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[PMID]:28154993
[Au] Autor:Kutzner KP; Freitag T; Donner S; Kovacevic MP; Bieger R
[Ad] Endereço:Department of Orthopaedic Surgery and Traumatology, St. Josefs Hospital Wiesbaden, Beethovenstr. 20, 65189, Wiesbaden, Germany. kkutzner@joho.de.
[Ti] Título:Outcome of extensive varus and valgus stem alignment in short-stem THA: clinical and radiological analysis using EBRA-FCA.
[So] Source:Arch Orthop Trauma Surg;137(3):431-439, 2017 Mar.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The principle of implanting a calcar-guided short stem consists of an individual alignment alongside the medial calcar providing the ability of reconstructing varus and valgus anatomy in a great variety. However, still, there are broad concerns about the safety of extensive varus and valgus positioning in regard to stability, bony alterations, and periprosthetic fractures. MATERIALS AND METHODS: 216 total hip arthroplasties using a calcar-guided short stem (optimys, Mathys Ltd.) in 162 patients were included. Depending on postoperative CCD angle, hips were divided into five groups (A-E). Varus- and valgus tilt and axial subsidence were assessed by "Einzel-Bild-Roentgen-Analyse"(EBRA-FCA, femoral component analysis) over a 2-year follow-up. The incidence of stress-shielding and cortical hypertrophy as well as clinical outcome [Harris Hip Score (HHS)] were reported. RESULTS: Postoperative CCD angles ranged from 117.9° to 145.6° and mean postoperative CCD angles in group A-E were 123.3°, 128.0°, 132.4°, 137.5°, and 142.5°, respectively. After 2 years, the mean varus/valgus tilt was -0.16°, 0.37°, 0.48°, 0.01°, and 0.86°, respectively (p = 0.502). Axial subsidence after 2 years was 1.20, 1.02, 1.44, 1.50, and 2.62 mm, respectively (p = 0.043). No periprosthetic fractures occurred and none of the stems had to be revised. Rates of stress-shielding and cortical hypertrophy as well as HHS showed no significant difference between the groups. CONCLUSIONS: Valgus alignment results in increased subsidence but does not affect the clinical outcome. There is no difference in stress shielding and cortical hypertrophy between the groups. The authors recommend long term monitoring of valgus aligned stems.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Coxa Valga/epidemiologia
Coxa Vara/epidemiologia
Prótese de Quadril
Osteoartrite do Quadril/cirurgia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Coxa Valga/diagnóstico por imagem
Coxa Valga/fisiopatologia
Coxa Vara/diagnóstico por imagem
Coxa Vara/fisiopatologia
Feminino
Necrose da Cabeça do Fêmur/cirurgia
Quadril/cirurgia
Luxação Congênita de Quadril/cirurgia
Articulação do Quadril/cirurgia
Seres Humanos
Masculino
Meia-Idade
Osteoartrite/cirurgia
Fraturas Periprotéticas/epidemiologia
Complicações Pós-Operatórias/diagnóstico por imagem
Complicações Pós-Operatórias/fisiopatologia
Período Pós-Operatório
Desenho de Prótese
Radiografia
Radiologistas
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170524
[Lr] Data última revisão:
170524
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170204
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-017-2640-z


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[PMID]:27793326
[Au] Autor:Song HK; Choi HJ; Yang KH
[Ad] Endereço:Department of Orthopaedic Surgery, Ajou University School of Medicine, Suwon, South Korea.
[Ti] Título:Risk factors of avascular necrosis of the femoral head and fixation failure in patients with valgus angulated femoral neck fractures over the age of 50 years.
[So] Source:Injury;47(12):2743-2748, 2016 Dec.
[Is] ISSN:1879-0267
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The aim of our study was to identify the risk factors for avascular necrosis of the femoral head (AVN) and fixation failure (FF) after screw osteosynthesis in patients with valgus angulated femoral neck fractures. PATIENTS AND METHODS: We conducted a retrospective study of 308 patients (mean age, 72.5 years, range, 50-97 years), with a mean follow-up of 21.4 months (range, 12-64 months). The risk for failure in treatment (FIT) associated with patient- and fracture-related factors was evaluated by logistic regression analyses. RESULTS: FIT was identified in 32 cases (10.3%): 22 cases (7.1%) of AVN and 10 cases (3.2%) of FF. Initial valgus tilt>15° (p=0.023), posterior tilt>15° (p=0.012), and screw sliding distance (p=0.037) were significantly associated with FIT. FIT occurred in 7 patients (5.2%) with B1.2.1 fractures and 17 patients (48.6%) with B1.1.2 fractures (p<0.001). The odds of FIT were 17-fold higher in patients with initial valgus and posterior tilts>15° (B1.1.2) compared to patients with <15° of tilt in both planes (B1.2.1). CONCLUSION: The severity of initial deformity predicts AVN and FF in patients with valgus angulated femoral neck fractures. Patients with an initial valgus and posterior tilt>15° are reasonable candidates for primary arthroplasty due to high risk of FIT.
[Mh] Termos MeSH primário: Coxa Valga/patologia
Fraturas do Colo Femoral/cirurgia
Necrose da Cabeça do Fêmur/patologia
Fixação Interna de Fraturas
Fraturas por Osteoporose/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Parafusos Ósseos
Coxa Valga/diagnóstico por imagem
Coxa Valga/cirurgia
Feminino
Fraturas do Colo Femoral/diagnóstico por imagem
Fraturas do Colo Femoral/fisiopatologia
Necrose da Cabeça do Fêmur/diagnóstico por imagem
Necrose da Cabeça do Fêmur/cirurgia
Fixação Interna de Fraturas/efeitos adversos
Fixação Interna de Fraturas/métodos
Consolidação da Fratura
Seres Humanos
Masculino
Meia-Idade
Fraturas por Osteoporose/diagnóstico por imagem
Fraturas por Osteoporose/fisiopatologia
Radiografia
Estudos Retrospectivos
Falha de Tratamento
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161030
[St] Status:MEDLINE


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[PMID]:27257630
[Au] Autor:Snyder JS; Grigereit L; Russo A; Seib DR; Brewer M; Pickel J; Cameron HA
[Ad] Endereço:Section on Neuroplasticity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland 20892; Department of Psychology, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.
[Ti] Título:A Transgenic Rat for Specifically Inhibiting Adult Neurogenesis.
[So] Source:eNeuro;3(3), 2016 May-Jun.
[Is] ISSN:2373-2822
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The growth of research on adult neurogenesis and the development of new models and tools have greatly advanced our understanding of the function of newborn neurons in recent years. However, there are still significant limitations in the ability to identify the functions of adult neurogenesis in available models. Here we report a transgenic rat (TK rat) that expresses herpes simplex virus thymidine kinase in GFAP+ cells. Upon treating TK rats with the antiviral drug valganciclovir, granule cell neurogenesis can be completely inhibited in adulthood, in both the hippocampus and olfactory bulb. Interestingly, neurogenesis in the glomerular and external plexiform layers of the olfactory bulb was only partially inhibited, suggesting that some adult-born neurons in these regions derive from a distinct precursor population that does not express GFAP. Within the hippocampus, blockade of neurogenesis was rapid and nearly complete within 1 week of starting treatment. Preliminary behavioral analyses indicate that general anxiety levels and patterns of exploration are generally unaffected in neurogenesis-deficient rats. However, neurogenesis-deficient TK rats showed reduced sucrose preference, suggesting deficits in reward-related behaviors. We expect that TK rats will facilitate structural, physiological, and behavioral studies that complement those possible in existing models, broadly enhancing understanding of the function of adult neurogenesis.
[Mh] Termos MeSH primário: Células-Tronco Adultas/fisiologia
Modelos Animais
Neurogênese/fisiologia
Ratos Transgênicos
[Mh] Termos MeSH secundário: Células-Tronco Adultas/patologia
Animais
Ansiedade/fisiopatologia
Coxa Valga
Sacarose na Dieta
Comportamento Exploratório/fisiologia
Preferências Alimentares/fisiologia
Proteína Glial Fibrilar Ácida/metabolismo
Hipocampo/crescimento & desenvolvimento
Hipocampo/patologia
Hipocampo/fisiologia
Seres Humanos
Masculino
Bulbo Olfatório/crescimento & desenvolvimento
Bulbo Olfatório/patologia
Bulbo Olfatório/fisiologia
Recompensa
Simplexvirus
Timidina Quinase/genética
Timidina Quinase/metabolismo
Proteínas Virais/genética
Proteínas Virais/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dietary Sucrose); 0 (Glial Fibrillary Acidic Protein); 0 (Viral Proteins); EC 2.7.1.21 (Thymidine Kinase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE


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[PMID]:27125086
[Au] Autor:Savin L; Mihailescu D; Grierosu C; Botez P
[Ti] Título:EFFECT OF TRANEXAMIC ACID USE ON POSTOPERATIVE BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY.
[So] Source:Rev Med Chir Soc Med Nat Iasi;120(1):137-41, 2016 Jan-Mar.
[Is] ISSN:0048-7848
[Cp] País de publicação:Romania
[La] Idioma:eng
[Ab] Resumo:AIM: To monitor the effect of tranexamic acid use (Exacyl) on postoperative bleeding (aspiration), autologous blood transfusion (autotransfusion), allogeneic blood transfusion and postoperative anemia (difference between preoperative and immediate postoperative hemoglobin levels) in total knee arthroplasty. MATERIALS AND METHODS: This retrospective observational study was conducted on a sample of 457 patients who underwent endoprosthetic knee arthroplasty in the interval January 1, 2008-July 3O, 2014 at the Traumatology-Orthopedics Clinic of the Iasi Rehabilitation Hospital. The mean age of the study group was 66 years (range 32-84 years), 74.4% were female, 39.8% presented varus and 6.1% valgus malalignment. The study group was subdivided into two groups: Group 1 served as controls and underwent surgery without the administration of tranexamic acid and Group 2 received tranexamic acid. RESULTS: In group 1 the average amount of blood lost was significantly higher than in group 2, 1168.94 ml vs. 452.9 ml (p < 0.001). The use of a cell saver was required in 70% of group 1 patients with an average amount of auto transfused blood of 480.70 ml, significantly more frequent and in greater amounts than in group 2 (below 10%) with an average of 15.05 ml (p < 0.001). In this study tranexamic acid had not a statistically significant favorable effect on blood transfusion requirements and anemia syndrome. CONCLUSION: Tranexamic acid has a favorable effect on postoperative blood loss and its associated complications, with a favorable impact on both early clinical and functional recovery.
[Mh] Termos MeSH primário: Antifibrinolíticos/administração & dosagem
Artroplastia do Joelho
Hemorragia Pós-Operatória/prevenção & controle
Ácido Tranexâmico/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Artroplastia do Joelho/efeitos adversos
Coxa Valga/cirurgia
Coxa Vara/cirurgia
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 6T84R30KC1 (Tranexamic Acid)
[Em] Mês de entrada:1606
[Cu] Atualização por classe:160429
[Lr] Data última revisão:
160429
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160430
[St] Status:MEDLINE


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[PMID]:26951643
[Au] Autor:Higuchi C; Sugano N; Yoshida K; Yoshikawa H
[Ad] Endereço:Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Japan. Electronic address: c-higuchi@umin.ac.jp.
[Ti] Título:Is hip dysplasia a common deformity in skeletally mature patients with hereditary multiple exostoses?
[So] Source:J Orthop Sci;21(3):323-6, 2016 May.
[Is] ISSN:1436-2023
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Various deformities appear in hereditary multiple exostoses (HMEs). Deformities around the knee or ankle joints are easy to detect in this disease because such deformities are visible in appearance. However, deformities in the hip joints of skeletally mature patients are not well understood because their tumors are invisible. METHODS: To understand deformities around the hip joint in HMEs, we investigated 36 hip joints in 19 skeletally mature patients (12 males, 7 females). The mean age at last X-ray imaging investigation was 29.2 years (14.5-66.5 years). We evaluated the lesions of exostoses around the acetabulum and proximal femur, Wiberg's center-edge angle (CEA), neck-shaft angle (NSA), acetabular depth-width ratio (ADR), and Sharp's acetabular angle. RESULTS: No exostoses were present in four hips of three cases. Thirty-one hip joints had exostoses on the medial side of the femoral neck. Exostoses existed on the lateral side of the femoral neck in 16 hips. None of the patients had acetabuluar tumors. One patient experienced pain because of impingement between the acetabular rim and medial tumors of the femoral neck. The increase in NSA, which is an index of proximal femoral deformity, was common with a mean NSA of 147.3 °. Two indices of acetabular deformity, Sharp's angle and ADR, were within normal limits with a mean Sharp's angle of 41.3 ° and mean ADR of 269. The average CEA was 29.9 °. CONCLUSIONS: Hip dysplasia is not necessarily common in skeletally mature patients with HMEs. To determine the possibility of hip dysplasia in skeletally immature patients with HMEs, ADR may be a useful reference index.
[Mh] Termos MeSH primário: Coxa Valga/diagnóstico por imagem
Coxa Valga/epidemiologia
Exostose Múltipla Hereditária/diagnóstico por imagem
Exostose Múltipla Hereditária/epidemiologia
Luxação do Quadril/diagnóstico por imagem
Luxação do Quadril/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Distribuição por Idade
Idoso
Estudos de Coortes
Comorbidade
Feminino
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Prevalência
Radiografia/métodos
Índice de Gravidade de Doença
Distribuição por Sexo
Tomografia Computadorizada por Raios X/métodos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160309
[St] Status:MEDLINE


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[PMID]:26883657
[Au] Autor:Kold S
[Ad] Endereço:Head of Orthopaedic Reconstructive Section, Aarhus University Hospital, Nørrebrogade, 8000, Aarhus, Denmark. s.kold@dadlnet.dk.
[Ti] Título:CORR Insights(®): Is there an Increase in Valgus Deviation in Tibial Distraction Using the Lengthening Over Nail Technique?
[So] Source:Clin Orthop Relat Res;474(5):1292-3, 2016 May.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Pinos Ortopédicos
Remodelação Óssea
Coxa Valga/etiologia
Osteogênese por Distração
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:COMMENT; JOURNAL ARTICLE
[Em] Mês de entrada:1608
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160218
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-016-4751-1


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[PMID]:26825816
[Au] Autor:Park H; Ryu KJ; Kim HW; Hwang JH; Han JW; Lee DH
[Ad] Endereço:Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Título:Is there an Increase in Valgus Deviation in Tibial Distraction Using the Lengthening Over Nail Technique?
[So] Source:Clin Orthop Relat Res;474(5):1283-91, 2016 May.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: During tibial lengthening, the soft tissues of the posterolateral compartment produce distraction-resisting forces causing valgus angulation. Although this occurs with the classic Ilizarov method, whether a valgus deformity develops with the lengthening over nail (LON) technique is questioned, because the intramedullary nail is thought to resist deforming forces and adequately maintain alignment of the distracted bone. QUESTIONS/PURPOSES: The purposes of this study were to (1) determine the amount of valgus deviation during tibial lengthening with the LON technique; and (2) analyze the factors that may be associated with valgus deviation with the LON technique. METHODS: Between June 2009 and September 2013, we performed 346 tibial lengthenings using the LON technique, lengthening and then nail technique, or lengthening with an intramedullary lengthening device. Sixty patients (120 tibias) who underwent bilateral lower leg lengthening with the LON technique were enrolled in this retrospective study. To limit the number of variables, we analyzed only the right tibia in all patients (60 tibias). The mean followup was 42 months (range, 26-71 months). The mean age of the patients was 25 years (range, 18-40 years). There were 36 male and 24 female patients. The mean final length gain was 67 ± 9 mm. The mean time for distraction was 100 ± 25 days. The overall valgus deviation was assessed by measuring the change in the medial proximal tibial angle and mechanical femorotibial angle on radiographs obtained before and after surgery and after completion of lengthening. Several demographic, surgical, and distraction-related variables were considered possible factors to prevent valgus deviation: proximal fixation method; presence of a blocking screw; diameter and length of the intramedullary nail; degree of nail insertion; length of the nail in the distal segment after completion of distraction; final length gain; and patient's BMI. During the period studied, the blocking screw was to maintain the mechanical axis in patients who had neutral or valgus alignment preoperatively, or to prevent more valgus change in patients who underwent acute correction of varus deformity intraoperatively. Uni- and multivariate analyses were conducted. RESULTS: Valgus deviation occurred during the tibial LON. The medial proximal tibial angle increased from 86° (95% CI, 85°-86°) to 90° (95% CI, 89°-91°) (p < 0.001). The mechanical femorotibial angle changed from 2.2° varus (95% CI, 3°-1.4° varus) to 2.6° valgus (95% CI, 1.8°-3.4° valgus) (p < 0.001). Valgus deviation was evident in proximal and distal segments. In the multivariate regression model, use of a blocking screw was the only factor that was associated with decreased valgus deviation, and its effect size, although detectable, was small (-2.62; 95% CI, -4.65 to -0.59; p = 0.013). CONCLUSIONS: We found that valgus deviation does occur during tibial lengthening using the LON technique, but that blocking screw placement may help to minimize the likelihood that severe valgus deviation will occur. Future prospective studies should be conducted to confirm this preliminary finding. LEVEL OF EVIDENCE: Level III, therapeutic study.
[Mh] Termos MeSH primário: Pinos Ortopédicos
Remodelação Óssea
Coxa Valga/etiologia
Osteogênese por Distração
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fenômenos Biomecânicos
Coxa Valga/diagnóstico
Coxa Valga/fisiopatologia
Feminino
Seres Humanos
Modelos Lineares
Masculino
Análise Multivariada
Osteogênese por Distração/efeitos adversos
Osteogênese por Distração/instrumentação
Osteogênese por Distração/métodos
Radiografia
Estudos Retrospectivos
Fatores de Risco
Tíbia/diagnóstico por imagem
Tíbia/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1608
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160131
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-016-4712-8


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[PMID]:25887815
[Au] Autor:Lee WC; Kao HK; Yang WE; Ho PC; Chang CH
[Ad] Endereço:Department of Pediatric Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
[Ti] Título:Guided Growth of the Proximal Femur for Hip Displacement in Children With Cerebral Palsy.
[So] Source:J Pediatr Orthop;36(5):511-5, 2016 Jul-Aug.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Guided growth by 1 eccentric transphyseal screw has been used to correct lower limb deformities. Pilot animal studies showed encouraging results in producing varus deformity in the proximal femur. The purpose of this study was to report the preliminary results of guided growth surgery to treat spastic hip displacement. METHODS: This case series study included consecutive patients who received soft-tissue release and guided growth at the proximal femur from January 2004 to May 2012 with minimal 2-year follow-up. Surgical indications were children with spastic cerebral palsy aged 4 to 10 years, a gross motor function classification system level IV or V, and hip displacement on 1 or both sides. Study outcomes were Reimer's migration percentage (MP) and the head-shaft angle (HSA). RESULTS: Nine children with 13 spastic displaced hips received surgery at the age of 6.2 years and were followed up for a mean of 45.6 months. The mean MP improved significantly from 52.2% preoperatively to 45.8% at 3 months, 40.3% at 1 year, and 37.1% at 2 years after operation. HSA was unchanged in the first 3 months, and deceased from 173.3 to 166.4 degrees at 1 year (P<0.01) and to 162.7 degrees at 2 years postoperatively. The screw was usually backed out from the femoral epiphysis in the second postoperative year, and no radiologic bony bar or other surgical complications occurred. CONCLUSIONS: The immediate postoperative improvement of MP was the result of soft-tissue release. From postoperative 3 months to 2 years, the HSA was reduced by 10.6 degrees and the MP further improved by 8.7%. Less surgical dissection, faster recovery of motion, and less comorbidity than varus osteotomy make guided growth surgery a treatment option for coxa valga in spastic hip displacement in nonambulant cerebral palsy children. LEVEL OF EVIDENCE: Level IV-therapeutic, case series.
[Mh] Termos MeSH primário: Parafusos Ósseos
Paralisia Cerebral/cirurgia
Coxa Valga/cirurgia
Epífises/cirurgia
Fêmur/cirurgia
Luxação do Quadril/cirurgia
[Mh] Termos MeSH secundário: Paralisia Cerebral/complicações
Criança
Pré-Escolar
Coxa Valga/diagnóstico por imagem
Coxa Valga/etiologia
Feminino
Fêmur/diagnóstico por imagem
Fêmur/crescimento & desenvolvimento
Seguimentos
Luxação do Quadril/diagnóstico por imagem
Luxação do Quadril/etiologia
Seres Humanos
Masculino
Osteotomia/métodos
Radiografia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150419
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000480


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[PMID]:26693491
[Au] Autor:Chen H; Hu X; Tang H; Yang G; Xiang M
[Ad] Endereço:Sichuan Orthopaedic Hospital, No. 132 Yihuan Road, Chengdu, Sichuan 610041, China.
[Ti] Título:Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS.
[So] Source:Biomed Res Int;2015:971216, 2015.
[Is] ISSN:2314-6141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO) with the proximal humeral internal locking system (PHILOS) for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 61-74) with valgus impacted proximal humeral fractures were enrolled in the study. The patients were treated with MIPPO using PHILOS-plate through the anterolateral delta-splitting approach. Rehabilitation exercises were done gradually. The NEER score and Constant-Murley score were used to evaluate shoulder function. All the patients were followed up by routine radiological imaging and clinical examination. There were 15 cases of II-part greater tuberosity fractures, 10 cases of III-part greater tuberosity fractures, and 2 cases of IV-part fractures according to the NEER classification. The surgery was successful in all patients with an average follow-up of 20.8 (range: 11-34) months. The fractures united in an average of 7.2 (6-14) weeks without implant loosening. According to NEER score, there were 17 excellent, 7 satisfactory, 2 unsatisfactory, and 1 poor. The mean Constant-Murley score was 89.4 ± 4.35. No complication including axillary nerve damage, postoperative nerve or vessel damage, infections, DVT, or death was observed. In conclusion, the MIPPO technique with the PHILOS through the anterolateral delta-splitting approach seems to be a safe and easy treatment for elderly valgus impacted proximal humeral fractures. A case-control study and longer follow-up time are needed.
[Mh] Termos MeSH primário: Coxa Valga/cirurgia
Fixação Interna de Fraturas/métodos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Fraturas do Ombro/cirurgia
[Mh] Termos MeSH secundário: Idoso
Coxa Valga/diagnóstico por imagem
Coxa Valga/patologia
Epífises/patologia
Epífises/cirurgia
Feminino
Fixação Interna de Fraturas/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos
Radiografia
Fraturas do Ombro/diagnóstico por imagem
Fraturas do Ombro/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1609
[Cu] Atualização por classe:170504
[Lr] Data última revisão:
170504
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151223
[St] Status:MEDLINE
[do] DOI:10.1155/2015/971216


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[PMID]:26290346
[Au] Autor:Chang CH; Wang YC; Ho PC; Hwang AW; Kao HK; Lee WC; Yang WE; Kuo KN
[Ad] Endereço:Department of Pediatric Orthopedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
[Ti] Título:Determinants of Hip Displacement in Children With Cerebral Palsy.
[So] Source:Clin Orthop Relat Res;473(11):3675-81, 2015 Nov.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Coxa valga and femoral anteversion often are seen in patients with spastic hip displacement and osteotomy is recommended. However, the relationship between femoral deformities and hip displacement has not been clearly defined and other factors, such as joint motion and posture, should be considered before recommending treatment. QUESTIONS: For children with cerebral palsy with Gross Motor Function Classification System Level IV or V, we questioned (1) whether hip abduction range correlates with hip displacement, (2) what the relationships are between proximal femoral deformities and hip displacement, and (3) whether the patient with a windblown posture has greater degrees of femoral anteversion? METHODS: We retrospectively studied 31 consecutive children with cerebral palsy with Level IV or V gross motor function who underwent three-dimensional CT for preoperative assessment of hip displacement between January 2010 and December 2013. Among the children, 23 had a windblown posture and eight had symmetric hip motion. Femoral anteversion and true neck-shaft angle were measured from the three-dimensional CT images. Migration percentage was the dependent variable we chose to study in relation to femoral anteversion, neck-shaft angle, maximal hip abduction, and hip flexion contracture, using correlations and multiple linear regressions. Using ANOVA and Scheffé's post hoc tests, we analyzed and compared the data of 23 abducted hips and 23 adducted hips in the 23 children with windblown posture and in 16 displaced hips in the eight children with symmetric hip abduction. RESULTS: Greater migration percentage was associated with less hip abduction range (r = -0.86; p < 0.001). Femoral anteversion had a weak correlation (r = 0.28; p < 0.05) to migration percentage, and the association became insignificant after considering hip abduction motion. Adducted windblown hips had greater femoral anteversion than the symmetric displaced hips and abducted windblown hips (46° vs 36° and 38°, respectively; p < 0.05). CONCLUSIONS: Our study results did not support a relationship between femoral deformities and hip displacement after considering gross motor function and hip abduction motion. Greater femoral anteversion was noted in the adducted hips of patients with windblown posture, and derotation osteotomy is especially recommended. LEVEL OF EVIDENCE: Level III, diagnostic study.
[Mh] Termos MeSH primário: Paralisia Cerebral/complicações
Coxa Valga/complicações
Fêmur/anormalidades
Luxação do Quadril/etiologia
Articulação do Quadril/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Fatores Etários
Fenômenos Biomecânicos
Paralisia Cerebral/diagnóstico
Paralisia Cerebral/fisiopatologia
Criança
Pré-Escolar
Coxa Valga/diagnóstico
Coxa Valga/fisiopatologia
Feminino
Fêmur/diagnóstico por imagem
Fêmur/fisiopatologia
Luxação do Quadril/diagnóstico
Luxação do Quadril/fisiopatologia
Articulação do Quadril/diagnóstico por imagem
Seres Humanos
Modelos Lineares
Masculino
Atividade Motora
Postura
Amplitude de Movimento Articular
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1601
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:150821
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-015-4515-3



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