Initial Clinical Experience with the IMEX™ Circular External Skeletal Fixation System

1999 ◽  
Vol 12 (03) ◽  
pp. 118-127 ◽  
Author(s):  
R. M. Radasch ◽  
B. S. Beale ◽  
J. T. Stallings ◽  
R. D. Welch ◽  
M. L. Samchukov ◽  
...  
Keyword(s):  
Deformity Correction ◽  
Latency Period ◽  
Functional Results ◽  
Substantial Improvement ◽  
Annual Conference ◽  
University Of Florida ◽  
Cosmetic Results ◽  
Linear Motors ◽  
Pin Track ◽  
Angular Deformities

SummaryThe IMEX™ Circular External Skeletal Fixation (CESF) System was used to treat 10 antebrachial deformities in nine dogs. The mandible of one dog with prognathism was also lengthened. Dogs ranged in age from four to 18 months (mean ± SD: 9 ± four months; median: eight months) and body weight from 2.6 to 46.0 kg (mean ± SD: 23.9 ± 11.2 kg; median: 24.2 kg). Linear distractions were performed with linear motors or threaded rods with paired nylon nuts securing the connecting rods to rings placed between ring blocks. Hinges and angular motors were used to correct angular deformities. A latency period of two to six days and a distraction rate of 1 mm/day, with a twice daily rhythm, were used. Distraction periods ranged from 12 to 32 days (mean ± SD: 21 ± 8 days; median: 25 days). Lengthening achieved ranged from 11 to 40 mm (mean ± SD: 20 ± 9 mm; median: 18 mm) or 6 to 30% (mean ± SD: 15 ± 8%; median: 13%) of the distracted bone’s initial length. All dogs had substantial improvement of their deformity and effective regenerate bone formation. Flexure contracture and wire and pin track inflammation were common complications during the convalescent period. Functional and cosmetic results (direct examination: mean ± SD: 130 ± 65 days; median: 123 days; telephone communication: mean ± SD: 351 ± 133 days; median: 324 days) were assessed as excellent in six, good in three and fair in two dogs and excellent in five, good in four and fair in one dog, respectively. The IMEX™ CESF system allowed precise deformity correction with minimal morbidity which was attributable to the system’s zero tolerance, zero motion properties.The IMEX™ Circular External Skeletal Fixator System was used to treat antebrachial deformities in nine dogs and to lengthen the mandible of one dog with prognathism. Functional results were assessed as excellent in six dogs, good in three dogs and fair in two dogs. Cosmetic results were assessed as excellent in five dogs, good in four dogs and fair in one dog.Presented at the 23rd Annual Conference of the Veterinary Orthopaedics Society, Telluride, CO, USA, March 5, 1996. University of Florida Journal Series #547.

scholarly journals Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Deformity Correction ◽  
Genu Valgum ◽  
Angular Deformity ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
The Mean ◽  
Low Incidence ◽  
Angular Deformities

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

Long-Term Results After Policization for Congenital Hand Deformities

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 79-85 ◽  
Author(s):  
Toshihiko Ogino ◽  
Seiichi Ishii
Keyword(s):  
Functional Results ◽  
Long Term Results ◽  
Pinch Strength ◽  
Cosmetic Results ◽  
Opposite Hand ◽  
Hand Deformities ◽  
The Mean ◽  
Congenital Hand Deformities

Thirteen patients — 18 hands — have been treated with pollicization and could be followed-up for 2 years to 19 years with an average of 7.9 years. Surgery was performed according to the Buck-Gramcko method. The mean age at the time of pollicization was 1.7 years. The parents were satisfied with the cosmetic results in all cases, and they were satisfied with the functional results in all except 4 hands. At follow-up, all patients could use the pollicized digit for pinch. Excellent pinch function has been achieved in 11 hands, good in 2, and fair in 1. The average percent pinch strength compared to the opposite hand was 55%. Association of a radial club hand and contracture of the pollicized digit and other fingers seemed to influence the postoperative pinch function.

scholarly journals EFFICACY OF FRONTALIS MUSCLE FLAP SUSPENSION IN TREATING MODERATE TO SEVERE BLEPHAROPTOSIS

2021 ◽  
Vol 506 (1-2) ◽  
Author(s):  
Pham Ngoc Minh ◽  
Dinh Viet Nghia ◽  
Nguyen Tai Son
Keyword(s):  
Clinical Trial ◽  
Study Design ◽  
Muscle Flap ◽  
Functional Results ◽  
Palpebral Fissure ◽  
Frontalis Muscle ◽  
Cosmetic Results ◽  
Clinical Trial Results

Purpose: This study aims to evaluate the efficacy of frontalis muscle flap suspension in treating moderate to severe blepharoptosis. Study subjects: 54 eyes of 47 moderate to severe blepharoptosis patients (aged 17.34 ± 9.17 years, 18 males, 29 females). Study design: Prospective uncontrolled clinical trial. Results: Following frontalis muscle flap suspension surgery, there was a statistically significant improvement (p<0.001) in margin reflex distance 1 (MRD1) and palpebral fissure height (PFH), from 0.009 ± 0.60 mm and 5.59 ± 0.68 mm (pre-operation) to 2.68 ± 1.10 mm and 8.26 ± 1.14 mm (1 week after operation), 3.63 ± 0.77 mm and 9.24 ± 0.85 mm (6 months after operation), 3.45 ± 0.80 mm and 9.02 ± 0.89 mm (12 months after operation). At the 12th month after operation, it was found that severe lagophthalmos, lid lag on down-gaze and forehead hypoesthesia were present in 7.4%, 9.3% and 14.0% of all treated eyes, respectively. Excellent functional results were determined in 66,0% of procedures postoperatively, with 31,9% and 2,1% rated as good and unsatisfactory. In terms of cosmetic results, 78,7%, 19,1% and 2,1% of cases were rated as excellent, good and unsatisfactory, respectively. Conclusion: Majority of case results were excellent (78,7%) and good (19,1%), unsatisfactory cases 2,1%.

Preliminary Outcomes of Calcaneal Lengthening in Adolescent Flatfoot in Müller-Weiss Disease

2019 ◽  
Vol 40 (7) ◽  
pp. 803-807 ◽  
Author(s):  
Abdel-Salam Abdel-Aleem Ahmed ◽  
Mahmoud Ibrahim Kandil ◽  
Eslam Abdelshafi Tabl
Keyword(s):  
Treatment Options ◽  
Case Series ◽  
Deformity Correction ◽  
Functional Results ◽  
The Body ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
The Mean ◽  
Calcaneal Lengthening

Background: Müller-Weiss disease (MWD) remains a controversial painful foot condition without consensus on its pathogenesis or a gold standard treatment modality. The aim of the study was to evaluate the outcomes of calcaneal lengthening in adolescent patients with symptomatic MWD with flatfoot. Methods: The study included 13 feet of 7 patients including 5 females and 2 males who were treated from March 2012 until June 2015 by calcaneal lengthening. The mean age was 15.6 years. The mean duration of symptoms was 13.5 months. The body mass index (BMI) averaged 28.9 kg/m2 at presentation. The patients were followed up for a mean of 37.8 months. Results: The osteotomy healed in all cases after a mean of 7.2 weeks. The second foot was operated on after an average of 11.5 months. The mean talometatarsal-1 angle improved from 39.8 degrees preoperatively to 5.9 degrees. The mean preoperative calcaneal pitch angle of 7.5 degrees increased to an average of 17.8 degrees postoperatively. The mean American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score was improved from 61.9 preoperatively to 94.2 postoperatively. Four patients had occasional exertional pain. Four feet had mild residual forefoot abduction. Arthrodesis was not needed in any case by the last follow-up. Conclusion: Early diagnosis of MWD with flatfoot was important and allowed for nonfusion treatment options. Calcaneal lengthening osteotomy in selected MWD cases achieved satisfactory outcomes with pain control, deformity correction, and improvement of the functional results. Level of Evidence: Level IV, retrospective case series.

Use of an interlocking nail-hybrid fixator construct for distal femoral deformity correction in three dogs

2011 ◽  
Vol 24 (03) ◽  
pp. 236-245 ◽  
Author(s):  
K. M. Wendelburg ◽  
C. W. Sereda ◽  
D. J. Reese ◽  
J. L. Wheeler ◽  
D. D. Lewis
Keyword(s):  
Three Dimensional ◽  
Deformity Correction ◽  
Functional Results ◽  
Three Dimensional Model ◽  
Interlocking Nail ◽  
Hybrid External Fixator ◽  
Femoral Deformity ◽  
Locking Nail ◽  
Centre Of Rotation ◽  
Hybrid Fixator

SummaryOur purpose was to report the use of an inter-locking nail-hybrid external fixator construct to correct distal femoral deformities in three dogs. Radiographs, computed tomography and a three-dimensional model were used to plan the surgical procedure. A femoral osteotomy or ostectomy was performed at the level of the centre of rotation of angulation in all three dogs. Angular and rotational deformities were corrected acutely. Distraction osteo-genesis was performed to lengthen each femur postoperatively. All three dogs had additional anatomic abnormalities of the affected hindlimb complicating the correction of the distal femoral deformity. While the interlocking nail-hybrid fixator construct allowed for stable distraction of the femur, all three dogs developed complications during the postoperative convalescent period, and each had some degree of residual lameness. Lengthening the femur following acute deformity correction is problematic and additional experimental and clinical studies are warranted to decrease postoperative morbidity and improve functional results.

scholarly journals Treatment of the overriding fifth toe: Butler’s arthroplasty is a good option

2018 ◽  
Vol 12 (1) ◽  
pp. 36-41 ◽  
Author(s):  
R. Simões ◽  
C. Alves ◽  
L. Tavares ◽  
I. Balacó ◽  
P. Sá Cardoso ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Telephone Interview ◽  
Deformity Correction ◽  
Functional Results ◽  
Level Of Evidence ◽  
Forefoot Deformity ◽  
Significant Difference ◽  
Fifth Toe ◽  
Clinical Records

Purpose The overriding fifth toe is a congenital triplane deformity that may cause aesthetic and functional concerns in children and adolescents. This study aims to evaluate the results obtained when using Butler’s arthroplasty to treat this forefoot deformity. Methods We performed a retrospective study, including all patients undergoing Butler’s arthroplasty from January 1995 to December 2012. Clinical records were reviewed to determine age at date of surgery, gender, laterality, preoperative symptoms, success of deformity correction, postoperative pain, scarring, need for adapted shoe, rates of complications and recurrence. Patient satisfaction was evaluated through a telephone interview. All p-values < 0.05 were considered statistically significant. Results A total of 21 patients were included in this study, the majority of which were male (57%), with a mean follow-up of 12 months (1 to 52). In the evaluation of the residual deformity (18 patients), 72% had excellent results, 17% good and 11% poor results. One patient had a keloid scar, three patients reported pain and three patients required adapted footwear. There was a partial recurrence of the deformity in three cases. The majority of patients (78%) were satisfied with the surgery. There was no statistically significant difference in terms of results, when comparing patients older and younger than seven years of age (p = 0.46). Conclusions Butler’s operation is effective and safe in the treatment of the overriding fifth toe, yielding good functional results and patient satisfaction, with low rate of complications. Level of Evidence IV

Split-Rib Graft for Reconstruction of the Mandible

1984 ◽  
Vol 92 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Jan Wersäll ◽  
Hans Bergstedt ◽  
Bengt Körlof ◽  
Magnus G. Lind
Keyword(s):  
Operation Time ◽  
Great Majority ◽  
Functional Results ◽  
Safe Procedure ◽  
Tumor Surgery ◽  
Cosmetic Results

Defects in the mandible after tumor surgery were reconstructed with split-rib grafts in 23 patients. Twenty of the patients were preoperatively irradiated with fractioned radiotherapy, ranging from 40 to 85 gray. Partial sequestration appeared in five patients. The ingrowth of the transplant was examined with technetium scintigraphy. Satisfactory cosmetic and functional results were achieved in the great majority of the patients. Split-rib grafting is recommended for reconstruction of the mandible as a safe procedure with little increased operation time and morbidity for the patient and good functional and cosmetic results.

scholarly journals Surgical Treatment of Severe Ptosis by Modified Brow Suspension Technique

2019 ◽  
Vol 28 (1) ◽  
pp. 40-45
Author(s):  
Ali Adawal Ali ◽  
Abdulhameed Abdul Majeed Hassan ◽  
Marwan Salah Salman
Keyword(s):  
Functional Results ◽  
Bilateral Ptosis ◽  
Effective Technique ◽  
Old Patients ◽  
Cosmetic Results ◽  
Eye Infection ◽  
Incomplete Closure ◽  
Type Of Surgery

Background: Blepharoptosis can occur at any age. Its surgical correction may be indicated for functional and cosmetic purposes. Blepharoptosis treatment in children <3 years old may be required on an urgent basis to prevent amblyopia. The type of surgery depends on the severity of ptosis. The purpose of the study is to assess the functional results and complications of frontalis sling operation using double-threaded prolene as a suspensory material to correct severe ptosis with minimal or no levator muscle function. Methods: In total, 72 lids of 59 patients (both male and female) having severe unilateral or bilateral ptosis were included. Frontalis sling with double-threaded prolene using cannula for introducing prolene was used to correct severe ptosis in these patients. Patients were followed up for an average of 21 (range: 12-24) months postoperatively for evaluating the functional and cosmetic results as well as possible complications. Results: Favourable long-term functional and cosmetic results were achieved in most patients. The overall recurrence rate of ptosis was in 5 lids, most of which were in <5-year-old patients. Other complications were incomplete closure in 2 lids, overcorrection in 1 lid, and corneal exposure and exposure keratitis in 1 eye. Infection, wound problems, and supratarsal sulcus obliteration were not observed in any case during the follow-up period. Conclusions: Frontalis sling operation using double-threaded prolene as a suspensory material is an effective technique to correct severe ptosis.

scholarly journals Two case reports of lower limb posttraumatic angular deformities correction by dynamic hinged external fixation

2015 ◽  
Vol 62 (1) ◽  
pp. 69-74
Author(s):  
Milan Mitkovic ◽  
Sasa Milenkovic ◽  
Ivan Micic ◽  
Igor Kostic ◽  
Predrag Stojiljkovic ◽  
...  
Keyword(s):  
Hospital Stay ◽  
External Fixation ◽  
External Fixator ◽  
Lower Limb ◽  
Deformity Correction ◽  
Operation Time ◽  
Angular Deformity ◽  
Surgical Trauma ◽  
Hinged External Fixation ◽  
Angular Deformities

The aim of this study was to present two patients with lower limb posttraumatic angular deformity treated by dynamic hinged external fixation. CD-V mode Mitkovic type external fixator had been used in both cases for correction of these deformities. The method is based on hemicallotasis - bone callus distraction after a partial transversal bone cut (hemocorticotomy). The first patient had varus-recurvatum posttraumatic deformity of the ankle joint. Operation time was 65 min and hospital stay was 9 days. Superficial pin-track infection was resolved by the pin removal and by daily wound toilette. The second patient had varus-antecurvatum malunion deformity of the femoral diaphysis. Operation time was 50 min and hospital stay was 6 days. Mild knee contracture had been successfully treated by physical therapy. Angular deformity correction had been performed by distraction (for the first patient) and compression (for the second patient) in the fixator frame. Hemicallotasis of femur or tibia using CD-V mode Mitkovic type external fixator is a good alternative in the treatment of posttraumatic lower limb angular deformities, providing minimal surgical trauma and maximal use of the bone osteogenetic capacity. Gradual compression or distraction in the fixator frame allows to perform accurate angular correction in both coronal and sagital plane in one act.

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