scholarly journals Lengthening the Lower Extremities of Children with Ollier’s and Maffucci’s Enchondromatosis Using Implantable Lengthening Nails

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 502
Author(s):  
Aaron J. Huser ◽  
Jason Shih Hoellwarth ◽  
Valentino Coppa ◽  
David S. Feldman ◽  
Dror Paley
Keyword(s):  
Case Series ◽  
Limb Lengthening ◽  
Limb Length Discrepancy ◽  
Knee Extension ◽  
Limb Length ◽  
External Fixators ◽  
Manipulation Under Anesthesia ◽  
Maffucci’S Syndrome ◽  
Ollier’S Disease ◽  
Ollier's Disease

There are multiple forms of enchondromatosis with Ollier’s and Maffucci’s being the most prevalent types. Limb length discrepancy is a common problem in patients with Ollier’s and Maffucci’s enchondromatosis. There are multiple reports about lengthening bones in patients with enchondromatosis using external fixators. However, there are no case series regarding the use of implantable lengthening technology. The purpose of this paper is to describe our experience with implantable nail lengthening in patients with enchondromatosis. A retrospective chart and radiographic review of patients with enchondromatosis who underwent implantable nail limb lengthening was performed. Seven patients with 14 bony segments were reviewed. A total of 11/14 lengthenings were completed without difficulty. There were no issues in terms of fixation location in patients with Ollier’s disease. One patient with Maffucci’s syndrome experienced migration of the nail during two lengthenings due to a combination of intralesional fixation and preconsolidation. One patient with Ollier’s disease developed a knee extension contracture requiring manipulation under anesthesia. No other complications were recorded. The use of implantable nail lengthening to resolve limb length discrepancies in patients with Ollier’s disease appears to be safe and effective.

scholarly journals Intramedullary Bone Lengthening Following Preceding Hip Surgery—A Case Series

2020 ◽  
Vol 9 (12) ◽  
pp. 4104
Author(s):  
Lukas Zak ◽  
Thomas Manfred Tiefenboeck ◽  
Gerald Eliot Wozasek
Keyword(s):  
Hip Dysplasia ◽  
Young Patients ◽  
Limb Lengthening ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Hip Surgery ◽  
Bone Lengthening ◽  
Safe Procedure ◽  
Length Discrepancy ◽  
Healing Index

Limb length discrepancy (LLD) is a common problem after joint-preserving hip surgeries, hip dysplasia, and hip deformities. Limping, pain, sciatica, paresthesia, and hip instability are common clinical findings and may necessitate limb-lengthening procedures. The study included five patients (two female and three male, mean age of 28 years (20–49; SD: 12)) with symptomatic limb length discrepancy greater than 2.5 cm (mean: 3.6 cm) after total hip arthroplasty (THA), hip dysplasia, or post-traumatic hip surgery. They underwent either ipsi- or contralateral intramedullary limb-lengthening surgeries using the PRECICE™ telescopic nail. All patients achieved complete bone healing and correction of the pelvic obliquity after intramedullary lengthening. None of the patients had a loss of proximal or distal joint motion. The mean distraction-consolidation time (DCT) was 3.8 months, the distraction index (DI) 0.7 mm/day, the lengthening index (LI) 1.8 months/cm, the consolidation index (CI) 49.2 days/cm, the healing index (HI) 1.1 months/cm, and the modified healing index (HI*) 34 days/cm. Intramedullary limb lengthening after LLD in cases of hip dysplasia, hip deformity, and various kinds of hip surgery is a useful and safe procedure in young patients to achieve equal limb length. No functional impairment of the preceded hip surgery was seen.

scholarly journals External fixation-assisted reduction for the treatment of neglected hip dislocations with limb length discrepancy: a retrospective study of 13 cases

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Pengyu Li ◽  
Fulin Tao ◽  
Wenhao Song ◽  
Jinlei Dong ◽  
Daodi Qiu ◽  
...  
Keyword(s):  
External Fixation ◽  
Open Reduction ◽  
Hip Dislocation ◽  
Limb Length Discrepancy ◽  
Limb Length ◽  
Acetabular Fractures ◽  
External Fixators ◽  
Residual Limb ◽  
Second Stage ◽  
Length Discrepancy

Abstract Background The purpose of this study was to evaluate a new method for treating neglected hip dislocation with limb length discrepancy by using external fixation-assisted pre-reduction. Methods Thirteen patients admitted between January 2010 to February 2018 with a mean duration from injury to surgery of 5.0 ± 2.1 months and an average preoperative leg-length discrepancy of 7.7 ± 2.3 cm were enrolled in this study. The dislocation and associated acetabular fracture type, clinical outcomes and residual limb length discrepancy were evaluated. Results All patients had posterior dislocations, and nine patients presented with acetabular fractures and were followed-up for at least 12 months. The average traction duration of external fixators was 28.8 ± 8.0 days and all patients received second-stage open reduction and internal fixation. Six patients showed residual limb length discrepancy within 2 cm. Patients showed significant improvement in hip function and pain relief. Complications including avascular femoral head necrosis and osteoarthritis occurred in three patients. Conclusion Effective correction of limb length discrepancy and improved function were observed in patients with neglected hip dislocations and limb equality using traction by external fixation combined with second-stage open reduction. Further follow-up is required to determine long-term outcomes.

Two-stage total hip arthroplasty following skeletal traction after extensive soft tissue release for severe limb-length discrepancy

2019 ◽  
pp. 112070001986574
Author(s):  
Soong Joon Lee ◽  
Kang Sup Yoon
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Limb Lengthening ◽  
Limb Length Discrepancy ◽  
Neurological Complications ◽  
Limb Length ◽  
Soft Tissue Release ◽  
Skeletal Traction ◽  
Length Discrepancy ◽  
Shortening Osteotomy

Introduction: To maximise limb-length discrepancy (LLD) resolution during total hip arthroplasty (THA) for untreated developmental hip dysplasia or septic hip sequelae, THA following limb lengthening was introduced using different methods. We aimed to evaluate 2-stage THA results following limb lengthening via skeletal traction after extensive soft tissue release. Method: In total, 24 hips with severe LLD in 10 men and 14 women (mean age, 49.6 ± 15.2 years) underwent 2-stage THA and were followed thereafter (mean 6.3 ± 3.7 years). The entire abductor muscle origin was subperiosteally released from the ilium, and the soft tissue around the hip joint, including the psoas tendon, short external rotator, joint capsule, and adductor tendon, was extensively released. 2-stage THA was performed after 2-week skeletal traction using proximal tibial pins. During the final THA, 7 hips necessitated subtrochanteric shortening osteotomy (STO) for hip joint reduction. We evaluated the clinical and radiological results and especially focused on LLD and neurological complications. Results: The Harris Hip Score improved from 57.1 ± 9.6 to 88.3 ± 6.3 points. No patients showed worse abductor power. LLD improved from 5.0 ± 2.0 to 1.4 ± 1.0 cm. No permanent neurological complications occurred except for 1 transient peroneal nerve palsy during traction, which resolved fully after cessation of traction. There were 2 hips with STO nonunion treated with osteosynthesis and stem revision. Conclusion: 2-stage THA following skeletal traction after extensive soft tissue release showed favourable results in terms of neurologic complication prevention and LLD resolution. However, a large proportion of patients still necessitated shortening osteotomy with a risk for nonunion at the osteotomy site. Though surgical procedures might be complicated and necessitate longer hospital stays, 2-stage THA with extensive soft tissue release might be an alternative treatment option for patients with severe LLD willing to resolve their limb length discrepancy.

scholarly journals Chondrosarcomas of the base of the skull in Ollier's disease or Maffucci's syndrome Three Case Reports and Review of the Literature

2004 ◽  
Vol 43 (8) ◽  
pp. 705-710 ◽  
Author(s):  
Georges Noël ◽  
Loïc Feuvret ◽  
Valentin Calugaru ◽  
Khalid Hadadi ◽  
François Baillet ◽  
...  
Keyword(s):  
Case Reports ◽  
Review Of The Literature ◽  
Maffucci’S Syndrome ◽  
Ollier’S Disease ◽  
Base Of The Skull ◽  
Ollier's Disease

Limb lengthening for deformities in Ollier’s disease: a systematic review

2020 ◽  
Vol 30 (8) ◽  
pp. 1325-1332 ◽  
Author(s):  
Andrea Angelini ◽  
Riccardo Baracco ◽  
Andrea Dolci ◽  
Marco Vigo ◽  
Andreas F. Mavrogenis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Limb Lengthening ◽  
Ollier’S Disease ◽  
Ollier's Disease

A Case of Dyschondroplasia Associated with Brain Stem Glioma: Diagnosis by Stereotactic Biopsy

Neurosurgery ◽  
1990 ◽  
Vol 27 (3) ◽  
pp. 487-491 ◽  
Author(s):  
Stephan Patt ◽  
Klaus Weigel ◽  
Heinz Michael Mayer
Keyword(s):  
Brain Stem ◽  
Malignant Degeneration ◽  
Low Grade ◽  
Brain Stem Glioma ◽  
Tumor Biopsy ◽  
Maffucci’S Syndrome ◽  
Right Lobe ◽  
Ollier’S Disease ◽  
The Right ◽  
Ollier's Disease

Abstract We present a 24-year-old patient with multiple chondromas of both hands, the pelvis, the left leg, and an associated brain stem glioma. There was no evidence of hemangioma or dyschromia. and the condition was diagnosed as Ollier's disease, a special type of dyschondroplasia like Maffucci's syndrome and Kast's disease. An increased overall risk for development of malignant skeletal and nonskeletal tumors is associated with Maffucci's syndrome. The risk of malignant degeneration is lower in Ollier's disease. A glioma in the pons and the right lobe of the cerebellum was found in this patient. The literature describes an association with gliomas in only 12 cases of dyschondroplasia and an infratentorial localization in just one case. Signs of malignancy were histologically confirmed in 7 cases without significant preponderance of any one type. Our patient had a low-grade brain stem astrocytoma with fibrillar and gemistocytic components. A stereotactic serial biopsy made it possible to rule out malignant degeneration. Stereotactic brain tumor biopsy as a routine neurosurgical procedure is particularly valuable for deep space-occupying processes and forms the basis for therapy. In the present case, irradiation was not recommended.

Treatment of lower limb deformities and limb-length discrepancies with the external fixator in Ollier’s disease

2007 ◽  
Vol 12 (5) ◽  
pp. 471-475 ◽  
Author(s):  
Koji Watanabe ◽  
Hiroyuki Tsuchiya ◽  
Keisuke Sakurakichi ◽  
Teruhisa Yamashiro ◽  
Hidenori Matsubara ◽  
...  
Keyword(s):  
External Fixator ◽  
Lower Limb ◽  
Limb Length ◽  
Limb Deformities ◽  
Ollier’S Disease ◽  
Ollier's Disease

scholarly journals Deformity progression in congenital posteromedial bowing of the tibia: a report of 44 cases.

2020 ◽  
Author(s):  
Giovanni Luigi Di Gennaro ◽  
Giovanni Gallone ◽  
Edgar Alejandro Martinez Vazquez ◽  
Leonardo Marchesini Reggiani ◽  
Costantina Racano ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Distal Tibia ◽  
Case Series ◽  
Limb Lengthening ◽  
Limb Length Discrepancy ◽  
Progressive Increase ◽  
Valgus Deformity ◽  
Radiographic Evaluation ◽  
Tibial Osteotomy ◽  
Spontaneous Correction

Abstract Background Congenital posteromedial bowing of the tibia (CPMBT) is an ultra-rare defect present at birth, characterized by shortened bowed leg, and ankle deformity. We described a single institution experience in the management of CPMBT Methods We identified 44 CPMBT in 44 children. The age at presentation was 5.5 ± 5.6 years and the mean age at the final review was 10.1 ± 4.8 years. Radiographic evaluation included the antero-posterior and lateral inter-physeal angle (AP-IPA and L-IPA), the limb length discrepancy (LLD), the morphology of the distal tibia and the lateral distal tibial angle (LDTA). During the study period, 26 children underwent surgical treatment. Results The estimated curves showed a progressive spontaneous correction of both AP-IPA and L-IPA during growth, but a progressive increase of the LLD. The L-IPA showed a more predictable behaviour while the AP-IPA showed a scattered correction, with a wider variation of the estimated final angle. The final LDTA was 83.4° ± 5.2° and was correlated with the L-IPA. Among the 26 children which underwent surgical treatment, 23 cases had limb lengthening, 1 case had contralateral epiphysiodesis, 1 child underwent tibial osteotomy, 1 patient was treated by hemiepiphysiodesis of the distal tibia to address ankle valgus deformity. Conclusions To date, we reported the largest case series of CPMBT. Nevertheless, further studies are needed to understand which is the best strategy to address this ultra-rare deformity during childhood.

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