Guided growth vs.Tibial osteotomy at early stage of Blount disease in squelletically immature patients

2021 ◽  
Author(s):  
Beaudelaire Romulus Assan ◽  
Anne-laure Simon ◽  
Sonia Adjadohoun ◽  
Géraud Garcia PS. Segbedji ◽  
Philippe Souchet ◽  
...  
Keyword(s):  
Early Stage ◽  
Guided Growth ◽  
Blount Disease

scholarly journals Guided Growth Vs. Tibial Osteotomy in Early Stage of Blount Disease

2021 ◽  
Author(s):  
Beaudelaire Romulus ASSAN ◽  
Anne-Laure SIMON ◽  
Sonia ADJADOHOUN ◽  
Geraud Garcia Philemon Satingo SEGBEDJI ◽  
Cedric Bignon Ulrich ASSOUTO ◽  
...  
Keyword(s):  
Analytical Study ◽  
Mechanical Axis ◽  
Early Stage ◽  
Tibial Osteotomy ◽  
Tibial Torsion ◽  
Guided Growth ◽  
Tibiofemoral Angle ◽  
Blount Disease ◽  
Radiological Stage

Abstract Background: There are no real comparative study between guided growth and tibial osteotomy in early stage of Blount disease. The aim of this work was to compare the results of patients treated by these two techniques. Method: We had performed a multicenter retrospective, descriptive and analytical study over a period of 05 years. All children admitted for Blount disease without medial proximal tibial epiphysiodesis and treated by one of these techniques were included. Age, sex, existence of tibial torsion, radiological stage based on Catonne's classification were studied. We also evaluated preoperatively, immediately postoperatively, and at latest follow-up tibiofemoral angle, mechanical medial proximal tibial angle, mechanical lateral distal femoral angle, and the tibial metaphyso-diaphyseal angle. Results: Seventeen (17) patients for 24 knees were included. The sex ratio was 0.54. All patients had tibial torsion. Fourteen knees (64%) were treated by guided growth at a mean age of 5.5±2.5 (range, 3-9 years). With a mean follow-up of 12 ± 3.5 months (range 6-15month); tibiofemoral, mechanical medial proximal tibial, and tibial metaphyso-diaphyseal angles were significantly corrected with normalization of the mechanical axis in 8 patients (60%). Ten patients (36%) were treated by revisited Rab osteotomy at a mean age of 7.7±4.9 years (range, 4-12 years). At a mean follow-up of 23±15 months (range, 10-48 months), only tibial metaphyso-diaphyseal angle was significantly corrected. The recurrence rate was 60%. Despite perfect correction of tibiofemoral, and mechanical medial proximal tibial angles in immediate postoperative follow-up, they gradually decrease in patients treated by Rab osteotomy, whereas they gradually increased in case of guided growth. Conclusion: Guided growth appears to be the best treatment for early stage of Blount disease. Trial registration: Retrospectively registered

scholarly journals The efficacy of guided growth as an initial strategy for Blount disease treatment

2020 ◽  
Vol 14 (4) ◽  
pp. 312-317
Author(s):  
Barry Danino ◽  
Robert Rödl ◽  
John E. Herzenberg ◽  
Lior Shabtai ◽  
Franz Grill ◽  
...  
Keyword(s):  
Proximal Tibia ◽  
Average Rate ◽  
Line Treatment ◽  
First Line ◽  
Guided Growth ◽  
Level Of Evidence ◽  
Post Surgery ◽  
Blount Disease ◽  
First Line Treatment

Purpose The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease. Methods This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion. Preoperative alignment analysis was compared with three measurements taken postoperatively. The normalization of the mechanical medial proximal tibia angle (mMPTA) was defined as the primary outcome measure. Results Mean age at surgery was 9.5 years. Average preoperative mMPTA was 77°. On average, at 24.5 months post-surgery, mMPTA was 86.33°, while 43/55 limbs (78.18%) have achieved normalization (mMPTA 85° to 90°). Average rate of correction was 1° per month. When grouping the children as infantile (11 limbs), juvenile (12 limbs) and adolescent (32 limbs), operated on before the age of four years, between four and ten years and after the age of ten years, respectively, 63.63%, 66.67%, 87.5% have completed correction of deformity during the follow-up period. Interestingly, the femoral component of the deformity has achieved correction as well in 33/55 limbs (64%). Conclusion Hemiepiphysiodesis is an effective first line treatment for Blount disease. Overall success rate is good but varies according to child’s age. Adolescent Blount has the best chance of achieving full correction while same treatment is less effective in infantile Blount. Level of evidence: IV

Alterations in the number of motoneurons containing immunoreactive calcitonin gene-related peptide(CGRP)& choline acetyltransferase(ChAT) in the cervical spinal cord of the wobbler mouse during the development of the motoneuron disease

1995 ◽  
Vol 53 ◽  
pp. 970-971
Author(s):  
L. Vacca-Galloway ◽  
Y.Q. Zhang ◽  
P. Bose ◽  
S.H. Zhang
Keyword(s):  
Spinal Cord ◽  
Early Stage ◽  
Cervical Spinal Cord ◽  
Wild Type Mouse ◽  
Reflex Response ◽  
Mouse Strains ◽  
Behavioral Tests ◽  
Wobbler Mouse ◽  
Stage 4 ◽  
Stage 1

The Wobbler mouse (wr) has been studied as a model for inherited human motoneuron diseases (MNDs). Using behavioral tests for forelimb power, walking, climbing, and the “clasp-like reflex” response, the progress of the MND can be categorized into early (Stage 1, age 21 days) and late (Stage 4, age 3 months) stages. Age-and sex-matched normal phenotype littermates (NFR/wr) were used as controls (Stage 0), as well as mice from two related wild-type mouse strains: NFR/N and a C57BI/6N. Using behavioral tests, we also detected pre-symptomatic Wobblers at postnatal ages 7 and 14 days. The mice were anesthetized and perfusion-fixed for immunocytochemical (ICC) of CGRP and ChAT in the spinal cord (C3 to C5).Using computerized morphomety (Vidas, Zeiss), the numbers of IR-CGRP labelled motoneurons were significantly lower in 14 day old Wobbler specimens compared with the controls (Fig. 1). The same trend was observed at 21 days (Stage 1) and 3 months (Stage 4). The IR-CGRP-containing motoneurons in the Wobbler specimens declined progressively with age.

Automated high-resolution microscopy: the approaches so far

1987 ◽  
Vol 45 ◽  
pp. 58-61
Author(s):  
W. O. Saxton
Keyword(s):  
High Resolution ◽  
Early Stage ◽  
Automatic Recording ◽  
Microprocessor Control ◽  
Alternative Systems ◽  
Electron Image ◽  
Complete Automation ◽  
Analysis System ◽  
High Resolution Microscopy

Recent commercial microscopes with internal microprocessor control of all major functions have already demonstrated some of the benefits anticipated from such systems, such as continuous magnification, rotation-free diffraction and magnification, automatic recording of mutually registered focal series, and fewer control knobs. Complete automation of the focusing, stigmating and alignment of a high resolution microscope, allowing focal series to be recorded at preselected focus values as well, is still imminent rather than accomplished, however; some kind of image pick-up and analysis system, fed with the electron image via a TV camera, is clearly essential for this, but several alternative systems and algorithms are still being explored. This paper reviews the options critically in turn, and stresses the need to consider alignment and focusing at an early stage, and not merely as an optional extension to a basic proposal.

Direct observation of Fe-Al-Zn ternary intermetallic compound and its transformation during the early stage of hot-dip galvanizing

1993 ◽  
Vol 51 ◽  
pp. 1116-1117
Author(s):  
C. S. Lin ◽  
W. A. Chiou ◽  
M. Meshii
Keyword(s):  
Intermetallic Compound ◽  
Reaction Rate ◽  
Diffusion Rate ◽  
Early Stage ◽  
Zinc Bath ◽  
Steel Sheets ◽  
Direct Observations ◽  
Solid Iron ◽  
Iron And Zinc ◽  
Ternary Intermetallic Compound

The galvannealed steel sheets have received ever increased attention because of their excellent post-painting corrosion resistance and good weldability. However, its powdering and flaking tendency during press forming processes strongly impairs its performance. In order to optimize the properties of galvanneal coatings, it is critical to control the reaction rate between solid iron and molten zinc.In commercial galvannealing line, aluminum is added to zinc bath to retard the diffusion rate between iron and zinc by the formation of a thin layer of Al intermetallic compound on the surface of steel at initial hot-dip galvanizing. However, the form of this compound and its transformation are still speculated. In this paper, we report the direct observations of this compound and its transformation.The specimens were prepared in a hot-dip simulator in which the steel was galvanized in the zinc bath containing 0.14 wt% of Al at a temperature of 480 °C for 5 seconds and was quenched by liquid nitrogen.

Anisotropy of interfacial defects in the initial stage of MOVPE GaAs growth On Si

1990 ◽  
Vol 48 (4) ◽  
pp. 592-593
Author(s):  
C. Vannuffel ◽  
C. Schiller ◽  
J. P. Chevalier
Keyword(s):  
Early Stage ◽  
Threading Dislocations ◽  
Mbe Growth ◽  
Detailed Mechanism ◽  
Si Substrates ◽  
Initial Stage ◽  
Interfacial Defects ◽  
Interfacial Dislocations ◽  
Step Growth ◽  
Essential Problem

Recently, interest has focused on the epitaxy of GaAs on Si as a promising material for electronic applications, potentially for integration of optoelectronic devices on silicon wafers. The essential problem concerns the 4% misfit between the two materials, and this must be accommodated by a network of interfacial dislocations with the lowest number of threading dislocations. It is thus important to understand the detailed mechanism of the formation of this network, in order to eventually reduce the dislocation density at the top of the layers.MOVPE growth is carried out on slightly misoriented, (3.5°) from (001) towards , Si substrates. Here we report on the effect of this misorientation on the interfacial defects, at a very early stage of growth. Only the first stage, of the well-known two step growth process, is thus considered. Previously, we showed that full substrate coverage occured for GaAs thicknesses of 5 nm in contrast to MBE growth, where substantially greater thicknesses are required.

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