Assessment of Hydrothermal Treatment Effects on Coir Fibers for Incorporation into Polyurethane Matrix Biocomposites Derived from Castor Oil.

The incorporation of natural lignocellulosic fibers as reinforcements in polymer composites has witnessed significant growth due to their biodegradability, cost-effectiveness, and mechanical properties. This study aims to evaluate castor-oil-based polyurethane (COPU), incorporating different contents of coconut coir fibers, 5, 10, and 15 wt%. The investigation includes analysis of the physical, mechanical, and microstructural properties of these composites.

Brazilian Version of the Myelomeningocele Functional Classification (MMFC): Translation, Cultural Adaptation, and Psychometric Properties.

 Perform the translation and cultural adaptation of the Myelomeningocele Functional Classification (MMFC) into Portuguese (Brazil) and study its psychometric properties.  Validation study with translation, cultural adaptation and evaluation of psychometric properties: reliability, test-retest and convergent validity. Sample of 20 individuals with myelomeningocele with a median age of 10 (5 - 24.

Myelomeningocele: a new functional classification.

Purpose: In myelomeningocele, several classifications have been used. The present manuscript proposes a new functional classification to better assess the prognosis and management of these patients.

Methods: The manual muscle test is what defines the actual group in which the patient should be included.

Hip Status and Long-term Functional Outcomes in Spina Bifida.

Background: Nearly 50% of individuals with myelomeningocele will develop a dislocated hip by skeletal maturity. The purpose of this study was to determine the influence of hip status on functional outcomes in a cohort of adult patients with myelomeningocele.

Methods: Patients with a diagnosis of myelomeningocele >18 years were prospectively enrolled over a 12-month period.

Midterm Results of the Ponseti Method for Treatment of Clubfoot in Patients With Spina Bifida.

Background: Clubfoot occurs in 30% to 50% of patients with spina bifida. The Ponseti casting method has changed treatment of idiopathic clubfoot to a primarily nonoperative regimen. The Ponseti method is now widely applied to clubfoot in spina bifida, however, few studies report treatment outcomes.

Hip Power and "Stiff Knee" Gait: A Tool for Identifying Appropriate Candidates for Rectus Transfer.

Background: Rectus femoris transfer (RFT) is performed in children with cerebral palsy to treat stiff-knee gait. However, the results are variable in part because there is no gold standard to identify appropriate candidates. Hip flexion kinematics and kinetics are important factors in the determination of peak knee flexion during gait.

Outcomes of Tibial Derotational Osteotomies Performed in Patients With Myelodysplasia.

Background: Rotational deformities of the tibia are common in patients with myelodysplasia. The current recommended treatment is tibial derotational osteotomy to improve gait biomechanics. Previously reported complication rates are widely variable.

Long-term retrospective study of patients with idiopathic clubfoot treated with posterior medial-lateral release.

Background: It has been demonstrated that an important component of clubfoot deformity is related to pathologic external rotation of the talus with respect to the remainder of the foot. The purpose of the present study was to review the long-term results for a cohort of patients with idiopathic clubfoot who were managed by a single surgeon with a uniform surgical protocol consisting of extensive posterior medial-lateral release in addition to the use of a temporary Kirschner wire to derotate the talus prior to fixation.

Methods: Eighty patients (120 clubfeet) with idiopathic clubfoot without previous surgery were managed with posterior medial-lateral release.

Orthopaedic management of spina bifida-part II: foot and ankle deformities.

Both congenital and acquired orthopaedic deformities are common in patients with spina bifida. Examples of congenital deformities, which are present at birth, include clubfoot and vertical talus. Acquired developmental deformities are related to the level of neurologic involvement and include calcaneus and cavovarus.

Hip dislocation in spina bifida: when is surgery required and what type of surgery should be performed?

Children with spina bifida develop a wide variety of congenital and acquired hip joint deformities. Among these are contractures, subluxation or dislocation. This paper will review both the overall orthopedic care of a spina bifida patient with hip problems and provide a focused review of surgery management of hip deformities.

Radical posterior capsulectomy improves sagittal knee motion in crouch gait.

Background: Knee flexion contracture leading to crouch gait is commonly seen in children with myelomeningocele. Progressive increase in knee flexion contracture increases energy cost, which interferes with efficient, functional ambulation. To prevent this, surgical release has been recommended when a knee flexion contracture exceeds 15° to 20°.

Orthopaedic deformities associated with lumbosacral spinal lipomas.

Background: Lipomeningocele is the most common cause of occult spinal dysraphism and spinal cord tethering. Children with this condition seem normal at birth except for cutaneous signs, and the initial complaints are usually musculoskeletal. We studied the orthopaedic deformities observed in this condition.

Orthopedic management of spina bifida. Part I: hip, knee, and rotational deformities.

Children with spina bifida develop a wide variety of congenital and acquired orthopedic deformities. Among these are hip deformities such as contracture, subluxation, or dislocation. Patients may also have problems with the knee joint, such as knee flexion or extension contracture, knee valgus deformity, or late knee instability and pain.

Monopolar electrosurgery on the extrahepatic bile ducts during laparoscopic cholecystectomy: an experimental controlled trial.

Introduction: The purpose of this study is to investigate the occurrence of thermal injury in the extrahepatic bile ducts when monopolar electrosurgery is used to perform dieresis of the cystic duct and cystic vessels in laparoscopic cholecystectomy.

Methods: Female pigs (n=40) of the Large White breed were separated into 2 groups of 20 animals. In the experimental groups, dieresis of the cystic duct and cystic vessels was performed with monopolar electrosurgery using a hook-like dissector using a power setting of 20 W, whereas in the control group this procedure was performed with a pair of Metzenbaum scissors disconnected from any kind of thermal energy source.

Functional gait comparison between children with myelomeningocele: shunt versus no shunt.

The aim of this study was to compare functional gait differences between patients with myelomeningocele (MM) who have a ventriculoperitoneal shunt (VPS) with those who do not. Our analyses were adjusted for confounding by age, lesion level, orthotic use, and assistive device use. The Functional Mobility Scale (FMS) was used to compare the shunted group (n=98; 60 males, 38 females; mean age 10y 2mo [SD 3y 11mo]; 73 sacral/19 low lumber/six high lumbar lesion level) with the non-shunted group (n=63; 32 males, 31 females; mean age 9y 11mo [SD 3y 11mo]; 45 sacral/12 low lumber/six high lumbar lesion level).

Crouched gait in myelomeningocele: a comparison between the degree of knee flexion contracture in the clinical examination and during gait.

The purpose of this study was to quantitatively evaluate, in patients with low lumbar and sacral level myelomeningocele who have knee flexion contractures, whether there are significant differences between the degree of knee flexion contracture measured clinically and the degree of actual knee flexion during gait, measured by computerized gait analysis. Patients were divided into two groups, those who walked with ankle-foot orthoses (AFOs) alone and those who walked with AFOs and crutches. In both groups, the patient's knee flexion contractures were measured clinically, and the degree of knee flexion was measured dynamically at two representative points in the gait cycle.

Do the hamstrings operate at increased muscle-tendon lengths and velocities after surgical lengthening?

Children with crouch gait frequently walk with improved knee extension during the terminal swing and stance phases following hamstrings lengthening surgery; however, the mechanisms responsible for these improvements are unclear. This study tested the hypothesis that surgical lengthening enables the hamstrings of persons with cerebral palsy to operate at longer muscle-tendon lengths or lengthen at faster muscle-tendon velocities during walking. Sixty-nine subjects who had improved knee extension after surgery were retrospectively examined.

Trunk kinematics and the influence on valgus knee stress in persons with high sacral level myelomeningocele.

Historically, trunk movement has been thought to be reactionary to lower body motions. The excessive trunk movement in patients with myelomeningocele may be a primary mechanism during ambulation. The purpose of this study was to quantify three-dimensional trunk movement in patients with myelomeningocele.

Relationships among musculoskeletal impairments and functional health status in ambulatory cerebral palsy.

Orthopedic surgery for patients with cerebral palsy addresses motion impairments, assuming that this will improve motor function. This study evaluates the relationships among clinical impairment measures with standardized assessments of function and disability as an initial step in testing this assumption. A total of 129 ambulatory children and adolescents across six institutions participated in a prospective evaluation that consisted of passive motion and spasticity examination of the lower extremities, three-dimensional gait temporal-spatial and kinematic analysis, and administration of the Gross Motor Function Measure (GMFM) and the Pediatric Outcomes Data Collection Instrument (PODCI).

Gait analysis in low lumbar myelomeningocele patients with unilateral hip dislocation or subluxation.

The surgical indications for the treatment of unilateral hip dislocations or subluxations in patients with low lumbar myelomeningocele remain highly debatable. This study examines the influence of unilateral hip dislocation or subluxation on the gait of these patients using three-dimensional gait analysis. Twenty patients with a diagnosis of low lumbar myelomeningocele underwent three-dimensional gait analysis.

Spastic hemiplegic cerebral palsy and the femoral derotation osteotomy: effect at the pelvis and hip in the transverse plane during gait.

Gait analysis techniques were used to evaluate the outcome of the femoral derotation osteotomy in children with hemiplegic cerebral palsy. Seventy-one patients were evaluated and classified according to the Winters and Gage scale. Nine of the 13 patients classified as type IV underwent a femoral derotation osteotomy.