scholarly journals Lengthening of the ulna by external fixation in children with congenital radial club hand

2020 ◽  
Vol 7 (4) ◽  
pp. 57-66
Author(s):  
Natalia V. Avdeychik ◽  
Sergey I. Golyana ◽  
Denis Yu. Grankin ◽  
Andrey V. Safonov
Keyword(s):  
Surgical Treatment ◽  
External Fixation ◽  
Deformity Correction ◽  
Contralateral Side ◽  
Treatment Results ◽  
Radial Deviation ◽  
Ulna Osteotomy ◽  
Distal Section ◽  
Observation Period ◽  
Group 1

Background. Congenital radial club hand is characterized by the radial deviation of the hand, the longitudinal underdevelopment of the forearm, and the dysfunction of the upper limb. The shortening of the ulna is observed in all types of congenital radial club hand. The average shortening of the ulna surgical treatment was 33.3% compared to the intact contralateral side. Aim. This study aimed to evaluate the results of ulna elongation by the method of external fixation, depending on the level of osteotomy, in patients with congenital radial club hand type IIIIV. Materials and methods. The treatment results of 36 patients with congenital radial club hand type IIIIV from 1998 to 2018 were analyzed. The average age of the patients was 7.4 years 3.5 years. The patients were divided into three groups, depending on the level of ulnar osteotomy. Shortening of the ulna, correction of the angle of deformity of the ulna, radial deviation of the hand, period of correction, elongation obtained, index of fixation and osteosynthesis, and associated complications were analyzed. Results. The observation period was an average of 5.8 years. Before surgical treatment, the ulna was 33.3% shorter, while after surgery, it was 16%. Before surgery, the angle of deformation was 20.5 14.8, while after surgery, it was 7.4 5.6; this gives an angle of deformity correction of 63.9%. The elongation of the ulna was 3.2 1.1 cm. In patients who underwent proximal osteotomy, the resulting elongation was 32% and 18.4% more, respectively, than in patients who underwent an osteotomy in the middle and distal sections of the ulna. In group 1, the correction period was 24.4% and 28.9% more than in groups 2 and 3, respectively. The index of fixation in group 1 was 53.6%, which was 45.7% less than in groups 1 and 3. Postoperative complications included a false joint (15%), inflammation (10%), and forearm deformities (7.5%). Conclusions. In patients with congenital radial club hand type IIIIV, the optimal part of an ulna osteotomy is the proximal section. With a hand deviation of more than 20, osteotomy is performed in the distal section with simultaneous correction of the deformity.

Application of femtolaser-assisted phacoemulsification in combined pathology of cataract and glaucoma

2021 ◽  
pp. 18-21
Author(s):  
A.P. Voznyuk ◽  
◽  
S.I. Anisimov ◽  
S.Y. Anisimova ◽  
L.L. Arutyunyan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Biomechanical Properties ◽  
Mean Values ◽  
Long Term Follow Up ◽  
The Mean ◽  
Group 2 ◽  
Observation Period ◽  
Group 1

Purpose. To evaluate the efficacy and safety of femtolaser-assisted phacoemulsification in glaucomatous eyes in the long-term follow-up. Materials and methods. A retrospective analysis of the results of the surgical treatment of patients with combined cataract and glaucoma pathology was analyzed. The patients were divided into groups depending on the method of surgical intervention: 1) phacoemulsification with femtolaser support (26 eyes, 23 patients); 2) phacoemulsification (36 eyes, 30 patients); Results. Before surgery, there were no statistically significant differences in IOP and corneal hysteresis (СН) between groups 1 and 2. The mean values of IOP cc, IOP g and СН of group 1 before surgery were 22.7±6.1 mm Hg, 20.9±6.9 mm Hg, 8.5±1.6 mm Hg; 2 group – 22.9±8.7 mm Hg, 21.6±8.9 mm Hg, 8.9±1.6 mm Hg respectively. Average values of IOP cc, IOP g and CН 5 years after the surgical treatment in group 1 were 15.3±1.2 mm Hg, 14.4±3.4 mm Hg, 9.6±4.2 mm Hg; in group 2 – 18.0±4.2 mm Hg, 16.1±4.2 mm Hg, 8.8±2.2 mm Hg respectively. In both groups, stabilization of IOP and CH indices was noted, which remained throughout the entire observation period, which shows the normalization of the biomechanical properties of the corneoscleral membrane of the eye in the long-term postoperative period. Conclusion. Femtolaser accompaniment of phacoemulsification is an effective and safe method of cataract surgery for combined pathology. Key words: femtolaser, cataract, glaucoma, phacoemulsification.

Effect of Low Compression on the Growth Plate. An Experimental Study in Sheep

1997 ◽  
Vol 10 (01) ◽  
pp. 16-22 ◽  
Author(s):  
P. Collard ◽  
J. Sales de Gauzy ◽  
D. Mathon ◽  
R. Darmana ◽  
J.-Ph. Cahuzac ◽  
...  
Keyword(s):  
External Fixation ◽  
Growth Plate ◽  
Contralateral Side ◽  
Fixation Device ◽  
Control Side ◽  
Mean Pressure ◽  
External Fixation Device ◽  
The Mean ◽  
Group 2 ◽  
Group 1

SummaryThis study was carried out to investigate the effect of compression on the growth plate. An external fixation device was applied across the distal radial physis in 24 eight-week-old lambs. Compression was applied continuously for seven weeks. A shamoperation was performed on the contralateral side. The animals were divided into two groups according to the rate of compression. In group #1, the mean pressure exerted by the compression device ranged from 0.03 ± 0.01 kg/cm2 to 0.05 ± 0.01 kg/cm2. In group #2, the mean pressure ranged from 0.08 ± 0.01 kg/cm2 to 0.16 ± 0.01 kg/cm2. The results obtained show that this pressure did not modify the longitudinal growth of the bone. A statistical difference was not noted between the operated side and the control side in any of the groups. We conclude that mild physeal compression (less than 0.16 kg/cm2) in the immature sheep would neither retard nor accelerate the growth of the distal radial epiphyseal plate.An external fixation device was applied to the distal radial growth plate in immature sheep. Compression was performed continuously for seven weeks. The authors conclude that mild physeal compression (between 0.03 and 0.16 kg/cm2) neither diminished nor increased the growth.

scholarly journals Lengthening of radius in patients with congenital radial club hand, type II

2019 ◽  
Vol 7 (1) ◽  
pp. 15-24
Author(s):  
Natalia V. Avdeychik ◽  
Sergey I. Golyana ◽  
Andrey V. Safonov ◽  
Denis Yu. Grankin ◽  
Ekaterina A. Zakharyan
Keyword(s):  
External Fixation ◽  
Growth Plate ◽  
Metatarsal Bone ◽  
Fixation Index ◽  
Type Ii ◽  
Second Metatarsal ◽  
Group 2 ◽  
Radial Bone ◽  
Observation Period ◽  
Group 1

Background. Congenital radial club hand (CRCH) is characterized by longitudinal underdevelopment of the forearm and hand on the radial surface. Underdevelopment can range from hypoplasia to aplasia of the radius. More than 50 methods to correct the forearm deformities, depending on the degree of radius underdevelopment, have been proposed. Aim. We evaluated the results of CRCH treatment using microsurgical technique and external fixation. Methods. We analyzed 16 patients (age, 4.6 0.9 years) with CRCH type II, according to the classification of Bayne and Klug, treated between 1994 and 2017. The patients were divided into two groups: Group 1 were patients undergoing microsurgical autotransplants of the epimetaphyseal second metatarsal bone with growth plate to the position of the radius defect and group 2 were patients treated by lengthening of the radius with external fixation. We analyzed the types of deformities, size of the radius defects, and range of motion in upper limb joints before the stage of the lengthening. External fixation index and number of complications also were determined. The type and number of recurrent deformities and timing of their detection were analyzed. Results. The observation period ranged from 12 months to 10 years (average, 3.8 years). In group 1, good results were obtained in 62.5% of cases. After transplantation of the metatarsal bone growth plate, the work of the growth plate continued, characterized by increasing radius length in the later observation period. In group 2, good results were obtained in 50% of cases. Clinical and X-ray examinations showed recurrent hand deviation and radius shortening, which required repeated radius lengthening. Conclusion. Microsurgical transplantation of the second metatarsal bone with growth plate is accepted more in reconstruction of the radial bone in patients with CRCH type II due to creation of a growth zone in the distal part of the radius. Radius lengthening via external fixation is applicable while maintaining the distal epimetaphysis and normal transverse dimensions of the radial bone.

scholarly journals Evaluation of the Influence of HaloGravity Traction upon the Results of Severe Neuromuscular Deformity Treatment

2016 ◽  
Vol 23 (2) ◽  
pp. 12-17
Author(s):  
S. V Kolesov ◽  
A. N Baklanov ◽  
A. I Shavyrin ◽  
S. A Kudryakov ◽  
A. N Shaboldin ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Postoperative Period ◽  
Deformity Correction ◽  
Preoperative Preparation ◽  
Treatment Results ◽  
Ponte Osteotomy ◽  
Halo Traction ◽  
One Step ◽  
Group 2 ◽  
Group 1

Evaluation of the effect of traction preoperative preparation on the degree of neuromuscular spinal deformity correction was performed. Treatment results for 50 patients with paralytic deformities operated on in 3 different clinics were analyzed. The patients were divided in 2 comparable groups, 25 patients in each group. In group 1 one-step intervention, i.e. dorsal correction under halo-traction and Ponte osteotomy was performed. In group 2 two-step correction, i.e. 12-14 days gradual halo-gravity traction followed by dorsal correction and Ponte osteotomy. Postoperative deformity correction made up 49 and 50% in the 1st and 2nd groups, respectively. In patients from the 2nd group the postoperative period was smoother. Thus, the study did not detect any influence of traction preparation on the degree of the deformity correction.

scholarly journals MET-05 Clinical investigation of treatment results and recurrence patterns of metastatic brain tumors from the viewpoint of postoperative irradiation

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii19-ii19
Author(s):  
Tetsuo Hashiba ◽  
Haruka Kawano ◽  
Katsuya Ueno ◽  
Qiang Lee ◽  
Haruna Isozaki ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Clinical Investigation ◽  
Postoperative Radiotherapy ◽  
En Bloc Resection ◽  
Metastatic Brain Tumors ◽  
Treatment Results ◽  
En Bloc ◽  
Postoperative Radiation Therapy ◽  
Observation Period

Abstract While whole brain radiation therapy (WBRT) had been the standard postoperative radiation therapy for metastatic brain tumors for long time, recently local radiation therapy (LRT) has be become to be a new standard due to the accumulation of clinical evidences. Treatment results and pattern of recurrence were retrospectively analyzed from view point of postoperative radiotherapy. In this study, totally 69 patients were included and they were divided into WBRT group or LRT group. We analyzed the number of lesions, treated era, overall survival after diagnosis of metastasis (OS), recurrence free survival after RT (RFS), and patterns of recurrences. The subjects consisted of 37males and 32 females and average age was 61.7 years old. There were 49 cases in the WBRT group and 20 cases in the LRT group. While all cases before November 2017 had WBRT performed, LRT was adopted mainly in cases with a small number of metastases since December 2017. Although there was a difference in the observation period between the two groups, OS tended to be longer in the LRT group (P=0.08), while RFS tended to be shorter in the LRT group (P=0.08). Radiological recurrence after RT was observed in 7 cases in both groups, and in WBRT group, all cases were local recurrence, whereas in LRT group, all cases were new lesions or disseminated recurrence. Although there are biases such as the difference in observation period between the two groups and the tendency to adopt WBRT in cases with a large number of metastases, there is a possibility that postoperative LRT is not inferior to WBRT, especially for cases with a small number of metastases. However, we have experienced some cases of disseminated recurrence, and so it is necessary to consider the resection fashion such as whether en-bloc resection or piece meal resection when selecting postoperative RT.

scholarly journals Peculiarities of Treatment of Lower Extremity Deformities in Children with Systemic Diseases of Loco-Motor System

2003 ◽  
Vol 10 (4) ◽  
pp. 88-89
Author(s):  
Yu A Lapkin ◽  
M P Konyukhov ◽  
Yu A Lapkin ◽  
M P Konyukhov
Keyword(s):  
Surgical Treatment ◽  
Motor System ◽  
Weight Bearing ◽  
Deformity Correction ◽  
Plaster Cast ◽  
Systemic Diseases ◽  
Joint Stability ◽  
Joint Dislocations ◽  
Systemic Nature ◽  
Conservative And Surgical Treatment

The analysis of conservative and surgical treatment results of more than 200 children with systemic diseases of loco-motor system showed that complications and deformity recurrence were mainly caused by the inadequate treatment tactics as well as the use of traditional orthopaedic techniques with no account of the systemic nature of the pathology. The most common mistakes in conservative treatment included the prolonged use of plaster cast, attempts to perform one-step reposition of joint dislocations and underestimation of osteoporosis severity. In surgical treatment the typical mistakes were the attempts to restore the joint function to the detriment of the joint stability and weight bearing function of the extremity, use of tenoligamentocapsulotomy in cases when either correction of bone deformities or the application of flizarov device were indicated. The rate of complications was significantly lower when the deformity correction was followed by additional joint stabilization using transposition of muscles and plasty of ligamentous system.

scholarly journals Idiopathic scoliosis surgical treatment. Results in Mexico’s National Rehabilitation Institute. 24-month follow-up

2019 ◽  
Vol 86 (5) ◽  
Author(s):  
Barón Zárate-Kalfópulos ◽  
Héctor R. Martínez-Ríos ◽  
Francisco López-Meléndez ◽  
Carla L. García-Ramos ◽  
Luis M. Rosales-Olivarez ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Idiopathic Scoliosis ◽  
Treatment Results

scholarly journals Comparative analysis of the quality of life of children with congenital scoliosis after surgical treatment: Extirpation of the hemivertebra from dorsal and combined access

2021 ◽  
Vol 9 (2) ◽  
pp. 153-162
Author(s):  
Dmitry N. Kokushin ◽  
Michael A. Khardikov ◽  
Sergey V. Vissarionov ◽  
Vera V. Sokolova ◽  
Nikita O. Khusainov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Deformity Correction ◽  
Lumbar Vertebra ◽  
Congenital Scoliosis ◽  
Congenital Deformity ◽  
Subsequent Increase ◽  
Level Of Satisfaction

BACKGROUND: Congenital scoliosis with disorders of the formation of the vertebrae is the most common cause of pronounced deformities of the spine in early childhood. This pathology can be treated surgically using various techniques that differ in invasiveness, severity of the condition in the postoperative period, achieved result of deformity correction, and nature of the long-term prognosis. Numerous studies have assessed the quality of life of patients who underwent surgery for acquired deformities, trauma, and degenerative and neoplastic diseases of the spine in adults. However, features of the childs quality of life following surgical technique for congenital scoliosis have not been sufficiently studied. AIM: This study aimed to compare the quality of life of children with congenital scoliosis of the thoracolumbar localization after extirpation of the hemivertebra from the dorsal and combined approaches. MATERIALS AND METHODS: An intergroup prospective analysis of the results of a survey of 60 patients with congenital deformity of the spine against the background of an isolated violation of the formation of the thoracic or lumbar vertebra was carried out. Patients underwent standard surgical treatment. Patients were divided into two groups according to the surgical approach to the abnormal vertebral body: dorsal group (n = 28) and combined group (n = 32). The average age of the patients was 75 (minmax, 26196) months. The follow-up period was 18 months after surgery. To assess the quality of life, a specialized Russian version of the PedsQL v4.0 questionnaire and a modified visual analog scale were used. RESULTS: After surgical treatment of congenital spinal deformity, quality of life indicators decreased more than two times than the results of a preoperative survey. At 18 months postoperatively, the physical activity and psychoemotional state were restored to the preoperative level, while patients of the combined group had a higher satisfaction score on the quality of life (p 0.05). CONCLUSIONS: The combined approach provides the best correction of congenital deformity of the spine and allows maintaining of the achieved result throughout the observation period. In the early postoperative period, the combined group demonstrated a significant decrease in the level of satisfaction with the quality of life, while the pain syndrome was higher than that in the dorsal group. Dynamic observation revealed the leveling of these differences and a subsequent increase in the level of satisfaction with the quality of life of these patients.

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