reliable procedure.

Arthritis↗
PubMedDate not supplied

[Operative treatment of hallux varus duplex].

The double great toe is a very rare deformity of the foot. This paper describes two cases with such a bilateral anomaly. In both cases the accessory toe was found lateral and not as described in literature medial. Surgery was done by excision of the rudimentary lateral great toe and correction of the varus position of the hallux by the use of a rotational skin flap.

Adolescent↗
PubMedDate not supplied

[Results of the follow-up of varus osteotomy in Perthes disease with reference to the hip value].

A total of 89 patients with 105 hip joints affected by Perthes' disease at Catterall's stages II to IV, which had been treated by varus osteotomy, were re-examined clinically and radiologically between two and ten years after surgery. The clinical and subjective results of treatment were generally good. The best clinical and radiologic results were found in patients who contracted the disease before the age of seven and in whom necrosis was not yet at an advanced stage. The results in children who did not undergo treatment until after the age of eight and those with the disease at Catterall's stage IV were significantly poorer as far as arthrotic deformation of the hip joint was concerned. Radiologic evaluation of the hips examined, with regard to severity of arthrosis, epiphyseal index, and hip value show that the hip value is the best means of distinguishing prearthrotically deformed hip joints from normal findings. For example, at the time of follow-up severe prearthrotic changes were found in 40 of 105 hip joints when the hip values were analyzed. Therefore, in cases of Perthes' disease also, the hip value is of special importance in prognostic counseling of patients as regards the extent to which the hip joint can be subjected to stress either at work or in sports.

Adolescent↗
PubMed1989

[Long-term results following intertrochanteric varus osteotomy in aseptic femur head necrosis in the adult].

25 patients suffering from femoral head necrosis in 30 hip joints were radiologically studied for an average of 11.6 years following intertrochanteric varus angulation osteotomy. Preoperatively only stages 2 and 3 according to Meyers were seen. The follow-up results could be distributed into 4 groups. At best the osteonecrosis was reconstructed within 6 to 9 years while the trabeculae started to become rearranged within 2 to 4 years. At worst, rapid destruction in absence of bony reaction was observed. The ability of the bone outside the osteonecrosis to react to changed circumstances following angulation osteotomy correlates with long-term results. This may indicate a general osteopathy even outside the necrotic area.

Adult↗
PubMed1981

[Biomechanical examination of stress distribution in the femoral neck for varus-implanted and valgus-implanted cups (author's transl)].

Femoral neck fractures occur after cup-prosthesis implantation and inadequate trauma. By reaming the head the tension stress in the lateral tension banding system of the femoral neck is reduced. Therefore high unphysiological bending moments occur in the medial trabecular system, which resists only high pressure forces. Our investigations showed that the unfavourable change in the stress distribution in the femoral neck is worse for the varus- than for the valgus-implanted cup. This could be the cause for the femoral neck fractures after cup implantation and inadequate trauma.

Biomechanical Phenomena↗
PubMedDate not supplied

[Long-term results of basal wedge osteotomy in metatarsus primus varus in the young patient].

INTRODUCTION: Aim of this retrospective study was to analyse the long term results after basal closing wedge osteotomy for correction of metatarsus primus varus and hallux valgus in the younger patient. PATIENT AND METHODS: 49 patients (70 feet) were operated according to a basal closing wedge osteotomy from 1974 to 1985 at our institution. Age was under 40 years in all patients at the time of surgery. 34 patients (50 feet) were evaluated in respect to their clinical and 26 patients (37 feet) to their radiological outcome. The average age was 26 years (14-39 years). The follow-up was 12 to 22 years (Median: 18 years). Analysis was performed using the patient's record, weight-bearing X-rays, a standardized questionnaire and clinical investigation. RESULTS: 82% of the patients had very good and good subjective results. Cosmetics was rated very good and good in 78%, 88% of the patients were painfree. Radiological analysis at follow-up: Hallux valgus-angle 19,3 degrees, intermetatarsal I/II-angle 6 degrees, shortening of first metatarsale 5 mm, at average; dorsal elevation of first metatarsale 38%, degenerative arthritis of the metatarsocuneiforme joint 19%, congruency of first metatarsophalangeal joint 54%,sesamoid subluxation: 46% grade 0, 30% grade I, 14% grade II and 10% grade III. In 14 feet (28%) metatarsalgia was found. DISCUSSION: The basal closing wedge osteotomy is rather a technically demanding procedure conjuncted with a higher risk of failure. Satisfactory long term results can be obtained by an ideal operating technique. As undesirable side effects shortening of the first ray and dorsal malangulation of the first metatarsale may occur consecutively leading to metatarsalgia. Lower risk procedures like the crescentic osteotomy according to Mann or chevron osteotomy should be preferred.

Adolescent↗
PubMed1993

Corrective osteotomy for bilateral forelimb varus deformities in a working dog.

Bilateral varus antebrachial deformity in a 7-month-old working dog was surgically corrected. The deformity was a sequela to premature closure of the distal radial physes after trauma to the forelimbs. Treatment was by ulnectomy and oblique radial osteotomy. Stabilisation of the fractures was maintained by an external fixation device. The treatment was successful and the dog returned to work as a sheep dog.

Journal Article↗
PubMed1975

A study of weight transmission through the knee joint with applied varus and valgus loads.

An electromechanical device is described which permits measurement of the amount of weight borne on each compartment of the knee during varying amounts of lateral angulation. A lateral angulation of only 3 degrees in either direction completely unloaded the opposite condyle. The correction to be obtained by tibial osteotomy of varus or valgus knee deformity should permit the mechanical axis of the extremity to pass the tibial spines on the side opposite the deformity. An angular deviation of 3 degrees more than that required to restore the mechanical axis to normal position is sufficient.

Adult↗
PubMedDate not supplied

Section of the abductor hallucis tendon for correction of metatarsus varus deformity.

Section of the abductor hallucis tendon is recommended for early correction of the metatarsus adductus deformity especially in the residual of a treated equinovarus foot. The operation is simple and safe, with very little postoperative morbidity. The effectiveness of the procedure is enhanced if a tight abductor hallucis tendon is demonstrated. The operation may also be helpful in conjunction with other surgical procedures for correction of the varus deformity of a clubfoot.

Child↗
PubMedDate not supplied

Radiographic results of proximal femoral varus osteotomy in Legg-Calvé-Perthes disease.

A retrospective review of 116 Legg-Calvé-Perthes patients with varus osteotomy for Herring group B and C disease involvement was conducted. Preoperative assessment consisting of anteroposterior pelvis and frog leg lateral radiographs and an arthrogram was performed on all patients. Radiographic extent of disease was classified using Herring's lateral pillar classification system. Radiographic outcome was assessed utilizing Stulberg's classification to grade residual deformity. Follow-up averaged 6 years 9 months (range, 3 years to 15 years 3 months). Stulberg class I and II (spherically congruent) results were obtained in 86% of patients younger than 9 years old with Herring class B disease. Patients 9 years and older with Herring class B disease had spherically congruent results in 67% of cases. Patients with Herring class C disease 9 years and older had spherically congruent results in 30% of cases and 43% spherically congruent results in those younger than 9 years.

Child↗
PubMed1975

Hallux valgus and metatarsus primus varus treated by bunionectomy and proximal metatarsal osteotomy.

Sixteen feet with hallux valgus and metatarsus primus varus have been treated by excision of the exostosis of the first metatarsal head, advancement of the medial capsule and the abductor hallucis, release of the lateral capsule and adductor tendon, and open-wedge osteotomy at the base of the first metatarsal inserting a bone graft. During a three-year period ther have been no nonunions of the osteotomy, and satisfactory maintenance of the corrections has occurred. This method is preferred over distal metatarsal osteotomy.

Bone Transplantation↗
PubMed2002

A comparison of the biomechanical effects of opening and closing wedge varus osteotomies in Perthes' disease.

Varus femoral osteotomy is a commonly employed surgical method of effecting containment in the management of Perthes' disease. This can be achieved by performing either an opening lateral wedge or a closing medial wedge osteotomy. The effects of these two techniques on the biomechanical interrelationships about the involved hip were compared using a three-dimensional computer simulation. Both procedures lead to femoral shortening and reduce the moment capacity of the hip abductors. The shortening effect and consequent leg length discrepancy are greater for the closing wedge osteotomy than for the opening wedge procedure. Pelvic obliquity compensation, likely to be greater for a closing wedge osteotomy, provides a beneficial increase in femoral head coverage but at the cost of a further reduction in the hip abductor moment capacity.

Biomechanical Phenomena↗
PubMed2006

The effect of 6 weeks of custom-molded foot orthosis intervention on postural stability in participants with >or=7 degrees of forefoot varus.

OBJECTIVE: Postural stability (PS) was assessed in a group of participants with >or=7 degrees of forefoot varus (FV) after 6 weeks of custom-molded functional foot orthosis (FO) intervention to investigate the effect of FO intervention in a population that may have decreased PS due to their foot structure. DESIGN: A force platform was used to assess right and left single-limb stance position and eyes open and eyes closed condition PS. SETTING: PS was assessed in a biomechanics research laboratory. PARTICIPANTS: Twelve participants with >or=7 degrees of FV (MFV) and 5 participants with <7 degrees of FV (LFV) participated in the study. INTERVENTIONS: PS of the MFV group was assessed initially when FOs were received and after 6 weeks of FO intervention. The LFV group PS was assessed during initial and 6-week testing sessions. MAIN OUTCOME MEASURES: The root mean square of the center of pressure velocity was used to quantify single-limb stance PS during no FO and FO conditions. RESULTS: LFV group PS did not change significantly (P=0.829) over the 6-week time period. Significant improvement was, however, reported in the MFV group anteroposterior (P=0.003) and mediolateral (P=0.032) PS at the 6-week assessment versus the initial assessment during both the noFO and FO conditions. CONCLUSIONS: Six weeks of FO intervention may significantly improve PS in participants with >or=7 degrees of FV both when wearing FOs and when not wearing FOs.

Adult↗
PubMed2005

Intertrochanteric varus osteotomy for osteoarthritis in patients with hip dysplasia: 6 to 28 years followup.

UNLABELLED: There have been few reports regarding midterm to long-term results of intertrochanteric varus osteotomy for treatment of hip dysplasia. We investigated 55 hips in 46 patients, with an average age at surgery of 32 years (range, 12-55 years), for an average followup of 17 years (range, 6-28 years). Preoperative osteoarthritis was Tonnis Grade 0 in seven hips, Grade 1 in 23 hips, Grade 2 in 21 hips, and Grade 3 in four hips. Preoperative anteroposterior radiographs of the 55 hips showed almost perfect congruency between the acetabulum and the femoral head with the hip in an abducted position. Excellent or good clinical results were obtained in 23 hips (42%). Using a Harris hip score less than 70 points or the time until additional surgery as the end point, the cumulative rates of survival were 81% at 10 years, 60% at 20 years, and 50% at 25 years. The clinical results of patients with Grade 0, 1, or 2 osteoarthritis, with good spherical femoral head and mild dysplasia, were acceptable; however, this osteotomy might not be indicated for patients with Grade 3 osteoarthritis or for those with severe acetabular dysplasia. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series--no, or historical control group). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗
PubMed2007

Femoral supracondylar malunions with varus medial condyle and shortening.

Femoral supracondylar malunions associated with varus deformity of the medial femoral condyle and shortening are rare, and all techniques for treatment of this complication reported to date have limitations. A one-stage antegrade locked intramedullary nailing technique to concomitantly treat these combined disorders was performed in 19 consecutive patients. The following procedures were performed: removal of previous implants, supracondylar corrective osteotomy, one-stage lengthening on a fracture table, antegrade static locked intramedullary nail stabilization, and corticocancellous bone grafting. Seventeen patients with malunions received regular followup for a median of 2.4 years (range, 1.1-5.2 years). Sixteen malunions healed with a union rate of 94.1% (16 patients) and a median union period of 4.5 months (range, 3-7 months). Only one nonunion associated with nail breakage occurred (5.9%; one patient) and one deep infection recurred (5.9%; one patient). Both patients recovered after appropriate treatment. All patients had improved knee alignment and function. Antegrade locked intramedullary nailing is an effective technique for one-stage treatment of combined disorders in patients with femoral supracondylar malunions. Complications can be avoided if patients and surgeons are careful during the treatment course. Protected weightbearing until fracture healing is crucial to successful treatment.

Adult↗