scholarly journals Free Non-vascularized Toe Phalangeal Transfers in Symbrachydactyly: Outcome Analysis

2020 ◽  
Vol 48 (02) ◽  
pp. 87-92
Author(s):  
Rita Sapage ◽  
João Rosa ◽  
Eva Campos Pereira ◽  
Marta Santos Silva ◽  
Alexandre Pereira ◽  
...  
Keyword(s):  
Bone Growth ◽  
Proximal Phalanx ◽  
Growth Potential ◽  
Outcome Analysis ◽  
Soft Tissue Envelope ◽  
Radiographic Outcomes ◽  
Final Length ◽  
The Stability ◽  
Clinical Records ◽  
Digit Function

Abstract Introduction Free nonvascularized toe phalangeal transfer is an established surgical option for the reconstruction of hypoplastic digits. The purpose of the present study was to evaluate our experience with this procedure and to assess bone growth and digit function as well foot morbidity. Material and Methods We retrospectively evaluated the clinical records for all children with symbrachydactyly submitted to free nonvascularized toe phalangeal transfer between 2002 and 2017. A total of 8 patients were included. We summoned the patients to an appointment to clinically assess the range of motion, the stability, and the alignment of the neo-joint. We radiographically measured the final length and the expected percentage of growth of the transferred phalanx. We also evaluated the foot for comorbidities. Results The mean age at the time of the first surgery was 19 months (range: 8–42 months). A total of 20 phalanges were harvested: 16 total proximal phalanges, 2 middle phalanges, 1 subtotal proximal phalanx, and 1 accessory thumb phalanx. The distal part of one proximal phalanx was trimmed because the skin pocket was too tight. Two patients underwent a secondary procedure to release the syndactyly. One transfer required revision surgery due to distal tip necrosis and exposition of the transferred phalanx. In the present series, the overall clinical and radiographic outcomes were compatible to those reported in other studies. Discussion The main limitation of the nonvascularized toe phalanx transfer is the preexisting soft tissue envelope of the finger and the limited growth potential of the transferred bone. Conclusion Irrespective of the amount of growth achieved in the transferred phalanx, the actual transfer and growth attained should not be viewed as the end result, but rather as a means of providing a stable and functional joint.

ON-TOP PLASTY USING A FREE METACARPAL HEAD GRAFT FOR LENGTHENING OF PROXIMAL PHALANX IN SYMBRACHYDACTYLY — A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 273-275 ◽  
Author(s):  
Kousuke Iba ◽  
Takuro Wada ◽  
Toshihiko Yamashita
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Growth ◽  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Soft Tissue Envelope ◽  
Metacarpal Head ◽  
Little Finger

A three-year old patient with symbrachydactyly (didactyly type) presented with a little finger that was too short to allow pinching and consisting of a floppy soft-tissue envelope with hypoplastic phalanges, although the thumb was functional. As the proximal phalanx was too small to permit distraction lengthening or conventional bone grafting, on-top plasty using a 4th metacarpal graft with a cartilage head was undertaken for lengthening the proximal phalanx of the little finger for pinch reconstruction. At ten weeks after surgery, the patient achieved satisfactory pinch function due to the lengthened and bone-stabilised postoperative digit and reconstruction of functional proximal interphalangeal joint. In addition, the grafted metacarpal demonstrated satisfactory bone growth throughout the six-year follow-up period.

scholarly journals The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

Biology ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 12
Author(s):  
David Chavarri-Prado ◽  
Aritza Brizuela-Velasco ◽  
Ángel Álvarez-Arenal ◽  
Markel Dieguez-Pereira ◽  
Esteban Pérez-Pevida ◽  
...  
Keyword(s):  
Dental Implants ◽  
Mechanical Loading ◽  
Bone Growth ◽  
Bone Matrix ◽  
Test Group ◽  
Control Group ◽  
Group A ◽  
Bone To Implant Contact ◽  
The Stability ◽  
Group B

Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.

scholarly journals Rational selection of treatment methods in recurrent clubfoot

2021 ◽  
pp. 64-71
Author(s):  
G. V. Divovich
Keyword(s):  
Surgical Treatment ◽  
Bone Growth ◽  
Soft Tissues ◽  
Primary Treatment ◽  
Ponseti Method ◽  
Growth Potential ◽  
Idiopathic Clubfoot ◽  
Rational Selection ◽  
Congenital Clubfoot ◽  
Selection Of

Objective. Based on an analytical assessment of the results of surgical treatment of children with equinovarus foot deformity of various origins (idiopathic clubfoot, syndromic clubfoot), to determine a way of rational selection of surgical techniquesin each specifc case.Materials and methods. The results of the treatment of 78 children with congenital idiopathic clubfoot over the period 2010–2018 were assessed in comparison with the results of the treatment of 41 children with recurrent congenital clubfoot, whose primary treatment had been carried out before 2010. We have gained the experience in treating 30 children with severe clubfoot syndrome (meningomyelocele, CNS lesions, chromosomal diseases and others).Results. In the treatment of congenital clubfoot with the Ponseti method, recurrences occur in 21.79 % of the cases, and in the traditional treatment — in 57.74 %. The Ponseti surgical treatment of recurrences consists in performing release operations on the tendon-ligament apparatus from mini-accesses. Cases of rigid, long-standing deformities require extensive releases on soft tissues, as well as resection and arthrodesis interventions on the joints of the foot. The treatment of clubfoot syndrome requires “surgically aggressive” methods of correction in early childhood.Conclusion. In the idiopathic variants of clubfoot and its relapses, it is possible to correct the vicious position of the feet by minimally invasive operations with minimal damage to the tissues of the circumflex joints and without damage to the flexor tendons and their sheaths in the medial ankle area. Long-standing recurrent rigid variants, as well as syndromic clubfoot, presuppose the performance of extensive releases, osteotomies and arthrodetic resections of the joints of the foot at an early age. A promising direction for clubfoot correction in the process of child development is a surgery with the use of the bone growth potential of the lower leg and foot.

scholarly journals Stability Evaluation and Degradation Studies of DAC® Hyaluronic-Polylactide Based Hydrogel by DOSY NMR Spectroscopy

Biomolecules ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 1478
Author(s):  
Tatiana Guzzo ◽  
Fabio Barile ◽  
Cecilia Marras ◽  
Davide Bellini ◽  
Walter Mandaliti ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Nmr Spectroscopy ◽  
Bone Growth ◽  
Orthopedic Implants ◽  
Structured Surfaces ◽  
Physiological Conditions ◽  
Hydrophilic Character ◽  
Dosy Nmr ◽  
The Stability

The stability and the degradation of polymers in physiological conditions are very important issues in biomedical applications. The copolymer of hyaluronic acid and poly-D,L-lactic acid (made available in a product called DAC®) produces a hydrogel which retains the hydrophobic character of the poly-D,L-lactide sidechains and the hydrophilic character of a hyaluronic acid backbone. This hydrogel is a suitable device for the coating of orthopedic implants with structured surfaces. In fact, this gel creates a temporary barrier to bacterial adhesion by inhibiting colonization, thus preventing the formation of the biofilm and the onset of an infection. Reabsorbed in about 72 h after the implant, this hydrogel does not hinder bone growth processes. In the need to assess stability and degradation of both the hyaluronan backbone and of the polylactic chains along time and temperature, we identified NMR spectroscopy as a privileged technique for the characterization of the released species, and we applied diffusion-ordered NMR spectroscopy (DOSY-NMR) for the investigation of molecular weight dispersion. Our diffusion studies of DAC® in physiological conditions provided a full understanding of the product degradation by overcoming the limitations observed in applying classical chromatography approaches by gel permeation UV.

scholarly journals Basilar Thumb Arthritis: The Utility of Suture-Button Suspensionplasty

Hand ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Brent R. DeGeorge ◽  
Sagar S. Chawla ◽  
Bassem T. Elhassan ◽  
Sanjeev Kakar
Keyword(s):  
Functional Outcomes ◽  
Tendon Transfer ◽  
Proximal Phalanx ◽  
Pain Syndrome ◽  
Pinch Strength ◽  
Suture Button ◽  
Radiographic Outcomes ◽  
Pain Scores ◽  
Joint Arthritis

Background: We sought to compare the functional outcomes, radiographic outcomes, and complications of trapeziectomy and flexor carpi radialis (FCR) to abductor pollicis longus (APL) side-to-side tendon transfer with or without suture-button suspensionplasty for thumb basilar joint arthritis. Methods: Patients treated with and without suture-button suspensionplasty were compared over a 6-year period. Data were reviewed for complications and functional outcomes, including grip and pinch strength, range of motion, and visual analog scale (VAS) pain scores. Plain radiographs were independently reviewed at initial presentation and at final follow-up, including proximal phalanx length, trapezial space height, and trapezial height ratio. Results: Seventy thumb arthroplasties were performed in 70 patients. Trapeziectomy with FCR-APL side-to-side tendon transfer was performed in 39 patients, and trapeziectomy with FCR-APL side-to-side tendon transfer with suture-button suspensionplasty was performed in 31 patients. Mean length of follow-up was 28.4 ± 3.9 and 23.8 ± 2.6 months, respectively. Postoperative grip, oppositional and appositional pinch strength, and VAS pain scores improved compared with preoperative values, but were not significantly different based on suture-button suspensionplasty. Percentage decline in trapezial space ratio was significantly different between groups at 36.7% and 20.4% for procedures with and without suture-button suspensionplasty, respectively indicating that the trapezial space was better maintained within the suture suspension cohort. The incidence of postoperative complications, including surgical site infection, paresthesias, reoperation, complex regional pain syndrome, and symptomatic subsidence, was not significantly different between groups. Conclusions: Trapeziectomy with FCR to APL side-to-side tendon transfer with and without suture-button suspensionplasty results in comparable improvement in pain, grip strength, and functional parameters. Suture-button suspensionplasty results in significantly greater preservation of trapezial space.

Evaluation and treatment of congenital and developmental anomalies of the cervical spine

2004 ◽  
Vol 1 (2) ◽  
pp. 188-197 ◽  
Author(s):  
Arnold H. Menezes
Keyword(s):  
Cervical Spine ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Growth Potential ◽  
Limb Weakness ◽  
Content Type ◽  
Spinal Stabilization ◽  
Vascular Abnormalities ◽  
The Stability ◽  
High Index Of Suspicion

✓ Congenital and developmental osseous abnormalities of the cervical spine can result in neural compression ranging from the medulla oblongata to the cervicothoracic spinal cord junction. These may present in infancy as scoliosis and even limb weakness. A high index of suspicion is essential. Neurodiagnostic imaging relies on high-resolution computerized tomography (CT) scanning and three-dimensional CT reconstructions as well as magnetic resonance imaging and angiography. The anatomical/physiological CT factors considered when developing a surgical approach are: 1) the stability and reducibility of the lesions; 2) direction and manner of encroachment of the lesion on the neural structures; 3) neural and vascular abnormalities; and 4) growth potential of the affected area. Primary stabilization is required for reducible lesions, whereas irreducible lesions are decompressed in the manner in which encroachment has occurred. Instability, whether present before or after operative intervention, required spinal stabilization. Illustrative examples of this approach are presented.

scholarly journals Biotin status, blood pyruvate carboxylase (EC 6.4.1.1) activity and performance in broilers under different conditions of bird husbandry and diet processing

1980 ◽  
Vol 43 (3) ◽  
pp. 541-549 ◽  
Author(s):  
C. C. Whitehead ◽  
D. W. Bannister
Keyword(s):  
Carbon Dioxide ◽  
Growth Performance ◽  
Pyruvate Carboxylase ◽  
Growth Potential ◽  
Good Criterion ◽  
Fast Growing ◽  
Wood Shavings ◽  
Blood Pyruvate ◽  
And Performance ◽  
The Stability

1. Three experiments were conducted to investigate the relationships between blood pyruvate carboxylase (pyruvate: carbon dioxide ligase (ADP-forming), EC 6.4.1.1; PC) activity, growth performance and dietary biotin level in broilers under different husbandry conditions. Blood PC activity was also used to gain information on the ingestion of biotin of faecal origin by birds housed on wood shavings and the effect of steam-pelleting on the biotin content of diets.2. Blood PC activity and relationship to dietary biotin level were similar in birds kept under different husbandry conditions.3. Biotin requirement for growth was higher in birds kept under conditions that allowed them to reach their growth potential more fully.4. The contribution of biotin of faecal origin to the biotin intake of birds housed on wood shavings was negligible at 3 weeks of age but by 7 weeks was equivalent to approximately 0.01 mg/kg diet.5. Steam-pelleting did not affect the stability or availability of biotin of natural or synthetic origin in diets.6. It is concluded that blood PC activity is a good criterion of biotin status and requirement in fast-growing

scholarly journals ANALISIS KINERJA KEUANGAN DENGAN METODE RADAR PADA PT SEMEN BATURAJA (PERSERO) TBK

2019 ◽  
pp. 1023
Author(s):  
Siska Mardiana ◽  
R. Deni Muhammad Danial ◽  
Erry Sunarya
Keyword(s):  
Financial Performance ◽  
Quantitative Data ◽  
Research Method ◽  
Stock Exchange ◽  
Growth Potential ◽  
Financial Statement ◽  
Stability Ratio ◽  
Analysis Technique ◽  
The Stability ◽  
Productivity Ratio

The purpose of this study is to assess the financial performance of PT Semen Baturaja (Persero) Tbk by comparing the performance of PT Semen Baturaja (Persero) Tbk in several similar companies that have been listed on the Indonesia Stock Exchange. The data used are financial statement data of PT Indocement Tunggal Prakarsa Tbk, PT Semen Baturaja Persero Tbk and PT Holcim Indonesia Tbk for the period 2015-2017. The research method used is descriptive with quantitative data. The analysis technique used with the radar method. Radar analysis includes 5 ratios, namely profitability, productivity, asset utility, stability and growth potential. The results showed that the best profitability ratio of PT Semen Baturaja (Persero) Tbk,  from the best productivity ratio of PT Holcim Indonesia Tbk, was seen from the best utility ratio of PT Indocement Tunggal Prakarsa Tbk, on the stability ratio of PT Holcim Indonesia Tbk and on the best growth potential of PT Semen Baturaja (Persero) Tbk.

scholarly journals Langenskiöld Procedure for Treatment of Partial Growth Arrest of Distal Ulna After Septic Osteomyelitis: A Case Report

Hand ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. NP63-NP67
Author(s):  
Takashi Yoshida ◽  
Yoshinobu Oka ◽  
Atsushi Nishida ◽  
Hiroaki Wada ◽  
Wook-Cheol Kim
Keyword(s):  
Bone Growth ◽  
Growth Arrest ◽  
Growth Potential ◽  
Long Bone ◽  
Distal Ulna ◽  
Growth Impairment ◽  
Joint Infections ◽  
Shortening Osteotomy ◽  
The Right ◽  
Ulnar Lengthening

Background: Although cases of impaired long bone growth due to bone and joint infections in childhood are sometimes reported, few cases of growth impairment of the ulna due to septic osteomyelitis have been described. We report herein a case of ulnar partial physeal arrest treated using the Langenskiöld procedure. Materials and Methods: A boy developed septic osteomyelitis of the right distal ulna at age 2 years 6 months. Osteomyelitis subsided after antibiotic treatment and external immobilization. As a result of impaired growth of the ulna along the long axis, shortening and trumpet-shaped deformity of the metaphysis gradually appeared. Computed tomography revealed a bony bridge, and premature epiphyseal closure due to osteomyelitis was diagnosed. The Langenskiöld procedure was performed at 4 years 4 months old. Results: As of 2 years 9 months later, no further ulnar shortening has occurred and morphological remodeling has been confirmed. Conclusions: The treatments employed for ulnar shortening include ulnar lengthening by callotasis as well as stapling of the distal radial epiphyseal line or radial shortening osteotomy. In this case, the Langenskiöld procedure proved effective because the patient was still young with growth potential and the area of the bony bridge after osteomyelitis-induced epiphyseal line damage was <30%.

scholarly journals Conditions of sustainable development in the Czech Republic in compliance with the recommendation of the European Commission − Scientific Information

2008 ◽  
Vol 53 (No. 6) ◽  
pp. 285-289 ◽  
Author(s):  
M. Hrabánková ◽  
I. Boháčková
Keyword(s):  
Sustainable Development ◽  
Social Economic ◽  
Scientific Information ◽  
Growth Potential ◽  
Production Functions ◽  
The European Union ◽  
Rural Regions ◽  
The Czech Republic ◽  
The Stability ◽  
Social Economic Development

The Program Period of the European Union for the years 2007–2013 is focused on supports of the rural development standardization and creation of the space for its sustainable development. Agriculture in the structure of production and non-production functions is an important factor of social-economic development of countryside and contributes to the increase of its growth potential. Diversification of activities in the countryside has a significant influence on the stability of settlement, the development of employment in the countryside, and sustenance of the entrepreneurial structures in rural regions.

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