Van Nes Rotationplasty in Skeletally Immature Patients with Malignant Sarcoma of the Lower Extremity

Limb Salvage ◽  
1991 ◽  
pp. 527-529
Author(s):  
J. I. Krajbich
Keyword(s):  
Lower Extremity ◽  
Skeletally Immature

Lower Extremity Injuries in the Skeletally Immature Athlete

2007 ◽  
Vol 15 (6) ◽  
pp. 356-366 ◽  
Author(s):  
Joshua B. Frank ◽  
Gregg J. Jarit ◽  
Jonathan T. Bravman ◽  
Jeffrey E. Rosen
Keyword(s):  
Lower Extremity ◽  
Skeletally Immature ◽  
Lower Extremity Injuries ◽  
Extremity Injuries

Lower extremity overuse injuries in the skeletally immature athlete

2014 ◽  
Vol 25 (4) ◽  
pp. 375-382
Author(s):  
Ariel A. Williams ◽  
Amy E. Valasek ◽  
John H. Wilckens
Keyword(s):  
Lower Extremity ◽  
Overuse Injuries ◽  
Skeletally Immature

scholarly journals RECOVERY OF LOWER EXTREMITY STRENGTH AND FUNCTION FOLLOWING ACL RECONSTRUCTION IN SKELETALLY IMMATURE PATIENTS

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0008
Author(s):  
Dai Sugimoto ◽  
Benton E. Heyworth ◽  
Farren Davis ◽  
Mininder S. Kocher ◽  
Lyle J. Micheli
Keyword(s):  
Lower Extremity ◽  
Cruciate Ligament ◽  
Case Series ◽  
Return To Play ◽  
Iliotibial Band ◽  
Skeletally Immature ◽  
Growth Plates ◽  
Hop Tests ◽  
Case Series Study ◽  
Hip Abductor

BACKGROUND: Following anterior cruciate ligament reconstruction (ACLR) surgery, lower extremity recovery of the uninjured limb >90% is commonly recommended for clearance to return-to-play (RTP). However, evidence regarding the timing of achieving such a recovery is lacking, especially in skeletally immature populations. Therefore, the purpose of this study was to examine the proportion of pediatric ACLR patients (<15 years) who achieve >90% of lower extremity recovery at 6-9 months following ACLR surgery. METHODS: Retrospective case series study design was employed. Following inclusion criteria were used: 1) those who had ACLR surgery, 2) their chronological ages were under 15 years, and 3) growth plates remains open. Status of physis (growth plates) was examined through radiographs and MRI images by orhtopaedic physicians. ACLR patients who had previous ACL surgery in either ipsilateral or contralateral limb were excluded. During RTP tests, bilateral strength (quadriceps, hamstrings, hip abductor, and hip extensor), Y-balance (anterior, posteromedial, and posterolateral reach), and hop (single, triple, cross-over, and 6 meter timed) tests were assessed. Main outcome variables were number of skeletally immature ACLR patients whose limb symmetry index (LSI) were >90% during RTP tests. Descriptive statistics were used to analyze frequency, mean, standard deviation, and percentages (%). RESULTS: A total of 106 skeletally immature ACLR patients were enrolled (Table 1). Hamstrings and iliotibial band grafts were commonly used for ACLR surgery (Table 2). Mean time from ACLR to RTP testing was 6.8±3.4 months (Table 2). The proportion of skeletally immature ACLR patients, overall, achieving >90% of LSI in strength was: 74.5% in quadriceps, 39.0% in hamstrings, 81.0% in hip abductors, and 82.9% in hip extensors. Y-balance test results indicated 79.5% in anterior reach, 84.8% in posteromedial reach, and 86.7% in posterolateral reach. Hop test showed 65.3% in single hop, 69.1% in triple hops, 59.1% in cross-over hops, and 74.2% in 6 meter timed hops. Proportion of skeletally immature ACLR patients who passed all four strength, three Y-balance, and four hop tests were 19.8%, 64.8%, and 27.8%. Only 4.2% of skeletally immature ACLR patients demonstrated >90% of LSI in all tests at RTP tests. CONCLUSION/SIGNIFICANCE: Approximately 7 months following ACLR, approximately 3/4 of the patients achieved >90% of quadriceps, hip abductor, and hip extensor strength, but not hamstrings strength. While over 4/5 of the patients performed >90% in Y-balance, less than 3/4 achieve >90% on hop tests. These results suggest approximately 7 months following ACLR may be too early for returning competitive sports in skeletally immature population. Future studies are warranted to find an association between those RTP test batteries and subsequent ACL tear risks. [Table: see text][Table: see text]

scholarly journals Recovery of Lower Extremity Strength and Function following ACL Reconstruction in Skeletally Immature Patients

2018 ◽  
Vol 50 (5S) ◽  
pp. 623
Author(s):  
Dai Sugimoto ◽  
Benton Heyworth ◽  
Farren Davis ◽  
Mininder Kocher ◽  
Lyle Micheli
Keyword(s):  
Lower Extremity ◽  
Acl Reconstruction ◽  
Skeletally Immature ◽  
Lower Extremity Strength ◽  
And Function

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

Quick Reference: Chapter 3: The Musculoskeletal System and Chapter 4: The Nervous System

2000 ◽  
Vol 5 (3) ◽  
pp. 4-4
Keyword(s):  
Nervous System ◽  
Lower Extremity ◽  
Musculoskeletal System ◽  
Multistep Method ◽  
Manual Muscle Testing ◽  
Motor Deficits ◽  
Lower Extremity Weakness ◽  
Residual Symptoms ◽  
Muscle Testing ◽  
Almost All

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, divides PNS deficits into sensory and motor and includes pain in the former. This article, which regards rating sensory and motor deficits of the lower extremities, is continued from the March/April 2000 issue of The Guides Newsletter. Procedures for rating extremity neural deficits are described in Chapter 3, The Musculoskeletal System, section 3.1k for the upper extremity and sections 3.2k and 3.2l for the lower limb. Sensory deficits and dysesthesia are both disorders of sensation, but the former can be interpreted to mean diminished or absent sensation (hypesthesia or anesthesia) Dysesthesia implies abnormal sensation in the absence of a stimulus or unpleasant sensation elicited by normal touch. Sections 3.2k and 3.2d indicate that almost all partial motor loss in the lower extremity can be rated using Table 39. In addition, Section 4.4b and Table 21 indicate the multistep method used for spinal and some additional nerves and be used alternatively to rate lower extremity weakness in general. Partial motor loss in the lower extremity is rated by manual muscle testing, which is described in the AMA Guides in Section 3.2d.

Q&A: Multiple Lower Extremity Impairments and AMA Guides, Third Edition, Revised

2017 ◽  
Vol 22 (2) ◽  
pp. 15-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Steven Demeter ◽  
Randolph Soo Hoo
Keyword(s):  
Lower Extremity

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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