Journal of Orthopaedics & Bone Disorders最新文献

{"title":"Intra Osseous Arteriovenous Malformations of Hand and Foot: Treatment Outcome after Open Surgical Cementoplasty in 9 Patients","authors":"C. Laurian","doi":"10.23880/jobd-16000189","DOIUrl":"https://doi.org/10.23880/jobd-16000189","url":null,"abstract":"Background: To evaluate the benefit of open surgical cementoplasty on the intra osseous nidus in the treatment of arteriovenous malformations (AVMs) on hand and forefoot. Methods: Over the period 2014 - 2017, 9 consecutive patients underwent open cementoplasty of bone f or AVMs of hand and foot. Investigations included digital radiography, Doppler ultrasound, and CT scan with bone and vascular reconstructions. The main outcome end points of this study were: pain, residual AVMs identified by CT scan, and quality of life. R esults: Over a period of 4 years, 65 patients with AVM on hand (38 pts.) or foot (27 pts.) were observed in our institution, 10 pts. (15%) of the cohort had bone involvement. Nine patients (4 F, 5 M) with a mean age of 30 years (range 10 - 50) were included in this study. On their hand (n=5), skeletal changes were at first metacarpal (2pts), in the proximal and middle phalanx (3 pts.). On their foot (n=4), changes were in the metatarsal (3 pts.), in proximal and distal phalanx (3 pts.). Nine patients had a ta rgeted cementoplasty of the involved bone. On control CT scan, 9 patients had no residual intraosseous AV shunts, 4 had minor shunt around bone. Mean follow - up was 29 months (range 10 - 55 m). No morbidity, no delays of healing were observed. Disappearance o f pain was the dominant impact in all the patients. Conclusion: Open surgical cementoplasty is a new option for AVMs bone lesions located in the digits and forefoot. The conclusions are restricted by the short period of follow - up.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121661400","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":"Rib-Based Anchors are Associated with Proximal Translational Deformity in Early Onset Spinal Deformity Patients undergoing Growth-Friendly Surgical Treatment","authors":"R. Murphy","doi":"10.23880/jobd-16000202","DOIUrl":"https://doi.org/10.23880/jobd-16000202","url":null,"abstract":"Objective/Background: No studies to date have evaluated the the effect of rib-based anchors on the translational relationship between the rib and spine. We hypothesized that there would be an increase in the translational distance between the rib anchor and anterior vertebral body in early onset spinal deformity patients managed with long-term rib-based anchors. Methods: All patients with EOSD from a single tertiary level institution treated with a growth-friendly technique surgery utilizing proximal rib-based anchors from 2006-2015 with a minimum of 2-year follow-up were included. Thoracic kyphosis and the translational distance from the rib anchor to the corresponding anterior vertebral body were measured. Results: Twenty-seven patients (13 female, 14 male) qualified for inclusion. Mean age at implantation of the index proximal rib-based construct was 5±1.9 years (range, 1-9). EOSD etiology was congenital: 3, neuromuscular: 17, syndromic: 3, and idiopathic: 4. Mean kyphosis improved from 31±33° preoperatively to 25±20° immediately post-operatively. No significant changes in kyphosis were noted over 1 and 2 year follow-up (p=0.3). Twenty-one (78%) patients demonstrated an increase in translational distance from the rib anchors to the adjacent anterior vertebral body. Immediately post-operatively, mean distance was 25±1 mm and increased at 1-year (26±1 mm) and significantly at 2-year (29±1 mm) follow-up (p=0.005). Conclusion: The use of long term rib-based anchors may lead to an increase in the distance between the rib utilized for proximal fixation and the associated vertebral body, generating what appears to be increased anterior translation of the spine. This translation, in conjunction with increased or increasing overall thoracic kyphosis, may be the source of unexpected obstacles at the time of future surgical procedures for revision or final fusion.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126001799","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":"Anatomic Study of Exposed Posterior Malleolus Using the Posterolateral Ankle Approach","authors":"Xin-long Ma","doi":"10.23880/jobd-16000203","DOIUrl":"https://doi.org/10.23880/jobd-16000203","url":null,"abstract":"We compared the effect of the posterolateral ankle approach on the exposed posterior malleolus and vascular nerves in order to reduce the probability of vascular nerve injury during surgical exposure. Five corpses were randomly allocated to incision A and B groups. The tip of the lateral malleolus was used as a starting point, while the lateral line of the Achilles tendon was used as the endpoint to its trisection. Using the two points near the side of the Achilles tendon, we drew two vertical horizontal lines to represent incisions A and B, then measured the horizontal distances between the tip of the lateral malleolus and incision A (a), the tip of the lateral malleolus and incision B (b), and the tip of the lateral malleolus and the midpoint of the sural nerve and small saphenous vein (c). We then exposed the fibula from the posterior portion of the peroneus brevis muscles, dissected the flexor pollicis longus from the posterior edge of the fibula, and used Vernier calipers to measure the maximum length and width of the exposed bone block. There was no statistically significant difference between distances (a) and (c), but there was a significant difference between distances (b) and (c). The length of the exposed posterior malleolus did not differ significantly between incisions A and B, but the width differed significantly. Exposing the posterior malleolus using an approach closer to the lateral Achilles tendon is less likely to injure the sural nerve and small saphenous vein and results in a larger exposed area and easier manipulation. Thus, this could be a better surgical treatment for ankle fractures.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133154281","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":"Slipped Capital Femoral Epiphysis (SCFE) Coxa Vara Adolescentium (CVA)","authors":"Gharaibeh A","doi":"10.23880/jobd-16000188","DOIUrl":"https://doi.org/10.23880/jobd-16000188","url":null,"abstract":"Slipped fem oral capital epiphysis is considered to be one of the most destructive conditions of hip joint during adolescence. The epiphysolysis of the femoral head was first defined in 1572 by the French surgeon Abrois Paré (1510 - 1590). The first authentic traumati c epiphysesolysis of the femoral head was described by Brousseau in 1867. It was in a 15 - year - old boy with multiple injuries after trauma with heavy carriage. Death occurred in a few hours, and was discovered by post - mortem examination. Complete separation of epiphysis of the femur head was found. The first mention of a non - traumatic form of epiphysolysis occurred in a fourteen years old boy later. In 1881, Fiorani reported fifteen cases of distorted hip joint with impaired adduction in children. He describ ed the deformity as a bend of the proximal part of the femur, which was based on rickets. With a high probability, some individua ls were coxa vara adolescentium . The first complete description of the disease was given by E Müller (1888) in his work “ About the bending of the femoral neck in the growth age ” Coxa vara adolescentium (CVA), epiphysesolysis of femural head or slipped femoral capital epiphysis represents a serious hip disease in the pubescent age at which the femoral proximal growth plate loses it s strength and influence mechanical forces, caused mainly by excessive body weight, the non - traumatic epiphysesolysis will occur. Symptoms like pain and twisting are initially vague, but they tend to escalate over time . The incidence of this disease is 0. 1 per one million, affect male more than female 2:1,4 in the rapid growth period 10 - 16 years old. Childhood obesity is the common cause of Slipped femoral capital epiphysis, then endocrine disorders and Down syndrome. Slipped femoral capital epiphysis has three grades first up to 33 degrees of slippage, second grade from 34 - 50% of slippage and the third degree more than 50%.Slipped femoral capital epiphysis, represents a serious disease of the puberty in the pubescent age at which the femoral proximal growth plate loses its strength and influence mechanical forces, caused mainly by excessive body weight, will occu r non - traumatic epiphysesolysis . Symptoms like pain and limping are initially vague, but they tend to escalate over time .","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"180 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121054482","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":"Impact of COVID-19 on Pediatric and Adult Orthopaedics","authors":"Daniel S Hayes","doi":"10.23880/jobd-16000201","DOIUrl":"https://doi.org/10.23880/jobd-16000201","url":null,"abstract":"Background: Social practices, hospital guidelines, and government regulations in response to COVID-19 have influenced orthopaedic practice volumes. The widespread cessation of non-essential surgeries has greatly decreased elective practices, but the extent to which trauma volumes diminish remains unknown. Access to common sites of orthopaedic injury was limited during this period, including organized sports, playgrounds, and travel. Methods: To examine the effect of COVID-19 in pediatric and adult practices, considering local responses to the pandemic, weather effects, and school activity. We retrospectively examined orthopaedic clinic changes for the first five months of the year in 2019 and 2020. An administrative database was used to obtain volume data for OR cases, OP visits, and OP clinic procedures. Temperature and precipitation records were collected for the same period. Results: All aspects of the adult practice greatly decreased in March, April, and May compared to the previous year. The largest decreases in OR cases occurred in April for adults, with a slight increase in May, but volumes remained decreased compared to the previous year. Pediatric and adult OP visits and OR cases dropped similarly in March and April. This trend continued into May for OP visits, but only pediatric OR visits increased in May. Conclusion: Practice trends from 2019 to 2020 established in January and February abruptly altered in the following months. Institutional cessation of elective procedures and government issued statewide stay-at-home orders greatly impacted orthopaedic volumes during this period. Decreased opportunity for social activity contributed to drops in pediatric and adult trauma. Proactive responses by local schools aided in a more rapid decline of pediatric trauma compared to adults in the month of March.","PeriodicalId":447832,"journal":{"name":"Journal of Orthopaedics & Bone Disorders","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115112728","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}