SEARCH · PubMed Health

Results for “Bone Malalignment”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources

PubMed2005

Low-intensity pulsed ultrasound: effects on nonunions.

To study the efficacy of low-intensity pulsed ultrasound (US), or LIPUS, of 85 treated nonunion cases with a minimum fracture age of 8 months, 67 cases met the study criteria. These were: no surgical intervention during 4 months before US treatment and radiographically ceased healing for 3 months before US. In a self-paired control study, the mean fracture age of the 67 patients was 39 +/- 6.2 months. After a daily 20-min US treatment at home for an average of 168 days, 85% (57 of 67) of the nonunion cases were clinically and radiographically healed. The study did not include any cases that were malaligned, grossly instable, actively infected or that had extensive bone loss. The results demonstrate that the specific US can effect heal rates similar to those achieved by surgical means, without the associated risks and complications, and to those achieved by electrical bone growth stimulation or by extracorporeal shock-wave therapy.

Adolescent↗

PubMedDate not supplied

Imaging features of discospondylitis in two horses.

Two horses with discospondylitis are described with emphasis on the imaging modalities used and their contribution to the final diagnosis and outcome. Radiographic findings were vertebral endplate lysis with sclerosis in both horses, with additional vertebral subluxation and ventral spondylosis in one horse. Ultrasonographic findings included vertebral malalignment and obliteration of the intervertebral disc by spondylotic bone in one horse and irregular endplates, a widened disc space, a hypoechoic paravertebral abscess and hypoechoic, atrophic adjacent musculature with loss of linear fiber pattern in the other horse. Bone scintigraphy excluded additional affected sites. A systematic approach is recommended when performing an ultrasound examination of the spine.

Animals↗

PubMed2001

Talar neck fractures.

Clinical management of talar neck fractures is complex and fraught with complications. As Gaius Julius Caesar stated: "The die is cast"; often the outcome of a talar neck fracture is determined at the time of injury. The authors believe, however, that better results can be achieved by following some simple guidelines. The authors advocate prompt and precise anatomic surgical reduction, preferring the medial approach with secondary anterolateral approach. Preservation of blood supply can be achieved by a thorough understanding of vascular pathways and efforts to stay within appropriate surgical intervals. The authors advocate bone grafting of medial neck comminution (if present) to prevent varus malalignment and rigid internal fixation to allow for joint mobilization postoperatively. These guidelines may seem simple, but when dealing with the complexity of talar neck fractures, the foot and ankle surgeon needs to focus and rely on easily grasped concepts to reduce poor outcomes.

Fractures, Bone↗

PubMed1995

Femoral component migration in total knee arthroplasty: randomized study comparing cemented and uncemented fixation of the Miller-Galante I design.

The Miller-Galante I knee replacement was inserted in 25 women and three men (33 knees) with osteoarthrosis. All patients received a TiAlV femoral component with a commercially pure titanium fiber-mesh undersurface. Cemented or cementless fixation was used based on a randomization protocol. Micromotions of the femoral components were recorded with roentgen stereophotogrammetric analysis during the first 2 postoperative years. The magnitude of migration did not differ between cemented and uncemented fixation. The number of nonmigrating prostheses decreased from 21 (12 cemented and nine uncemented) at 3 months to six (three cemented and three uncemented) at 24 months. In both groups, the magnitude of prosthetic tilting about the longitudinal axis (internal-external rotation) was as large as that about the transverse axis (flexion-extension). Rotation into extension was as common as rotation into flexion. The largest translations were recorded at either of the posterior condyles. In 10 uncemented components, radiolucent lines were seen at the distal interface postoperatively. Proximal migration of the femoral component was recorded in these knees, and the width of the lines decreased or the lines disappeared totally at 24 months. After 2 years, lines were noted around four cemented and four uncemented replacements, mainly anteriorly or distally. All of these prostheses migrated. One prosthesis, revised because of malalignment, displayed pronounced migration after an initial period of stability. Bone ingrowth was observed anteriorly and anterodistally despite the presence of motions of 1 mm or more.

Aged↗

PubMed1988

Martsolf syndrome in a brother and sister: clinical features and pattern of inheritance.

A brother and sister with Martsolf syndrome are reported. The main characteristics of the syndrome are mental retardation, short stature, cataracts, hypogonadism and craniofacial anomalies including microcephaly, maxillary retrusion, pouting mouth, malaligned teeth and mildly dysplastic pinnae. The metacarpal and phalangeal bones are short. The occurrence of Martsolf syndrome in sibs of opposite sex suggests autosomal recessive inheritance.

Abnormalities, Multiple↗

PubMed2001

Distal femoral fractures: current treatment, results and problems.

The evolution of treatment for supracondylar femoral fractures has sequentially addressed the difficulties of alignment, articular reduction, stabilization and fracture union. Adequate surgical stabilization and early motion diminished stiffness, while newer indirect techniques in handling periarticular tissues have greatly improved union rates. Indirect methods of reduction require an understanding of anatomy and deformity to avoid malalignment. The problems we currently face are fixation in osteoporotic bone or small distal articular segments.

Bone Plates↗

PubMed2006

Pedicle subtraction osteotomy in the treatment of chronic, posttraumatic kyphotic deformity.

OBJECT: Thoracolumbar fractures, treated operatively or nonoperatively, may cause painful kyphotic deformities over time. A pedicle subtraction osteotomy (PSO) is a single-stage posterior procedure designed to correct sagittal plane deformity. Although it was initially used to treat nontraumatic conditions, a PSO can be highly effective in chronic, posttraumatic fractures of the lumbar spine. In this report the authors review details obtained in the treatment of three patients with severe, posttraumatic spinal deformities. They describe the surgical technique used to correct the sagittal malalignments. METHODS: All three patients were middle aged, and good bone mineral density had been demonstrated in each case preoperatively. After PSO, a mean 51 degrees improvement in sagittal alignment was achieved and maintained until a solid arthrodesis was documented in each case. Substantial improvements in pain relief and functional outcome were observed. A detailed, procedure-specific literature review was undertaken. CONCLUSIONS: A PSO is a valuable tool to add to the armamentarium of neurosurgeons who treat patients suffering from painful posttraumatic deformity following fractures of the upper lumbar spine.

Adult↗

PubMed1986

[X-ray diagnosis of foot deformities].

In order to analyze foot deformities, the foot is divided into three compartments. Their normal and pathological positions are defined by the alignment of the bones' axes. The various foot deformities can be put down to a malalignment of the particular compartments. X-ray analysis of the malalignment allows a diagnosis to be made. The most important congenital and acquired foot deformities are discussed.

Calcaneus↗

PubMed1979

[Recurrent fractures of both bones of the forearm in children].

Repeated fractures are not unusual in the course of forearm fractures in children. 49 cases were reviewed in this work. Some of them result from insufficient duration of the plaster. Other fractures are due to the weakness of the forearm bones after the fractures especially when there is a residual malalignment. The findings of this work emphasize the importance of the reduction even when the displacement is moderate. Open reduction and internal fixation is reserved in only rare cases.

Bony Callus↗

PubMed2000

Femoral bone loss in total hip arthroplasty: classification and preoperative planning.

A single comprehensive classification system that can adequately describe all types of bone loss associated with hip arthroplasty should become a standard for reporting purposes. There is a need for a critical appraisal of the classification systems currently in use and, through a consensus, for development of a system that will permit comparison between the reported results of different techniques. Although no one classification system is ideal, the one proposed by the AAOS Committee on the Hip is the most comprehensive and the most consistently used. It addresses not only revision total hip arthroplasty but also primary hip replacement. It also addresses other conditions related to problems with the bone stock, such as those resulting from a previous hip arthrodesis on the acetabular side and femoral stenosis and malalignment on the femoral side. The only drawback to this classification system is its complexity; however, the problem of acetabular and femoral bone loss is of sufficient complexity and variety that a simple classification system, although ideal, cannot be comprehensive. Regardless of the absence of a common language and a comprehensive classification system that is applicable to all types of reconstructions, it is clear that femoral bone loss is a problem that will continue to challenge orthopaedic surgeons. It is only by careful and methodical analysis of patients who have femoral bone loss and by meticulous attention being paid to detail in preoperative evaluation and investigation, surgical planning, and the recording of outcomes that we will be able to improve our treatment of this difficult problem.

Arthroplasty, Replacement, Hip↗

PubMed2005

[Reorientational arthrodesis of the ankle joint using four screws].

BACKGROUND: Arthrodesis of the ankle has gained wide acceptance as a first-line treatment option for painful posttraumatic osteoarthritis. The technique using four to five lag screws for internal osteosynthesis is a safe and biomechanically stable method to obtain a sound ankle fusion with good to excellent long-term results in the majority of patients. Malalignment hazards are minimized by preservation of the ankle mortise. METHODS: The meticulous resection of all cartilage and sclerotic bone as well as an atraumatic surgical technique are essential for preventing major complications. The need for revision surgery is minimized by correction of talar malalignment, fusion with the foot in a 90 degrees position and preoperative evaluation of the subtalar joint. In a series of 40 ankle fusions fixed with the lag screw technique, 82.5% good to excellent results were obtained after 5.6 (4.8-7.6) years. No infection, stress fracture or non-union was seen. RESULTS: In cases of osteitis, osteonecrosis, osteoporosis, and poor soft-tissue condition, external fixation techniques are preferred. In the presence of severe loss of bone stock at the distal tibia, stability can be achieved by using a compression nail for tibiotalar fusion without additional subtalar arthrodesis.

Adult↗

PubMed2003

Stabilization of proximal tibial fractures with the LIS-System: early clinical experience in Berlin.

The Proximal Tibia Less Invasive Stabilization System (LISS PLT) is an internal fixator for the treatment of proximal tibial fractures according to the principles of "Minimally invasive surgery". From July 1998 to August 2000 22 fractures were treated in our clinic with the new Proximal Tibia LISS and the prospective course of healing was documented. The period of follow-up was 12 months. The inclusion criteria were defined as proximal tibial shaft fractures and intraarticular proximal tibial fractures of all degrees of severity. A total of 15 proximal medial and lateral tibial plateau fractures (AO 41) and 7 metaphyseal fractures were treated (AO 42), seven of these fractures presented with open soft tissue damage. The average age of the patients treated was 42 years. With a follow-up rate of 91% (2 patients lost to follow-up), definite consolidation of the fracture was seen in 19/20 cases. In one patient, the fracture had only been partially bridged and secondary bone grafting was performed. Radiologically, there was one case of a varus malalignment of 6 degrees, in two further cases there were valgus malalignments of 5 degrees and 7 degrees at the time of surgery. The other cases all healed in correct alignment. In one case, the implant became loose on the distal shaft and was stabilized again using bicortical screws. In a case with type IIIB soft tissue damage, a soft tissue infection became manifest, but healed uneventfully after a revision operation with the implant in situ.

Adult↗

PubMed1994

[Callus distraction with the AO tubular fixator--principles, techniques and clinical examples].

Callus distraction in segmental transport for closure of traumatic or operative bone defects can be performed with the AO tubular fixator in various ways. Depending on the soft tissue situation and personal preference segmental shifting may either be achieved by tension wires running through the soft tissues (Augsburg model) or by percutaneous Schanz' screws (Basel model). Transportation along an intramedullary nail has certain advantages but also specific draw-backs. To be able to apply the optimal technique to a given situation it is necessary to be familiar with each of these methods. A hybrid system under development at this moment will facilitate anchorage in short epiphyseal segments. We are also going to have a clamp which can turn in itself for correction of axial malalignment.

Adult↗

PubMed2003

[New minimally invasive methods of stabilizing distal femoral fractures].

New, minimally invasive methods of stabilizing distal femur fractures offer the advantage of superior bone healing rates and lower infection rates despite of a decreased necessity of bone grafts. In comparison to conventional plating, the employed indirect reduction method does not lead to an increase in postoperative malalignments. The Less Invasive Stabilizing System (LISS) and the Distal Femur Nail (DFN) are introduced as examples of these new methods of stabilization. Although bone biology is widely respected by these new implants and operation techniques, distal femur fractures remain a serious injury, often resulting in subnormal function.

Adult↗

PubMed1984

[Carpal instability. General therapeutic principles].

Ligamentous injuries must be looked for and repaired on an emergency basis. Correct alignment may be achieved by pinning through a posterior approach. Secondary repair is hazardous. When dealing with compensatory carpal malalignments, intracarpal surgery should strive not only to correct the one bone involved but the entire carpal complex and, in particular, to correct the horizontally tilted scaphoid which may otherwise lead to arthrosis.

Carpal Bones↗

PubMedDate not supplied

[Surgical treatment of a bunionette].

The term Bunionette or Tailor's Bunion is applied to an abnormal prominence on the lateral aspect of the fifth toe similar to the Hallux valgus of the first ray. Several different operative procedures-proximal, diaphyseal or distal-are advocated. Our analysis compares the clinical and radiological results of the distal oblique osteotomy and the distal Chevron metatarsal osteotomy. The clinical evaluation is based on the "Mayo Clinic Forefoot Scoring System" (max. 75 points). Radiographic examination includes measurement of the fourth to fifth intermetatarsal angel, the fifth metatarsal phalangeal angel, as well as the shortening of the fifth metatarsal ray. Overall clinical results were evaluated as very good in both surgical techniques, all the patients obtained more than 70 points in the score. The radiographic analyses show an improvement of the "functional angels" (IMT IV-V, MTP V) with both osteotomies. In all the cases of the distal oblique osteotomy there was a shortening of the fifth metatarsal bone and sometimes a tilting of the head with a consecutive "malalignment" of the metatarsal row without clinical impairment. The Chevron procedure resulted in correct positioning of the metatarsal head in all patients.

Adolescent↗

PubMed1994

[Current status of surgical technique for unreamed nailing of tibial shaft fractures with the UTN (unreamed tibia nail)].

Nailing technique has changed in recent years in some important aspects which are not limited to the omitted reaming procedure. These changes concern patient positioning, reduction technique, the use of temporary stabilizers such as the 'Pinless', and determination of implant length and diameter. Approach and exposure techniques have been modified to new, less invasive procedures, in order to fulfill technical, functional and aesthetic requirements. Techniques and tricks have been developed for avoidance of fragment diastasis and axial and torsional malalignment. Finally, simple algorithms are described for the management of large bone defects, bilateral tibia shaft or ipsilateral femoral shaft fractures, number and location of locking bolts, the 'when and how' of patient mobilization and load bearing, and primary and secondary dynamization. These algorithms, techniques and procedures were developed in a series of 152 tibia shafts, which were stabilized with the AO unreamed tibia nail (UTN) in a prospective study between March 1989 and June 1994. Of these, 75 cases with a mean follow-up of 19.4 +/- 6.3 (range 11-37) months after trauma were reviewed. Fractures were classified according to Müller (1990): 14 type A, 37 type B and 24 type C. Closed soft tissue damage was categorized according to our classification: C0/1, n = 5; C2, n = 12; C3, n = 9 (Tscherne 1982). Among 49 open fractures 8 were OI, 18 OII, 10 OIIIA and 13 OIIIB (Gustilo 1976). The main minor intraoperative complication was drill bit breakage (n = 10), most frequently at the proximal locking holes. The main postoperative complication was breakage of locking bolts (n = 16), mainly between weeks 6 and 20. Minor secondary reinterventions were, in most cases, secondary dynamization under local anaesthesia. Major reintervention were: soft tissue reconstructions (n = 5), isolated cancellous bone graft (n = 6), and change of treatment (n = 12). There were nine changes to a reamed nail, two changes, in very proximal fractures, to plate osteosyntheses. There were three deep infections. Mean time to union was 23.9 weeks (range 10-48 weeks, n = 73); in two cases non-union was observed. The overall result was judged with the Karlström-Olerud score, which was applicable in 66 of 75 cases; excellent, n = 2; good, n = 22; satisfactory, n = 24; fair, n = 9; poor, n = 9. In the remaining nine cases no scoring was attempted because of severe injuries around the knee or ankle.

Adolescent↗

PubMed1992

Changing concepts in the management of secondary orbital deformities.

Techniques borrowed for the correction of congenital craniofacial deformities and acute traumatic reconstruction have improved the quality of secondary post-traumatic orbital reconstruction. These techniques include precise pre- and postoperative assessment made possible by thin section axial and coronal CT imaging. Wide exposure through remote incisions borrowed from aesthetic surgery allows access for repositioning or recontouring of malaligned structures without additional morbidity to the soft tissues. The use of osteotomy and camouflage techniques will depend on the severity of comminution and displacement. Most often, a combination of techniques is employed. Rigid fixation techniques, particularly the use of micro systems, allows the potential for complex configurational reconstruction with little morbidity. The lag microscrew technique allows in-place contouring of onlay grafts and increases volume persistence, thus decreasing the amount of relapse. These techniques taken together provide the potential for unparalleled sophistication in our secondary orbital reconstructions. The factor limiting the quality of the result is most often a function of the damage imparted to the soft tissues at the time of initial injury. The soft tissues are known to absorb more energy at the time of impact than the underlying bones. The resultant contraction of the soft-tissue envelope over the malaligned and compacted skeletal infrastructure can never be restored to its preinjury appearance. For this reason, reconstruction in the acute phase remains the ideal time to prevent or limit post-traumatic orbital deformity.

Adult↗