Database : MEDLINE
Search on : Leg and Length and Inequality [Words]
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[PMID]: 29229292
[Au] Autor:Campbell TM; Ghaedi BB; Tanjong Ghogomu E; Welch V
[Ad] Address:Department of Physical Medicine and Rehabilitation, Elisabeth Bruyère Hospital, Ottawa, ON, Canada. Electronic address: tcampbell@bruyere.org.
[Ti] Title:Shoe Lifts for Leg Length Discrepancy in Adults With Common Painful Musculoskeletal Conditions: A Systematic Review of the Literature.
[So] Source:Arch Phys Med Rehabil;, 2017 Dec 09.
[Is] ISSN:1532-821X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To determine whether shoe lifts effectively treat leg length discrepancy (LLD)-associated morbidities in adults with common painful musculoskeletal conditions. DATA SOURCES: Trip database, Cochrane Central Register of Controlled Trials database, PubMed database, Physiotherapy Evidence Database, and National Guideline Clearinghouse database. The search was performed in September 2017, was limited to English only, and had no time constraints. STUDY SELECTION: Two reviewers independently determined study eligibility. Inclusion criteria were (1) participants ≥18 years old with musculoskeletal-related complaints and LLD; (2) a shoe lift intervention was used; and (3) the study reported on pain, function, range of motion, patient satisfaction, quality of life, or adverse events. Randomized controlled trials (RCTs) and controlled intervention, cohort, before-and-after, case series, and case report studies were included. Three-hundred and nineteen articles were screened, and 9 guidelines were reviewed. DATA EXTRACTION: We extracted data pertaining to participant demographic characteristics, study setting, recruitment, randomization, method of LLD measurement, shoe lift characteristics, treatment duration, and outcome measures. We included 10 studies, including 1 RCT. DATA SYNTHESIS: LLD was associated with low back pain, scoliosis, and osteoarthritis of the hip and knee. Description of LLD correction strategy was often inadequate. Study quality was very low or poor. In non-RCT studies reporting on the proportion of participants who improved with a shoe lift, 88%±3% of 349 participants treated had partial or complete pain relief (effect size range, 66.7%-100%). All 22 RCT participants receiving treatment experienced pain relief (mean pain reduction, 27±9mm on a 150-mm visual analog scale). Two of 9 guidelines recommended shoe lift use based on consensus and were of moderate-to-high quality. CONCLUSIONS: There is low-quality evidence that shoe lifts reduce pain and improve function in patients with LLD and common painful musculoskeletal conditions. High-quality research evaluating a threshold LLD to correct and a strategy to do so is necessary. Developing an appropriate comparison group to test clinically relevant outcome measures would make a valuable contribution in this regard.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 180210
[Lr] Last revision date:180210
[St] Status:Publisher

  2 / 2996 MEDLINE  
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[PMID]: 28448898
[Au] Autor:Eek MN; Zügner R; Stefansdottir I; Tranberg R
[Ad] Address:Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Box 21062, SE-418 04 Gothenburg, Sweden. Electronic address: meta.nystrom-eek@vgregion.se.
[Ti] Title:Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole.
[So] Source:Gait Posture;55:150-156, 2017 Jun.
[Is] ISSN:1879-2219
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP. RESULTS: Ten children with spastic CP, able to walk without aids, and 10 typically developing (TD) children aged between seven and 14 years were assessed with 3D gait analysis: 1) barefoot, 2) with shoes and 3) with an extra sole beneath the shoe for the shorter leg. All children with CP had a leg length discrepancy of more than or equal to 1.0cm. In the barefoot condition, the velocity was slower and the stride length was shorter, in children with CP compared with TD. The stride length and gait velocity increased in children with CP with shoes and shoe+sole and the stance time became more symmetrical. Among children with CP, there was more flexion in the longer leg relative to the short leg during barefoot walking. Differences in the kinematic pattern between the long and the short leg decreased with the extra sole.
[Mh] MeSH terms primary: Cerebral Palsy/physiopathology
Foot Orthoses
Gait Disorders, Neurologic/physiopathology
Leg Length Inequality/physiopathology
Leg Length Inequality/rehabilitation
[Mh] MeSH terms secundary: Adolescent
Case-Control Studies
Child
Female
Humans
Male
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180206
[Lr] Last revision date:180206
[Js] Journal subset:IM
[Da] Date of entry for processing:170428
[St] Status:MEDLINE

  3 / 2996 MEDLINE  
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[PMID]: 29292338
[Au] Autor:Hambright D; Hellman M; Barrack R
[Ad] Address:Barnes-Jewish Hospital , 660 South Euclid, Campus Box 8233, St. Louis, MO 63110, USA.
[Ti] Title:Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty.
[So] Source:Bone Joint J;100-B(1 Supple A):36-43, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:AIMS: The aims of this study were to examine the rate at which the positioning of the acetabular component, leg length discrepancy and femoral offset are outside an acceptable range in total hip arthroplasties (THAs) which either do or do not involve the use of intra-operative digital imaging. PATIENTS AND METHODS: A retrospective case-control study was undertaken with 50 patients before and 50 patients after the integration of an intra-operative digital imaging system in THA. The demographics of the two groups were comparable for body mass index, age, laterality and the indication for surgery. The digital imaging group had more men than the group without. Surgical data and radiographic parameters, including the inclination and anteversion of the acetabular component, leg length discrepancy, and the difference in femoral offset compared with the contralateral hip were collected and compared, as well as the incidence of altering the position of a component based on the intra-operative image. RESULTS: Digital imaging took a mean of five minutes (2.3 to 14.6) to perform. Intra-operative changes with the use of digital imaging were made for 43 patients (86%), most commonly to adjust leg length and femoral offset. There was a decrease in the incidence of outliers when using intra-operative imaging compared with not using it in regard to leg length discrepancy (20% 52%, p = 0.001) and femoral offset inequality (18% 44%, p = 0.004). There was also a difference in the incidence of outliers in acetabular inclination (0% 7%, p = 0.023) and version (0% 4%, p = 0.114) compared with historical results of a high-volume surgeon at the same centre. CONCLUSION: The use of intra-operative digital imaging in THA improves the accuracy of the positioning of the components at THA without adding a substantial amount of time to the operation. Cite this article: 2018;100B(1 Supple A):36-43.
[Mh] MeSH terms primary: Arthroplasty, Replacement, Hip/methods
Bone Anteversion/prevention & control
Hip Prosthesis
Intraoperative Care/methods
Leg Length Inequality/prevention & control
Postoperative Complications/prevention & control
Radiographic Image Enhancement
[Mh] MeSH terms secundary: Acetabulum/diagnostic imaging
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip/instrumentation
Bone Anteversion/epidemiology
Bone Anteversion/etiology
Female
Femur/diagnostic imaging
Humans
Leg Length Inequality/epidemiology
Leg Length Inequality/etiology
Male
Middle Aged
Operative Time
Postoperative Complications/epidemiology
Retrospective Studies
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180104
[Lr] Last revision date:180104
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180103
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0596.R1

  4 / 2996 MEDLINE  
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[PMID]: 29182127
[Au] Autor:Niedzielski K; Flont P; Domzalski M; Lipczyk Z; Malecki K
[Ti] Title:Lower limb equalization with percutaneus epiphysiodesis of the knee joint area.
[So] Source:Acta Orthop Belg;82(4):843-849, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] Country of publication:Belgium
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Epiphysiodesis has become one of the most popular methods in the treatment of leg length discrepancy (LLD) due to its surgical simplicity, short hospitalization time, and a low risk of complications. PATIENTS AND METHODS: A retrospective analysis was performed on 34 patients treated for LDD with percutaneus epiphisiodesis of the distal femur and/or the proximal tibia. The mean discrepancy was 2.8 cm. The outcome evaluation method was based on Kemnitz et al. RESULTS: Based on the Kemnitz criteria, 23 (67.6%) patients experienced good results, while 2 (5.9%) satisfactory and 9 (26.5%) poor results. In 47% of patients, swellings of the knee joint were observed in the postoperative period. One serious complication - varus deformity of 10 degrees in femur occurred in the follow-up period. CONCLUSIONS: Percutaneous epiphysiodesis is a simple method of the LLD correction, with a low rate of complications and applicable in cases of late LDD diagnosis.
[Mh] MeSH terms primary: Arthrodesis/methods
Bone Lengthening/methods
Epiphyses/surgery
Femur/surgery
Knee Joint/surgery
Leg Length Inequality/surgery
Tibia/surgery
[Mh] MeSH terms secundary: Adolescent
Child
Female
Humans
Male
Retrospective Studies
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171228
[Lr] Last revision date:171228
[Js] Journal subset:IM
[Da] Date of entry for processing:171129
[St] Status:MEDLINE

  5 / 2996 MEDLINE  
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[PMID]: 29182122
[Au] Autor:Castelein S; Docquier PL
[Ti] Title:Complications associated with bone lengthening of the lower limb by callotasis.
[So] Source:Acta Orthop Belg;82(4):806-813, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] Country of publication:Belgium
[La] Language:eng
[Ab] Abstract:The present study aims to assess the incidence of complications related to bone lengthening procedures and to identify factors that may predict these complications. We retrospectively studied 51 lengthening procedures in 39 patients (mean age 13 years) from 2001 to 2015. A circular external fixator was used in 37 procedures and a monolateral fixator in 14 procedures. Duration of distraction, fixator's time, days of treatment, lengthening percentage, bone healing index, distraction regenerate length, distraction index, risk factors and complications were evaluated. The mean follow-up was 5 years. Complications occurred in 84 % of the procedures. Duration of distraction, fixator's time, days of treatment and distraction regenerate length were predictors of complications. Close follow-up is necessary during distraction and healing period and after fixator removal.
[Mh] MeSH terms primary: Leg Length Inequality/surgery
Osteogenesis, Distraction/methods
Postoperative Complications/epidemiology
Prosthesis-Related Infections/epidemiology
Surgical Wound Infection/epidemiology
[Mh] MeSH terms secundary: Adolescent
Adult
Bone Nails
Child
Child, Preschool
Depression/epidemiology
External Fixators
Female
Follow-Up Studies
Humans
Incidence
Infant
Male
Pneumonia/epidemiology
Retrospective Studies
Risk Factors
Stress, Psychological/epidemiology
Time Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171228
[Lr] Last revision date:171228
[Js] Journal subset:IM
[Da] Date of entry for processing:171129
[St] Status:MEDLINE

  6 / 2996 MEDLINE  
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[PMID]: 29182105
[Au] Autor:Zhang YT; Jin D; Niu J; Li ZJ; Fu S; Zou ZL
[Ti] Title:A meta-analysis of external fixation and flexible intramedullary nails for femoral fractures in children.
[So] Source:Acta Orthop Belg;82(4):673-680, 2016 Dec.
[Is] ISSN:0001-6462
[Cp] Country of publication:Belgium
[La] Language:eng
[Ab] Abstract:Background : The purpose of this meta-analysis was to compare the outcomes of external fixation and flexible intramedullary nails for femoral fractures in children between 5 and 15 years of age based on the current evidence. Materials and methods: We searched relevent studies in the following database: Cochrane library, PubMed and EMABASE up to May 2014. All randomized controlled trials, Clinical controlled trials and retrospective controlled studies comparing external fixation and flexible intramedullary nails in femoral fractures of children were included. Data was extracted independently for meta-analysis. Results: Seven trials altogether involving 338 cases of femoral fractures of children treated by external fixation (128 cases) and flexible intramedullary nails (210 cases) were included in the meta-analysis. Results showed that flexible intramedullary nails was superior to external fixation in less time to union , lower postoperative infection rate and refracture rate . It may not increase delayed union, Limb-length discrepancy , pain and bursitis . Both fixations obtained a similar patient satisfaction. conclusion: Flexible intramedullary nail had greater advantages for the treatment of femoral fractures in children aged 5-15 years, compared to external fixation based on current meta-analysis. This conclusion will ultimately require rigorous and adequately powered randomized controlled trials to be proved.
[Mh] MeSH terms primary: Bone Nails
Femoral Fractures/surgery
Fracture Fixation, Intramedullary/methods
Fracture Healing
Pain, Postoperative/epidemiology
Surgical Wound Infection/epidemiology
[Mh] MeSH terms secundary: Adolescent
Bursitis/epidemiology
Child
Child, Preschool
Fracture Fixation/methods
Humans
Leg Length Inequality/epidemiology
Patient Satisfaction
Postoperative Complications/epidemiology
Treatment Outcome
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Entry month:1712
[Cu] Class update date: 171228
[Lr] Last revision date:171228
[Js] Journal subset:IM
[Da] Date of entry for processing:171129
[St] Status:MEDLINE

  7 / 2996 MEDLINE  
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[PMID]: 29193926
[Au] Autor:Zierenberg García C; Beaton Comulada D; Pérez López JC; Lamela Domenech A; Rivera Ortiz G; González Montalvo HM; Reyes-Martínez PJ
[Ti] Title:Acute Shortening and re-lengthening in the management of open tibia fractures with severe bone of 14 CMS or more and extensive soft tissue loss.
[So] Source:Bol Asoc Med P R;108(1):89-92, 2016.
[Is] ISSN:0004-4849
[Cp] Country of publication:Puerto Rico
[La] Language:eng
[Ab] Abstract:INTRODUCTION: A traumatic event to the tibia with more than 14 cm of bone and soft tissue loss represents a challenge to most orthopedic surgeons and is considered a limb-threatening condition. Few solutions are available in such clinical situations and among them is the acute shortening and re-lengthening of bone and soft tissue. MATERIALS AND METHODS: Our study presents the management of 7 patients with grade III B open fractures (according to the Gustillo-Anderson classification) of the tibia who underwent resection of all the devitalized tissues, acute limb shortening to close the defect, application of an external fixator, and metaphyseal osteotomy for re-lengthening. The patient outcomes were based on different parameters using the evaluation system established by Paley et al. RESULTS: Results acquired during the study show an average bone loss of 19cm (with a minimum of 14 cm and a maximum of 31.50cm). The average time to full recovery of all patients was 19 months with a minimum of 14 months and a max of 34 months. Patient presented with excellent bony union and none existent or small refractory leg length discrepancy and did not require bone grafts or free flaps. Complications that the patients had were contractures, which required secondary procedures such as Achilles tendon re-lengthening and recurrent infections. DISCUSSION: Overall patients had excellent bone union and were able to perform activities of their daily living. The Ilizarov technique of compression-dis- traction osteogenesis is an elegant treatment option that should be considered in patients suffering such traumatic events providing excellent bony union and good functional outcomes for the patient.
[Mh] MeSH terms primary: Fractures, Open/surgery
Leg Length Inequality/surgery
Soft Tissue Injuries/etiology
Tibial Fractures/surgery
[Mh] MeSH terms secundary: Adolescent
Adult
External Fixators
Fracture Fixation/methods
Fracture Healing/physiology
Humans
Ilizarov Technique
Leg Length Inequality/etiology
Osteotomy/methods
Recovery of Function
Soft Tissue Injuries/pathology
Tibial Fractures/complications
Time Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171214
[Lr] Last revision date:171214
[Js] Journal subset:IM
[Da] Date of entry for processing:171202
[St] Status:MEDLINE

  8 / 2996 MEDLINE  
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[PMID]: 29081149
[Au] Autor:Zhang HF; Liao JL; Ji M; Tang SY; Jin JF; Chen L; Wu LJ
[Ad] Address:Institute of Digitized Medicine, Wenzhou Medical University, Zhejiang 325035, China.
[Ti] Title:[Effect of simulating leg length inequality on spinal and pelvic posture in the elderly].
[So] Source:Zhonghua Yi Xue Za Zhi;97(39):3062-3067, 2017 Oct 24.
[Is] ISSN:0376-2491
[Cp] Country of publication:China
[La] Language:chi
[Ab] Abstract:To study the effects of simulating leg length inequality on the spine and pelvic posture in standing and walking states and to explore their compensatory laws. From January to April, a total of 44 healthy volunteers were rasterstereographically examined for spine and pelvis in Institute of Digitized Medicine, Wenzhou Medical University and Department of Orthopaedics, First Affiliated Hospital of Wenzhou Medical University.Volunteers wore uniform shoes, and single 5 mm thick insoles were customized.The simulating leg length inequalities (5-30 mm) were artificially created by increasing insole height.The parameters of 3D body surface parameters and 4D dynamic parameters of the pelvic and spine were measured and statistically analyzed in standing and walking states. In the static standing state, with the increase of the difference of both lower extremities, coronal plane pelvic tilt and sagittal plane pelvic torsion also increased[the maximum value about (10.6±4.3) mm and (3.3±3.5)°], as well as the frontal deviation of the spine [the maximum value about (11.1±17.9) mm]. But the pelvic rotation, vertebral surface rotation angle (rms) and spine sagittal plane deviation were no obvious changes.In the walking state, with the difference between lower extremities increased, the maximum angles of vertebral surface rotation to the left and right and pelvic rotation to the left and right were no obvious changes, but (coronal) spinal maximum offset distance to left and right increased [the maximum value about (9.8±5.1), (10.4±6.9) mm]. The effect of the leg length discrepancy on the pelvic coronal plane and the sagittal plane changes are obvious, but little effect has on the pelvic cross section.The pelvis is compensated by the increase of the inclination of the coronal plane and the sagittal angle at first order.Similarly, the effect on the coronal plane of the spine is more markedly, but the changes of sagittal and cross-section of the spine is less affected, the spine is mainly compensated by the coronal plane bending at second order.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171030
[Lr] Last revision date:171030
[St] Status:In-Process
[do] DOI:10.3760/cma.j.issn.0376-2491.2017.39.005

  9 / 2996 MEDLINE  
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[PMID]: 29049196
[Au] Autor:Kurz S; Pieroh P; Lenk M; Josten C; Böhme J
[Ad] Address:aRG Numerical Simulation and Material Science, ZESBO - Center for Research on the Musculoskeletal System bDepartment of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Leipzig cDepartment of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
[Ti] Title:Three-dimensional reduction and finite element analysis improves the treatment of pelvic malunion reconstructive surgery: A case report.
[So] Source:Medicine (Baltimore);96(42):e8136, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Pelvic malunion is a rare complication and is technically challenging to correct owing to the complex three-dimensional (3D) geometry of the pelvic girdle. Hence, precise preoperative planning is required to ensure appropriate correction. Reconstructive surgery is generally a 2- or 3-stage procedure, with transiliac osteotomy serving as an alternative to address limb length discrepancy. PATIENT CONCERNS: A 38-year-old female patient with a Mears type IV pelvic malunion with previous failed reconstructive surgery was admitted to our department due to progressive immobilization, increasing pain especially at the posterior pelvic arch and a leg length discrepancy. The leg discrepancy was approximately 4 cm and rotation of the right hip joint was associated with pain. DIAGNOSIS: Radiography and computer tomography (CT) revealed a hypertrophic malunion at the site of the previous posterior osteotomy (Mears type IV) involving the anterior and middle column, according to the 3-column concept, as well as malunion of the left anterior arch (Mears type IV). INTERVENTIONS: The surgery was planned virtually via 3D reconstruction, using the patient's CT, and subsequently performed via transiliac osteotomy and symphysiotomy. Finite element method (FEM) was used to plan the osteotomy and osteosynthesis as to include an estimation of the risk of implant failure. OUTCOMES: There was not incidence of neurological injury or infection, and the remaining leg length discrepancy was ≤ 2 cm. The patient recovered independent, pain free, mobility. Virtual 3D planning provided a more precise measurement of correction parameters than radiographic-based measurements. FEM analysis identified the highest risk for implant failure at the symphyseal plate osteosynthesis and the parasymphyseal screws. No implant failure was observed. LESSONS: Transiliac osteotomy, with additional osteotomy or symphysiotomy, was a suitable surgical procedure for the correction of pelvic malunion and provided adequate correction of leg length discrepancy. Virtual 3D planning enabled precise determination of correction parameters, with FEM analysis providing an appropriate method to predict areas of implant failure.
[Mh] MeSH terms primary: Finite Element Analysis
Fracture Fixation/methods
Fractures, Malunited/surgery
Pelvic Bones/injuries
Reconstructive Surgical Procedures/methods
Surgery, Computer-Assisted/methods
[Mh] MeSH terms secundary: Adult
Bone Plates
Female
Fractures, Malunited/complications
Humans
Ilium/surgery
Imaging, Three-Dimensional
Leg Length Inequality/etiology
Leg Length Inequality/surgery
Osteotomy/methods
Pelvic Bones/surgery
Reoperation/methods
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171122
[Lr] Last revision date:171122
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008136

  10 / 2996 MEDLINE  
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[PMID]: 29039128
[Au] Autor:Fragomen AT; Fragomen FR
[Ad] Address:Weill Medical College, Cornell University, 535 East 70th Street, New York, NY, 10021, USA. FragomenA@hss.edu.
[Ti] Title:Distal femoral flexion deformity from growth disturbance treated with a two-level osteotomy and internal lengthening nail.
[So] Source:Strategies Trauma Limb Reconstr;12(3):159-167, 2017 Nov.
[Is] ISSN:1828-8936
[Cp] Country of publication:Italy
[La] Language:eng
[Ab] Abstract:Salter Harris fractures of the distal femur can lead to growth disturbance with resulting leg length inequality and knee deformity. We have looked at a case series (3) of patients who presented with a distal femur flexion malunion and shortening treated with a distal femoral osteotomy and plating and a proximal femoral osteotomy with a magnetic internal lengthening nail. Does a two-level osteotomy and internal fixation approach provide a reliable result both radiographically and functionally? The average knee extension loss was 12°, LLD 47 mm, PDFA 65°, MAD 2 mm. The patients were treated with an acute, posterior, opening wedge osteotomy of the distal femur stabilized with a lateral plate and screws and grafted with cancellous chips and putty. A second osteotomy was made proximally in the femur percutaneously, and the internal lengthening nail was inserted. Lengthening was done at approximately 1 mm/day. The average extension gain was 12°; amount of lengthening at the proximal site was 40 mm, LLD was 3 mm. The average PDFA was 81°, and MAD 3 mm. There were no complications. Functional results were excellent. Bone healing index was 24 days/cm. The average distance from the distal osteotomy to the joint line was 57 mm. The technique of two-level femur osteotomy stabilized with a plate and lengthening nail yielded excellent results with acceptable correction of deformity, full knee extension, and improved function. There were no complications including implant failure, infection, need for blood transfusion, knee stiffness, nonunion, compartment syndrome, or malunion.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1007/s11751-017-0298-2


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