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81.
《Journal of Clinical Orthopaedics and Trauma》2020,11(2):307-309
Cornelia de Lange syndrome is a genetic disorder with multiple system abnormalities. It is especially characterized by typical facial appearance and hirsutism. Growth and mental retardation, gastrointestinal, cardiovascular, and orthopedic abnormalities are other important features of this syndrome. In this case, we present a rare manifestation of Cornelia de Lange syndrome with a unilateral pes equinovarus deformity without other more specific orthopedic manifestations. Ponseti method's was applied as the initial procedure. Afterwards, complete subtalar release was performed. After four years follow-up, clinical and radiological results were satisfactory. Unilateral pes equinovarus deformity may be a part of this syndrome as well as a sporadic presentation. The discrimination is important for anesthetic procedures and surgical outcomes. 相似文献
82.
《The Journal of arthroplasty》2020,35(2):380-387
BackgroundThe aims of this study were to (1) describe our functional stepwise multiple needle puncturing (MNP) technique as the final step in medial ligament balancing during total knee arthroplasty (TKA) and (2) evaluate whether this technique can provide sufficient medial release with safety.MethodsA total of 137 patients with 212 consecutive knees who underwent TKAs with or without functional stepwise MNP of superficial medial collateral ligament was recruited in this prospective cohort. Eighty-one patients with 129 knees who performed serial stress radiographs were enrolled in the final assessment. Superficial medial collateral ligament was punctured selectively (anteriorly or posteriorly or both) and sequentially depending on the site and degree of tightness. Mediolateral stability was assessed using serial stress radiographs and comparison was performed between the MNP and the non-MNP groups at postoperative 6 months and 1 year. Clinical outcomes were also evaluated between 2 groups.ResultsFifty-five TKAs required additional stepwise MNP (anterior needling 19, posterior needling 3, both anterior and posterior needling 33). Preoperative hip-knee-ankle angle and the difference in varus-valgus stress angle showed significant difference between the MNP and the non-MNP groups, respectively (P = .009, P = .037). However, there was no significant difference when comparing the varus-valgus stress angle between the MNP and the non-MNP groups during serial assessment. Clinical outcomes including range of motion also showed no significant differences between the 2 groups.ConclusionFunctional medial ligament balancing with stepwise MNP can provide sufficient medial release with safety in TKA with varus aligned knee without clinical deterioration or complication such as instability.Level of EvidenceLevel II, Prospective cohort study. 相似文献
83.
Review of the literature, primarily articles published in the last few years, revealed that the subject of prophylactic (protective) knee bracing in athletes is highly complex and controversial. Published results of studies on knee bracing strongly suggest that it is ineffective in preventing ligamentous knee injuries, that it is time-consuming and often expensive, and most dramatically that it may contribute to a higher incidence of injury than when no external support is applied to healthy knees. Possible reasons for this include placing undue stress on the MCL (preloading), especially in varus knees, twisting or slipping of the brace during use, and changing directions of force as the knee moves during impact. Functional and rehabilitative knee braces, on the other hand, seem to have almost universal approval when combined with physical therapy and conditioning designed to prevent recurrence of knee injuries. The authors conclude that a need exists for effective prophylactic knee bracing and believe that, with continuing research, improved design, and rigorous testing, achieving this goal is possible. 相似文献
84.
目的 研究治疗儿童肘内翻畸形的手术方法。方法 采用楔形不全截骨加尼龙线内固定法,治疗32例肘内翻畸形。结果 32例肘内翻均纠正,治疗效果好。结论 楔形不全截骨加尼龙线内固定,是治疗儿童肘内翻畸形的简单有效的手术方法。 相似文献
85.
Early-stage varus ankle arthritis can usually be treated with a medial, open-wedge, valgus, distal tibial osteotomy; however, the value of adding a fibular osteotomy has been debated. We sought to determine the increase in the maximum medial osteotomy gap and correction angle provided by fibular osteotomy. In 3 sequential experiments on 12 fresh cadaveric legs, we first performed a medial open-wedge, valgus, distal tibial osteotomy alone. Second, we added a transverse fibular osteotomy. Finally, we added a blocked fibular osteotomy. In each experiment, we measured the maximum corrected osteotomy gap and the maximum correction angle. Correction was defined as the absence of lateral cortex diastasis and talocrural joint incongruity. The mean ± standard deviation maximum osteotomy gaps and correction angles were 8.40 ± 1.6 mm and 10.70° ± 3.3° for the tibial osteotomy alone, 15.70 ± 4.6 mm and 20.20° ± 5.6° for the tibial plus transverse fibular osteotomy, and 16.67 ± 3.7 mm and 20.56° ± 4.6° for the tibial plus transverse plus blocked fibular osteotomies, respectively. The corresponding median maximum correction angles were 10° (range 8° to 18°), 19.5° (range 14° to 30°), and 20° (range 14° to 28°). The osteotomy gap and correction angle in the distal tibial and transverse fibular osteotomy were significantly greater than those in the distal tibial osteotomy alone (p < .001 for both) but not in the distal tibial and blocked fibular osteotomy (p = .62 for the gap and p = .88 for the correction angle). Our data support the clinical use of adjunct transverse fibular osteotomies. The blocked fibular osteotomy provided no additional benefit. 相似文献
86.
The outward angulation of elbow with supinated forearm is cubitus varus deformity. This deformity is
often seen as sequelae of malunited supracondylar fracture of humerus in paediatric age group of 5e8
years. The deformity is usually non-progressive, but in cases of physeal injury or congenital bony bar formation in the medial condyle of humerus, the deformity is progressive and can be grotesque in
appearance. Various types of osteotomies are defined for standard non-progressive cubitus varus
deformity, while multiple surgeries are required for progressive deformity until skeletal maturity. In this study we described a novel surgical approach and osteotomy of distal humerus in a 5 years old boy having grotesque progressive cubitus varus deformity, achieving good surgical outcome. 相似文献
87.
88.
89.
Coronoid fractures can be challenging to understand and treat. There are five common patterns of coronoid fractures, modified from the Regan Morrey classification: tip fractures, mid transverse fractures, basal fractures, anteromedial oblique fractures and anterolateral oblique fractures. Specific tools to understand the fracture pattern and associated injuries, and to develop a treatment plan, are presented. 相似文献
90.
小儿肱骨髁上骨折肘内翻预防 总被引:9,自引:5,他引:4
目的:探讨小儿伸直型肱骨髁上骨折的治疗方法和防止肘内翻发生的有效措施。方法:伸直型小儿肱骨髁上骨折患者91例,其中男64例,女27例;年龄17个月~15岁,平均7.3岁;骨折类型全部为闭合性伸直型,桡偏型36例,尺偏型31例,旋转型24例。采用手法复位、曲肘前臂旋前位夹板固定治疗。结果:91例均获随访,随访时间3~36个月,平均19个月,参照李稔生等的疗效评定标准,优62例,良23例,可5例,差1例,优良率93.4%。肘内翻7例,占7.7%。结论:手法复位夹板固定是治疗小儿肱骨髁上骨折的常用方法,预防肘内翻的关键是正确的复位与合理的固定以及早期正确的X线评价。 相似文献