scholarly journals A method of surgical treatment of unstable severe forms of juvenile femoral head epiphysiolysis

2013 ◽  
Vol 94 (6) ◽  
pp. 838-843
Author(s):  
A R Pulatov ◽  
V V Mineev
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Open Reduction ◽  
Slipped Capital Femoral Epiphysis ◽  
Late Results ◽  
Biomechanical Study ◽  
Long Term Results ◽  
Slip Angle

Aim. To analyze the long-term results of the designed method for the open epiphysis reduction in patients with severe unstable forms of juvenile femoral head epiphysiolysis. Methods. The article describes the method of surgical treatment of severe forms of unstable juvenile femoral head epiphysiolysis and long-term outcomes in 21 patients. The indications for the method were the unstable form of juvenile femoral head epiphysiolysis and slipped capital femoral epiphysis with a slip angle of more than 40 degrees. The age of patients at time of treatment ranged from 11 to 16 years, follow-up period - from 2 to 15 years. Five patients underwent a comprehensive biomechanical study within one year after surgery. Results. The early and late results of the femoral head epiphysis open reduction were analyzed. Positive results were obtained in 19 cases (good results in 17, satisfactory in 2). The complication rate was 14.3% and included 3 cases of avascular femoral head necrosis, no cases of chondrolysis were revealed. According to biomechanical examination data performed in five patients 1 year after the surgery, almost complete functional recovery of the musculoskeletal system was revealed. Conclusion. Analysis of the results showed that being properly executed the open reduction of the femoral head with a corrective femoral neck osteotomy allowed to restore normal anatomic proportions and function of the affected joint, positive result was maintained for the entire follow-up period.

Long-term results of the surgical treatment of 129 intramedullary spinal gliomas

1981 ◽  
Vol 54 (3) ◽  
pp. 323-330 ◽  
Author(s):  
Beniamino Guidetti ◽  
Sandro Mercuri ◽  
Roberto Vagnozzi
Keyword(s):  
Surgical Treatment ◽  
Late Results ◽  
Long Term Results ◽  
Postoperative Results ◽  
Content Type ◽  
Fine Print ◽  
Spinal Gliomas

✓ The authors report the late results of surgical treatment of 129 intramedullary gliomas (48 ependymomas, 53 astrocytomas, 13 spongioblastomas, five glioblastomas, one oligodendroglioma, and nine others), with follow-up periods ranging from 1 to 27 years. The value of surgical treatment is considered in relation to the postoperative results.

Patients with severe slipped capital femoral epiphysis treated by the modified Dunn procedure have low rates of avascular necrosis, good outcomes, and little osteoarthritis at long-term follow-up

2019 ◽  
Vol 101-B (4) ◽  
pp. 403-414 ◽  
Author(s):  
T. D. Lerch ◽  
S. Vuilleumier ◽  
F. Schmaranzer ◽  
K. Ziebarth ◽  
S. D. Steppacher ◽  
...  
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Slipped Capital Femoral Epiphysis ◽  
Harris Hip Score ◽  
Slip Angle ◽  
Functional Scores ◽  
Screw Breakage ◽  
Long Term Follow Up

AimsThe modified Dunn procedure has the potential to restore the anatomy in hips with severe slipped capital femoral epiphyses (SCFE). However, there is a risk of developing avascular necrosis of the femoral head (AVN). In this paper, we report on clinical outcome, radiological outcome, AVN rate and complications, and the cumulative survivorship at long-term follow-up in patients undergoing the modified Dunn procedure for severe SCFE.Patients and MethodsWe performed a retrospective analysis involving 46 hips in 46 patients treated with a modified Dunn procedure for severe SCFE (slip angle > 60°) between 1999 and 2016. At nine-year-follow-up, 40 hips were available for clinical and radiological examination. Mean preoperative age was 13 years, and 14 hips (30%) presented with unstable slips. Mean preoperative slip angle was 64°. Kaplan–Meier survivorship was calculated.ResultsAt the latest follow-up, the mean Merle d’Aubigné and Postel score was 17 points (14 to 18), mean modified Harris Hip Score was 94 points (66 to 100), and mean Hip Disability and Osteoarthritis Outcome Score was 91 points (67 to 100). Postoperative slip angle was 7° (1° to 16°). One hip (2%) had progression of osteoarthritis (OA). Two hips (5%) developed AVN of the femoral head and required further surgery. Three other hips (7%) underwent implant revision due to screw breakage or change of wires. Cumulative survivorship was 86% at ten-year follow-up.ConclusionThe modified Dunn procedure for severe SCFE resulted in a low rate of AVN, low risk of progression to OA, and high functional scores at long-term follow-up. The slip deformities were mainly corrected but secondary impingement deformities can develop in some hips and may require further surgical treatment. Cite this article: Bone Joint J 2019;101-B:403–414.

scholarly journals Treatment of Injuries of the Lumbar Spine

2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Canal ◽  
Thoracolumbar Spine ◽  
Spinal Injuries ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

Fractures and Fracture Dislocations of the Midfoot: Occurrence, Causes and Long-term Results

2001 ◽  
Vol 22 (5) ◽  
pp. 392-398 ◽  
Author(s):  
Martinus Richter ◽  
Burkhard Wippermann ◽  
Christian Krettek ◽  
Hanns Eberhard Schratt ◽  
Tobias Hufner ◽  
...  
Keyword(s):  
Open Reduction ◽  
Traffic Accidents ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Treatment Optimization ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fracture Dislocations

Etiology and outcome of 155 patients with midfoot fractures between 1972 and 1997 were analyzed to create a basis for treatment optimization. Cause of injuries were traffic accidents (72.2%), falls (11.6%), blunt injuries (7.7%) and others (5.8%). Isolated midfoot fractures (I) were found in 55 (35.5%) cases, Lisfranc fracture dislocations (L) in 49 (31.2%), Chopart-Lisfranc fracture dislocations (CL) in 26 (16.8%) and Chopart fracture dislocations (C) in 25 (16%). One hundred and forty eight (95%) of the midfoot fractures were treated operatively; 30 with closed reduction, 115 with open reduction, 3 patients had a primary amputation. Seven (5%) patients were treated non-operatively. Ninety seven (63%) patients had follow-up at an average of 9 (1.3–25, median 8.5) years. The average scores of the entire follow-up group were as follows: AOFAS – sum of all four sections (AOFAS-ET): 296, AOFAS-Midfoot (AOFAS-M): 71, Hannover Scoring System (HSS): 65, and Hannover Questionnaire (Q): 63. Regarding age, gender, cause, time from injury to treatment and method of treatment no score differences were noted (t-test: p > 0.05). L, C or I showed similar scores and CL significantly lower scores (AOFAS-ET, AOFAS-M, HSS, Q). The highest scores in all groups were achieved in those fractures treated with early open reduction and operative fixation. Midfoot fractures, particularly fracture dislocation injuries, effect the function of the entire foot in the long-term outcome. But even in these complex injuries, an early anatomic (open) reduction and stable (internal) fixation can minimize the percentage of long-term impairment.

scholarly journals Long-term follow-up of patients undergoing the modified Dunn procedure for slipped capital femoral epiphysis

2020 ◽  
Vol 1 (4) ◽  
pp. 80-87
Author(s):  
Caroline Passaplan ◽  
Lucienne Gautier ◽  
Emanuel Gautier
Keyword(s):  
Avascular Necrosis ◽  
Femoroacetabular Impingement ◽  
Revision Surgery ◽  
Slipped Capital Femoral Epiphysis ◽  
Implant Removal ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Ucla Activity Score

Aims Our retrospective analysis reports the outcome of patients operated for slipped capital femoral epiphysis using the modified Dunn procedure. Results, complications, and the need for revision surgery are compared with the recent literature. Methods We retrospectively evaluated 17 patients (18 hips) who underwent the modified Dunn procedure for the treatment of slipped capital femoral epiphysis. Outcome measurement included standardized scores. Clinical assessment included ambulation, leg length discrepancy, and hip mobility. Radiographically, the quality of epiphyseal reduction was evaluated using the Southwick and Alpha-angles. Avascular necrosis, heterotopic ossifications, and osteoarthritis were documented at follow-up. Results At a mean follow-up of more than nine years, the mean modified Harris Hip score was 88.7 points, the Hip Disability and Osteoarthritis Outcome Score (HOOS) 87.4 , the Merle d’Aubigné Score 16.5 points, and the UCLA Activity Score 8.4. One patient developed a partial avascular necrosis of the femoral head, and one patient already had an avascular necrosis at the time of delayed diagnosis. Two hips developed osteoarthritic signs at 14 and 16 years after the index operation. Six patients needed a total of nine revision surgeries. One operation was needed for postoperative hip subluxation, one for secondary displacement and implant failure, two for late femoroacetabular impingement, one for femoroacetabular impingement of the opposite hip, and four for implant removal. Conclusion Our series shows good results and is comparable to previous published studies. The modified Dunn procedure allows the anatomic repositioning of the slipped epiphysis. Long-term results with subjective and objective hip function are superior, avascular necrosis and development of osteoarthritis inferior to other reported treatment modalities. Nevertheless, the procedure is technically demanding and revision surgery for secondary femoroacetabular impingement and implant removal are frequent. Cite this article: 2020;1-4:80–87.

Gamma Knife thalamotomy for treatment of essential tremor: long-term results

2010 ◽  
Vol 112 (6) ◽  
pp. 1311-1317 ◽  
Author(s):  
Ronald F. Young ◽  
Francisco Li ◽  
Sandra Vermeulen ◽  
Robert Meier
Keyword(s):  
Surgical Treatment ◽  
Essential Tremor ◽  
Gamma Knife ◽  
Surgical Intervention ◽  
Long Term Results ◽  
The Mean ◽  
Lost To Follow Up ◽  
Deep Brain

Object The goal of this report was to describe the safety and effectiveness of nucleus ventralis intermedius (VIM) thalamotomy performed with the Leksell Gamma Knife (GK) for the treatment of essential tremor (ET). Methods One hundred seventy-two patients underwent a total of 214 VIM thalamotomy procedures with the Leksell GK between February 1994 and March 2007 for treatment of disabling ET. Eleven patients were lost to follow-up less than 1 year after the procedures, so that in this report the authors describe the results in 161 patients who underwent a total of 203 thalamotomies (119 unilateral and 42 bilateral). Results There were statistically significant decreases (p < 0.0001) in tremor scores for both writing and drawing. The mean postoperative follow-up duration for all patients was 44 ± 33 months. Fifty-four patients have been followed for more than 60 months posttreatment. There were 14 patients who suffered neurological side effects that were temporary (6) or permanent (8), which accounted for 6.9% of the 203 treatments. All complications were related to lesions that grew larger than expected. Conclusions A VIM thalamotomy with the Leksell GK offers a safe and effective alternative for surgical treatment of ET. It is particularly applicable to patients who are not ideal candidates for deep brain stimulation but can be offered to all patients who are considering surgical intervention for ET.

Long-Term Results of the Surgical Treatment of Spinal Dermoid and Epidermoid Tumors.

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 860-864 ◽  
Author(s):  
Pierpaolo Lunardi ◽  
Paolo Missori ◽  
Franco M. Gagliardi ◽  
Aldo Fortuna
Keyword(s):  
Surgical Treatment ◽  
Nervous Tissue ◽  
Working Life ◽  
Clinical Findings ◽  
Long Term Results ◽  
Tumor Capsule ◽  
Follow Up Study

Abstract The clinical findings and the results of surgical treatment in 16 patients with spinal dermoid or epidermoid tumors are reported. In 9 patients the tumor capsule adhered so tightly to the nervous tissue that part of it was left in situ. In a follow-up study ranging from 5 to 30 years with a mean of 14.2 years only 1 patient had a recurrence of the tumor and 10 patients resumed a normal working life.

scholarly journals LAPAROSCOPIC ADRENALECTOMY IN SURGICAL TREATMENT OF ADRENANOCORTICAL CARCINOMA

2019 ◽  
Vol 21 (1) ◽  
pp. 75-78
Author(s):  
A V Krivosheev ◽  
T A Britvin ◽  
M E Beloshitsky
Keyword(s):  
Surgical Treatment ◽  
Laparoscopic Adrenalectomy ◽  
Distant Metastases ◽  
Long Term Results ◽  
R0 Resection ◽  
Morphological Examination ◽  
Number Of Patients ◽  
Immunohistochemical Studies

Relevance of research: аdrenalectomy remains the only method of potentially radical treatment of adrenocortical carcinoma (AСС), and the complete resection is considered one of the leading factors in the prognosis of disease. The question of the possibility and feasibility of using video- endoscopic technologies in the treatment of patients with ACC is still being discussed. Objective: the purpose of our study was to evaluate the effectiveness of laparoscopic adrenalectomy in the treatment of ACC patients. Material and methods: the study is based on the analysis of the results of diagnostics and surgical treatment of 12 patients who underwent laparoscopic adrenalectomy and verified ACC during histological and immunohistochemical studies. Results: stage I were verified (according to the ENSAT) in 4 cases, in 4 - II stage, and in 4 - III stage. The median of tumor size was 4.9 cm. Intraoperative and postoperative complications did not occur. In all cases, the R0-resection was confirmed by morphological examination. The median patient follow-up was 71 months (1; 141), during this period 11 patients were alive, 1 patient, who had surgery in stage III died of disease progression (distant metastases) 49 months after surgery. During the follow-up period tumor recurrence did not occur. Overall 5-year survival was 75% (95% CI; 30-95%). Conclusion: despite the small number of patients included in this study, satisfactory immediate results (absence of complications, R0-resection) and long-term results allow us to consider video- endoscopic surgery as an effective treatment for patients with ACC.

scholarly journals PRIMARY-MULTIPLE TUMORS IN PATIENTS WITH NEOPLASMS OF THYROID GLAND

2015 ◽  
Vol 174 (2) ◽  
pp. 70-76
Author(s):  
A. F. Romanchishen ◽  
K. V. Vabalaite
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Thyroid Carcinoma ◽  
Chemical Nature ◽  
Malignant Tumors ◽  
Long Term Results ◽  
Occupational Hazard ◽  
Other Neoplasms

The authors studied the long-term results of surgical treatment of 949 patients with thyroid carcinoma. The malignant tumors of other organs were revealed in 55 (5,8%) cases during 20 years of follow-up. It was stated that patients with thyroid carcinoma had a higher risk of developing other malignant tumors than in population. A typical background for onset of other neoplasms was a latent hypothyroidism, hyperlipidemia, hypersecretion of gonadotropins, an influence of occupational hazard of chemical nature and hereditary load of oncology.

scholarly journals Lesión compleja del codo pediátrico: fractura de cóndilo externo asociada a luxación posteromedial de codo.

2020 ◽  
pp. 56-60
Author(s):  
A DARAS-BALLESTER ◽  
NADIA JOVER-JORGE ◽  
PEDRO DOMENECH-FERNANDEZ
Keyword(s):  
Open Reduction ◽  
Elbow Dislocation ◽  
Complex Case ◽  
Long Term Results ◽  
K Wires ◽  
Condyle Fracture ◽  
Clinical And Radiological Results ◽  
Humeral Condyle

Background and aim: External humeral condyle fracture associated with a posteromedial elbow dislocation is a very rare entity, of which there are very few cases published. Our objective is to present a complex case treated in our Hospital, the diagnosis, the treatment we chose, and the follow-up at 9 weeks after the intervention. Clinical case: 5-year-old boy with a posteromedial elbow dislocation associated with an external humeral condyle fracture, which was diagnosed by CT and treated surgically using an anterior approach over the elbow, open reduction, and osteosynthesis with K-wires. Results: clinical and radiological results 9 weeks after the intervention were excellent, presenting a Radiographic consolidation of the fracture and an excellent range of joint mobility. Conclusion: early diagnosis and surgical treatment through open reduction and osteosynthesis of the external condyle is the gold standard on treatment for these injuries, since a bad reduction leads to poor long-term results.

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