SEARCH · PubMed Health

Results for “Osteotomy”

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 55 records · Page 3Linked to original sources

PubMed1996

Corrective osteotomy for malunion of the distal radius: the effect of concomitant ulnar shortening osteotomy.

Positive ulnar variance due to inadequate correction of radial length is a common disorder after radial corrective osteotomy. To avoid this complication we performed a combination of ulnar-shortening osteotomy and radial corrective osteotomy in 6 of 22 radial corrections. The indication for the combined procedure was a relative ulnar length of minimally 6 mm. The functional outcome was fair in 1 and good in 5 cases with combined osteotomy. Overall, the functional results were good in 17 cases, and pain in the distal radioulnar joint was observed in 3 of 22 patients. Positive ulnar variance was the reason for pain in only 1 patient. Eventually, 2 hemiresections of the ulnar head (Bower's arthroplasty) were performed. It appears that a combination of ulnar shortening and radial osteotomy is a reliable technique, which can reduce symptoms and need for secondary operations on the ulnar side of the wrist.

Adult↗

PubMed1997

[Possibilities of osteotomy. Osteotomy and corticotomy techniques].

Corrective measures on the bone undertaken after the fusion of epiphyses are only possible through an initial break in its continuity. This paper deals with the different methods of osteotomy available to the orthopaedic or trauma surgeon. After introducing the terminology of the so-called "osteotomy", the vascularity of the bone, special features of the various osteotomy site, the different indications, and particular details of the operative procedures are discussed. Special emphasis is placed on minimally invasive techniques and osteotomies in the framework of callus distraction. In addition to established procedures a new sawing technique for the Küntscher's closed osteotomy is described.

Bone Lengthening↗

PubMed2005

Long-term results of Chiari pelvic osteotomy in patients with developmental dysplasia of the hip: indications for Chiari pelvic osteotomy according to disease stage and femoral head shape.

BACKGROUND: We evaluated the long-term results of Chiari pelvic osteotomy for developmental dysplasia of the hip (DDH) after follow-up of 10 years or more. The indications for Chiari osteotomy were assessed based on the results. METHODS: We evaluated 74 hips in 69 patients treated for DDH with Chiari osteotomy. The average postoperative follow-up period was 13 years. The mean age at the time of surgery was 32 years (range 6-64 years). The disease was classified into two stages based on joint space measurements on radiographs: an early stage (36 hips) in which the mean age at surgery was 21 years (range 6-48 years) and an advanced stage (38 hips) in which the mean age at surgery was 41 years (range 18-64 years). Femoral head shape was classified into two types based on measurements of the sphericity of the femoral head: spherical (33 hips) or flat (41 hips). Clinical manifestations were evaluated according to Japanese Orthopaedic Association (JOA) hip scores. The joint space was measured on radiographs as an index of the progression of osteoarthritis. We attempted to identify factors that affected the long-term results of Chiari osteotomy, especially in regard to disease stage and femoral head shape. RESULTS: The mean total JOA score was 72 preoperatively and 87 at final follow-up. It had improved in 66 hips and was worse in 7 hips. All of the worse cases were at the advanced stage at the time of surgery, and in 6 of the worse cases the femoral head was spherical. Hips with advanced DDH and a spherical femoral head had poor outcomes and exhibited joint space narrowing postoperatively. CONCLUSIONS: Early DDH is considered a good indication for Chiari pelvic osteotomy because of the good results at 10 years or more. Even with advanced DDH, a flat femoral head predicts a good surgical outcome, but patients with a spherical femoral head may experience early progression to osteoarthritis.

Adolescent↗

PubMedDate not supplied

Results of tibial rotational osteotomy without concomitant fibular osteotomy in children with cerebral palsy.

A retrospective review was performed of 46 consecutive ambulatory children with cerebral palsy and tibial torsion who underwent 72 distal tibial derotational osteotomies without concomitant fibular osteotomy. The average amount of derotation measured at surgery was 21 +/- 5 degrees. The average change in thigh-foot angle at follow-up was 21 +/- 9 degrees. There were eight perioperative complications (11%): three delayed unions, three superficial wound dehiscences, one case of osteomyelitis, and one superficial pin tract infection. There were no incidences of malunion or nonunion. Preoperative and postoperative three-dimensional gait analysis data were used to determine the effect of distal tibial osteotomy on foot progression angle in seven subjects (11 limbs). Foot progression improved significantly. This study shows that distal tibial osteotomy alone (without concomitant fibular osteotomy) is an effective and safe procedure for correcting and maintaining correction of tibial torsion in patients with cerebral palsy.

Adolescent↗

PubMedDate not supplied

Unilateral versus bilateral peri-ilial pelvic osteotomies combined with proximal femoral osteotomies in children with cerebral palsy: perioperative complications.

The purpose of this study is to evaluate if bilateral peri-ilial pelvic osteotomies (PIPO) combined with proximal femoral varus derotation osteotomies (VDRO) influenced postoperative complications in children with spastic quadriplegia. Bilateral and unilateral hip subluxation or dislocation secondary to spasticity was present in 29 and 61 patients, respectively. The children were divided into 2 groups: group 1 were to be performed a surgery for unilateral PIPO associated with bilateral VDRO, and group 2 were to be performed a surgery for bilateral PIPO and VDRO. The average age of patients at initiation of surgery was 11.7 years (range, 5-20 years) for group 1 and 10.7 years (range, 5-19 years) for group 2. The hospital stay was similar for group 1 and 2 (P = 0.797), which was 9 days. In group 1, 11 (18%) of 61 children needed an average of 2 days (range, 1-7 days) in the intensive care unit postoperatively, and 4 of these 11 patients were reintubated because of respiratory problems. In group 2, 6 (20%) of 29 children were transferred to the intensive care unit postoperatively for an average of 2 days (range, 1-4 days) and 3 of these 6 children were reintubated because of respiratory problems. In conclusion, respiratory problems and anemia were the most common early postoperative complications, which occur with a similar rate in children with spastic quadriplegia who underwent bilateral or unilateral peri-ilial pelvic osteotomy(ies) combined with proximal femoral osteotomies. We believe that bilateral hip procedures including PIPO, proximal femoral osteotomies, and soft-tissue release can be performed safely in 1 stage and, based on this data, the staged procedure would probably have the same risk as the first procedure.

Adolescent↗

PubMed1995

The stability of facial osteotomies. 1. The evolution of maxillary, mandibular and chin osteotomies.

Surgical repositioning of the dento-skeletal components of the face, combined with appropriate orthodontic treatment, can be used to improve function and aesthetics. An extensive number of osteotomies are performed within the maxillofacial region. The most common of these are the Le Fort I osteotomy of the maxilla, the bilateral sagittal split osteotomy of the mandibular ramus, and the horizontal osteotomy of the anterior mandible. The attainment of three dimensional stability following corrective jaw surgery continues to be a major problem in the post-surgical period, in spite of the widespread adoption of rigid internal osteosynthesis. The evolution of these osteotomies to advance dento-skeletal components is traced from their inception to the present day and the concept of stability is explained (Part I). This serves as a prelude to an investigation into the stability of these procedures, undertaken in isolation or combination, to advance selected segments of the mid- and lower face (Parts 2, 3, 4, 5).

Chin↗

PubMed2000

Scarf osteotomy for correction of hallux valgus. Surgical technique and results as compared to distal chevron osteotomy.

With the Scarf osteotomy, a good correction of moderate hallux valgus can be obtained, comparable to the distal or proximal Chevron or crecentic osteotomy. Correction of the IMA averages between 5 degrees to 6 degrees. When used in combination with an adductor release and proximal phalangeal osteotomy, the indication can be extended to severe hallux valgus deformities as long as there is no arthrosis at the MTP joint. The Scarf osteotomy, however, is certainly a more extensive surgical procedure, with a longer learning curve than a distal Chevron osteotomy. With more than 1000 Scarf procedures performed, the author has not encountered one delayed union, even in osteoporotic bone, or an avascular necrosis. In two cases a stress fracture was encountered in the first 3 months after surgery, but these healed uneventfully with partial weight bearing for 5 weeks.

Hallux Valgus↗

PubMedDate not supplied

[Long-term results of the treatment of medial femoro-tibial gonarthrosis by tibial valgisation osteotomy. Outcome of 93 osteotomies after more than 10 years].

Amongst the 250 tibial valgisation osteotomies performed for medial femoro-tibial osteoarthrosis of the knee between 1970 and 1973, only 93 in 66 patients could be followed up for 10 years or more (10-13 years). The long term outcome of the operation is dominated by frontal angular correction. The radiological and clinical result was regularly satisfactory after ten years only when the valgus was between 3 and 6 degrees. With more than 6 degrees valgus, there was deterioration of the lateral femoro-tibial compartment in all cases. Clinical and radiological results were variable with more than 3 degrees varus and were all the worse when there was considerable persistent varus. However functional impairment of those knees in which correction was inadequate occurred only after a mean latent period of 7 years. It remained slow and moderate, offering the possibility of a new osteotomy in case of failure. This would confirm that tibial osteotomy has at least two actions: a trophic action which disappears at about 7 years and a mechanical action, the importance of which appears in the long term. It is therefore felt that tibial valgisation osteotomy is a sufficiently reliable operation to be proposed in all cases of symptomatic and progressive osteoarthrosis with genu varum. Correction and results are all the more satisfactory when the operation is carried out before flexion deformity or laxity interfere with the accuracy of the correction. A preference for the insertion of a prosthesis may be preferred only in the elderly (the authors preferring the medial unicompartmental type), the principal advantage being to decrease the relatively long period of postoperative immobilisation following osteotomy.

Aged↗

PubMed1977

The pivotal metatarsal osteotomy: a modification of the metatarsal metaphyseal osteotomy.

The presence of cancellous bone determines the choice of location for osteotomies in the metatarsals. The head and base have good cancellous bone, whereas the shaft has cortical bone and a medullary canal which make it a poor choice of osteotomy site. Many practitioners are now using a transverse metaphyseal osteotomy; however, the authors choose the pivotal metaphyseal osteotomy as the procedure of choice using a 10- or 12-mm Pivotal Osteotomy Blade attached to an oscillating power source.

Humans↗

PubMedDate not supplied

The effect of unilateral varus rotational osteotomy with or without pelvic osteotomy on the contralateral hip in patients with perinatal static encephalopathy.

Forty-eight patients with perinatal static encephalopathy were treated with unilateral varus rotational femoral osteotomy for hip subluxation. Twenty-one of the 48 also had concomitant pelvic osteotomy. Twenty-seven of the patients were nonambulators. Bilateral soft-tissue releases had been performed previously in 20 patients. At the time of varus rotational osteotomy, the mean age was 8 years, 11 months. The indication for a varus rotational osteotomy was femoral head subluxation or dislocation in all cases. The preoperative center-edge angle ranged from -8 degrees to 18 degrees (mean, 4 degrees), and on the contralateral side, the center-edge angle ranged from 0 degree to 32 degrees (mean, 19 degrees). The center-edge angle on the operative side at follow-up averaged 25 degrees (-10 degrees to 78 degrees), an improvement of 21 degrees, and on the contralateral side averaged 27 degrees (range, 9 degrees-40 degrees), an improvement of 8 degrees. Forty-seven patients have had no subsequent surgery on the contralateral hip. One patient had a varus rotational osteotomy on the contralateral hip 5 years postoperatively; however, this hip was subluxated at the time of the index procedure. Twelve patients have had no surgery at any time on the contralateral side. None of these patients had deterioration of the contralateral hip. Surgery on one hip should not, in itself, be an indication for surgery on the contralateral concentrically reduced hip with adequate abduction in patients with acetabular dysplasia secondary to perinatal static encephalopathy.

Adolescent↗

PubMed1997

Skeletal and dento-alveolar stability of Le Fort I intrusion osteotomies and bimaxillary osteotomies in anterior open bite deformities. A retrospective three-centre study.

A sample of 267 patients with maxillary hyperplasia, a Class I or Class II/I occlusion and anterior vertical open bites, collected from three different institutions, was analysed regarding stability after surgical corrections. Skeletal and dento-alveolar stability of the maxilla, and positional changes of the mandible and of the incisors were evaluated. All patients underwent Le Fort I intrusion osteotomies and in 92 patients segmentation of the maxillae was performed. An additional bilateral sagittal split advancement osteotomy was performed in 123 patients. Intraosseous wire fixation was used in 153 patients and rigid internal fixation in 114 patients. Cephalometric radiographs were collected before orthodontic treatment, before surgery, immediately after surgery, one year postoperatively and at the latest follow up. The mean follow up was 69 months (range 20-210 months). It can be concluded that patients with anterior open bites, treated with a Le Fort I osteotomy in one-piece or in multi-segments, with or without bilateral sagittal split osteotomy, exhibited good skeletal stability of the maxilla. Rigid internal fixation produced the best maxillary and mandibular stability. The mean overbite at the longest follow up was 1.24 mm and a lack of overlap between opposing incisors was present in 19%. The overbite did not differ significantly between the different treatment procedures, probably due to compensatory movements of the mandibular and maxillary incisors.

Adolescent↗

PubMed1994

Long-term neurosensory deficits associated with bilateral sagittal split osteotomy versus inverted 'L' osteotomy.

Ten cases of bilateral sagittal split osteotomies and nine cases of intraoral inverted "L" osteotomies were examined for postsurgical neurosensory disturbances. Neurosensory tests included brushstroke direction, temperature, and light touch. All patients completed a short questionnaire that elicited subjective information with respect to neurosensory symptoms and their perception of the surgical results. Analysis of the data obtained from the tests of neurosensory disturbances revealed no significant differences between the two surgical groups. The variance of the scores on each of the neurosensory disturbances measures was significantly greater (p < 0.01) for the BSSO group. Analysis of the data from the questionnaire indicated that BSSO patients were significantly more likely to report postsurgical hypoesthesia of the lip (p < 0.01) and chin (p < 0.001) than the intraoral inverted "L" osteotomies group. None of the intraoral inverted "L" osteotomies group reported a moderate level of hypoesthesia of the lower lip or the chin, 66% reported no lip hypoesthesia, and 89% indicated no hypoesthesia in the chin area. In contrast, 33% of the BSSO group reported moderate hypoesthesia of the lip, and 22% reported moderate hypoesthesia of the chin. All patients in both groups expressed satisfaction with the surgical outcome, and had not changed their opinion on having the surgery. Although the tests of neurosensory disturbances revealed some disparity between the groups, the differences were not statistically significant. However, the subjective impressions of the groups differed regarding postsurgical neurosensory disturbances; the BSSO group related significantly more symptoms.

Adult↗

PubMed2004

Open wedge high tibial osteotomy: biomechanical investigation of the modified Arthrex Osteotomy Plate (Puddu Plate) and the TomoFix Plate.

OBJECTIVE: To determine the biomechanical properties of different fixation methods for high tibial medial opening wedge osteotomy in order to determine appropriate surgical and rehabilitation guidelines. DESIGN: A biomechanical testing examined the construct stiffness and the fixation strength of two different plates. BACKGROUND: Although medial opening wedge techniques for high tibial osteotomies have become popular in recent years, biomechanical data of frequently used implants is lacking. METHODS: A 15-mm medial opening gap was stabilized in each of eight medium composite tibial bones either with the modified Arthrex Osteotomy Plate (Puddu Plate) or the TomoFix Plate. RESULTS: Both constructs failed under compression and torsion at the lateral cortex and occurred at higher maximal forces by using the TomoFix Plate. After fracture of the lateral cortex the axial stiffness was reduced by 47% and the torsional rigidity by 54% for the TomoFix. For the Puddu Plate these reductions were 66% and 78%, respectively. The differences between the two groups were significant in all conducted tests (P < 0.05). CONCLUSIONS: This study indicates that an unharmed lateral hinge largely dictates the stability after high tibial osteotomy. If the lateral cortex is injured, the TomoFix plate provides superior stability in both compression and torsion compared to the Puddu Plate. In the latter case additional fixation might be considered. RELEVANCE: These biomechanical tests helped to identify clinical situations in which the mechanical attributes of the plates would prove advantageous.

Biomimetic Materials↗

PubMed2006

Outcomes using an internal osteotomy and distraction device for corrective osteotomy of distal radius malunions requiring correction in multiple planes.

PURPOSE: Many different methods have been proposed for correction of distal radius malunions; however, precise correction of a severe malunion that requires simultaneous adjustment of displacement, angulation, and rotation in multiple planes is difficult. This prospective study measured radiographic and functional outcomes using an adjustable osteotomy, distraction, and fixation system for distal radius malunions that required correction in multiple planes. METHODS: Five consecutive patients with symptomatic distal radius malunions requiring correction in multiple planes were recruited into this study. All patients had correction of the malunion with an adjustable osteotomy, distraction, and fixation device. Radiographic parameters and objective and subjective functional outcomes were measured before surgery and at 3 months, 6 months, and 1 year after surgery. RESULTS: All radiographic measurements improved after surgery. Grip strength, pinch strength, and the Jebsen-Taylor test showed only marginal improvement. Ulnar deviation of the wrist and forearm pronation-supination improved, but the wrist extension-flexion arc did not. The Michigan Hand Outcomes Questionnaire showed improvement in all domains, and significant improvement was seen in the overall, work, aesthetic, and satisfaction domains. The Michigan Hand Outcomes Questionnaire, however, also indicated a substantial amount of residual impairment in all domains, including activities of daily living and pain. CONCLUSIONS: Corrective osteotomy with the adjustable osteotomy, distraction, and fixation device resulted in improvement in distal radius anatomy and function. However, not all improvements were statistically significant, and anatomy and function did not returned to baseline levels. Despite residual disability, patients noted substantial improvement in subjective outcomes. This system is useful for improving anatomy and function in distal radius malunions that require correction in multiple planes, but patients should be informed that they cannot expect to regain normal anatomy or function. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Activities of Daily Living↗

PubMed1978

Surgical-orthodontic approach to skeletal class III malocclusion. Analysis of 45 cases with evaluation of curved oblique osteotomy and sliding osteotomy.

A curved oblique osteotomy in which the ascending ramus was cut obliquely on a curved line from its anterior border to the angle was used for the treatment of 29 patients with skeletal Class III malocclusion, and 16 other patients were corrected by either an ordinary body ostectomy or a sliding osteotomy in the first premolar region. Both curved oblique osteotomy and sliding osteotomy could easily be performed with a Stryker's reciprocating saw, and osseous healing at the sites of surgery was rapid as a large area of intimate bony contact between the segments was obtained. The resulting profile and skeletal changes studied by cephalograms were excellent, with no significant relapse, and recovery of a stable occlusion was attained. The combined approach with orthodontists which included thorough analysis of each patient, preoperative alignment of the dental arches and postoperative care was essential for obtaining the best results.

Adolescent↗

PubMedDate not supplied

[Long-term management results of Pemberton's ilium osteotomy in combination with inter-trochanter derotation-varisation osteotomy in hip dysplasia of childhood].

AIM: The aim of the present study was to obtain long-term functional and radiographic results after a pericapsular osteotomy of the ilium (Pemberton) and a simultaneously performed derotation-varisation osteotomy of the proximal femur in children with developmental dysplasia of the hip (DDH) after the end of the maturity process. METHOD: The clinical results and x-ray measurements of 79 patients with 100 operated hips were analysed. The average follow-up time after surgery was 14 years and 7 months (range: 10.4 to 19.5 years). The indication for operation was determined using the acetabular angle of more than two standard deviations. RESULTS: The clinical investigation shows that 85 % of the operated patients had no functional limitations. 14 % of the patients had minor limitations and 1 % had major limitations in their hip movement. No patient suffered constant hip pain; 62 % had no pain even after long walking; 32 % had pain after walking for more than an hour; 6 % complained of hip pain after walking for less than an hour. The radiological measurements show that 95.9 % of the patients had normal or mildly pathological ACM angle scores, and 92.8 % had normal or mildly pathological CE angle scores. CONCLUSION: Surgical treatment of residual hip dysplasia by simultaneously performed pericapsular ilium and proximal femur osteotomy is very effective. Although a radiographically almost normal acetabulum could be documented in patients after the end of the maturity process, revalgisation of the proximal femur occurred. With an appropriate acetabular correction additional osteotomy of the femur might therefore be unnecessary.

Adolescent↗

PubMed2002

Radial osteotomy for late-stage Kienböck's disease. Wedge osteotomy versus radial shortening.

We have reviewed 20 patients with stage-IIIB and stage-IV Kienböck's disease in order to examine the efficacy of two forms of radial osteotomy, namely radial wedge osteotomy and radial shortening. Lateral closing wedge osteotomies and radial shortenings were carried out on 11 and nine patients, respectively. There were no preoperative differences with respect to age, gender, and radiological stage. After a mean follow-up of 29 months, all patients, in both groups, had either a good or an excellent outcome. After the lateral closing wedge osteotomy, the radioscaphoid angle significantly increased and the Ståhl index significantly decreased. Progression of the degenerative changes at the radioscaphoid joint was found in two patients in this group. By contrast, there were no significant changes in any radiological parameters after radial shortening. Both procedures gave acceptable clinical results in stage-IIIB and stage-IV Kienböck's disease.

Adolescent↗

PubMed1999

Changes in osseous correction after proximal tibial osteotomy: radiostereometry of closed- and open-wedge osteotomy in 33 patients.

33 patients (22 men), median age 54 (40-68) years, with medial gonarthrosis grades 1-3, were treated by closed-wedge osteotomy (high tibial osteotomy = HTO, n 16) or open-wedge osteotomy by hemicallotasis (hemicallotasis osteotomy = HCO, n 19). 2 patients were operated on bilaterally. The patients were studied by RSA (radiostereometric analysis) for measuring 3-D changes in the correction achieved. In the HTO group the RSA measurements were obtained at the time of plaster removal, 1 month later and 1 year after surgery. In the HCO group, the RSA measurements were performed at the time of removal of the external fixator, 1 month later and 1 year after surgery. After removal of the fixation, HTO was associated with increased medial/lateral and distal translation of the proximal segment, compared to HCO. In addition, the tibial plateau rotated more around the longitudinal axis of the tibia after HTO.

Adult↗