Background: Spastic cerebral palsy (CP) is a prevalent cause of motor dysfunction in children, with patients often experiencing secondary musculoskeletal deformities, including tibial torsion. This study aimed to investigate the short-term effect of selective dorsal rhizotomy (SDR) on tibial torsion in children with spastic CP.
Methods: We conducted a retrospective review of children with spastic CP who underwent SDR at the Department of Neurosurgery, Shanghai Children's Hospital, between July 2019 and November 2022. Pre- and post-operative physical assessments were examined.
Results: A total of 148 children were included in the study. After SDR, there was a significant decrease in muscle tone in the lower limb muscle groups. Joint range of motion in the lower limbs also increased post-surgery. Bilateral transmalleolar angle (TMA) showed a significant increase after the surgery, and 21% limbs classified as internal tibial torsion before SDR changed into normal angle post-operatively. Limbs with better improvement after SDR derived from younger patients and had lower muscle tone in the hamstring muscles when compared to those that did not show improvement.
Conclusions: SDR has the potential to increase TMA in children with spastic CP. Limbs classified as internal tibial torsion are more likely to improve after SDR if they have lower muscle tone in the hamstring muscles and are derived from younger patients.
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http://dx.doi.org/10.21037/tp-23-339 | DOI Listing |
J Exp Orthop
January 2025
Department of Trauma Surgery, BG Trauma Center Tuebingen University of Tuebingen Tuebingen Germany.
Purpose: Malalignment of the lower extremity can affect one, two or all three anatomic planes. We hypothesized an influence between the malalignment of the coronal and axial planes.
Methods: A total of 356 lower extremities of 226 patients were included.
Vet Med (Praha)
December 2024
Department of Veterinary Surgery, College of Veterinary Medicine, Jeonbuk National University, Jeollabuk-do, Republic of Korea.
Tibial torsion assessment is crucial for understanding deformities and malalignments that can lead to joint pathologies in dogs. Different methods such as radiography, computed tomography (CT), and three-dimensional (3D) volume-rendering techniques have been employed to measure tibial torsion. This study compared the accuracy and reliability of tibial torsion angle (TTa) measurements obtained using radiography and ultrasound tilting techniques against those obtained using the 3D volume-rendering method in small-to-medium-sized non-chondrodystrophic dogs.
View Article and Find Full Text PDFOrthop Traumatol Surg Res
January 2025
Ramsay Santé, Hôpital Privé d'Antony, 1, Rue Velpeau, 92160 Antony, France.
Anterior tibial tuberosity osteotomy is a well-described therapeutic option for the treatment of patellar instability. External torsion of the anterior tibial tuberosity can be one of several factors that adversely affect the patellofemoral joint and its stability. The Anterior Tibial Tubercle Internal Torsion Osteotomy (ATTITO) allows the correction of excessive external torsion of the tibial tuberosity in a safe and reproducible manner.
View Article and Find Full Text PDFJ Spine Surg
December 2024
Surgical and Orthopaedic Research Laboratories, Prince of Wales Clinical School, University of New South Wales, Sydney, AUS.
Background: Implant fixation is often the cornerstone of musculoskeletal surgical procedures performed to provide bony fixation and/or fusion. The aim of this study was to evaluate how different design features and manufacturing methods influence implant osseointegration and mechanical properties associated with fixation in a standardized model in cancellous bone of adult sheep.
Methods: We evaluated the performance of three titanium alloy implants: (A) iFuse-TORQ implant; (B) Fenestrated Sacroiliac Device; and (C) Standard Cancellous Bone Screw in the cancellous bone of the distal femur and proximal tibia in 8 sheep.
Knee Surg Sports Traumatol Arthrosc
January 2025
Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China.
Purpose: To propose a new sign of patellar maltracking in recurrent patellar dislocation (RPD) and compare the differences in lower limb rotational and bony structural abnormalities among the different signs.
Patients And Methods: A retrospective study included 279 patients (mean age: 22 years; female: 81%) who underwent primary surgery for RPD over the past 4 years was performed. The patients were grouped based on the characteristics of patellar tracking: low-, moderate- and high-grade J-sign.
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