Database : MEDLINE
Search on : Bone and Malalignment [Words]
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[PMID]: 29503035
[Au] Autor:Tajima T; Zenke Y; Yamanaka Y; Menuki K; Sakai A
[Ad] Address:Department of Orthopaedic Surgery, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. Electronic address: takafumi0216@yahoo.co.jp.
[Ti] Title:Pisiform malalignment associated with distal radius fractures.
[So] Source:J Orthop Sci;, 2018 Mar 01.
[Is] ISSN:1436-2023
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:BACKGROUND: The association of scaphoid or other carpal bone fractures with distal radius fractures is frequently reported, whereas few studies have described pisiform malalignment associated with distal radius fractures. The purpose of this study was to investigate the frequency and characteristics of pisiform malalignment associated with distal radius fractures. METHODS: We performed a retrospective study by reviewing the data of 152 consecutive patients with a mean age of 63 years who were treated surgically for distal radius fractures during a five-year period. We evaluated the pisotriquetral joint via preoperative sagittal computed tomography (CT) and assessed pisiform malalignment. Pisiform malalignment was defined as follows: (1) wide type, joint space ≥4.0 mm; (2) non-parallel type, loss of parallelism of the joint surface of ≥20°; or (3) overriding type, proximal or distal overriding of the pisotriquetral joint ≥2.0 mm. We investigated the relationship between pisiform malalignment and the patterns of distal radius fractures. Pisiform malalignment was assessed using postoperative CT to determine whether it had been reduced. RESULTS: Pisiform malalignment was observed in 48 cases involving 44 patients with a mean age of 58 (17-81) years. The patients included 16, 17, and 15 cases of the wide type, non-parallel type, and overriding type, respectively. Distal radius fractures with dorsal displacement exhibited pisiform malalignment significantly more frequently than those with volar displacement. No significant difference was noted between intra- and extra-articular fractures or between patients with and without distal ulnar fractures. Among the 22 pisiform malalignment cases assessed via postoperative CT, 15 cases were reduced, and 7 cases remained malaligned. The non-parallel type exhibited the lowest reduction rate among the 3 types. CONCLUSIONS: Among distal radius fractures, 29% were complicated by pisiform malalignment. Distal radius fractures with dorsal displacement exhibited a significantly increased frequency of pisiform malalignment compared to those with volar displacement.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

  2 / 2640 MEDLINE  
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[PMID]: 29410077
[Au] Autor:Amsallem L; Pierrart J; Bihel T; Sekri J; Lafosse T; Masmejean E; Delgrande D
[Ad] Address:Service de chirurgie de la main, du membre supérieur et des nerfs périphériques, université Paris-Descartes, Sorbonne Paris Cité, hôpital européen Georges-Pompidou (HEGP), Assistance publique-Hôpitaux de Paris (AP-HP), 20, rue Leblanc, 75908 Paris cedex 15, France. Electronic address: lioramsallem@h
[Ti] Title:Simplified internal fixation of fifth metacarpal neck fractures.
[So] Source:Orthop Traumatol Surg Res;, 2018 Feb 02.
[Is] ISSN:1877-0568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:BACKGROUND: Fifth metacarpal neck fractures (boxer's fractures) are common injuries that contribute 20% of all hand fractures. Divergent percutaneous pinning (bouquet fixation) as described by Foucher has gained popularity but is challenging and at times arduous, as it requires the insertion of several slender K-wires into a narrow medullary canal. Here, we report on a simplified technique in which a single thick K-wire is inserted. TECHNIQUE: An 18/10 K-wire is bent at one end then mounted on a drill chuck. The incision is performed and the entry hole created using the K-wire, which is then advanced along the medullary canal. After reduction of the metacarpal head using the Jahss manoeuvre, the K-wire is inserted across the fracture site into the subchondral bone. Any persistent rotational malalignment is corrected by rotating the metacarpal around the K-wire. Immobilisation is by buddy taping covered by a resin guard. METHODS: We collected follow-up data for 30 patients treated using our technique, at a mean age of 32 years. RESULTS: 90 days after surgery, the fracture was healed in all patients. No patients had rotational malalignment. Mean operative time was 14minutes. No complications were recorded. DISCUSSION: The use of a single thick K-wire proved simple, effective, reproducible, and rapid. No rotational malalignment occurred. This technique is faster and easier to perform than divergent pinning with multiple K-wires. CONCLUSION: This technique can be used to treat fifth metacarpal neck fractures.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180304
[Lr] Last revision date:180304
[St] Status:Publisher

  3 / 2640 MEDLINE  
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[PMID]: 29273255
[Au] Autor:Woodmass JM; O'Malley MP; Krych AJ; Reardon PJ; Johnson NR; Stuart MJ; Levy BA
[Ad] Address:Department of Orthopedic Surgery & Sports Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
[Ti] Title:Revision Multiligament Knee Reconstruction: Clinical Outcomes and Proposed Treatment Algorithm.
[So] Source:Arthroscopy;34(3):736-744.e3, 2018 Mar.
[Is] ISSN:1526-3231
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To (1) assess clinical outcomes of revision multiligament knee injury (MLKI) reconstruction at a minimum of 2 years' follow-up and (2) present a standardized treatment algorithm used in treating revision MLKI patients. METHODS: A retrospective review of our institution's MLKI database was performed to identify all patients who underwent revision MLKI reconstructions (≥2 ligaments reconstructed) after implementation of a standardized treatment algorithm in 2000 and had a minimum of 2 years' follow-up. Patient demographic information, injury description (mechanism of injury, neurovascular status, knee dislocation grade, associated chondral or meniscal injury), surgical technique (repair vs reconstruction, staged vs nonstaged, concomitant procedures), mechanism of failure, knee stability, and range of motion, as well as International Knee Documentation Committee and Lysholm scores, were obtained. RESULTS: We assessed 23 patients (8 female and 15 male patients), with an average age of 26.7 ± 11.5 years at primary surgery and 30.8 ± 11.0 years at revision surgery. The mean follow-up period was 7.5 ± 5.3 years. Of the 23 patients, 10 (43.4%) underwent staged revision procedures: isolated bone grafting in 3, osteotomy in 4, hardware removal with osteochondral allograft in 1, hardware removal with bone grafting in 1, and meniscus repair for a locked knee in 1. The average International Knee Documentation Committee and Lysholm scores were 74.5 ± 22.3 and 79.4 ± 20.2, respectively. High-energy injury and increasing age at revision surgery were the only risk factors found to be associated with significantly worse outcomes (P < .05). CONCLUSIONS: Patients with recurrent instability after MLKI reconstruction present with many concomitant pathologies, including limb malalignment, bone tunnel widening, retained hardware, meniscal incompetence, and cartilage defects. Revision MLKI reconstruction can provide these patients with modest functional outcomes when a standardized treatment algorithm is used focusing on identification and treatment of the concomitant pathology, often in a staged manner. LEVEL OF EVIDENCE: Level IV, case series.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review

  4 / 2640 MEDLINE  
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[PMID]: 29294396
[Au] Autor:Goel A; Gore S; Shah A; Dharurkar P; Vutha R; Patil A
[Ad] Address:Department of Neurosurgery, K.E.M. Hospital and Seth G.S. Medical College, Parel, Mumbai; Lilavati Hospital and Research Centre, Bandra, Mumbai. Electronic address: atulgoel62@hotmail.com.
[Ti] Title:Atlantoaxial Fixation for Chiari 1 Formation in Pediatric Age-Group Patients: Report of Treatment in 33 Patients.
[So] Source:World Neurosurg;111:e668-e677, 2018 Mar.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: The role of atlantoaxial instability in the pathogenesis of Chiari 1 formation (Chiari formation) in pediatric age-group patients is evaluated. MATERIAL AND METHODS: During the period of January 2010 to June 2017, 33 pediatric patients having Chiari formation were treated with atlantoaxial fixation. Twenty-four patients had basilar invagination, and 9 patients had no bone abnormality at the craniovertebral junction. Sixteen patients had syringomyelia, and 9 patients had both basilar invagination and syringomyelia. Considering the type of facet alignment and atlantoaxial instability, the patients were divided into 3 groups. Type 1 dislocation (13 patients) was anterior atlantoaxial instability wherein the facet of the atlas was dislocated anterior to the facet of the axis. Type 2 dislocation (5 patients) was posterior atlantoaxial instability wherein the facet of the atlas was dislocated posterior to the facet of the axis. Type 3 dislocation (15 patients) was the absence of demonstrable facet malalignment. Type 2 and 3 atlantoaxial facet instability were labeled as central atlantoaxial dislocation. In 14 patients, dynamic images showed mobile and at least partially reducible vertical atlantoaxial dislocation. RESULTS: All patients were treated with atlantoaxial plate and screw fixation using techniques described in 1994 and 2004. Foramen magnum decompression or syrinx manipulation was not performed in any patient. Occipital bone and subaxial spinal elements were not included in the fixation construct. All patients had gratifying and sustained clinical improvement. CONCLUSIONS: The outcome further confirms the cause-effect relationship of Chiari formation and atlantoaxial instability.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  5 / 2640 MEDLINE  
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[PMID]: 29227353
[Au] Autor:Vina ER; Kwoh CK
[Ad] Address:Division of Rheumatology, Department of Medicine.
[Ti] Title:Epidemiology of osteoarthritis: literature update.
[So] Source:Curr Opin Rheumatol;30(2):160-167, 2018 Mar.
[Is] ISSN:1531-6963
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE OF REVIEW: The purpose of this review is to highlight recent studies of osteoarthritis epidemiology, including research on prevalence, disease impact, and potential risk factors. RECENT FINDINGS: Osteoarthritis is highly prevalent in the United States and around the globe. It is a leading cause of disability and can negatively impact people's physical and mental well being. Healthcare resources and costs associated with managing the disease can be substantial. There is increasing evidence that there are different osteoarthritis phenotypes that reflect different mechanisms of the disease. Various person-level risk factors are recognized, including sociodemographic characteristics (e.g. female sex, African-American race), genetic predispositions, obesity, diet-related factors, and high bone density/mass. Joint-level risk factors include specific bone/joint shapes, thigh flexor muscle weakness, joint malalignment, participation in certain occupational/sports activities, and joint injury. Recent studies have enhanced our understanding of preradiographic lesions associated with osteoarthritis. SUMMARY: Application of these new findings may allow us to develop innovative strategies and novel therapies with the purpose of preventing new disease onset and minimizing disease progression.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review
[do] DOI:10.1097/BOR.0000000000000479

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[PMID]: 29241817
[Au] Autor:Pollon T; Sales de Gauzy J; Pham T; Thévenin Lemoine C; Accadbled F
[Ad] Address:Département de chirurgie orthopédique, traumatologique et plastique, CHU de Toulouse, place du Dr-Baylac, 31059 Toulouse, France. Electronic address: tristan.pollon@gmail.com.
[Ti] Title:Salvage of congenital pseudarthrosis of the tibia by the induced membrane technique followed by a motorised lengthening nail.
[So] Source:Orthop Traumatol Surg Res;104(1):147-153, 2018 Feb.
[Is] ISSN:1877-0568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:An 18-year-old male with neurofibromatosis type I was treated for congenital pseudarthrosis of the tibia using the Masquelet induced-membrane technique with internal fixation by retrograde implantation of a transplantar intramedullary nail. Bone healing was obtained at the expense of malunion with external rotation and 5.5cm of lower limb shortening. A motorised intramedullary-lengthening nail (Fitbone , Wittenstein, Igersheim, Germany) was implanted. This treatment was successful in correcting the rotational malalignment and limb length discrepancy. The motorised nail Fitbone may be a valid option for treating complex cases of limb length discrepancy, including those combined with limb deformities.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Data-Review

  7 / 2640 MEDLINE  
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[PMID]: 29397444
[Au] Autor:Galbusera F; Bassani T; Stucovitz E; Martini C; Ismael Aguirre MF; Berjano PL; Lamartina C
[Ad] Address:Laboratory of Biological Structures Mechanics, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
[Ti] Title:Surgical treatment of spinal disorders in Parkinson's disease.
[So] Source:Eur Spine J;27(Suppl 1):101-108, 2018 Feb.
[Is] ISSN:1432-0932
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:PURPOSE: Most patients suffering from Parkinson's disease (PD) exhibit alterations in the posture, which can in several cases give rise to spine deformities, both in the sagittal and the coronal plane. In addition, degenerative disorders of the spine frequently associated to PD, such as spinal stenosis and sagittal instability, can further impact the quality of life of the patient. In recent years, spine surgery has been increasingly performed, with mixed results. The aim of this narrative review is to analyze the spinal disorders associated to PD, and the current evidence about their surgical treatment. METHODS: Narrative review. RESULTS: Camptocormia, i.e., a pronounced flexible forward bending of the trunk with 7% prevalence, is the most reported sagittal disorder of the spine. Pisa syndrome and scoliosis are both common and frequently associated. Disorders to the spinopelvic alignment were not widely investigated, but a tendency toward a lower ability of PD patients to compensate the sagittal malalignment with respect to non-PD elderly subjects with imbalance seems to emerge. Spine surgery in PD patients showed high rates of complications and re-operations. CONCLUSIONS: Disorders of the posture and spinal alignment, both in the sagittal and in the coronal planes, are common in PD patients, and have a major impact on the quality of life. Outcomes of spine surgery are generally not satisfactory, likely mostly due to muscle dystonia and poor bone quality. Knowledge in this field needs to be consolidated by further clinical and basic science studies. These slides can be retrieved under Electronic Supplementary Material.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Data-Review
[do] DOI:10.1007/s00586-018-5499-y

  8 / 2640 MEDLINE  
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[PMID]: 29218364
[Au] Autor:Garcia K; Jaramillo D; Rubesova E
[Ad] Address:Department of Pediatric Radiology, Lucile Packard Children's Hospital, 725 Welch Road, Palo Alto, CA, 94304, USA.
[Ti] Title:Ultrasound evaluation of stress injuries and physiological adaptations in the fingers of adolescent competitive rock climbers.
[So] Source:Pediatr Radiol;48(3):366-373, 2018 Mar.
[Is] ISSN:1432-1998
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:BACKGROUND: The impact of high-intensity, repetitive training on the fingers of adolescent climbers is relatively unknown. OBJECTIVE: To evaluate this effect by ultrasound (US) and to confirm some findings by magnetic resonance imaging (MRI). MATERIALS AND METHODS: The US study was performed in 20 adolescent rock climbers (ages 10-17 years) and 6 non-climbing controls (ages 11-15 years). US was used to examine the third digit of the right hand for differences in thickness of soft tissue, flexor and extensor tendon, volar plate and bony and growth plate adaptations. In four climbers with finger deformity or pain, 3-T MR images were compared with US findings. Number of hours/week and years of climbing were used to group climbers in three levels (3=most intense training). Mann-Whitney test was used for statistical analysis. RESULTS: Compared with non-climbing controls, climbers demonstrated significantly thicker flexor tendons, volar plates and soft tissues. Joint effusions were found in 13/19 (68%) climbers. Significant phalangeal malalignment was seen in 10/19 (53%) climbers. Growth plate deformities were identified in three level 3 climbers. US findings correlated with MRI for effusions, phalangeal growth plate injury, malalignment and adaptive changes. MRI additional showed capsule rupture (n=1), stress fracture (n=1) and phalangeal physeal stress injury (n=1). CONCLUSION: Competitive rock climbing results in physiological adaptations in the fingers, an example being significant soft-tissue hypertrophy of the flexor. US demonstrated several non-physiological changes in response to repetitive stress in half of the climbers. MRI showed additional stress injuries to the growth plate, joints and bone.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:In-Data-Review
[do] DOI:10.1007/s00247-017-4033-4

  9 / 2640 MEDLINE  
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[PMID]: 29476323
[Au] Autor:Scott CEH; Wade FA; MacDonald D; Nutton RW
[Ad] Address:Department of Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK. chloe.scott@nhslothian.scot.nhs.uk.
[Ti] Title:Ten-year survival and patient-reported outcomes of a medial unicompartmental knee arthroplasty incorporating an all-polyethylene tibial component.
[So] Source:Arch Orthop Trauma Surg;, 2018 Feb 23.
[Is] ISSN:1434-3916
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Biomechanical studies have suggested that proximal tibial strain is elevated in UKAs incorporating all-polyethylene tibial components with concern that this leads to premature failure. This study reports minimum 10-year outcomes for a UKA incorporating an all-polyethylene tibial component to determine whether these concerns were realised. MATERIALS AND METHODS: 109 fixed bearing UKAs (97 patients, mean age 68 (range 48-87), 54/97 (56%) female) with all-polyethylene tibial components were followed up for ≥ 10 years with Oxford Knee Scores, Forgotten Joint Scores and Kaplan-Meier analysis. 106/109 implants were 7 mm, 3 were 9.5 mm. RESULTS: Ten-year survival was 85.5% (78.6-92.4 95% CI) with the end-point failure for any reason. Unexplained pain was the commonest mode of failure (6/17) followed by lateral compartment osteoarthritis (5/17) and tibial subsidence/loosening (4/17). Revision rate was highest at 2-5 years due to revisions for unexplained pain. Ten-year survival was worse in patients < 65 years old (p = 0.035), in those with BMI > 30 (p = 0.017) and in those with postoperative increases in medial tibial sclerosis (p < 0.001 log-rank). Implant malalignment was not significantly associated with failure. Radioisotope bone scans in 16 patients all remained "hot" at mean 6.1 years (range 2.1-11.5). Relative risk of failure in patients < 65 years was 2.9 (1.2-7.0 95% CI) and when BMI > 30 was 2.9 (1.2-6.9 95% CI). In those with intact UKAs at 10 years, mean Oxford Knee Score was 34.8 ± 10.7, Forgotten Joint Score was 37.9 ± 26.7 and 96% were satisfied with their knee. CONCLUSION: The high rate of early failure between 2 and 5 years in this all-polyethylene tibial component UKA did not persist in the long term. Though medial proximal tibial metabolic changes appear to persist they are not necessarily symptomatic. BMI > 30 and age < 65 years were significant risk factors for revision.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:Publisher
[do] DOI:10.1007/s00402-018-2908-y

  10 / 2640 MEDLINE  
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[PMID]: 29396963
[Au] Autor:Redondo ML; Beer AJ; Yanke AB
[Ad] Address:Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
[Ti] Title:Cartilage Restoration: Microfracture and Osteochondral Autograft Transplantation.
[So] Source:J Knee Surg;31(3):231-238, 2018 Mar.
[Is] ISSN:1938-2480
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:The treatment of patellofemoral cartilage defects presents several distinct challenges when compared with cartilage restoration techniques used for other compartments of the knee due to the unique anatomy and distribution of forces. The etiologies of patellofemoral articular cartilage lesions include acute traumatic instability injuries, such as dislocation and subluxation, osteochondritis dissecans, and chronic degenerative changes. Regardless of the etiology, untreated patellofemoral cartilage lesions can contribute to activity-limiting anterior knee pain. The goal of patellofemoral cartilage restoration procedures is to impart symptomatic relief and improve quality of life by repairing the articular cartilage surface and any comorbid malalignment or maltracking.Microfracture and osteochondral autograft transplantation (OAT) are two cartilage restoration procedures to consider when treating full-thickness patellofemoral chondral defects. Considered by some experts to be the gold standard therapy, microfracture is one of the most common procedures used for cartilage restoration. The technique involves the perforation of the subchondral bone plate for the release of marrow elements, filling the defect with a fibrocartilage clot repair. Though less commonly used, OAT allows defect replacement with native hyaline cartilage via autologous transplantation from a non-weight bearing area. The purpose of this article is to discuss the indication, technical considerations, and outcomes of microfracture and OAT when used for treating chondral lesions of the patellofemoral joint.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Process
[do] DOI:10.1055/s-0037-1618592


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