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  1 / 2058 MEDLINE  
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[PMID]:29182127
[Au] Autor:Niedzielski K; Flont P; Domzalski M; Lipczyk Z; Malecki K
[Ti] Título: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] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo: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] Termos MeSH primário: Artrodese/métodos
Alongamento Ósseo/métodos
Epífises/cirurgia
Fêmur/cirurgia
Articulação do Joelho/cirurgia
Desigualdade de Membros Inferiores/cirurgia
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Criança
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


  2 / 2058 MEDLINE  
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[PMID]:28926385
[Au] Autor:Kocyigit IA; Olgun ZD; Demirkiran HG; Ayvaz M; Yazici M
[Ad] Endereço:1Department of Orthopaedics and Traumatology, Hacettepe University School of Medicine, Ankara, Turkey 2University Orthopaedics, Hawthorne, New York.
[Ti] Título:Graduation Protocol After Growing-Rod Treatment: Removal of Implants without New Instrumentation Is Not a Realistic Approach.
[So] Source:J Bone Joint Surg Am;99(18):1554-1564, 2017 Sep 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The growing rod remains an effective option in the treatment of early-onset scoliosis, and has previously been likened to an internal brace. While details of growing-rod treatment have been largely agreed on, the appropriate end point remains a matter of controversy. A decision was made in 2004, at the beginning of growing-rod treatment at our institution, to remove longitudinal instrumentation when the period of lengthening concluded and, similar to discontinuing a brace, leave the spine free. METHODS: From 2004, patients managed with a growing rod who were ≤10 years old at the time of the index surgery and had no previous surgery were enrolled in the prospective treatment pathway. For this report, the inclusion criteria were complete records and radiographs; regular lengthenings; no complications defined as SV (severity grade) IIA, IIB, III, or IV; and a minimum follow-up of 2 years after reaching the age of 14 years. At the age of 14 years, the patients were reevaluated and 1 of 3 treatments was undertaken. In Group 1, which included patients with adequate correction and no requirement for extension of fusion, the growing rods were removed. In Group 2, which included patients with inadequate correction and/or interval changes, the growing rods were removed and instrumented fusion was performed. In Group 3, which included patients with a Risser sign of 0 or who were otherwise immature, lengthening was continued. RESULTS: Twenty-six patients met the inclusion criteria. The mean age at the time of the index operation was 82.6 months. There were 10 patients in Group 1, 9 patients in Group 2, and 7 patients in Group 3. Of the 10 patients whose rods were removed without additional instrumentation, 9 had clinically important worsening of the deformity and required reimplantation with fusion. CONCLUSIONS: Despite the initial intention to remove the implants, allow the spine to regain motion, and observe patients when they turned 14, the results of this report reveal that only 10 of the initially included 26 patients met the criteria to do so. In 9 of these patients, the deformity worsened after removal, confirming that prolonged growing-rod treatment does not necessarily result in spontaneous, reliable fusion. Removal of spinal implants without new instrumentation is not a realistic graduation protocol following growing-rod treatment, and implants should be retained, or if extension is required, another procedure should be undertaken. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Alongamento Ósseo/instrumentação
Próteses e Implantes
Escoliose/cirurgia
Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Crescimento
Seres Humanos
Masculino
Complicações Pós-Operatórias/etiologia
Estudos Prospectivos
Estudos Retrospectivos
Fusão Vertebral/instrumentação
Fusão Vertebral/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170920
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.17.00031


  3 / 2058 MEDLINE  
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[PMID]:28481811
[Au] Autor:Hammouda AI; Jauregui JJ; Gesheff MG; Standard SC; Herzenberg JE
[Ad] Endereço:International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD.
[Ti] Título:Trochanteric Entry for Femoral Lengthening Nails in Children: Is It Safe?
[So] Source:J Pediatr Orthop;37(4):258-264, 2017 Jun.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Antegrade intramedullary (IM) nailing for skeletally immature femur fractures can damage the capital femoral epiphysis blood supply, leading to avascular necrosis (AVN) of the femoral head. Reported AVN rates are 2% for piriformis entry and 1.4% for trochanteric entry. None of previous reports described IM lengthening nails for limb lengthening procedures. We have used self-lengthening telescopic nails with a proximal Herzog bend and standard trochanteric entry for femoral lengthening in children. The purpose of this study is to determine whether trochanteric entry IM lengthening nails can be used safely (no AVN or proximal femoral deformity) in the skeletally immature femur. METHODS: A retrospective review was performed between 2004 and 2014 to determine all skeletally immature patients younger than 18 years of age who had a reamed IM lengthening nail inserted through the greater trochanter, with at least 1-year follow-up. RESULTS: Thirty-one femurs were lengthened in 28 patients (17 males and 11 females). The etiology was congenital femoral deficiency (10), achondroplasia (6), post-traumatic (5), hemihypertrophy (3), Ollier disease (2), and miscellaneous (5). An attending surgeon was present for all procedures. Mean age at time of surgery was 12.9 years (range, 7 to 17 y). Mean follow-up was 3.5 years (range, 1.4 to 9 y). The average amount of lengthening was 5.4 cm (range, 3 to 6.7 cm). Twenty-four nails were 10.7 mm in diameter. Seven nails were 12.5 mm in diameter. Intramedullary skeletal kinetic distractor was used in 18 femurs and PRECICE in 13 femurs. Ten segments (7 intramedullary skeletal kinetic distractor; 3 PRECICE) experienced 13 complications. None of the patients developed AVN or proximal femoral deformity. CONCLUSIONS: IM lengthening nails inserted through the greater trochanter may be utilized in skeletally immature patients without increased risk of AVN of the femoral head or proximal femoral deformity. Larger trials would be helpful to confirm our hypothesis. We recommend careful surgical technique with liberal use of the image intensifier to avoid trauma to the femoral head blood supply. LEVEL OF EVIDENCE: Level IV-therapeutic.
[Mh] Termos MeSH primário: Alongamento Ósseo/métodos
Pinos Ortopédicos
Fêmur/cirurgia
Fixação Intramedular de Fraturas/efeitos adversos
Fixação Intramedular de Fraturas/métodos
[Mh] Termos MeSH secundário: Acondroplasia/cirurgia
Adolescente
Criança
Feminino
Fraturas do Fêmur/cirurgia
Seres Humanos
Masculino
Osteonecrose/etiologia
Estudos Retrospectivos
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000636


  4 / 2058 MEDLINE  
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[PMID]:28249982
[Au] Autor:Kang S; Lee JS; Park J; Park SS
[Ad] Endereço:University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, South, Korea.
[Ti] Título:Staged lengthening and reconstruction for children with a leg-length discrepancy after excision of an osteosarcoma around the knee.
[So] Source:Bone Joint J;99-B(3):401-408, 2017 Mar.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Children treated for osteosarcoma around the knee often have a substantial leg-length discrepancy at skeletal maturity. The aim of this study was to investigate the results of staged skeletal reconstruction after a leg lengthening procedure using an external fixator in these patients. PATIENTS AND METHODS: We reviewed 11 patients who underwent staged reconstruction with either an arthroplasty (n = 6) or an arthrodesis (n = 5). A control group of 11 patients who had undergone wide excision and concurrent reconstruction with an arthroplasty were matched for gender, location, and size of tumour. We investigated the change in leg-length discrepancy, function as assessed by the Musculoskeletal Tumor Society Scale (MSTS) score and complications. RESULTS: A mean 5.2 cm (1.7 to 8.9) of lengthening was achieved. The mean MSTS scores significantly improved after staged reconstruction (p = 0.003) but were still worse than those of the control group (p = 0.049). However, the MSTS scores of the arthroplasty subgroup were comparable with those of the controls, although the extensor lag was greater and the range of movement was less. The patient group experienced more complications, but all of these resolved. CONCLUSION: Approximately 5 cm of lengthening and significant functional improvement can be achieved by staged reconstruction and lengthening, without major complications. Although it has limitations, this method of treatment seems to be a satisfactory surgical option for growing children with a significant leg-length discrepancy after excision of an osteosarcoma around the knee. Cite this article: 2017;99-B:401-8.
[Mh] Termos MeSH primário: Alongamento Ósseo/métodos
Neoplasias Ósseas/cirurgia
Articulação do Joelho/cirurgia
Desigualdade de Membros Inferiores/cirurgia
Osteossarcoma/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Artrodese/efeitos adversos
Artrodese/métodos
Artroplastia/efeitos adversos
Artroplastia/métodos
Alongamento Ósseo/efeitos adversos
Neoplasias Ósseas/diagnóstico por imagem
Estudos de Casos e Controles
Criança
Fixadores Externos
Feminino
Seguimentos
Seres Humanos
Desigualdade de Membros Inferiores/diagnóstico por imagem
Desigualdade de Membros Inferiores/etiologia
Salvamento de Membro/métodos
Osteossarcoma/diagnóstico por imagem
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B3.38018


  5 / 2058 MEDLINE  
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[PMID]:28244924
[Au] Autor:Kurtz AM; Rozbruch SR
[Ad] Endereço:*MaineOrtho, Portland, ME †The Limb Lengthening and Complex Reconstruction Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY.
[Ti] Título:Humerus Lengthening With the PRECICE Internal Lengthening Nail.
[So] Source:J Pediatr Orthop;37(4):e296-e300, 2017 Jun.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Deformity and growth arrest of the humerus in children may result as sequelae of proximal humerus fractures and unicameral bone cysts, or as complications of their treatment. As approximately 80% of the growth of the humerus arises from the proximal physis, the resultant upper limb-length discrepancy can be substantial. Benefits to lengthening the shortened arm have been previously demonstrated with the use of external fixation devices. To our knowledge, no reports have been published on the use of intramedullary implants for this purpose. METHODS: A 15-year-old girl with humeral shortening secondary to proximal humeral growth disturbance following treatment for a unicameral bone cyst was treated with humeral osteoplasty and gradual lengthening with an off-label use of a fully implantable motorized intramedullary lengthening nail. A varus proximal humeral deformity and lateral starting point allowed for avoidance of the rotator cuff insertion. RESULTS: Humeral lengthening (5 cm) was achieved at 9 weeks, with bony union at 7 months, and hardware removal at 9½ months. Shoulder and elbow motion was maintained during and after treatment. CONCLUSIONS: This is the first case report of humeral lengthening using a fully implantable motorized intramedullary lengthening nail. Although some technical limitations remain when compared with other methods, the procedure was well tolerated throughout the course of treatment. LEVEL OF EVIDENCE: Level IV-case report.
[Mh] Termos MeSH primário: Alongamento Ósseo/instrumentação
Alongamento Ósseo/métodos
Pinos Ortopédicos
Úmero/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Fixadores Externos
Feminino
Seres Humanos
Úmero/diagnóstico por imagem
Período Pós-Operatório
Radiografia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170301
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000941


  6 / 2058 MEDLINE  
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[PMID]:28159053
[Au] Autor:Chowdhary A; Drittenbass L; Stern R; Assal M
[Ad] Endereço:Center for Surgery of the Foot & Ankle, Clinique La Colline, Av. de Beau-Séjour 6, Geneva 1206, Switzerland. Electronic address: ashwinchowdhary@hotmail.com.
[Ti] Título:Technique tip: Simultaneous first metatarsal lengthening and metatarsophalangeal joint fusion for failed hallux valgus surgery with transfer metatarsalgia.
[So] Source:Foot Ankle Surg;23(1):e8-e11, 2017 Mar.
[Is] ISSN:1460-9584
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Failed hallux valgus surgery may result in residual or recurrent hallux valgus, and as well transfer metatarsalgia. The present technical tip concerns the combination of fusion of the first metatarsophalangeal (MTP) joint and lengthening of the first metatarsal (MT) through a scarf osteotomy. MATERIALS AND METHODS: Six patients underwent the presented technique, all for the indication of failed hallux valgus surgery with shortening of the first MT and degenerative changes in the 1st MTP joint. RESULTS: Follow-up at six months revealed all patients had complete healing of the osteotomy and arthrodesis sites. They were all asymptomatic and fully active, completely satisfied with the outcome. CONCLUSIONS: Combined fusion of the first MTP joint and lengthening of the first MT through a scarf osteotomy results in an excellent outcome in patients with failed hallux valgus surgery with shortening of the first MT and degenerative changes in the 1st MTP joint.
[Mh] Termos MeSH primário: Artrodese/métodos
Alongamento Ósseo/métodos
Hallux Valgus/cirurgia
Ossos do Metatarso/cirurgia
Metatarsalgia/cirurgia
Articulação Metatarsofalângica/cirurgia
[Mh] Termos MeSH secundário: Hallux Valgus/complicações
Seres Humanos
Metatarsalgia/etiologia
Osteotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE


  7 / 2058 MEDLINE  
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[PMID]:28141689
[Au] Autor:Sweeney KR; Shi WJ; Gottschalk MB; Kappa JE; Bruce RW; Fletcher ND
[Ad] Endereço:*Emory Department of Orthopaedics †Emory University School of Medicine, Atlanta, GA ‡George Washington Department of Orthopaedics, Washington, DC.
[Ti] Título:Radiographic Assessment of Guided Growth: The Correlation Between Screw Divergence and Change in Anatomic Alignment.
[So] Source:J Pediatr Orthop;37(4):e261-e264, 2017 Jun.
[Is] ISSN:1539-2570
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Assessment of changes in anatomic alignment following guided growth traditionally utilizes full-length standing radiographs which subjects patients to larger radiation doses than does a single anteroposterior radiograph of the knee. In an effort to minimize radiation exposure, the present study sought to determine whether changes in screw divergence (SD) of the 2-hole tension band plate used for hemiepiphysiodesis reliably predicts change in alignment. METHODS: A retrospective review was conducted involving all patients with genu varum or genu valgum treated with hemiepiphysiodesis at a single institution. Preoperative anatomic alignment of the femur, using anatomic lateral distal femoral angle (aLDFA) and anatomic femoral-tibial angle (aTFA), and intraoperative divergence of hemiepiphysiodesis screws were compared with postoperative imaging. Linear regression analysis determined the relationship between changes in SD and changes in alignment, and multivariate regression analysis explored the relationship between the angular changes being measured and various demographic factors. RESULTS: Linear regression analysis revealed that for every 1 degree change in SD there was a resultant 1.80 degrees of change in aTFA and 2.11 degrees of change in aLDFA. Change in aTFA is predicted by the equation: [INCREMENT]aTFA=0.41×|[INCREMENT]SD|+1.39. The change in aLDFA was predicted by the equation [INCREMENT]aLDFA=0.27×[INCREMENT]SD+1.84 with a R2 of 0.31. [INCREMENT]aTFA and [INCREMENT]SD had a correlation coefficient of 0.68 (95% confidence interval, 0.54-0.78.) [INCREMENT]aLDFA and [INCREMENT]SD had a correlation coefficient of 0.56 (95% confidence interval, 0.42-0.68). [INCREMENT]SD and sex were the only 2 independent predictors for [INCREMENT]aLDFA and [INCREMENT]aTFA as determined by multivariate regression analysis. CONCLUSION: Change in coronal plane anatomic alignment in patients being treated for genu valgum or genu varum with hemiepiphysiodesis can be reasonably estimated by measuring the change in SD. Therefore, when following patients postoperatively, focal radiographic imaging of the knee can be utilized in lieu of standing full-length limb radiographs to limit radiation to the pelvis in this sensitive patient population. LEVEL OF EVIDENCE: Level III-retrospective comparative study.
[Mh] Termos MeSH primário: Alongamento Ósseo
Placas Ósseas
Genu Valgum/diagnóstico por imagem
Genu Varum/diagnóstico por imagem
Articulação do Joelho/crescimento & desenvolvimento
[Mh] Termos MeSH secundário: Idoso
Parafusos Ósseos
Feminino
Fêmur/crescimento & desenvolvimento
Fêmur/cirurgia
Genu Valgum/cirurgia
Genu Varum/cirurgia
Seres Humanos
Articulação do Joelho/cirurgia
Masculino
Meia-Idade
Período Pós-Operatório
Radiografia
Estudos Retrospectivos
Tíbia/crescimento & desenvolvimento
Tíbia/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1097/BPO.0000000000000950


  8 / 2058 MEDLINE  
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[PMID]:28094861
[Au] Autor:Palumbo Piccionello A; Salvaggio A; Volta A
[Ad] Endereço:Department of Veterinary Medicine, School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy.
[Ti] Título:Caudal vertebra transfer: treatment of radio-ulnar nonunion and severe bone shortening in a dog.
[So] Source:J Small Anim Pract;58(1):56, 2017 Jan.
[Is] ISSN:1748-5827
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Alongamento Ósseo/veterinária
Transplante Ósseo/veterinária
Doenças do Cão/cirurgia
Coxeadura Animal/cirurgia
Cauda/cirurgia
[Mh] Termos MeSH secundário: Animais
Cães
Masculino
Rádio (Anatomia)/cirurgia
Coluna Vertebral/cirurgia
Ulna/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170118
[St] Status:MEDLINE
[do] DOI:10.1111/jsap.12614


  9 / 2058 MEDLINE  
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[PMID]:28042118
[Au] Autor:Su EP
[Ad] Endereço:Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
[Ti] Título:Post-operative neuropathy after total hip arthroplasty.
[So] Source:Bone Joint J;99-B(1 Suppl):46-49, 2017 01.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Nerve palsy is a well-described complication following total hip arthroplasty, but is highly distressing and disabling. A nerve palsy may cause difficulty with the post-operative rehabilitation, and overall mobility of the patient. Nerve palsy may result from compression and tension to the affected nerve(s) during the course of the operation via surgical manipulation and retractor placement, tension from limb lengthening or compression from post-operative hematoma. In the literature, hip dysplasia, lengthening of the leg, the use of an uncemented femoral component, and female gender are associated with a greater risk of nerve palsy. We examined our experience at a high-volume, tertiary care referral centre, and found an overall incidence of 0.3% out of 39 056 primary hip arthroplasties. Risk factors found to be associated with the incidence of nerve palsy at our institution included the presence of spinal stenosis or lumbar disc disease, age younger than 50, and smoking. If a nerve palsy is diagnosed, imaging is mandatory and surgical evacuation or compressive haematomas may be beneficial. As palsies are slow to recover, supportive care such as bracing, therapy, and reassurance are the mainstays of treatment. Cite this article: Bone Joint J 2017;99-B(1 Supple A):46-9.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Doenças do Sistema Nervoso Periférico/etiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/métodos
Alongamento Ósseo/efeitos adversos
Gerenciamento Clínico
Feminino
Neuropatia Femoral/diagnóstico
Neuropatia Femoral/epidemiologia
Neuropatia Femoral/etiologia
Neuropatia Femoral/terapia
Seres Humanos
Incidência
Masculino
Meia-Idade
Doenças do Sistema Nervoso Periférico/diagnóstico
Doenças do Sistema Nervoso Periférico/epidemiologia
Doenças do Sistema Nervoso Periférico/terapia
Prognóstico
Fatores de Risco
Neuropatia Ciática/diagnóstico
Neuropatia Ciática/epidemiologia
Neuropatia Ciática/etiologia
Neuropatia Ciática/terapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RETRACTED PUBLICATION
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170519
[Lr] Data última revisão:
170519
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170103
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B1.BJJ-2016-0430.R1


  10 / 2058 MEDLINE  
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[PMID]:27892743
[Au] Autor:Bhave A; Shabtai L; Woelber E; Apelyan A; Paley D; Herzenberg JE
[Ad] Endereço:a International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore , Baltimore , Maryland , USA.
[Ti] Título:Muscle strength and knee range of motion after femoral lengthening.
[So] Source:Acta Orthop;88(2):179-184, 2017 Apr.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - Femoral lengthening may result in decrease in knee range of motion (ROM) and quadriceps and hamstring muscle weakness. We evaluated preoperative and postoperative knee ROM, hamstring muscle strength, and quadriceps muscle strength in a diverse group of patients undergoing femoral lengthening. We hypothesized that lengthening would not result in a significant change in knee ROM or muscle strength. Patients and methods - This prospective study of 48 patients (mean age 27 (9-60) years) compared ROM and muscle strength before and after femoral lengthening. Patient age, amount of lengthening, percent lengthening, level of osteotomy, fixation time, and method of lengthening were also evaluated regarding knee ROM and strength. The average length of follow-up was 2.9 (2.0-4.7) years. Results - Mean amount of lengthening was 5.2 (2.4-11.0) cm. The difference between preoperative and final knee flexion ROM was 2° for the overall group. Congenital shortening cases lost an average of 5% or 6° of terminal knee flexion, developmental cases lost an average of 3% or 4°, and posttraumatic cases regained all motion. The difference in quadriceps strength at 45° preoperatively and after lengthening was not statistically or clinically significant (2.7 Nm; p = 0.06). Age, amount of lengthening, percent lengthening, osteotomy level, fixation time, and lengthening method had no statistically significant influence on knee ROM or quadriceps strength at final follow-up. Interpretation - Most variables had no effect on ROM or strength, and higher age did not appear to be a limiting factor for femoral lengthening. Patients with congenital causes were most affected in terms of knee flexion.
[Mh] Termos MeSH primário: Alongamento Ósseo
Fêmur/cirurgia
Técnica de Ilizarov
Articulação do Joelho/fisiopatologia
Força Muscular/fisiologia
Músculo Quadríceps/fisiopatologia
Amplitude de Movimento Articular/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Alongamento Ósseo/métodos
Alongamento Ósseo/reabilitação
Pinos Ortopédicos
Criança
Feminino
Fixação Intramedular de Fraturas/métodos
Fixação Intramedular de Fraturas/reabilitação
Seres Humanos
Técnica de Ilizarov/reabilitação
Masculino
Meia-Idade
Dinamômetro de Força Muscular
Músculo Esquelético/fisiopatologia
Osteotomia
Modalidades de Fisioterapia
Estudos Prospectivos
Coxa da Perna
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2016.1262678



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