Congenital Synostosis of the Knee: Long-term Outcomes of Limb Reconstruction Surgery.

Background: Congenital synostosis of the knee is a rare condition with limited data on treatment options and outcomes. This study reports clinical findings, treatment approach, and surgical/clinical outcomes for congenital synostosis of the knee.

Methods: An institutional review board-approved retrospective review of patients with congenital synostosis of the knee presenting to 2 institutions between 1997 and 2021 was performed.

Dynamic Standing Exercise using the Innowalk Device in Patients with Genetic and Acquired Motor Impairments.

Objective: For individuals with motor impairments, dynamic standing has been proposed as an opportunity for regular daily physical activity. The aim of this study was to analyse patient characteristics, indications, intensity of usage, desired objectives and outcomes of dynamic standing in daily clinical practice in order to form the basis for research regarding this treatment option.

Setting: Data were analysed from standardized questionnaires completed prospectively before supply of a home-based medical device for dynamic standing (Innowalk; Made for Movement GmbH, Langenhagen, Germany) and at the time of individual adaptations.

General synovitis score and immunologic synovitis score reflect clinical disease activity in patients with advanced stage rheumatoid arthritis.

The purpose of this study was to investigate the relationship between clinical disease activity in patients with advanced stage rheumatoid arthritis (RA) on treatment with Disease Modifying Antirheumatic Drugs (DMARDs) and histopathological scores of synovial inflammation. To this end, synovial biopsies of 62 RA patients who underwent surgery for either synovectomy or total joint arthroplasty were assessed by a general synovitis score (GSS) and an immunologic synovitis score (IMSYC). The clinical disease activity index (CDAI) was significantly correlated with both the GSS and the IMSYC (r = 0.

Treatment failures and complications in patients with Blount disease treated with temporary hemiepiphysiodesis: a critical systematic literature review.

Unlabelled: This systematic review sums up the state of knowledge about complications and reasons for failure when children with Blount disease are treated with temporary hemiepiphysiodesis. Twelve studies meet the inclusion criteria. The main reported obstacles were under correction and the poor predictability of the amount of correction that was obtainable.

Symptomatic Os Vesalianum.

Os vesalianum is a rare accessory bone located proximal to the base of the fifth metatarsal in the peroneus brevis tendon. It is a radiographic diagnosis and mostly an asymptomatic incidental finding with a reported prevalence of 0.1% to 0.

PRECICE magnetically-driven, telescopic, intramedullary lengthening nail: pre-clinical testing and first 30 patients.

Introduction: Femoral/tibial lengthening with a telescopic, magnetically-powered, intramedullary nail is an alternative to lengthening with external fixation.

Methods: Pre-clinical testing was conducted of the PRECICE in a human cadaver. A retrospective review of the first 30 consecutive patients who underwent unilateral lengthening was also conducted.

Bilateral double level tibial lengthening in dwarfism.

Purpose: Outcome assessment after double level tibial lengthening in patients with dwarfism.

Methods: Fourteen patients with dwarfism were analyzed after bilateral simultaneous double level tibial lengthening.

Results: Average age was 15.

Growth Disturbance of the Distal Tibia in Patients With Idiopathic Clubfeet: Ankle Valgus and Anteflexion of the Distal Tibia.

Background: The aim of this study was to evaluate the incidence of deformities of the distal tibia in patients with idiopathic clubfeet who had undergone surgical intervention with a circumferential release through a Cincinnati incision in early infancy.

Methods: A retrospective follow-up evaluation of children with idiopathic clubfoot was conducted. We reviewed children who had undergone surgical treatment by a circumferential release in our department after unsuccessful casting, and who were at least 10 years of age.

Distraction osteogenesis for complex foot deformities: Gigli saw midfoot osteotomy with external fixation.

Open midfoot wedge osteotomy correction can cause neurovascular compromise, requires extensive exposure, sacrifices normal joints, and shortens the foot. We used a minimally invasive technique to treat complex foot deformities by combining percutaneous Gigli saw midfoot osteotomy, circular external fixation, and acute, gradual, or gradual with acute manipulation correction. The medical records of 23 patients (26 feet) with complex foot deformities (congenital, 18 feet; neuromuscular, 4 feet; post-traumatic, 3 feet; malunion, 1 foot) who had undergone treatment within an 18-year period (1990 through 2007) were retrospectively reviewed.

Preliminary experience with motorized distraction for tibial lengthening.

Limb lengthening by callus distraction is commonly performed with the use of external fixation. Lengthening is routinely performed by the patient through small increments throughout the course of a day. Ilizarov has shown that both the rate and frequency of distraction are important factors in the quality of osteogenesis.

Exothermic properties of plaster-synthetic composite casts.

Purpose: Plaster casts can cause burns. Synthetic casts do not. Composite plaster-synthetic casts have not been thoroughly evaluated.

Resistant metatarsus adductus: prospective randomized trial of casting versus orthosis.

Background: Metatarsus adductus is a common pediatric foot deformity related to intrauterine molding. It is usually a mild deformity that responds well to simple observation or minimal treatment with a home program of stretching. Resistant cases may need a more aggressive approach such as serial casting or special bracing to avoid the need for surgical intervention.

Compartment syndrome of thigh and lower leg with disruption of the popliteal vascular bundle after being run over by a 25-ton truck.

Compartment syndrome of the thigh is a rare condition, potentially resulting in devastating functional outcome. Increasing intracompartmental pressure which suppresses microcirculation and capillary perfusion may lead to cellular anoxia and muscle ischemia. The muscle compartments in the thigh have a more compliant fascia and blend anatomically into the open compartments of the pelvis, thus compensating higher volumes than the compartments in the lower leg.

A technical note on improved instrumentation for Blount staple insertion.

Purpose: Temporary hemiepiphysiodesis has gained increasing popularity after the introduction of the eight-Plate Guided Growth System. Since its introduction, the eight-Plate has largely supplanted the traditional Blount staple. The eight-Plate offers better purchase in the bone and a more precise insertion technique.

Lower limb alignment in the frontal plane: analysis from long standing radiographs and computer tomography scout views: an experimental study.

Objectives: A profound knowledge of physiologic lower limb alignment is essential to understand deformities and to plan surgical correction. The gold standard in radiographic assessment is the long standing radiograph with a forward directed patella. The advantage of computed tomography (CT) is that its cutting-edge image technique can visualize the femur condyles.

Trigonometric analysis of the mechanical axis deviation induced by telescopic intramedullary femoral lengthening nails.

Femoral lengthening with intramedullary nails can create alterations in the mechanical axis of the limb. This is based on the relationship of the anatomic femur axis to the mechanical femur axis, which is typically 5-9 degrees valgus. We developed trigonometric formulas to calculate the predicted change, using the lengths of the tibia, femur, and whole limb; the amount of lengthening; and the angle between the anatomic and the mechanical axis of the femur.

Hemiepiphyseal arrest in a porcine model.

Background: Treating angular deformities with temporary hemiepiphysiodesis in skeletally immature patients can avoid the need for osteotomies. Recently, newer implants have been introduced as alternatives to the Blount staple, which was commonly used for the past 60 years. The purpose of this project was to develop a porcine model that can be used to compare various methods of temporary hemiepiphyseal arrest.

Temporary hemiepiphysiodesis with the eight-Plate for angular deformities: mid-term results.

Background: Angular deformities can be treated with corrective osteotomies and application of internal or external fixation. In children, this major intervention can be avoided with temporary hemiepiphysiodesis (i.e.

Mechanical failures of eight-plateguided growth system for temporary hemiepiphysiodesis.

Background: For decades, the Blount staple has been used to perform temporary hemiepiphysiodesis for angular deformity correction in children with open growth plates. Recently, the eight-PlateGuided Growth System (Orthofix, McKinney, TX) has gained popularity for use in this procedure. The eight-Plate is said to be superior to the Blount staple, as it is less likely to break or migrate out of the bone.

Compartment syndrome of the thigh. A case report with delayed onset after stable pelvic ring fracture and chronic anticoagulation therapy.

Compartment syndrome of the thigh is a rare occurrence potentially leading to devastating functional restrictions. There is a wide spectrum of reported conditions leading to increased tissue pressure in the thigh possibly resulting in a compartment syndrome, ranging from deep venous thrombosis to blunt injuries and femoral fractures. We report a case of a delayed development of a compartment syndrome of the thigh secondary to an undisplaced anterior pelvic ring fracture and chronic anticoagulation therapy in a 94-year-old woman.

Medial migration of lag screw with intrapelvic dislocation in gamma nailing--a unique problem? A report of 2 cases.

Within the last decade, intramedullary nailing systems have gained popularity in the treatment of unstable fractures of the trochanteric region with good clinical results. However, these implants are not free of complications. Commonly reported treatment failures include implant cutout through the femoral neck, stress-derived femur fractures at the distal end of the nail, and secondary rotational displacement and varus deformity of the femoral neck and head.

Temporary hemiepiphyseal arrest using a screw and plate device to treat knee and ankle deformities in children: a preliminary report.

Purpose: Traditionally, angular deformities are treated by means of osteotomy. In patients who are skeletally immature, this major intervention can be avoided by influencing or guiding the growth of the affected physis. Recently, a new device was presented as an alternative to the widely used Blount staple.

Tibial lengthening: extraarticular calcaneotibial screw to prevent ankle equinus.

Unlabelled: Between 2003 and 2006, we used an extraarticular, cannulated, fully threaded posterior calcaneotibial screw to prevent equinus contracture in 10 patients (four male and six female patients, 14 limbs) undergoing tibial lengthening with the intramedullary skeletal kinetic distractor. Diagnoses were fibular hemimelia (two), mesomelic dwarfism (two), posteromedial bow (one), hemihypertrophy (one), poliomyelitis (one), achondroplasia (one), posttraumatic limb-length discrepancy (one), and hypochondroplasia (one). Average age was 24.

Compartment syndrome after hypocalcemic tetany: a case report.

Compartment syndrome results from pathologically elevated muscle tissue pressure within a closed space. It is almost always related to either trauma or reperfusion after loss of arterial inflow from occlusion of a major blood vessel. We present an unusual case of nontraumatic and nonvascular compartment syndrome after hypocalcemia-induced sustained tetany in a 2-year-10-month-old male child after a neuroblastoma tumor resection.

Pseudoaneurysm after Ponseti percutaneous Achilles tenotomy: a case report.

The Ponseti method has become a popular technique to treat idiopathic clubfoot. In most cases, a percutaneous Achilles tenotomy is required to correct residual equinus contracture. Bleeding has been reported as a complication of percutaneous tenotomy.