Single time angular deformity correction and treatment of knee instability in congenital fibular hemimelia. A case report

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 504-507 ◽  
Author(s):  
David Figueroa ◽  
Rafael Calvo ◽  
Ignacio E. Villalón ◽  
Andrés Schmidt-Hebbel ◽  
Francisco Figueroa ◽  
...  
Keyword(s):  
Case Report ◽  
Deformity Correction ◽  
Knee Instability ◽  
Angular Deformity ◽  
Single Time ◽  
Fibular Hemimelia

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.

scholarly journals Bilateral Tibial Proximal Fractures Caused by Secondary Osteomalacia due to Autoimmune Polyendocrine Syndrome Type 2: A Case Report

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Daisuke Nakagawa ◽  
Keisuke Oe ◽  
Tomoaki Fukui ◽  
Ryosuke Kuroda ◽  
Takahiro Niikura
Keyword(s):  
Case Report ◽  
Pharmacological Treatment ◽  
Plate Osteosynthesis ◽  
Deformity Correction ◽  
Serum Phosphate ◽  
Tibial Osteotomy ◽  
Syndrome Type ◽  
Radiographic Findings ◽  
Autoimmune Polyendocrine Syndrome

Introduction: Hypophosphatemic osteomalacia can be overlooked or confused with other musculoskeletal disorders due to the variety of associated clinical, laboratory, and radiographic findings. If osteomalacia is diagnosed early and the fractures are not displaced, they often heal with nutritional supplements, but, if they progress to displaced fractures, they may require surgical intervention. Case Report: We present a case of secondary osteomalacia due to autoimmune polyendocrine syndrome Type 2 due to this condition, the patient developed bilateral tibial proximal fractures and her varus deformity had progressed. No clear indication of the timing for surgery for adults with osteomalacia has been reported. However, medical treatment improves the symptoms of osteomalacia and it is reported that in children, appropriate level of the serum phosphate (P) should be attained and maintained for the successful bone healing after osteotomy. Therefore, we prioritized pharmacological treatment and prescribed surgery after confirming that the value of serum phosphate P had been improved to recommended levels (2.5-3.5 mg/dl). We performed high tibial osteotomy for the right side and gradual correction by an external fixation for the left tibia, because of more severe deformation, and converted to an internal fixation to shorten the treatment period. During conversion, we performed the operation with a locking plate by the minimal invasive plate osteosynthesis method (MIPO). Conclusion: We conclude that the use of different deformity correction methods, depending on the degree of deformity, and the pharmacological treatment of osteomalacia may lead to favorable results. Keywords: Osteomalacia, autoimmune polyendocrine syndrome type 2, deformity correction method.

scholarly journals Change in Effective Leg Length after Angular Deformity Correction by Hemiepiphyseal Stapling

2010 ◽  
Vol 2 (2) ◽  
pp. 85 ◽  
Author(s):  
Ho-Joong Jung ◽  
Tae-Joon Cho ◽  
In Ho Choi ◽  
Chin Youb Chung ◽  
Won Joon Yoo ◽  
...  
Keyword(s):  
Deformity Correction ◽  
Angular Deformity ◽  
Leg Length

scholarly journals Crecimiento guiado con placas en 8 para la corrección de deformidades angulares en pacientes esqueléticamente inmaduros. [Eight plate guided growth for angular deformity correction in skeletally immature patients.]

10.15417/448 ◽  
2015 ◽  
Vol 80 (4) ◽  
pp. 254 ◽  
Author(s):  
Diego Tourn ◽  
Victoria Allende ◽  
Julio Javier Masquijo
Keyword(s):  
Deformity Correction ◽  
Angular Deformity ◽  
Skeletally Immature ◽  
Guided Growth

<p><strong>Introducción</strong></p><p><strong></strong><em> </em>La manipulación de la fisis permite la corrección de deformidades <em>ón</em>en pacientes esqueléticamente inmaduros. Recientemente, se ha propuesto el empleo de un nuevo implante (placas en 8) que presentaría algunas ventajas con sus antecesores. El objetivo de este estudio es evaluar los resultados radiográficos y las complicaciones de una serie consecutiva de pacientes tratados con este método.</p><p><strong>Material y Métodos</strong></p><p><strong></strong>Se revisaron retrospectivamente las historias clínicas de todos los pacientes esqueléticamente inmaduros con deformidades angulares que se sometieron a cirugía de realineación de miembros inferiores (Rodilla o tobillo) mediante crecimiento guiado con placas en 8 entre Enero de 2009 y Julio del 2013. Se evaluaron los datos demográficos, evolución radiográfica  y la tasa de complicaciones. Todos los niños fueron intervenidos en la misma institución, por tres ortopedistas infantiles.</p><p><strong>Resultado<em>s</em></strong></p><p>Se evaluaron 27 pacientes (47 fisis), 12 de sexo masculino, 15 sexo femenino. 38 fueron tratados por deformidades en valgo y 9 por varo. De las 47 fisis tratadas, 33 fueron en el fémur distal, 12 en la tibia proximal y 2 en la tibia distal.  La edad promedio en la que se realizó el procedimiento fue de 11.8±1.36 años (rango de edad de 8 años – 14 años). El tiempo promedio entre la colocación y el retiro fue de 10.6±3 meses (rango 7 – 26 meses). Todos los pacientes menos uno, presentaron corrección completa de la deformidad. Se presentaron 6 complicaciones postoperatorias y 2 de ellas requirieron una nueva intervención (1 efecto rebote y 1 migración del implante).</p><p><strong>Conclusión</strong></p><p>La utilización de placas en 8 para la corrección de deformidades angulares en pacientes esqueléticamente inmaduros es un método efectivo con una baja tasa de complicaciones.</p>

scholarly journals Wedge Osteotomy with Tens Nailing in Monostotic Fibrous Dysplasia of Tibia – A Case Report

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Mangal Parihar ◽  
Eknath Pawar ◽  
Eknath Pawar ◽  
Eknath Pawar ◽  
Eknath Pawar ◽  
...  
Keyword(s):  
Case Report ◽  
Fibrous Dysplasia ◽  
Male Patient ◽  
Deformity Correction ◽  
Wedge Osteotomy ◽  
Radiological Findings ◽  
Titanium Elastic Nailing ◽  
Operative Planning ◽  
The Right ◽  
Definitive Management

Introduction: Titanium elastic nailing (TENS) with wedge osteotomy for the management of monostotic fibrous dysplasia (FD) of tibia is done in a 6-year-old male patient. Case Report: This is a case describing monostotic FD of right tibia in a 6-year-old male patient. The patient’s parents noticed a diffuse swelling in the right leg a few days after birth. It was managed conservatively till 3 years of age when the patient started complaining of pain in his right leg and difficulty in walking and running. The patient developed gradual and progressive anterior bowing in the right leg in the next 3 years. The patient was diagnosed with monostotic FD of the right tibia based on clinical and radiological findings. Wedge osteotomies were done in the tibia and fibula with TENS nailing as a definitive procedure for this patient. Discussion: Management of monostotic FD of the right tibia with TENS nailing and wedge osteotomy can be a possible modality of definitive management with complete pain relief and deformity correction. Conclusion: Correction of deformities secondary to FD requires meticulous pre-operative planning and execution. But with proper planning, even major deformities as in our case, procedures as simple as wedge osteotomy and TENS nailing can give excellent outcomes. Keywords: Fibrous dysplasia, monostotic, titanium elastic nailing.

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