scholarly journals Cross-Union Surgery for Congenital Pseudarthrosis of the Tibia

Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 547
Author(s):  
Claire E. Shannon ◽  
Aaron J. Huser ◽  
Dror Paley
Keyword(s):  
Retrospective Study ◽  
Zoledronic Acid ◽  
Postoperative Complications ◽  
Surgical Procedures ◽  
Bone Grafting ◽  
Average Rate ◽  
Rare Condition ◽  
Acid Infusion ◽  
Bone Morphogenic Protein 2

Congenital Pseudoarthrosis of the Tibia (CPT) is a rare condition with a reputation for recurrent fractures and failure to achieve union. A large variety of surgical procedures have been attempted for the treatment of fractured cases of CPT with an average rate of union without refracture of only 50%. Intentional cross-union between the tibia and fibula has been reported to improve these results to 100% union with no refractures. This is a retrospective study of 39 cases of CPT in 36 patients treated by the Paley cross-union protocol with internal fixation, bone grafting, zoledronic acid infusion and bone morphogenic protein 2 (BMP2) insertion. All 39 cases of CPT united at the tibia and developed a cross-union to the fibula. Two patients had a persistent fibular pseudarthrosis, one that was later treated at the time of planned rod exchange and one that has remained asymptomatic. There were few postoperative complications. There were no refractures during the up to 7-year follow-up period. The most common problem was the Fassier-Duval (FD) rod pulling through the proximal or distal physis into the metaphysis (66.7%). This did not negatively affect the results and was remedied at the time of the planned rod exchange. The Paley Cross-Union Protocol is very technically demanding, but the results have radically changed the prognosis of this once sinister disease.

scholarly journals Acetabular reaming and sartorius muscle pedicle iliac bone grafting in the treatment of developmental dysplasia of the hip in older children: a retrospective study of 15 patients with more than two years follow-up

2020 ◽  
Vol 14 (3) ◽  
pp. 201-207
Author(s):  
Zhang Fan ◽  
Luo Cong ◽  
Liu Hang ◽  
Li Ming ◽  
Wu Jun ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Grafting ◽  
Developmental Dysplasia ◽  
Iliac Bone ◽  
Sartorius Muscle ◽  
Acetabular Defect ◽  
Older Children ◽  
Short Term ◽  
Dysplasia Of The Hip

Purpose Despite the early diagnosis and treatment of developmental dysplasia of the hip (DDH), some older children still need open reduction. It is usually difficult to get a satisfactory reduction particularly in patients with acetabular defect. The purpose of this study was to evaluate the short-term outcomes of acetabulum reaming and sartorius muscle pedicle iliac bone grafting in the treatment of older children with DDH and acetabular defect. Methods The records of 15 patients with DDH (mean age 113.9 months (sd 29); 17 hips) who were treated with the reported technique between February 2015 and January 2017 were retrospectively reviewed. All patients acquired regular clinical and radiographic follow-ups, and alterations in the acetabular index, centre-edge angle and acetabular head index were measured. Joint function and radiographic results were evaluated with McKay and Severin modified criteria, respectively. Results A total of 15 patients were followed up for mean 32.4 months (sd 6.9). The percentages of excellent and good conditions were 94.1% (16/17) according to the Severin modified criteria and 88.2% (15/17) according to the McKay modified criteria. Avascular necrosis of the femoral head and redislocation only occurred in one hip. No cases of ankylosis or bone graft absorption occurred during the follow-up. Conclusion Reaming the acetabulum and sartorius muscle pedicle iliac bone grafting for repairing the acetabular defect can recover the arcuate structure by increasing the volume of the acetabulum, which is beneficial for achieving a concentric reduction. The short-term outcome was satisfactory, while the long-term results need to be further observed. Level of Evidence IV – retrospective study

scholarly journals Response to Zoledronic Acid Infusion in Children With Fibrous Dysplasia

2020 ◽  
Vol 8 ◽  
Author(s):  
Sujit Kumar Tripathy ◽  
Shakti Swaroop ◽  
Sandeep Velagada ◽  
Debashree Priyadarshini ◽  
Rashmi Ranjan Das ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Fibrous Dysplasia ◽  
Term Treatment ◽  
Acid Infusion ◽  
Café Au Lait Spots ◽  
Long Term Treatment ◽  
Radiological Response ◽  
Radiological Changes

Objective: This retrospective study evaluated the outcome and safety of long-term treatment with zoledronic acid, in both polyostotic and mono-ostotic fibrous dysplasia (FD) of children.Methods: The case records of children and adolescents with symptomatic FD who received zoledronic acid (0.1 mg/kg IV infusion over 1 h) and have completed at least 2 years follow-up were analyzed. The relevant details were recorded in a predesigned chart. Clinical assessment [pain assessment by visual analog scale (VAS) and incidence of new fracture], radiological changes (cortical thickening, ossification, and decrease in the diameter of the osteolytic lesions) and biochemical parameters [alkaline phosphatase (ALP)] were used to evaluate the improvement.Results: The mean age of presentation was 9.1 years, with four males and six females. All patients had symptomatic FD in the lower limb with complaints of pain, tenderness, swelling, or deformity. Four children had associated pathological fracture. The radiological evaluation with bone scan revealed polyostotic involvement in eight patients and mono-ostotic involvement in two patients. Three patients had associated systemic features like café-au-lait spots or precocious puberty. The fracture united within 3 months and the radiological improvement was evident in the form of filling of the osteolytic defect. The pain score in six patients showed significant improvement (VAS < 3). The ALP level decreased to 544.12 ± 47.35 IU/L from an initial value of 895.75 ± 79.64 IU/L (p = 0.04) at 12 months. One patient had symptomatic hypocalcaemia after zoledronic acid infusion.Conclusion: The clinical and radiological response of zoledronic acid treatment in FD of children is promising. Further randomized control trials with a larger sample size are required to establish this drug as a first-line medical treatment in FD.

Is Onlay Polypropylene Mesh Repair an Available Option for Incisional Hernia Repair? A Retrospective Cohort Study

2019 ◽  
Vol 85 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Oscar Cano-Valderrama ◽  
JosÉ L. Porrero ◽  
Esther Quirós ◽  
Oscar Bonachia ◽  
MarÍA J. Castillo ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Surgical Procedures ◽  
Polypropylene Mesh ◽  
Mesh Repair ◽  
Incisional Hernia Repair ◽  
Hernia Recurrence ◽  
Onlay Mesh

Lately, incisional hernia repair (IHR) with onlay polypropylene mesh has been replaced by other surgical procedures. The aim of this study was to compare the complication and recurrence rate after onlay mesh repair and other surgical procedures for IHR. A retrospective cohort study of patients who underwent IHR in a single center was conducted. The data were obtained from electronic medical records. Patients who had been lost during follow-up were contacted for a visit in the clinic. Univariate and multivariate analysis was performed with Stata 13.0 to analyze the factors associated with postoperative complications and hernia recurrence. Between June 2004 and December 2015, 1078 patients underwent IHR in a single center. Onlay mesh repair was performed in 125 patients (11.6%). Other surgical procedures included Rives procedure (29.3%), sublay mesh repair (38.6%), intrabdominal mesh repair (17.1%), and primary closure (3.4%). After a mean follow-up of 2.8 years, 73 (7%) patients developed a recurrence. A higher percentage of complications were seen after onlay mesh repair than after other surgical procedures (22.4% vs 13.1%, P = 0.005). Nevertheless, recurrence was less frequent after onlay mesh repair (4.2% vs 7.1%, P = 0.241). Logistic regression discarded an association between onlay mesh repair and hernia recurrence or postoperative complications. Incisional hernia repair with onlay polypropylene mesh repair was not associated with a higher incidence of postoperative complications or recurrence rate. So, this procedure should not be discarded in selected patients presenting with incisional hernia.

scholarly journals Surgery and anesthesia in sickle cell disease. Cooperative Study of Sickle Cell Diseases

Blood ◽  
1995 ◽  
Vol 86 (10) ◽  
pp. 3676-3684 ◽  
Author(s):  
M Koshy ◽  
SJ Weiner ◽  
ST Miller ◽  
LA Sleeper ◽  
E Vichinsky ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Sickle Cell Disease ◽  
General Anesthesia ◽  
Sickle Cell ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Complication Rates ◽  
Cooperative Study ◽  
Cell Disease

From 1978 to 1988, The Cooperative Study of Sickle Cell Disease observed 3,765 patients with a mean follow-up of 5.3 +/- 2.0 years. One thousand seventy-nine surgical procedures were conducted on 717 patients (77% sickle cell anemia [SS], 14% sickle hemoglobin C disease [SC], 5.7% S beta zero thalassemia, 3% S beta zero + thalassemia). Sixty-nine percent had a single procedure, 21% had two procedures, and the remaining 11% had more than two procedures during the study follow- up. The most frequent procedure was abdominal surgery for cholecystectomy or splenectomy (24% of all surgical procedures, N = 258). Of these, 93% received blood transfusion, and there was no association between preoperative hemoglobin A level and complication rates (except reduction in pain crisis). Overall mortality within 30 days of a surgical procedure was 1.1% (12 deaths after 1,079 surgical procedures). Three deaths were considered to be related to the surgical procedure and/or anesthesia (0.3%). No deaths were reported in patients younger than 14 years of age. Sickle cell diseases (SCD)-related complications after surgery were more frequent in SS patients who received regional compared with general anesthesia (adjusted for risk level of the surgical procedure, patient age, and preoperative transfusion status, P = .058). Non-SCD-related postoperative complications were higher in both SS and SC patients who received regional compared with those who received general anesthesia (P =.095). Perioperative transfusion was associated with a lower rate of SCD- related postoperative complications for SS patients undergoing low-risk procedures (P = .006, adjusted for age and type of anesthesia), with crude rated of 12.9% without transfusion compared with 4.8% with transfusion. In SC patients, preoperative transfusion was beneficial for all surgical risk levels (P = .009). Thus, surgical procedures can be performed safely in patients with SCD.

scholarly journals Endoscopic posterior cordotomy for treatment of dyspnea due to vocal fold immobility

2020 ◽  
Vol 15 ◽  
Author(s):  
Narin Nard Carmel Neiderman ◽  
Max Chason ◽  
Anat Wengier ◽  
Oshri Wasserzug ◽  
Oren Cavel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Respiratory Distress ◽  
Surgical Procedures ◽  
Medical Records ◽  
Vocal Fold ◽  
Surgical Intervention ◽  
Acute Setting ◽  
Vocal Fold Immobility ◽  
The Mean

Introduction: Several surgical procedures have been described for the treatment of respiratory distress secondary to vocal fold immobility (VFI), but the contribution of posterior cordotomy (PC) to tracheostomy weaning or prevention has not been studied in depth, particularly in the acute setting. The objective of this study was to show the effectiveness of PC to relieve dyspnea, prevent the need for tracheostomy, and enable decannulation in patients with VFI. Methods: We conducted a retrospective study and reviewed the medical records of all patients whose dyspnea warranted surgical intervention from January 2013 to January 2018. Data were retrieved on epidemiology, etiology, and duration of VFI, tracheostomy dependence, success in decannulation from tracheostomy or respiratory relief, number of procedures until decannulation, and complications. Results: Twelve suitable patients were identified of whom eleven had bilateral VFI and one had unilateral VFI. Five were tracheostomy-dependent. Ten patients underwent unilateral PC, and two patients underwent bilateral PC. All the patients experienced respiratory relief, eleven after a single PC and one after two PCs. All tracheostomy-dependent patients were decannulated. The mean follow-up after PC was 24.55 months during which none of the patients required a re-tracheostomy and three patients required revision of the PC. There were no surgical complications. Postoperatively, eight patients (67%) experienced a breathy voice and three patients (25%) had dysphagia for fluids. No patient had aspiration pneumonia. Conclusions: We conclude that PC is an easy, safe, and effective procedure for tracheostomy weaning and respiratory relief in patients with VFI. A revision PC may be indicated in some patients. A breathy voice is to be expected, and a few patients will experience dysphagia to fluids that may be addressed by instructing the patient to use a fluid thickener and take small sips.

scholarly journals Surgical treatment of relapsed megaesophagus

2020 ◽  
Vol 47 ◽  
Author(s):  
LUIGI CARLO DA SILVA COSTA ◽  
JOÃO GABRIEL ROMERO BRAGA ◽  
VALDIR TERCIOTI JUNIOR ◽  
JOÃO DE SOUZA COELHO NETO ◽  
JOSÉ ANTÔNIO POSSATTO FERRER ◽  
...  
Keyword(s):  
Weight Loss ◽  
Retrospective Study ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Chagas Disease ◽  
Surgical Procedures ◽  
Postoperative Period ◽  
Outpatient Clinic ◽  
Surgical Result ◽  
Stage 1

ABSTRACT Objective: to analyze the surgical treatment of patients with recurrent megaesophagus followed at the esophageal-stomach-duodenal outpatient clinic of the Hospital de Clínicas - UNICAMP. Methods: a retrospective study, from 2011 to 2017, with 26 patients with Chagas or idiopathic megaesophagus, surgically treated, and who recurred with dysphagia. Clinical, endoscopic and radiographic aspects were assessed and correlated with the performed surgical procedures. Results: 50% had dysphagia for liquids, 69% regurgitation, 65.3% heartburn, 69.2% weight loss and 69.2% had Chagas disease. In addition, 38.4% had megaesophagus stage 1 and 2 and 61.5% stage 3 and 4. Regarding the reoperations, 53% of them underwent Heller-Pinotti surgery by laparoscopy, Serra-Dória in 30.7% and esophageal mucosectomy in 7.9%. In 72% of the reoperations there were no postoperative complications, and 80% of the patients had a good outcome, with reduction or elimination of dysphagia. Among the reoperated patients undergoing the laparoscopic Heller-Pinotti technique, three reported little improvement of dysphagia in the postoperative period and among those who underwent Serra-Dória surgery, 100% had no dysphagia. It was observed that, when the time between the first procedure and the reoperation was longer, the better the surgical result was, with statistical significant decreased dysphagia (p=0.0013, p<0.05). Conclusions: there was a preference to perform laparoscopic re-miotomy and, as a second option, Serra-Dória surgery, for patients with recurrent megaesophagus. Esophagectomy or esophageal mucosectomy were reserved for more severe patients.

scholarly journals The Function-Preserving Frontalis Orbicularis Oculi Muscle Flap for the Correction of Severe Blepharoptosis With Poor Levator Function

2021 ◽  
Author(s):  
Shu-Hung Huang ◽  
Chia-Chen Lee ◽  
Hsin-Ti Lai ◽  
Hidenobu Takahashi ◽  
Yu-Chi Wang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Muscle Flap ◽  
Palpebral Fissure ◽  
Orbicularis Oculi Muscle ◽  
Postoperative Evaluation ◽  
Orbicularis Oculi ◽  
Frontalis Suspension

Abstract Background Severe blepharoptosis with poor LF has traditionally been managed with exogenous frontalis suspension but complications such as lagophthalmos, infection, rejection were often reported. Objectives The function-preserving frontalis orbicularis oculi muscle (FOOM) flap was designed to correct severe blepharoptosis with poor levator function (LF). With preservation of the OOM function, the long-term surgical outcome of the technique was assessed. Methods This retrospective study included only adult patients with severe blepharoptosis and poor LF, all of whom had their surgery performed by the senior surgeon, Lai CS, over a 6-year period. Clinical assessment of LF, palpebral fissure height (PFH), marginal reflex distance 1 (MRD1), duration of follow up, and postoperative complications were recorded. Results 34 patients and 59 eyelids were recorded during a mean follow-up period of 17.7 months. Postoperative evaluation yielded improvements of an average PFH gain of 5.62 ± 1.61 mm (p &lt; 0.001) as well as MRD1 and PFH increase by an average of 4.03 ± 0.82 mm (p &lt; 0.001) and 8.94 ± 0.81 mm (p &lt; 0.001), respectively. All patients demonstrated normalization of orbicularis function as no lagophthalmos was observed at the 8-month postoperative follow up. Recurrence of ptosis were recorded in four eyelids (6.78%). Revisions were performed in two eyelids (3.39%). No infection or granuloma was noted. Conclusions The function-preserving FOOM flap is a useful vector for frontalis suspension. Not only does it effectively address lagophthalmos as well as other complications, but it provides aesthetically pleasing outcomes in patients with severe blepharoptosis and poor LF.

scholarly journals Résultats De La Trabéculectomie Dans Le Glaucome Infantile Au Chu Campus De Lomé (Togo)

2017 ◽  
Vol 13 (12) ◽  
pp. 119
Author(s):  
Nidain Maneh ◽  
Kokou Vonor ◽  
Bénédicte Marèbe Diatewa ◽  
Nonon Saa Kassoula Batomaguela ◽  
Kokou Messan Amedomé ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Substantial Reduction ◽  
Congenital Glaucoma ◽  
Pressure Reduction ◽  
Topical Medication ◽  
Surgical Success ◽  
Target Pressure ◽  
The Mean

Purpose: To evaluate the results of the trabeculectomy without antimitotic in children aged 5 to 15 years and identify the factors of success of this technique. Method: we have conducted a retrospective study based on records of children of 5 to 15 years, operated from January 2011 to December 2013 for glaucoma excepted congenital glaucoma. The trabeculectomy was performed without antimitotic and the follow up was done during 6 months. Nineteen children (35 eyes) were included over 23 children (43 eyes) operated. Surgical success was defined for intra ocular (IOP) ≤ 20mmhg (target pressure) pressure associated with a pressure reduction over 30% with or without topical medication and major postoperative complications. Results: On the 19 included Sham children (35 eyes) the mean age was 9.05 years [5;15], 11 were of boys and 8 girls and the sex ratio was 0.73. The mean cup/disc of the papillary excavation was 0.54 [0.2; 0.8]. The mean preoperative IOP was 20.08 mm Hg [11;30]. Postoperative complications was seen in 17% (6 eyes) with 11.4% (4 eyes) of hypothalamy. The mean post operative IOP at 6 months was 12.86 mm Hg [10; 23]. The success rate was 62.86% (22 eyes). IOP control was the only factor influencing the success of surgery (p = 0. 0055). Conclusion: The trabeculectomy without antimitotic allowed a substantial reduction in IOP. The control of IOP determine the success of the surgery at 6 months. The spreading of the technique with the use of an antimitotic will optimize our results.

Ocular dermoids in 13 cats: a multicentre retrospective study

2021 ◽  
pp. 1098612X2110438
Author(s):  
Anaïs Cathelin ◽  
Anne-Sandrine Augsburger ◽  
Jennifer Anne ◽  
Sylvain Medan ◽  
Julien Michel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ocular Surface ◽  
Rare Condition ◽  
Surgical Excision ◽  
Genetic Transmission ◽  
Study Population ◽  
The Mean ◽  
Lost To Follow Up ◽  
Multicentre Retrospective Study

Objectives The aim of this multicentre retrospective study was to review the clinical data, outcomes and histopathological features of cats that had been treated for ocular surface dermoids. Methods Thirteen cats from various private practices in France with a clinical diagnosis of ocular surface dermoid were included in the study. Results The mean age of the study population at the time of diagnosis was 5 months. There were nine males and four females. Three different breeds were, including: domestic shorthair (n = 7), Birman (n = 4) and Havana Brown (n = 2). Two of the four Birmans were related (same sire). The two Havana Browns were also related (same sire). All of the dermoids were unilateral. Five of the dermoids were strictly conjunctival. Four affected both the conjunctiva and the cornea. Three affected both the conjunctiva and the eyelid, and one was strictly corneal. They were located in various positions: temporal (n = 9), inferonasal (n = 1), dorsonasal (n = 1) and dorsotemporal (n = 1). The last dermoid was heterogeneous and involved the nasal, dorsal and temporal quadrants. Concurrent eye diseases were observed in five patients: four cats exhibited associated eyelid agenesis and one cat exhibited persistent iris-to-iris pupillary membranes. Ten dermoids were surgically excised with no recurrences. Surgery was not performed for three cats: one cat died a few days after diagnosis and two cats were lost to follow-up after initial presentation. Conclusions and relevance Ocular surface dermoids are a rare condition in cats that can be treated successfully by surgical excision. Although our study reports only a small number of cases, the observation of ocular surface dermoids in two related cats in two different breeds indicates that genetic transmission is likely.

ENCHONDROMA IN THE HAND RETROSPECTIVE STUDY — RECURRENCE CASES

Hand Surgery ◽  
2002 ◽  
Vol 07 (01) ◽  
pp. 7-10 ◽  
Author(s):  
Lidia Merida Montero ◽  
Yoshikazu Ikuta ◽  
Osamu Ishida ◽  
Yoshinori Fujimoto ◽  
Masakazu Nakamasu
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Retrospective Analysis ◽  
Bone Grafting

This is a retrospective analysis of 21 patients with documented enchondroma of the hand. They were operated on between 1980 to 2000 with conventional curettage nd bone grafting. The objective of this study is to analyse the chance of recurrence and evaluate the effectiveness of surgical treatment. One patient had recurrence after six years. Longer follow-up period is recommended as there is a possibility of recurrence even after five years. This study revealed that enchondroma of the hand is more common on the ulnar site.

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