AI Article Synopsis
Article Abstract
Background: Although lengthening of the lateral column through an osteotomy of the anterior calcaneus is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, the procedure has been implicated in iatrogenic calcaneocuboid (CC) subluxation and subsequent degenerative changes at the CC articulation. The purpose of this study is to characterize alterations at the CC joint after lateral column lengthening (LCL) and determine if Steinmann pin stabilization of the CC joint before distraction maintains a normal relationship.
Methods: Seven matched pairs of fresh-frozen cadaveric feet underwent preprocedure plain radiography and cross-sectional computed tomography (CT) imaging. LCL by osteotomy through the anterior calcaneus was then performed. One foot of each matched pair had a single smooth Steinmann pin placed centrally across the CC joint before osteotomy distraction. Distraction across each osteotomy was then performed and maintained with a 12-mm porous titanium wedge. Repeat imaging was obtained and compared with preprocedure studies to quantify sagittal and rotational differences at the CC articulation.
Results: Following LCL, plain radiography demonstrated statistically significant increases in the percentage of the calcaneal articular surface dorsal to the superior aspect of the cuboid in both the pinned (8.2% vs. 17.6%, P=0.02) and unpinned (12.5% vs. 16.3%, P=0.04) specimens. No difference in the percentage of subluxation was found between the 2 groups after LCL. CT imaging demonstrated statistically significant increases in rotation between the calcaneus and cuboid after LCL in both the pinned (7.6±5.6 degrees, P=0.01) and unpinned (17±12.3 degrees, P=0.01) specimens. The degree of rotation was greater in unpinned specimens after LCL (P=0.043).
Conclusions: Both sagittal and rotatory subluxation seem to occur at the CC joint after LCL regardless of pin stabilization. As a single pin would be expected to limit pure translation while having little effect on rotation, it is possible that the rotational changes identified on 3-dimensional imaging are interpreted as dorsal translation when viewed 2 dimensionally using plain radiography. Consideration should therefore be given to CC stabilization with 2 pins during LCL to prevent this rotatory subluxation.
Level Of Evidence: Level V-cadaver study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0000000000001752 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The standard treatment for displaced pediatric supracondylar fracture of humer us (PSCFH) is closed reduction and percutaneous pinning under image intensifier guidance. This technical note describes Kapandji intrafocal pinning technique (KIPT) for achieving optimal fracture reduction and stable fixation in Gartland Type III or IV extension type PSCFH. In KIPT, a K wire was introduced into the fracture site from the posterior aspect, fracture manipulation was done by levering with wire reducing the posterior displacement of the distal fragment and the wire was fixed to the anterior cortex of the proximal fragment.
View Article and Find Full Text PDFBiomechanical and clinical evaluation of PSO, modified PSO and VCR treating OVCF kyphosis: a finite element analysis.
Front Bioeng Biotechnol
December 2024
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Objective: To confirm the effect of surgery on spinal column biomechanics and to provide theoretical support for the advantages and disadvantages of different surgical methods and their clinical efficacy.
Methods: 33 continuous patients with no significant difference in risk factors related to the mechanical complications were enrolled in this retrospective study. Sagittal parameters were measured in the pre-, post-operative and following-up lateral radiograph of spine.
Indications, complications and outcomes of minimally-invasive lateral lumbar interbody fusion with anterior column realignment vs. standard LLIF using expandable interbody spacers.
Front Surg
December 2024
Spine Center of Eastern Switzerland, Cantonal Hospital of St. Gallen & Medical School of St. Gallen, St. Gallen, Switzerland.
Background: Anterior column realignment (ACR), using a lateral lumbar or thoracic interbody fusion (LLIF) approach to release the anterior longitudinal ligament (ALL), is a powerful technique to increase segmental lordosis. We here report our experience with the use of expandible LLIF cages for ACR.
Methods: Retrospective, single-center observational cohort study including consecutive patients treated by LLIF using an expandible interbody implant.
Two-stage spinal osteotomy combined with lateral lumbar interbody fusion for lumbar kyphosis: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Orthopaedic Surgery, University of Toyama, Toyama City, Toyama, Japan.
Background: Adult spinal reconstructive surgery that requires multilevel spinal fusion is highly invasive and requires two-stage surgery using lateral lumbar interbody fusion (LLIF) and/or percutaneous pedicle screw (PPS) fixation to make it less invasive. However, it is still difficult to make spinal osteotomy less invasive, and the high complication rate is an issue.
Observations: The authors present the surgical techniques of a two-stage Schwab grade 4 spinal osteotomy using LLIF, which could reduce surgical invasiveness and enable good correction and anterior spinal column reconstruction for lumbar kyphosis, and also report a case treated with this procedure.
Laparoscopic Intraperitoneal Onlay Mesh Repair for Symptomatic Secondary Lumbar Hernia After Retroperitoneoscopic Nephrectomy: A Case Report.
Cureus
December 2024
Gastroenterological Surgery, Tohoku Medical and Pharmaceutical University, Sendai, JPN.
Lumbar hernia (LH) is a rare abdominal wall hernia that occurs within the anatomic boundaries of the 12th rib, iliac crest, external oblique muscles, erector spinae muscles, and vertebral column. Secondary LH after urological surgery is rare, and the limited evidence hinders consensus on optimal surgical treatment. Here, we present a case of laparoscopic intraperitoneal onlay mesh (IPOM) repair for a large, symptomatic secondary LH after retroperitoneoscopic nephrectomy (RN) with mid-term postoperative outcomes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!