Journal of Limb Lengthening & Reconstruction最新文献

{"title":"Acute deformity correction and lengthening using the PRECICE magnetic intramedullary lengthening nail","authors":"A. Hammouda, V. Szymczuk, M. Gesheff, N. Mohamed, J. Conway, S. Standard, Philip K. McClure, J. Herzenberg","doi":"10.4103/jllr.jllr_6_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_6_20","url":null,"abstract":"Background: External fixators have been used to treat patients with limb length discrepancy with deformity. Implantable intramedullary (IM) lengthening nails are an attractive alternative achieving accurate results with fewer complications than external fixators. We report on PRECICE™ nail utilization for simultaneous lower limb lengthening and acute deformity correction. Materials and Methods: A retrospective institutional study included a total of 22 segments (13 femurs, 9 tibias; mean age = 17 years) that underwent simultaneous acute deformity correction and lengthening using fixator-assisted nailing and the PRECICE™ IM nail between 2012 and 2015. Results: All segments were corrected with mean final mechanical axis deviation 0.8 cm (0–2.0 cm). Femoral segments achieved frontal plane correction from a preoperative mean lateral distal-femoral angle of 86° to a postoperative mean of 89°; and a sagittal plane correction from a preoperative mean posterior distal femoral angle of 76° to a postoperative mean of 84°. Tibial segments achieved frontal plane correction from a preoperative mean medial proximal tibial angle of 94° to a postoperative mean of 89°; and a sagittal plane correction from a preoperative mean posterior proximal tibial angle of 72° to a postoperative mean of 79°. Rotational malalignment was corrected in all cases based on clinical examination of the rotational profile. The mean length achieved was 4.7 cm. One femoral segment (4.5%) did not achieve the lengthening goal. The mean consolidation index was 42 days/cm. Mean distraction index was 0.7 days/mm. Conclusions: Internal lengthening can permit both lengthening and acute deformity correction, with appropriate preoperative planning, using fixator assisted nailing techniques.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131446649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tibial lengthening with a motorized magnetic intramedullary nail after combined plating and titanium mesh cage for distal femur periprosthetic fracture nonunion","authors":"R. Khalifa, Chris Gerzina, Amr A. Abdelgawad, A. Thabet","doi":"10.4103/jllr.jllr_12_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_12_20","url":null,"abstract":"Fifty-seven years old female presented with resistant nonunion and limb length discrepancy (LLD) following distal periprosthetic fracture. The report described the experiences treating these conditions and literature review about the topic. Nonunion in periprosthetic distal femoral fractures can be challenging to the orthopedic surgeon and can result in a significant LLD. With the patient described herein, a combined technique with plating and titanium mesh cage and subsequent tibial lengthening with a motorized lengthening nail was used to address these conditions.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122727632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insufficiency fracture of the distal femur during ilizarov treatment for congenital pseudarthrosis of the tibia","authors":"M. El-Rosasy, A. Nada","doi":"10.4103/jllr.jllr_1_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_1_20","url":null,"abstract":"Background: Patients with congenital pseudarthrosis of the tibia (CPT) usually have significant limb length discrepancy that requires lengthening. In the presence of generalized osteopenia in CPT patients, insufficiency fractures of distal femur can occur during lengthening. No reports in the literature have described this complication and its management. Patients and Methods: We report three cases of CPT with distal femur insufficiency fracture during the treatment by Ilizarov frame. The fracture was minimally displaced. Under general anesthesia, traction and manipulation for fracture reduction were done. A cast was wrapped around the thigh, then three rods were added to the proximal ring to surround the thigh, and then another cast was used to connect the rods and the first cast. Results: In these three cases, healing of the fracture was achieved within 7 weeks without any complications, and the management of CPT continued as planned. Conclusion: The new technique provides a stable construct based on the already mounted frame; thus, healing of the fracture is achieved in a simple, easy, and cheap way with no documented complications.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131614591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is bone morphogenetic protein 2 effective, safe and cost-efficient in nonunion surgery of long bones","authors":"Chunfang Tang, S. Jehan, H. Sharma","doi":"10.4103/jllr.jllr_9_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_9_20","url":null,"abstract":"Background: The prevalence of fracture nonunion surgery is increasing in the general population with greater advancement in trauma surgery. Increasingly complex injuries involving the limbs are now amenable for limb preservation surgery, where in the past amputations would have been common place. Aims and Objectives: We carried out a literature review on the evidence available on the use of Bone Morphogenetic Protein 2 (BMP-2) for long bone nonunion surgery. Methods: This literature review was initially undertaken for a systematic review using PRISMA guidelines, however due to lack of high-quality published literature, we present a narrative review instead. The abstracts of the articles obtained on Medline and Embase database were scrutinised according to the inclusion and exclusion criterions. The primary endpoint was union rates, and secondary end points were time to union, re-operation and post op infection rates. Results: A total of 240 titles were obtained, and after review, 3 articles were selected for final analysis. There were no statistically significant differences noted between the primary and secondary endpoints in the autologous bone graft (ABG) group when compared against the BMP-2 with allograft group. An additional review of the literature suggests that BMP-2 is cost neutral to the healthcare system. Conclusion: Although no firm conclusions can be drawn due to lack of power, the trend suggests no significant difference in union rates between autograft or BMP-2 with allograft, with comparable results to each other in all measurable end-points.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132110049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Azhar dome physioclasis: A new surgical technique of treating patients with late presenting blount's disease","authors":"Y. Elbatrawy, A. Hammouda, M. Khaled","doi":"10.4103/jllr.jllr_15_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_15_20","url":null,"abstract":"Introduction: Surgical treatment of patients with multi-planar deformity secondary to Late Presenting Blount disease (LPBD). Is there a new method for acute deformity correction of tibial deformity in patients with LPBD? The new method entailed acute deformity correction of the deformity by manual rotation of the deformed limb relative to the CORA in the physis itself. Patients and Methods: A prospective case study performed on two patients. First patient was eleven years old boy with LPBD and bilateral affection. Patient's height was 127cm, and weight was 60 kg; with BMI was 37.2 kg/m2. Both sides were done, left sided correction preceded the right side by 6 weeks. The second patient was twelve years old female. Her height was 145cm, and weight was 67kg with BMI 31.8 kg/ m2. Results: Acute correction of the varus, procurvatum and internal rotation was achieved intraoperatively with corrected mechanical axis. Average follow up was 20 months. No complications encountered in either limb. Conclusion: “Dome Physioclasis” is a new novel surgical technique that allows acute tibial multi-plane deformity correction in patients with LPBD. This method is suitable for selected cases where patients complain from severe deformity and near skeletal maturity. Future more experience in the technique may improve its understanding.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115120422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to Galina victorovna diachkova","authors":"D. Paley","doi":"10.4103/2455-3719.288558","DOIUrl":"https://doi.org/10.4103/2455-3719.288558","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125231739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological and orthopedic outcomes after stature lengthening surgery using intramedullary nails","authors":"M. Assayag, Joshua R. Buksbaum, Nathan Khabyeh-Hasbani, Ellen Westrich, A. Fragomen, S. Rozbruch","doi":"10.4103/jllr.jllr_4_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_4_20","url":null,"abstract":"Introduction: Patients undergo stature-lengthening surgery (SLS) with the hope of improving their psychological health. The presumption is that increased height will improve body-image and self-esteem. The use of motorized internal lengthening nail and lengthening and then nailing techniques has eliminated or minimized time in external fixation increasing interest in the procedure. Material and Methods: Fifteen patients (32 bone segments) who underwent SLS were included in the study. All patients were bilateral, and one patient underwent four-segment treatments in two stages. Psychological assessment was performed with the body image quality of life inventory (BIQLI), the situational inventory of body-image dysphoria (SIBID), and the multidimensional body-self relations questionnaire before surgery and at latest follow-up. Orthopedic data included length obtained, bone healing index (BHI), adjacent joint range of motion, and Association for the Study and Application of Methods of Ilizarov (ASAMI). bone and functional scores. Results: The mean magnitude of lengthening was 64 ± 9.3 mm (48–77) (P < 0.001), resulting in an average increase from 161 cm to 167.4 cm. Mean BHI was 0.86 month/cm. ASAMI bone and functional results were all excellent after average follow-up of 37 months, with no loss of adjacent joint range of motion. BIQLI score significantly increased from 0.62 ± 1.26 (range −1.6–1.9) to 1.67 ± 0.85 (range −0.16–2.6) (P = 0.02). SIBID score significantly improved from 1.3 ± 0.81 (range 0.4–2.5) to 1.02 ± 0.68 (range 0.42–2.1) (P = 0.03). Discussion: Patients' significant increase in BIQLI score postoperatively, when compared to their scores preoperatively, demonstrate higher satisfaction in their body-image following SLS. Significant improvement in patients' SIBID score demonstrate a decrease in the impact of stature dysphoria in patients' everyday life following SLS. Conclusion: SLS is a safe and effective treatment to increase height. In patients, psychological health, including body-image and self-esteem, is improved.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"36 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114002734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ilizarov","authors":"G. Diachkova","doi":"10.4103/2455-3719.288557","DOIUrl":"https://doi.org/10.4103/2455-3719.288557","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"11 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132463185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tibial lengthening evolution: Classic ilizarov, lengthening and then nailing, motorized internal lengthening nail","authors":"A. Fragomen, Thomas D Falls, Jae-Sung Suh, Nathan Khabyeh-Hasbani, S. Rozbruch","doi":"10.4103/jllr.jllr_3_20","DOIUrl":"https://doi.org/10.4103/jllr.jllr_3_20","url":null,"abstract":"Introduction: Distraction osteogenesis is an effective method for the treatment of congenital and acquired limb length discrepancy. Lengthening and then nailing (LATN) was developed to decrease the time in external fixation. With the advent of motorized internal lengthening nails (MILN), external fixation has been eliminated and lengthening of the tibia has become a less burdensome process for patients. Methods: We performed a retrospective review of three groups of patients: Twenty-four patients (27 tibiae) using MILN, 20 patients (32 tibiae) using LATN and 24 patients (34 tibiae) using a classic Ilizarov technique. Results: In the MILN group, the average bone healing index (BHI) was 1.5 months/cm, with an average BHI of 0.9 months/cm for LATN patients and 1.9 months/cm for classic patients. There was a statistically significant difference among the three groups (P < 0.001). There were no deep infections in the internal lengthening nail group. There were no nonunions, persistent joint contractures, or significant unintended changes in alignment in any of the groups. Discussion: Applied appropriately, all three techniques are effective and lead to healing without any significant deformity. Conclusion: Motorized internal lengthening of the tibia is an effective treatment option. The LATN technique still allows for longer lengthenings and faster healing than MILN, however, it does require an additional surgery and the need to wear an external fixator.","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129680997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shortening: The orthopedic theory of relativity","authors":"D. Paley","doi":"10.4103/2455-3719.288573","DOIUrl":"https://doi.org/10.4103/2455-3719.288573","url":null,"abstract":"","PeriodicalId":307806,"journal":{"name":"Journal of Limb Lengthening & Reconstruction","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133331977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}