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At least 451 records · Page 25Linked to original sources

PubMed1983

A literature review of congenital digiti quinti varus: clinical description and treatment.

Congenital digiti quinti varus is a deformity in which the fifth toe overlaps the base of the fourth; it consists of three main components: adduction, dorsiflexion, and external rotation. Treatment for this deformity may consist of conservative or surgical techniques, depending on the severity and/or age of the patient. The surgical techniques recommended by various authors may involve skin plasties, tenotomies and capsulotomies, tendon transfers and lengthenings, and bone resections.

Humans↗

PubMedDate not supplied

Growth of the proximal femur after varus-derotation osteotomy in the treatment of congenital dislocation of the hip.

The growth of the upper end of the femur was studied in 50 children with congenital dislocation of the hip in whom a femoral osteotomy had been carried out. All children had unilateral dislocations and had been treated by a proximal femoral varus-derotation osteotomy after closed reduction, excision of the limbus, or open reduction. The average age at osteotomy was 2.3 years. The minimum follow-up was five years (average, 11.6 years). The neck-shaft angle, CE angle, shaft-epiphysis angle, neck-epiphysis angle, diameter of the femoral head, and widths of the femoral neck and shaft were measured on the anteroposterior radiographs. Although no cases of avascular necrosis of the capital epiphysis occurred, 21 children developed deformities of the femoral head, of whom eight showed an abnormal angulation of the capital-epiphyseal plate. The neck-epiphysis angle is described as an alternative to the shaft-epiphysis angle in assessing the orientation of the capital-epiphyseal plate. The best radiographic outcome was obtained when the neck-shaft angle measured 100 degrees to 110 degrees immediately after osteotomy.

Adolescent↗

PubMed1982

A study of anatomy and biomechanics of the ankle region in normal and club feet (talipes equino varus) of infants.

Three normal feet and three feet exhibiting talipes equino varus from infants were dissected and their anatomy studied and compared. The tibiae were immobilised in plaster and held in a bench clamp while the range of dorsiflexion (extension) was studied before and after immobilisation of either the medial or lateral, or of both groups of tendons. Movements at the subtalar and ankle joints were studied as well as factors controlling movements at the subtalar joint. There was minimal subtalar movement in normal feet during dorsiflexion (extention) but for the clubbed feet the joint showed far greater movement. Tethering of the lateral malleolus to the calcaneum by a suture, in normal feet, caused similar biomechanical behaviour to that seen in clubbed feet.

Ankle↗

PubMed1981

A new osteotomy for hallux valgus: a horizontally directed "V" displacement osteotomy of the metatarsal head for hallux valgus and primus varus.

A new operation for hallux valgus consists of a horizontally directed "V" displacement osteotomy done in the head of the first metatarsal. This procedure corrects most of the primus varus, the valgus tilt of the articular surface of the first metatarsal and, if present, the axial rotation of the great toe. The osteotomy is combined with a release and balancing of soft-tissue structures on both sides of the joint. No casting and usually no internal fixation is necessary. Ambulation is generally recommended on the third postoperative day. The operative techniques, indications for surgery, clinical material, and postoperative care are discussed. The operation, when done correctly, does not result in recurrence of the deformity. Significant complications are rare.

Biomechanical Phenomena↗

PubMed1981

Joint force analysis in degenerative varus or valgus knees during standing -importance of tibial tilt to the floor-.

A two-dimensional skeletal model of the knee was constructed to estimate joint compression force in varus of valgus osteoarthrotic knees. Angle and length constants and variables were measured for 100 X-ray films of normal and osteoarthrotic subjects while they were standing on one foot. The results showed that the tibial tilting angle to the floor primarily determined the joint forces in the deformed knees. The angle has mechanically more significance than the femoro-tibial tilting angle which has been widely used clinically. The results have some clinical implications.

Body Weight↗

PubMed1981

Acquired hallux varus: a new corrective procedure.

In hallux varus, which may be either congenital or acquired, the great toe deviates tibialward at the metatarsophalangeal joint. Dr. Wood discusses the acquired type and its causes and treatment. A new technique involving the surgical detachment from bone of all structures located superficial to the periosteum that surrounds the distal half of the shaft of the first metatarsal has been developed. It may be used in conjunction with the available soft tissue procedures before bone surgery for correction of the deformity, and it may make bone surgery unnecessary or alter the extent and scope of any required bone surgery.

Aged↗

PubMed1980

Evaluation of treatment of hip subluxation in myelomeningocele by intertrochanteric varus derotation femoral osteotomy.

A retrospective study of 27 subluxed hips was carried out in 18 patients with myelomeningocele treated by varus derotation intertrochanteric osteotomy. Twenty-three of the 27 hips were stable at follow-up review. The causes of failure were related to the presence of pelvic obliquity secondary to scoliosis or to a dysplastic acetabulum (acetabular index above 25 to 30 degrees). Transfer of the iliopsoas tendon was not found to be necessary in order to achieve stable reduction.

Child↗

PubMedDate not supplied

Intertrochanteric varus osteotomy in the treatment of Perthes' disease.

Seventy-eight hips with Perthes' disease (LCPD) were treated with an intertrochanteric varus osteotomy. The hips were preoperatively graded according to Catterall's classification. There were 7 Group II, 32 Group III, and 39 Group IV hips. Good results occurred in 5 of the Group II hips, 19 of the Group III hips, and 12 of the Group IV hips. The average age of the patients at the onset of symptoms was 6 years and 6 months, and the average age at the time of the osteotomy was 7 years and 8 months. This means that the average age of patients was high and that the operations were performed in a late state of the disease. A control group consisting of 52 hips was treated conservatively with a Thomas splint. In 11 hips classified as Catterall's Group IV, there were 8 poor results. The results indicate that with osteotomy the results improve in Group IV of Catterall's classification. There are, however, still about 30% poor results in the Group IV. A prolonged prevention of weight-bearing after osteotomy may be indicated in patients with unfavorable results.

Child↗

PubMed1978

Repair of calcaneal varus and cavus.

Calcaneal varus or calcaneal cavus alone can be readily corrected, and the surgical procedure is not technically difficult. The author states that if the four basic points he describes are followed, good results will be obtained, and the osteotomy will heal in the desired position without incident. If other osseous deformities of the foot are involved, the deformities must be considered separately and in relation to each other, and other procedures may be necessary.

Adult↗

PubMed1995

Varus derotation osteotomy for persistent dysplasia in congenital dislocation of the hip. Proximal femoral growth and alignment changes in the leg.

We studied the morphological changes in the proximal femur in 42 patients (42 hips) who had had varus derotation osteotomy of the upper femur for residual acetabular dysplasia and congenital subluxation of the hip and who did not show deformity of the head of the femur. In 19 patients the alignment of the whole leg was examined. The femoral neck-shaft angle (FNSA) at the final examination was unrelated to that immediately after operation or to the state of the acetabulum at that time. The postoperative FNSA was not related to the final result but the CE angle obtained at surgery influenced the outcome. The femoral length did not differ significantly between the unaffected and affected sides. Significant differences were found in the femorotibial angle (176.6 degrees v 174.5 degrees) and in the point of intersection between the mechanical axis and knee (65.0% v 57.2%).

Acetabulum↗

PubMed1995

Femoral varus derotational osteotomy in cerebral palsy.

The records concerning 64 hips in 36 cerebral palsy patients treated with varus derotational osteotomy (VDO) alone (2 hips), VDO with muscle releases (adductors, iliopsoas, hamstrings; 46 hips), and VDO, soft-tissue release, and innominate bone osteotomy (16 hips) were reviewed. There were 23 quadriplegic and 13 diplegic patients. Average age at surgery was 7 years. Average follow-up period was 3.8 years. All hips that had VDO, soft-tissue release, and innominate osteotomy were stable at follow-up. Nine hips of the 44 treated with VDO and muscle release alone dislocated, and required second osteotomies.

Adolescent↗

PubMed1994

Severe varus and valgus deformities treated by total knee arthroplasty.

We report a prospective case-controlled study which compared the outcome of knee replacement in seriously deformed and slightly deformed knees. There were 51 knees with varus or valgus deformity greater than 20 degrees matched for age, gender, disease, type of prosthesis and time of operation with a control group in which the alignment of the leg was within 5 degrees of normal. The clinical outcome at a mean 5.5 years was similar in the two groups. Some deformity persisted in 14 patients in the first group, 13 of whom were initially in valgus. These patients had a significantly poorer mean clinical outcome. Lateral dislocation or subluxation of the patella was found in four knees, all of which had had valgus deformity of 30 degrees or more.

Aged↗

PubMed1993

[High tibial osteotomy for osteoarthritis of the knee with varus deformity].

Twenty-eight cases (31 joints) with osteoarthritis of the knee associated with varus deformity were operated on by modified Koshino high tibial osteotomy. After operation 19 knee joints were followed up for more than one year (average 34.1 months). Eighteen knee joints had a satisfactory result, especially excellent are the pain relief and increment of walking ability. The operative procedures and surgical indication were described. The main factors affecting the curative effect of high tibial osteotomy on osteoarthritis of the knee, the advantages and disadvantages of this method were discussed.

Aged↗

PubMed1993

Gait analysis study on patients with varus osteoarthrosis of the knee.

Biomechanical changes that occur after high tibial osteotomy (HTO) was investigated in 30 patients with osteoarthrosis (OA) of the knee and 11 age-matched normal subjects. Of the 37 knees with varus OA evaluated, 21 were analyzed before and after surgery (average follow-up evaluation, two years). The mean age of the patient group was 58.2 years. Clinical assessment was based on the Hospital for Special Surgery (HSS) knee scoring system. Full-length weight-bearing radiograms were taken for the measurement of the mechanical axis of the lower limb. Results from clinical assessment showed that 90% of the patients had good or excellent postoperative clinical results, as opposed to 9.5% before surgery. An overall improvement in the gait parameters was evident in the group evaluated after surgery, although control levels were not attained. Further analysis based on moments about the knee showed that 57% of the surgically treated knees with good or excellent clinical results had abnormal load distribution. This may lead to deterioration in the future, and further surgery may be required. The abnormal loading was also reflected in the ground-reaction force vector diagram. Therefore, the force vector diagram can be used as a quick screening method to detect abnormal joint loading.

Aged↗

PubMed1993

Distal femoral varus osteotomy for painful genu valgum. A five-to-11-year follow-up study.

From 1978 until 1984, 23 patients (24 knees) were treated with varus producing distal femoral osteotomy for painful, lateral compartment osteoarthrosis. Evaluation at five to 11 years (average, 8.3 years) included orthopedic examination, calculation of the Hospital for Special Surgery (HSS) knee score, and standing knee roentgenograms. Based on the objective knee scores, 71% of the patients had good or excellent results, with no difference in those followed for longer periods. Complications occurred in 63% of the cases, including nonunion (25%) and loss of correction (21%). Both complications were associated exclusively with staple fixation, which was performed during the period of this study and is now known to be inadequate to fix this osteotomy. Despite increasing morbidity rates, these complications did not appear to influence the ultimate result. A statistically significant prognostic factor was the severity of the disease as reflected by the pre- and postoperative knee scores. Further, the degree of correction was a function of the initial deformity. At follow-up evaluation 13% of the knees had been converted to a total knee replacement.

Adult↗

PubMedDate not supplied

Complications of varus derotation osteotomy in the treatment of CHD during growth.

Complications of varus derotation osteotomies in the treatment of congenital hip displacement (CHD) are reported. Only "true" complications were considered, that is, those related to errors in technique, while those related to errors in indications were excluded. An analysis of 150 cases with a mean follow-up of 4.2 years revealed that "true" complications are a rare occurrence. Among these the most frequent are dysmetria (20%), and infection (2.6%). There was only one case of osteochondrosis (0.6%). The dysmetria (usually under 2 cm) rarely required further surgical treatment involving temporary epiphysiodesis of the homolateral knee, while the infection responded satisfactorily to combined conservative and surgical treatment.

Acetabulum↗

PubMed1977

Varus derotational osteotomy of the femur in cerebral palsy.

Varus derotational osteotomy of the femur is designed to correct coxa valga and femoral anteversion which contribute to progressive hip subluxation and dislocation in certain cases of cerebral palsy. By the application of a careful preoperative evaluation, vigorous postoperative rehabilitation and treatment of complications, satisfactory results were obtained in 17 of 20 patients followed for one to 17 years after osteotomy. No hip subsequently dislocated and dysplastic acetabulae were predictably remodeled in those patients less than 8 years of age.

Cerebral Palsy↗

PubMed1996

[High tibial in plus osteotomy for proximal tibia varus deformity using the CZ-2 distractor-compressor].

The original technique of in plus high tibial osteotomy with the use of CZ-2 (after Czyrny) external distractor/compressor in proximal tibia varus deformity is presented. It has been used in 5 cases with 3 years follow-up. Fixing the device to the bone before performing an incomplete osteotomy allows for precise correction and prevents intraoperative complications. If desired correction exceeds 10 degrees, two stages are recommended: first intraoperative one with filling of the created defect with frozen bone graft and final, postoperative one, performed according to bone lengthening principles.

Bone Lengthening↗