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Results for “Bone Malalignment”

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At least 793 records · Page 44Linked to original sources

PubMed1988

Treatment of femoral shaft fractures with the Brooker-Wills interlocking intramedullary nail.

Fifty femur fractures were treated with the Brooker-Wills intramedullary locking nail. The indications included subtrochanteric, subisthmal, segmental or comminuted acute fractures or nonunions, and intramedullary shortening procedures. Eighteen technical problems in 13 (26%) patients were encountered during insertion of the nail. The incidence of technical problems was high early in the series and in procedures done with the patient in the supine position. Adverse clinical results from technical errors occurred in two patients. Most technical errors seem avoidable with careful technique. The mean healing time was only 12.1 weeks and there were four nonunions (8%). One patient had a 10 degrees malunion, four patients had 1-2 cm of shortening, and there were two late device fractures. No patients had rotational malalignment or deep infections. The results and complication rate are comparable to those reported for other interlocking systems. The Brooker-Wills nail is useful for treatment of complex femur fractures and has been effective in preventing malrotation, angulation, and excessive shortening.

Adolescent↗

PubMed1995

Selective hindfoot arthrodesis for the treatment of adult acquired flatfoot deformity: an in vitro study.

An acquired flatfoot deformity with significant laxity at the transverse tarsal joint was created experimentally and the amount of correction that was obtained with selective hindfoot fusions was measured radiographically. Results showed that the talonavicular, double (talonavicular and calcaneocuboid), and triple arthrodeses were able to fully correct the deformity, including correction of hindfoot valgus with just a talonavicular fusion. Subtalar and calcaneocuboid fusions failed to completely correct the deformity. This study provides experimental evidence that although the triple joints are interconnected, they differ with respect to their ability to malalignment. We conclude that talonavicular or double arthrodesis will correct deformity in a flatfoot with considerable laxity through the transverse tarsal joint, but that a subtalar fusion will not provide consistent correction.

Adult↗

PubMed1992

Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis.

Fresh osteochondral allografts were used to repair post-traumatic osteoarticular defects in 92 knees. At the time of grafting, varus or valgus deformities were corrected by upper tibial or supracondylar femoral osteotomies. A survivorship analysis was performed in which failure was defined as the need for a revision operation or the persistence of the pre-operative symptoms. There was a 75% success rate at five years, 64% at ten years and 63% at 14 years. The failure rate was higher for bipolar grafts than for unipolar and the results in patients over the age of 60 years were poor. The outcome did not depend on the sex of the patient and the results of allografts in the medial and lateral compartments of the knee were similar. Careful patient selection, correction of joint malalignment by osteotomy, and rigid fixation of the graft are all mandatory requirements for success. We recommend this method for the treatment of post-traumatic osteochondral defects in the knees of relatively young and active patients.

Adolescent↗

PubMed1998

Intramedullary nailing and functional bracing of tibial shaft fractures: 167 cases followed for minimum 2 years.

We treated 167 diaphyseal tibial fractures without reaming and with intramedullary fixation, using an unlocked Küntscher nail. The patients were followed for a minimum of 2 years. The mean time to union was 16 weeks. There were no serious complications, but 1 case of nonunion, 1 case of deep infection and 2 cases of clinically relevant malalignment. Migration of the nail was observed in 11 cases. We conclude that this treatment is simple and gives satisfactory results in diaphyseal fractures after low- or mid-energy trauma.

Adolescent↗

PubMed1987

Cervical radiculopathy or myelopathy secondary to athetoid cerebral palsy.

Radiculopathy or myelopathy often occurs during adult life in patients who have athetosis. Herniation of an intervertebral disc, spondylosis, malalignment or instability of the cervical spine, or a combination of these lesions, can develop because of the athetoid hyperactivity. We reviewed the cases of ten patients who had cervical radiculopathy or myelopathy, or both, secondary to athetosis and who were surgically treated between the ages of thirty and fifty-eight years. The surgery consisted of discectomy, removal of osteophytes, and anterior interbody fusion. When several segments were involved, an extensive subtotal resection of the vertebrae and discs, followed by strut bone-grafting, was done.

Adult↗

PubMed1986

Idiopathic osteonecrosis of the first metatarsal sesamoid.

Four patients with histologically confirmed osteonecrosis of the first metatarsal sesamoid are presented. No patient was an athlete, nor recalled any noticeable trauma or significant stress as having occurred to the feet. No foot deformities or joint malalignments were found. Excellent results were obtained by excision of the affected sesamoid in all patients, after follow-up periods of 1 to 12 years. Microscopic findings were compatible with those seen in idiopathic osteonecrosis of the femoral head.

Adolescent↗

PubMed2005

Combined pelvic osteotomy in the treatment of both deformed and dysplastic acetabulum three years--prospective study.

Kuwait has a very high incidence of all types of developmental dysplasia of the hip. One of the most complicated forms is the deformed dysplastic acetabulum, which has not only abnormal orientation but it also has lost its shape by the pressure of the subluxed femoral head. The outer part of the socket involves the upper part of the original acetabulum, thus giving it a bipartite appearance. Clear border like edge separates this outer part from the inner part, which represents the lower part of the original acetabulum and it has no direct contact with the femoral head. Combined pelvic osteotomy (CPO) restores both the original shape and treats the malalignment of the acetabulum. Twelve children, aged between 18 and 54 months underwent CPO, two of them bilaterally. The follow up is between 36 - 60 months. In all cases, concentric stable reduction with good acetabular cover was obtained.

Acetabulum↗

PubMed1986

The effect of early weight-bearing in total knee arthroplasty.

Patients undergoing bilateral simultaneous total knee arthroplasty experienced early supported-weight-bearing on both knees. They were compared with two similar groups of patients whose postoperative weight-bearing on the operated extremity was markedly restricted. The clinical results and incidence of complications were similar in the three groups. There were no significant differences in the incidence of radiolucent lines at follow-up examination two to five years later. Bilateral simultaneous total knee arthroplasty is an effective and safe method of managing patients with arthritic knees where both require replacement. Early supported bilateral weight-bearing does not appear to have any deleterious effects on the bone-cement interface that can be detected on clinical or radiographic analysis. However, all patients should not be considered for bilateral prosthetic knee arthroplasty simply because they have arthritic changes in both knees and the procedure is efficacious. Frequently, only one knee is significantly painful or deformed, and its correction may relieve the opposite knee for an extended period. Bilateral operations are indicated when the pain and deformity of an unoperated knee will significantly retard the reconstructed knee, as in severe flexion contractures or malalignment.

Early Ambulation↗

PubMed1984

[Compensatory carpal malalignments].

This new nosological chapter deals with carpal malalignments due to osseous disorders which are secondary to alterations of the spatial coherence of the carpus with respect to variations in the form or in the volume of the carpal complex. The authors have included as well, the compensatory realignments which are secondary to modifications of the radial buttress. The malalignments secondary to disorders of the lunate (excision of the lunate, Kienböck's disease, lunar implants), scaphoid (excision of the scaphoid, nonunion, implants) as well as those due to proximally located malunions of the lower extremity of the radius, are studied. The therapeutic rationale which may be concluded from this study is exposed.

Bone Transplantation↗

PubMed2003

Operative repair of fourth and fifth toe corns.

METHODS: We report a retrospective review of 57 consecutive patients (72 feet) over a period of 20 years who had been treated operatively for either a lateral fifth toe corn or an interdigital corn of the fourth interdigital space more than two years previously. Of these, 51 patients (62 feet) returned for a follow-up evaluation at a minimum of two years (average of over seven years) which included a review of the interval history since the surgery, a physical examination, a radiographic evaluation, and assessment of the patient's satisfaction with the alignment and results of surgery. Treatment of 31 lateral fifth toe corns involved either a lateral condylectomy and flexor tenotomy or a complete condylectomy. Treatment of 31 interdigital corns comprised either a single condylectomy, double condylectomy of adjacent corns, or a complete condylectomy (hammertoe repair) of a symptomatic corn. Treatment in each case was dependent upon the severity of the deformity. RESULTS: There was found to be no significant difference in comparison of the two major groups (interdigital corns and lateral fifth toe corns) with the measurement of the relative length of the fourth and fifth metatarsals, toe malalignment, angulation of the fourth and fifth toes (MTP-4, MTP-5 angles), and the phalangeal-5 angle. Pain was relieved in 58 of 62 feet (93%) and subjective acceptable alignment was achieved in 54 of 62 feet (87%). At final follow-up 53 feet were rated by patients as excellent, seven as good, one as fair, and one as poor. Complications included numbness of the involved digit (six feet). There were two superficial infections. There were two cases of joint instability due to excessive bone resection. Joint stiffness was commonly observed (34/62 feet, 55%), but was not associated with diminished satisfaction at final follow-up. Mild asymptomatic recurrence of a callosity was noted in 10 feet and moderate or severe recurrence was noted in two feet. Dissatisfaction was associated with moderate or severe recurrence. CONCLUSION: In this retrospective study at an average of more than seven years, we achieved a high level of patient satisfaction treating both lateral fifth toe corns and interdigital corns with a partial and/or complete condylectomy, the choice depending upon the magnitude of the deformity and the callus, and the fixed nature of the lesser toe deformity.

Adult↗

PubMed2004

[Periprosthetic supracondylar femoral fractures: LISS or retrograde intramedullary nailing? Problems with the use of minimally invasive technique].

Retrograde intramedullary locking nailing as well as the LIS system are propagated as minimally invasive treatment options for distal femoral fractures following total knee arthroplasty. In a retrospective study, we reviewed the clinical results after operative treatment of 18 periprosthetic supracondylar femoral fractures. The fracture was stabilized with the less invasive stabilization system (LISS) in nine patients (average age: 80.3 years) and with a retrograde intramedullary locking nail in the remaining nine patients (average age: 76.8 years). The mean follow-up was 18.2 months (6-35 months). We did not find significant differences concerning the operation time (nailing 99.8 min vs 102.3 min with the LISS) or the length of stay in the hospital (nailing 10.6 days vs 12.7 days with the LISS). In one patient of the nailing group we found a valgus malalignment of 18 degrees. Seven patients in each group were satisfied with the clinical results. In one patient of the LISS group a revision due to an infection was necessary. In one patient of the nailing group a reosteosynthesis had to be performed. To sum up, both systems are useful tools in the treatment of dislocated periprosthetic fractures and both systems are not without any problems. However, under special consideration of the complications we found in our study, the LISS seems to be a better alternative in osteoporotic bone with a small distal fragment. The choice of the optimal implant should therefore depend on the type of fracture and knee arthroplasty, the type of bone, and the experience of the surgeon.

Activities of Daily Living↗

PubMed2003

[Anterior cruciate ligament reconstruction by autogenous bone-patellar tendon-bone graft: correlation between bone-tunnel position and clinical results].

The authors evaluate correlation between bone-tunnel position and clinical results of 50 patients, aged 18-47 years, after anterior cruciate ligament reconstruction by bone-patellar tendon-bone autograft with half-tunnel technique. The evaluation comprises the femoral tunnel placement at the lateral femoral condyle, the angle of the tibial tunnel to the medial joint line of the tibia and paraarticular location of the tibial tunnel width clinical outcome within one to five years prior to operation. Bone-tunnel placement was based on radiograms done in anteroposterior and lateral view. Clinical evaluation was based on the International Knee Documentation Committee (IKDC) scale. Statistical analysis was performed by using Fisher exact test, Mann-Whitney test and chi 2 test with Yates correction. The results show that placement the femoral tunnel anteriorly to the line which was perpendicular to the Blumensaat line where it starts to curve posteriorly and tibial tunnel angle of 75 degrees or more is associated with statistically significant worsened of clinical outcome. Malalignment of femoral tunnel placement characterised much larger effects of qualitative and quantitative changes.

Adult↗

PubMed1990

Late lengthening of the fibula for malaligned ankle fractures.

We describe a technique of lengthening osteotomy of the fibula for the late treatment of symptomatic malaligned or malunited fractures of the ankle. Good results at two to three years were achieved in five of six cases despite delays of up to four years from the original injury. The method can prevent progressive instability and degenerative arthritis.

Adult↗

PubMed2000

Supracondylar humerus fractures in children. Comparison of operative treatment methods.

A retrospective analysis was performed of 87 children treated operatively for supracondylar humerus fractures by 18 different surgeons during a 6-year period. No patient suffered from compartment syndrome or Volkmann's ischemic contracture. Early postoperative fracture displacement occurred in four (7%) of 60 patients with Type III fractures, and in one (4%) of 23 patients with Type II fractures. Displacement occurred in one (2%) of 52 Type III fractures stabilized with crossed medial and lateral Kirschner wires, whereas displacement occurred in two (28%) of seven Type III fractures stabilized with lateral wires only. Thirty-four patients could be located for long-term followup; complete examination of both upper extremities was performed on these 34 patients at an average of 33 months postoperatively. The long-term results were excellent in 19 (56%), good in seven (21%), fair in one (3%), and poor in seven (21%) patients. Five additional patients were not available for followup at the time of the current study, but had followup of at least 6 months available. Of the 39 patients with followup of at least 6 months, five patients' fractures (13%) healed with coronal plane malalignment greater than 10 degrees which resulted in gunstock deformity. There was no statistically significant relationship between treatment method and gunstock deformity. However, none of the patients with gunstock deformity had compromised activity because of the deformity, and all had full elbow extension and at least 130 degrees elbow flexion.

Adolescent↗

PubMed1996

Classification and treatment of axis body fractures.

We have classified 31 cases of axis body fracture by the type of bony injury depicted in radiographic images into the following four types: avulsion, transverse, burst, and sagittal fractures. The results of treatment in these types were retrospectively analyzed. In all of nine cases of avulsion fracture and two cases of transverse fracture, bone union was obtained by nonoperative treatment. All three cases of burst fracture healed, one by nonoperative treatment, and the remaining two by C2/3 anterior interbody fusion. Bone union was also obtained in all of the 17 cases of sagittal fracture, which included nonoperative treatment in 15 cases, and transoral atlanto-axial fusion in the remaining two cases. because many axis body fractures are inherently stable injuries, the authors normally select nonoperative treatment as initial therapy. However, in sagittal fractures, eight patients had sequelae of nuchal pain caused by osteoarthrosis of the atlanto-axial joint. As a result of these findings, the authors deem it appropriate to utilize atlanto-axial fusion when severe malalignment of the atlanto-axial joint is recognized.

Adult↗

PubMed2004

Comparison of the PFC Sigma fixed-bearing and rotating-platform total knee arthroplasty in the same patient: short-term results.

This study compares the fixed-bearing PFC Sigma Total Knee Arthroplasty to the recently introduced rotating-platform version of the same design in 26 patients. At an average follow-up time of 46 months for the fixed-bearing side and 16 months for the rotating-platform side, no significant differences were found in terms of knee preference, knee pain, range of motion, overall satisfaction, or Knee Society scores (KSSs). No revisions, subluxations, dislocations, or infections were seen. Also no radiographic evidence of component loosening, osteolysis, or malalignment was found in any knee. The results of cementing the PFC Sigma rotating-platform, posterior-stabilized total knee show excellent patient satisfaction at 1 year and comparable clinical and radiographic results to the fixed-bearing version.

Aged↗

PubMedDate not supplied

Transfibular osteotomy in the correction of ankle joint incongruity.

The mechanics involved in Danis-Weber-types B and C ankle fractures may allow the fibula to seek a shortened and externally rotated position following injury. Residual talar instability secondary to fibular malalignment may ensue if proper anatomic restoration is not achieved at the time of reduction. Evaluation of ankle incongruity may take the form of clinical, radiographic, and diagnostic techniques. Three case studies are presented in which fibular osteotomies were utilized to restore proper anatomic alignment and function to the ankle mortise.

Adult↗

PubMed1993

A new solid unreamed tibial nail for shaft fractures with severe soft tissue injury.

In a prospective study, 51 tibial shaft fractures with severe open or closed soft tissue damage were treated with a new, thin (8 mm or 9 mm) solid locking nail, inserted without reaming. At 6 months or more after trauma, 43 cases were reviewed. Fractures were classified according to Müller with six type A, 25 type B, and 12 type C fractures. In 13 cases there was group II (n = 8) or group III (n = 5) closed soft tissue damage (Tscherne). Of 30 open fractures, 16 were group OII, six were group OIIIA and eight were group OIIIB (Gustilo). Postoperative treatment in 42 of 44 cases was possible without additional cast or brace. Full weight bearing was achieved in 26 cases within 12 weeks, and in 42 cases within 26 weeks. In 43 cases, fracture healing occurred with a mean of 21.9 weeks (range 12-40 weeks). There was one case with valgus of 6 degrees and three cases with anterecurvatum deformities of 5 degrees to 10 degrees. In four cases there was an external rotation malalignment between 10 degrees and 20 degrees. In three cases we found an internal rotation deformity of 10 degrees to 20 degrees. Shortening between 0.5 and 1.0 cm was found in five cases, and in one case shortening was 1.5 cm. None of the patients had an osteomyelitis.

Adolescent↗