共查询到20条相似文献，搜索用时 31 毫秒
1.
Ilker Abdullah Sarikaya Ali Seker Ozan Ali Erdal Mehmet Ali Talmac Muharrem Inan 《Acta orthopaedica et traumatologica turcica》2018,52(3):174-178
Objective
This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results.Methods
29 patients (45 feet) were included in the study. The mean age of the patients at the time of the surgery was 14 (range 6–22) years. The mean follow-up was 33 (range 22–59) months. A reconstructive procedure was performed on 19 patients (27 feet); a soft tissue surgery and exostectomy of the bunion in six patients (11 feet); and MTP joint arthrodesis in four patients (7 feet). The hallux valgus angle (HVA) and the anteroposterior intermetatarsal angle (IMA) were used for radiologic evaluation and the DuPont Bunion Rating Score was used for clinical evaluation.Results
The follow-up period was 36 (range 22–59) months in reconstructive group, 27 (range 24–29) months in soft tissue group, and 29 (range 23–41) months in MTP arthrodesis group. Significant improvements were detected in hallux valgus angle in three groups postoperatively but in soft tissue group correction loss was observed during follow up. Best results were achieved in arthrodesis group and worse in soft tissue group in terms of clinical evaluation.Conclusion
According to our results isolated soft tissue procedures are ineffective in CP patients. Soft tissue procedure combined with metatarsal osteotomy has satisfactory results.Level of evidence
Level IV, therapeutic study. 相似文献2.
Hisateru Niki Naoki Haraguchi Takafumi Aoki Hiroko Ikezawa Kazuo Ouchi Ryuzo Okuda Masataka Kakihana Hiroaki Shima Yasunori Suda Masato Takao Yasuhito Tanaka Kota Watanabe Shinobu Tatsunami 《Journal of orthopaedic science》2017,22(4):737-742
Background
In this study, we investigated the responsiveness of the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) for patient's assessment before and after hallux valgus surgery.Methods
Patient-reported answers on the SAFE-Q and Short Form-36 (SF-36) before and at a mean of 3–4 and 9–12 months after hallux valgus surgery were analyzed. Data of 100 patients (92 women, eight men) from 36 institutions throughout Japan were used for analysis.Results
In all subscales of the SAFE-Q, the trend of increased scores after surgery was statistically significant (P < 0.001). Among the patients with available scores both before and at 9–12 months after surgery (n = 66), the largest effect sizes (ESs) were observed for shoe-related (1.60), pain and pain-related (1.05), and general health and well-being (0.84) scales. In the SF-36 (n = 64), the largest ES was observed for the bodily pain scale (0.86). Less notable changes were observed for the remaining SF-36 domains.Conclusion
The SAFE-Q is the first patient-reported outcome measure which includes a quality of life assessment of shoes. In our cohort, the most remarkable responsiveness was observed for the shoe-related subscale. Based on its responsiveness, the SAFE-Q appears to be sufficient for evaluation of foot-related quality of life before and after surgery. 相似文献3.
Background
The purpose of this retrospective study was to evaluate the clinical and radiological results of hallux valgus surgery using a plantar locking plate.Methods
Proximal oblique metatarsal osteotomy combined with distal soft tissue treatment was performed in 59 adult patients (68 feet) with hallux valgus, using an anatomically pre-contoured plantar locking plate for fixation of the osteotomy. The median age was 64.0 years and the median follow-up period was 16.5 months.Results
The mean JSSF scale improved significantly from 56.0 points preoperatively to 95.8 points postoperatively. The mean intermetatarsal angle and hallux valgus angle decreased from 16.4° and 41.8° preoperatively to 4.2° and 10.8° postoperatively, respectively. The mean inclination angle was 19.9° preoperatively and 20.5° postoperatively. Removal of hardware was needed in 2 feet (2.9%).Conclusions
Proximal oblique metatarsal osteotomy is an effective method for relief of pain and improvement of function in correction of hallux valgus deformity. Use of a plantar locking plate provides sufficient maintenance of the correction, and complications associated with the hardware are rare. 相似文献4.
Tomoyuki Nakasa Masakazu Ishikawa Yasunari Ikuta Masahiro Yoshikawa Mikiya Sawa Yusuke Tsuyuguchi Nobuo Adachi 《Journal of orthopaedic science》2017,22(6):1066-1070
Background
A high incidence of dorsomedial cutaneous nerve (DMCN) damage in hallux valgus surgery has been reported. Identification of the vein around 1st metatarsal head is reported to be helpful to reduce the DMCN damage during surgery. The near-infrared (NIR) vascular imaging system, the VeinViewer® Flex, projects the vein onto the skin. The purpose of this study was to investigate the difference of the vein course between normal and hallux valgus foot using the VeinViewer® Flex, and to validate that the DMCN was accompanied with its vein.Methods
Twenty-seven feet with the hallux valgus and 27 feet in healthy subjects were included. The vein was projected onto the skin at the metatarsal head by the VeinViewer® Flex. The distance between the vein and the mid-line of the metatarsal head was measured. The correlation of the distance and hallux valgus angle or 1–2 intermetatarsal angle (IMA) was analyzed. The vein depicted by the VeinViewer® Flex and operative findings was compared in 4 patients during surgery.Results
The vein in the hallux valgus patients shifted toward the dorsolateral side on the metatarsal bone head compared to that in healthy subjects. The distance from the midline of the 1st metatarsal bone to the vein in the hallux valgus (12.1 mm) was significantly higher than that in healthy subjects (2.7 mm) (p < 0.05). There was a significant correlation between the shift of the vein course toward dorsolateral and IMA. Surgical exploration revealed that the vein depicted by VeinViewer® Flex could be easily identified and the nerve was along with this vein in all 4 surgical cases.Conclusions
The vein in the hallux valgus patients shifted toward the dorsolateral on the metatarsal bone and it could be a landmark to identify DMCN. The NIR vascular imaging system would be useful to reduce the risk of nerve damage in great toe surgery. 相似文献5.
Takashi Hida Ryuzo Okuda Toshito Yasuda Tsuyoshi Jotoku Hiroaki Shima Masashi Neo 《Journal of orthopaedic science》2017,22(6):1054-1059
Background
Detailed information regarding differences in plantar pressure distribution between hallux valgus and healthy feet is unavailable. The purposes of the present study were to clarify the characteristics of the plantar pressure distribution in patients with hallux valgus compared with healthy matched controls and to determine whether hallux valgus leads to dysfunction of the great toe during walking.Methods
The study consisted of 25 patients with symptomatic moderate-to-severe hallux valgus (HV group) and 13 healthy matched volunteers (C group) without hallux valgus. All patients and volunteers were women. The HV and C groups did not differ significantly in age, height, weight, and body mass index. Plantar pressure during walking was measured using F-scan. The plantar aspect of the foot was divided into eight regions. The peak pressure (Peak-P), maximum force (Max-F), contact time (Con-T), contact area (Con-A), and force time integral (FTI) were measured in each region.Results
The Peak-P of the great toe did not differ significantly between the HV and C groups. However, all other parameters: Max-F, Con-T, Con-A, and FTI of the great toe in the HV group were significantly lower than in the C group. In the central forefoot, the Peak-P and Max-F in the HV group were significantly higher than in the C group.Conclusion
The present study demonstrated that a moderate-to-severe hallux valgus deformity leads to dysfunction of the great toe during walking and may increase mechanical loading on the central forefoot. 相似文献6.
Namık Şahin Gökhan Cansabuncu Nazan Çevik Oğuz Türker Güven Özkaya Yüksel Özkan 《Acta orthopaedica et traumatologica turcica》2018,52(4):261-266
Objectives
The aim of this study was to compare clinical and radiological results of proximal crescentic osteotomy (PCO) and rotational scarf osteotomy performed in the treatment of hallux valgus.Methods
A total of 57 consecutive patients (60 feet) with symptomatic hallux valgus deformity were randomly assigned to one of two groups. The PCO group consisted of 22 women and 5 men (30 feet) and the mean age was 43(±14.5) years. The scarf group consisted of 23 women and 7 men (30 feet) and the mean age was 40.9(±12.6) years. Outcomes were assessed by using of preoperative and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores and visual analogue scale (VAS). Weight bearing X-rays were used for radiological evaluation.Results
The mean AOFAS scores improved from 42(±16.2) to 66.7(±13.4) points in PCO group and from 36.2(±16.1) to 73.2(±13.5) points in scarf group. The mean pain score improved from 6.3(±1.3) to 2.4(±2) in PCO group and from 6.5(±1.9) to 2.5(±1.3) in scarf group. The mean hallux valgus angle (HVA) decreased from 38.1°(±7.1) preoperatively to 23.8°(±8.5) at postoperative first year in PCO group, and from 36.1°(±7.5) preoperatively to 22.2°(±7.5) at postoperative first year in scarf group. The mean intermetatarsal angle (IMA) decreased from 17.3°(±3.8) preoperatively to 11.8°(±3.3) at postoperative first year in PCO group, and from 16.2°(±2.6) preoperatively to 9.3°(±2.4) at postoperative first year in scarf group.When all the patients were assessed together, the relations between preoperative DMAA values and postoperative first year HVA (r = 0,327) and IMA (r = 0,399) values were positive but had low significance. The HVA and IMA values were increased in both groups at the end of the first year when compared to the postoperative sixth week values (p < 0.01 for both groups for both values).Conclusion
The PCO and the rotational scarf osteotomy in the treatment of hallux valgus deformity provides a satisfactory correction. The clinical and radiological results of both methods are similar. Especially in patients with high preoperative DMAA, an increase in the HVA and the IMA values may occur in the first postoperative year when compared to the postoperative sixth week values.Level of evidence
Level II, therapeutic study. 相似文献7.
Kyeong-Hyeon Park Joon-Woo Kim Hee-June Kim Hee-Soo Kyung Jong-Keon Oh Tae-Joon Cho Il Seo Chang-Wug Oh 《Journal of orthopaedic science》2017,22(3):474-480
Purpose
Varus or valgus deformity of the distal femur may progress into knee osteoarthritis. To delay or prevent this, various types of corrective osteotomy techniques have been used to shift the mechanical axis from the diseased compartment to the healthy one. We introduced a new, minimally invasive osteotomy of the distal femur with the assistance of temporary external fixation.Methods
We retrospectively studied 25 legs that underwent open-wedge osteotomy of the distal femur, involving insertion of a Schanz pin at the medial femoral condyle and another pin at the distal diaphysis of the femur. At the meta-diaphyseal junction, osteotomy was performed. After achieving angular correction, two pins were locked for temporary external fixation and a locking plate was fixed at the lateral side of the femur submuscularly. Radiological and functional outcomes were evaluated, including mechanical lateral distal femoral angle (m-LDFA), mechanical axis deviation, tibiofemoral angle, osseous union, and knee joint motion.Results
The minimum follow-up was 12 months (mean, 39 months; range, 12–88 months). Bone healing occurred in all legs, with an average of 16.6 weeks. The m-LDFA was corrected from 77.7° (18 valgus) and 104.6° (7 varus) to 88.1° after surgery, with an average correction of 12.9°. At the final follow-up, the mechanical axis deviation averaged 7.6 mm and the tibia-femoral angle averaged 5.6°. Most of legs (88%) achieved acceptable m-LDFA (87° ± 3°).Conclusions
A new, minimally invasive osteotomy of the distal femur offers excellent bone healing with few complications, attributable to preserved blood supply. 相似文献8.
D. Arbab C. Wingenfeld D. Frank B. Bouillon D. P. König 《Operative Orthopadie und Traumatologie》2016,28(2):128-137
Objective
Distal, lateral soft tissue release to restore mediolateral balance of the first metatarsophalangeal (MTP) joint in hallux valgus deformity. Incision of the adductor hallucis tendon from the fibular sesamoid, the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament.Indications
Hallux valgus deformities or recurrent hallux valgus deformities with an incongruent MTP joint.Contraindications
General medical contraindications to surgical interventions. Painful stiffness of the MTP joint, osteonecrosis, congruent joint. Relative contraindications: connective tissue diseases (Marfan syndrome, Ehler–Danlos syndrome).Surgical technique
Longitudinal, dorsal incision in the first intermetatarsal web space between the first and second MTP joint. Blunt dissection and identification of the adductor hallucis tendon. Release of the adductor tendon from the fibular sesamoid. Incision of the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament.Postoperative management
Postoperative management depends on bony correction. In joint-preserving procedures, dressing for 3 weeks in corrected position. Subsequently hallux valgus orthosis at night and a toe spreader for a further 3 months. Passive mobilization of the first MTP joint. Postoperative weight-bearing according to the osteotomy.Results
A total of 31 patients with isolated hallux valgus deformity underwent surgery with a Chevron and Akin osteotomy and a distal medial and lateral soft tissue balancing. The mean preoperative intermetatarsal (IMA) angle was 12.3° (range 11–15°); the hallux valgus (HV) angle was 28.2° (25–36°). The mean follow-up was 16.4 months (range 12–22 months). The mean postoperative IMA correction ranged between 2 and 7° (mean 5.2°); the mean HV correction was 15.5° (range 9–21°). In all, 29 patients (93?%) were satisfied or very satisfied with the postoperative outcome, while 2 patients (7?%) were not satisfied due to one delayed wound healing and one recurrent hallux valgus deformity. There were no infections, clinical and radiological signs of avascular necrosis of the metatarsal head, overcorrection with hallux varus deformity, or significant stiffness of the first MTP joint.9.
Dejin Yang Hongyi Shao Yixin Zhou Hao Tang Shengjie Guo 《The Journal of arthroplasty》2017,32(11):3539-3543
Background
Lateral soft-tissue release can jeopardize the common peroneal nerve (CPN) in total knee arthroplasty for valgus knees. Previous studies reporting safe zones to protect the CPN were based on well-aligned knees. We conducted this study to compare the localization of the CPN in well-aligned knees and in valgus knees.Methods
We conducted a consecutive 3-dimensional radiographic study on magnetic resonance images of 58 well-aligned knees and 39 valgus knees. We measured the distance between the CPN and the tibia, as well as the mediolateral, anteroposterior, and angular location of the CPN. We compared the results between well-aligned knees and valgus knees.Results
We found that there is an increased distance between the CPN and the tibia at the level of the tibial cut, but not at the joint line in valgus knees. It is safer to release the posterolateral capsule at the tibial side than at the level above this. The angular location and the mediolateral or anteroposterior location of the CPN in valgus knees are similar to those of well-aligned knees.Conclusion
The location of the CPN in valgus knees is similar to that in well-aligned knees. The previously reported safe zone in well-aligned knees is applicable in valgus knees to protect the CPN. 相似文献10.
Background
Soft tissue release for hallux valgus correction is traditionally performed through a dorsal first web space incision. We performed a single surgeon series review of hallux valgus correction with Scarf ± Akin osteotomy and lateral release using a single medial incision.Methods
192 feet were included. Patient satisfaction survey was conducted at the time of study. Pre-operative and final post-operative radiographic data obtained.Results
All radiological parameters had statistically significant improvement [p < 0.05 for each variable]. Response rate was 71% (completely satisfied 69%, satisfied with minor reservation 14%, satisfied with major reservation 11%, dissatisfied 6%). There was no correlation of any preoperative or postoperative radiographic measure with satisfaction grade. No patient required revision procedure.Conclusions
Single medial incision surgery for hallux valgus correction is a simple, safe and effective technique with very high satisfaction. The results are comparable to traditional two-incision surgery. 相似文献11.
Kiyoshi Yoshida Ichiro Kajiura Tsunehiko Suzuki Hidehiko Kawabata 《Journal of orthopaedic science》2018,23(4):649-652
Background
Scoliosis in cerebral palsy (CP) often occurs and causes a disturbance in daily life. The purpose of this study was to investigate the natural history of scoliosis in cerebral palsy and determine risk factors for the progression of scoliosis using multivariate analyses.Methods
We revised 113 patients with CP (47 males and 66 females) who had scoliosis with a curve of at least 10° were reviewed and retrospectively investigated these cases of scoliosis and analyzed the risk factors for the progression of this condition.Results
The mean follow-up period was 16.5 years and the mean age at onset of scoliosis was 6.6 years (range: 1–16 years). In 59 patients (52%), the age at onset of scoliosis was under 6 years. On the final radiographs, the mean Cobb angle was 55.1° (range: 10° to 169°). After the age of 20 years, 13 of 40 patients (32.5%) had a progression of over 10° in scoliosis. Multivariate analyses showed the risk factors for the progression of scoliosis to be hip displacement (p = 0.0038), the onset of scoliosis before the age of 6 years (p = 0.0024), and 30° of the Cobb angle before the age of 10 years (p < 0.001). A subtype of CP (spastic quadriplegia) was identified as a potential risk factor.Conclusions
After the age of 20 years, 32.5% patients had a progression of over 10° in scoliosis. Risk factors for the progression of scoliosis in CP included hip displacement, early-onset scoliosis, and Cobb angle of 30° before the age of 10 years.Level of evidence
Prognostic level IV - case series. 相似文献12.
Kazuhisa Hatayama Masanori Terauchi Kenichi Saito Hiroshi Higuchi 《The Journal of arthroplasty》2017,32(6):1808-1813
Background
The purpose of this study is to investigate whether varus-valgus laxity of cruciate-retaining (CR) total knee arthroplasty (TKA) changes between 1 year and >5 years after surgery based on postoperative limb alignment.Methods
One hundred twenty-one varus osteoarthritic knees that underwent CR TKA were included. The minimum follow-up was 5 years. Weight-bearing full-leg radiographs were obtained postoperatively and the hip-knee-ankle (HKA) angle was measured. Knees were grouped in varus (HKA angle ≤ ?3°, 47 knees) and neutral groups (?3° < HKA angle < 3°, 70 knees). The range of motion was measured and a Hospital for Special Surgery score was obtained at the last follow-up. Varus-valgus laxity at 15° of knee flexion was measured with stress radiographs after 1 year and at the last follow-up.Results
No knees required revision surgery. The mean knee flexion angle (121.0° vs 117.1°) and Hospital for Special Surgery score (90.3 vs 90.4) at the last follow-up were not significantly different between the varus and neutral groups. In both groups, there was no significant change in varus or valgus laxity between 1 year and at the last follow-up.Conclusion
Postoperative residual varus limb alignment did not lead to increasing varus laxity after CR TKA in the mid-term. 相似文献13.
Jun Young Choi Heri Babu Francis Ngimwhichi Joseph Stephanie Stephanie Jin Soo Suh 《Foot and Ankle Surgery》2018,24(4):330-335
Background
Maasai tribe members walk long distances daily either barefoot or wearing traditional shoes made from recycled car tires, without any foot ailments. To figure out the characteristic of their feet, we designed a radiographic comparative study of middle-aged partially shod Maasai women’s feet and regularly shod Maasai and Korean women’s feet.Methods
Weight bearing radiographs of bilateral foot and ankle joints from 20 healthy middle-aged bush-living partially shod (PS) Maasai women were obtained. Same number of radiographs from 20 urban-living regularly shod (RS) Maasai and 20 Korean women were obtained and compared. The hallux valgus angle, the first to second intermetatarsal angle, talonavicular coverage angle, talo-first metatarsal angle, Meary angle, naviculo-cuboidal overlap, and the medial cuneiform height were measured to establish the degree of pes plano-valgus and hallux valgus deformity.Results
On comparing PS and RS Maasai groups radiographically, the talonavicular coverage angle, talo-first metatarsal angle, and naviculo-cuboidal overlap were significantly greater in the PS Maasai group, whereas hallux valgus angle, the first and second intermetatarsal angle, Meary angle, and the medial cuneiform height were greater in the RS Maasai and Korean group.Conclusions
Regularly wearing shoes would protect the feet from pes plano-valgus deformity, despite potentially contributing to hallux valgus deformity. 相似文献14.
Kuniji Ohara Yasuhito Tanaka Akira Taniguchi Hiroaki Kurokawa Tsukasa Kumai Harumoto Yamada 《Journal of orthopaedic science》2019,24(2):312-319
Background
Hallux rigidus and metatarsus primus elevatus (MPE) are associated, but their causal relationship remains unknown. Several surgical approaches for treating hallux rigidus are available. We evaluated morphological characteristics of hallux rigidus with different grades to determine the optimal surgical approach. The amount of degenerative change in the metatarsophalangeal joint on the preoperative roentgenograms was graded on a scale of 1–3. We analyzed the morphology of hallux rigidus using X-ray image mapping developed by our team.Methods
This study involved weight-bearing, dorsoplantar, and lateral foot X-rays of 36 feet from 26 patients underwent surgery for hallux rigidus (Group R) at our institution, and 26 normal feet (Group N). A two-dimensional coordinate system was used to analyze the sharps of these feet by converting each dot on the radiographs into X and Y coordinates. Diagrams of the feet from each group were drawn for comparison. Feet with grades 2 (Group R2) and 3 (Group R3) hallux rigidus and normal feet were compared by Kruskal–Wallis test.Results
Mapping revealed that the tip of distal phalanges of the second, and third toes in Group R medially shifted (P < 0.05) in dorsoplantar image of the feet, and that the medial point, a part of the talus, navicular, cuneiform, and first metatarsal bone in Group R, shifted lower (P < 0.05) in lateral feet images of the feet. Multiple comparisons revealed a significant navicular bone depression in grade 3 hallux rigidus compared with normal feet. A significant difference was observed between Group N and R3 but not between Group R2 and N or R3.Conclusions
X-ray morphological analysis of the foot revealed MPE in Group R. Elevation gradually increased as hallux rigidus grade worsened. Therefore, osteotomy combined with cheilectomy, whereby the first metatarsal bone can be tilted toward the plantar side, are useful for treating a higher-grade hallux rigidus.Level of evidence
Level III, comparative study. 相似文献15.
Hwa-Chang Liu Wen-Tien Wu Kai-Chiang Yang Kuang-Ting Yeh Shoichiro Sumi Chen-Chie Wang 《Journal of orthopaedic science》2017,22(3):506-511
Background
Rotational alignment of the distal femur is important in total knee arthroplasty. The purpose of this study is to use a roentgenographic technique to evaluate the accuracy of mini-incision total knee arthroplasty (MIS TKA) performed based on the transepicondylar line from the kneeling view.Methods
Totally 32 patients (aged from 64 to 80 years with an average of 70.9 years) with 46 cases of knee osteoarthritis received MIS TKA were registered. Before surgery, the condylar twist angle was measured from the kneeling view. The bone cut for the external rotation was completed, with regard to the condylar twist angle. The control group including 26 patients (aged from 50 to 89 years with an average of 69.7 years) with 42 cases of knee osteoarthritis underwent TKA with built-in cutting jig design 3 degrees of femoral external rotation. This study is a prospective continuous-time duration analysis study. The level of evidence is IIc.Results
The mean condylar twist angle was 5.1° in the experimental group and 5.4° in the control group. The mean postoperative angle between the clinical epicondylar axis and the posterior condylar line of the femoral component was 0.46°. The same postoperative angle of the built-in external rotation in the control group was 2.7°. The condylar twist angle was significantly more accurate than the built-in design.Conclusion
Our result substantiates that the kneeling view is practicable and reproducible as the cutting reference for femoral external rotation. The accuracy of the kneeling view shows that the epicondylar axis can be used in smaller wound surgery, such as MIS TKA.Level of evidence
Level IIc. 相似文献16.
Tatsuo Mae Konsei Shino Ryo Iuchi Kazutaka Kinugasa Ryohei Uchida Shigeto Nakagawa Hideki Yoshikawa Ken Nakata 《Journal of orthopaedic science》2017,22(5):886-891
Purpose
To clarify 1) the force sharing between two portions of BTB graft in anatomic rectangular tunnel (ART) reconstruction and 2) the knee stability in ART technique under anterior tibial load.Methods
Eleven fresh cadaveric knees were used. First, anterior-posterior (A-P) laxity was measured with Knee Laxity Tester® in response to 134 N of A-P tibial load at 20° on the normal knees. Then ART ACL reconstruction was performed with a BTB graft. For graft, the patellar bone plug and tendon portion was longitudinally cut into half as AM and PL portions. After the tibial bone plug was fixed at femoral aperture, AM/PL portions were connected to the tension-adjustable force gauges at tibial tubercle, and were fixed with 10 N to each portion at 20°. Then the tension was measured 1) under anterior tibial load of 134 N at 0, 30, 60, and 90°, and 2) during passive knee extension from 120 to 0°. Next the graft tension was set at 0, 10, 20, 30, or 40 N at 20°, and the A-P laxity was measured by applying A-P load of 134 N. By comparing the laxity for the normal knee, the tension to restore the normal A-P laxity (LMP) was estimated.Results
The AM force was significantly smaller at 0° and larger at 90° than the PL force under anterior load, while the force sharing showed a reciprocal pattern. During knee extension motion, the tension of both portions gradually increased from around 5 N to 20–30 N with knee extended. And the LMP was 1.6 ± 1.0 N with a range from 0.3 to 3.5 N.Conclusion
The pattern of force sharing was similar to that in the normal ACL in response to anterior tibial load and during passive knee extension motion. LMP in this procedure was close to the tension in the normal ACL.Level of evidence
Level IV, a controlled-laboratory study. 相似文献17.
Background
Primary total knee arthroplasty (TKA) for valgus knee deformities can be challenging. Soft tissue releases are often necessary to achieve a well-balanced knee. We reviewed the frequency of soft tissue releases including lateral retinacular release (LRR) as it pertains to preoperative limb alignment. Postoperatively, we evaluated limb alignment, knee range of motion, and complications.Methods
From 2010 to 2016, 214 primary TKAs with valgus deformity were performed by a single surgeon. One hundred eighty-one patients had an average follow-up of 24 months. For these patients, clinical data including preoperative and postoperative range of motion, complications, and revision rates were collected. Soft tissue releases, preoperative and postoperative limb axis deviation, and level of prosthetic constraint were recorded in all patients regardless of length of follow-up.Results
There were 33 knees (15%) that required 1 release, 69 knees (32%) required 2 releases, 81 knees (38%) required 3 releases, and 31 knees (14%) that required 4 or more releases. The average preoperative mechanical axis was 9.4°, and the average postoperative mechanical axis was 0.13°. There were 85 knees (40%) that required an LRR. Increased severity of preoperative deformity correlated with the need for more soft tissue release, but did not correlate with the need for LRR. No knees were revised for instability. No patella complications resulted from LRR.Conclusion
Selective soft tissue release for primary valgus TKA was effective without increasing prosthetic constraint. Severe deformities required more soft tissue releases. LRR can be frequently used with minimal complications. 相似文献18.
Joyce White Lisa Coppola Andrea Skomurski Emma Mitchell-Rekrut 《Journal of hand therapy》2018,31(3):390-397
Study Design
Cross-sectional clinical measurement study.Introduction
The carpometacarpal (CMC) joint of the thumb is a complex joint making accurate measurement of range of motion (ROM) challenging. There are limited normative data available to base rehabilitative decisions, which is unfortunate as this joint is frequently affected by arthritis and is critical to hand function.Purpose of the Study
To provide passive ROM values for the first CMC joint and investigate the effects of age and gender.Methods
Ninety-six healthy subjects were divided into 4 age groups of equal gender: 20-34, 35-49, 50-64, and 65+ years. Six-inch plastic universal goniometers were used to take 3 measurements of flexion, extension, and abduction of the dominant hand.Results
Mean ROM values were 21.7 ± 6.8 degrees of flexion, 19.5 ± 5.7 degrees of extension, and 51.1 ± 5.5 degrees of abduction. There was a weak negative correlation (r = ?0.22; P = .03) between age and abduction and a difference between 2 age groups. No other relationship or difference due to age, gender, or interactions reached significance.Conclusions
These normative ROM values for adults can be used by clinicians assessing patients for impaired motion at the CMC joint. No differences in flexion, extension, and abduction due to age and gender were supported, except for a small decrease (4.5°) in abduction in adults 65+ years compared with those of 35-49 years.Level of Evidence
3. 相似文献19.
Takashi Namikawa Hiroshi Taneichi Satoshi Inami Hiroshi Moridaira Daisaku Takeuchi Yo Shiba Yutaka Nohara 《Journal of orthopaedic science》2017,22(3):415-419
Background
Hybrid constructs have been widely used to surgically correct thoracic adolescent idiopathic scoliosis (AIS). To enhance the correction obtained with hybrid constructs, we perform concave rib head resection and convex costovertebral release as posterior release procedures. The objective of the study was to evaluate coronal and sagittal curve correction in patients with adolescent idiopathic scoliosis (AIS) treated with hybrid constructs combined with concave rib head resection and convex transverse process resection as posterior release procedures.Methods
The records of 24 patients with Lenke type 1 or 2 AIS treated with hybrid constructs combined with posterior release procedures were retrospectively reviewed. The mean age at surgery was 14.3 years. The mean follow-up period was 33.0 months (range, 24–60 months). Radiographs were evaluated before surgery, immediately postoperatively, and at latest follow-up.Results
The average preoperative Cobb angle of the main thoracic (MT) curve was 58.1 ± 12.6° (range, 45–88°). The MT curve was corrected to 12.8 ± 9.0° (range, 0–38°) immediately after surgery. At the latest follow-up, the average Cobb angle was 13.6 ± 9.9° (range, 0–44°; correction, 77.5 ± 14.0%). The average loss of coronal correction was 0.8°. The average preoperative flexibility of the MT curve was 54.6 ± 17.4%. The average Cincinnati correction index was 1.53 ± 0.48 at the latest follow-up. The average preoperative thoracic kyphosis (TK) was 13.7 ± 12.0° (range, ?12–34°). Immediately after surgery, TK was corrected to 18.6 ± 5.9° (range, 10–29°). At the latest follow-up, TK measured 18.1 ± 6.5° (range, 6–32°).Conclusions
Hybrid instrumentation combined with concave rib head resection and convex transverse process resection as posterior release procedures achieved satisfactory coronal and sagittal curve correction with little loss of correction at 2-year follow-up. 相似文献20.
Ilker Abdullah Sarikaya Ali Seker Ozan Ali Erdal Mehmet Ali Talmac Muharrem Inan 《Acta orthopaedica et traumatologica turcica》2018,52(5):352-356