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Sample records for fort ii osteotomy

  1. Severe gummy smile with class II malocclusion treated with LeFort I osteotomy combined with horseshoe osteotomy and intraoral vertical ramus osteotomy.

    Science.gov (United States)

    Shimo, Tsuyoshi; Nishiyama, Akiyoshi; Jinno, Tokiari; Sasaki, Akira

    2013-01-01

    In this article, we report the successful surgical treatment of a patient, 34 years of age, who had a severe gummy smile and a class II malocclusion. The patient had an 11-mm gingival exposure during full smile and a convex profile. A LeFort I osteotomy combined with a horseshoe osteotomy was used for the superior repositioning of the maxilla;then, an intraoral vertical ramus osteotomy (IVRO) and genioplasty were performed for mandibular advancement. The maxilla was acceptably impacted 8mm at the first incisor and 5mm at the first molar. Both the occlusion and facial appearance were significantly improved by this surgical-orthodontic treatment. Our results suggest that the combination of a horseshoe osteotomy with a LeFort I osteotomy is a useful technique for reliable superior repositioning of the maxilla.

  2. Severe gummy smile with class II malocclusion treated with LeFort I osteotomy combined with horseshoe osteotomy and intraoral vertical ramus osteotomy

    National Research Council Canada - National Science Library

    Shimo, Tsuyoshi; Nishiyama, Akiyoshi; Jinno, Tokiari; Sasaki, Akira

    2013-01-01

    .... The patient had an 11-mm gingival exposure during full smile and a convex profile. A LeFort I osteotomy combined with a horseshoe osteotomy was used for the superior repositioning of the maxilla...

  3. Segmental distraction osteogenesis with modified LeFort II osteotomy for a patient with craniosynostosis.

    Science.gov (United States)

    Watanabe, Keiichiro; Kuroda, Shingo; Takahashi, Takumi; Kijima, Takeshi; Torikai, Katsuyuki; Moriyama, Keiji; Tanaka, Eiji

    2012-11-01

    In this article, we report successful orthodontic treatment combined with segmental distraction osteogenesis after a modified LeFort II osteotomy in a patient with craniosynostosis. An 8-year-old boy diagnosed with craniosynostosis had a dished-in face, an anterior crossbite, and a skeletal Class III jaw relationship because of midfacial hypoplasia. At the age of 13 years 6 months, the maxillary second and mandibular first premolars were extracted, and leveling and alignment of both arches was started with preadjusted edgewise appliances. At age 14 years 11 months, the patient had a modified LeFort II osteotomy, and the maxillary segment was advanced 7 mm and fixed to the zygomatic bone. At the same time, segmental distraction osteogenesis was started with a rigid external distraction system, and the nasal segment was advanced for 20 days at a rate of 1.0 mm per day. The total active treatment period was 40 months. As a result of the modified segmental distraction osteogenesis, significant improvement of his severe midfacial hypoplasia was achieved without excessive advancement of the maxillary dentition. Both the facial profile and the occlusion were stable after 1 year of retention. However, the nasal segment relapsed 1.4 mm during the 1.5 years after the segmental distraction osteogenesis. Evaluation of the stability and retention suggests that some overcorrection in midfacial advancement is recommended. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  4. LeFort I Osteotomy.

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    Buchanan, Edward P; Hyman, Charles H

    2013-08-01

    The LeFort I osteotomy is one of the most commonly used procedures to correct midface deformities. It allows for correction in three dimensions including advancement, retrusion, elongation, and shortening. It is indicated, often in conjunction with mandibular surgery, for class II and III malocclusion, facial asymmetry, obstructive sleep apnea, and maxillary atrophy. Before surgery, proper orthodontics and surgical planning should be undertaken to ensure adequate outcomes. Overall, the surgery is widely used due to its low complication profile and reliable long-term results.

  5. Severe Class II malocclusion with facial asymmetry treated with intraoral vertico-sagittal ramus osteotomy and LeFort I osteotomy.

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    Kuroda, Shingo; Murakami, Kaoru; Morishige, Yasuko; Takano-Yamamoto, Teruko

    2009-06-01

    In this article, we report the successful treatment of a patient, aged 19 years 11 months, who had a severe Class II malocclusion and facial asymmetry. A combination of intraoral vertical-sagittal ramus osteotomy (IVSRO), intraoral vertical ramus osteotomy (IVRO), and LeFort I osteotomy was used for mandibular advancement and maxillary impaction. The patient had a convex profile because of a retrognathic mandible. She also had severe mandibular deviation and vertical maxillary excess with a canted occlusal plane. A deep overbite of 8.0 mm and an excessive overjet of 10.0 mm were observed. After 16 months of presurgical orthodontic treatment, IVRO in the left ramus and IVSRO in the right ramus were performed with maxillary impaction by LeFort I osteotomy. The mandible was advanced 6.0 mm on the right side, and the maxilla was impacted 4.0 mm at ANS, 2.0 mm at the right first molar, and 5.0 mm at the left first molar. The total active treatment time was 35 months. Both occlusion and facial appearance were significantly improved by the surgical-orthodontic treatment. Occlusion was stable after a year of retention. There were no functional problems during or after treatment. Our results suggest that IVSRO and IVRO combined with LeFort I osteotomy in a patient with severe mandibular retrusion with facial asymmetry might be useful to improve occlusion and facial esthetics.

  6. Nasomaxillary hypoplasia with a congenitally missing tooth treated with LeFort II osteotomy, autotransplantation, and nickel-titanium alloy wire.

    Science.gov (United States)

    Ishida, Takayoshi; Ikemoto, Shigehiro; Ono, Takashi

    2015-09-01

    In some skeletal Class III adult patients with nasomaxillary hypoplasia, the LeFort I osteotomy provides insufficient correction. This case report describes a 20-year-old woman with a combination of nasomaxillary hypoplasia and a protrusive mandible with a congenitally missing mandibular second premolar. We performed a LeFort II osteotomy for maxillary advancement. Autotransplantation of a tooth was also performed; the donor tooth was used to replace the missing permanent tooth. To increase the chance of success, we applied light continuous force with an improved superelastic nickel-titanium alloy wire technique before extraction and after transplantation. The patient's profile and malocclusion were corrected, and the autotransplanted tooth functioned well. The postero-occlusal relationships were improved, and ideal overbite and overjet relationships were achieved. The methods used in this case represent a remarkable treatment. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  7. Stability of simultaneous modified LeFort III/LeFort I osteotomies.

    Science.gov (United States)

    Schmitz, J P; Tiner, B D; Van Sickels, J E

    1995-10-01

    The objective of this study was to examine maxillary skeletal stability after simultaneous modified LeFort III/LeFort I osteotomy in patients who presented for the simultaneous correction of midface and maxillary hypoplasia. Eleven patients underwent simultaneous modified LeFort III/LeFort I osteotomies using transoral and transconjunctival surgical approaches. The mean net surgical movement at A point (A pt) was 5.2 mm anteriorly and 2 mm inferiorly. Titanium mini-plates were used to stabilize both the midface component and the LeFort I segment; iliac crest or calvarial bone grafts as well as freeze-dried cancellous blocks were used at the zygoma and lateral orbital rim regions. All patients had lateral cephalometric radiographs taken immediately postoperatively, and at their sixth week, sixth month, and one year follow-up visits. Five maxillary landmarks (CI, A pt, ANS, PNS, and 2M) were used to examine the horizontal and vertical changes occurring at each time period. The central incisor relapsed vertically 2.8 mm at six months, A pt relapsed vertically 2.3 mm at six months, ANS relapsed posteriorly 1.6 mm at 6 weeks, PNS relapsed 1.5 mm anteriorly at one year. This study demonstrated that the maxilla moved anteriorly 1.5 mm and superiorly 2.8 mm in simultaneous modified LeFort III/LeFort I osteotomies performed with mini-plate fixation and bone grafts. This movement should be considered when planning and performing simultaneous surgical movement of the maxilla and midface using modified LeFort II/LeFort I osteotomies. Appropriate occlusal overcorrection at the time of surgery is necessary.

  8. Dimensions of Velopharyngeal Space following Maxillary Advancement with Le Fort I Osteotomy Compared to Zisser Segmental Osteotomy: A Cephalometric Study

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    Furkan Erol Karabekmez

    2015-01-01

    Full Text Available The objectives of this study are to assess the velopharyngeal dimensions using cephalometric variables of the nasopharynx and oropharynx as well as to compare the Le Fort I osteotomy technique to Zisser’s anterior maxillary osteotomy technique based on patients’ outcomes within early and late postoperative follow-ups. 15 patients with severe maxillary deficiency treated with Le Fort I osteotomy and maxillary segmental osteotomy were assessed. Preoperative, early postoperative, and late postoperative follow-up lateral cephalograms, patient histories, and operative reports are reviewed with a focus on defined cephalometric landmarks for assessing velopharyngeal space dimension and maxillary movement (measured for three different tracing points. A significant change was found between preoperative and postoperative lateral cephalometric measurements regarding the distance between the posterior nasal spine and the posterior pharyngeal wall in Le Fort I osteotomy cases. However, no significant difference was found between preoperative and postoperative measurements in maxillary segmental osteotomy cases regarding the same measurements. The velopharyngeal area calculated for the Le Fort I osteotomy group showed a significant difference between the preoperative and postoperative measurements. Le Fort I osteotomy for advancement of upper jaw increases velopharyngeal space. On the other hand, Zisser’s anterior maxillary segmental osteotomy does not alter the dimension of the velopharyngeal space significantly.

  9. [Recovery of maxillary tooth sensibility after Le Fort I osteotomy].

    Science.gov (United States)

    Bonnot, P; Salles, F; Cheynet, F; Blanc, J L; Ricbourg, B; Meyer, C

    2014-11-01

    Upper alveolar nerves, when injured during Le Fort I osteotomies, alter maxillary tooth sensitivity. We had for aim to analyze post-operative maxillary tooth sensitivity recovery. We conducted a prospective study in a series of patients having undergone Le Fort I osteotomy, with, or without mandibular osteotomy or intermaxillary disjunction (IMD). The direction and range of displacement of the maxillary bone were recorded. One tooth in each alveolar sector (incisivocanine, premolar, molar) was tested with an electric stimulator for each patient. The tests were performed before (D-1), and after surgery (D2 or day+2, D+15, M2 (or month +2), M3, and M6). Twenty-two patients were included. Among the tested teeth, 91.9 % were sensitive at D-1. At D2, only 12.7 % of teeth were sensitive. At D15, M2, M3, and M6, the sensitivity was respectively 33.3 %, 43.1 %, 50 %, and 61.8 %. The recovery of sensitivity was faster in young patients (under 35 years of age) and for upper middle and superior alveolar nerves. There was no difference regarding the direction of maxillary movement. Among the teeth that were sensitive before surgery, 87.3 % had not regained sensitivity at D2. The recovery of sensitivity increased at D15. A great displacement of the maxillary bone was an aggravating factor for loss of tooth sensitivity. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

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    Elio Hitoshi Shinohara

    2013-01-01

    Full Text Available In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

  11. Modified versus classic alar base sutures after LeFort I osteotomy: a systematic review.

    Science.gov (United States)

    Liu, Xianwen; Zhu, Songsong; Hu, Jing

    2014-01-01

    The purpose of this systematic review is to evaluate the efficacy of a new modified alar base cinch suture by comparing it with the commonly used classic alar base suture after LeFort I osteotomy. A comprehensive search strategy was performed to include interventional studies involving the comparisons of alar base suturing methods after LeFort I osteotomy. Data analyses were conducted using the random-effects model. Three studies with 146 participants undergoing LeFort I maxillary osteotomy were included in this review. The results showed that, compared with the classic method, both modified transseptal alar base suture and modified reinsertion sutures significantly decreased postoperative alar and alar base widening. The modified alar base cinch suture was more effective than the classic alar base suture in maintaining preoperative alar and alar base width after LeFort I osteotomy. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Severe unilateral scissor bite and bimaxillary protrusion treated by horseshoe Le Fort I osteotomy combined with mid-alveolar osteotomy.

    Science.gov (United States)

    Shimazaki, Kazuo; Otsubo, Kunihiko; Yonemitsu, Ikuo; Kimizuka, Sachiko; Omura, Susumu; Ono, Takashi

    2014-03-01

    This report describes an orthognathic surgical case employing horseshoe Le Fort I osteotomy (HLFO) combined with mid-alveolar osteotomy and bilateral sagittal split ramus osteotomy (BSSRO) for a patient with severe unilateral scissor bite and bimaxillary protrusion. A female patient (aged 26 years, 2 months) presented with a chief complaint of dysmasesis caused by scissor bite on the right side. The clinical examination revealed difficulty in lip closure and a convex profile. Overerupted right maxillary premolars and molars and lingual tipping of the right mandibular premolars and molars were indicated before treatment. After 3 months of presurgical orthodontic treatment, two-jaw surgery involving a combination of HLFO with mid-alveolar osteotomy and BSSRO was performed. A good interdigitation in the right side was established by superior-posterior-medial movement of the dento-alveolar segment of the maxilla. Next, both the maxilla and mandible were moved superiorly and posteriorly to correct the improper lip protrusion, thereby improving the patient's profile. Our results suggest that this new orthognathic surgery technique-achieved by combining HLFO with mid-alveolar osteotomy and BSSRO-is effective for adult patients exhibiting severe unilateral scissor bite and bimaxillary protrusion.

  13. Delayed progressive haematoma after Le Fort I osteotomy: A possible severe complication in orthognatic surgery

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    Dario Bertossi

    2012-01-01

    Full Text Available Although the Le Fort I osteotomy is a safe surgical technique, many complications have been reported. We present a case of an extended cervico-facial haematoma due to delayed bleeding from the terminal branches of the maxillary artery after orthognatic surgery. A 23-year-old man was referred to our observation for the surgical correction of a class III asymmetric malocclusion. The patient underwent a Le Fort I osteotomy, with impaction of the maxilla, associated with an Epker mandibular bilateral sagittal split osteotomy, with maxillary advancement and rigid internal fixation of the mandible with four miniplates and another four for the upper maxilla as well. The first post-surgery day, the patient developed a gradual dispnea together with neck swelling. By second postoperative day, the patient′s general condition improved with a progressive normalization of laboratory tests values. The Computerised Axial Tomography (CAT scan confirmed a decrease in the parapharyngeal thickening. Total recovery was achieved within two months, the final clinical check showed a healthy appearance with good occlusion. An increased knowledge of the basic biology of the Le Fort I osteotomy, the development of instruments specially designed for the Le Fort I procedure and the use of hypotensive anaesthesia could reduce the morbidity and duration of this procedure.

  14. High Le Fort I osteotomy for correction of mid-face deformity in Crouzon syndrome.

    Science.gov (United States)

    Nakajima, Yasumichi; Nakano, Hiroyuki; Sumida, Tomoki; Yamada, Tomohiro; Inoue, Kazuya; Sugiyama, Goro; Mishima, Katsuaki; Mori, Yoshihide

    2016-09-01

    An 18-year-old woman with mild Crouzon syndrome was referred with malocclusion and mandibular protrusion. Examination revealed Class III canine and molar relationships, hypoplastic maxilla, 1-mm overbite, and -2-mm overjet. Analysis showed 69° sella-nasion-A, 73.6° sella-nasion-B, and -4.6° A point-nasion-B point angles. Polysomnography revealed respiratory disturbance and 6.3% oxygen desaturation indices of 5.4/h and 9.0/h. We performed double-jaw surgery using high Le Fort I osteotomy and bilateral sagittal split ramus osteotomy for midfacial deformity correction. Twelve months post-surgery, her measures were 70.8°, 72°, -1.2°, 3.0/h, and 6.1/h, respectively. Esthetics were satisfactory. High Le Fort I osteotomy is effective for midfacial deformity correction in patients with Crouzon syndrome. © 2016 Japanese Teratology Society.

  15. Photometric Evaluation of Soft Tissue Changes in CLP Patients: Le Fort I Advancement Osteotomy (ALO) Versus Anterior Maxillary Distraction (AMD)

    National Research Council Canada - National Science Library

    Paulose, Joby; Markose, Eldho

    2014-01-01

    ...) and anterior maxillary distraction (AMD).Twenty patients with maxillary hypoplasia associated with cleft lip and palate who had undergone either LeFort I osteotomy or distraction osteogenesis with maxillary advancement were included in this study...

  16. Custom-made prefabricated titanium miniplates in Le Fort I osteotomies: principles, procedure and clinical insights.

    Science.gov (United States)

    Philippe, B

    2013-08-01

    This paper describes a new type of miniplate system that is designed and custom made during virtual surgery planning based on an individual patient's osteotomy. These miniplates are prefabricated with commercially pure porous titanium using direct metal laser sintering. The principles that guide the conception and production of this new miniplate are presented. The surgical procedure from the stage of virtual surgery planning until the final Le Fort I osteotomy and bone fixation are described using a case example. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Splintless surgery : does patient-specific CAD-CAM osteosynthesis improve accuracy of Le Fort I osteotomy?

    NARCIS (Netherlands)

    Kraeima, J.; Jansma, J.; Schepers, R. H.

    2016-01-01

    To analyse the accuracy of maxillary positioning after Le Fort I osteotomy, we retrospectively assessed the outcome in three patients (mean (range) age 40 (21 60) years) who had been treated with patient-specific CAD-CAM osteosynthesis plates as part of a bimaxillary osteotomy. Virtual surgical

  18. Le Fort II midfacial distraction combined with orthognathic surgery in the treatment of nasomaxillary hypoplasia.

    Science.gov (United States)

    Yu, Hongbo; Dai, Jiewen; Wang, Xudong; Zhang, Wenbin; Shen, Steve Guofang

    2014-05-01

    Patients with nasomaxillary hypoplasia have severe facial concavity and compromised skeletal class III malocclusion. Its treatment is still a challenge to surgeons. Our aim was to evaluate the combination of midfacial distraction and orthognathic surgery in the treatment of nasomaxillary hypoplasia. Four patients with nasomaxillary hypoplasia were enrolled in this study. After Le Fort II osteotomy, the rotational distraction of nasomaxillary complex was performed to rehabilitate facial convexity. Then bilateral sagittal split ramus osteotomy with or without Le Fort I osteotomy was used to correct malocclusion. All patients healed uneventfully, and the maxillae moved forward conspicuously. No obvious pain and severe discomfort were complained during distraction. A significant advancement and downward movement of the maxilla were shown by cephalometric analysis. The combination of midfacial distraction and orthognathic surgery provides us an ideal alternative in the treatment of nasomaxillary hypoplasia.

  19. CT study on bony interface after Le Fort I osteotomy; Examination of bony interface in maxillary advancement and impaction

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    Goto, Satoshi; Kawamura, Hiroshi; Motegi, Katsutoshi (Tohoku Univ., Sendai (Japan). School of Dentistry)

    1994-04-01

    Bony contact after the maxilla had been mobilized by Le Fort I osteotomy was evaluated by computed tomographic examination of 52 Japanese dry skulls. The lateral piriform wall and the base of the zygomatic process of the maxilla which consist of thick bone are important areas to achieve good stability. Some cases of maxillary advancement and/or impaction lacked an osseous interface at the posterior wall. Preoperative CT along the osteotomy-line is recommended to achieve better postoperative stability. (author).

  20. Deep Venous Thrombosis in Teen With Crouzon Syndrome Post-Le Fort III Osteotomy With Rigid External Distraction.

    Science.gov (United States)

    Roussel, Lauren O; Myers, Rene P; Girotto, John A

    2015-11-01

    Venous thromboembolic events are rare in pediatric patients. Risk factors associated with the development of venous thromboembolic events in pediatric patients include the use of central venous catheters, hospitalization, cancer, sepsis, trauma, surgery, and congenital prothrombotic disorders.The authors present the case of a 14-year-old man with Crouzon syndrome who required Le Fort III osteotomy with rigid external distraction for significant midface hypoplasia who presented postoperatively with an extensive deep venous thrombosis. This is the first reported case of symptomatic venous thrombosis post-Le Fort III osteotomy and rigid external distraction. Although rare, surgeons should be aware of this potential complication.

  1. Is the Pyriform Ligament Important for Alar Width Maintenance After Le Fort I Osteotomy?

    Science.gov (United States)

    Peacock, Zachary S; Susarla, Srinivas M

    2015-12-01

    To determine whether identification and incorporation of the pyriform ligament in the alar cinch results in decreased alar base widening compared with standard alar cinch techniques. This was a retrospective case series and the sample was composed of patients undergoing Le Fort I osteotomy. Intraoperatively, the pyriform ligament was identified and incorporated in the alar cinch suture. Greatest alar width (GAW) measured immediately after closure was compared with GAW measured at least 5 months postoperatively. The change in alar base width was compared with that reported in the literature using other alar cinch techniques. Two case examples are reported. The sample was composed of 15 patients (mean age, 27.1 yr; 27% female). The mean postoperative change in GAW was 1.0 ± 0.6 mm (2.59 ± 1.59%). Postoperative change in alar base width reported in the literature ranged from 0.5 to 10.8%. The pyriform ligament is easily identified during exposure of the maxilla and pyriform aperture and can be used to control widening of the alar base after Le Fort I osteotomy. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. The effects of guided tissue regeneration (GTR) on modified Le Fort I osteotomy healing in rabbits.

    Science.gov (United States)

    Verschueren, D S; Gassner, R; Mitchell, R; Mooney, M P

    2005-09-01

    Osteogenesis following surgery depends on the osteoblasts at the wound site. Fibrous nonunions may be the result of differential and rapid migration of fibroblasts compared to osteoblasts into the wound. The present study was designed to test this hypothesis through the use of guided tissue regeneration (GTR) in a rabbit model. Bilateral, Le Fort I osteotomies (n=20) were produced in the maxillae of 10 New Zealand White rabbits. The segments were advanced 6mm and rigidly fixed using microplates and screws. One side was covered with a resorbable collagen membrane or left uncovered. Rabbits were followed for four weeks with radiographs and the maxillae were harvested for histology. Cephalometry revealed that membrane-covered defects had significantly (Ptissue than uncovered defects. Histomorphometry revealed that membrane covered defects had significantly (P<0.05) reduced defect areas (by approximately 20%) compared to uncovered defects. While findings suggest that GTR can facilitate osseous wound healing in Le Fort I osteotomies, results also caution against relying exclusively on two-dimensional radiography to assess bony wound healing in lieu of three-dimensional imaging and evaluations.

  3. Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

    DEFF Research Database (Denmark)

    Blæhr, Tue Lindberg; Jensen, Thomas; Due, Karen Margrethe

    2014-01-01

    OBJECTIVES: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. MATERIAL AND METHODS: 29 consecutive patients underwent segmental Le Fort I...... osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral...... in segmental Le Fort I osteotomy....

  4. Biomechanical interactions of different mini-plate fixations and maxilla advancements in the Le Fort I Osteotomy: a finite element analysis.

    Science.gov (United States)

    Huang, Shao-Fu; Lo, Lun-Jou; Lin, Chun-Li

    2016-12-01

    This study investigates the biomechanical interaction of different mini-plate fixation types (shapes/sizes and patterns) with segmental advancement levels on the Le Fort I osteotomy using the non-linear finite element (FE) approach. Nine models were generated under a standard 1-piece LeFort I osteotomy for advancement with 3, 6 and 9 mm distances and four mini-plates with three fixation patterns including LL, LI, and II patterns placed on the maxillae models by integrating computed tomography images and computer-aided design system. The axial and oblique occlusal forces were 250 N applied to each premolar/molar and 125 N applied at 30° inclination to the tooth long axis and from palatal to buccal, respectively. The relative micro-movement values between the two maxillary bone segments and maximum mini-plate stress increased obviously with maxilla advancement increment and the increasing trend can be fitted by exponential curve. The corresponding values in II mini-plate fixation presented apparently high values in all simulated cases. The mini-plate stress concentration locations were found at the bending regions to increase high fracture risk. The mini-plate yield strength can be mapped to a critical (limited) advancement for three types of fixations for safe consideration. This study concluded that L-shaped mini-plates with lateral fixation are recommended to provide better stability. The risk for mini-plate fracture and bone relapse increases when maxillary advancement is larger than a critical value of 5 mm in the Le Fort I osteotomy.

  5. Segmental LeFort I osteotomy for treatment of a class III malocclusion with temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    Marcos Janson

    2008-08-01

    Full Text Available This article reports the case of a 19-year-old young man with Class III malocclusion and posterior crossbite with concerns about temporomandibular disorder (TMD, esthetics and functional problems. Surgical-orthodontic treatment was carried out by decompensation of the mandibular incisors and segmentation of the maxilla in 4 pieces, which allowed expansion and advancement. Remission of the signs and symptoms occurred after surgical-orthodontic intervention. The maxillary dental arch presented normal transverse dimension. Satisfactory static and functional occlusion and esthetic results were achieved and remained stable. Three years after the surgical-orthodontic treatment, no TMD sign or symptom was observed and the occlusal results had not changed. When vertical or horizontal movements of the maxilla in the presence of moderate maxillary constriction are necessary, segmental LeFort I osteotomy can be an important part of treatment planning.

  6. Stability of the anterior maxillary segment and teeth after segmental Le Fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

    OpenAIRE

    2015-01-01

    ABSTRACT Objectives To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. Material and Methods 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively ...

  7. Le Fort I osteotomy to enucleation of grand proportions fissural cyst-presentation of case report.

    Science.gov (United States)

    Cavalcante, Rafael Correia; Durski, Fernanda; Deliberador, Tatiana Miranda; Giovanini, Allan Fernando; Rebellato, Nelson Luís Barbosa; da Costa, Delson João; Klüppel, Leandro Eduardo; Scariot, Rafaela

    2016-01-01

    Fissural cysts (FC) are caused by entraped epithelium between nasal and maxilar processes. They are commonly treated with surgical enucleation precedded or not by marsupialization depending on the cyst size. Biopsy of lesion is recommended due to confirm radiographic evaluation. It is rare to observe Le Fort I surgical approach to this type of injury. This study reports the case of an uncommon grand proportions fissural cyst in a female patient, 53, that was referred to the Oral and Maxillofacial Surgery Departament of Hospital XV presenting volume increase in maxilla associated with numbness of palate. Radiograph examination showed an intimate relationship between incisors apexes and FC. Expansion of both buccal and palate cortical was then confirmed as well as its unusual size, approximately 25 millimeters. Due to the abnormal size of lesion and possible impairment of upper incisors, LeFort I osteotomy associated with downfracture to cystic enucleation was the chosen treatment. After enucleation, the remaining space was filled with BIOSs and bioguide (lyophilized bone and collagen membrane). Patients' twelve months follow-up demonstrate no relapses and maintenance of teeth involved.

  8. Transverse Expansion and Stability after Segmental Le Fort I Osteotomy versus Surgically Assisted Rapid Maxillary Expansion: a Systematic Review

    OpenAIRE

    Thomas Starch-Jensen; Tue Lindberg Blæhr

    2017-01-01

    Objectives: The objective of the present systematic review was to test the hypothesis of no difference in transverse skeletal and dental arch expansion and relapse after segmental Le Fort I osteotomy versus surgically assisted rapid maxillary expansion. Material and Methods: A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted by including human studies published in English from January 1, 2000 to June 1, 2016. Res...

  9. Three-dimensional evaluation of the alar cinch suture after Le Fort I osteotomy.

    Science.gov (United States)

    van Loon, B; Verhamme, L; Xi, T; de Koning, M J J; Bergé, S J; Maal, T J J

    2016-10-01

    Orthognathic surgery has an influence on the overlying soft tissues of the translated bony maxillomandibular complex. Improvements in both function and facial appearance are the goals of surgery. However, unwanted changes to the soft tissues, especially in the nose region, frequently occur. The most common secondary change in the nasolabial region is widening of the alar base. Various surgical techniques have been developed to minimize this effect. The purpose of this study was to evaluate the changes in the nasal region due to orthognathic surgery, especially the alar width and nasal volume, using combined cone beam computed tomography (CBCT) and three-dimensional (3D) stereophotogrammetry datasets. Twenty-six patients who underwent a Le Fort I advancement osteotomy between 2006 and 2013 were included. From 2006 to 2010, no alar base cinch sutures were performed. From 2010 onwards, alar base cinch sutures were used. Preoperative and postoperative documentation consisted of 3D stereophotogrammetry and CBCT scans. 3D measurements were performed on the combined datasets, and the alar base width and nose volume were analyzed. No difference in alar base width or nose volume was observed between patients who had undergone an alar cinch and those who had not. Postoperatively the nose widened and the volume increased in both groups. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Nasal Airway Evaluation After Le Fort I Osteotomy Combined With Septoplasty in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Wang, Zhongying; Wang, Peihua; Zhang, Yixin; Shen, Guofang

    2017-01-01

    Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP. Twenty-three patients with complete unilateral CLP presenting with nasal obstruction and septum deviation were included (12-combined surgery group; 11-control group). Types of septum deviation in the patients were analyzed. Presurgical and 6-month-postsurgical acoustic rhinometry (AR) was performed for objective assessment; and the nasal obstruction symptom evaluation (NOSE) scale was used for subjective assessment. The authors used SPSS to compare the baseline and follow-up results. Acoustic rhinometry assessment showed improvements in the nasal minimal cross-sectional area (MCA), nasal resistance, and nasal volumes in 12 patients who received combined surgery. For the 2 groups, significant improvements in nasal breathing were documented (by NOSE scores) at 6 months after surgery. Simultaneous management of the maxillary dysplasia (Le Fort I osteotomy) and intranasal pathology (septoplasty) were effective for relief of nasal airway obstruction in patients with complete unilateral CLP. The combination of objective (AR) and subjective (NOSE scale) assessments allowed better evaluation of the nasal function.

  11. Transverse Expansion and Stability after Segmental Le Fort I Osteotomy versus Surgically Assisted Rapid Maxillary Expansion: a Systematic Review

    Science.gov (United States)

    Blæhr, Tue Lindberg

    2016-01-01

    ABSTRACT Objectives The objective of the present systematic review was to test the hypothesis of no difference in transverse skeletal and dental arch expansion and relapse after segmental Le Fort I osteotomy versus surgically assisted rapid maxillary expansion. Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted by including human studies published in English from January 1, 2000 to June 1, 2016. Results The search provided 130 titles and four studies fulfilled the inclusion criteria. All the included studies were characterized by high risk of bias and meta-analysis was not possible due to considerable variation. Both treatment modalities significantly increase the transverse maxillary skeletal and dental arch width. The transverse dental arch expansion and relapse seems to be substantial higher with tooth-borne surgically assisted rapid maxillary expansion compared to segmental Le Fort I osteotomy. The ratio of dental to skeletal relapse was significantly higher in the posterior maxilla with tooth-borne surgically assisted rapid maxillary expansion. Moreover, a parallel opening without segment tilting was observed after segmental Le Fort I osteotomy. Conclusions Maxillary transverse deficiency in adults can be treated successfully with both treatment modalities, although surgically assisted rapid maxillary expansion seems more effective when large transverse maxillary skeletal and dental arch expansion is required. However, considering the methodological limitations of the included studies, long-term randomized studies assessing transverse skeletal and dental expansion and relapse with the two treatment modalities are needed before definite conclusions can be provided. PMID:28154745

  12. A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

    Science.gov (United States)

    Nakamura, Masahiro; Matsumura, Tatsushi; Yamashiro, Takashi; Iida, Seiji; Kamioka, Hiroshi

    2016-01-01

    We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR. PMID:27896214

  13. The effect of alar cinch sutures and V-Y closure versus simple closing sutures after Le Fort I osteotomies on nasolabial esthetics and dynamics

    NARCIS (Netherlands)

    Muradin, M.S.M.|info:eu-repo/dai/nl/304817775

    2010-01-01

    Surgical reposition of the maxilla by means of a Le Fort I osteotomy is a, widely used, procedure to correct dentofacial deformities. Maxillary intrusion, especially, is known to cause unwanted side effects on the orofacial soft tissues, such as broadening of the alar base, loss of vermilion show of

  14. The effect of alar cinch sutures and V-Y closure on soft tissue dynamics after Le Fort I intrusion osteotomies.

    NARCIS (Netherlands)

    Muradin, M.S.; Rosenberg, A.; Bilt, A. van der; Stoelinga, P.J.W.; Koole, R.

    2009-01-01

    Adverse effects on the soft tissues after Le Fort I osteotomies include: broadening of the alar base, loss of vermilion show of the upper lip and down sloping of the commissures. In theory, an alar cinch suture combined with a muco-musculo-periosteal V-Y closure (ACVY) should improve not only the na

  15. The effect of alar cinch sutures and V-Y closure on soft tissue dynamics after Le Fort I intrusion osteotomies.

    NARCIS (Netherlands)

    Muradin, M.S.; Rosenberg, A.; Bilt, A. van der; Stoelinga, P.J.W.; Koole, R.

    2009-01-01

    Adverse effects on the soft tissues after Le Fort I osteotomies include: broadening of the alar base, loss of vermilion show of the upper lip and down sloping of the commissures. In theory, an alar cinch suture combined with a muco-musculo-periosteal V-Y closure (ACVY) should improve not only the na

  16. Stability of Vertical, Horizontal and Angular Parameters Following Superior Repositioning of Maxilla by Le Fort I Osteotomy: A Cephalometric Study.

    Science.gov (United States)

    Venkategowda, Pruthvi Raj Hanthur; Prakash, A T; Roy, E T; Shetty, K Sadashiva; Thakkar, Surbhi; Maurya, Rajkumar

    2017-01-01

    The restoration of normal jaw function, optimal facial aesthetics and long term stability are the goals of any orthognathic surgical procedures. During the last two decades, several cephalometric investigations have been reported on the skeletal changes following maxillary surgical procedures. The stability following LeFort I osteotomy and maxillary superior repositioning of the maxilla has not been studied extensively. This study was aimed at determining the surgical changes brought about by superior repositioning of the maxilla by Le Fort I osteotomy and evaluate the stability of the surgical procedure one year following surgery. Presurgical and postsurgical and one year post surgical lateral cephalograms of 10 adult patients (age group - 17 to 40 years, with a mean age of 22.2 years) who had been treated successfully by maxillary Le-Fort I osteotomy and impaction were obtained. The lateral cephalograms were grouped into three categories: T1- Presurgical, T2- Postsurgical, T3- One year postsurgical. Comparisons were made between T1-T2 and T2-T3 to assess the changes following surgery and to evaluate the stability, one year following the surgery using 5 horizontal, 5 vertical linear and 2 angular measurement. Statistical analysis was done with SPSS (Version 17). Results were expressed as mean±standard deviation. A paired t-test was used to analyze the paired observations. The difference between T1 and T2 values of vertical changes showed that they were statistically highly significant whereas from T2 to T3 they were insignificant. The difference between T1 and T2 values of all the horizontal changes showed that they were statistically significant whereas True Vertical Line (TVL) to point Anterior Nasal Spine (ANS) was not statistically significant. The horizontal changes from T2 to T3 were statistically not significant whereas TVL to point Incisal edge of upper incisor (Is) was statistically significant. The angular changes from T1 to T2, T2 to T3 were

  17. Stability of the anterior maxillary segment and teeth after segmental le fort I osteotomy and postoperative skeletal elastic fixation with or without occlusal splint

    DEFF Research Database (Denmark)

    Blæhr, Tue Lindberg; Jensen, Thomas; Due, Karen Margrethe;

    2014-01-01

    OBJECTIVES: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. MATERIAL AND METHODS: 29 consecutive patients underwent segmental Le Fort I.......83 to 1.69°). There was no statistically significant difference in stability between the two groups at the P value 0.05. CONCLUSIONS: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment...... osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A) or dismounted perioperatively (group B). Changes in landmarks and reference planes between the two timepoints were estimated on lateral...

  18. Long-term stability of limiting nasal alar base width changes with a cinch suture following Le Fort I osteotomy with submental intubation.

    Science.gov (United States)

    Raithatha, R; Naini, F B; Patel, S; Sherriff, M; Witherow, H

    2017-06-29

    The aim of this study was to assess the effectiveness of the nasal alar base cinch suture following Le Fort I osteotomy at long-term follow-up. One hundred and forty participants (89 female, 51 male) aged between 16 and 51 years underwent Le Fort I osteotomy with submental intubation. Anthropometric measurements of the nose were taken intraoperatively, immediately postoperative, and for up to 3 years postoperative: the maximum lateral convexity of the alae (Al-Al) and the lateral extremity of the alar base curvature at the alar groove (Ac-Ac). The use of a cinch suture was recorded. The results were analysed using a linear mixed-effects model analysis. One hundred and six participants had cinch sutures and 34 had no cinch sutures. Following Le Fort I osteotomy, there were significant increases in Ac-Ac (by 4.29mm) and Al-Al (by 3.70mm) (both PAlar width remained stable over 3 years, with an increase of 0.36mm for Al-Al (P>0.05) and 1.03mm for Ac-Ac (Palar base width changes, which were found to be relatively stable at 3 years. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Le Fort I osteotomies using Bio-Oss® collagen to promote bony union: a prospective clinical split-mouth study.

    Science.gov (United States)

    Rohner, D; Hailemariam, S; Hammer, B

    2013-05-01

    The purpose of this study was to evaluate whether a bone substitute can be used to promote bony union in patients undergoing maxillary advancement after Le Fort l osteotomy. Nine patients were treated bilaterally with Le Fort I osteotomies and maxillary advancements of 5mm or less. In each patient, one gap was grafted with the bone substitute Bio-Oss(®) Collagen (BOC). The contralateral site was left empty and served as control. After 6 months there were still empty gaps in the control sites of three patients, while in the grafted sites all gaps were completely filled with bone. The histomorphometric analysis performed with biopsies from the region of the original gap showed a similar amount of new bone in both groups, however, in the test group the mean overall amount of the mineralized fraction was higher compared to the control group (test site 65.0±6.2%, control site 38.9±32.6%). The bone substitute seemed to be a suitable material to promote bony union in Le Fort I osteotomies. Further studies are needed to analyse whether this technique is efficient in preventing relapse and promoting bony union in larger advancements.

  20. [Computer-assisted navigation in orthognathic surgery. Application to Le Fort I osteotomy.

    Science.gov (United States)

    Benassarou, M; Benassarou, A; Meyer, C

    2013-08-05

    Computer-assisted navigation is a tool that allows the surgeon to reach intraoperatively a previously defined target. This technique can be applied to the positioning of bone fragments in orthognathic surgery. It is not used routinely yet because there are no specifically dedicated systems available on the market for this kind of surgery. The goal of our study was to describe the various systems that could be used in orthognathic surgery and to report our experience of computer-assisted surgery in the positioning of the maxilla during maxillomandibular osteotomies.

  1. A report of 2 patients with transient blindness following Le Fort I osteotomy and a review of past reported cases

    Directory of Open Access Journals (Sweden)

    Philip Mathew

    2015-01-01

    Full Text Available Blindness following a LeFort I osteotomy is a rare but extremely serious complication. Ten cases have been reported to date. None of these patients recovered vision. Optic neuropathy is believed to be the cause but the exact mechanism has not been settled. We report the first, and the only two, documented cases of complete loss of vision that recovered subsequently. The first patient was a 19-year-old male with repaired bilateral cleft lip and palate. He developed loss of vision in the right eye on the second postoperative day. The second patient was a 22-year-old male with repaired unilateral cleft lip and palate. He developed complete loss of vision in the left eye on the day of surgery. Both these patients underwent ongoing studies, which did not show any abnormalities. Both were treated with methylprednisolone. Both the patients gradually showed improvement in their vision. The first patient recovered normal vision several months postoperatively. The second patient′s vision improved to 4/60 by 4 months postoperatively. We discuss the probable mechanisms of optic nerve injury and also the possible reasons why sight was restored in these patients. This is a rare but serious complication following a fairly common procedure. Through this article we wish to create an awareness of this complication and also a possible way of avoiding such a disaster.

  2. Distal humeral Salter Harris (Type II) fracture repair by an ulnar osteotomy approach in a horse.

    Science.gov (United States)

    Ahern, Benjamin J; Richardson, Dean W

    2010-08-01

    To report repair of a comminuted distal humeral type II Salter-Harris fracture using an ulnar osteotomy approach and locking compression plates (LCP). Case report. A 3-month-old Standardbred filly with a type II Salter-Harris fracture of the distal humerus. Radiographic and computed tomography examinations were performed to assist surgical planning. The distal humeral fracture was approached by an ulnar osteotomy and repaired using a 7-hole broad LCP and screws inserted in lag fashion. The osteotomy was subsequently repaired using a 7-hole narrow LCP. The distal humeral fracture was successfully approached and stabilized by an ulnar osteotomy approach. At 6-month follow-up, the filly was ambulating comfortably with a normal cosmetic appearance. An ulnar osteotomy approach was readily performed and allowed for repair of a type II Salter-Harris fracture of the distal humerus. The equine distal humerus can be accessed readily using an ulnar osteotomy approach. LCPs allow for repair of complicated fractures that have previously been associated with a grave prognosis.

  3. Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

    Directory of Open Access Journals (Sweden)

    Meyer Ulrich

    2007-01-01

    Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

  4. Stability of the Anterior Maxillary Segment and Teeth after Segmental Le Fort I Osteotomy and Postoperative Skeletal Elastic Fixation With or Without Occlusal Splint

    Directory of Open Access Journals (Sweden)

    Tue Lindberg

    2014-10-01

    Full Text Available Objectives: To assess the short term dental and skeletal stability of the anterior maxillary segment after segmental Le Fort I osteotomy with postoperative skeletal elastic fixation with or without occlusal splint. Material and Methods: 29 consecutive patients underwent segmental Le Fort I osteotomy and elastic skeletal fixation was applied. Patients were divided into two groups according to whether a fixed occlusal splint was used for six weeks (group A or dismounted perioperatively (group B. Changes in landmarks and reference planes between the two timepoints were estimated on lateral cephalometric radiographs. Results: Group A: The upper incisor had a mean intrusion of -0.56 mm (SD 0.77; range -2.04 to 1.08 mm and a mean posterior movement of -0.93 mm (SD 1.03; range -2.52 to 0.96 mm. The mean change in the axial inclination of the upper incisor was -0.33° (SD 2.56; range -6° to 4° (95% CI: -1.75 to 1.08°. Group B: The upper incisor had a mean intrusion of -0.13 mm (SD 1.36; range -1.92 to 3.6 mm and a mean anterior movement of 0.11 mm (SD 1.78; range -2.88 to 3.84 mm. The mean change in the axial inclination of the upper incisor was -0.07° (SD 3.05; range -5° to 5° (95% CI: -1.83 to 1.69°. There was no statistically significant difference in stability between the two groups at the P value 0.05. Conclusions: The skeletal anterior fixation with postoperative elastics for eight weeks may not compromise the early postoperative dental and skeletal stability of the anterior segment in segmental Le Fort I osteotomy.

  5. A prospective study on the effect of modified alar cinch sutures and V-Y closure versus simple closing sutures on nasolabial changes after Le Fort I intrusion and advancement osteotomies.

    NARCIS (Netherlands)

    Muradin, M.S.; Seubring, K.; Stoelinga, P.J.W.; Bilt, A. van der; Koole, R.; Rosenberg, A.J.

    2011-01-01

    PURPOSE: The purpose of this study was to determine whether a modified alar cinch suture and V-Y closure (mACVY) have a beneficial effect on labial form after Le Fort I intrusion and advancement osteotomies and whether they result in excessive upward nasal tip rotation. Both are possible effects com

  6. A Prospective Study on the Effect of Modified Alar Cinch Sutures and V-Y Closure Versus Simple Closing Sutures on Nasolabial Changes After Le Fort I Intrusion and Advancement Osteotomies

    NARCIS (Netherlands)

    Muradin, Marvick S. M.; Seubring, Karlien; Stoelinga, Paul J. W.; Bilt, Andries Vd; Koole, Ronald; Rosenberg, Antoine J. W. P.

    2011-01-01

    Purpose: The purpose of this study was to determine whether a modified alar cinch suture and V-Y closure (mACVY) have a beneficial effect on labial form after Le Fort I intrusion and advancement osteotomies and whether they result in excessive upward nasal tip rotation. Both are possible effects com

  7. Using three-dimensional CT to guide Le Fortosteotomy in maxillary retrognathism patients%三维CT在上颌发育不足患者行Le Fort Ⅰ型截骨术中的应用

    Institute of Scientific and Technical Information of China (English)

    陈海华; 卢利

    2012-01-01

    Objective To analysis the maxillary bony structures by three-dimensional CT in maxillary retrognathism patients so as to provide information for Le Fortosteotomy.Methods 20 maxillary retrognathism patients underwent Le Fortosteotomy,while 20 patients with simple mandibular fractures were included as control group.All the patients received Skull 3-D CT before operation.The measurement about descending palatine artery and wing palatal was performed by Surgicase 5.0.The data were analyzed statistically.Results The average distance from the piriform aperture margin to wing palatal tube was (33.74±6.74) mm in the retrognathism group; while (35.67±7.50) mm in the control group,showing a significant difference between the two groups(P<0.05),but there was no statistically difference in the height of pterygomaxillary junction between the two groups.Conclusion The safe depth for Le FortⅠ osteotomy in patients with hypoplasia maxilla is 32 mm.CT scanning can provide guidance for osteotomy.%目的 采用三维CT影像对下颌前突、上颌发育不足患者的上颌硬组织进行测量分析,以期为临床Le Fort Ⅰ型截骨术提供指导.方法 2009年6月至2011年2月在中国医科大学附属口腔医院就诊的40例患者,随机分为2组,20例行上颌骨Le Fort Ⅰ型截骨的患者作为实验组,20例单纯下颌骨骨折为对照组,进行颅颌面部CT扫描.应用软件Surgicase5.0对颅颌面部CT影像进行三维重建后,测量腭降动脉和翼板相关结构,并对所得数据进行统计学分析.结果 梨状孔边缘至翼腭管的距离实验组平均为(33.74±6.74) mm,对照组平均为(35.67±7.50) mm,二者比较,差异有统计学意义(P<0.05).而翼上颌连接的高度,实验和对照组比较,差异无统计学意义(P>0.05).结论 下颌前突,上颌发育不足患者行Le FortⅠ型截骨的安全距离约为32 mm,在手术过程中应注意控制骨切开深度;有必要对Le Fort Ⅰ型截骨术患者术前拍

  8. Evaluation of soft tissue morphologic changes after using the alar base cinch suture in Le Fort I osteotomy in mandibular prognathism with and without asymmetry.

    Science.gov (United States)

    Moroi, Akinori; Ishihara, Yuri; Sotobori, Megumi; Nakazawa, Ryuichi; Higuchi, Masatoshi; Nakano, Yoshio; Marukawa, Kohei; Ueki, Koichiro

    2014-09-01

    The purpose of this study was to investigate the effects of alar base cinch suture in Le Fort I osteotomy in mandibular prognathism with and without asymmetry. Forty patients who underwent Le Fort I osteotomy were divided into an asymmetry group and a symmetry group (n = 20 each). Computed tomography (CT) was taken in all patients before and 1 year after surgery. The CT-3D volume rendering data with Aquarius Net (TeraRecon, Foster City, CA, USA) was reconstructed and the soft tissue was measured as follows, the distance between the bilateral alar base (Alar base width), the distance between the bilateral alar (Alar width), the angles between the FH plane and the line between the bilateral alar base (Alar base angle), the angle between the FH plane and the line between the bilateral alar (Alar angle), the angle between the FH plane and the line between the bilateral corners of the mouth (Lip angle), and the angle between the perpendicular line to the FH plane and the Philtrum (Philtrum angle). Significant differences were observed in the Alar width (P = 0.0448), the Alar angle (P = 0.0044), the Lip angle (P alar base cinch suture could prevent increases in the alar base width in both groups and help to improve the angle of soft tissue in the asymmetry group, although alar width significantly increases after surgery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Finite element study of maxillary Le Fort-Ⅰ osteotomy with rigid internal fixation%上颌骨Le Fort-Ⅰ型截骨术坚强内固定的有限元研究

    Institute of Scientific and Technical Information of China (English)

    周健; 孙庚林; 吴炜; 许崇涛; 王鹏林

    2010-01-01

    Objective To study the biomechanical characteristic of maxillary Le fort- I osteotomy with rigid internal fixation (RIF), so as to choose best fixation method. Methods The 3-dimensional finite element models of maxillary Le Fort- I osteotomy with 9 kinds of RIF methods were established. Then the models were divided into three groups to calculate the stress distribution of the maxilla and the displacement of bone segment under 3 kinds of occlusion condition. The fixation stability of the different RIF methods was evaluated. Results Under the incisor occlusion condition, the stress of the cranio maxillary complex transmits mainly along the nasal-maxillary buttress. Under the premolar and molar occlusion condition, the stress transmits along the alveolar process first, then turns to the nasal-maxillary and zygomatic-maxillary buttress. The focused stress position of the internal fixation system is at the connection between the screws and the plate and at the plate near the osteotomy line. Under the premolar occlusion condition, the displacement of bone segment with different RIF methods was (in a decreasing order) 0.396509 mm ( with bio-absorbable plate), 0.148393 mm (with micro-plate ), 0.078436 mm (with mini-plate ) in group 1;0.188791 mm (fixing at the nasal-maxillary buttress), 0.121718 mm (fixing at the zygomatic-maxillary buttress) , 0.078436 mm (fixing at the both buttress) in group 2;0.091023 mm (with straight plate), 0.078436 mm (with L shape plate), 0.072450 mm (with Y shape plate) , 0. 065617 mm (with T shape plate) in group 3. Conclusions The fixation stability of using the bio-absorbable plate in Le Fort-Ⅰ osteotomy is less stable than using the titanium plate. Fixing at the zygomatic-maxillary buttress is more stable than at the naso-maxillary buttress. The fixation stability is different by using different shapes of plates.%目的 研究不同接骨板在上颌骨Le Fort-Ⅰ型截骨正颌手术中固定的生物力学特性,以期

  10. The effect of nasal application of cocaine/adrenaline on blood loss in Le Fort I osteotomies

    NARCIS (Netherlands)

    de Lange, J.; Baas, E.M.; Horsthuis, R.B.G.; Booij, A.

    2008-01-01

    Cocaine is a very potent vasoconstrictor that is used by ENT specialists to reduce blood loss and enhance visibility during nasal surgery. In orthognathic surgery, especially Le Fort I procedures, excessive blood loss is a relatively frequent complication. In this study, a prospective randomized

  11. The effect of nasal application of cocaine/adrenaline on blood loss in Le Fort I osteotomies

    NARCIS (Netherlands)

    de Lange, J.; Baas, E.M.; Horsthuis, R.B.G.; Booij, A.

    2008-01-01

    Cocaine is a very potent vasoconstrictor that is used by ENT specialists to reduce blood loss and enhance visibility during nasal surgery. In orthognathic surgery, especially Le Fort I procedures, excessive blood loss is a relatively frequent complication. In this study, a prospective randomized cli

  12. Modified alar base cinch suture fixation at the bilateral lower border of the piriform rim after a maxillary Le Fort I osteotomy.

    Science.gov (United States)

    Yen, C Y; Kuo, C L; Liu, I H; Su, W C; Jiang, H R; Huang, I G; Liu, S Y; Lee, S Y

    2016-11-01

    Classic cinch suture narrowing of the nasal alar base by medially suturing the bilateral nasolabial soft tissue with one long suture has a limited effect. The modified cinch method described in the present study anchors non-absorbable sutures to the bilateral lower border of the piriform rim and provides optimal direction, position, and stability. The sutures can be shortened and the strength kept stable while the surgical wounds heal. Separate bilateral sutures can also reduce interference and distortion from nasotracheal intubation and make the nasolabial profile more symmetrical. Seventeen consecutive cases of maxillary Le Fort I osteotomy were analyzed. The nasal and alar base width changes were 0.4±1.2mm and 0.1±1.1mm, respectively, and the widening rate was only 1.1%. Compared with the results of other studies, postoperative nasal flaring was well controlled using the modified cinch suture anchored to the bilateral lower border of the piriform rim described in this study.

  13. Le Fort I osteotomy for the removal of a rare unicystic ameloblastoma lesion in the maxillary sinus.

    Science.gov (United States)

    Iwaki, Lilian Cristina Vessoni; Tolentino, Elen Souza; Lustosa, Rômulo Maciel; Jacomacci, Willian Pecin; Casaroto, Ana Regina; Leite, Pablo Cornelius; Iwaki-Filho, Liogi

    2016-01-01

    The unicystic ameloblastoma (UA) presents the clinical and radiographic characteristics of a maxillary cyst, making early diagnosis difficult. A 30-year-old man had an extensive, asymptomatic lesion in the right maxillary sinus. Radiographic examinations demonstrated a retained tooth in association with a lesion. Histopathologic examination revealed the presence of UA with intraluminal and mural infiltration and a follicular pattern. Le Fort I access was chosen for enucleation of the lesion and curettage of the site, which were followed by cryotherapy. The treatment provided adequate intraoperative visibility, enabled the preservation of the surrounding bone, and eliminated postoperative complications. Follow-up over 5 years demonstrated no recurrence.

  14. Experience with bone morphogenetic protein-2 and interpositional grafting of edentulous maxillae: a comparison of Le Fort I downfracture to full-arch (horseshoe) segmental osteotomy done in conjunction with sinus floor grafting.

    Science.gov (United States)

    Jensen, Ole T; Cottam, Jared R; Ringeman, Jason L; Leopardi, Aldo; Butler, Brian; Laviv, Amir; Fleissig, Yoram; Casap, Nardy

    2013-01-01

    This paper is a retrospective report of the treatment of six patients with severely resorbed maxillae. Patients were treated, based on the amount of maxillary retrognathia, with either a Le Fort I downfracture or a "horseshoe" interpositional sandwich osteotomy, along with sinus elevation. Recombinant human bone morphogenetic protein-2 in an absorbable collagen sponge carrier was used for grafting in all patients, either alone or in combination with other grafting materials. Implants were placed and the patients were restored with fixed prostheses. Both grafting techniques are described, and the treated patients are presented.

  15. Biomechanical Analysis of Cuboid Osteotomy Lateral Column Lengthening for Stage II B Adult-Acquired Flatfoot Deformity: A Cadaveric Study

    Directory of Open Access Journals (Sweden)

    Haichao Zhou

    2017-01-01

    Full Text Available Purpose. To investigate the effect of cuboid osteotomy lateral column lengthening (LCL for the correction of stage II B adult-acquired flatfoot deformity in cadaver. Methods. Six cadaver specimens were loaded to 350 N. Flatfoot models were established and each was evaluated radiographically and pedobarographically in the following conditions: (1 intact foot, (2 flatfoot, and (3 cuboid osteotomy LCL (2, 3, 4, and 5 mm. Results. Compared with the flatfoot model, the LCLs showed significant correction of talonavicular coverage on anteroposterior radiographs and talus-first metatarsal angle on both anteroposterior and lateral radiographs (p<.05. Compared with the intact foot, the above angles of the LCLs showed no significant difference except the 2 mm LCL. In terms of forefoot pressure, medial pressure of the 2 mm LCL (p=.044 and lateral pressure of the 3, 4, and 5 mm LCLs showed statistical differences (p<.05, but lateral pressure of the 3 mm LCL was not more than the intact foot as compared to the 4 and 5 mm LCLs, which was less than medial pressure. Conclusion. Cuboid osteotomy LCL procedure avoids damage to subtalar joint and has a good effect on correction of stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

  16. Osteotomy of the knee

    Science.gov (United States)

    Proximal tibial osteotomy; Lateral closing wedge osteotomy; High tibial osteotomy; Distal femoral osteotomy ... There are two types of surgery: Tibial osteotomy is surgery done on ... osteotomy is surgery done on the thigh bone above the knee ...

  17. Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis.

    Science.gov (United States)

    Haeseker, Guus A; Mureau, Marc A; Faber, Frank W M

    2010-01-01

    In this study, clinical and radiological results after lateral column lengthening by calcaneocuboid distraction arthrodesis and calcaneus osteotomy were compared. Thirty-three patients (35 feet) treated with lateral column lengthening by distraction arthrodesis (14 patients, 16 feet; group I) or by calcaneus osteotomy (19 patients, 19 feet; group II) for adult-acquired flatfoot deformity caused by stage II posterior tibial tendon dysfunction were compared retrospectively. Mean follow-up was 42.4 months (range, 6-78 months) for group I and 15.8 months (range, 6-32 months) for group II (P < .001). The American Orthopaedic Foot & Ankle Society ankle-hindfoot score was determined, 4 variables were measured on preoperative and postoperative weight-bearing radiographs, and a number of independent and outcome variables, including patient satisfaction, were recorded. Group 2 had a significantly higher American Orthopaedic Foot & Ankle Society score compared with group I (mean, 85 vs. 72, respectively; P < .02) at time of last follow-up, and there were no dissatisfied patients in group I, whereas 2 patients in group II were dissatisfied with the result of the operation. All radiological results were significantly better at time of follow-up in both groups (except for talocalcaneal angle in group I), although no significant differences were noted in the amount of change in radiographic measurements between the groups. No significant correlation was found between follow-up time and radiographic improvement, indicating stable radiographic measurements over time. In group II, 13 mild calcaneocuboid subluxations were observed. In both groups, 1 nonunion and 1 wound complication occurred. Based on our experience with the patients described in this report, we recommend lateral column lengthening by means of calcaneus osteotomy rather than distraction arthrodesis of the calcaneocuboid joint, for correction of stage II posterior tibial tendon dysfunction.

  18. Comparison between the classical and a modified trans-septal technique of alar cinching for Le Fort I osteotomies: a prospective randomized controlled trial.

    Science.gov (United States)

    Nirvikalpa, N; Narayanan, V; Wahab, A; Ramadorai, A

    2013-01-01

    The aim of this prospective randomized control trial was to analyse the efficacy of a new trans-septal alar base cinch suture in controlling alar width in patients undergoing maxillary intrusion and setback by comparing it with the traditional cinch suture. Statistical evaluation was carried out in 62 of 76 patients. Group I (31 patients) received the traditional alar base cinch suture, and group II (31 patients) received the alar base cinch suture with an anchoring bite taken through the nasal septum 10mm behind its anterior edge. In both groups the accurate identification of alar fibroareolar tissue was facilitated by an 18 gauge green needle passed extra orally. Alar base width was measured before and 6 months after surgery using Vernier callipers. Preoperative alar base width for group I was 29.76 mm (1.901SD) and for group II 29.79 mm (3.141SD); the postoperative values were 32.42 mm (1.858SD) and 29.94 mm (2.568SD), respectively. Mean alar base widening was 2.661 mm (0.800SD) in group I and 0.145 mm (2.050) in group II. The difference in alar widening was statistically significant (palar cinch suture offers better control of alar base architecture in maxillary intrusion and setback. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. The fate of fibular osteotomies performed during high tibial osteotomy.

    Science.gov (United States)

    Bicer, Elcil Kaya; Basa, Can Doruk; Gunay, Huseyin; Aydogdu, Semih; Sur, Hakki

    2016-08-01

    High tibial osteotomy (HTO) is an important treatment alternative in isolated single compartment knee osteoarthritis. To achieve adequate mechanical axis corrections in the lower extremity fibula is also osteotomized concomitantly. The aim of this study was to compare the union rates of proximal and diaphyseal fibular osteotomies accompanying high tibial osteotomies. Sixty-seven knees of sixty-three patients who had undergone HTO were retrospectively evaluated. The patients were grouped according to the level of the fibular osteotomy (FO). In group I, the level of FO was proximal, and in group II, it was at the level of junction of middle and distal third of diaphysis. The union rates of FOs at two different levels were compared. The influence of the presence of displacement at the osteotomy site and apposition between bone ends on union was also evaluated. Fifty-nine of sixty-seven FOs (88.06 %) were united. The union rate of proximal FOs was significantly greater than diaphyseal osteotomies (p < 0.0001); 97.9 % of proximal FOs were united, whereas this ratio was 65 % for the diaphyseal FOs. The presence of displacement at the FO and apposition between bone ends significantly influenced the bony union rate (p values 0.035 and <0.0001, respectively). Union rates and nonunion characteristics of FO might differ according to its level, apposition of bone ends, and contact area. The fate of FO might also affect the union of HTO.

  20. Periacetabular osteotomy

    DEFF Research Database (Denmark)

    Klit, Jakob; Hartig-Andreasen, Charlotte; Jacobsen, Steffen;

    2014-01-01

    Hip joint survivorship and functional outcome are traditional outcome measures applied after periacetabular osteotomy (PAO). Younger adults however have greater demands and expectations on the function of their hip joints and these demands are not expressed using traditional outcome assessment...... tools. The main purpose of this study was to explore alternative functional and quality of life measure after PAO. A cross sectional survey of preserved hip joints following PAO was performed. Fifty-two patients (68 hips), mean age 41 years (range 24-67), returned a questionnaire examining satisfaction...

  1. Long-term follow-up of flexor digitorum longus transfer and calcaneal osteotomy for stage II posterior tibial tendon dysfunction.

    Science.gov (United States)

    Chadwick, C; Whitehouse, S L; Saxby, T S

    2015-03-01

    Flexor digitorum longus transfer and medial displacement calcaneal osteotomy is a well-recognised form of treatment for stage II posterior tibial tendon dysfunction. Although excellent short- and medium-term results have been reported, the long-term outcome is unknown. We reviewed the clinical outcome of 31 patients with a symptomatic flexible flat-foot deformity who underwent this procedure between 1994 and 1996. There were 21 women and ten men with a mean age of 54.3 years (42 to 70). The mean follow-up was 15.2 years (11.4 to 16.5). All scores improved significantly (p Foot and Ankle Society (AOFAS) score improved from 48.4 pre-operatively to 90.3 (54 to 100) at the final follow-up. The mean pain component improved from 12.3 to 35.2 (20 to 40). The mean function score improved from 35.2 to 45.6 (30 to 50). The mean visual analogue score for pain improved from 7.3 to 1.3 (0 to 6). The mean Short Form-36 physical component score was 40.6 (sd 8.9), and this showed a significant correlation with the mean AOFAS score (r = 0.68, p = 0.005). A total of 27 patients (87%) were pain free and functioning well at the final follow-up. We believe that flexor digitorum longus transfer and calcaneal osteotomy provides long-term pain relief and satisfactory function in the treatment of stage II posterior tibial tendon dysfunction. ©2015 The British Editorial Society of Bone & Joint Surgery.

  2. Polygonal triple (Kotz) osteotomy (over 10 years experience)

    OpenAIRE

    Sen, Cengiz; Gunes, Taner; Erdem, Mehmet; Ozger, Harzem; Tozun, I. Remzi

    2006-01-01

    We evaluated the results of polygonal triple (Kotz) osteotomy for the treatment of acetabular dysplasia over 10 years. This study included 31 hips of 27 patients who had the Kotz osteotomy for acetabular dysplasia. The mean age was 21.5 years. We performed the original Kotz osteotomy for the first 22 hips (group I), while the modified Kotz osteotomy through an intra-pelvic approach without damage to the abductor muscle was applied for the last 9 hips (group II). Patients were evaluated by cli...

  3. Polygonal triple (Kotz) osteotomy (over 10 years experience).

    Science.gov (United States)

    Sen, Cengiz; Gunes, Taner; Erdem, Mehmet; Ozger, Harzem; Tozun, I Remzi

    2007-06-01

    We evaluated the results of polygonal triple (Kotz) osteotomy for the treatment of acetabular dysplasia over 10 years. This study included 31 hips of 27 patients who had the Kotz osteotomy for acetabular dysplasia. The mean age was 21.5 years. We performed the original Kotz osteotomy for the first 22 hips (group I), while the modified Kotz osteotomy through an intra-pelvic approach without damage to the abductor muscle was applied for the last 9 hips (group II). Patients were evaluated by clinically and radiologically. The average follow-up was 106 months in group I, and 18 months in group II. The Trendelenburg gait was unchanged for four patients in group I and for one patient in group II. The Harris Hip Score improved in all patients postoperatively. Radiographic assesment showed improvement in both groups in terms of the angle of CE, VCE, and Sharp postoperatively(PTrendelenburg gait compared to the original Kotz osteotomy.

  4. Segmental Maxillary Osteotomies in Conjunction With Bimaxillary Orthognathic Surgery: Indications - Safety - Outcome.

    Science.gov (United States)

    Posnick, Jeffrey C; Adachie, Anayo; Choi, Elbert

    2016-07-01

    The purpose of the present study was to evaluate the indications, safety, and treating orthodontists' assessment of outcomes after bimaxillary orthognathic surgery that included segmental osteotomies. We performed a retrospective cohort study of patients treated by a single surgeon from 2004 to 2013. The index group consisted of a consecutive series of subjects with a bimaxillary dentofacial deformity (DFD) involving the chin and symptomatic chronic obstructive nasal breathing. All the subjects underwent Le Fort I osteotomy, bilateral sagittal ramus osteotomy, septoplasty, inferior turbinate reduction, and osseous genioplasty. The predictor variables included age, gender, pattern of presenting DFD, type of maxillary osteotomy, and maxillary premolar extractions. The outcome variables included orthodontist assessment of the results achieved and the occurrence of maxillary complications. The orthodontist assessment was documented through a survey questionnaire completed 1 to 11 years after surgery. The maxillary complications studied included gingival recession, pulpal injury, oronasal fistula, and the need for hardware removal. During the study period, 262 subjects met the inclusion criteria. Their age at surgery averaged 25 years (range 13 to 63), and 134 were female (51%). The major patterns of the presenting DFD included long face (30%) and maxillary deficiency (25%). Of the 262 subjects, 66 (25%) underwent maxillary premolar extractions to relieve dental compensations. Also, 30% of the subjects presented for preoperative reassessment with a posterior arch form of skeletal anomaly. They underwent 2-segment Le Fort I osteotomy, and 34% presented with both posterior arch form and curve of Spee skeletal anomalies. They underwent 3-segment Le Fort I osteotomy. The subjects who had not undergone preoperative maxillary premolar extractions were more likely to have undergone 3-segment Le Fort I osteotomy (P = .008). No direct surgical injury occurred to a dental root

  5. Static and dynamic loading of mandibular condyles and their positional changes after bilateral sagittal split advancement osteotomies.

    Science.gov (United States)

    Dicker, G J; Tuijt, M; Koolstra, J H; Van Schijndel, R A; Castelijns, J A; Tuinzing, D B

    2012-09-01

    This study analysed the effects of change of direction of masseter (MAS) and medial pterygoid muscles (MPM) and changes of moment arms of MAS, MPM and bite force on static and dynamic loading of the condyles after surgical mandibular advancement. Rotations of the condyles were assessed on axial MRIs. 16 adult patients with mandibular hypoplasia were studied. The mandibular plane angle (MPA) was 39° in Group II (n=8). All mandibles were advanced with a bilateral sagittal split osteotomy (BSSO). In Group II, BSSO was combined with Le Fort I osteotomy. Pre and postoperative moment arms of MAS, MPM and bite force were used in a two-dimensional model to assess static loading of the condyles. Pre and postoperative data on muscle cross-sectional area, volume and direction were introduced in three-dimensional dynamic models of the masticatory system to assess the loading of the condyles during opening and closing. Postsurgically, small increases of static condylar loading were calculated. Dynamic loading decreased slightly. Minor rotations of the condyles were observed. The results do not support the idea that increased postoperative condylar loading is a serious cause for condylar resorption or relapse.

  6. Fort Hood Solar Total Energy Project. Volume II. Preliminary design. Part 2. System performance and supporting studies. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None,

    1979-01-01

    The preliminary design developed for the Solar Total Energy System to be installed at Fort Hood, Texas, is presented. System performance analysis and evaluation are described. Feedback of completed performance analyses on current system design and operating philosophy is discussed. The basic computer simulation techniques and assumptions are described and the resulting energy displacement analysis is presented. Supporting technical studies are presented. These include health and safety and reliability assessments; solar collector component evaluation; weather analysis; and a review of selected trade studies which address significant design alternatives. Additional supporting studies which are generally specific to the installation site are reported. These include solar availability analysis; energy load measurements; environmental impact assessment; life cycle cost and economic analysis; heat transfer fluid testing; meteorological/solar station planning; and information dissemination. (WHK)

  7. Maquet Osteotomy, Results

    Science.gov (United States)

    Díaz, Jorge Luis; Vega, Marcelo; Matesevach, Ivan

    2017-01-01

    Objectives: The objectives are to assess the results and to discuss the indications for Maquet osteotomy in patients with patellofemoral osteoarthritis. Methods: Retrospective study of a series of 32 patients (4 bilateral, that is to say, 36 knees) operated between March 1999 and October 2013 in " Arthroscopy Private Center ", 12 male and 20 female, average age 59 years with an average postoperative surgery outcomes of 53 months. The technique consists of an arthroscopic procedure to treat joint lesions and a tibial tuberosity osteotomy of 5 cm long, by embedding a 1cm subsequent graft taken from the same metaphysis and fixed with 2 screws. Results: All patients had significant improvement, evaluated with Kujala’s score (54 points preop to 86 points postop) and Guillamon Ferguson’s criteria (27.2 very good and 60.7 good). The complication rate was acceptable. Conclusion: The available technics are surgeries on proximal soft structures, osteotomies of tibial tuberosity and patellofemoral arthroplasty. Maquet osteotomy is an excellent procedure when the patient’s selection is right. Obtaining the graft from the same metaphysis simplified the procedure.

  8. Self-drilling and self-tapping miniscrews for osteosynthesis fixture after LeFort I osteotomy: An ex vivo trial for primary stability and a randomized clinical study.

    Science.gov (United States)

    Bolm, Irina; Goetze, Elisabeth; Kämmerer, Peer W; Sader, Robert; Klos, Michelle; Landes, Constantin; Al-Nawas, Bilal

    2017-05-15

    Self-drilling osteosynthesis screws (SDS) have a potential higher primary stability together with clinical advantages such as less time effort compared to self-tapping screws (STS). The aims of the study were to compare the primary stability of SDS and STS ex vivo and to analyze of the time-saving effect in vivo. Ex vivo, both screws were placed in porcine bone. Torque was measured for insertion and removal. Four specimens were kept in bone for histologic bone-to-implant-contact examination. In vivo, 49 patients who received orthognathic surgery in the maxilla were included in 2 centers. In a split-mouth design, the time for osteosynthesis fixation and perioperative events were recorded. Ex vivo, insertion and removal torque measurements were higher for SDS, especially in dense bone. Histologic imaging on the exemplary-stained specimens showed higher bone contact and compressed bone matrix for SDS in all bone densities. In vivo, the mean osteosynthesis time in both centers was 5.5 min (±3.03) for SDS and 5.5 min (±2.37) for STS. Separate analysis showed that center I was faster with STS and center II with SDS. Although, in center I a higher rate of failed primary stability of SDS compared to STS was documented. SDS showed a partially higher primary stability ex vivo, especially in dense bone. The timesaving effect of SDS is less pronounced than expected, but technically SDS might be favorable where drilling is difficult or even impossible. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Fort Hood Solar Total Energy Project. Volume II. Preliminary design. Part 1. System criteria and design description. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None,

    1979-01-01

    This volume documents the preliminary design developed for the Solar Total Energy System to be installed at Fort Hood, Texas. Current system, subsystem, and component designs are described and additional studies which support selection among significant design alternatives are presented. Overall system requirements which form the system design basis are presented. These include program objectives; performance and output load requirements; industrial, statutory, and regulatory standards; and site interface requirements. Material in this section will continue to be issued separately in the Systems Requirements Document and maintained current through revision throughout future phases of the project. Overall system design and detailed subsystem design descriptions are provided. Consideration of operation and maintenance is reflected in discussion of each subsystem design as well as in an integrated overall discussion. Included are the solar collector subsystem; the thermal storage subsystem, the power conversion sybsystem (including electrical generation and distribution); the heating/cooling and domestic hot water subsystems; overall instrumentation and control; and the STES building and physical plant. The design of several subsystems has progressed beyond the preliminary stage; descriptions for such subsystems are therefore provided in more detail than others to provide complete documentation of the work performed. In some cases, preliminary design parameters require specific verificaton in the definitive design phase and are identified in the text. Subsystem descriptions will continue to be issued and revised separately to maintain accuracy during future phases of the project. (WHK)

  10. Salter osteotomy in Legg-Calvé-Perthes disease.

    Science.gov (United States)

    Thompson, George H

    2011-09-01

    Femoral head containment in Legg-Calvé-Perthes disease (LCPD) can be either surgical or nonsurgical. The Salter or innominate osteotomy is a common method of surgical containment. This is a review of the technique and results of this osteotomy in LCPD. The operative technique is relatively simple but requires considerable experience to perform correctly. It can be used alone or in combination with a proximal femoral varus osteotomy. The indications for a Salter osteotomy are essentially the same as in any form of containment treatment in LCPD. This includes: age at clinical onset of 6 to 10 years (perhaps, 5 y in female), more than one-half capital femoral epiphyseal involvement (Catterall groups III or IV, Salter-Thompson group B, and lateral pillar groups B, B/C, and C), and a good range of hip motion before surgery. The osteotomy alone is usually indicated for younger children with recent clinical onset and no femoral head deformity or subluxation. The combined procedure is better suited for older children and those with subluxation or a deformed femoral head. Currently, the results of treatment are best determined at skeletal maturity using the Stulberg et al classification. When used alone, approximately 90% to 95% of the involved hips will have achieved a Stulberg et al class I, II, or III result. When combined with a proximal femoral varus osteotomy, the results are somewhat less because of the older age at onset and/or the presence of a deformed hip. The Salter osteotomy in LCPD is an effective method of surgical treatment that can alter the natural history of the disease process. The main advantage of this osteotomy is its effect on femoral head remodeling during remaining growth.

  11. Craniofacial stability in patients with crouzon or apert syndrome after le fort III distraction osteogenesis

    NARCIS (Netherlands)

    J.H. Reitsma (Jacobus Harmen); E.M. Ongkosuwito (Edwin); P.H. Buschang (Peter); L.N.A. V Adrichem (Léon); B. Prahl-Andersen (Birte)

    2013-01-01

    textabstractObjective: Le Fort III osteotomy with distraction osteogenesis (DO) is used to improve the retruded midface in patients with Crouzon or Apert syndrome. This study aimed to evaluate sagittal and vertical preoperative and postoperative cephalometric changes of DO of the midface in patients

  12. Le fort I maxillary advancement using distraction osteogenesis.

    Science.gov (United States)

    Combs, Patrick D; Harshbarger, Raymond J

    2014-11-01

    Treatment of maxillary hypoplasia has traditionally involved conventional Le Fort I osteotomies and advancement. Advancements of greater than 10 mm risk significant relapse. This risk is greater in the cleft lip and palate population, whose anatomy and soft tissue scarring from prior procedures contributes to instability of conventional maxillary advancement. Le Fort I advancement with distraction osteogenesis has emerged as viable, stable treatment modality correction of severe maxillary hypoplasia in cleft, syndromic, and noncleft patients. In this article, the authors provide a review of current data and recommendations concerning Le Fort I advancement with distraction osteogenesis. In addition, they outline their technique for treating severe maxillary hypoplasia with distraction osteogenesis using internal devices.

  13. Total hip arthroplasty with femoral subtrochanteric osteotomy after Schanz osteotomy.

    Science.gov (United States)

    Sonohata, Motoki; Kitajima, Masaru; Kawano, Shunsuke; Tanaka, Riki; Mawatari, Masaaki

    2016-07-01

    Schanz osteotomy is one of the options for the management of hip instability caused by congenital or septic arthritis. Following Schanz osteotomy, there is risk of hip pain secondary to hip arthritis. It may be necessary to perform subtrochanteric femoral osteotomy in conjunction with total hip arthroplasty (THA). This study evaluates the outcomes and complications associated with THA. We performed 36 THA after Schanz osteotomy. Patients were divided into three groups: (1) successful Schanz osteotomy, (2) highly dislocated hip with contact between the femoral head and pelvis, and (3) completely dislocated hip without contact between the femur and pelvis. Clinical and radiological evaluations were completed for each group. In all three groups, hip function improved significantly (p osteotomy after Schanz osteotomy. However, this procedure is a technically demanding treatment option, and there were characteristic complications intra and after surgery. Therefore, surgeons should treat hip osteoarthritis after Schanz operation with utmost care, especially completely dislocated hip. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  14. Osteotomy configuration of the proximal wedge and analysis of the affecting factors in the medial open-wedge high tibial osteotomy.

    Science.gov (United States)

    Lee, Yong Seuk; Kang, Jong Yeal; Lee, Myung Chul; Elazab, Ashraf; Choi, Uk Hyun; Kang, Seo Goo; Lee, Kyoung Jae; Lee, Sahnghoon

    2017-03-01

    The purposes of this study were (1) to confirm the disparity of the measured thickness at the lateral hinge between anterior-posterior (AP) radiograph and 3D CT image, (2) to evaluate the affecting factors, and (3) to evaluate the differences between uniplanar and biplanar osteotomies. From 2012 to 2014, a prospective comparative study was performed with 30 patients who received uniplanar osteotomy (group I) and 35 patients who received biplanar osteotomy (group II). For measurement of the proximal wedge, postoperative AP radiograph and 3D CT images were used. In the AP radiograph, medial and lateral bony bridge thicknesses were measured. In the 3D CT, the anterior and posterior images parallel to the coronal plane were selected for the evaluation. Coronal osteotomy slope was measured with the anterior image of the 3D CT scan. Sagittal osteotomy slope was measured with the sagittal section of the CT scan. Differences between the lateral bony bridge thicknesses measured in AP radiograph and the posterolateral posterolateral bony bridge thicknesses measured in 3D CT were statistically significant in both groups. Negative correlation was observed in the biplanar osteotomy group. Differences of the sagittal osteotomy slope from the native tibial slope showed negative correlation in the biplanar osteotomy group. Thickness of the posterolateral bony bridge was smaller compared to the observed thickness on the AP radiograph image that is routinely used for the follow-up. The thickness would be getting smaller if osteotomy is performed with an abrupt angle on the coronal plane and reverse slope on the sagittal plane. Therefore, osteotomy with abrupt angle on the coronal plane and reverse slope on the sagittal plane should be avoided for the proper thickness of the posterolateral bony bridge. III.

  15. Surgical correction of class II skeletal malocclusion in an adult patient

    Directory of Open Access Journals (Sweden)

    Ramakrishnan Balachander

    2014-01-01

    Full Text Available Correction of skeletal deformities in adult patients with orthodontics is limited. Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting vertical maxillary excess along with class II skeletal deformity. A cosmetic correction was achieved by superior repositioning of maxilla with LeFort I osteotomy and augmentation genioplasty, along with orthodontic treatment. The patient′s facial appearance was markedly improved along with functional and stable occlusion

  16. Comparison of three approaches of Bernese periacetabular osteotomy

    Directory of Open Access Journals (Sweden)

    Luo DZ

    2016-01-01

    Full Text Available Dianzhong Luo, Hong Zhang, Weijia Zhang Division of Joint Surgery and Sport Medicine, Department of Orthopaedics, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, People’s Republic of China Background: Developmental dysplasia of the hip is a common disease and treated with various surgical approaches. Improved ilioinguinal (I-I approach, two-incision Smith-Peterson (TSP approach, and modified Smith-Peterson (MSP approach are three main approaches; however, they are rarely compared. The present study compared the operative time, blood loss, intraoperative and postoperative allogeneic blood transfusion, and postoperative complications of these three different approaches. Hypothesis: Surgical approach does not influence the operation time, blood loss, and complications of periacetabular osteotomy. Level of evidence: Level III. Case–control study. Patients and methods: In a total of 101 hips of 95 cases, from February 2010 to July 2011, three different approaches of Bernese periacetabular osteotomy, I-I, TSP, and MSP, were conducted. The operation time, intraoperative bleeding, allogeneic blood transfusion, and early complications in different operation approaches were compared by a retrospective study when there were similar ages, genders, and lesions. Results: Among the three approaches, I-I had less operation time and more blood loss (P<0.05, TSP had less blood loss (P<0.05 but more complications, and MSP had less blood loss (P<0.05 and less complications. Discussion: The MSP approach is superior to the other two approaches in doing periacetabular osteotomy. Keywords: periacetabular osteotomy, operation approaches, complications

  17. Complications of minimally invasive calcaneal osteotomy versus open osteotomy.

    Science.gov (United States)

    Kendal, Adrian R; Khalid, Ali; Ball, Tom; Rogers, Mark; Cooke, Paul; Sharp, Robert

    2015-06-01

    Calcaneal osteotomy is an established technique for correcting hindfoot deformity. Patients traditionally receive an osteotomy through the open lateral approach to the calcaneus. To reduce the rate of wound complications associated with a direct open lateral approach, a minimally invasive surgical (MIS) technique has been adopted. This uses a low-speed, high-torque burr to perform the same osteotomy under radiographic guidance. We hypothesized that the new MIS calcaneal osteotomy would be a safe alternative to open calcaneal osteotomy while obtaining the same displacement. The safety of the new MIS technique was investigated with a case controlled study on all patients who underwent displacement calcaneal osteotomy at the Nuffield Orthopaedic Centre from 2008 to 2014. The primary outcome measure was 30 day postoperative complication rate. Secondary outcome measures included operating time, duration of stay, fusion rates, and calcaneal displacement. Eighty-one patients underwent calcaneal osteotomy as part of their corrective surgery, 50 in the Open approach group and 31 in MIS group. The average age was 47.7 years (range 16-77) for the Open group and 50.1 (range 21-77) in the MIS group. A mean calcaneal displacement of 9.4 mm (SD = 1.16, 8 to 11 mm) and 10.2 mm (SD = 1.06, 8 to 13 mm) was achieved through the MIS and Open approaches, respectively. There were significantly fewer wound complications in the MIS group (6.45%) compared to the Open group (28%, P = .022). The MIS group was associated with significantly lower rate of wound infection (3% versus 20%, P = .044). Three patients in the Open group experienced sural peripheral neuropathy. The average length of stay was 3.8 days following MIS and 4.3 days following open calcaneal osteotomy. Nonunion occurred in only 1 patient in the MIS group and none in the open group. MIS calcaneal osteotomy was found to be a safe technique. It was technically as effective as calcaneal osteotomy performed through an open lateral

  18. The skeletal stability after maxillo-mandibular osteotomy with a "physiological positioning strategy".

    Science.gov (United States)

    Ohba, Seigo; Nakao, Noriko; Nakatani, Yuya; Kawasaki, Takako; Minamizato, Tokutarou; Koga, Takamitsu; Kohara, Haruka; Yoshida, Noriaki; Asahina, Izumi

    2014-12-01

    The aim of this study was to estimate skeletal and dental stability after maxillomandibular osteotomy with physiological positioning. Ten patients (7 men and 3 women) with skeletal mandibular prognathism were treated by conventional Le Fort I osteotomy for the maxilla and unfixed short lingual osteotomy for the mandible together with physiological positioning. We used cephalometric analysis to evaluate the skeletal and dental stability preoperatively, immediately after maxillomandibular osteotomy, and more than 1 year later. The immediately postoperative measurements for the SNA and the SN-palatal planes were 0.15° (p=0.67) and 1.0° (p=0.17), respectively. The positions of the anterior nasal spine, posterior nasal spine, and A point showed minimal changes 1 year postoperatively. The postoperative difference for SNB was 0.76° (p=0.04). Dental stability was apparent postoperatively. We conclude that reliable stability of both the maxilla and the mandible was achieved after maxillomandibular osteotomy with physiological positioning in patients with mandibular prognathism.

  19. Inventory of Forts in Indonesia

    Science.gov (United States)

    Rinandi, N.; Suryaningsih, F.

    2015-08-01

    The great archipelago in Indonesia with its wealthy and various nature, the products and commodities of tropic agriculture and the rich soil, was through the centuries a region of interest for other countries all over the world. For several reasons some of these countries came to Indonesia to establish their existence and tried to monopolize the trading. These countries such as the Portuguese, the Spanish, the Dutch and the British built strengthened trade stations which later became forts all over Indonesia to defend their interest. The archipelago of Indonesia possesses a great number of fortification-works as legacies of native rulers and those which were built by European trading companies and later became colonial powers in the 16th to the 19th centuries. These legacies include those specific structures built as a defence system during pre and within the period of World War II. These fortresses are nowadaysvaluable subjects, because they might be considered as shared heritage among these countries and Indonesia. It's important to develop a vision to preserve these particular subjects of heritage, because they are an interesting part of the Indonesian history and its cultural treasures. The Government of the Republic of Indonesia has national program to compile a comprehensive documentation of the existing condition of these various types of forts as cultural heritage. The result of the 3 years project was a comprehensive 442 forts database in Indonesia, which will be very valuable to the implementation of legal protection, preservation matters and adaptive re-use in the future.

  20. Biplanar chevron osteotomy.

    Science.gov (United States)

    Nery, Caio; Barroco, Rui; Réssio, Cibele

    2002-09-01

    Results of biplanar chevron osteotomy performed on patients with mild-to-moderate hallux valgus deformity with an increased distal metatarsal articular angle (DMAA) are shown. The study included clinical data of 32 patients (54 feet) who had completed a 2-year follow-up, and radiological data of these 32 and other 29 patients (50 feet) for a total of 61 patients (104 feet, 53 right and 51 left). There were 59 females and two males with ages varying from 11 to 66 years. According to the AOFAS Hallux Rating, the preoperative average score (50) improved to 90 (average score after the surgery). The hallux valgus angle was improved from an average of 25 degrees to 14 degrees, the first intermetatarsal angle from 12 degrees to 8 degrees and the DMAA from 15 degrees to 5 degrees. At the end of treatment, 94% of patients were classified as having grade 0 or 1 sesamoid lateral sub-luxation. Given improvement in angles and 90% of patients satisfied with an average AOFAS postoperative score of 90, the technique seems indicated for treatment of symptomatic hallux valgus deformity with increased DMAA.

  1. Hallux varus following scarf osteotomy.

    Science.gov (United States)

    Akhtar, Shahid; Malek, Sabur; Hariharan, Kartik

    2016-12-01

    Hallux varus is an uncommon condition and majority of the cases are iatrogenic. It can occur as a result of any type of hallux valgus correction surgery and in our cases scarf osteotomy is not an exception. Treatment of this complication can be challenging and it is important to understand the factors that cause this deformity before embarking on surgical correction. Four cases of hallux varus following Scarf osteotomy (1% of our total Scarf osteotomy cases) and discuss the salient features of these patients. The authors ascertained the factors that caused iatrogenic hallux varus and formulated a classification of the nature of the deformity. The management of iatrogenic hallux varus based on our experience and proposed classification system has also been outlined and discussed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  2. Sagittal osteotomy inclination in medial open-wedge high tibial osteotomy.

    Science.gov (United States)

    Lee, Seung-Yup; Lim, Hong-Chul; Bae, Ji Hoon; Kim, Jae Gyoon; Yun, Se-Hyeok; Yang, Jae-Hyuk; Yoon, Jung-Ro

    2017-03-01

    Unlike postoperative changes in posterior tibial slope after medial open-wedge high tibial osteotomy, sagittal osteotomy inclination has not been examined. It has been recommended that the osteotomy line in the sagittal plane be parallel to the medial posterior tibial slope. The purpose of this study was to determine the frequency of parallel osteotomy in medial open-wedge high tibial osteotomy. To determine the sagittal osteotomy inclination, the angle between the medial joint line and the osteotomy line was measured in the lateral radiograph. A positive angle value indicates that the osteotomy is anteriorly inclined relative to the medial posterior tibial slope. Correlation between the sagittal osteotomy inclination and posterior tibial slope was also evaluated. The mean sagittal osteotomy inclination was 15.1 ± 7.5°. The majority 87.1 % of knees showed an anterior-inclined osteotomy. There was a significantly positive correlation between the postoperative posterior tibial slope and the sagittal osteotomy inclination (r, 0.33; 95 % confidence interval (CI) 0.19-0.46; P osteotomy inclination (r, 0.35; 95 % CI 0.21-0.47; P osteotomy in the sagittal plane relative to the medial joint line was planned, only 12.9 % of cases achieved osteotomy parallel to the medial posterior tibial slope in the sagittal plane. Because of high rate of the anterior-inclined osteotomy and their correlations with posterior tibial slope, surgeons should make all efforts to perform parallel osteotomy relative to medial posterior tibial slope. IV.

  3. Comparison of three approaches of Bernese periacetabular osteotomy.

    Science.gov (United States)

    Luo, Dianzhong; Zhang, Hong; Zhang, Weijia

    2016-01-01

    Developmental dysplasia of the hip is a common disease and treated with various surgical approaches. Improved ilioinguinal (I-I) approach, two-incision Smith-Peterson (TSP) approach, and modified Smith-Peterson (MSP) approach are three main approaches; however, they are rarely compared. The present study compared the operative time, blood loss, intraoperative and postoperative allogeneic blood transfusion, and postoperative complications of these three different approaches. Surgical approach does not influence the operation time, blood loss, and complications of periacetabular osteotomy. Level III. Case-control study. In a total of 101 hips of 95 cases, from February 2010 to July 2011, three different approaches of Bernese periacetabular osteotomy, I-I, TSP, and MSP, were conducted. The operation time, intraoperative bleeding, allogeneic blood transfusion, and early complications in different operation approaches were compared by a retrospective study when there were similar ages, genders, and lesions. Among the three approaches, I-I had less operation time and more blood loss (P<0.05), TSP had less blood loss (P<0.05) but more complications, and MSP had less blood loss (P<0.05) and less complications. The MSP approach is superior to the other two approaches in doing periacetabular osteotomy.

  4. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage to predict early failure of Bernese periacetabular osteotomy for hip dysplasia.

    Science.gov (United States)

    Cunningham, Torin; Jessel, Rebecca; Zurakowski, David; Millis, Michael B; Kim, Young-Jo

    2006-07-01

    Hip dysplasia leads to abnormal loading of articular cartilage, which results in osteoarthritis. Pelvic osteotomies such as the Bernese periacetabular osteotomy can improve the mechanics of the joint, but the results are variable and appear to depend on the amount of preexisting arthritis. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a technique designed to measure early arthritis, and it potentially could be used to select hips with too severe arthritis to benefit from a joint-preserving reconstructive procedure. The purpose of our study was to identify radiographic, clinical, and magnetic resonance imaging measurements that predict failure after pelvic osteotomy. We performed a cohort study of forty-seven patients undergoing a Bernese periacetabular osteotomy for the treatment of hip dysplasia. Our goal was to identify preoperative radiographic factors, such as the grade of arthritis, joint congruency, and the dGEMRIC index, that are associated with a poor outcome after osteotomy. Hips in which the osteotomy did not fail had a significant decrease in pain compared with their status preoperatively (p Bernese periacetabular osteotomy for the treatment of hip dysplasia can decrease pain and improve function in symptomatic dysplastic hips. The dGEMRIC index, as an early measure of osteoarthritis, appears to be useful for identifying poor candidates for a pelvic osteotomy. Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.

  5. Corrective osteotomy for malunion of the distal radius - The effect of concomitant ulnar shortening osteotomy

    NARCIS (Netherlands)

    Oskam, J; Bongers, KM; Karthaus, AJM; Frima, AJ; Klasen, HJ

    1996-01-01

    Positive ulnar variance due to inadequate correction of radial length is a common disorder after radial corrective osteotomy. To avoid this complication we performed a combination of ulnar-shortening osteotomy and radial corrective osteotomy in 6 of 22 radial corrections. The indication for the comb

  6. Is McMurray′s osteotomy obsolete?

    Directory of Open Access Journals (Sweden)

    Phaltankar P

    1995-10-01

    Full Text Available A review of the method of performing, advantages, disadvantages of McMurray′s displacement osteotomy with regard to treatment of nonunion of transcervical fracture neck femur with viable femoral head was carried out in this study of ten cases, in view of the abandonment of the procedure in favour of angulation osteotomy. Good results obtained in the series attest to the usefulness of McMurray′s osteotomy in the difficult problem of nonunion of transcervical fracture neck femur in well selected cases with certain advantages over the angulation osteotomy due to the ′Armchair effect′.

  7. Computer assisted SCFE osteotomy planning

    Energy Technology Data Exchange (ETDEWEB)

    Drapikowski, Pawel [Poznan University of Technology, Institute of Control and Information Engineering, Poznan (Poland); Tyrakowski, Marcin; Czubak, Jaroslaw; Czwojdzinski, Adam [Postgraduate Medical Education Center, Department of Orthopaedics, Warsaw (Poland)

    2008-11-15

    Slipped capital femoral epiphysis (SCFE) is a common pediatric orthopedic disorder that requires surgical correction. Preoperative planning of a proximal femoral osteotomy is essential in cases of SCFE. This planning is usually done using 2D radiographs, but 3D data can be acquired with CT and analyzed with 3D visualization software. SCFEanalyzer is a computer program developed for preoperative planning of proximal femoral osteotomy to correct SCFE. Computed tomography scans were performed on human bone specimens: one pelvis and two femoral bones (right and left) and volume data of a patient. The CT data were used to test the abilities of the SCFEanalyzer software, which utilizes 3D virtual models of anatomic structures constructed from CT image data. Separation of anatomical bone structures is done by means of ''cutting'' 3D surface model of the pelvis. The software enables qualitative and quantitative spatial analysis of chosen parameters analogous to those done on the basis of plain radiographs. SCFEanalyzer makes it possible to evaluate the function of the hip joint by calculating the range of motion depending on the shape of bone structures based on oriented bounding box object representation. Pelvic and hip CT scans from a patient with SCFE were subjected to femoral geometry analysis and hip joint function assessment. These were done to plan and simulate osteotomy of the proximal femur. Analogous qualitative and quantitative evaluation after performing the virtual surgery were evaluated to determine the potential treatment effects. The use of computer assistance in preoperative planning enable us to increase objectivity and repeatability, and to compare the results of different types of osteotomy on the proximal femur, and thus to choose the optimal operation in each individual case. (orig.)

  8. Complications of intertrochanteric rotational osteotomy

    Energy Technology Data Exchange (ETDEWEB)

    Braunstein, E.M.; Weissman, B.N.; Sosman, J.L.; Drew, M.

    1983-11-01

    Intertrochanteric anterior rotational osteotomy is a recently developed surgical procedure to treat osteonecrosis of the femoral head. We reviewed the radiographic findings in four cases to acquaint radiologists with the usual appearance of the procedure and to assess surgical complications. In all cases, immediate postoperative radiographs showed rotation of the necrotic portion of the femoral head anteriorly so that it was no longer weight-bearing. Clinical and radiologic follow-up ranged from 12 to 30 months. In this time, three patients developed complications, including nonunion of the osteotomy, further osteonecrosis with collapse of the femoral head, and worsening pain in the absence of progressive radiologic change. Radiology provides an important means of assessing rotational osteotomy, particularly in demonstrating sufficient rotation of the femoral head to assure nonweight-bearing by diseased bone. Also, surgical complications such as nonunion and hardware loosening may be identified. Nevertheless, the patient may deteriorate clinically even in the absence of radiologic demonstration of disease pregression, and the absence of radiographic change does not assure a successful surgical outcome.

  9. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity

    DEFF Research Database (Denmark)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels

    2016-01-01

    BACKGROUND: Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after...... operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. METHODS: Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal...... open wedge osteotomy and fixation with plate (Hemax), group 1, or operation with proximal crescentic osteotomy and fixation with a 3mm cannulated screw, group 2. The mean age was 52 years (19-71). Forty-one females and four males were included. Clinical and radiological follow-ups were performed 4...

  10. Evaluation of Condylar Position after Orthognathic Surgery for Treatment of Class II Vertical Maxillary Excess and Mandibular Deficiency by Using Cone-Beam Computed Tomography

    Directory of Open Access Journals (Sweden)

    Reza Tabrizi

    2016-12-01

    Full Text Available Statement of the Problem: In orthognathic surgeries, proper condylar position is one of the most important factors in postoperative stability. Knowing the condylar movement after orthognathic surgery can help preventing postoperative instabilities. Purpose: The aim of this study was to evaluate the condylar positional changes after Le Fort I maxillary superior repositioning along with mandibular advancement by using cone beam computed tomography (CBCT. Materials and Method: This cross-sectional study was conducted on 22 subjects who had class II skeletal malocclusion along with vertical maxillary excess. Subjects underwent maxillary superior repositioning (Le Fort I osteotomy along with mandibular advancement. The CBCT images were taken a couple of days before the surgery (T0, and one month (T1 and 9 months (T2 after the surgery. The condyles positions were determined from the most superior point of the condyle to three distances including the deepest point of the glenoid fossa, the most anterior-inferior point of the articular eminence, and the most superior point of the external auditory meatus in the sagittal plane. Results: The mean mandibular advancement was 4.33±2.1 mm and the mean maxillary superior repositioning was 4.66±0.3 mm. The condyles displaced inferiorly, anteriorly, and laterally between T0 and T1. They were repositioned approximately in the initial position in T2. No correlation was observed between the mandibular and maxillary movement and the condylar positions. Conclusion: The condyles displaced in the inferior-anterior-lateral position one month after the bilateral sagittal split osteotomy for mandibular advancement in combination with the maxillary Le Fort I superior repositioning. It seems that the condyles adapted approximately in their initial position nine months after the surgeries. Keywords ● Mandible ● Condyle ● CBCT ● Sagittal Osteotomy ● Vertical Maxillary Excess

  11. Acetabular Remodeling and Role of Osteotomy After Closed Reduction of Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Shin, Chang Ho; Yoo, Won Joon; Park, Moon Seok; Kim, Jun Ho; Choi, In Ho; Cho, Tae-Joon

    2016-06-01

    The purposes of this study were to evaluate acetabular remodeling after closed reduction of developmental dysplasia of the hip (DDH) and to delineate the role of osteotomy. Eighty-four hips with DDH treated with closed reduction and followed until the patient was 8 years of age or older were included in this study. The mean age at closed reduction was 14.0 months (range, 3 to 30 months) and that at the latest follow-up visit was 12.7 years (range, 8.0 to 24.7 years). Osteotomy was performed in 26 hips (31%) during the follow-up period, at an average age of 2.8 years (range, 2.0 to 5.8 years). The acetabular index (AI) and center-edge angle (CEA) were measured, and osteonecrosis was graded. The treatment outcome was evaluated as satisfactory (Severin grade I or II) or unsatisfactory (III or IV). We retrospectively analyzed the associations among radiographic parameters, performance of osteotomy, grade of osteonecrosis, and final outcome. A satisfactory outcome was observed in 67 (80%) of the 84 hips. An osteotomy was not performed in 30 of 34 hips with an AI of 14° at the age of 3 years, and 28 (93%) of these 30 hips showed a satisfactory outcome. Of the 33 hips with an AI of ≥32° and a CEA of ≤14° at the age of 3 years, the 20 that had undergone an osteotomy showed a higher proportion of satisfactory outcomes than the 13 hips that had not (p = 0.01). Three of the 4 hips that showed an unsatisfactory outcome following an osteotomy had an AI of ≥34° at 1 year post-osteotomy. Grade-II, III, or IV osteonecrosis, according to the Bucholz-Ogden classification, developed in 10 of the 84 hips, and these 10 hips had a higher proportion of unsatisfactory outcomes than did those that developed no or grade-I osteonecrosis (p = 0.004). Hips with DDH showing poor acetabular remodeling after closed reduction may benefit from osteotomy. The AI and CEA at the age of 3 years can serve as one of the guidelines for osteotomy. Continued surveillance for acetabular remodeling

  12. Fortæller

    DEFF Research Database (Denmark)

    Larsen, Gorm

    2012-01-01

    Siden Gerard Genettes ”Discours du récit” (1972) er distinktionen mellem hvem, der taler, og hvem, der ser, blevet cementeret som et grundparadigme i narratologien og litteraturteorien. Genettes pointe var, at den etablerede narrative teori – som fx Wayne C. Booths The Rhetoric of Fiction (1961...... narratologi blevet forsøgt udfordret, enten fordi det hævdes, at en tekst ikke nødvendigvis er udstyret med en fortæller, eller fordi begrebet om fortæller antages at bero på en misvisende og reduktiv antropomorficering. Eller omvendt fordi der i Genettes begrebsdannelse ligger en forkastelse af...... forestillingen om en implicit forfatter (implied author) og dermed også en afvisning af en upålidelige fortæller. Kapitlet præsenterer begreberne fortæller og synsvinkel i narratologien med afsæt i Genettes bestemmelser og diskutere de problemer, der opstår i kølvandet herpå. Det være sig både de rent...

  13. Fortællerfiktionen

    DEFF Research Database (Denmark)

    Reitan, Rolf

    Bogen er en kritisk nærlæsning af Gérard Genettes Discours du récit og viser, hvorden den franske teoretiker løser og forenkler en række centrale problemer i traditionel fortælleteori, idet han uudtalt forudsætter et fiktionsbegreb, som han eksplicit afviser som narratologisk relevant. Det...

  14. Hightower Engineering Academy Prepares High School Students for the Engineering Professions - A Program by the Fort Bend Independent School District - II

    Science.gov (United States)

    Cain, Lee; Verret, Doug; Griffin, Richard

    1998-10-01

    Hightower Engineering Academy, a project of the Fort Bend Independent School District, near Houston Texas, introduces high school students to the engineering professions. It has a college preparatory curriculum in which students are first grounded in the fundamentals of science and mathematics. Then more specific courses help them develop an appreciation for, and many of the skills of, the engineering profession. The Academy will implement a consistent teaching philosophy using a diverse array of innovative technology. The Academy is unique in the degree of partnership with local industry and state universities. It is committed to using the best known science pedagogy in combination with proven teaching art, experienced science educators and state-of-the art facilities all aimed at providing future engineers with complete mastery of the foundation knowledge of the profession. Hightower is committed to a "constructivist" teaching philosophy, the synergy of teamwork, and an appreciation of personal and professional ethics To the greatest extent possible, Hightower will have working engineers present the profession to students. There will be guest lecturers, field trips, and mentorships. Students will participate in engineering-specific organizations and competitions. Students will build a portfolio of their accomplishments at Hightower. They will experience project-based learning, culminating in a senior project that will encompass college-level research, experimentation, data analysis, and technical writing.

  15. Complications after intraoral vertical ramus osteotomy: relationship to the shape of the osteotomy line.

    Science.gov (United States)

    Kawase-Koga, Y; Mori, Y; Fujii, Y; Kanno, Y; Chikazu, D; Susami, T; Takato, T

    2016-02-01

    Intraoral vertical ramus osteotomy (IVRO) is used widely to correct mandibular prognathism. However, several disadvantages of this procedure have been reported, such as condylar luxation and bony interference at the osteotomy site. The aim of this study was to survey the incidence of complications (condylar luxation and bony interference) based on the shape of the osteotomy line. One hundred and eighty-five rami in 118 patients with jaw deformities, which were treated with IVRO, were examined retrospectively. The shape of the osteotomy line and the postoperative complications were examined on panoramic radiographs. Osteotomy lines were classified into three types: vertical, C-shaped, and oblique. Of the 185 osteotomy sites, 98 were vertical, 37 C-shaped, and 50 oblique. Condylar luxation was found in six rami (3.2%); four had undergone vertical osteotomy and two had undergone C-shaped osteotomy. Bony interference occurred in seven rami (3.8%), all with vertical type osteotomy lines. Most complications occurred in the vertical type cases and no complications were found in oblique type cases. Condylar luxation was found mainly in unilateral IVRO cases and bony interference was found in bilateral IVRO cases. These results suggest that the oblique type of osteotomy line has the advantage of avoiding complications. Copyright © 2015. Published by Elsevier Ltd.

  16. Logica condicional forte

    OpenAIRE

    1997-01-01

    Resumo: As lógicas não-monotônicas podem ser classificadas, segundo as conclusões que podem ser obtidas, em fracas ou fortes. As lógicas fortes, entre as quais se incluem sistemas nãomonotônicos clássicos [Reiter, 80] [McCarthy,80] [Moore, 85] [Marek e Truszczynski, 91], permitem conclusões não desejáveis, deixando de tratar aspectos como, por exemplo, especificidade. Lógicas não-monotônicas fracas, como as condicionais [Delgrande, 87] [Boutilier, 94], não permitem algumas conclusões desejáve...

  17. The Fort Collins Science Center

    Science.gov (United States)

    Wilson, Juliette T.; Banowetz, Michele M.

    2012-01-01

    With a focus on biological research, the U.S. Geological Survey Fort Collins Science Center (FORT) develops and disseminates science-based information and tools to support natural resource decision-making. This brochure succinctly describes the integrated science capabilities, products, and services that the FORT science community offers across the disciplines of aquatic systems, ecosystem dynamics, information science, invasive species science, policy analysis and social science assistance, and trust species and habitats.

  18. Effects on the Tarsal Tunnel Following Malerba Z-type Osteotomy Compared to Standard Lateralizing Calcaneal Osteotomy.

    Science.gov (United States)

    Cody, Elizabeth A; Greditzer, Harry G; MacMahon, Aoife; Burket, Jayme C; Sofka, Carolyn M; Ellis, Scott J

    2016-09-01

    Tarsal tunnel syndrome is a known complication of lateralizing calcaneal osteotomy. A Malerba Z-type osteotomy may preserve more tarsal tunnel volume (TTV) and decrease risk of neurovascular injury. We investigated 2 effects on the tarsal tunnel of the Malerba osteotomy compared to a standard lateralizing osteotomy using a cadaveric model: (1) the effect on TTV as measured by magnetic resonance imaging (MRI) and (2) the proximity of the osteotomy saw cuts to the tibial nerve. Ten above-knee paired cadaveric specimens underwent MRI of the ankle to obtain a baseline measurement of TTV. One foot in each pair received a standard lateralizing calcaneal osteotomy, with the other foot receiving a Malerba osteotomy. MRIs were performed after each of 3 increasing amounts of lateral displacement, which were accompanied by increasing amounts of wedge resection in the Malerba osteotomy group. TTV was measured on MRI using previously described and validated parameters. Differences in TTV with osteotomy type, displacement, and their interaction were assessed with generalized estimating equations. After all MRIs were completed, each specimen was dissected and the nearest distance of tibial nerve branches to the osteotomy site was measured. Baseline TTV averaged 13 229 ± 2354 mm(3) and did not differ between groups (P = .386). TTV decreased on average by 7% after the first translation, 14% after the second, and 27% after the third (P osteotomies versus those with Malerba osteotomies (P = .578). At least one of the major branches of the tibial nerve crossed the osteotomy site in 5 of 5 specimens that received the Malerba osteotomy versus 2 of 5 that received a standard osteotomy. Regardless of osteotomy type, lateralizing calcaneal osteotomy decreased TTV. In all specimens, the osteotomy was at the level of branches of the tibial nerve. Our results demonstrate that lateralizing calcaneal osteotomies must be performed with care to avoid excessive lateral translation as well as

  19. Effect of a biplanar osteotomy on primary stability following high tibial osteotomy: a biomechanical cadaver study.

    Science.gov (United States)

    Pape, Dietrich; Lorbach, Olaf; Schmitz, Christian; Busch, Lüder C; Van Giffen, Nicolien; Seil, Romain; Kohn, Dieter M

    2010-02-01

    Open-wedge high tibial osteotomy (HTO) is becoming increasingly popular for the treatment of varus gonarthrosis in the active patient. The various implants used in HTO differ with regard to its design, the fixation stability and osteotomy technique. It is assumed that the combination of a plate fixator with a biplanar, v-shaped osteotomy supports bone healing. So far, there are no biomechanical studies that quantify the stabilizing effect of a biplanar versus uniplanar osteotomy. We hypothesized that a significant increase in primary stability of bone-implant constructs is achieved when using a biplanar as opposed to a uniplanar osteotomy. Twenty-four fresh-frozen human tibiae were mounted in a metal cylinder, and open-wedge osteotomy (12 mm wedge size) was performed in a standardized fashion. Proximal and distal tibial segments were marked with tantalum markers of 0.8 mm diameter. Two different plates with locking screws were used for fixation: a short spacer plate (group 1, n = 12) and a plate fixator (group 2, n = 12). In six specimens of each group, a biplanar V-shaped osteotomy with a 110 degrees angulated anterior cut behind the tuberosity parallel to the ventral tibial shaft axis was performed. In the remaining six specimens of each group, a simple uniplanar osteotomy was performed in an oblique fashion. Axial compression of the tibiae was performed using a material testing machine under standardized alignment of the loading axis. Load-controlled cyclical staircase loading tests were performed. The specimens were radiographed simultaneously in two planes together with a biplanar calibration cage in front of a film plane with and without load after each subcycle. Radiostereometry allowed for serial quantification of plastic and elastic micromotion at the osteotomy site reflecting the stability provided by the combination of implant and osteotomy technique. No significant additional stabilizing effect of a biplanar osteotomy in craniocaudal and mediolateral

  20. Minimally Invasive Osteotomies of the Calcaneus.

    Science.gov (United States)

    Guyton, Gregory P

    2016-09-01

    Osteotomies of the calcaneus are powerful surgical tools, representing a critical component of the surgical reconstruction of pes planus and pes cavus deformity. Modern minimally invasive calcaneal osteotomies can be performed safely with a burr through a lateral incision. Although greater kerf is generated with the burr, the effect is modest, can be minimized, and is compatible with many fixation techniques. A hinged jig renders the procedure more reproducible and accessible. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Phase II Fort Ord Landfill Demonstration Task 8 - Refinement of In-line Instrumental Analytical Tools to Evaluate their Operational Utility and Regulatory Acceptance

    Energy Technology Data Exchange (ETDEWEB)

    Daley, P F

    2006-04-03

    The overall objective of this project is the continued development, installation, and testing of continuous water sampling and analysis technologies for application to on-site monitoring of groundwater treatment systems and remediation sites. In a previous project, an on-line analytical system (OLAS) for multistream water sampling was installed at the Fort Ord Operable Unit 2 Groundwater Treatment System, with the objective of developing a simplified analytical method for detection of Compounds of Concern at that plant, and continuous sampling of up to twelve locations in the treatment system, from raw influent waters to treated effluent. Earlier implementations of the water sampling and processing system (Analytical Sampling and Analysis Platform, A A+RT, Milpitas, CA) depended on off-line integrators that produced paper plots of chromatograms, and sent summary tables to a host computer for archiving. We developed a basic LabVIEW (National Instruments, Inc., Austin, TX) based gas chromatography control and data acquisition system that was the foundation for further development and integration with the ASAP system. Advantages of this integration include electronic archiving of all raw chromatographic data, and a flexible programming environment to support development of improved ASAP operation and automated reporting. The initial goals of integrating the preexisting LabVIEW chromatography control system with the ASAP, and demonstration of a simplified, site-specific analytical method were successfully achieved. However, although the principal objective of this system was assembly of an analytical system that would allow plant operators an up-to-the-minute view of the plant's performance, several obstacles remained. Data reduction with the base LabVIEW system was limited to peak detection and simple tabular output, patterned after commercial chromatography integrators, with compound retention times and peak areas. Preparation of calibration curves, method

  2. Total Hip Arthroplasty after Previous Acetabular Osteotomy: Comparison of Three Types of Acetabular Osteotomy.

    Science.gov (United States)

    Tamaki, Tatsuya; Oinuma, Kazuhiro; Miura, Yoko; Shiratsuchi, Hideaki

    2016-01-01

    To compare surgical results of total hip arthroplasty (THA) following acetabular osteotomy, operative records of 13 hips following Chiari osteotomy (Chiari group), 22 hips following rotational periacetabular osteotomy (RAO; RAO group), 16 hips following shelf acetabuloplasty (Shelf group), and 2475 hips without previous osteotomy (Control group) were retrospectively reviewed. The operative time was significantly longer in the RAO group than in the Control group. Bulk bone augmentation was required more often in the Chiari and RAO groups than in the Control group. An early migration of the acetabular cup occurred in 2 hips in the RAO group. RAO made conversion to THA more complicated than did the Chiari osteotomy or the shelf acetabuloplasty. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Total knee arthroplasty after high tibial osteotomy. A systematic review

    NARCIS (Netherlands)

    T.M. van Raaij (Tom); M. Reijman (Max); A. Furlan (Alessandro); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractBackground: Previous osteotomy may compromise subsequent knee replacement, but no guidelines considering knee arthroplasty after prior osteotomy have been developed. We describe a systematic review of non-randomized studies to analyze the effect of high tibial osteotomy on total knee art

  4. Tibial Tubercle Osteotomy: Indication and Techniques.

    Science.gov (United States)

    Grawe, Brian; Stein, Beth Shubin

    2015-08-01

    Osteotomy of the tibial tubercle is a versatile procedure that can be utilized for several common pathologies about the patellofemoral joint. Most commonly, tuberosity transfer is employed for the treatment of patellar instability or symptomatic overload of the patella. The osteotomy can be combined with soft tissue realignment procedures or cartilage reconstructive techniques. A precise understanding of the surgical anatomy and the biomechanics of the patellofemoral articulation is essential for producing a successful outcome during surgery. Tailoring the direction of transfer to the pathoanatomy of each patient is critical for producing a durable and lasting result following a tibial tubercle osteotomy. When evaluating a patient for a possible transfer, a thorough history and physical evaluation must be undertaken, along with imaging to the patellofemoral joint. Several useful advanced imaging techniques can also be used to guide the surgeon toward the most appropriated osteotomy for the patient. The purpose of this article is to review the indications for performing a tibial tubercle osteotomy, and highlighting the various techniques for transfer.

  5. Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis.

    Science.gov (United States)

    Hongmou, Zhao; Xiaojun, Liang; Yi, Li; Hongliang, Liu; Junhu, Wang; Cheng, Liu

    2016-09-01

    Supramalleolar osteotomy (SMOT) is an alternative operative procedure for the management of early and midstage varus ankle arthritis. However, whether fibular osteotomy is needed is controversial. The purpose of the current study was to evaluate the functional and radiologic outcomes of pre- and postoperative SMOT, and to compare the outcomes between patients with and without fibular osteotomy. Forty-one Takakura stage 2 and 3 varus ankle osteoarthritis patients treated with SMOT were included. Fourteen males and 27 females with a mean age of 50.7 (range, 32-71) years were followed with a mean of 36.6 (range, 17-61) months. There were 22 cases with fibular osteotomy and 19 without. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Maryland foot score, and Ankle Osteoarthritis Score (AOS) were used for pre- and postoperative functional evaluation. The tibial articular surface angle (TAS), talar tilt (TT), tibiocrural angle (TC), and tibial lateral surface angle (TLS) were evaluated pre- and postoperatively. At the last follow-up, the mean AOFAS score (from 50.8 to 83.1 points) and Maryland score (from 58.3 to 81.6 points) in overall were improved (P osteotomy. However, in the fibular osteotomy group, TT was decreased (P osteotomy may be necessary in cases with large TT and small TC angles. Level III, retrospective comparative study. © The Author(s) 2016.

  6. Fort Richardson moose tagging project

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Of the big game animals that inhabit the Fort Richardson-Elmendorf AFB military reservation, moose (Alces a1ces gigas) are the predominant species and may be found...

  7. Fort Carson Wind Resource Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Robichaud, R.

    2012-10-01

    This report focuses on the wind resource assessment, the estimated energy production of wind turbines, and economic potential of a wind turbine project on a ridge in the southeastern portion of the Fort Carson Army base.

  8. Stiltiende fortællinger

    DEFF Research Database (Denmark)

    Wind, Gitte

    udtryk for afvigelse, uorden og biografisk brud men også kan forstås som grundvilkår og som rutine, der hører med til livet; og dels for at fortælling ikke altid skaber sammenhæng, orden og mening men tværtimod kan være med til at skabe uorden, fordi de er sygefortællinger, fortællinger om kronisk sygdom...

  9. Arthroscopic subcapital realignment osteotomy in chronic and stable slipped capital femoral epiphysis: early results

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    Full Text Available ABSTRACT OBJECTIVE: This study aimed to evaluate the clinical and radiographic outcomes, as well as the complications of arthroscopic subcapital realignment osteotomy in chronic and stable slipped capital femoral epiphysis (SCFE. As indicated by the literature review, this is the first time this type of arthroscopic osteotomy was described. METHODS: Between June 2012 and December 2014, seven patients were submitted to arthroscopic subcapital realignment osteotomy in chronic and stable SCFE. The mean age was 11 years and 4 months, and the mean follow-up period was 16.5 months (6-36. Clinical results were evaluated using the Modified Harris Hip Score (MHHS, which was measured pre- and postoperatively. Radiographs were evaluated using the Southwick quantitative classification and the epiphysis-diaphysis angle (pre- and postoperatively. Complications were assessed. RESULTS: The mean preoperative MHHS was 35.8 points, and 97.5 points post-operatively (p < 0.05. Radiographically, five patients were classified as Southwick classification grade II and two as grade III. The mean correction of the epiphysis-diaphysis angle was 40°. No immediate postoperatively complications were observed. One patient presented femoral head avascular necrosis, without collapse or chondrolysis at the most recent follow-up (22 months. CONCLUSION: The arthroscopic technique presented for subcapital realignment osteotomy in chronic and stable SCFE showed satisfactory clinical and radiographic outcomes in a 16.5 months follow-up period.

  10. Distal femoral osteotomy using a novel deformity reduction device.

    Science.gov (United States)

    Panichi, Enrico; Cappellari, Fulvio; Olimpo, Matteo; Piras, Lisa A; Radasch, Robert; Ferretti, Antonio; Peirone, Bruno

    2016-09-20

    Distal femoral osteotomy is a surgical procedure used to correct patellar luxation, secondary to a femoral deformity. A distal femoral osteotomy using the tibial plateau levelling osteotomy-jig to temporarily provide stability of the distal femoral osteotomy, maintaining limb alignment in the frontal and axial planes prior to internal plate fixation of the osteotomy, has been described. This report describes a novel jig named Deformity Reduction Device (DRD). This device was developed with the specific aim of increasing precision and predictability during corrective osteotomy execution in order to be consistent with the preoperative planning. The distal femoral osteotomy DRD-assisted procedure is described in detail, discussing the theoretical and practical principles of the application.

  11. The distal radial decompression osteotomy for ulnar impingement syndrome.

    Science.gov (United States)

    Krimmer, Hermann; Unglaub, Frank; Langer, Martin F; Spies, Christian K

    2016-01-01

    The decompression of the distal radioulnar joint (DRUJ) is performed by ulnar translation of the radial shaft proximal to the sigmoid notch, i.e. detensioning of the distal part of the interosseous membrane (DIOM) while containment of the DRUJ is achieved by closed wedge osteotomy of the radius. The osteotomy shortens the radius which entails detensioning of the triangular fibrocartilage complex (TFCC). Facilitating the modified Henry approach to the distal palmar radius a radial based wedge osteotomy is applied. The proximal osteotomy is proximal to the ulnar head and distal osteotomy is proximal to the sigmoid notch to prevent iatrogenic impingement. Ulnar translation of the radial shaft is performed to loosen the DIOM. The closed wedge osteotomy reduces radial inclination which will foster containment of the DRUJ. Distal radial decompression osteotomy of the DRUJ preserves DRUJ function while relieving painful impingement. Further surgical interventions are not compromised in case of failure.

  12. Triple pelvic osteotomy in the treatment of hip dysplasia.

    Science.gov (United States)

    Vukasinović, Zoran; Spasovski, Dusko; Zivković, Zorica; Slavković, Nemanja; Cerović, Sofija

    2009-01-01

    Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery "Banjica" in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, chi2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. The average CE angle after triple pelvic osteotomy was 43.5 degrees, more improved than after the Salter osteotomy (33.0 degrees) and Chiari osteotomy (31.4 degrees) (F = 16.822; p triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy) and increase in joint coverage (compared to Salter osteotomy). Triple pelvic osteotomy is the method of choice in the management of

  13. Evaluation of Condylar Position after Orthognathic Surgery for Treatment of Class II Vertical Maxillary Excess and Mandibular Deficiency by Using Cone-Beam Computed Tomography

    Science.gov (United States)

    Tabrizi, Reza; Shahidi, Shoaleh; Bahramnejad, Emad; Arabion, Hamidreza

    2016-01-01

    Statement of the Problem: In orthognathic surgeries, proper condylar position is one of the most important factors in postoperative stability. Knowing the condylar movement after orthognathic surgery can help preventing postoperative instabilities. Purpose: The aim of this study was to evaluate the condylar positional changes after Le Fort I maxillary superior repositioning along with mandibular advancement by using cone beam computed tomography (CBCT). Materials and Method: This cross-sectional study was conducted on 22 subjects who had class II skeletal malocclusion along with vertical maxillary excess. Subjects underwent maxillary superior repositioning (Le Fort I osteotomy) along with mandibular advancement. The CBCT images were taken a couple of days before the surgery (T0), and one month (T1) and 9 months (T2) after the surgery. The condyles positions were determined from the most superior point of the condyle to three distances including the deepest point of the glenoid fossa, the most anterior-inferior point of the articular eminence, and the most superior point of the external auditory meatus in the sagittal plane. Results: The mean mandibular advancement was 4.33±2.1 mm and the mean maxillary superior repositioning was 4.66±0.3 mm. The condyles displaced inferiorly, anteriorly, and laterally between T0 and T1. They were repositioned approximately in the initial position in T2. No correlation was observed between the mandibular and maxillary movement and the condylar positions. Conclusion: The condyles displaced in the inferior-anterior-lateral position one month after the bilateral sagittal split osteotomy for mandibular advancement in combination with the maxillary Le Fort I superior repositioning. It seems that the condyles adapted approximately in their initial position nine months after the surgeries. PMID:27942547

  14. SEGMENTAL LEFORT I OSTEOTOMY FOR TREATMENT OF A CLASS III MALOCCLUSION WITH TEMPOROMANDIBULAR DISORDER

    Science.gov (United States)

    Janson, Marcos; Janson, Guilherme; Sant'Ana, Eduardo; Nakamura, Alexandre; de Freitas, Marcos Roberto

    2008-01-01

    This article reports the case of a 19-year-old young man with Class III malocclusion and posterior crossbite with concerns about temporomandibular disorder (TMD), esthetics and functional problems. Surgical-orthodontic treatment was carried out by decompensation of the mandibular incisors and segmentation of the maxilla in 4 pieces, which allowed expansion and advancement. Remission of the signs and symptoms occurred after surgical-orthodontic intervention. The maxillary dental arch presented normal transverse dimension. Satisfactory static and functional occlusion and esthetic results were achieved and remained stable. Three years after the surgical-orthodontic treatment, no TMD sign or symptom was observed and the occlusal results had not changed. When vertical or horizontal movements of the maxilla in the presence of moderate maxillary constriction are necessary, segmental LeFort I osteotomy can be an important part of treatment planning. PMID:19089265

  15. Clinical and radiological outcome after periacetabular osteotomy

    DEFF Research Database (Denmark)

    Dahl, Line B; Dengsø, Kristine; Bang-Christiansen, Karl

    2014-01-01

    PURPOSE: Few papers have described results after periacetabular osteotomy (PAO) and risk factors for conversion to total hip arthroplasty (THA). The aim of the present paper was to analyse clinical and radiographic outcome, survival of the hip joint and risk factors of early conversion to THA in ...

  16. Periacetabulaer osteotomi og hoftedysplasi hos yngre voksne

    DEFF Research Database (Denmark)

    Troelsen, Anders; Søballe, Kjeld

    2009-01-01

    The periacetabular osteotomy is recognized as the surgical treatment of choice in young adults with symptomatic hip dysplasia. The procedure is performed to delay or prevent the development of osteoarthritis. The procedure has the ability to improve function and preserve hip joints in > 80% of ca...

  17. Rod strain after pedicle subtraction osteotomy

    DEFF Research Database (Denmark)

    Gehrchen, Poul Martin; Hallager, Dennis Winge; Dahl, Benny

    2016-01-01

    Pedicle subtraction osteotomy (PSO) can provide major sagittal correction for adult spinal deformity, sometimes achieving correction greater than 308. Surgeons have reported failure rates up to 30% within 2 years, increasing to 46% after 4 to 5 years (SDC Figure 1, http://links.lww.com/BRS/B87). ...

  18. Southwick Osteotomy Stabilised with External Fixator

    Science.gov (United States)

    Grubor, Predrag; Mitkovic, Milorad; Grubor, Milan

    2014-01-01

    ABSTRACT Introduction: Epiphysiolysis of the femoral head is the most common accident occurring towards the end of pre-puberty and puberty growth. Case report: The author describes the experience in the treatment of chronic epiphysiolysis in two patients treated by Southwick osteotomy. The site is accessed by way of a 15-cm long lateral skin incision and the trochanteric region is reached through the layers. The osteotomy angles prepared beforehand on a thin aluminium model are used to mark the Southwick osteotomy site on the anterior and lateral sides at the level of the lesser trochanter. Before performing the trochanteric osteotomy, two Mitković convergent pins type M20 are applied distally and proximally, above the planned osteotomy site. A tenotomy of the iliopsas muscle is performed, and then the previously marked bone triangle is redissected up to three quarters of the width of the femur. The distal part of the femur is rotated inwards, so that the patella is turned towards the ceiling. The osteotomised fragments of the femur are adapted, repositioned and fixated by installing an external fixator on the previously placed pins. Two more pins are placed, one proximally and one distally, with a view to adequately stabilising the femur. The patient was mobile from day two after the surgery. If, after the surgery, the lead surgeon realises that there is a requirement to make a correction of 5, 10 and 15 degrees of the valgus, varus, anteversion or retroversion deformity, the correction shall be performed without surgically opening the patient, using the fixator pins. Conclusion: After performing a Southwick osteotomy it is easier to adapt, reposition and fixate the osteotomised fragments of the femur using a fixator type M20. Adequate stability allows regaining mobility quickly, which in turn is the best prevention of chondrolysis of the hip. It is possible to make post-operative valgus, varus, anteversion and retroversion corrections of 5, 10 and 15 degrees

  19. Method of osteotomy fixation and need for removal following bimaxillary orthognathic, osseous genioplasty, and intranasal surgery: a retrospective cohort study.

    Science.gov (United States)

    Posnick, J C; Choi, E; Chavda, A

    2017-10-01

    The purpose of this study was to determine the incidence and causes of fixation hardware removal after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. A retrospective study was performed, involving subjects with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing. At a minimum, subjects underwent Le Fort I osteotomy, bilateral sagittal ramus osteotomies (SROs), septoplasty, inferior turbinate reduction, and osseous genioplasty. The primary outcome variable studied was fixation hardware removal. Demographic, anatomical, and surgical predictor variables were assessed. Two hundred sixty-two subjects met the inclusion criteria. Their mean age at operation was 25 years (range 13-63 years); 134 were female (51.1%). Simultaneous removal of a third molar was performed in 39.9% of SROs. Three of 262 Le Fort I procedures (1.1%) and two of 524 SROs (0.4%) required hardware removal. There were four cases of ramus wound dehiscence, four of ramus surgical site infection (SSI), one of chin SSI, two of maxillary sinusitis, and one of lingual nerve injury; none of these subjects underwent hardware removal. A limited need for fixation hardware removal after orthognathic procedures was confirmed. There was no statistical correlation between hardware removal and patient sex, age, pattern of DFD, simultaneous removal of a third molar, or occurrence of wound dehiscence, SSI, or lingual nerve injury. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Limitations in the surgical treatment of skeletal Class II deep bite malocclusions.

    Science.gov (United States)

    Nassif, Laeticia; Anhoury, Patrick; Chebel, Naji Abou

    2010-01-01

    The present article illustrates a treatment option for managing the skeletal Class II malocclusion complicated by a deep bite and short face in an adult and emphasizes the limitations of such an approach and its potential complications. The patient had an inadequate tooth display upon smiling and a deep lower curve of Spee. Treatment consisted of a double jaw surgery with a maxillary three-piece LeFort to expand, downgraft, and advance the maxilla and a bilateral sagittal split osteotomy to advance the mandible. Treatment was staged so that the leveling of the mandibular arch was completed postsurgically by extrusion of the mandibular buccal segments. During surgery, the mandible was rotated clockwise at the osteotomy site to bring the chin down. This treatment approach resulted in a dramatic increase in the lower facial height, as well as an improvement in skeletal and occlusal relationships, with a much improved tooth display upon smiling, despite the few complications that occurred. © 2011 BY QUINTESSENCE PUBLISHING CO, INC.

  1. 33 CFR 100.736 - Annual Fort Myers Beach air show; Fort Myers Beach, FL.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Annual Fort Myers Beach air show; Fort Myers Beach, FL. 100.736 Section 100.736 Navigation and Navigable Waters COAST GUARD, DEPARTMENT... Fort Myers Beach air show; Fort Myers Beach, FL. (a)(1) Regulated Area. The regulated area is formed...

  2. Three-dimensional evaluation of the alar cinch suture after Le Fort I osteotomy

    NARCIS (Netherlands)

    Loon, B. van; Verhamme, L.; Xi, T.; Koning, M.J.J. de; Berge, S.J.; Maal, T.J.J.

    2016-01-01

    Orthognathic surgery has an influence on the overlying soft tissues of the translated bony maxillomandibular complex. Improvements in both function and facial appearance are the goals of surgery. However, unwanted changes to the soft tissues, especially in the nose region, frequently occur. The most

  3. Surgical risk factors and maxillary nerve function after Le Fort I osteotomy

    DEFF Research Database (Denmark)

    Thygesen, Torben; Bardow, Allan; Norholt, Sven Erik;

    2009-01-01

    with a number of possible intraoperative risk factors. PATIENTS AND METHODS: Twelve men and 13 women (mean +/- standard deviation: aged 25+/-10 years) participated in 4 sessions: 1 before LFO (baseline), and the rest at 3, 6, and 12 months after LFO. At each session, somatosensory sensitivity was assessed......: The thresholds of tactile stimuli on the gingiva and palate were increased 12 months after LFO (Pdiscrimination detection thresholds (P

  4. Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients.

    Science.gov (United States)

    Hyun, Seung-Jae; Kim, Yongjung J; Rhim, Seung-Chul

    2013-11-16

    In addressing spinal sagittal imbalance through a posterior approach, the surgeon now may choose from among a variety of osteotomy techniques. Posterior column osteotomies such as the facetectomy or Ponte or Smith-Petersen osteotomy provide the least correction, but can be used at multiple levels with minimal blood loss and a lower operative risk. Pedicle subtraction osteotomies provide nearly 3 times the per-level correction of Ponte/Smith-Petersen osteotomies; however, they carry increased technical demands, longer operative time, and greater blood loss and associated significant morbidity, including neurological injury. The literature focusing on pedicle subtraction osteotomy for fixed sagittal imbalance patients is reviewed. The long-term overall outcomes, surgical tips to reduce the complications and suggestions for their proper application are also provided.

  5. The pelvic support osteotomy: indications and preoperative planning

    OpenAIRE

    Pafilas, Dimitrios; Nayagam, Selvadurai

    2008-01-01

    The pelvic support osteotomy is a double level femoral osteotomy with the objective of eliminating a Trendelenburg and short limb gait in young patients with severe hip joint destruction as a consequence of neonatal septic arthritis. The osteotomy has seen several changes and a brief historical overview is provided to set the evolution of the modifications of the procedure in context. We present an analysis of the preoperative assessment that will assist the surgeon to plan out the procedure....

  6. First metatarsal proximal opening wedge osteotomy for correction of hallux valgus deformity: comparison of straight versus oblique osteotomy.

    Science.gov (United States)

    Han, Seung Hwan; Park, Eui Hyun; Jo, Joon; Koh, Yong Gon; Lee, Jin Woo; Choi, Woo Jin; Kim, Yong Sang

    2015-05-01

    The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy. We retrospectively reviewed 104 consecutive first metatarsal proximal opening wedge osteotomies performed in 95 patients with hallux valgus deformity. Twenty-six feet were treated using straight metatarsal osteotomy (group A), whereas 78 feet were treated using oblique metatarsal osteotomy (group B). The hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle, and distance from the first to the second metatarsal (distance) were measured for radiographic evaluation, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was used for clinical evaluation. Significant corrections in the HVA, IMA, and distance from the first to the second metatarsal were obtained in both groups at the last follow-up (posteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes.

  7. Radial head dislocation during proximal radial shaft osteotomy.

    Science.gov (United States)

    Hazel, Antony; Bindra, Randy R

    2014-03-01

    The following case report describes a 48-year-old female patient with a longstanding both-bone forearm malunion, who underwent osteotomies of both the radius and ulna to improve symptoms of pain and lack of rotation at the wrist. The osteotomies were templated preoperatively. During surgery, after performing the planned radial shaft osteotomy, the authors recognized that the radial head was subluxated. The osteotomy was then revised from an opening wedge to a closing wedge with improvement of alignment and rotation. The case report discusses the details of the operation, as well as ways in which to avoid similar shortcomings in the future.

  8. Mid-Face Degloving: An Alternate Approach to Extended Osteotomies of the Midface.

    Science.gov (United States)

    Parameswaran, Anantanarayanan; Jayakumar, Naveen Kumar; Ramanathan, Manikandhan; Sailer, Hermann F

    2017-01-01

    Extended osteotomies for mid-face advancement require generous exposure of the anterior maxilla, nasal bones, infraorbital rims, orbital floor, zygoma, and the anterior third of the zygomatic arches. This cannot be obtained with an exclusive transoral approach. Hence, the surgeon is usually compelled to utilize supplemental cutaneous incisions that are a compromise on the purpose behind a cosmetic surgery. In order to alleviate the need for such compromise, the authors advocate the mid face degloving approach for extended osteotomies at Lefort II and Lefort III levels. Mid face degloving involves a combination of circumvestibular incision, with inter cartilaginous and transfixation components from a nasal incision. The authors have utilized this technique for 9 patients and documented favorable results. The purpose of this paper is to focus the utility of this approach in orthognathic surgery and promote this as a viable alternative to traditional approaches in surgery of the mid face because of the absence of external scars.

  9. Vertebral Osteotomies in Ankylosing Spondylitis-Comparison of Outcomes Following Closing Wedge Osteotomy versus Opening Wedge Osteotomy: A Systematic Review.

    Science.gov (United States)

    Ravinsky, Robert A; Ouellet, Jean-Albert; Brodt, Erika D; Dettori, Joseph R

    2013-04-01

    Study Design Systematic review. Study Rationale To seek out and assess the best quality evidence available comparing opening wedge osteotomy (OWO) and closing wedge osteotomy (CWO) in patients with ankylosing spondylitis to determine whether their results differ with regard to several different subjective and objective outcome measures. Objective The aim of this study is to determine whether there is a difference in subjective and objective outcomes when comparing CWO and OWO in patients with ankylosing spondylitis suffering from clinically significant thoracolumbar kyphosis with respect to quality-of-life assessments, complication risks, and the amount of correction of the spine achieved at follow-up. Methods A systematic review was undertaken of articles published up to July 2012. Electronic databases and reference lists of key articles were searched to identify studies comparing effectiveness and safety outcomes between adult patients with ankylosing spondylitis who received closing wedge versus opening wedge osteotomies. Studies that included pediatric patients, polysegmental osteotomies, or revision procedures were excluded. Two independent reviewers assessed the strength of evidence using the GRADE criteria and disagreements were resolved by consensus. Results From a total of 67 possible citations, 4 retrospective cohorts (class of evidence III) met our inclusion criteria and form the basis for this report. No differences in Oswestry Disability Index, visual analog scale for pain, Scoliosis Research Society (SRS)-24 score, SRS-22 score, and patient satisfaction were reported between the closing and opening wedge groups across two studies. Regarding radiological outcomes following closing versus opening osteotomies, mean change in sagittal vertical axis ranged from 8.9 to 10.8 cm and 8.0 to 10.9 cm, respectively, across three studies; mean change in lumbar lordosis ranged from 36 to 47 degrees and 19 to 41 degrees across four studies; and mean change

  10. Newborn exstrophy closure without osteotomy: Is there a role?

    Science.gov (United States)

    Inouye, Brian M; Lue, Kathy; Abdelwahab, Mahmoud; Di Carlo, Heather N; Young, Ezekiel E; Tourchi, Ali; Grewal, Mehnaj; Hesh, Christopher; Sponseller, Paul D; Gearhart, John P

    2016-02-01

    Recent articles document successful classic bladder exstrophy (CBE) closure without osteotomy. Still, many patients require osteotomy if they have a large bladder template and pubic diastasis, or non-malleable pelvis. To understand the indications and outcomes of bladder closure with and without pelvic osteotomy in patients younger than 1 month of age. An institutional database of 1217 exstrophy-epispadias patients was reviewed for CBE patients closed at the authors' institution within the first month of life. Patient demographics, closure history, pubic diastasis distance, bladder capacity, and outcomes were recorded and compared using chi-square tests between osteotomy and non-osteotomy patients. Failure was defined as bladder dehiscence, prolapse, vesicocutaneous fistula, or bladder outlet obstruction requiring reoperation. Bladder capacity >100 mL was deemed sufficient for bladder neck reconstruction (BNR). One hundred CBE patients were included for analysis: 38 closed with osteotomy (26 male, 12 female), and 62 closed without osteotomy (42 male, 20 female). There were four failed closures in the osteotomy group (2 dehiscence, 2 prolapse) and four failed closures in the non-osteotomy group (2 dehiscence, 2 prolapse). This corresponded to statistically equivalent rates of failure between the osteotomy and non-osteotomy groups (10.5% vs. 6.5%, p = 0.466). There was no statistically significant difference between the groups' ability to achieve bladder capacity sufficient for BNR (82% vs. 71%, p = 0.234). A successful primary bladder closure, regardless of the use of osteotomy, has been shown to be the single most important predictor of eventual continence. Because of the complexity of exstrophy manifestations, a multidisciplinary team approach is of the utmost importance. Based on our institutional experience, closure without osteotomy is considered when patients are osteotomy in patients considered suitable for closure by both the pediatric urologist and

  11. 3D imaging in corrective osteotomy of the distal radius

    NARCIS (Netherlands)

    Vroemen, Joy

    2013-01-01

    The research described in this thesis is on the development, design, implementation and testing of new techniques for corrective osteotomy of the distal radius. The goal of this thesis is threefold. At first, possible pitfalls of conventional corrective osteotomy surgery were determined and quantifi

  12. Fort Monroe Historic Image Report

    Science.gov (United States)

    2010-08-01

    ERDC/CERL SR-10-8 August 2010 Fort Monroe Historic Image Report Adam Smith , Megan Weaver Tooker, Meghan Roller, and Rory Nicholson Construction... Adam Smith was the CERL Project Manager and lead architectural historian, Megan Weaver Tooker was the lead land- scape architect, and Meghan Roller...5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S). Adam Smith , Megan Weaver Tooker, Meghan Roller and Rory Nicholson 5d. PROJECT NUMBER 5e. TASK

  13. Triple pelvic osteotomy in the treatment of hip dysplasia

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2009-01-01

    Full Text Available Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. Methods. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, χ2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. Results. The average CE angle after triple pelvic osteotomy was 43.5°, more improved than after the Salter osteotomy (33.0° and Chiari osteotomy (31.4° (F=16.822; p<0.01. Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy and increase in joint

  14. The pelvic support osteotomy: indications and preoperative planning.

    Science.gov (United States)

    Pafilas, Dimitrios; Nayagam, Selvadurai

    2008-09-01

    The pelvic support osteotomy is a double level femoral osteotomy with the objective of eliminating a Trendelenburg and short limb gait in young patients with severe hip joint destruction as a consequence of neonatal septic arthritis. The osteotomy has seen several changes and a brief historical overview is provided to set the evolution of the modifications of the procedure in context. We present an analysis of the preoperative assessment that will assist the surgeon to plan out the procedure. Specifically, we set out to answer the following questions: (a) Where should the first osteotomy be performed and what is the magnitude of valgus and extension correction desired at this level? (b) Where should the second osteotomy be performed and what is the magnitude of varus and derotation desired at this level?

  15. Surgical site infection after osteotomy of the adult spine: does type of osteotomy matter?

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Laarhoven, C.J.H.M. van; Cohen, D.B.

    2010-01-01

    BACKGROUND CONTEXT: Surgical site infection after spinal surgery is frequently seen. It occurs between 0.7% and 12% of patients, leading to higher morbidity, mortality, and health-care costs. Osteotomy procedures are known to have increased blood losses and surgical times when compared with other sp

  16. Surgical site infection after osteotomy of the adult spine: does type of osteotomy matter?

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Laarhoven, C.J.H.M. van; Cohen, D.B.

    2010-01-01

    BACKGROUND CONTEXT: Surgical site infection after spinal surgery is frequently seen. It occurs between 0.7% and 12% of patients, leading to higher morbidity, mortality, and health-care costs. Osteotomy procedures are known to have increased blood losses and surgical times when compared with other

  17. Surgical site infection after osteotomy of the adult spine: does type of osteotomy matter?

    NARCIS (Netherlands)

    Pull ter Gunne, A.F.; Laarhoven, C.J.H.M. van; Cohen, D.B.

    2010-01-01

    BACKGROUND CONTEXT: Surgical site infection after spinal surgery is frequently seen. It occurs between 0.7% and 12% of patients, leading to higher morbidity, mortality, and health-care costs. Osteotomy procedures are known to have increased blood losses and surgical times when compared with other sp

  18. Results of Chiari pelvic osteotomy for acetabular dysplasia in adults; Association with bone scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Nobuo; Ozono, Kenji; Sugano, Nobuhiko; Takaoka, Kunio; Ono, Hiroo (Osaka Univ. (Japan). Faculty of Medicine)

    1993-02-01

    In an attempt to determine indications of Chiari pelvic osteotomy in acetabular dysplasia, postoperative outcome of hip joint (64 joints) was examined on the basis of findings of bone scintigraphy. The subjects were 61 patients with osteoarthrosis of hip joint who underwent preoperative bone scintigraphy. The follow-up period ranged from 2 years to 9 years and 7 months with a mean of 4 years and 9 months. According to X-ray findings, 37 osteoarthrosis joints were staged as early and 27 as progressive. Preoperative bone scintigraphic findings fell into three: (I) normal or slight hot type (33 joints), (II) hot type at the weighting part (16 joints), and (III) double hot type in the weighting part and inside part (15 joints). None of the patients had severe surgical complications such as deep-seated infection, neuroparalysis and pseudojoint. According to the clinical staging for hip joint function, 7 (47%) of 64 joints were judged as poor after osteotomy, belonging to type III. Deterioration of osteoarthrosis was seen in 11 joints (41%) on X-ray films. Of these, 9 had type III. In conclusion, Chiari pelvic osteotomy should not be indicated when type III is shown on bone scintigrams. (N.K.).

  19. Intraosseous heat generation during sonic, ultrasonic and conventional osteotomy.

    Science.gov (United States)

    Rashad, Ashkan; Sadr-Eshkevari, Pooyan; Heiland, Max; Smeets, Ralf; Hanken, Henning; Gröbe, Alexander; Assaf, Alexandre T; Köhnke, Robert H; Mehryar, Pouyan; Riecke, Björn; Wikner, Johannes

    2015-09-01

    To assess heat generation in osteotomies during application of sonic and ultrasonic saws compared to conventional bur. Two glass-fiber isolated nickel-chromium thermocouples, connected to a recording device, were inserted into fresh bovine rib bone blocks and kept in 20 ± 0.5 °C water at determined depths of 1.5 mm (cortical layer) and 7 mm (cancellous layer) and 1.0 mm away from the planned osteotomy site. Handpieces, angulated 24-32°, were mounted in a vertical drill stand, and standardized weights were attached to their tops to exert loads of 5, 8, 15 and 20 N. Irrigation volumes of 20, 50 and 80 ml/min were used for each load. Ten repetitions were conducted using new tips each time for each test condition. The Mann-Whitney-U test was used for statistical analysis (p osteotomies were associated with significantly lower heat generation than conventional osteotomy (p osteotomy showed non-significantly lower heat generation than ultrasonic osteotomy. Generated heat never exceeded the critical limit of 47 °C in any system. Variation of load had no effect on heat generation in both bone layers for all tested systems. An increased irrigation volume resulted in lower temperatures in both cortical and cancellous bone layers during all tested osteotomies. Although none of the systems under the conditions of the present study resulted in critical heat generation, the application of ultrasonic and sonic osteotomy systems was associated with lower heat generation compared to the conventional saw osteotomy. Copious irrigation seems to play a critical role in preventing heat generation in the osteotomy site. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  20. Nuclear Energy Center: upper St. Lawrence region. Part I. Siting. Part II. Fort Drum surrogate site, description and impact assessment. Part III. Dispersed sites impact assessment and comparison with the NEC

    Energy Technology Data Exchange (ETDEWEB)

    Merry, P.A.; Luner, C.; Hong, S.W.; Canham, H.O.; Boggs, J.F.; McCool, T.P.

    1976-12-01

    This report is one of many supporting documents used by the Nuclear Regulatory commission in the preparation of the Nuclear Energy Center Site Survey (NECSS) mandated by Congress. While the overall study focuses on the feasibility and practicability of nuclear energy centers (NECs), this report is directed towards choosing a suitable surrogate site in the upper St. Lawrence region of New York State, assessing the probable impacts associated with construction and operation of the NEC, and comparing these impacts with those associated with small dispersed nuclear power stations. The upper St. Lawrence region is surveyed to identify a specific site that might be suitable for a surrogate NEC. Several assumptions about the basic design of an NEC are delineated, and a general overview of the characteristics of the region is given. The Fort Drum Military Reservation is chosen as a suitable surrogate site. Fort Drum and the surrounding area are described in terms of land use and population patterns, terrestrial and aquatic ecology, water use and quality, meteorology, institutional framework, and socioeconomic structure. The impacts associated with NEC development are assessed. Then the impacts associated with smaller dispersed nuclear power stations located throughout New York State are assessed and compared with the impacts associated with the NEC. Finally, the impacts due to development of the transmission line networks associated with the NEC and with the dispersed power stations are assessed and compared.

  1. [Bernese periacetabular osteotomy (Ganz procedure). First experience].

    Science.gov (United States)

    Chládek, Petr; Trc, T; Schejbalová, A; Rehácek, V

    2009-08-01

    Developmental dysplasia of the hip (DDH), treated either conservatively or surgically, may result in a dysplastic acetabulum. To treat this after bone maturation is completed, Bernese periacetabular osteotomy, also known as the Ganz procedure, has recently been used as the method of choice at our department. The evaluation of the first results is presented here. The group evaluated comprised 25 hips (21 female and 4 male) in 22 patients. Nineteen hips were treated for residual dysplasia of the acetabulum due to DDH, and six for a spastic hip. The average age was 26 years (range, 12 to 44) and 14 right and 11 left hips were involved On pre- and post-operative radiographs the AC index, Wiberg lateral CE angle, Wagner index, improvement in Shenton's line, and lateralisation and anteversion of the acetabulum were compared. Bernese periacetabular osteotomy is an extensive surgical procedure requiring special instrumentation. It may be associated with serious complications and has a relatively long learning curve. The average follow-up was 18 months (range, 2 to 36). The average duration of surgery was 2 hours and 44 min (range, 2 to 31/ 2 h). The average values improved in the AC index by 24 degrees, lateral CE angle by 29 degrees and Wagner index by 18 %. Shenton's line was corrected by surgery in 20 hips and lateral migration in 16 hips. In two hips lateralisation did not changed. Two serious complications were recorded: para-articular ossification requiring excision and concomitant acetabular trimming, and great intra-operative blood loss. Various mechanisms of damage to the hip are discussed and the methods of treatment outlined, together with prerequisites for successful surgery. Potential complications and their treatment are mentioned. Bernese periacetabular osteotomy makes the range of roofing procedures for hip joint treatment wider. These, as well as hip joint reduction techniques, should be performed in major specialized centres.

  2. Complex osteotomies vertebral column resection and decancellation.

    Science.gov (United States)

    Obeid, Ibrahim; Bourghli, Anouar; Boissière, Louis; Vital, Jean-Marc; Barrey, Cédric

    2014-07-01

    Pedicle subtraction osteotomy (PSO) is nowadays widely used to treat sagittal imbalance. Some complex malalignment cases cannot be treated by a PSO, whereas the imbalance is coronal or mixed or the sagittal imbalance is major and cannot be treated by a single PSO. The aim of this article was to review these complex situations--coronal imbalance, mixed imbalance, two-level PSO, vertebral column resection, and vertebral column decancellation, and to focus on their specificities. It wills also to evoke the utility of navigation in these complex cases.

  3. Patella height changes post high tibial osteotomy

    Directory of Open Access Journals (Sweden)

    Siew Ghim Gooi

    2017-01-01

    Full Text Available Background: Medial opening wedge high tibial osteotomy (HTO is a well-described treatment in early medial compartmental osteoarthritis of the knee. However, two undesirable sequelae may follow –patella baja and changes in the posterior tibial slope (TS. Materials and Methods: We conducted a retrospective study in patients who underwent HTO in our center between September 2009 and February 2017. Preoperative and 6-week postoperative long-leg weight bearing films and lateral knee radiographs were assessed. Pre- and postoperative radiological measurements include the Caton-Deschamps Index (CDI, the mechanical axis deviation (MAD, and the posterior TS. Independant t-test and Pearson correlation test were performed. Results: A total of 106 knees were recruited. The mean age was 48.8 ± 10.8 years. 66 (62.3% and 40 (37.7% knees were from males and females, respectively. The mean pre- and postoperative measurements was (−9.70° ± 3.67° to 0.08° ± 2.80° (−varus; +valgus for the MAD, (7.14° ± 1.78° to 8.72° ± 3.11° for posterior TS, and (0.93° ± 0.084° to 0.82° ± 0.13° for CDI (P ≤ 0.001 for all. The association between patella height change and the level of osteotomy (supra-tubercle vs. infra-tubercle was statistically significant (P < 0.001. A supra-tubercle osteotomy cut significantly lowering patella height (P = 0.011. There was otherwise no statistically significant correlations between patella height changes and the correction angle (P = 0.187 or posterior TS change (P = 0.744. Conclusions: A medial opening wedge HTO above the tibial tubercle was significantly associated with lowering patella height or reducing CDI postoperatively. Based on our results, we would recommend the use of an infra-tubercle osteotomy during the corrective surgery to prevent the complication of patella baja.

  4. Fort England as a military base.

    OpenAIRE

    Sampson, Sally

    1980-01-01

    • Opsomming: Tans is Fort England in Grahamstad ʼn sielsieke-inrigting. Dit het oorspronklik bekend gestaan as die East Barracks en was die brandpunt van die vroegste nedersetting op die Kaapse Oosgrens. Fort England was trouens die bakermat en vesting van die militêre eenheid wat later die Cape Mounted Rifles geword het. Ofskoon dit in werklikheid sIegs as barakke gedien het, is die naam Fort England in 1832 aan hierdie kompleks gegee. Die 'fort' was vir 'n halfeeu die militêre hoofkwartie...

  5. Salter pelvic osteotomy in the treatment of Legg-Calve-Perthes disease: the medium-term results.

    Science.gov (United States)

    Bulut, Mehmet; Demirtş, Abdullah; Uçar, Bekir Yavuz; Azboy, Ibrahim; Alemdar, Celil; Karakurt, Lokman

    2014-03-01

    In this study, clinical and radiological results were evaluated in patients with Legg-Calve-Perthes disease treated with Salter pelvic osteotomy. Between 2004 and 2008, 16 patients underwent a Salter osteotomy as treatment for Legg-Calve-Perthes disease (15 male, 1 female; 10 right hip, 6 left hip). The mean age at the time of surgery was 8.1 +/- 1.4 (range: 6 to 10) years. Surgical indications were : age between 6-10 years at the onset of the disease; Herring classification type B, B/C, or C; and at least one risk sign. 6-8 year old patients were classified as group I and 9-10 year olds were classified as group II. We investigated the effects of age and Herring classification on radiological outcomes. The final radiographic evaluation according to the Stulberg classification showed nine hips (56.25%) classified as good (Stulberg I/II), five (31.25%) as fair (Stulberg III); and two (12.5%) as poor (Stulberg IV). In group I, 7 patients (70%) had good results, while only 2 (33.3%) in group II. The results in group I were statistically better than group II (p Salter pelvic osteotomy is an effective method of surgical treatment for Legg-Cave-Perthes in patients between 6-8 years of age.

  6. 75 FR 78799 - Noise Compatibility Program Notice, Fort Worth Alliance Airport, Fort Worth, TX

    Science.gov (United States)

    2010-12-16

    ... Federal Aviation Administration Noise Compatibility Program Notice, Fort Worth Alliance Airport, Fort... Administration (FAA) announces its findings on the noise compatibility program submitted by the city of Fort Worth, Texas under the provisions of 49 U.S.C. (the Aviation Safety and Noise Abatement Act,...

  7. Medial displacement calcaneal osteotomy using minimally invasive technique.

    Science.gov (United States)

    Kheir, Ehab; Borse, Vishal; Sharpe, Jon; Lavalette, David; Farndon, Mark

    2015-03-01

    Medial displacement calcaneal osteotomy is a common procedure often used as part of pes planovalgus deformity correction. Traditionally the osteotomy is performed using a direct lateral or extended lateral approach, which may carry the risk of wound problems, infection and neurovascular injury. The authors describe a minimally invasive technique to perform the osteotomy and achieve the desired correction. The article illustrates our experience and learning curve with the use of this technique as an option for calcaneal osteotomy. We retrospectively reviewed the records of a sequential series of patients since 2011 whose calcaneal osteotomies were performed by 2 surgeons, after cadaveric training using a minimally invasive operative approach. Prior to 2011, similar surgeries, performed by the senior authors, were undertaken using a direct lateral approach. Thirty cases were identified; 29 had tibialis posterior reconstruction coupled with calcaneal osteotomy for acquired flexible planovalgus deformity and 1 patient had surgery for a malunited calcaneal fracture. Radiological and clinical union occurred in all 30 cases (100%). The radiographs of all cases were reviewed by a specialist musculoskeletal radiologist. There were no neurovascular or wound complications. All patients had restoration of neutral hindfoot alignment. One patient required screw removal after union, resolving all symptoms. This series suggests that minimally invasive calcaneal osteotomy surgery can achieve excellent union rates aiding correction of deformity with no observed neurovascular or soft tissue complications. For surgeons experienced in open surgery, there is a short learning curve after appropriate training. © The Author(s) 2014.

  8. Intraoral Zygoma Reduction Using L-shaped Osteotomy

    Science.gov (United States)

    Hong, Seung Eup; Liu, Si You; Kim, Jeong Tae; Lee, Jong Hun

    2014-01-01

    Background Because of the various defects of malarplasty, including a large incision, much bleeding, visible scars after the operation, and so on, caused by the conventional coronal incision or the temporal incision with the intraoral incision approach, the malarplasty by simple intraoral approach is an innovative development. Methods Through the intraoral approach and subperiosteal dissection, we can reach the osteotomy point on the zygomatic body directly and arrive at the osteotomy point at the zygomatic arch end along the medial side of the zygoma. A new L osteotomy is applied with the reciprocating saw. In addition, the osteotomy was performed on the zygomatic arch from the inside out with an angle of 20 degrees horizontally. Results From 1997 to 2010, we were satisfied with the results of 114 cases of malarplasty with the intraoral approach and L osteotomy as the observed objects. There are 103 cases for women and 11 for men. Ages ranged from 16 to 48 years. The mean operation time is approximately 1 hour. We just had a few complications: 3 nonunion at the osteotomy line and needed a second surgery to repair as well as 2 slight cheek drooping during the initial period and required face lifting. Conclusions The method of intraoral approach and L-shaped osteotomy for zygoma reduction can reduce prominent zygoma while maintaining the natural curves of the zygomatic body and arch. Because of the simple procedures, fewer complications, and excellent results, this method will be considered a relatively desirable way. Level of Evidence Therapeutic, III. PMID:24657982

  9. A dual anteroposterior approach to the Bernese periacetabular osteotomy.

    Science.gov (United States)

    Kim, H T; Woo, S H; Lee, J S; Cheon, S J

    2009-07-01

    When the Bernese periacetabular osteotomy is performed through an anterior approach, the ischial and retroacetabular osteotomies and manual fracture of the incompletely osteotomized ischium are conducted with an incomplete view resulting in increased risk and morbidity. We have assessed the dual anteroposterior approach which appears to address this deficiency. We compared the results of the Bernese periacetabular osteotomy performed in 11 patients (13 osteotomies) through a single anterior approach with those in 12 patients (13 osteotomies) in whom the procedure was carried out through a dual anteroposterior approach. The estimated blood loss, the length of anaesthesia, duration of surgery and radiological parameters were measured. The mean operative time and length of anaesthesia were not significantly different in the two groups (p = 0.781 and p = 0.698, respectively). The radiological parameters improved to a similar extent in both groups after the operation but there was significantly less blood loss in the dual osteotomy group (p = 0.034). The dual anteroposterior approach provides a direct view of the retroacetabular and ischial parts of the osteotomy, within a reasonable operating time and with minimal blood loss and gives a satisfactory outcome.

  10. Fort Drum integrated resource assessment

    Energy Technology Data Exchange (ETDEWEB)

    Dixon, D.R.; Armstrong, P.R.; Brodrick, J.R.; Daellenbach, K.K.; Di Massa, F.V.; Keller, J.M.; Richman, E.E.; Sullivan, G.P.; Wahlstrom, R.R.

    1992-12-01

    The US Army Forces Command (FORSCOM) has tasked the Pacific Northwest Laboratory (PNL) as the lead laboratory supporting the US Department of Energy (DOE) Federal Energy Management Program's mission to identify, evaluate, and assist in acquiring all cost-effective energy projects at Fort Drum. This is a model program PNL is designing for federal customers served by the Niagara Mohawk Power Company. It will identify and evaluate all electric and fossil fuel cost-effective energy projects; develop a schedule at each installation for project acquisition considering project type, size, timing, and capital requirements, as well as energy and dollar savings; and secure 100% of the financing required to implement electric energy efficiency projects from Niagara Mohawk and have Niagara Mohawk procure the necessary contractors to perform detailed audits and install the technologies. This report documents the assessment of baseline energy use at one of Niagara Mohawk's primary federal facilities, the FORSCOM Fort Drum facility located near Watertown, New York. It is a companion report to Volume 1, the Executive Summary, and Volume 3, the Resource Assessment. This analysis examines the characteristics of electric, gas, oil, propane, coal, and purchased thermal capacity use for fiscal year (FY) 1990. It records energy-use intensities for the facilities at Fort Drum by building type and energy end use. It also breaks down building energy consumption by fuel type, energy end use, and building type. A complete energy consumption reconciliation is presented that includes the accounting of all energy use among buildings, utilities, central systems, and applicable losses.

  11. Use of allogenic (iliac) corticocancellous graft for Le Fort I interpositional defects: technique and results.

    Science.gov (United States)

    Posnick, Jeffrey C; Sami, Ali

    2015-01-01

    We performed a retrospective review of a consecutive series of 50 patients who had undergone Le Fort I with interpositional grafting during a 3-year period. Maxillary repositioning included horizontal advancement and vertical and transverse change to the extent that an interpositional graft was considered necessary. Allogenic (iliac) corticocancellous bone was used in all cases. Each patient underwent analytic model planning to document the maxillary vector change data points. The recorded data served as an indicator of the osteotomy site gaps requiring grafting. Standardized photographs in centric relation at a minimum of 12 months after treatment were analyzed to measure overjet, overbite, midline position, and first molar lateral occlusion. Specific maxillary region wound healing parameters were reviewed. The patients' mean age at surgery was 32 years (range 15 to 60). Analytic model planning clarified that the study patients had an average of 8 mm horizontal advancement, 2 mm vertical lengthening, and 2 mm of transverse expansion. The data confirmed a favorable occlusion at a minimum of 1 year after surgery with maintenance of a normal overjet (49 of 50 patients, 98%), normal overbite (48 of 50 patients, 96%), planned dental midline positioning (45 of 50 patients, 90%), and ideal first molar lateral occlusion (48 of 50 patients, 96%) for most patients. None of the study patients sustained wound healing complications. Also, no cases of postoperative sepsis or viral illness developed. The results of the present study have confirmed that iliac corticocancellous allograft has minimal systemic or recipient site complications and can be safely used to fill complex 3-dimensional interpositional defects associated with Le Fort I osteotomy and/or repositioning. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Les PME en forte croissance.

    OpenAIRE

    Brun, M; F. Chai

    2012-01-01

    Les PME indépendantes en forte croissance dynamisent le tissu économique français : elles créent de nombreux emplois, contribuent significativement à l’innovation et sont particulièrement rentables lorsqu’elles parviennent à émerger. Leur développement rapide exige un mode de financement adapté : une fois parvenues à maturité, ces entreprises augmentent leur ressources propres afin d’équilibrer leur bilan, ouvrant leur capital à des investisseurs privés, particuliers ou entreprises....

  13. [Reorientation osteotomy of the trapezial saddle].

    Science.gov (United States)

    Kapandji, Adalbert I; Heim, Urs F A

    2002-03-01

    At its early stage, the thumb TM osteo-arthritis is occasionally painful during some activities and there are mainly radiological signs, only visible on specific views and with maximum amplitudes. They are the first metacarpal base imperfect reintegration in the trapezium saddle in ante-position and an increased slope angle of 140 degrees. So, the "slippery saddle" of the trapezium induces a metacarpal base subluxation. The goal of the proposed technique is to correct the orientation of the trapezial saddle. The slope angle must return to its normal value of about 125 degrees, thanks to an opening wedge osteotomy into the trapezium, completed with a bony wedge insertion. Proposed for the first time in 1983, and used only once by Dr. Heim, this technique was "rediscovered" recently and used on five patients in ten years. It is easy to do, the only complication being two post-operative radial nerve sensitive branch neuromas. In six cases on seven, the pain disappeared, even if the osteo-arthritis was evolving for the two former cases. The functional recovery was total and the patients were satisfied in most of the cases. In spite of this short series, this technique is worth being used for the early stage of thumb osteo-arthritis, eventually combined with others techniques like tenotomy of the Abductor pollicis longus accessories or different types of ligamentoplasties. It is, in any case, more logical than the first metacarpal osteotomy.

  14. Supramalleolar Osteotomies for Posttraumatic Malalignment of the Distal Tibia.

    Science.gov (United States)

    Krause, Fabian; Veljkovic, Andrea; Schmid, Timo

    2016-03-01

    Supramalleolar osteotomies of the tibia (SMOT) for posttraumatic distal tibial malalignment has shown to reduce pain, improve function and radiographic signs of osteoarthritis, and delay ankle arthrodesis or total joint replacement. The procedure also protects the articular cartilage from further degenerative processes by shifting and redistributing loads in the ankle joint. It is technically demanding and requires extensive preoperative planning. The type of osteotomy (opening vs closing wedge) does not influence the final outcome. However, based on the limited evidence, a grade I treatment recommendation has been given for supramalleolar osteotomies of the tibia to treat mild to moderate ankle arthritis in the presence of distal tibial malalignment.

  15. The biomechanical differences of rotational acetabular osteotomy, Chiari osteotomy and shelf procedure in developmental dysplasia of hip

    Science.gov (United States)

    2014-01-01

    Background Rotational acetabular osteotomy (RAO), Chiari osteotomy and shelf procedure are important treatments to delay the progression of osteoarthritis in developmental dysplasia of hip (DDH) patients, but their biomechanical differences are still unknown. This study was to evaluate the different biomechanical changes of hip joint after these three surgeries. Methods Sixteen DDH models of 8 human cadaver specimens were reconstructed, and treated by different surgeries, and then strain around femoral head was evaluated by strain gauges. Results Hip strain value of DDH model was decreased after treated by shelf procedure (Pleft = 0.016 and Pright = 0.021) and rotational acetabular osteotomy (P = 0.004), but not in Chiari osteotomy (P = 0.856). Moreover, the improved ratio of RAO treatment was better than shelf procedure (P = 0.015) and Chiari osteotomy (P = 0.0007), and the descendent range of shelf procedure was greater than Chiari osteotomy (P = 0.018). Conclusions From biomechanics points, RAO was more effective in relieving hip joint stress compared with shelf procedure and Chiari osteotomy. PMID:24555880

  16. Fort Lee's Comprehensive Peer Outreach Program.

    Science.gov (United States)

    Kehayan, V. Alex

    This paper describes the Peer Outreach Service Team (POST), a peer multi-service, student support system organization operating in the Fort Lee schools in Fort Lee, New Jersey. The goals of the POST program are described as reducing numbers of school dropouts as well as levels of negative behavior, chemical dependency, teenage depression, and…

  17. Osteochondritis dissecans after rotational acetabular osteotomy for dysplastic hip

    Energy Technology Data Exchange (ETDEWEB)

    Nozawa, Masahiko; Maezawa, Katsuhiko; Yuasa, Takahito; Morimoto, Kouichi; Asakura, Taro; Kurosawa, Hisashi [Juntendo University School of Medicine, Department of Orthopaedic Surgery, Tokyo (Japan)

    2005-12-01

    We encountered a rare case of osteochondritis dissecans of the femoral head after rotational acetabular osteotomy that recovered with conservative treatment 4 years after the detection of characteristic radiological findings. (orig.)

  18. Evolution of technique and indications for the Bernese periacetabular osteotomy.

    Science.gov (United States)

    Leunig, Michael; Ganz, Reinhold

    2011-01-01

    Acetabular dysplasia is among the most frequent causes of secondary osteoarthritis (OA) of the hip. While hip arthrolasty is a valid option in elderly patients, young and active patients are likely to outlive their implants and therefore may require a different approach. During the last 20 years, the emphasis of these osteotomies shifted from the femoral to the acetabular side, with the Bernese periacetabular osteotomy being one of the most frequently and successfully used techniques today. The procedure combines a polygonal juxta-articular osteotomy using a modified Smith-Peterson approach. During refinement of the technique, the principle osteotomy steps remained unchanged, while the soft-tissue dissection has been modified, in that the abductors are not detached from the iliac wing. Due to a better appreciation of hip deformities, other indications for this technique have continuously evolved over time.

  19. Tibial tubercle osteotomy for patello-femoral joint disorders.

    Science.gov (United States)

    Hall, Matthew J; Mandalia, Vipul I

    2016-03-01

    Tibial tubercle osteotomy has a long history in the management of patella instability and patello-femoral arthritis. This review aims to provide a comprehensive review of the literature describing the biomechanics of the patello-femoral joint and the rationale behind the use of the tibial tubercle osteotomy in modern day practice. Several different tibial tubercle osteotomies are available and we aim to detail the concepts behind their use and the subsequent clinical results. With continued developments of chondrocyte implantation techniques, the potential to fill defects on the chondral surface of either the patella or trochlea in conjunction with a tibial tubercle osteotomy may well become more commonplace in a group that is commonly young and difficult to manage. Level of evidence III.

  20. Supramalleolar osteotomy for realignment of the ankle joint.

    Science.gov (United States)

    Siddiqui, Noman A; Herzenberg, John E; Lamm, Bradley M

    2012-10-01

    Ankle replacement systems have not been as reliable as hip replacements in providing long-term relief of pain, increased motion, and return to full activity. Supramalleolar Osteotomy is an extraarticular procedure that realigns the mechanical axis, thereby restoring ankle function. The literature discussing knee arthritis has shown that realignment osteotomies of the tibia improve function and prolong total knee replacement surgery. The success of the procedure is predicated on understanding the patient's clinical and radiographic presentation and proper preoperative assessment and planning.

  1. Blood flow in rabbit osteotomies studied with radioactive microspheres

    Energy Technology Data Exchange (ETDEWEB)

    Aalto, K. (Department of Surgery, Aurora Hospital, Nordenskioeldinkatu, Helsinki, Finland); Slaetis, P. (Department of Orthopaedic Surgery and Traumatology, Surgical Hospital, University Central Hospital, Helsinki, Finland)

    1984-01-01

    Arterial embolisation with radioactive microspheres was used to measure the proportion of cardiac output to the skeleton and the tibiofibular bone both in unoperated rabbits and in rabbits after tibial osteotomy and subsequent external fixation. The mean uptake of the intact tibiofibula was 0.11 per cent of the cardiac output and, correspondingly, 0.21 per cent after the osteotomy. Maximal uptake occurred 18 days after the operation which was accompanied by a slight decrease in overall skeletal circulation.

  2. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  3. [Sports activities after osteotomies around the knee].

    Science.gov (United States)

    Paul, J; Heitner, A H; Mauch, M; Imhoff, A B

    2017-07-01

    In the current literature, the rate of return to sports following high tibial osteotomy is high. Patients are largely able to carry out the type of exercise done before the onset of symptoms and are satisfied with the clinical outcome. In general, however, a differentiated view of the sporting ability should be made, and the different requirements of the sport should be considered. A classification according to functional and biomechanical movement analysis seems to advisable. In addition, the recommendations of the treating physician seem to have a high impact on the postoperative level of the sports activities of the patients. A realistic assessment (by both the patient and the treating physician) that considers the sport, its requirements and the level of performance is necessary.

  4. Lateral closed wedge osteotomy for cubitus varus deformity

    Directory of Open Access Journals (Sweden)

    Srivastava Amit

    2008-01-01

    Full Text Available Background: Lateral closed wedge (LCW osteotomy is a commonly accepted method for the correction of the cubitus varus deformity. The fixation of osteotomy is required to prevent loss of correction achieved. The fixation of the osteotomy by the two screw and figure of eight wire is not stable enough to maintain the correction achieved during surgery. In this prospective study we supplemented the fixation by Kirschner′s (K- wires for stable fixation and evaluated the results. Materials and Methods: Twenty-one cases of the cubitus varus deformity following supracondylar fractures of the humerus were operated by LCW osteotomy during February 2001 to June 2006. The mean age of the patients at the time of corrective surgery was 8.5 years (range 6.6-14 years. The osteotomy was fixed by two screws with figure of eight tension band wire between them and the fixation was supplemented by passing two to three K-wires from the lateral condyle engaging the proximal medial cortex through the osteotomy site. Result: The mean follow-up period was 2.5 years (range seven months to 3.4 years. The results were assessed as per Morrey criteria. Eighteen cases showed excellent results and three cases showed good results. Two cases had superficial pin tract infection. Conclusion: The additional fixation by K wires controls rotational forces effectively besides angulation and translation forces and maintains the correction achieved peroperatively.

  5. Bernese periacetabular osteotomy for hip dysplasia: Surgical technique and indications.

    Science.gov (United States)

    Kamath, Atul F

    2016-05-18

    For young, active patients with healthy hip cartilage, pelvic osteotomy is a surgical option in to address hip pain and to improve mechanical loading conditions related to dysplasia. Hip dysplasia may lead to arthrosis at an early age due to poor coverage of the femoral head and abnormal loading of the joint articulation. In patients with symptomatic dysplasia and closed triradiate cartilage (generally over age 10), including adolescents and young adults (generally up to around age 40), the Bernese periacetabular osteotomy (PAO) is a durable technique for addressing underlying structural deformity. The PAO involves a modified Smith-Petersen approach. Advantages of the Bernese osteotomy include preservation of the weight-bearing posterior column of the hemi-pelvis, preservation of the acetabular blood supply, maintenance of the hip abductor musculature, and the ability to effect powerful deformity correction about an ideal center of rotation. There is an increasing body of evidence that preservation of the native hip can be improved through pelvic osteotomy. In contrast to hip osteotomy and joint preservation, the role of total hip arthroplasty in young, active patients with correctable hip deformity remains controversial. Moreover, the durability of hip replacement in young patients is inherently limited. Pelvic osteotomy should be considered the preferred method to address correctable structural deformity of the hip in the young, active patient with developmental dysplasia. The Bernese PAO is technically demanding, yet offers reproducible results with good long-term survivorship in carefully selected patients with preserved cartilage and the ability to meet the demands of rehabilitation.

  6. Vascular lesions secondary to osteotomy by corticotomy.

    Science.gov (United States)

    Spinelli, Francesco; Spinelli, Renato; Stilo, Francesco; De Caridi, Giovanni; Mirenda, Francesco

    2007-01-01

    Management of vascular traumas is frequently delayed. Vascular injuries after elective operation for bone lengthening or correction of a deformity are very'rare situations. We describe 3 cases. Case 1: male, aged 22, undergoing corticotomy for bone lengthening; immediately presented acute limb ischaemia due to a partial lesion of the popliteal artery, documented by U.S. After 7 h, direct reconstruction of the artery and fasciotomies were performed. Case 2: male, aged 27, undergoing directional osteotomy for genu varus correction. For 30 days, constant increase in leg volume and decrease in function. US showed an important haematoma at the popliteal level; arteriography documented a partial lesion of the infra-genicular popliteal artery and a voluminous false aneurysm. Direct correction of the artery and fasciotomies were performed. Case 3: male, aged 22, undergoing corticotomy for leg lengthening; immediately presented leg pain with decreased distal pulses. After 4h, there was an increase in leg volume, and arteriography showed a total lesion of the infra-genicular popliteal artery and an arteriovenous fistula. Popliteo-tibial bypass with the contralateral greater saphenous vein and fasciotomies were performed. After 1 month endovascular closure of the fistula was obtained. All patients had recovered after two months with only minor leg insufficiency. Patency of the bypass and absence of infections or delayed false aneurysms were achieved. Vascular injuries after elective orthopaedic procedures are very rare situations. Such lesions are caused by an osteotomy via corticotomy performed percutaneously. The variety of clinical presentations accounts for the difficulty in diagnosing such lesions and for the delays in implementing treatment. It is very important to obtain an early diagnosis complete with an arteriography.

  7. Evaluation of Bernese periacetabular osteotomy: prospective studies examining projected load-bearing area, bone density, cartilage thickness and migration.

    Science.gov (United States)

    Mechlenburg, Inger

    2008-06-01

    The typical dysplastic hip joint is characterised by maldirection of the acetabulum and femoral neck, insufficient coverage of the femoral head focally and globally and erosions of the limbus acetabuli (1). An unknown number of persons with hip dysplasia will suffer from pain in hip or groin, decreased hip function and development of osteoarthritis at a young age. The Bernese periacetabular osteotomy is performed to prevent osteoarthritis in patients with hip dysplasia and has been carried out at Aarhus University Hospital, Denmark since 1996 with more than 500 osteotomies performed. Throughout the years, research and quality improvement of the treatment has taken place and this PhD thesis is part of that process. The aims of this PhD thesis were to evaluate outcome aspects after periacetabular osteotomy in terms of I) estimating the projected loadbearing surface before and after periacetabular osteotomy, II) estimating bone density changes in the acetabulum after periacetabular osteotomy, III) developing a technique to precisely and efficiently estimate the thickness of the articular cartilage in the hip joint and IV) examining the stability of the re-orientated acetabulum after periacetabular osteotomy. In study I, we applied a stereologic method based on 3D computed tomography (CT) to estimate the projected loadbearing surface in six normal hip joints and in six dysplastic hips. The dysplastic hips were CT scanned before and after periacetabular osteotomy. We found that the average area of the projected loadbearing surface of the femoral head preoperatively was 7.4 (range 6.5-8.4) cm2 and postoperatively 11 (9.8-14.3) cm2. The area of the projected loadbearing surface was increased significantly with a mean of 49% (34-70%) postoperatively and thus comparable with the load-bearing surface in the normal control group. Double measurements were performed and the error variance of the mean was estimated to be 1.6%. The effect of overprojection, on the projected

  8. Open wedge metatarsal osteotomy versus crescentic osteotomy to correct severe hallux valgus deformity - A prospective comparative study.

    Science.gov (United States)

    Wester, Jens Ulrik; Hamborg-Petersen, Ellen; Herold, Niels; Hansen, Palle Bo; Froekjaer, Johnny

    2016-03-01

    Different techniques of proximal osteotomies have been introduced to correct severe hallux valgus. The open wedge osteotomy is a newly introduced method for proximal osteotomy. The aim of this prospective randomized study was to compare the radiological and clinical results after operation for severe hallux valgus, comparing the open wedge osteotomy to the crescentic osteotomy which is our traditional treatment. Forty-five patients with severe hallux valgus (hallux valgus angle >35̊, and intermetatarsal angle >15̊) were included in this study. The treatment was proximal open wedge osteotomy and fixation with plate (Hemax), group 1, or operation with proximal crescentic osteotomy and fixation with a 3mm cannulated screw, group 2. The mean age was 52 years (19-71). Forty-one females and four males were included. Clinical and radiological follow-ups were performed 4 and 12 months after the operation. In group 1 the hallux valgus angle decreased from 39.0̊ to 24.1̊ after 4 months and 27.9̊ after 12 months. In group 2 the angle decreased from 38.3̊ to 21.4̊ after 4 months and 27.0̊ after 12 months. The intermetatarsal angle in group 1 was 19.0̊ preoperatively, 11.6̊ after 4 months and 12.6̊ after 12 months. In group 2 the mean intermetatarsal angle was 18.9̊ preoperatively, 12.0̊ after 4 months and 12.6̊ after 12 months. The AOFAS score improved from 59.3 to 81.5 in group 1 and from 61.8 to 84.8 in group 2 respectively measured 12 months postoperatively. The relative length of the 1 metatarsal compared to 2 metatarsal bone was 0.88 and 0.87 preoperatively and 0.88 and 0.86 for group 1 and 2 respectively measured after 12 months. Crescentic osteotomy and open wedge osteotomy improve AOFAS score and VAS scores on patients operated with severe hallux valgus. No significant difference was found in the two groups looking at the postoperative improvement of HVA and IMA measured 4 and 12 months postoperatively. The postoperative VAS score and AOFAS score were

  9. Walking pattern in 9 women with hip dysplasia 18 months after periacetabular osteotomy

    DEFF Research Database (Denmark)

    Pedersen, Eva N G; Alkjaer, Tine; Søballe, Kjeld

    2006-01-01

    BaCKGROUND: Periacetabular osteotomy improves radiographic predictors of osteoarthrosis and diminishes pain and functional impairment. No changes in function quantified by gait analysis have yet been documented. We evaluated the functional outcome of periacetabular osteotomy in relation to gait...

  10. Bathymetry--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the bathymetry and shaded-relief maps of the Offshore of Fort Ross map area, California. Raster data file is included in...

  11. Renewable Energy Opportunities at Fort Hood, Texas

    Energy Technology Data Exchange (ETDEWEB)

    Solana, Amy E.; Warwick, William M.; Orrell, Alice C.; Russo, Bryan J.; Parker, Kyle R.; Weimar, Mark R.; Horner, Jacob A.; Manning, Anathea

    2011-11-14

    This report presents the results of Pacific Northwest National Laboratory's (PNNL) follow-on renewable energy (RE) assessment of Fort Hood. Fort Hood receives many solicitations from renewable energy vendors who are interested in doing projects on site. Based on specific requests from Fort Hood staff so they can better understand these proposals, and the results of PNNL's 2008 RE assessment of Fort Hood, the following resources were examined in this assessment: (1) Municipal solid waste (MSW) for waste-to-energy (WTE); (2) Wind; (3) Landfill gas; (4) Solar photovoltaics (PV); and (5) Shale gas. This report also examines the regulatory issues, development options, and environmental impacts for the promising RE resources, and includes a review of the RE market in Texas.

  12. Bison management on Fort Niobrara NWR

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document describes bison management on the Fort Niobrara National Wildlife Refuge and Sullys Hill National Game Preserve. Information on the bison herd grazing...

  13. Contours--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the bathymetric contours for several seafloor maps of the Offshore of Fort Ross map area, California. The vector data file is...

  14. Bathymetry--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the bathymetry and shaded-relief maps of the Offshore of Fort Ross map area, California. Raster data file is included in...

  15. Fort Richardson moose range rehabilitation program

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Areas to be rehabilitated have been selected for traditional winter moose range along the Glen Highway on Fort Richardson. We use a field reconnaissance to...

  16. Habitat--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the habitat map of the seafloor of the Offshore of Fort Ross map area, California. The polygon shapefile is included in...

  17. Contours--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the bathymetric contours for several seafloor maps of the Offshore of Fort Ross map area, California. The vector data file is...

  18. Safety and Efficacy of Derotational Osteotomy for Congenital Radioulnar Synostosis.

    Science.gov (United States)

    Simcock, Xavier; Shah, Apurva S; Waters, Peter M; Bae, Donald S

    2015-12-01

    Congenital radioulnar synostosis (CRUS) refers to an abnormal connection between the radius and ulna due to embryological failure of separation. Derotational osteotomy has been advocated for children with functional limitations, although historically this procedure has been associated with a 36% complication rate including compartment syndrome and loss of correction. A retrospective evaluation of consecutive patients who underwent derotational osteotomy for CRUS at a single institution was performed. Children with functional limitations secondary to excessive pronation were indicated for surgery with a goal of correction to 10 to 20 degrees of pronation. All patients were treated with a standardized surgical technique including careful subperiosteal elevation, rotational osteotomy at the level of the synostosis, control of the osteotomy fragments, appropriate pinning techniques, and prophylactic forearm fasciotomies. Electronic medical records, preoperative radiographs, and postoperative radiographs were reviewed. Derotational osteotomy was performed in 31 forearms in 26 children (13 bilateral, 13 unilateral) with a mean age of 6.8 years (range, 3.0 to 18.8 y). The mean clinical follow-up was 46 months (range, 6 to 148 mo). The mean preoperative pronation deformity was 85 degrees (range, 60 to 100 degrees). The mean correction achieved was 77 degrees (range, 40 to 95 degrees), resulting in a mean final position of 8 degrees of pronation (range, 0 to 30 degrees). All patients successfully achieved union by 8 weeks postoperatively. There were no cases of compartment syndrome, vascular compromise, or loss of fixation. The overall complication rate was 12% (2 transient anterior interosseous nerve palsies, 1 transient radial nerve palsy, 1 symptomatic muscle herniation). Both transient anterior interosseous nerve palsies occurred in patients with rotational corrections exceeding 80 degrees. Derotational osteotomy can be safely and effectively performed in children with

  19. A Comparison between External versus Internal Lateral Osteotomy in Rhinoplasty

    Directory of Open Access Journals (Sweden)

    M Hashemi

    2005-01-01

    Full Text Available Background: Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing of nasal base and dorsum after removal of the hump. There are two techniques for lateral osteotomy known as external and internal. Each of these provide advantages and impose limitations. The purpose of our study was to compare the severity of postoperative edema and ecchymosis between internal and external osteotomy techniques. Methods: This study was designed as a clinical trial on 30 cases. With randomization, one side of the nasal bone was selected for internal approach, and the other side, for external approach. Then, on the 1st and 7th days after surgery, the patients were scored for the severity of edema and ecchymosis. Results: On the first day after surgery, not only edema, but also ecchymosis was lower with the external osteotomy than with the internal approach (P = 0.037, P = 0.002, respectively. The severity of ecchymosis, on the 7th postoperative day, was lower with the external approach, and the difference was significant (P = 0.011. The severity of both edema and ecchymosis on the first postoperative day was evaluated higher in females, with statistically significant differences (P = 0.05 for edema and P = 0.003 for ecchymosis. The extension of ecchymosis on the 7th postoperative day was higher in women (P = 0.05. There were no significant differences between the two approaches in medialization of the involved bones and no apparent asymmetries either. Conclusion: According to the results of this study, external osteotomy seems to be the approach of choice, provided that the surgeon has enough experience in doing it. Keywords: Rhinoplasty, Internal osteotomy, External osteotomy, Ecchymosis, Edema

  20. Fortællinger fra praksis

    DEFF Research Database (Denmark)

    Fortællinger fra praksis formidler erfaringer fra et udviklingsprojekt, hvor pædagoger sætter fokus på børns og brugeres livshistorier. En livshistorie er en dynamisk størrelse under stadig forandring og konstruktion. Vi fortæller historier om vores liv på den måde, det giver mening for os her og...

  1. Patterns of healing: a comparison of two proximal tibial osteotomy techniques

    OpenAIRE

    Peek, Anna C.; Timms, Anna; Chin, Kuen F.; Calder, Peter; Goodier, David

    2016-01-01

    Several low-energy osteotomy techniques are described in the literature, but there is limited evidence comparing them. Our study evaluates the patterns of regenerate formation using two different osteotomy techniques. Two cohorts of patients underwent osteotomy of the tibia using a Gigli saw (n = 15) or De Bastiani corticotomy (n = 12) technique. The patient radiographs were assessed by the two senior authors who were blinded to the osteotomy type. Regenerate quality was assessed along the an...

  2. Mitchell′s osteotomy in the management of hallux valgus: An Indian perspective

    Directory of Open Access Journals (Sweden)

    Baba Asif

    2009-01-01

    Full Text Available Background: Hallux valgus is a common condition that affects the forefoot. A large number of procedures are described for managing this condition. Mitchell′s osteotomy and its modifications are being widely used for treating hallux valgus. However, most of the studies describe the results from the developed world. We present results of the classic Mitchell′s osteotomy in hallux valgus in Indian subcontinent. Materials and Methods: Forty eight adult patients (including 12 bilateral ones in the age range of 18-60 years with hallux valgus were managed with the classic Mitchell′s osteotomy. Pain over the bunion was the reason for surgery in 53 of 60 feet and cosmesis in the remaining 7 feet. Patients with hallux valgus angle more than 20° degrees and not responding to a trial of conservative treatment were included. Patients having metatarsophalangeal (MTP joint osteoarthritis (Grade II and higher, hallux rigidus, rheumatoid arthritis, and with subluxation of MTP joint were excluded from the study. Further, patients with first metatarsal more than 3 mm shorter than second metatarsal were also excluded. Results: The average follow-up period is 3 yrs (range 18months - 6yrs. About 55 feet (83% were painless after surgery. Forty-two (70% patients were happy with the cosmetic results of the surgery. Metatarsalgia was the reason for dissatisfaction with the procedure in five patients. The average correction of hallux valgus and the intermetatarsal angles achieved was 19.7° and 6.9°, respectively. Using the Broughton and Winson scoring system, 37 (61.7% feet had excellent results, 18 (30% had good, and five (8.3% feet had a poor results. Conclusion: The classic Mitchell′s procedure is a simple procedure and gives good cosmetic and radiological results.

  3. Local application of ibandronate/gelatin sponge improves osteotomy healing in rabbits.

    Directory of Open Access Journals (Sweden)

    Zongyou Yang

    Full Text Available Delayed healing or non-union of skeletal fractures are common clinical complications. Ibandronate is a highly potent anti-catabolic reagent used for treatment of osteopenia and fracture prevention. We hypothesized that local application of ibandronate after fracture fixation may improve and sustain callus formation and therefore prevent delayed healing or non-union. This study tested the effect of local application of an ibandronate/gelatin sponge composite on osteotomy healing. A right-side distal-femoral osteotomy was created surgically, with fixation using a k-wire, in forty adult male rabbits. The animals were divided into four groups of ten animals and treated by: (i intravenous injection of normal saline (Control; (ii local implantation of absorbable gelatin sponge (GS; (iii local implantation of absorbable GS containing ibandronate (IB+GS, and (iv intravenous injection of ibandronate (IB i.v.. At two and four weeks the affected femora were harvested for X-ray photography, computed tomography (CT, biomechanical testing and histopathology. At both time-points the results showed that the calluses in both the ibandronate-treated groups, but especially in the IB+GS group, were significantly larger than in the control and GS groups. At four weeks the cross sectional area (CSA and mechanical test results of ultimate load and energy in the IB+GS group were significantly higher than in other groups. Histological procedures showed a significant reduction in osteoclast numbers in the IB+GS and IB i.v. groups at day 14. The results indicate that local application of an ibandronate/gelatin sponge biomaterial improved early osteotomy healing after surgical fixation and suggest that such treatment may be a valuable local therapy to enhance fracture repair and potentially prevent delayed or non-union.

  4. Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy.

    Science.gov (United States)

    Chen, Shu-Jung; Cheng, Yuh-Min; Lin, Sung-Yen; Chen, Chung-Hwan; Huang, Hsuan-Ti; Huang, Peng-Ju

    2015-04-01

    Transfer metatarsalgia (TM) is a common forefoot disorder secondary to hallux valgus (HV). Some authors suggest that a combined lesser metatarsal osteotomy while undergoing HV surgery improves metatarsalgia, whereas others concluded that isolated HV corrective osteotomy can improve symptomatic metatarsalgia. The main purpose of this retrospective study was to compare clinical outcomes in patients with and without combined lesser metatarsal osteotomy while receiving HV correction surgery. We retrospectively reviewed the patients who underwent osteotomy for HV correction between January 2000 and December 2010. All patients underwent HV correction with modified Mitchell osteotomy. Clinical evaluations including the American Orthopaedic Foot and Ankle Society score and residual metatarsalgia were assessed, and radiographic measurements were carried out. Sixty-five patients (83 feet) meeting the selection criteria were enrolled. Thirty feet receiving a combined lesser metatarsal osteotomy were classified as the combined surgery (CS) group, and the others were classified as the control (CN) group (53 feet). The overall rate of persistent symptomatic metatarsalgia was 19.28% after operative treatment. There were six feet with residual metatarsalgia in the CS group, and 10 feet in the CN group. There was no significant difference in the rate of persistent symptoms between the two groups (p = 0.9). According to this result, modified Mitchell osteotomy alone did not have a higher rate of residual metatarsalgia than CS. We also found that the average recovery rate of TM was about 80.7% and those patients whose preoperative HV angle was > 30° had the higher risk of residual metatarsalgia after surgery. Copyright © 2015. Published by Elsevier Taiwan.

  5. Modified Mitchell osteotomy alone does not have higher rate of residual metatarsalgia than combined first and lesser metatarsal osteotomy

    Directory of Open Access Journals (Sweden)

    Shu-Jung Chen

    2015-04-01

    Full Text Available Transfer metatarsalgia (TM is a common forefoot disorder secondary to hallux valgus (HV. Some authors suggest that a combined lesser metatarsal osteotomy while undergoing HV surgery improves metatarsalgia, whereas others concluded that isolated HV corrective osteotomy can improve symptomatic metatarsalgia. The main purpose of this retrospective study was to compare clinical outcomes in patients with and without combined lesser metatarsal osteotomy while receiving HV correction surgery. We retrospectively reviewed the patients who underwent osteotomy for HV correction between January 2000 and December 2010. All patients underwent HV correction with modified Mitchell osteotomy. Clinical evaluations including the American Orthopaedic Foot and Ankle Society score and residual metatarsalgia were assessed, and radiographic measurements were carried out. Sixty-five patients (83 feet meeting the selection criteria were enrolled. Thirty feet receiving a combined lesser metatarsal osteotomy were classified as the combined surgery (CS group, and the others were classified as the control (CN group (53 feet. The overall rate of persistent symptomatic metatarsalgia was 19.28% after operative treatment. There were six feet with residual metatarsalgia in the CS group, and 10 feet in the CN group. There was no significant difference in the rate of persistent symptoms between the two groups (p = 0.9. According to this result, modified Mitchell osteotomy alone did not have a higher rate of residual metatarsalgia than CS. We also found that the average recovery rate of TM was about 80.7% and those patients whose preoperative HV angle was > 30° had the higher risk of residual metatarsalgia after surgery.

  6. Proximal first metatarsal opening wedge osteotomy: geometric analysis on saw bone models.

    Science.gov (United States)

    Kugan, R; Currall, V A; Johal, P; Clark, C I C

    2015-03-01

    For hallux valgus correction, distal first metatarsal osteotomy is generally used for minor to moderate deformities, diaphyseal osteotomy for moderate deformities and basal osteotomy or arthrodesis for severe deformities. With the advent of locking plates, there has been renewed interest in opening wedge basal osteotomy. We undertook this study in order to understand the power and limitations of this osteotomy. Proximal opening wedge osteotomies were performed on saw bone models in four orientations, with three different wedge sizes: (1) perpendicular to the ground (PG); (2) perpendicular to the shaft (PS); (3) perpendicular to shaft with 30° declination (DEC); (4) 30° oblique (OB). Pre- and post-osteotomy measurements were made of axial and plantar translation and inter-metatarsal angle. Plantar translation and intermetatarsal angle correction increased with increasing wedge size. The DEC osteotomy produced the greatest increase in length of metatarsal shaft, while the PS osteotomy gave the least. The most plantar translation was achieved with the DEC osteotomy. Overall, the PS osteotomy gave the largest correction of the intermetatarsal angle. Although there are several published clinical case series of the proximal opening wedge osteotomy, this is the first study to fully evaluate its geometry. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Trochanteric osteotomy versus posterolateral approach: Function the first year post surgery. A pilot study

    NARCIS (Netherlands)

    M. van der Grinten (Margot); M. Reijman (Max); F.C. van Biezen (Frans); J.A.N. Verhaar (Jan)

    2011-01-01

    textabstractBackground: Although no prospective studies have compared functional results of trochanteric osteotomy and a non-trochanteric approach, most surgeons feel that trochanteric osteotomy is outdated in simple hip arthroplasty. Reasons not to perform an osteotomy include the fear of longer re

  8. Poly(L-lactide) bone plates and screws for internal fixation of mandibular swing osteotomies

    NARCIS (Netherlands)

    Tams, J; Rozema, FR; Bos, RRM; Roodenburg, JLN; Nikkels, PGJ; Vermey, A

    1996-01-01

    This study evaluated bone healing after mandibular swing osteotomies fixed with biodegradable poly(L-lactide) (PLLA) bone plates in four patients. A step osteotomy treated with two PLLA bone plates (n=3), and a straight osteotomy treated with one PLLA bone plate (n=1) were performed. Bone healing wa

  9. Effect of Combined Fibular Osteotomy on the Pressure of the Tibiotalar and Talofibular Joints in Supramalleolar Osteotomy of the Ankle: A Cadaveric Study.

    Science.gov (United States)

    Choi, Gi Won; Lee, Soon Hyuck; Nha, Kyung Wook; Lee, Sung Jae; Kim, Won Hyeon; Uhm, Chang-Sub

    We investigated the effect of combined fibular osteotomy on the pressure of the tibiotalar and talofibular joints in medial opening-wedge supramalleolar osteotomy. Three different tibial osteotomy gaps (6, 8, and 10 mm) were created in 10 cadaveric models, and the pressure in the tibiotalar and talofibular joints was measured under axial load before and after fibular osteotomy. The heel alignment angle and talar translation ratio were evaluated radiographically. An increase in osteotomy gap led to increases in hindfoot valgus (p = .001) and the contact and peak pressures in the talofibular joint (p = .03 and p = .004). In contrast, the contact and peak pressures in the tibiotalar joint were unchanged with an increasing osteotomy gap (p = .52 and p = .76). Fibular osteotomy reduced the contact and peak pressures in the talofibular joint (p osteotomy might be necessary in supramalleolar osteotomy for medial ankle arthritis to minimize the increase in pressure in the talofibular joint, especially when the osteotomy gap is large. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Comparison of the surgical approaches for a Chiari pelvic osteotomy.

    Science.gov (United States)

    Ito, H; Matsuno, T; Minami, A

    2003-03-01

    We present the mid- to long-term results of the Chiari pelvic osteotomy for dysplastic hips. We followed 135 hips in 129 patients, with a mean age at the time of surgery of 24 years, for a mean of 16.2 years We used the anterior iliofemoral approach without trochanteric osteotomy in the initial 31 hips. Thereafter, we used transtrochanteric approaches in an attempt to ensure that the osteotomy was at the most appropriate level, and to advance the high-riding greater trochanter distally. The next 79 hips therefore underwent a posterolateral approach and the most recent 25 hips an Ollier lateral U approach. The clinical result was excellent or good in 103 hips (77%). The outcome in 104 hips in which we used a transtrochanteric approach was superior, the osteotomy level was more appropriate and a Trendelenburg gait less common than in 31 hips in which we used an anterior approach. We therefore recommend the use of a transtrochanteric approach in order to ensure that the osteotomy is at an appropriate level and in order to achieve effective distal advancement of the high-riding greater trochanter.

  11. One-stage rotational osteotomy for congenital radioulnar synostosis.

    Science.gov (United States)

    Hwang, J H; Kim, H W; Lee, D H; Chung, J H; Park, H

    2015-10-01

    We report the results of a one-stage rotational osteotomy of the proximal third of the ulna and distal third of the radius with segmental bone resection for treating congenital radioulnar synostosis. We retrospectively reviewed 25 patients (28 forearms) treated by operation. Patients were divided into two groups according to the method of internal fixation at the osteotomy sites. In Group 1 the ulnar osteotomy was stabilized with an intramedullary pin and in Group 2 no fixation was used. The average forearm position improved from 47° pronation before surgery, to 27° supination after surgery. There were no statistically significant differences between the two groups in surgical outcomes. One-stage rotational osteotomy of the proximal third of the ulna and distal third of the radius with segmental bone resection is a simple and safe treatment for patients with congenital radioulnar synostosis. Internal fixation at the osteotomy site seems to be unnecessary. Level of evidence: Level 4. © The Author(s) 2015.

  12. Non-union following bilateral simultaneos Ganz trochanteric osteotomy

    Directory of Open Access Journals (Sweden)

    Sean M. Dixon

    2010-01-01

    Full Text Available Between January 2003 and December 2004, 13 patients underwent bilateral resurfacing arthroplasty via a Ganz trochanteric osteotomy. This bilateral group was mobilised fully weight-bearing with crutches. During the same period 139 Ganz trochanteric osteoto-mies were performed for unilateral hip resurfacing. These patients were mobilised with crutches, weight-bearing up to 10 kg on the operated leg. Nine osteotomies (32% in the bilateral group subsequently developed a symptomatic non-union requiring revision of fixation. This compares with 10 patients (7% in the unilateral group. Applying the Fisher’s exact test, the difference reached significance (P=0.0004. In two patients a second revision was required to achieve union. In one patient, revision of trochanteric fixation precipitated a deep infection. Protected weight-bearing following a Ganz trochanteric osteotomy is important to the success of the procedure. Simultaneous bilateral hip arthroplasty through a Ganz approach should be avoided. If it is undertaken, we recommend that patients should be non weight-bearing for 6 weeks following surgery. Non-union following a Ganz trochanteric osteotomy for arthroplasty carries a significant morbidity.

  13. Patellar instability treated with distal femoral osteotomy.

    Science.gov (United States)

    Swarup, Ishaan; Elattar, Osama; Rozbruch, S Robert

    2017-06-01

    Patellar instability can cause significant disability in both pediatric and adult patients, and it is associated with several factors including genu valgum. In this study, we describe the role of a lateral opening wedge distal femoral osteotomy (DFO) combined with lateral retinacular release in addressing genu valgum with associated patellar instability. The rationale for this approach is to medialize the patellar tendon insertion and decrease the Q angle with DFO. A consecutive series of patients were studied, and our outcomes of interest included improvements in radiographic measures and patient outcomes. Radiographic improvement was assessed using patella congruency angle (PCA), mechanical axis deviation (MAD), and lateral distal femoral angle (LDFA). Patient outcomes were assessed using Oxford Knee scores, KOOS-PS scores, VAS pain scores, and Kujala scores. We studied eight patients (10 knees) that underwent a lateral opening wedge DFO for genu valgum and patellar instability. Mean follow-up duration was 27 months. PCA improved from 30.4° lateral preoperatively to 5.7° lateral postoperatively (p=0.016). Similarly, MAD improved from 33.1mm lateral to 6.5mm medial, and LDFA improved from 82.4° to 92.7° after surgery (p=0.002). There were significant improvements in VAS pain and Kujala scores after surgery (pgenu valgum. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 75 FR 48411 - Noise Compatibility Program Notice; Fort Worth Alliance Airport, Fort Worth, TX

    Science.gov (United States)

    2010-08-10

    ... Federal Aviation Administration Noise Compatibility Program Notice; Fort Worth Alliance Airport, Fort... Administration (FAA) announces that it is reviewing a proposed noise compatibility program that was submitted for... Noise Abatement Act, hereinafter referred to as ``the Act'') and 14 CFR Part 150 by the city of...

  15. [EFFECTIVENESS OF Bernese OSTEOTOMY FOR TREATMENT OF DEVELOPMENTAL DYSPLASIA OF THE HIP IN ADULTS].

    Science.gov (United States)

    Chu, Linyang; Shang, Xifu; He, Rui; Hu, Fei

    2015-07-01

    To investigate the effectiveness of Bernese osteotomy for the treatment of developmental dysplasia of the hip (DDH) in adults. Between August 2012 and April 2014, 16 patients with DDH were treated with Bernese osteotomy by S-P approach, and the clinical data were retrospectively analyzed. There were 4 males and 12 females with an average age of 27.8 years (range, 18-35 years). The left side was involved in 6 cases and the right side in 10 cases. The visual analogue scale (VAS) score was 4.8 ± 0.5, and the Harris hip score was 81.2 ± 5.4. The lateral center edge (CE) angle (the angle between the vertical center of the femoral head and the lateral edge of the acetabulum) was (6.5 ± 8.7); the horizontal tilt angle was (25.6 ± 5.9); and the femoral head extrusion index was 36.5% ± 6.5%. According to the Tonnis osteoarthritis classification, 12 hips were rated as Grade 0, 3 hips as Grade I, and 1 hip as Grade II. The operation time was 90-135 minutes; the intraoperative blood loss was 400-800 mL; 10 cases accepted blood transfusion and the amount of blood transfusion was 200-600 mL; the postoperative drainage volume was 100- 300 mL; and the hospitalization time was 7-12 days. All the cases achieved primary healing of incision with no early complications. Two cases had numb in the lateral femoral cutaneous nerve innervating area. All patients were followed up 12-26 months (mean, 20 months). The X-ray examination showed osseous healing at osteotomy site, and the healing time was 12-16 weeks (mean, 13.5 weeks). No acetabulum fracture, heterotopic ossification, osteonecrosis, and internal fixation loosening occurred during follow-up. No progression of osteoarthritis or acetabular cystic change was observed. At last follow-up, the lateral CE angle was (27.7 ± 6.8); the horizontal tilt angle was (16.2 ± 4.8)°; the femoral head extrusion index was 19.7% ± 5.3%; VAS score was 0.8 ± 0.3; the Harris hip score was 96.8 ± 6.7; and all showed significant differences when

  16. Equivalent correction in scarf and chevron osteotomy in moderate and severe hallux valgus: a randomized controlled trial.

    NARCIS (Netherlands)

    Deenik, A.; Mameren, H van; Visser, E. de; Waal Malefijt, M.C. de; Draijer, F.; Bie, R. de

    2008-01-01

    BACKGROUND: Chevron osteotomy is a widely accepted osteotomy for correction of hallux valgus.(18) Algorithms were developed to overcome the limitations of distal osteotomies. Scarf osteotomy has become popular as a versatile procedure that should be able to correct most cases of acquired hallux valg

  17. High tibial osteotomy in varus knees: indications and limits

    Science.gov (United States)

    LOIA, MARCO CORGIAT; VANNI, STEFANIA; ROSSO, FEDERICA; BONASIA, DAVIDE EDOARDO; BRUZZONE, MATTEO; DETTONI, FEDERICO; ROSSI, ROBERTO

    2016-01-01

    Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss. For these reasons, interest in this procedure has grown in recent years. The aim of this study is to review the literature on OWHTO, considering indications and prognostic factors (body mass index, grade of osteoarthritis, instability, range of movement and age), outcomes at mid-term follow-up, and limits of the procedure (slope modifications, patellar height changes and difficulties in conversion to a total knee arthroplasty). PMID:27602350

  18. Double First Metatarsal and Akin Osteotomy for Severe Hallux Valgus.

    Science.gov (United States)

    Al-Nammari, Shafic Said; Christofi, Theodoros; Clark, Callum

    2015-10-01

    The technique of double first metatarsal osteotomies was first developed in response to the high frequency of recurrence noted in the treatment of severe adolescent congruent hallux valgus deformities. The concept behind the use of this technique is that it allows the individual correction of each component of the deformity. We have modified the technique for use in adult hallux valgus where the majority of deformities are incongruent deformities and the distal chevron osteotomy is used primarily for its additional translational properties rather than purely to correct the distal metatarsal articular angle (DMAA). We report on a series of double first metatarsal osteotomies (basal opening wedge and distal chevron osteotomy) with Akin osteotomy in the treatment of moderate to severe adult hallux valgus deformity. All patients presenting to our institution with a hallux valgus deformity and treated with this procedure between 2008 and 2013 with a minimum of 1 year of follow-up were identified. Data were obtained through review of case notes, electronic charts, and digital imaging. A total of 50 feet in 48 patients underwent double first metatarsal osteotomy with Akin osteotomy. Three patients were excluded due to loss to follow-up, leaving 47 feet in 45 patients with a mean follow-up of 45 months (range, 14-60 months). Of these 43 (96%) were female and the mean age was 56 years (range, 35-70 years). The mean preoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), DMAA, sesamoid position, and lateral first metatarsotalar angle were 42 degrees (range, 32-52 degrees), 18 degrees (range, 6-26 degrees), 12 degrees (range, 4-26 degrees), stage 6 (range, 4-7), and 2 degrees of dorsiflexion (range, 20 degrees of dorsiflexion to 4 degrees of plantar flexion), respectively. The mean postoperative HVA, IMA, DMAA, sesamoid position, and lateral first metatarsotalar angle were 7 degrees (range, 2 to 24 degrees), 4 degrees (range, 4-14 degrees), 6 degrees (range, 10

  19. Pertrochanteric osteotomy and distraction femoral neck lengthening for treatment of proximal hip ischemic deformities in children.

    Science.gov (United States)

    Teplenky, Mikhail; Mekki, Waleed

    2016-02-01

    Proximal femoral ischemic deformities in the pediatric population is a challenging pathological situation. Many surgical techniques have been proposed to treat this problem, with variable reported results. We believe that a C-shaped pertrochanteric osteotomy plus neck lengthening utilizing distraction osteogenesis principles would restore the femoral anatomical ratios between neck, shaft, and the head, and redress the biomechanics of the proximal femur with resultant sufficient containment of the femoral head within the acetabulum. We reviewed the results of 19 patients divided into two groups with proximal femoral ischemic deformities. Between 2002 and 2009, preoperative and postoperative clinical examination and radiographs were assessed measuring the neck-shaft angle (NSA), neck-epiphyseal angle (NEA), articulo-trochanteric distance (ATD), lateralization of the greater trochanter (LT), the angle of Wiberg (CEA), index of lateral head displacement by Reimers (IM), and lateral angle of displacement (LDA). All patients were followed prospectively. Clinical outcome was assessed using Colton's criteria, which showed average good improvement in function (58.9 %). Radiological indicators were assessed using Kruczynski's criteria. For group I, the postoperative NSA, NEA, and CEA showed significant change (p < 0.01, p < 0.001, and p < 0.001, respectively). For group II, the postoperative NSA, NEA, and CEA showed significant change (p < 0.001, p < 0.001, and p < 0.001, respectively). The midterm functional results are favorable for the implementation of pertrochanteric osteotomy and distraction osteogenesis to treat proximal femoral ischemic deformities in the pediatric population.

  20. Three-phase bone scintigraphic analysis of radial osteotomy for Kienboeck`s disease

    Energy Technology Data Exchange (ETDEWEB)

    Nakao, Etsuhiro; Nakamura, Ryogo; Imaeda, Toshihiko [Branch Hospital of Nagoya Univ. (Japan); Tsunoda, Kenji; Makino, Naoki

    1996-02-01

    Three-phase bone scintigraphy was performed before and after radial wedge osteotomy on 11 joints. All 11 patients were suffering from Kienboeck`s disease. We analized the relations between the change of those images and the clinical courses. On blood pool images that were performed before radial wedge osteotomy, we observed decreased accumulation in the lunate bone in 4 of 9 patients in Lichtman`s stage II or IIIA. Intensive accumulation in the carpal area that seemed to represent the activity of Kienboeck`s disease were seen in all patients. Delayed image showed accumulation demonstrating osteoarthritic changes. Accumulation in the lunte bone on blood pool images was confirmed in all patients 6 to 12 months after operation. This appeared to suggest the increase of blood flow into the lunate bone. Compared with preoperative blood pool images, accumulation in the carpal area decreased in 8 patients who followed good postoperative course and their clinical symptoms improved relatively quickly. In the other 3 patients no decrease in this accumulation was confirmed by the initial postoperative scintigraphy. The improvement in their symptoms was delayed. The postoperative change of delayed images was visualized less sensitively than that of blood pool images. The decreased accumulation in the carpal area on blood pool images allows prediction of the subsequent clinical course prior to improvement in clinical symptoms. We consider this finding to be useful clinically. (author).

  1. Influence of the design in sagittal split ramus osteotomy on the mechanical behavior.

    Science.gov (United States)

    Pozzer, Leandro; Olate, Sergio; Cavalieri-Pereira, Lucas; de Moraes, Márcio; Albergaría-Barbosa, José Ricardo

    2014-01-01

    The aim of this study was to determine the influence of the design of the sagittal split ramus osteotomy (SSRO) on the mechanical resistance to vertical forces. An in vitro study was designed for 30 test specimens. Two osteotomy models were made on two polyurethane hemimandibles, where group I presented a SSRO with an angle at vestibular level between both molars and group II presented a linear SSRO towards the basilar border. In both groups a standard osteosynthesis was performed with a 2.0 system plate and four monocortical screws, establishing sub-groups according to the degree of mandibular advancement: group A without advancement, group B with an advancement of 3 mm, and group C with advancement of 7 mm. Hemimandibles were subjected to a vertical load in the Instron machine until reaching peak load with failure, recording the value of the load and displacement. The data were analyzed with a t-test to establish statistical significance, considering pdesign influences mechanical resistance and that the linear SSRO offers the best mechanical resistance.

  2. Comparison of two approaches to lateral osteotomy in Saudi patients.

    Science.gov (United States)

    Mirza, Ahmad A; Marglani, Osama A; Farooq, Mian U; Al-Khatib, Talal A; Jameel, Waed S; Sultan, Noran A; Aly, Mohammed S

    2017-01-01

    Nasal deformity is an abnormality in the appearance of the nose due to either congenital defect or trauma. In traumatic cases, patients often present with combined functional and cosmetic complaints. Therefore, otolaryngologists take into account both breathing and aesthetic nasal issues. To evaluate the changes in the nasal dorsum and base; compare breathing and aesthetic satisfaction scores between two approaches to lateral nasal osteotomy: low-to-low and low-to-high. Comparative observational; data gathered retrospectively and prospectively. Head and Neck and Skull Base Center, King Abdullah Medical City, Makkah, Saudi Arabia. Patients who received hump reduction rhinoplasty from 2013 to 2016 met the inclusion criteria. Patients with a low satisfaction level for aesthetic sensibility (neutral and dissatisfied) underwent low-to-high osteotomy. The differences in dorsal (DW) and ventral (VW) widths with a fixed interpupillary distance (IPD). Satisfaction scores for both cosmetic perspective and breathing functionality. We included 46 patients; 28 patients underwent low-to-low osteotomy and 18 patients underwent low-to-high osteotomy. With both approaches, there were statistically decreases from preoperative to postoperative ratios of VW/IPD and DW/IPD. However, differences in DW/IPD ratio and VW/IPD ratio (pre- versus post-op) were significantly higher in the low-to-low group (P osteotomy showed a satisfactory outcome in both objective and subjective measures. However, low-to-low osteotomy was superior in pre- to post-operative differences in DW/IPD and VW/IPD ratios. Sampling was by convenience. The study was conducted in a single tertiary center and was a small sample.

  3. Intra-Articular Osteotomy for Distal Humerus Malunion

    Directory of Open Access Journals (Sweden)

    René K. Marti

    2009-01-01

    Full Text Available Intra-articular osteotomy is considered in the rare case of malunion after a fracture of the distal humerus to restore humeral alignment and gain a functional arc of elbow motion. Traumatic and iatrogenic disruption of the limited blood flow to the distal end of the humerus resulting in avascular necrosis of capitellum or trochlea is a major pitfall of the this technically challenging procedure. Two cases are presented which illustrate the potential problems of intra-articular osteotomy for malunion of the distal humerus.

  4. Dome-shaped osteotomy for distal radius fracture malunions.

    Science.gov (United States)

    Brunelli, Giorgio A

    2003-06-01

    After having hinted to the various component of the malformity caused by malunions of the distal radius fracture, the various possibilities of correcting this deformity are described. The difficulty to correct all the components of the deformity are considered. Then a Dome-shaped osteotomy of the distal radius is described that allows to correct all the deformities in all the directions as the gliding plane of the osteotomy is spherical. The ulnar plus and the DRUJ alterations are corrected by means of an added Sauvé-Kapandji procedure that guarantees against any painful movement of the DRUJ preserving effective prono-supination.

  5. High tibial osteotomy in Sweden, 1998-2007

    DEFF Research Database (Denmark)

    W-Dahl, Annette; Robertsson, Otto; Lohmander, Stefan

    2012-01-01

    Most studies on high tibial osteotomies (HTOs) have been hospital-based and have included a limited number of patients. We evaluated the use and outcome-expressed as rate of revision to knee arthroplasty-of HTO performed in Sweden with 9 million inhabitants, 1998-2007.......Most studies on high tibial osteotomies (HTOs) have been hospital-based and have included a limited number of patients. We evaluated the use and outcome-expressed as rate of revision to knee arthroplasty-of HTO performed in Sweden with 9 million inhabitants, 1998-2007....

  6. Advanced containment methods for the treatment of Perthes disease: Salter plus varus osteotomy and triple pelvic osteotomy.

    Science.gov (United States)

    Wenger, Dennis R; Pandya, Nirav K

    2011-09-01

    The goal of intervention in Legg-Calvé-Perthes disease has been to prevent femoral head deformation by containing the head within the acetabulum, using it as a mold for guiding femoral head development. With appropriate proximal femoral morphology, premature arthritis can hopefully be avoided. Both nonsurgical and surgical methods of treatment have evolved over time, from abduction casts and braces to advanced surgical containment methods, which are now the mainstay of treatment. The purpose of this study is to briefly review the evolution of surgical treatment of Legg-Calvé-Perthes disease, and to concentrate on 2 advanced surgical containment methods: combined Salter innominate osteotomy with femoral varus osteotomy and triple pelvic osteotomy.

  7. Medial opening wedge distal femoral osteotomy for post-traumatic secondary knee osteoarthritis.

    Science.gov (United States)

    Matsui, Gen; Akiyama, Takenori; Ikemura, Satoshi; Mawatari, Taro

    2014-04-30

    Osteoarthritis of the knee secondary to femoral fracture is difficult to treat. There are some surgical options, such as total knee arthroplasty or correction osteotomy. Opening wedge high tibial osteotomy is an established treatment of gonarthrosis. However, few reports are available on the effectiveness of a medial opening wedge distal femoral osteotomy. We present a case of a medial opening wedge distal femoral osteotomy on gonarthrosis secondary to a malunited femoral fracture with varus deformity and leg length discrepancy. This osteotomy was performed at the deformed femur, with locking plate fixation and autologous bone graft. Six months after the surgery, the osteotomy site was filled with bridging callus. Two years later, the Knee Society Score improved from 45 to 90 points. Medial opening wedge distal femoral osteotomy can be a useful method to treat knee osteoarthritis associated with distal femoral deformity.

  8. Correction of Hallux Valgus Interphalangeus With an Osteotomy of the Distal End of the Proximal Phalanx (Distal Akin Osteotomy).

    Science.gov (United States)

    Vander Griend, Robert

    2017-02-01

    Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI. All of the patients had other forefoot deformities which were corrected at the same time. Eight of these were revision procedures of prior forefoot operations. The length of follow-up was determined by the associated procedures with a minimum follow-up of 4 months. The preoperative hallux valgus interphalangeus angle averaged 16 degrees of valgus (range 7-32 degrees) and was corrected to an average of 2 degrees of valgus (range 5 degrees valgus to 5 degrees varus). All of the patients were satisfied with the postoperative appearance and function of the first toe. Because of simultaneous correction of numerous other forefoot problems, it was not possible to specifically isolate or evaluate the effects and benefits of this osteotomy using outcomes measures. There was one intraoperative complication resulting in a fracture extending into the adjacent IP joint. Correction of an HVI deformity can be achieved with an osteotomy at the distal end of the proximal phalanx. This was a safe technique with few complications and with good results in terms of both correction and patient satisfaction. Level IV, retrospective case series.

  9. [The bare area of the proximal ulna : An anatomical study on optimizing olecranon osteotomy].

    Science.gov (United States)

    Hackl, M; Lappen, S; Neiss, W F; Scaal, M; Müller, L P; Wegmann, K

    2016-10-01

    Olecranon osteotomy is an established approach for the treatment of distal humerus fractures. It should be performed through the bare area of the proximal ulna to avoid iatrogenic cartilage lesions. The goal of this study was to analyze the anatomy of the proximal ulna with regard to the bare area and, thereby, to optimize the hitting area of the bare area when performing olecranon osteotomy. The bare areas of 30 embalmed forearm specimens were marked with a radiopaque wire and visualized three-dimensionally with a mobile C‑arm. By means of 3D reconstructions of the data sets, the following measurements were obtained: height of the bare area; span of the bare area-hitting area in transverse osteotomy; ideal angle for olecranon osteotomy to maximize the hitting area of the bare area; distance of the posterior olecranon tip to the entry point of the transverse osteotomy and the ideal osteotomy. The height of the bare area was 4.92 ± 0.81 mm. The hitting area of the transverse osteotomy averaged 3.73 ± 0.89 mm. The "ideal" angle for olecranon osteotomy was 30.7° ± 4.19°. The distance of the posterior olecranon tip to the entry point was 14.08 ± 2.75 mm for the transverse osteotomy and 24.21 ± 3.15 mm for the ideal osteotomy. The hitting area of the bare area in the ideal osteotomy was enhanced significantly when compared to the transverse osteotomy (p osteotomy of the olecranon. Moreover, a 30° angulation of the osteotomy can significantly increase the hitting area of the bare area.

  10. A guiding oblique osteotomy cut to prevent bad split in sagittal split ramus osteotomy: a technical note

    Directory of Open Access Journals (Sweden)

    Gururaj Arakeri

    2015-06-01

    Full Text Available Aim: To present a simple technical modification of a medial osteotomy cut which prevents its misdirection and overcomes various anatomical variations as well as technical problems. Methods: The medial osteotomy cut is modified in the posterior half at an angle of 15°-20° following novel landmarks. Results: The proposed cut exclusively directs the splitting forces downwards to create a favorable lingual fracture, preventing the possibility of an upwards split which would cause a coronoid or condylar fracture. Conclusion: This modification has proven to be successful to date without encountering the complications of a bad split or nerve damage.

  11. Seafloor character--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents the seafloor-character map Offshore of Fort Ross, California (raster data file is included in "SeafloorCharacter_OffshoreFortRoss.zip,"...

  12. Seafloor character--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents the seafloor-character map Offshore of Fort Ross, California (raster data file is included in "SeafloorCharacter_OffshoreFortRoss.zip,"...

  13. Short lingual osteotomy without fixation: a new strategy for mandibular osteotomy known as "physiological positioning".

    Science.gov (United States)

    Ohba, Seigo; Yoshida, Masashi; Kohara, Haruka; Kawasaki, Takako; Minamizato, Tokutarou; Koga, Takamitsu; Nakatani, Yuya; Wanatabe, Etsuko; Nakao, Noriko; Yoshida, Noriaki; Asahina, Izumi

    2014-02-01

    We describe the strategy of physiological positioning, which we regard as a new alternative treatment to conventional orthognathic operations, and treated 18 patients with skeletal mandibular prognathism using it. The positions of SNB, FMA, and Me were measured postoperatively to assess skeletal stability, changes in the angle and perpendicular length of the upper and lower central incisors were measured to assess dental stability, and we confirmed that both skeletal and dental stability were excellent. The width to which the jaw could be opened recovered early, and we saw only one case of disorder of the temporomandibular joint. Short lingual osteotomy with physiological positioning is an effective new approach to the treatment of deformities of the mandible.

  14. Renewable Energy Opportunities at Fort Sill, Oklahoma

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Brian K.; Hand, James R.; Horner, Jacob A.; Orrell, Alice C.; Russo, Bryan J.; Weimar, Mark R.; Nesse, Ronald J.

    2011-03-31

    This document provides an overview of renewable resource potential at Fort Sill, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Sill took place on June 10, 2010.

  15. Renewable Energy Opportunities at Fort Polk, Louisiana

    Energy Technology Data Exchange (ETDEWEB)

    Solana, Amy E.; Boyd, Brian K.; Horner, Jacob A.; Gorrissen, Willy J.; Orrell, Alice C.; Weimar, Mark R.; Hand, James R.; Russo, Bryan J.; Williamson, Jennifer L.

    2010-11-17

    This document provides an overview of renewable resource potential at Fort Polk, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Polk took place on February 16, 2010.

  16. First bite syndrome after bimaxillary osteotomy: case report.

    Science.gov (United States)

    Scholey, April Louise; Suida, Mohamed Imran

    2015-07-01

    We present what is to the best of our knowledge the first reported case of first bite syndrome as a delayed complication of bimaxillary osteotomy. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Postoperative contamination of mandibular osteotomy sites with saliva

    NARCIS (Netherlands)

    Koole, Ronald; Egyedi, P.

    1987-01-01

    Postoperative salivary contamination of surgical wounds around the mandible was found in several types of osteotomy and bone grafting procedure. This problem was investigated by determining the amylase content of wound secretions in redon bottles every 24h. The implications for antibiotic

  18. High Tibial Osteotomy: A Systematic Review and Current Concept

    Science.gov (United States)

    Sabzevari, Soheil; Ebrahimpour, Adel; Roudi, Mostafa Khalilipour; Kachooei, Amir R.

    2016-01-01

    High tibia osteotomy is a common procedure in orthopedic surgery. A precise overview on indications, patients selection, pre-operative planning, surgical technique, methods of fixation, and complications have been presented. This paper focused on the points that should be considered to achieve good long-term outcomes. PMID:27517063

  19. [Bernese periacetabular osteotomy for the treatment of severe hip dysplasia].

    Science.gov (United States)

    Huang, Ye; Zhang, Hong; Liu, Qing; Jiang, Zeng-hui; Dou, Yong

    2010-02-15

    To analyze the mid-term clinical and radiographic results obtained with the Bernese periacetabular osteotomy for the treatment of severe hip dysplasia. From October 1997 to December 2002 20 hips of 18 patients were classified as having severe acetabular dysplasia (Severin classification Grade IVb). Preoperatively, all patients had hip pain, and sufficient hip joint congruency on functional radiographs. All 20 hips underwent Bernese periacetabular osteotomy. Postoperatively, the hips were assessed radiographically on center edge angle (CE), acetabular roof obliquity and the progression of osteoarthritis. Clinical results and hip function were measured with the Harris hip score at an average of 6.2 years follow-up. Comparison of preoperative and follow-up radiographs demonstrated significant improvements in the lateral CE angle, the anterior CE angle, and roof obliquity. The average Harris hip score improved from 78.5 points preoperatively to 91.1 points at the time of the latest follow-up. Fourteen of 18 patients were satisfied with the result of the surgery, and 16 of 20 hips had a good or excellent clinical result. Under-correction occurred in 5 hips. The Bernese periacetabular osteotomy is an effective procedure for surgical correction of the severe dysplastic hip. This osteotomy can predictably obtain major reorientation of the acetabulum in all planes. The clinical results in the mid-term follow-up are encouraging.

  20. Corrective Osteotomy for Ipsilateral Distal Clavicular and Coracoid Malunions.

    Science.gov (United States)

    Yoshida, Atsushi

    2015-08-01

    Malunion after double disruption injuries of the superior shoulder suspensory complex accompanied by shoulder pain and dysfunction has been reported infrequently. A 37-year-old man had a double disruption injury (fractures of the distal clavicle and the base of the coracoid process). Conservative treatment resulted in malunion. Twelve months after the injury, pain continued in the coracoclavicular interval, and there was only 125° forward shoulder elevation. Radiographs showed 50° inferior angulation of the distal clavicle and elongated base of the coracoid process. Corrective osteotomy was required; however, the concomitant malunion of the coracoid prevented correction of the deformity with osteotomy of the distal clavicle alone. Therefore, osteotomy of the coracoid was performed. Twelve months postoperatively, successful bone union resulted in loss of pain. Forward elevation had recovered to 160°. Distal clavicular fractures with concomitant coracoid fractures are often significantly displaced, which disrupts physiologic coupling of clavicular and scapular motion and limits forward elevation. In the case of such malunions, excessive movement at the clavicle-scapula junction during mobilization causes pain in the coracoclavicular interval. Correction of this deformity requires osteotomy of both the clavicular and coracoid malunions.

  1. Postoperative contamination of mandibular osteotomy sites with saliva

    NARCIS (Netherlands)

    Koole, Ronald; Egyedi, P.

    1987-01-01

    Postoperative salivary contamination of surgical wounds around the mandible was found in several types of osteotomy and bone grafting procedure. This problem was investigated by determining the amylase content of wound secretions in redon bottles every 24h. The implications for antibiotic prophylaxi

  2. Isolated lunotriquetral ligament tears treated with ulnar shortening osteotomy.

    Science.gov (United States)

    Mirza, Ather; Mirza, Justin B; Shin, Alexander Y; Lorenzana, Daniel J; Lee, Brian K; Izzo, Brett

    2013-08-01

    To evaluate outcomes in a single-surgeon series of ulnar shortening osteotomy for the treatment of traumatic isolated tears to the lunotriquetral interosseous ligament (LTIL). This study includes 53 consecutive cases of posttraumatic isolated LTIL tears treated with ulnar shortening osteotomy with minimum 1-year follow-up (range, 1.0-10.6 y). We confirmed all LTIL tears via arthroscopy before performing a precision 2.5-mm oblique osteotomy using a modified Rayhack technique. We assessed outcomes using grip strength measurements and Chun and Palmer's modified Gartland Werley wrist scoring system, which includes subjective and objective outcome measures. Preoperatively, 45 cases were graded as fair (28%; n = 15) or poor (57%; n = 30) on the modified Gartland Werley score. There were insufficient data to calculate grades in 8 cases (15%). At final follow-up, most patients exhibited excellent (51%; n = 27) or good (32%; n = 17) scores, some scored fair (17%; n = 9), and none scored as poor. All subjective and objective variables significantly improved over a mean follow-up of 36 months (range, 12-127 mo). Mean grip strength increased from a value of 23 kg before surgery to 33 kg over the same period, a 41% increase. All patients achieved clinical and radiographic union by 10 months. Osteotomy plates were removed routinely in most cases (89%; n = 47) at a mean of 17 months. Ulnar shortening osteotomy reduced symptoms of posttraumatic isolated LTIL tears in this single-surgeon series. Therapeutic IV. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  3. Comparative analysis of two different alar base sutures after Le Fort I osteotomy: randomized double-blind controlled trial.

    Science.gov (United States)

    Ritto, Fabio G; Medeiros, Paulo José; de Moraes, Márcio; Ribeiro, Danilo Passeado Branco

    2011-02-01

    The aim of this prospective study was to analyze the efficacy of a new alar base cinch suture by comparing it with the commonly used cinch suture described by Schendel and Delaire in Dr. William Bell's book. Thirty-five patients submitted to maxillary impaction and/or advancements of ≥ 3 mm were randomly divided into 2 groups. Group 1 received an extra oral alar base cinch suture, and patients from group 2 received the classic intraoral suture. Alar and alar base width were measured before and after surgery in digital photographs, with the patient's head in a submental oblique view. Data were reported as means and standard deviations, and difference between groups were determined using Welch t test. A P value of alar base widening was 1.38 mm in group 1 and 2.5 mm in group 2, and mean alar widening was 1.40 mm in group 1 and 2.31 mm in group 2. The difference was statistically significant (P alar base cinch suture was more effective in maintaining preoperative Alar and alar base width compared with classic intraoral nasal suture. Copyright © 2011 Mosby, Inc. All rights reserved.

  4. Model surgery technique for Le Fort I osteotomy--alteration in occlusal plane associated with upward transposition of posterior maxilla.

    Science.gov (United States)

    Yosano, Akira; Yamamoto, Masae; Shouno, Takahiro; Shiiki, Sayaka; Hamase, Maki; Kasahara, Kiyohiro; Takaki, Takashi; Takano, Nobuo; Uchiyama, Takeshi; Shibahara, Takahiko

    2005-08-01

    It is difficult to translate analytical values into accurate model surgery by traditional methods, especially when moving the posterior maxilla. This is because cephalometric radiographic analysis generated information on movement of the posterior nasal spine (PNS) can not be recreated in model surgery. Therefore, we propose a method that accurately reflects such analysis and simulation of movement using Quick Ceph 2000 (Orthodontic Processing Corporation, USA). This will allow the enrichment of model surgery prior to actual surgery in cases where upward movement of the posterior maxilla is involved. All patients who participated in this study had skeletal mandibular prognathism characterized by a small occlusal plane angle in respect to the S-N plane. Cephalometric radiographs were taken and analyzed with the Quick Ceph 2000. Pre- and post-surgical evaluations were performed using Sassouni arc analysis and Ricketts analysis. Prior to transposition, we then prepared an anterior occlusal bite record on a model mounted on an articulator. This bite was then used as a reference when the molar parts were to be transposed upwards. The use of a occlusal bite permitted an accurate translation of the preoperative computer simulation into model surgery, thus facilitating favorable surgical results.

  5. Novel TPLO Alignment Jig/Saw Guide Reproduces Freehand and Ideal Osteotomy Positions.

    Science.gov (United States)

    Mariano, Abigail D; Kowaleski, Michael P; Boudrieau, Randy J

    2016-01-01

    To evaluate the ability of an alignment jig/saw guide to reproduce appropriate osteotomy positions in the tibial plateau leveling osteotomy (TPLO) in the dog. Lateral radiographs of 65 clinical TPLO procedures using an alignment jig and freehand osteotomy performed by experienced TPLO surgeons using a 24 mm radial saw blade between Dec 2005-Dec 2007 and Nov 2013-Nov 2015 were reviewed. The freehand osteotomy position was compared to potential osteotomy positions using the alignment jig/saw guide. The proximal and distal jig pin holes on postoperative radiographs were used to align the jig to the bone; saw guide position was selected to most closely match the osteotomy performed. The guide-to-osteotomy fit was categorized by the distance between the actual osteotomy and proposed saw guide osteotomy at its greatest offset (≤1 mm = excellent; ≤2 mm = good; ≤3 mm = satisfactory; >3 mm = poor). Sixty-four of 65 TPLO osteotomies could be matched satisfactorily by the saw guide. Proximal jig pin placement 3-4 mm from the joint surface and pin location in a craniocaudal plane on the proximal tibia were significantly associated with the guide-to-osteotomy fit (P = 0.021 and P = 0.047, respectively). The alignment jig/saw guide can be used to reproduce appropriate freehand osteotomy position for TPLO. Furthermore, an ideal osteotomy position centered on the tibial intercondylar tubercles also is possible. Accurate placement of the proximal jig pin is a crucial step for correct positioning of the saw guide in either instance.

  6. Fort Calhoun puts OPEP in its step

    Energy Technology Data Exchange (ETDEWEB)

    Michal, R.A.

    1995-03-01

    This article is a review of a corrective action program at Omaha Public Power District`s Fort Calhoun Station. As a result of repeated problems in operator performance and the ensuing enforcement action, Ft. Calhoun personnel developed the Operations Performance Enhancement Program. OPEP development, general content and layout, and Program maintenance were discussed. The result is a program developed by operators for operators.

  7. Distal femoral varus osteotomy: problems associated with the lateral open-wedge technique.

    Science.gov (United States)

    Jacobi, Matthias; Wahl, Peter; Bouaicha, Samy; Jakob, Roland P; Gautier, Emanuel

    2011-06-01

    Varisation osteotomies on the distal femur are an established treatment method for valgus osteoarthritis of the knee in younger patients. Osteotomy can be done in a lateral open-wedge or medial closed-wedge manner. We retrospectively studied 14 patients treated by the lateral open-wedge technique, fixed with the Tomofix plate, with a mean duration of follow-up of 45 ± 3.4 months. We observed often delayed osteotomy healing after 3, 6 and 12 months, no secondary dislocations, and frequent troublesome irritation due to the plate being on the iliotibial band. However, outcome was satisfactory once the osteotomy healed and the plate was removed. Based on the often slow healing of the osteotomy and frequent irritation due to the plate, this procedure has been abandoned by the authors, and the medial closing-wedge osteotomy adopted as the alternative treatment.

  8. Curved Periacetabular Osteotomy for the Treatment of Dysplastic Hips

    Science.gov (United States)

    Nakamura, Yoshinari

    2014-01-01

    Curved periacetabular osteotomy (CPO) was developed for the treatment of dysplastic hips in 1995. In CPO, the exposure of osteotomy sites and osteotomy of the ischium are made in the same manner as Bernese periacetabular osteotomy, and iliac and pubic osteotomies are performed in the same manner as rotational acetabular osteotomy. We studied the dynamic instabilities of 25 dysplastic hips before and after CPO using triaxial accelerometry. Overall magnitude of acceleration was significantly decreased from 2.30 ± 0.57 m/sec2 preoperatively to 1.55 ± 0.31 m/sec2 postoperatively. Pain relief and improvement of acetabular coverage resulting from acetabular reorientation seem to be related with reduction of dynamic instabilities of dysplastic hips. Isokinetic muscle strengths of 24 hips in 22 patients were measured preoperatively and after CPO. At 12 months postoperatively, the mean muscle strength exceeded the preoperative values. These results seem to be obtained due to no dissection of abductor muscles in CPO. The preoperative presence of acetabular cysts did not influence the results of CPO. An adequate rotation of the acetabular fragment induced cyst remodeling. Satisfactory results were obtained clinically and radiographically after CPO in patients aged 50 years or older. CPO alone for the treatment of severe dysplastic hips classified as subluxated hips of Severin group IV-b with preoperative CE angles of up to -20° could restore the acetabular coverage, weight-bearing area and medialization of the hip joint. CPO without any other combined procedure, as a treatment for 17 hips in 16 patients with Perthes-like deformities, produced good mid-term clinical and radiographic results. We have been performing CPO in conjunction with osteochondroplasty for the treatment of acatabular dysplasia associated with femoroacetabular impingement since 2006. The combined procedure has been providing effective correction of both acetabular dysplasia and associated femoral head

  9. Safety of modified Stoppa approach for Ganz periacetabular osteotomy: A preliminary cadaveric study.

    Science.gov (United States)

    Elmadağ, Mehmet; Uzer, Gökçer; Yıldız, Fatih; Ceylan, Hasan H; Acar, Mehmet A

    2016-08-01

    The aim of this cadaveric study was to investigate the efficacy of the modified Stoppa approach in Ganz periacetabular osteotomy (PAO). The Ganz PAO was performed on 10 hemipelvises with normal hips, from 5 cadavers using the modified Stoppa approach through the Pfannenstiel incision. All of the osteotomies were performed under fluoroscopic control and direct visualizing the osteotomy site from the same incision. After the osteotomy, the acetabulum was medialized and redirected anterolaterally, and fixed with 2 screws. The neurovascular structures and the joints were examined by dissecting the soft tissues after fixation of the osteotomies. Outcome parameters were center-edge (CE) angle, the distances between the osteotomy and anterior superior iliac spine (ASIS), and between the osteotomy and the sciatic notch, neurovascular and joint penetrations. After the osteotomy, the mean CE angle was improved from 19.8° to 25.2°, mean distance between the osteotomy and ASIS was 3.1 cm, and the mean distance between the osteotomy and the sciatic notch was 10.2 mm. The neurovascular structures and the joints were examined by dissecting the soft tissues after fixation of the osteotomies. No damage to the joint, surrounding arteries, veins or nerves was detected in any of the cadavers. Bilateral dysplastic hips can be treated with a 10 cm, cosmetically more acceptable incision in the same session using this approach. Quadrilateral surface of the acetabulum can be directly seen using this approach and the osteotomy can be safely performed. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  10. Role of computer-assisted surgery in osteotomies around the knee.

    Science.gov (United States)

    Saragaglia, D; Chedal-Bornu, B; Rouchy, R C; Rubens-Duval, B; Mader, R; Pailhé, R

    2016-11-01

    The goal of this article is to present our experience on navigation for osteotomies around the knee and especially osteotomies for coronal deformities. The first computer-assisted osteotomy was performed in March 2001 and since that time more than 1000 osteotomies have been performed in our department. All the osteotomies were performed with the Orthopilot(®) device (B-Braun-Aesculap, Tuttlingen, Germany). The main indication was for genu varum deformities but several cases were operated for genu valgum. The surgical procedure as well as the indications and the rationale for each osteotomy (high tibial osteotomy-HTO, double-level osteotomy-DLO, femoral osteotomy-FO) are addressed in the article. The results are focused on several papers published by the authors since more than 10 years. Regarding HTO for genu varum, the preoperative goal (HKA angle: 184° ± 2°) was reached in 96 % of cases and the difference was statistically significant compared to the non-navigated series (71 %: p genu varum, the preoperative goal was reached in 92.7 % for the HKA angle and in 88.1 % for the medial proximal tibial mechanical angle (MPTMA). Regarding genu valgum deformity, the preoperative goal was achieved in 86.2 % of cases for the HKA angle and 100 % of cases for the MPTMA. According to these results, one can say that, regardless the type of osteotomy, the procedure is reliable, reproducible and accurate. Since 15 years, all the osteotomies around the knee are navigated in our department. Provided that one uses a reproducible radiograph protocol, navigation allows to perform double-level osteotomies, both for genu varum and genu valgum, with optimal accuracy in order to avoid oblique joint line, which will be difficult to revise to TKA. IV.

  11. PELVIC OSTEOTOMY IN THE COMPLEX TREATMENT OF CHILDREN WITH LEGG-CALVE-PERTHES DISEASE

    OpenAIRE

    Дмитрий Борисович Барсуков; Михаил Михайлович Камоско

    2014-01-01

    At the Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner we analyzed survey data of 120 patients aged from 6 to 14 years old with Legg-Calve-Perthes disease with severe epiphysis deformation, in order to improve the outcomes. All patients underwent reconstructive (remodeling) surgery - a corrective hip osteotomy, a pelvic osteotomy by Salter, a combination of these techniques and a triple pelvic osteotomy. Postoperative follow-up period averaged 10 years. It is s...

  12. Modified retro-tubercle opening-wedge versus conventional high tibial osteotomy.

    Science.gov (United States)

    Keyhani, Sohrab; Abbasian, Mohammad Reza; Kazemi, Seyed Morteza; Esmailiejah, Ali Akbar; Seyed Hosseinzadeh, Hamid Reza; Shahi, Alisina; Shahi, Ali Sina; Firouzi, Farzad

    2011-01-01

    Despite the fact that common surgical techniques for the treatment of genu varum usually correct the malalignment in the affected knee, these methods have significant complications and cause problems in the long term. Retro-tubercle opening-wedge high tibial osteotomy is among the newer techniques for the treatment of genu varum. The goal of this study was to compare the results of retro-tubercle opening-wedge high tibial osteotomy with those of medial opening-wedge osteotomy. In a randomized, controlled trial, 72 patients with varus knees who were scheduled for surgery were assigned into either the retro-tubercle opening-wedge high tibial osteotomy (n=34) or medial opening-wedge osteotomy groups (n=38). Groups were matched for age and sex. The position of the patella was compared with respect to the tuberosity and the upper tibial slope pre- and postoperatively. Patients were followed for an average of 13 months (range, 10-21 months). In the retro-tubercle opening-wedge high tibial osteotomy group, the length of the patellar tendon did not significantly differ pre- and postoperatively (P≥.5); however, in the medial opening-wedge osteotomy group, a statistically significant shortening was noted in patellar tendon postoperatively (P≤.05). Similarly, the tibial plateau inclination showed a statistically significant difference postoperatively in the medial opening-wedge osteotomy group, while the difference in the retro-tubercle opening-wedge high tibial osteotomy group did not reach statistical significance.

  13. Trochanteric osteotomy in total hip replacement for congenital hip disease.

    Science.gov (United States)

    Hartofilakidis, G; Babis, G C; Georgiades, G; Kourlaba, G

    2011-05-01

    We studied the effect of trochanteric osteotomy in 192 total hip replacements in 140 patients with congenital hip disease. There was bony union in 158 hips (82%), fibrous union in 29 (15%) and nonunion in five (3%). The rate of union had a statistically significant relationship with the position of reattachment of the trochanter, which depended greatly on the pre-operative diagnosis. The pre-operative Trendelenburg gait substantially improved in all three disease types (dysplasia, low and high dislocation) and all four categories of reattachment position. A persistent Trendelenburg gait post-operatively was noticed mostly in patients with defective union (fibrous or nonunion). Acetabular and femoral loosening had a statistically significant relationship with defective union and the position of reattachment of the trochanter. These results suggest that the complications of trochanteric osteotomy in total hip replacement for patients with congenital hip disease are less important than the benefits of this surgical approach.

  14. Roentgen stereogrammetry in high tibial osteotomy for gonarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Tjoernstrand, B.; Selvik, G.; Egund, N.; Lingstrand, A.

    1981-01-01

    In three cases operated with high tibial osteotomy for medial gonarthrosis the exact method of roentgen stereophotogrammetry with tantalum balls as bone markers was used to study angular and translational movements in three dimensions at the operation and during the healing period. Tibial osteotomy caused angular and translational movements even in planes where correction was not intended, and the stereo technique revealed that stability was not present when knee mobilisation started. Correlation between the stereo values and conventional radiographic measurements were best in the frontal plane (root mean square value of discrepancies 1.3/sup 0/). Roentgen stereophotogrammetry gives superior information compared with the conventional radiographic technique, but it is concluded that the latter has sufficient accuracy for the clinical assessment of corrections in the frontal plane.

  15. Extended trochanteric osteotomy: planning, surgical technique, and pitfalls.

    Science.gov (United States)

    Meek, R M; Greidanus, Nelson V; Garbuz, Donald S; Masri, Bassam A; Duncan, Clive P

    2004-01-01

    The extended trochanteric osteotomy is appropriate for a number of surgical indications. It facilitates removal of well-fixed cement mantles with a loose or well-fixed stem and of extensively porous-coated or tapered cementless stems. This exposure is particularly valuable in the presence of varus remodeling of the proximal femur, permitting correction of proximal femoral deformity and reducing the risk of fracture of the greater trochanter. It is also indicated in the removal of a well-fixed cemented stem that is complicated by infection, where it is vital to extract all foreign material for successful eradication of the infection. In addition, when the osteotomy is required for femoral exposure, it enhances acetabular exposure to allow even the most complex reconstruction. Also, as the soft-tissue attachments to the bone fragment are preserved in this approach, abductor muscle tension can be adjusted.

  16. Varus distal femoral osteotomy in young adults with valgus knee

    Science.gov (United States)

    Omidi-Kashani, Farzad; Hasankhani, Ibrahim G; Mazlumi, Mahdi; Ebrahimzadeh, Mohamad H

    2009-01-01

    Background Musculoskeletal disorders specially knee osteoarthritis are the most common causes of morbidity in old patients. Disturbance of the mechanical axis of the lower extremity is one of the most important causes in progression of knee osteoarthritis. The purpose of the present study was to analyze the surgical results of distal femoral varus osteotomy in patients with genu valgum. Methods In this study, after recording history and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by standard medial subvastus approach and 90-angle blade plate fixation then followed the patients clinically and radiographically. Results This study was done on 23 knees (16 patients) age 23.3 years (range, 17 to 41 years). The mean duration of following up was 16.3 months (range, 8 to 25 months). Based on paired T test, there were statistically significant difference between pre- and postoperative tibiofemoral and congruence angles (p genu valgum correction, the patella should be stabilized simultaneously. PMID:19435527

  17. Piezosurgical osteotomy for harvesting intraoral block bone graft

    Directory of Open Access Journals (Sweden)

    Mahalingam Lakshmiganthan

    2012-01-01

    Full Text Available The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient′s psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device.

  18. Effect of osteotomies during rhinoplasty on intraocular pressure

    Directory of Open Access Journals (Sweden)

    Amr N. Rabie

    2016-07-01

    Full Text Available Objective: To investigate whether rhinoplasty with osteotomies for the treatment of deformed nose induces changes in intraocular pressure (IOP. Design: Prospective, nonrandomized study. Setting: University-affiliated medical center. Patients: Thirty patients who underwent rhinoplasty with osteotomies for the nose were prospectively enrolled in this study. Fifteen patients had lateral osteotomies with the external perforating technique, and fifteen with an internal continuous technique with periosteal elevation. We excluded patients with diabetes mellitus, hypertension, glaucoma, previous ocular trauma, history of ocular surgery, and previous use of topical corticosteroid eye drops. Main outcome measures: The intraocular pressure (IOP in each patient was measured by Goldmann tonometry preoperatively and postoperatively on days 1, 2, and 7. Results: 23 women and 7 men with a mean age of 27 years were enrolled in the study. The mean ± SD IOP of the eye was 15.69 ± 2.37 mmHg preoperatively. Postoperatively, the mean ± SD IOPs were 15.96 ± 1.92 mmHg on day 1, 15.45 ± 2.55 mmHg on day 2, and 15.72 ± 2.86 mmHg on day 7 (P = .863. Conclusions: Although osteotomes during rhinoplasty caused variations in the IOP compartment, the changes in IOP were not statistically significant. Therefore, rhinoplasty should be a safe surgical procedure with respect to ocular physiological function, however monitoring IOP peri-operatively is advised. To our best knowledge, this is the first clinical trial to determine the effect of rhinoplasty with osteotomy on intraocular pressure.

  19. Successful Return to Sport Following Distal Femoral Varus Osteotomy

    Science.gov (United States)

    Voleti, Pramod Babu; Degen, Ryan; Tetreault, Danielle; Krych, Aaron John; Williams, Riley J.

    2016-01-01

    Objectives: Distal femoral varus osteotomy is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and return to sport for athletic patients that underwent distal femoral varus osteotomy. Methods: A consecutive series of athletic patients that had undergone distal femoral varus osteotomy for symptomatic lateral compartment overload and valgus knee malalignment were prospectively reviewed. All patients had a minimum of 2-year follow-up. Radiographs were assessed to determine pre-operative and post-operative alignment. Details regarding sport of interest, ability to return to sport, and timing of return were obtained from the patients. Prospective institutional registries were utilized to collect pre-operative and post-operative Marx Activity Scale and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) scores; these values were compared using paired t-tests with p allografts, 2 partial lateral meniscectomies, 1 lateral meniscus allograft transplantation, and 1 revision anterior cruciate ligament reconstruction. All patients were able to successfully return to their sport of choice (4 soccer, 2 softball, 2 running, 1 football, 1 basketball, 1 ice hockey, 1 volleyball, 1 rowing) at a mean of 11 months (range: 9-13). Furthermore, all 13 patients demonstrated an improvement in both Marx Activity Scale and IKDC scores after surgery. The mean improvement in Marx Activity Scale was 7 (mean pre-op: 4, mean post-op: 11, p ligamentous pathology is addressed. Therefore, distal femoral varus osteotomy should be considered in the athletic population for correction of symptomatic valgus knee malalignment.

  20. Surgical Outcome of Acetabular Fracture Using Trochanteric Flip Osteotomy

    Directory of Open Access Journals (Sweden)

    Espandar R

    2012-01-01

    Full Text Available Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy. Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS, Harris hip score (HHS, force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.Results : The mean HHS was 82.5 (55-95. Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or nonunion. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

  1. Bone changes after bilateral sagittal split osteotomy for mandibular prognathism

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Jung; Jung, Yun Hoa; Cho, Bong Hae [Pusan National Univ. Collefe of Dentistry, Pusan (Korea, Republic of)

    2006-12-15

    The purpose of this research was to study bone changes after bilateral sagittal split osteotomy through fractal analysis and measurement of mandibular cortical thickness. This study included twenty-two prognathic patients who underwent bilateral sagittal split osteotomy. Panoramic radiographs of these patients were taken immediately before operation and at 1 month, 6 months, and 12 months postoperatively. The fractal dimension was measured by the box-counting method in the region of interest centered on both the basal and interdental bones between the first and second mandibular molars. Measurements of mandibular cortical thickness were taken both in the area between the first and second mandibular molars and at the osteotomy site. Changes of fractal dimension and cortical thickness over four stages were statistically analyzed. The fractal dimension of the mandibular basal bone before surgery and after 1 month, 6 months and 12 months were 1.4099{+-}0.0657, 1.382{+-}0.0595, 1.2995{+-}0.0949, and 1.4166{+-}0.0676. respectively (Repeated-measures ANOVA, P<0.001). However, no statistically significant differences were noted in interdental fractal dimensions among the four stages. Mandibular cortical thickness between the first and second mandibular molars before operation and after 1 month, 6 months and 12 months was 3.74{+-}0.48 mm. 3.63{+-}0.47 mm. 3.41{+-}0.61 mm and 3.55{+-}0.66 mm (P<0.01), respectively. Mandibular cortical thickness at the osteotomy site at each of the four stages was 3.22{+-}0.44 mm, 2.87{+-}0.59 mm, 2.37{+-}0.61 mm and 2.64{+-}0.62 mm, respectively (P<0.001). This study suggests that the mandibular tissue continued decreasing for 6 months postoperatively and then increased over the subsequent 6 months.

  2. Factors That Predict Blood Loss After Bernese Periacetabular Osteotomy.

    Science.gov (United States)

    Novais, Eduardo N; Carry, Patrick M; Kestel, Lauryn A; Koerner, Jason; Tan, Gee Mei

    2016-11-01

    Although strategies to reduce bleeding and avoid allogeneic transfusion have been described, there is controversy about the factors associated with blood loss after Bernese periacetabular osteotomy. This study was conducted to determine risk factors for postoperative blood loss. After institutional review board approval was obtained, a retrospective review was conducted of 41 young patients who underwent periacetabular osteotomy for symptomatic acetabular dysplasia over a 3-year period. Of these patients, two-thirds donated blood before surgery. A Cell Saver Elite autotransfusion system (Haemonetics, Braintree, Massachusetts) was used intraoperatively in all cases. Hemoglobin and hematocrit were obtained before surgery and during the hospital stay. The primary outcome variable was the percentage of total blood volume lost during surgery. Univariate analysis was performed to test the association between potential predictors of blood volume loss. Candidate variables that were significant at alpha=0.15 were tested with multivariate analysis. The average percentage of blood volume lost during surgery was 30.3% (95% confidence interval, 25.1%-35.5%). Univariate analysis showed that operative time, arthrotomy, femoral head-neck osteochondroplasty, labral procedure, male sex, and age were prognostic factors associated with increased blood volume loss. However, operative time (average, 294.6 minutes; range, 204-444 minutes) was the only independent predictor of increased blood loss in the final model. Additional procedures, such as femoral head-neck osteochondroplasty and labral repair or debridement performed through an anterior hip arthrotomy at the time of periacetabular osteotomy, were associated with increased operative time. The findings suggest that all patients undergoing periacetabular osteotomy, including those having concomitant procedures, may benefit from pre- and intraoperative strategies to conserve blood and avoid allogeneic transfusion. [Orthopedics. 2016

  3. Risk factors affecting somatosensory function after sagittal split osteotomy

    DEFF Research Database (Denmark)

    Thygesen, Torben Henrik; Jensen, Allan Bardow; Helleberg, M;

    2008-01-01

    Purpose The aim of this study was to evaluate potential individual and intraoperative risk factors associated with bilateral sagittal split osteotomy (BSSO) and to correlate the findings with postoperative changes in somatosensory function. Patients and Methods A total of 18 men and 29 women (mean...... and free dissection of the inferior alveolar nerve during BSSO increased self-reported changes in lower lip sensation and lower lip tactile threshold after BSSO (P discrimination (P

  4. Available Conservation Research for Fort Bliss

    Science.gov (United States)

    2005-11-01

    model to a training area landscape at Fort Bliss… Couvillion (1980) Survey for antibodies to viruses of bovine virus diarrhea, bluetongue and...simulated time of arrival of landfill … ⌧ Fuchs (1997) Sediment removal by water following mechanical surface disturbance on… Gallacher (1991...Survey for antibodies to viruses of bovine virus diarrhea, bluetongue and epizootic hemorrhagic disease in hunter-killer mule deer (Odicoileus hemionus

  5. Fort Bragg Embraces Groundbreaking Heat Pump Technology

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-03-01

    The U.S. Army’s Fort Bragg partnered with the Department of Energy (DOE) to develop and implement solutions to build new, low-energy buildings that are at least 50% below Standard 90.1-2007 of the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), the American National Standards Institute (ANSI), and the Illuminating Engineering Society of North America (IESNA) as part of DOE’s Commercial Building Partnerships (CBP) Program.

  6. Fort Hood: Home of the Third Corps

    Science.gov (United States)

    1989-01-01

    painted with camoflauge I LS- HOWITZER FIRING The white flash of the weapon firing is seen as the weapon is enveloped in smoke MS- SOLDIER JUMPING MS...HELICOPTER FIRING FORT HOOD WAS NAMED FOR GENERAL JOHN BELL HOOD THE FAMOUS CONFEDERATE A painting of Gen Hood, after whom GENERAL JOHN BELL HOOD, the post was...EXT. OF DARNALL HOSPITAL PROVIDED BY DARNALL ARMY 78 VIDEO AUDIO COMMUNITY HOSPITAL, MS- PATIENT GOING THROUGH XRAY ONE OFTHE BEST EQUIPPED AND MOST

  7. Hazardous Waste Minimization Assessment: Fort Meade, MD

    Science.gov (United States)

    1991-01-01

    Eliminate Generation Reduce Generation RUSand ROCOVerY Treatment FRjiue Disposal FIgure 1. Wadte IAIikaflon hierarchy. 21 ar= z = OPZPATIO PRAwcgCS 0 waSt...evaluation o eonomic evalu~ationt a *eLeCt options fox Z ~mleatatiaa Figmr 4. Hawadous waie inniizadion amnen and feadblty analysis procedure 25 3 FORT MEADE...Waste Generation at FORSCOM Installations’ Quam4ty of Wmt Quanity of Wast Quantity of Wow Geerated Generated Osae Generated Of ske Imtallatoe (metri

  8. Renewable Energy Opportunities at Fort Hood, Texas

    Energy Technology Data Exchange (ETDEWEB)

    Chvala, William D.; Warwick, William M.; Dixon, Douglas R.; Solana, Amy E.; Weimar, Mark R.; States, Jennifer C.; Reilly, Raymond W.

    2008-06-30

    The document provides an overview of renewable resource potential at Fort Hood based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 DoD Renewables Assessment. This effort focuses on grid-connected generation of electricity from renewable energy sources and also ground source heat pumps for heating and cooling buildings, as directed by IMCOM.

  9. Fortælleværksteder

    DEFF Research Database (Denmark)

    Krøjer, Jo; Hutters, Camilla

    2009-01-01

    Unges valg af videregående uddannelse er omgærdet af forventninger. Forventninger til hvad man skal vælge. Forventninger til hvor lang tid, man skal være om at tage en uddannelse. Og forventninger til, hvad uddannelsen skal føre til. Artiklen præsenterer fortælleværkstedet, en metode til kollekti...

  10. Mean 20-year followup of Bernese periacetabular osteotomy.

    Science.gov (United States)

    Steppacher, Simon D; Tannast, Moritz; Ganz, Reinhold; Siebenrock, Klaus A

    2008-07-01

    The goal of the Bernese periacetabular osteotomy is to correct the deficient acetabular coverage in hips with developmental dysplasia to prevent secondary osteoarthrosis. We determined the 20-year survivorship of symptomatic patients treated with this procedure, determined the clinical and radiographic outcomes of the surviving hips, and identified factors predicting poor outcome. We retrospectively evaluated the first 63 patients (75 hips) who underwent periacetabular osteotomy at the institution where this technique was developed. The mean age of the patients at surgery was 29 years (range, 13-56 years), and preoperatively 24% presented with advanced grades of osteoarthritis. Four patients (five hips) were lost to followup and one patient (two hips) died. The remaining 58 patients (68 hips) were followed for a minimum of 19 years (mean, 20.4 years; range, 19-23 years) and 41 hips (60%) were preserved at last followup. The overall mean Merle d'Aubigné and Postel score decreased in comparison to the 10-year value and was similar to the preoperative score. We observed no major changes in any of the radiographic parameters during the 20-year postoperative period except the osteoarthritis score. We identified six factors predicting poor outcome: age at surgery, preoperative Merle d'Aubigné and Postel score, positive anterior impingement test, limp, osteoarthrosis grade, and the postoperative extrusion index. Periacetabular osteotomy is an effective technique for treating symptomatic developmental dysplasia of the hip and can maintain the natural hip at least 19 years in selected patients. Level III, prognostic study.

  11. Varus distal femoral osteotomy in young adults with valgus knee

    Directory of Open Access Journals (Sweden)

    Mazlumi Mahdi

    2009-05-01

    Full Text Available Abstract Background Musculoskeletal disorders specially knee osteoarthritis are the most common causes of morbidity in old patients. Disturbance of the mechanical axis of the lower extremity is one of the most important causes in progression of knee osteoarthritis. The purpose of the present study was to analyze the surgical results of distal femoral varus osteotomy in patients with genu valgum. Methods In this study, after recording history and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by standard medial subvastus approach and 90-angle blade plate fixation then followed the patients clinically and radiographically. Results This study was done on 23 knees (16 patients age 23.3 years (range, 17 to 41 years. The mean duration of following up was 16.3 months (range, 8 to 25 months. Based on paired T test, there were statistically significant difference between pre- and postoperative tibiofemoral and congruence angles (p Conclusion Distal femoral varus osteotomy with blade plate fixation can be a reliable procedure for the treatment of valgus knee deformity. In this procedure, with more tibiofemoral angle correction, more congruence angle correction can be achieved. Therefore, along with genu valgum correction, the patella should be stabilized simultaneously.

  12. Total knee arthroplasty after failed high tibial osteotomy: a systematic review of open versus closed wedge osteotomy.

    Science.gov (United States)

    Han, Jae Hwi; Yang, Jae-Hyuk; Bhandare, Nikhl N; Suh, Dong Won; Lee, Jong Seong; Chang, Yong Suk; Yeom, Ji Woong; Nha, Kyung Wook

    2016-08-01

    Medial opening wedge high tibial osteotomy (HTO) has become increasingly popular as an alternative to lateral closing wedge osteotomy for the treatment of medial compartment knee osteoarthritis with varus deformity. The present systematic review was conducted to provide an objective analysis of total knee arthroplasty (TKA) outcomes following previous knee osteotomy (medial opening wedge vs. lateral closing wedge). A literature search of online databases (MEDLINE, EMBASE, Cochrane Library database) was made, in addition to manual search of major orthopaedic journals. The methodological quality of each of the studies was assessed on the Newcastle-Ottawa Scale and Effective Practice and Organization of Care. A total of ten studies were included in the review. There were eight studies with Level IV and two studies with Level III evidence. Eight studies reported clinical and radiologic scores. Comparative studies between TKA following medial opening and lateral closing wedge HTO did not demonstrate statistically significant clinical and radiologic differences. The revision rates were similar. However, more technical issues during TKA surgery after lateral closing wedge HTO were mentioned than the medial open wedge group. The quadriceps snip, tibial tubercle osteotomy, and lateral soft tissue release were more frequently needed in the lateral closing wedge HTO group. In addition, because of loss of proximal tibia bone geometry in the lateral closing wedge HTO group, concerns such as tibia stem impingement in the lateral tibial cortex was noted. The present systematic review suggests that TKA after medial opening and lateral closing wedge HTO showed similar performance. Clinical and radiologic outcome including revision rates did not statistically differ from included studies. However, there are more surgical technical concerns in TKA conversion from lateral closing wedge HTO than from the medial opening wedge HTO group. IV.

  13. Skeletal Stability after Large Mandibular Advancement (> 10 mm with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

    Directory of Open Access Journals (Sweden)

    Kristoffer Schwartz

    2016-06-01

    Full Text Available Objectives: The aim of the present study was to assess the skeletal stability after large mandibular advancement (> 10 mm with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation and to correlate the skeletal stability with the vertical facial type. Material and Methods: A total of 33 consecutive patients underwent bimaxillary surgery to correct skeletal Class II malocclusion with a mandibular advancement (> 10 mm measured at B-point and postoperative skeletal elastic intermaxillary fixation for 16 weeks. Skeletal stability was evaluated using lateral cephalometric radiographs obtained preoperative (T1, 8 weeks postoperatively (T2, and 18 month postoperatively (T3. B-point and pogonion (Pog was used to measure the skeletal relapse and the mandibular plane angle (MP-angle was used to determine the vertical facial type. Results: The mean advancement from T1 to T2 were 11.6 mm and 13.5 mm at B-point and Pog, respectively. The mean skeletal relapse from T2 to T3 was -1.3 mm at B-point and -1.6 mm at Pog. The nineteen patients characterized as long facial types, showed the highest amount of skeletal relapse (-1.5 mm at B-point and -1.9 mm at Pog. Conclusions: The present study showed a limited amount of skeletal relapse in large mandibular advancement (> 10 mm with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation. Bilateral sagittal split osteotomy in combination with skeletal intermaxillary fixation can therefore be an alternative to distraction osteogenesis in large mandibular advancements.

  14. Skeletal Stability after Large Mandibular Advancement (> 10 mm) with Bilateral Sagittal Split Osteotomy and Skeletal Elastic Intermaxillary Fixation

    Science.gov (United States)

    Rodrigo-Domingo, Maria; Jensen, Thomas

    2016-01-01

    ABSTRACT Objectives The aim of the present study was to assess the skeletal stability after large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation and to correlate the skeletal stability with the vertical facial type. Material and Methods A total of 33 consecutive patients underwent bimaxillary surgery to correct skeletal Class II malocclusion with a mandibular advancement (> 10 mm) measured at B-point and postoperative skeletal elastic intermaxillary fixation for 16 weeks. Skeletal stability was evaluated using lateral cephalometric radiographs obtained preoperative (T1), 8 weeks postoperatively (T2), and 18 month postoperatively (T3). B-point and pogonion (Pog) was used to measure the skeletal relapse and the mandibular plane angle (MP-angle) was used to determine the vertical facial type. Results The mean advancement from T1 to T2 were 11.6 mm and 13.5 mm at B-point and Pog, respectively. The mean skeletal relapse from T2 to T3 was -1.3 mm at B-point and -1.6 mm at Pog. The nineteen patients characterized as long facial types, showed the highest amount of skeletal relapse (-1.5 mm at B-point and -1.9 mm at Pog). Conclusions The present study showed a limited amount of skeletal relapse in large mandibular advancement (> 10 mm) with bilateral sagittal split osteotomy and skeletal elastic intermaxillary fixation. Bilateral sagittal split osteotomy in combination with skeletal intermaxillary fixation can therefore be an alternative to distraction osteogenesis in large mandibular advancements. PMID:27489609

  15. Open-wedge high tibial osteotomy: incidence of lateral cortex fractures and influence of fixation device on osteotomy healing.

    Science.gov (United States)

    Dexel, Julian; Fritzsche, Hagen; Beyer, Franziska; Harman, Melinda K; Lützner, Jörg

    2017-03-01

    Open-wedge high tibial osteotomy (HTO) is an established treatment for young and middle-aged patients with medial compartment knee osteoarthritis and varus malalignment. Although not intended, a lateral cortex fracture might occur during this procedure. Different fixation devices are available to repair such fractures. This study was performed to evaluate osteotomy healing after fixation with two different locking plates. Sixty-nine medial open-wedge HTO without bone grafting were followed until osteotomy healing. In patients with an intact lateral hinge, no problems were noted with either locking plate. A fracture of the lateral cortex occurred in 21 patients (30.4 %). In ten patients, the fracture was not recognized during surgery but was visible on the radiographs at the 6-week follow-up. Lateral cortex fracture resulted in non-union with the need for surgical treatment in three out of eight (37.5 %) patients using the newly introduced locking plate (Position HTO Maxi Plate), while this did not occur with a well-established locking plate (TomoFix) (0 out of 13, p = 0.023). With regard to other adverse events, no differences between both implants were observed. In cases of lateral cortex fracture, fixation with a smaller locking plate resulted in a relevant number of non-unions. Therefore, it is recommended that bone grafting, another fixation system, or an additional lateral fixation should be used in cases with lateral cortex fracture. III.

  16. CSU solar house II, Fort Collins, Colorado, USA

    Energy Technology Data Exchange (ETDEWEB)

    Loef, G.

    1999-07-01

    This middle-sized single-family house, with its type 1 solar air system, has been in operation for almost a quarter of a century. The system consists of factory-built collectors, site-built rock-bed heat storage, an electric heat-pump for auxiliary heating and fully automatic temperature controls. Extensive measuring and testing facilities were provided for continuous monitoring of all energy sources and uses. The solar air system meets about three quarters of the annual heat requirements of the building. (author)

  17. The influence of foot geometry on the calcaneal osteotomy angle based on two-dimensional static force analyses

    NARCIS (Netherlands)

    Reilingh, M.L.; Tuijthof, G.J.M.; Van Dijk, C.N.; Blankevoort, L.

    2011-01-01

    Background: Malalignment of the hindfoot can be corrected with a calcaneal osteotomy (CO). A well-selected osteotomy angle in the sagittal plane will reduce the shear force in the osteotomy plane while walking. The purpose was to determine the presence of a relationship between the foot geometry and

  18. Effect of the high femoral osteotomy upon the vascularity and blood supply of the hip joint

    Energy Technology Data Exchange (ETDEWEB)

    Day, B.; Shim, S.S.; Leung, G.

    1984-05-01

    This investigation was done to study the effects of high femoral osteotomy upon the vascularity and blood supply of the hip and to further our knowledge of its physiologic basis. We have used established methods of study, including bone scans, microangiography, isotope clearance and perosseous venography, and based upon the results of these studies, we have reached certain conclusions. First, high femoral osteotomy increases the blood flow and vascularity in the hip joint, the femoral head and neck and the great trochanter. Second, bone scanning techniques using /sup 99m/Tc labeled diphosphonate have shown increased uptake in the femoral head and neck after high femoral osteotomy. The localization was done using a Digital Gamma III computer, and the activity on the osteotomy side at two weeks was 3.5 times as great as on the control side. By 16 weeks postoperatively, there was still two times as much activity on the osteotomy side. Third, microangiography showed increased vascularity both at the osteotomy site and in the femoral head and neck and the greater trochanter on that side. Such an increase in vascularity first became evident two weeks after osteotomy and persisted during the four month period studied. Fourth, the results of the /sup 99m/Tc diphosphonate clearance study showed a 25 per cent increase in femoral head blood flow on the operative side. Fifth, perosseous venography of the femoral head and neck showed a marked increase in venous drainage through the osteotomy site in the immediate postosteotomy stage.

  19. Reducing the risk of nerve injury during Bernese periacetabular osteotomy: a cadaveric study.

    Science.gov (United States)

    Kalhor, M; Gharehdaghi, J; Schoeniger, R; Ganz, R

    2015-05-01

    The modified Smith-Petersen and Kocher-Langenbeck approaches were used to expose the lateral cutaneous nerve of the thigh and the femoral, obturator and sciatic nerves in order to study the risk of injury to these structures during the dissection, osteotomy, and acetabular reorientation stages of a Bernese peri-acetabular osteotomy. Injury of the lateral cutaneous nerve of thigh was less likely to occur if an osteotomy of the anterior superior iliac spine had been carried out before exposing the hip. The obturator nerve was likely to be injured during unprotected osteotomy of the pubis if the far cortex was penetrated by > 5 mm. This could be avoided by inclining the osteotome 45° medially and performing the osteotomy at least 2 cm medial to the iliopectineal eminence. The sciatic nerve could be injured during the first and last stages of the osteotomy if the osteotome perforated the lateral cortex of ischium and the ilio-ischial junction by > 10 mm. The femoral nerve could be stretched or entrapped during osteotomy of the pubis if there was significant rotational or linear displacement of the acetabulum. Anterior or medial displacement of Bernese peri-acetabular osteotomy. ©2015 The British Editorial Society of Bone & Joint Surgery.

  20. The Bernese peri-acetabular osteotomy through a modified approach. A technical note.

    Science.gov (United States)

    Whittingham-Jones, Paul; Kirit Patel, Nirav; Hashemi-Nejad, Aresh

    2013-03-01

    A modification of the technique for performing the Bernese periacetabular osteotomy is described. A medial approach to the Ischium and a subtle re-orientation of the pubic osteotomy are detailed. Surgical morbidity is likely decreased with a concurrent cosmetic advantage without compromise to surgical correction or patient safety.

  1. Trochanteric osteotomies in revision total hip arthroplasty: contemporary techniques and results.

    Science.gov (United States)

    Jando, Victor T; Greidanus, Nelson V; Masri, Bassam A; Garbuz, Donald S; Duncan, Clive P

    2005-01-01

    Revision total hip arthroplasty (THA) presents several challenges to the orthopaedic surgeon and typically requires the use of a more extensile surgical approach. Osteotomy of the greater trochanter can be considered as the ultimate extensile exposure in revision THA. The methods of trochanteric osteotomy can be categorized into three types: the standard trochanteric osteotomy, the trochanteric slide, and the extended trochanteric osteotomy. Although the standard osteotomy and trochanteric slide osteotomy provide excellent acetabular exposure, in the revision setting they are frequently associated with an unacceptably high rate of nonunion and proximal migration of the trochanteric fragment. The extended trochanteric osteotomy (ETO) has increased in popularity as the number and complexity of revision THAs continue to increase. Two commonly used techniques are the ETO via a posterolateral approach or via a modified direct lateral approach. Both techniques provide wide exposure of the acetabulum, facilitate femoral component exposure and removal, aid in canal preparation and femoral reconstruction, and allow for correction of proximal femoral deformity. The osteotomy fragment is easily secured and may be advanced distally to achieve proper tensioning of the abductors. Recent literature demonstrates that the ETO has a relatively low rate of nonunion and is associated with fewer intraoperative femoral fractures or cortical perforations, as well as decreased surgical time.

  2. Asymmetric osteotomy of the spine for coronal imbalance: a technical report.

    Science.gov (United States)

    Thambiraj, Sathya; Boszczyk, Bronek M

    2012-05-01

    Technical report on the surgical technique of asymmetric osteotomy of the spine for coronal imbalance. To describe a successful method of performing asymmetrical pedicle subtraction osteotomy (APSO) through a posterior only approach. Rigid coronal deformity of the spine can be sharply angulated and can create significant coronal imbalance. Surgical correction is the only definitive treatment of restoring the balance as bracing is unhelpful. Corrective surgery can be anterior or posterior. The literature on the methods of surgical correction of rigid coronal deformities of the spine is limited. Unlike osteotomies for sagittal imbalance, blunt dissection of the anterior cortex is necessary in asymmetrical osteotomy to allow resection of the anterior cortex for closure of the wedge. We describe a method by which we performed this in the thoracic and lumbar spine with case examples. After insertion of pedicle screws, laminectomy and unilateral facetectomy of the proposed level of osteotomy is performed. Next, dissection lateral to the pedicle and vertebral body is performed bluntly with mastoids to reach the front of the anterior cortex and confirmed with fluoroscopy. An oblique osteotomy including the lateral and posterior cortex is performed above and below the pedicle under imaging. The osteotomy site is closed through unilateral compression. Satisfactory correction of coronal deformity can be achieved with APSO from an isolated posterior approach. In contrast to sagittal osteotomies, blunt dissection along the anterior cortex is necessary to allow safe resection of anterior cortical bone for closure of the wedge.

  3. PELVIC OSTEOTOMY IN THE COMPLEX TREATMENT OF CHILDREN WITH LEGG-CALVE-PERTHES DISEASE

    Directory of Open Access Journals (Sweden)

    Дмитрий Борисович Барсуков

    2014-06-01

    Full Text Available At the Scientific and Research Institute for Children’s Orthopedics n. a. G. I. Turner we analyzed survey data of 120 patients aged from 6 to 14 years old with Legg-Calve-Perthes disease with severe epiphysis deformation, in order to improve the outcomes. All patients underwent reconstructive (remodeling surgery - a corrective hip osteotomy, a pelvic osteotomy by Salter, a combination of these techniques and a triple pelvic osteotomy. Postoperative follow-up period averaged 10 years. It is shown that pelvic osteotomy is an operation of choice for Legg-Calve- Perthes disease along with corrective hip osteotomy, and remodeling of the femoral head is only possible when the degree of bone coverage is equal to one or more. We highlighted radioanatomical structure of the affected hip joint, allowing to precise indications for surgical remodeling type of femoral head.

  4. Treatment of a Class II Division 1 malocclusion with a severe unilateral lingual crossbite with combined orthodontic/orthognathic surgery.

    Science.gov (United States)

    Cureton, S L; Bice, R; Strider, J

    2000-06-01

    A 24-year-old woman had a Class II Division 1 malocclusion with a severe unilateral crossbite. The crossbite was due partially to the maxilla being much wider than the mandible, allowing the mandibular left canine and first and second premolars to overerupt, impinging on the palatal tissue in habitual occlusion. The maxillary left segment from the lateral incisor to the first molar also overerupted producing 2 planes of occlusion. The malocclusion was treated successfully with comprehensive orthodontics, combined with a 2 piece Lefort I osteotomy procedure, a 3 tooth mandibular segmental osteotomy procedure, and a bilateral sagittal split osteotomy procedure.

  5. Fort Lincoln School Cost Model and Funding for Comprehensive Plan. Fort Lincoln New Town Education System.

    Science.gov (United States)

    Cohen, Bonnie; And Others

    As part of the overall education plans for Fort Lincoln New Town (FLNT) an automated school cost model was developed. Chapter 1 overviews the FLNT model's features and sets its operational context, while chapter 2 discusses the model in detail. The appendices provide model inputs and cost calculations, names of approximately 500 inputs used in the…

  6. Indledning: Fortælling og fællesskab

    Directory of Open Access Journals (Sweden)

    Marianne Holm Pedersen

    2010-12-01

    Full Text Available Alle mennesker fortæller historier. Hele dagen igennem fortæller vi og lytter tilhinandens historier - fra de små fortællinger over kaffen til de store fortællinger om nationens tilblivelse. Gennem andres fortællinger spejler tilhørerne sig selv og hører om det liv, der venter dem eller andre. De bliver vidne til, hvad der er godt og ondt, vigtigt eller ligegyldigt, og de ser langsomt verden folde sig ud i fælles øjenhøjde. Fortællinger er således tæt knyttet til skabelsen af fællesskaber. Dette nummer af Kulturstudier sætter fokus på sammenhængen mellem fortælling ogfællesskab og vil belyse, hvordan de historier, vi fortæller til os selv og om os selv, er med til at fylde de fællesskaber, som vi alle er en del af. Ved at bruge fortællingen som indgang til studiet af fællesskab kan man få indblik i, hvordan fællesskaber konstitueres, og hvad de konstitueres omkring - fx normer og værdier, rigtigt og forkert, lighed og forskellighed. De fem artikler i dette temanummer lægger vægten forskelligt - nogle fokuserer mere på fortællingen, andre mere påfællesskabet - men de giver fem eksempler på, hvordan fortælling og fællesskab kan forstås i forhold til hinanden.

  7. Trochanteric osteotomy versus posterolateral approach: function the first year post surgery. A pilot study

    Directory of Open Access Journals (Sweden)

    van Biezen Frans C

    2011-06-01

    Full Text Available Abstract Background Although no prospective studies have compared functional results of trochanteric osteotomy and a non-trochanteric approach, most surgeons feel that trochanteric osteotomy is outdated in simple hip arthroplasty. Reasons not to perform an osteotomy include the fear of longer rehabilitation and worse (final functional outcome. Method This prospective study examines differences in rehabilitation between posterolateral and trochanteric approach one year post-surgery using questionnaires (WOMAC, SF-36, HHS and functional tests (walking, climbing stairs, rising from sitting, and strength tests. Of the 109 patients 24 had a trochanteric osteotomy: the selected approach was based on the surgeon's preference. The trochanteric osteotomy group included more patients with developmental dysplasia of the hip. Before the start of the study no power analysis was performed. Results Data from the questionnaires showed no significant differences between the two groups at 3, 6 and 12-months follow-up. At 3-months follow-up patients in the trochanteric osteotomy group scored lower on the functional tests. This difference had disappeared at 6 and 12-months follow-up, except for abduction force which remained lower in the trochanteric osteotomy group in patients with a non union of the TO. Conclusion For simple hip arthroplasty an approach without osteotomy seems a logical choice. Although the power of this study is low, in experienced hands trochanteric osteotomy seems to give good functional results at 6-12 months post surgery if trochanteric union is obtained. Therefore, one should not hesitate to perform an osteotomy in difficult cases.

  8. The use of sternal wedge osteotomy in pectus surgery: when is it necessary?

    Science.gov (United States)

    Kara, Murat; Gundogdu, Ahmet Gokhan; Kadioglu, Salih Zeki; Cayirci, Ertug Can; Taskin, Necati

    2016-09-01

    The Ravitch procedure is a well-established surgical procedure for correction of chest wall deformities. Sternal wedge osteotomy is an important part of this procedure. We studied the incidence of wedge osteotomy with respect to the type of chest wall deformity in patients undergoing surgical correction with the use of a recently developed chest wall stabilization system. A total of 47 patients, 39 (83%) male and 8 (17%) female with a mean age of 14.9 ± 2.1 years, underwent the Ravitch procedure. Twenty-four (51.1%) had pectus carinatum, 19 (40.4%) had pectus excavatum, and 4 (8.5%) had pectus arcuatum. A conventional or oblique sternal wedge osteotomy was performed as indicated, followed by chest wall stabilization using the MedXpert system. Of the 47 patients, 27 (57.4%) had a sternal wedge osteotomy. All cases of pectus arcuatum and redo cases underwent sternal wedge osteotomy. Pectus excavatum cases tended to have a greater incidence of wedge osteotomy compared to pectus carinatum cases (68.4% vs. 41.7%, p = 0.052). Patients with more resected ribs had a greater rate of wedge osteotomy (63.4%) compared to those with fewer resected ribs (16.7%, p = 0.043). A sternal wedge osteotomy is more commonly performed in patients with pectus excavatum compared to those with pectus carinatum. All redo and pectus arcuatum cases need a wedge osteotomy for proper correction. Wedge osteotomy is very likely in more aggressive corrections with more rib resections. © The Author(s) 2016.

  9. Moberg Osteotomy Shifts Contact Pressure Plantarly in the First Metatarsophalangeal Joint in a Biomechanical Model.

    Science.gov (United States)

    Kim, Paul Hyon-Uk; Chen, Xiang; Hillstrom, Howard; Ellis, Scott J; Baxter, Josh R; Deland, Jonathan T

    2016-01-01

    A proximal phalangeal dorsiflexion osteotomy (Moberg osteotomy) is commonly used to treat hallux rigidus, but the mechanical explanation for its effectiveness is unclear. The purpose of our study was to test the effect of a Moberg osteotomy on first metatarsophalangeal joint contact mechanics. Ten cadaveric first ray specimens were dissected, with the medial band of the plantar aponeurosis preserved at its origin, and placed in a custom testing apparatus. Forefoot loads during mid-stance with the first metatarsal positioned at 10 degrees were simulated using a custom-made loading jig while contact mechanics were acquired with a thin pressure-sensitive sensor. A Moberg osteotomy was performed starting 9 mm distal to the proximal phalanx with excision of a 3-mm wedge of bone and fixated with a 2-mm Kirschner wire. The effect of the Moberg osteotomy was tested by reapplying the forefoot loads and acquiring the joint pressures. The center of pressure, peak pressure, and contact area were calculated. Paired t tests were performed to determine if the Moberg osteotomy affected joint contact mechanics. The Moberg osteotomy shifted the center of contact pressure on the proximal phalanx surface more plantarly (P osteotomy did not affect the peak pressure (P = .62) or the joint contact area (P = .96). There were no differences in peak pressure or first MTPJ contact area, but a plantar shift in the center of pressure occurred after the Moberg osteotomy. The plantar cartilage, which is often spared from arthritic changes, may be preferentially loaded and the potential edge loading following cheilectomy may be avoided with the Moberg osteotomy secondary to the plantar shift of center of pressure. © The Author(s) 2015.

  10. Belarus, A Chinese Fort in Europe

    Institute of Scientific and Technical Information of China (English)

    Liu Xinwen

    2008-01-01

    @@ "In recent years,we've found increasing interest from Chinese investors in the Belarus economy.Please let China know,Belarus is always ready to be a true friend to China.We have built a fort in Europe for China,"the President of Belarus,Alexander Lukashenko told Zhou Xiaochuan,President of the Bank of China,during his visit to the capital of Minsk,on January 8th,he expressed his high praise and firm confidence in the development of Sino-Belarusian relations.

  11. Fort Ord Groundwater Remediation Studies, 2002 - 2005

    Science.gov (United States)

    2006-08-01

    water Velocity at OU 1, Former Fort Ord, California. Su, G.W., B.M. Freifeld , C.M. Oldenburg, P.D. Jordan and P.F. Daley. 2005. Lawrence Berkeley...138. Oldenburg, C. M., P. F. Daley, B. M. Freifeld , J. Hinds, and P. D. Jordan, 2002. Three- Dimensional Groundwater Flow, Aquifer Response, and...U.S. Geological Survey Contract Number 1434-95-C-40232, 29 pp. Su, G.W., B.M. Freifeld , C.M. Oldenburg, P.D. Jordan, and P.F. Daley, 2005. Data

  12. FORTE antenna element and release mechanism design

    Energy Technology Data Exchange (ETDEWEB)

    Rohweller, D.J. [Astro Aerospace Corp., Carpinteria, CA (United States); Butler, T.Af. [Los Alamos National Lab., NM (United States)

    1995-02-01

    The Fast On-Orbit Recording of Transient Events (FORTE) satellite being built by Los Alamos National Laboratory (LANL) and Sandia National Laboratories (SNL) has as its most prominent feature a large deployable (11 m by 5 m) log periodic antenna to monitor emissions from electrical storms on the Earth. This paper describes the antenna and the design for the long elements and explains the dynamics of their deployment and the damping system employed. It also describes the unique paraffin-actuated reusable tie-down and release mechanism employed in the system.

  13. Experimental fixation of femoral osteotomies by cerclage with nylon straps.

    Science.gov (United States)

    Rhinelander, F W; Stewart, C L

    1983-10-01

    Following the successful experience of Partridge in the fixation of human femoral fractures by nylon-strap cerclage, this research in 23 mature dogs was performed to compare nylon-strap with wire-loop cerclage for healing periods of up to 12 weeks. Supplemented by intramedullary fixation with Steinmann pins, long oblique femoral osteotomies were fixed in one femur of each dog by nylon straps and in the other femur by wire loops, at separate operations. The nylon straps were all secured at the same tension by a special "gun." The wire loops were all secured at the same tension by the Rhinelander tightener-twister. Half of the nylon straps had "bumps" along the inner surface, which were added by Partridge in an effort to circumvent the microvascular disturbance reported with Parham bands. On examination by microangiography and correlated histology, all of the osteotomies, regardless of the type of fixation, showed good progress toward osseous union. After fixation by wire cerclage no loss of position or disturbance of blood supply was noted. After fixation by nylon straps slight (clinically insignificant) longitudinal displacement, attributed to slight lengthening of the straps, with consequent loosening was noted in all cases. This loosening was considered advantageous because it appeared to be responsible for the unexpected lack of impairment of the vascularization of the underlying cortical bone by any of the straps. The bumps on the undersurface of some of the straps were, thus, of no vascular advantage, and their presence made accurate fixation of the ostectomy fragments more difficult on the small bones. These studies support the value of fixation by plain nylon straps and show their advantage over straps with bumps for fixation of long oblique single osteotomies of bones the size of the canine femur.

  14. Architectural Survey of Pershing Elementary School, Fort Leonard Wood, Missouri

    Science.gov (United States)

    2013-08-01

    classroom needs flexibility.14 Lincoln Elementary School , located at Fort Campbell, Kentucky, was the first school ...resources management ; Pershing Elementary School ; historic buildings 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES...ER D C/ CE RL T R- 13 -1 1 Architectural Survey of Pershing Elementary School , Fort Leonard Wood, Missouri Co ns tr uc tio n En gi

  15. Guidelines for reconstructing the metatarsal parabola with the shortening osteotomy.

    Science.gov (United States)

    Valley, B A; Reese, H W

    1991-08-01

    Lesser metatarsal pathology is difficult to treat surgically. The shortening osteotomy has shown promise as a useful technique. The following objectives are addressed in this study: 1) to discuss present techniques and two new radiographic measurement systems; 2) to establish mean, standard deviation, and normal range values for these measurement systems; 3) to determine if these measurements vary with foot size; and 4) to use the results to establish general guidelines for metatarsal parabola reconstruction. Means and normal ranges for the various radiographic measurements are identified to help the surgeon with preoperative evaluation and planning. The measurements vary mildly with foot size.

  16. Functional outcome in adult patients following Bernese periacetabular osteotomy.

    Science.gov (United States)

    Badra, Mohammad I; Anand, Ashish; Straight, Joseph J; Sala, Debra A; Ruchelsman, David E; Feldman, David S

    2008-01-01

    This study evaluated functional outcome following Bernese periacetabular osteotomy. In 24 patients with mean follow-up of 3.5 years, mean dysfunction score was 15.23 on the Short Musculoskeletal Function Assessment. Eighteen patients (75%) scored = or <20, indicating a high functional level. Irrespective of preoperative Shenton line continuity, most patients demonstrated a high functional level. However, a trend toward a poorer outcome was observed in patients with preoperative noncongruent joints and Tonnis osteoarthritis grade 3. These results suggest patients with less than optimal presentation may still benefit from this surgery, delaying or eliminating the need for total hip arthroplasty.

  17. Approaches and perioperative management in periacetabular osteotomy surgery

    DEFF Research Database (Denmark)

    Søballe, Kjeld; Troelsen, Anders

    2012-01-01

    In the early days of periacetabular osteotomy (PAO), surgical approaches were characterized by extensive soft-tissue dissection. The Smith-Petersen approach (and iliofemoral modifications) and the ilioinguinal approach have traditionally been used for PAO. The optimal surgical approach for PAO.......9 to 8.1 years) of 209 PAOs performed using this approach have shown Kaplan-Meier survivorship rates of 94.7% at 5 years and 88.6% at 8.1 years, with conversion to total hip arthroplasty as the end point. Perioperative management includes a patient education program, optimized pain treatment strategies...

  18. Flood inundation map library, Fort Kent, Maine

    Science.gov (United States)

    Lombard, Pamela J.

    2012-01-01

    Severe flooding occurred in northern Maine from April 28 to May 1, 2008, and damage was extensive in the town of Fort Kent (Lombard, 2010). Aroostook County was declared a Federal disaster area on May 9, 2008. The extent of flooding on both the Fish and St. John Rivers during this event showed that the current Federal Emergency Management Agency (FEMA) Flood Insurance Study (FIS) and Flood Insurance Rate Map (FIRM) (Federal Emergency Management Agency, 1979) were out of date. The U.S. Geological Survey (USGS) conducted a study to develop a flood inundation map library showing the areas and depths for a range of flood stages from bankfull to the flood of record for Fort Kent to complement an updated FIS (Federal Emergency Management Agency, in press). Hydrologic analyses that support the maps include computer models with and without the levee and with various depths of backwater on the Fish River. This fact sheet describes the methods used to develop the maps and describes how the maps can be accessed.

  19. Does proximal tibial osteotomy with a novel osteotomy system obtain coronal plane correction without affecting tibial slope and patellar height?

    Science.gov (United States)

    Blackman, Andrew J; Krych, Aaron J; Engasser, William M; Levy, Bruce A; Stuart, Michael J

    2015-12-01

    To determine changes in tibial slope, patellar height, and coronal plane alignment after medial opening wedge proximal tibial osteotomy (PTO) using a modern osteotomy system. Patients undergoing medial opening wedge PTO for any indication with follow-up until radiographic union were identified. Pre- and post-operative tibial slope (referenced off the anterior tibial cortex, proximal tibial anatomic axis, and posterior tibial cortex), patellar height (Caton-Deschamps, Blackburne-Peel, and Insall-Salvati indices), and coronal plane [mechanical axis and weight-bearing line (WBL) ratio] measurements were taken by two observers and compared. Review of 27 patients demonstrated unchanged tibial slope and slightly decreased patellar height post-operatively (Caton-Deschamps: -0.10 ± 0.09; Blackburne-Peel: -0.11 ± 0.10). Coronal plane measurements showed 6.4° ± 1.8° mean change in mechanical axis. Mean post-operative WBL ratio was significantly lower (51.6 ± 11.5 %) than mean goal WBL ratio (62.2 ± 2.5 %). Preoperative mechanical axis >6° varus and osteoarthritis alone as the surgical indication were risk factors for undercorrection >10 %. Medial opening wedge PTO using a recently developed instrumentation system was found to have no effect on tibial slope. Patellar height was decreased after osteotomy using this system, although clinical significance of these findings is unknown. Coronal plane undercorrection of 10.6 % of the target WBL ratio was seen in the group as a whole, although secondary analysis of these results indicated that patients with medial compartment osteoarthritis and/or preoperative mechanical axis of >6° varus accounted for the majority of the cases of undercorrection. Retrospective case series, Level IV.

  20. Comparison of Surgical Parameters and Results between Curved Varus Osteotomy and Rotational Osteotomy for Osteonecrosis of the Femoral Head.

    Science.gov (United States)

    Lee, Young-Kyun; Park, Chan Ho; Ha, Yong-Chan; Kim, Do-Yeon; Lyu, Sung-Hwa; Koo, Kyung-Hoi

    2017-06-01

    Various osteotomies have been introduced to treat osteonecrosis of the femoral head. The purpose of this study was to compare surgical parameters, postoperative limb length discrepancy, and minimum 5-year clinical and radiological results between transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head. From 2004 to 2009, 103 consecutive TROs (97 patients) followed by 72 consecutive TCVOs (64 patients) were performed for the treatment of osteonecrosis of the femoral head. Of these, 85 patients (91 hips) in the TRO group and 58 patients (65 hips) in the TCVO group completed minimum 5-year clinical and radiological follow-up. The Kaplan-Meier product-limit method was used to estimate survival. The TCVO group had shorter operation time (p TRO group and 7 hips (10.8%) in the TCVO group (p = 0.007). Osteophyte formation was observed in 34 hips (37.4%) in the TRO group and 13 hips (20%) in the TCVO group (p = 0.020). Fifteen hips (16.5%) in the TRO group and 7 hips (10.8%) in the TCVO group underwent conversion total hip arthroplasty (THA). The survival rate at 9 years with radiographic collapse as the endpoint was 68.7% (95% confidence interval [CI], 58.1% to 79.3%) in the TRO group, and 84.7% (95% CI, 71.5% to 97.9%) in the TCVO group. With conversion to THA as the endpoint, the survival rate was 82.2% (95% CI, 73.1% to 91.3%) in the TRO group and 89.2% (95% CI, 81.7% to 96.7%) in the TCVO group. The comparison indicates that TCVO was better than TRO in terms of surgical parameters including operation time and estimated blood loss while the 9-year survival rates were similar.

  1. 77 FR 74870 - Notice of Inventory Completion: U.S. Department of Defense, Army, Fort Sill Museum, Fort Sill, OK...

    Science.gov (United States)

    2012-12-18

    ..., geology, and historical accounts. The people of the Wichita, Comanche, Kiowa, Apache, Cheyenne, and... National Park Service Notice of Inventory Completion: U.S. Department of Defense, Army, Fort Sill Museum, Fort Sill, OK, and Museum of the Great Plains, Lawton, OK AGENCY: National Park Service,...

  2. Arthroscopic evaluation of persistent pain following supramalleolar osteotomy for varus ankle osteoarthritis.

    Science.gov (United States)

    Kim, Yong Sang; Youn, Hyun Kook; Kim, Bom Soo; Choi, Yun Jin; Koh, Yong Gon

    2016-06-01

    The purposes of this study were to investigate pain experienced by patients after supramalleolar osteotomy for varus ankle osteoarthritis and to analyse correlations between this pain and arthroscopic findings. Twenty-nine patients (31 ankles) who underwent arthroscopic evaluation after supramalleolar osteotomy were reviewed retrospectively. The visual analog scale (VAS) was used to assess pain, and the patients were instructed to record the time point, location, and character of the pain. The tibial-ankle surface angle, talar tilt, and tibial-lateral surface angle were measured on radiographs. The location, time point, and character of the pain experienced by the patients changed after supramalleolar osteotomy. The mean VAS score was significantly improved after supramalleolar osteotomy at the time of the arthroscopic evaluation (P osteotomy was found to be associated with adhesions, synovitis, and soft-tissue impingement in medial and lateral gutters of the ankle. Arthroscopy can be helpful in identifying and treating painful lesions commonly seen after supramalleolar osteotomy. An understanding of these painful lesions will help patients have more realistic expectations regarding the supramalleolar osteotomy. Case series study, Level IV.

  3. Outcome of peri-acetabular osteotomy for hip dysplasia in teenagers.

    Science.gov (United States)

    Sakamoto, Tetsuya; Naito, Masatoshi; Nakamura, Yoshinari

    2015-11-01

    Peri-acetabular osteotomy, especially curved peri-acetabular osteotomy, is an effective surgical procedure for re-orientating the acetabulum. However, there have been few reports on this procedure in teenagers. The purpose of this study was to investigate the treatment outcomes of curved peri-acetabular osteotomy in teenagers. We retrospectively reviewed 33 hips in 27 teenage patients with acetabular dysplasia who underwent curved peri-acetabular osteotomy between 1995 and 2012. The mean age was 17.0 years (range, 14-19 years). The mean follow-up duration at the most recent physical examination was 33.3 months (range, 24-96 months). All hips were evaluated in terms of the Harris hip score, radiographic measurements, and complications. The mean Harris hip score improved from 80.1 points pre-operatively to 95.4 points post-operatively (p osteotomy (four hips), superficial stitch abscess (two hips), and transient lateral femoral cutaneous nerve palsy (three hips). Satisfactory results can be obtained clinically and radiographically after curved peri-acetabular osteotomy in adolescents. Osteotomy for acetabular dysplasia is effective in teenagers.

  4. Radiographic Correction Following Reconstruction of Adult Acquired Flat Foot Deformity Using the Cotton Medial Cuneiform Osteotomy.

    Science.gov (United States)

    Aiyer, Amiethab; Dall, Graham F; Shub, Jeffrey; Myerson, Mark S

    2016-05-01

    The Cotton osteotomy has been used to correct residual forefoot supination in flexible flatfoot deformity reconstruction. The purpose of this study was to delineate the radiographic effects of the Cotton osteotomy by controlling for concomitant procedures used for deformity correction. We retrospectively analyzed 67 patients who underwent a Cotton osteotomy as part of a flatfoot reconstructive procedure. We evaluated 12 radiographic parameters including the articular surface angles of the foot, Meary angle, and a newly defined medial arch sag angle (MASA). Twenty-eight of these patients were matched to a cohort that did not undergo a Cotton osteotomy. In all patients who underwent a Cotton osteotomy, there were statistically significant changes in the articular surface angles and medial arch height (P osteotomy did not improve Meary angle but provided an additional 6.5 degrees correction of the MASA (P = .002). After reliability testing, the intraclass correlation coefficient was found to be substantial for the MASA compared to Meary angle. The data suggest that the MASA was a useful radiographic tool for assessing midfoot collapse in the setting of pes planovalgus. The current study demonstrated the corrective capacity of the Cotton osteotomy on the MASA; at final follow-up, there was no evidence of radiographic instability. This is suggestive that a naviculocuneiform arthrodesis may not be warranted for medial column stabilization in the setting of flatfoot reconstruction. Level III, case control study. © The Author(s) 2015.

  5. Ulnar Shortening Osteotomy After Distal Radius Fracture Malunion: Review of Literature

    Science.gov (United States)

    Barbaric, Katarina; Rujevcan, Gordan; Labas, Marko; Delimar, Domagoj; Bicanic, Goran

    2015-01-01

    Malunion of distal radius fracture is often complicated with shortening of the radius with disturbed radio- ulnar variance, frequently associated with lesions of triangular fibrocartilage complex and instability of the distal radioulnar joint. Positive ulnar variance may result in wrist pain located in ulnar part of the joint, limited ulnar deviation and forearm rotation with development of degenerative changes due to the overloading that occurs between the ulnar head and corresponding carpus. Ulnar shortening osteotomy (USO) is the standard procedure for correcting positive ulnar variance. Goal of this procedure is to minimize the symptoms by restoring the neutral radio - ulnar variance. In this paper we present a variety of surgical techniques available for ulnar shorthening osteotomy, their advantages and drawbacks. Methods of ulnar shortening osteotomies are divided into intraarticular and extraarticular. Intraarticular method of ulnar shortening can be performed arthroscopically or through open approach. Extraarticular methods include subcapital osteotomy and osteotomy of ulnar diaphysis, which depending on shape can be transverse, oblique, and step cut. All of those osteotomies can be performed along wrist arthroscopy in order to dispose and treat possibly existing triangular fibrocartilage complex injuries. At the end we described surgical procedures that can be done in case of ulnar shorthening osteotomy failure. PMID:26157524

  6. Transposition of the acetabulum after iliac ischial osteotomy in the treatment of hip dysplasia in infants

    Directory of Open Access Journals (Sweden)

    Владимир Евгеньевич Басков

    2016-06-01

    Full Text Available Background. Transposition of the acetabulum after pelvic osteotomy is the most effective surgical method to treat dysplastic hip joint disorders in patients of different ages. According to Salter, iliac osteotomy of the pelvis is the main surgical method used to correct dysplastic acetabulum in 7- and 8-year-old children. In older patients, the pubic symphysis and pelvic ligaments become more rigid, which significantly limits the degree of rotation of the acetabulum. In these cases, a triple pelvic osteotomy is performed to enhance the mobility of the acetabular fragment. This pubic bone osteotomy is performed near the femoral neurovascular bundle, which may be damaged during the procedure.Aim. To describe a technique for transposition of the acetabulum after iliac and ischial osteotomy of the pelvis, which was developed to reduce trauma, prevent vascular complications, and increase postoperative stability of the pelvic ring.Materials and methods. A method developed by the authors for transposition of the acetabulum after iliac and sciatic pelvic osteotomy is described in detail. The surgical method was performed 99 times on 89 children with dysplastic hip joint disorders, and the results are presented.Conclusion. Transposition of the acetabulum after iliac and ischial pelvic osteotomy is an effective treatment for dysplastic instability of the acetabulum in children aged 9–16 years. The procedure is indicated when it is necessary to rotate the acetabular fragment by more than 25°, and there is no need for hip medialization.

  7. Biomechanical optimization of different fixation modes for a proximal femoral L-osteotomy

    Directory of Open Access Journals (Sweden)

    Chen Hsih-Hao

    2009-09-01

    Full Text Available Abstract Background Numerous proposed surgical techniques have had minimal success in managing greater trochanter overgrowth secondary to retarded growth of the femoral capital epiphysis. For reconstruction of residual hip deformities, a novel type of proximal femur L-osteotomy was performed with satisfactory results. Although the clinical outcome was good, the biomechanical characteristics of the femur after such an osteotomy have not been clearly elucidated. Therefore, this study presents a three dimensional finite element analysis designed to understand the mechanical characteristics of the femur after the L-osteotomy. Methods A patient with left hip dysplasia was recruited as the study model for L-osteotomy. The normal right hip was used as a reference for performing the corrective surgery. Four FEA models were constructed using different numbers of fixation screws but the same osteotomy lengths together with four FEA models with the same number of fixation screws but different osteotomy lengths. The von Mises stress distributions and femoral head displacements were analyzed and compared. Results The results revealed the following: 1. The fixation devices (plate and screws sustained most of the external loading, and the peak value of von Mises stress on the fixation screws decreased with an increasing number of screws. 2. Additional screws are more beneficial on the proximal segment than on the distal segment for improving the stability of the postoperative femur. 3. The extent of osteotomy should be limited because local stress might be concentrated in the femoral neck region with increasing length of the L-osteotomy. Conclusion Additional screw placement on the proximal segment improves stability in the postoperative femur. The cobra-type plate with additional screw holes in the proximal area might improve the effectiveness of L-osteotomies.

  8. Humeral head osteotomy in shoulder arthroplasty: a comparison between anterosuperior and inferoanterior resection techniques.

    Science.gov (United States)

    Suter, Thomas; Kolz, Christopher W; Tashjian, Robert Z; Henninger, Heath B; Gerber Popp, Ariane

    2017-02-01

    The best chance that a shoulder arthroplasty will restore motion and muscle balance across the glenohumeral joint is by closely replicating natural articular morphology. Defining the humeral osteotomy plane along clear landmarks at the anatomic neck is critical. We hypothesized that a new osteotomy, based on alternative landmarks on the anatomic neck, would restore 3-dimensional humeral head morphology more reliably than the traditional osteotomy. The anatomic neck was digitized in 30 human cadaver shoulders and compared with its 3-dimensional computed tomography reconstruction. Two different osteotomy techniques were virtually performed: the traditional, following the anterosuperior anatomic neck; and a new technique, defined by the inferoanterior anatomic neck. The length-width difference and orientation (retroversion, inclination) of the resection area were compared between the techniques and with native anatomy. Length-width difference of the anterosuperior resection area was higher than in the inferoanterior osteotomy (6 ± 2 mm vs. 3 ± 1 mm; P osteotomy (32° ± 12°) did not differ from native (P = .057). Inclination differed after the anterosuperior osteotomy (129° ± 5°) and the inferoanterior osteotomy (127° ± 4°) compared with the native head (134° ± 4°; P ≤ .001). The inferoanterior referenced osteotomy generated a more circular resection area, matching the native humeral head retroversion more closely than in the anterosuperior technique. This study suggests that in shoulder arthroplasty, the humeral resection level should be referenced at the inferoanterior rather than the anterosuperior anatomic neck. Further studies should investigate the biomechanical effects of this alternative resection plane. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Refinements in osteotomy design to improve structural integrity: a finite element analysis study.

    Science.gov (United States)

    Bujtar, P; Simonovics, János; Váradi, Károly; Sándor, George K B; Pan, Jingzhe; Avery, C M E

    2013-09-01

    Osteotomy cuts are typically made using a saw, and the meeting point acts as a focus for the concentration of stress and failure. We have studied the impact of different designs of osteotomy cut. Cadaver sheep tibias were scanned by computed tomography (CT) and transformed into a computer-aided design (CAD) model. A standard marginal resection defect was created and then modified, and a finite element analysis made. The relative stress concentrations at the intersection of osteotomy cuts were recorded using principal stresses S1, S3, and von Mises stress, von Mises under both 4-point bending and torsion testing. The osteotomy designs studied were: right-angled and bevelled osteotomy end cuts, overcutting, and a stop drill hole. Peak stress values for 4-point bending and torsion were 24-30% greater at the right-angled osteotomy than the bevelled end cut. Overcutting dramatically increased peak stress values caused by bending and torsion by 48% and 71%, respectively. Substantially lower concentrations of stress were noted with a stop hole using both a 90° (bending 38% and torsion 56%), and a tangential (bending 58% and torsion 60%) cut. A bevelled osteotomy has substantially lower concentrations of stress than a right-angled osteotomy. It is important to avoid creating an overcut as this causes an appreciable increase in the concentration of stress, while a stop drill hole substantially reduces the stress. The creation of a stop hole and the use of judicious bevelling techniques are modifications in the design of an osteotomy that are readily applicable to surgical practice. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Valgus osteotomy for nonunion and neglected neck of femur fractures.

    Science.gov (United States)

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-05-18

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure.

  11. Arthroscopic and computer-assisted high tibial osteotomy using standard total knee arthroplasty navigation software.

    Science.gov (United States)

    Thompson, Stephen R; Zabtia, Nazar; Weening, Bradley; Zalzal, Paul

    2013-05-01

    Opening-wedge high tibial osteotomy is an increasingly performed procedure for treatment of varus gonarthrosis and correction of malalignment during meniscal transplantation or cartilage restoration. Precise preoperative planning and meticulous surgical technique are required to achieve an appropriate mechanical axis correction. We describe our technique of arthroscopic and computer-assisted high tibial osteotomy using commonly available total knee arthroplasty navigation software as an intraoperative goniometer. We believe that our technique, by providing intraoperative real-time guidance of the degree of correction that is accurate and reliable, represents a useful tool for the surgeon who uncommonly performs high tibial osteotomy.

  12. Lateral epicondylar osteotomy for severe varus deformity during total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Hong Chen; Wei Huang; Xi Liang; Ning Hu; Wei Xu; Dianming Jiang

    2015-01-01

    In most cases of arthritic varus knees, stepwise osteophytes removal and medial soft tissue release could achieve satisfactory soft tissue balance during total knee arthroplasty.However, in some severe cases, conventional balancing techniques are not enough, necessitating other procedures like epicondylar osteotomy.To the best of our knowledge, no published article has reported the application of lateral epicondylar osteotomy in a severe varus knee.Here we reported a case of successful correction of a severe varus knee following lateral epicondylar osteotomy, and described its underlying rationale.

  13. A Modified Triple Pelvic Osteotomy for the Treatment of Hip Hypoplasia

    Directory of Open Access Journals (Sweden)

    Hassan Rahimi

    2013-09-01

    Full Text Available Background: The prevalence of hip dysplasia is 1 in 1000. Several pelvic osteotomy methods have been developed to prevent early osteoarthritis, such as triple osteotomy. In this study we are going to introduce our new technique that was done on 4 patients with favorable short-term results.   Methods: Four patients underwent triple osteotomy and fixation using a reconstruction plate and early weight bearing was started. Results: The Harris Hip Score, limb length, center-edge angle, and acetabular inclination showed improvement. Conclusion: This modified technique is suggested for corrective surgery on adult dysplastic hips.

  14. A Modified Triple Pelvic Osteotomy for the Treatment of Hip Hypoplasia

    Directory of Open Access Journals (Sweden)

    Hassan Rahimi

    2013-09-01

    Full Text Available   Background: The prevalence of hip dysplasia is 1 in 1000. Several pelvic osteotomy methods have been developed to prevent early osteoarthritis, such as triple osteotomy. In this study we are going to introduce our new technique that was done on 4 patients with favorable short-term results.   Methods: Four patients underwent triple osteotomy and fixation using a reconstruction plate and early weight bearing was started. Results: The Harris Hip Score, limb length, center-edge angle, and acetabular inclination showed improvement. Conclusion: This modified technique is suggested for corrective surgery on adult dysplastic hips.

  15. Osteotomy does not improve early outcome after slipped capital femoral epiphysis.

    Science.gov (United States)

    Diab, Mohammad; Daluvoy, Sanjay; Snyder, Brian D; Kasser, James R

    2006-03-01

    We performed a retrospective, nonrandomized cohort study of unilateral, chronic, severe, stable slipped capital femoral epiphysis comparing five girls and five boys who underwent in-situ screw fixation alone with five girls and five boys who underwent in-situ screw fixation combined with staged flexion intertrochanteric femoral osteotomy to restore proximal femoral alignment. Functional outcome was measured by the Harris hip score, with 20% selected as a goal for improvement in functional outcome after corrective osteotomy. While flexion intertrochanteric femoral osteotomy improved hip range of motion, we found no significant difference in functional outcome between the two groups at early follow-up. This is a level 3 evidence study.

  16. The Confederate Command During the Fort Henry-Fort Donelson Campaign, February 1862.

    Science.gov (United States)

    2007-11-02

    30/R, 359-390. " Ezra J. Warner, Generals in Gray, Lives of the Confederate Commanders (Baton Rouge: Louisiana State University Press, 1959...left Camp Halleck at 11:00 A.M. on February 6th, and in just over two hours the gunboats pounded Fort Henry into submission. Led by Tilghman, the...Ward, Geoffrey C. The Civil War: An Illustrated History. New York: Alfred A. Knoff, Inc., 1990. Warner, Ezra J. Generals in Gray, Lives of

  17. Fort Collins Science Center: Fiscal Year 2007 Accomplishments

    Science.gov (United States)

    Wilson, J.T.

    2008-01-01

    In Fiscal Year 2007 (FY07), the U.S. Geological Survey (USGS) Fort Collins Science Center (FORT) continued research vital to U.S. Department of the Interior science and management needs and associated USGS programmatic goals. FORT work also supported the science needs of other government agencies as well as private cooperators. Specifically, FORT scientific research and technical assistance focused on client and partner needs and goals in the areas of biological information management, fisheries and aquatic systems, invasive species, status and trends of biological resources, terrestrial ecosystems, and wildlife resources. In addition, FORT's 5-year strategic plan was refined to incorporate focus areas identified in the USGS strategic science plan, including ecosystem-landscape analysis, global climate change, and energy and mineral resource development. As a consequence, several science projects initiated in FY07 were either entirely new research dor amplifications of existing work. Highlights of FORT project accomplishments are described below under the USGS science program with which each task is most closely associated. The work of FORT's 6 branches (Aquatic Systems and Technology Applications, Ecosystem Dynamics, Information Science, Invasive Species Science, Policy Analysis and Science Assistance, and Species and Habitats of Federal Interest) often involves major partnerships with other agencies or cooperation with other USGS disciplines (Geology, Geography, Water Resources) and the Geospatial Information Office.

  18. Master environmental plan for Fort Devens, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    Biang, C.A.; Peters, R.W.; Pearl, R.H.; Tsai, S.Y. (Argonne National Lab., IL (United States). Energy Systems Div.)

    1991-11-01

    Argonne National Laboratory has prepared a master environmental plan (MEP) for Fort Devens, Massachusetts, for the US Army Toxic and Hazardous Materials Agency. The MEP is an assessment based on environmental laws and regulations of both the federal government and the Commonwealth of Massachusetts. The MEP assess the physical and environmental status of 58 potential hazardous waste sites, including 54 study areas (SAs) that pose a potential for releasing contamination into the environment and 4 areas of concern (AOCs) that are known to have substantial contamination. For each SA or AOC, this MEP describes the known history and environment, identifies additional data needs, and proposes possible response actions. Most recommended response actions consist of environmental sampling and monitoring and other characterization studies. 74 refs., 63 figs., 50 tabs.

  19. Gynecologic Malignancies Post-LeFort Colpocleisis

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah

    2014-01-01

    Full Text Available Introduction. LeFort colpocleisis (LFC is a safe and effective obliterative surgical option for older women with advanced pelvic organ prolapse who no longer desire coital activity. A major disadvantage is the limited ability to evaluate for post-LFC gynecologic malignancies. Methods. We present the first case of endometrioid ovarian cancer diagnosed after LFC and review all reported gynecologic malignancies post-LFC in the English medical literature. Results. This is the second reported ovarian cancer post-LFC and the first of the endometrioid subtype. A total of nine other gynecologic malignancies post-LFC have been reported in the English medical literature. Conclusions. Gynecologic malignancies post-LFC are rare. We propose a simple 3-step strategy in evaluating post-LFC malignancies.

  20. Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?

    Science.gov (United States)

    Ziebarth, K; Balakumar, J; Domayer, S; Kim, Y J; Millis, M B

    2011-02-01

    The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients. We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males. We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months). We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively. Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

  1. Review - Le bergers du Fort Noir

    Directory of Open Access Journals (Sweden)

    Katia Buffetrille

    2013-12-01

    Full Text Available Review of: Pascale Dollfus. 2012. Les bergers du Fort Noir. Nomades du Ladakh (Himalaya occidental Société d'ethnologie (collection "Haute Asie". This is a detailed ethnography by Pascale Dollfus of the Kharnakpa (Mkhar nag pa, a small community of Ladakhi nomads living at more than 4,200 meters in the Indian state of Jammu-Kashmir. The total population was only 150 in 2004, down from 375 in 1992, and 261 in 1996. The author started her fieldwork in the 1990s, and was thus able to observe the slow disappearance of the way of life of the shepherds of the Black Fort over the last twenty years. The book features thirteen chapters. The first deals with the problem of the definition of the terms 'nomads' and 'nomadism' and the relations between nomads and sedentary people. The author provides accounts related to the nomads of Ladakh that were written by missionaries, adventurers, scientists, and civil servants. In the second chapter, Dollfus questions the origins of the Ladakhi people, and more specifically of the Kharnakpa population, making use of written chronicles and oral traditions. In the third chapter, the community's religious life is introduced. All members belong to the Drugpa Kagyü ('Brug pa bka' brgyud sect of Tibetan Buddhism and consider Dat Monastery their ideal religious center, where all gather for the spring gyetsa (dge rtsa festival, which is described in detail. The fourth chapter deals with the social organization of these nomadic pastoralists who, in spite of the 1941 law prohibiting polyandry, still practice this type of marriage in order "to have a joint ..

  2. Do the changes in muscle mass, muscle direction, and rotations of the condyles that occur after sagittal split advancement osteotomies play a role in the aetiology of progressive condylar resorption?

    Science.gov (United States)

    Dicker, G J; Castelijns, J A; Tuinzing, D B; Stoelinga, P J W

    2015-05-01

    Changes in cross-sectional area (CSA), volume (indicating muscle strength), and direction of the masseter and medial pterygoid muscles after surgical mandibular advancement were measured, along with the rotation of the condyles after bilateral sagittal split osteotomies (BSSOs) to advance the mandible. Measurements were done on magnetic resonance images obtained before and 2 years after surgery. CSA and volume were measured in five short-face and seven long-face patients (five males, seven females). Muscle direction was calculated in eight short-face and eight long-face patients (eight males, eight females). Short-face patients underwent BSSO only; long-face patients underwent combined BSSO and Le Fort I osteotomies. The CSA and volume decreased significantly (mean 18%) in all patients after surgery. The postoperative muscle direction was significantly more vertical (9°) in long-face patients. Rotations of the proximal segments (condyles) were minimal after 2 years. The results of this study showed that, after BSSO advancement surgery, changes in the masseter and medial pterygoid muscles are not likely to cause increased pressure on the condyles and nor are the minimal rotations of the condyles. It is concluded that neither increased muscle traction nor condylar rotations can be held responsible for progressive condylar resorption after advancement BSSO.

  3. 75 FR 33273 - Final Environmental Impact Statement (FEIS) for Disposal and Reuse of Fort Monroe, VA

    Science.gov (United States)

    2010-06-11

    ... Department of the Army Final Environmental Impact Statement (FEIS) for Disposal and Reuse of Fort Monroe, VA... socioeconomic impacts associated with the disposal and reuse of Fort Monroe, Virginia. DATES: The waiting period... reuse of Fort Monroe. The 2005 BRAC Commission Report directed the closure of Fort Monroe and...

  4. Proceedings of the Military Librarians’ Workshop (18th) Held at Fort Hauchuca, Arizona on 10-12 September 1974

    Science.gov (United States)

    1974-09-12

    in the proceedings. 4R6 OR~ CONTENTS Page Foreword ii Program iv Welcome I Special Command Briefing 3 Workshop Sessions 11 "Some Unwritten History of...Ms. Cathryn Lyon 34 NEW OEVELOPMENTS AT DDC . . . . Mr. Paul Klinefelter 35 Reminiscing . . . . Mr. Ernest DeWald 37 Participants 49 Sponsors of...Talk by Dr. Bruno Rolak, USACC Historian "Some Unwritten History of I Fort Huachuca" 0900-1100 Working Groups Ramada Inn Academic Earl SchwasG General

  5. Comparison of osteotomy technique and jig type in completion of distal femoral osteotomies for correction of medial patellar luxation. An in vitro study.

    Science.gov (United States)

    Olimpo, Matteo; Piras, Lisa A; Peirone, Bruno; Fox, Derek B

    2017-01-16

    Femoral osteotomies are frequently completed to correct malalignment associated with patellar luxation. The objectives of this study were to compare the use of: 1) two different types of jig; and 2) different types of osteotomy in the realignment of canine femoral bone models which possessed various iterations of angular deformity. Models of canine femora possessing distal varus, external torsion and a combination of varus and torsion underwent correction utilizing two alignment jigs (Slocum jig and Deformity Reduction Device) and either a closing wedge ostectomy (CWO) or an opening wedge osteotomy (OWO). Post-correctional alignment was evaluated by radiographic assessment and compared between groups. The use of the Slocum jig resulted in frontal plane overcorrection when used with CWO in models of femoral varus, and when used with OWO in models of femoral varus and external torsion when compared to other techniques. The Deformity Reduction Device tended to realign the frontal plane closer to the post-correction target value in all angulation types. The use of both jigs resulted in undercorrection in the transverse plane in models with varus and torsion. Jig selection and osteotomy type may lead to different post-correctional alignment results when performing distal femoral osteotomies. Whereas OWO allows accurate correction when used with either jig to address frontal plane deformities, the Deformity Reduction Device can be utilized with both CWO and OWO to correct torsion-angulation femoral deformities to optimize frontal plane alignment.

  6. Minimally Invasive Calcaneal Displacement Osteotomy Site Using a Reference Kirschner Wire: A Technique Tip.

    Science.gov (United States)

    Lee, Moses; Guyton, Gregory P; Zahoor, Talal; Schon, Lew C

    2016-01-01

    As a standard open approach, the lateral oblique incision has been widely used for calcaneal displacement osteotomy. However, just as with other orthopedic procedures that use an open approach, complications, including wound healing problems and neurovascular injury in the heel, have been reported. To help avoid these limitations, a percutaneous technique using a Shannon burr for calcaneal displacement osteotomy was introduced. However, relying on a free-hand technique without direct visualization at the osteotomy site has been a major obstacle for this technique. To address this problem, we developed a technical tip using a reference Kirschner wire. A reference Kirschner wire technique provides a reliable and accurate guide for minimally invasive calcaneal displacement osteotomy. Also, the technique should be easy to learn for surgeons new to the procedure. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Bone grafting with granular biomaterial in segmental maxillary osteotomy: A case report

    Directory of Open Access Journals (Sweden)

    Orion Luiz Haas Junior

    2016-01-01

    Conclusion: This is the first report of bone grafting with a granular biomaterial in segmental maxillary osteotomy. Successful formation of new bone with density greater than that of the surrounding tissue was achieved, preventing pseudarthrosis and postoperative instability.

  8. Shortening Scarf osteotomy for correction of severe hallux valgus. Does shortening affect the outcome?

    Science.gov (United States)

    Karpe, Prasad; Killen, Marie C; Pollock, Raymond D; Limaye, Rajiv

    2016-12-01

    Translation and shortening of Scarf osteotomy allows correction of severe hallux valgus deformity. Shortening may result in transfer metatarsalgia. To evaluate outcome of patients undergoing shortening Scarf osteotomy for severe hallux valgus deformities. Fifteen patients (20feet, mean age 58 years) underwent shortening Scarf osteotomy for severe hallux valgus deformities. Outcomes were pre and postoperative AOFAS scores, IM and HV angles, patient satisfaction. Mean follow-up was 25 months (range 22-30). The IM angle improved from a median of 18.60 (range 13.4-26.20) preoperatively to 9.70 (range 8.0-13.70) postoperatively (8.9; 95% CI=7.6-10.3; posteotomies united. Shortening Scarf osteotomy is a viable option for treating severe hallux valgus deformities with no transfer metatarsalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. [Medial closing wedge osteotomy for correction of genu valgum and torsional malalignment].

    Science.gov (United States)

    Petersen, W; Forkel, P

    2013-12-01

    Femoral medial closing wedge osteotomy for the correction of valgus malalignment to unload the cartilage in the lateral compartment and/or correction of symptomatic torsional malalignment. Lateral unicompartmental osteoarthritis of the knee with genu valgum in young patients. Symptomatic torsional malalignement of > 30° and genu valgum with medial closing osteotomy of the distal femur (6 men and 17 women). After 3.5-years follow-up, the KOOS increased from 48.4 points to 84.9 points. In one case, there was an early loss of correction, with subsequent revision with bone grafting and lateral osteosynthesis. No peri-or postoperative complications such as infection, thrombosis, and embolism occurred. In 5 cases a torsional osteotomy was performed. The torsional osteotomy was performed 4 times due to chronic patellofemoral instability, and once due to a medial tibiofemoral instability. Healing complications were not observed in this population. Recurrent instability was not observed.

  10. The role of AO external fixation in proximal femoral osteotomies in the pediatric neuromuscular population.

    Science.gov (United States)

    Handelsman, John E; Weinberg, Jacob; Razi, Afshin; Mulley, Debra A

    2004-09-01

    Internal fixation in proximal femoral osteotomies using traditional devices may be sub-optimal in children with neuromuscular disorders who have small or osteopenic bone. In this population, between 1988 and 2000, we performed 36 proximal femoral varus osteotomies in 28 patients. These were controlled by the AO external fixator. The average age at surgery was 7 years (range, 2-13 years). A mean varus correction of 34 degrees (range, 15-90 degrees) was obtained. Complications consisted of one superficial pin tract infection, one skin breakdown, and one non-union. Other than the non-union, all osteotomies were stable at the time of the fixator removal. The AO external fixator is an effective alternative in maintaining corrective proximal femoral osteotomies in children with fragile bones.

  11. Premaxillary osteotomy fixation in bilateral cleft lip/palate: Introducing a new technique

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma

    2016-04-01

    Conclusion: In protruding premaxilla, osteotomy and fixation of premaxilla with miniplate to the vomer bone during alveolar bone grafting through a lip-split approach yielded satisfactory results in patients requiring secondary functional cheilorhinoplasty.

  12. Effect of prior Salter or Chiari osteotomy on THA with developmental hip dysplasia.

    Science.gov (United States)

    Tokunaga, Kenji; Aslam, Nadim; Zdero, Rad; Schemitsch, Emil H; Waddell, James P

    2011-01-01

    Controversy exists regarding the outcome of THA after prior pelvic osteotomy. We conducted a retrospective chart and radiographic review to obtain outcome measures for perioperative complications, acetabular and femoral component revisions, Harris hip score, and survivorship and compared these outcomes for patients presenting with developmental dysplasia of the hip treated surgically using THA with and without prior pelvic osteotomy. We performed 103 primary THAs in 87 patients with osteoarthritis secondary to developmental dysplasia of the hip with a minimum 3-year followup. Previous pelvic osteotomy was performed in 52 hips (Salter, 40; Chiari, nine; Salter and Chiari, three), and 51 hips had no previous surgery (control group). The pelvic osteotomy group did not have higher rates of femoral or acetabular intraoperative fracture or dislocation compared with the control group. The overall revision rate was 28.8% in the pelvic osteotomy group compared with 19.6% in the control group. The revision rate for aseptic loosening was 23.1% in the pelvic osteotomy group compared with 17.6% in the control group. Harris hip scores (range, 20-87) were not compromised, and overall survivorship rates 8 years postoperatively were not different at any time between the pelvic osteotomy (83.3%) and control (88.4%) groups. Prior pelvic osteotomy did not lead to a higher perioperative complication rate, higher revision rate, compromised Harris hip score, or shortened survivorship in eventual THA in developmental dysplasia of the hip. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  13. Subtrochanteric osteotomy for femoral mal-torsion through a surgical dislocation approach

    Science.gov (United States)

    Kamath, Atul F.; Ganz, Reinhold; Zhang, Hong; Grappiolo, Guido; Leunig, Michael

    2015-01-01

    Missed torsional femur deformities may contribute to reasons for failure after open and more likely arthroscopic hip preservation surgery. A number of surgical approaches have been described for addressing torsion abnormalities. This report describes a subtrochanteric osteotomy technique in a consecutive series of patients with complex hip pathologies, for which intertrochanteric osteotomy is not suitable and precise derotation is required. Subtrochanteric derotation was performed, always in combination with a surgical hip dislocation, in accordance with the authors’ preferred technique. Before osteotomy, a localized decortication was executed. Application of a 4.5-mm broad or narrow plate was undertaken with dynamic compression of the osteotomy. Twenty-eight consecutive subtrochanteric derotational osteotomies were performed in 26 patients. Twenty-one females and five males were treated at an average age of 21.4 years (range, 12–43). Underlying diagnoses included dysplasia, arthrogryposis, cerebral palsy, Down’s syndrome, instability and impingement. The decision to perform derotation was for antetorsion over 20° or less than 0° (retrotorsion). Patients were followed clinically and radiographically till final follow-up. All patients went on to successful osteotomy union. There were two initial failures: one delayed union prompting revision fixation in a chronic smoker and one plate failure due to self-accelerated weight-bearing in a patient status post successful contralateral derotational osteotomy. Rotational deformity of the femur must be considered in the patient undergoing hip preservation surgery. This technique of subtrochanteric derotational osteotomy, with adjunctive surgical hip dislocation, is applicable and reproducible in the setting of complex hip pathologies. Level of evidence: IV, case series. PMID:27011816

  14. Effects of rotation on measurement of lower limb alignment for knee osteotomy.

    Science.gov (United States)

    Kawakami, Hideo; Sugano, Nobuhiko; Yonenobu, Kazuo; Yoshikawa, Hideki; Ochi, Takahiro; Hattori, Asaki; Suzuki, Naoki

    2004-11-01

    The purposes of this study were to clarify the effects of rotation on two-dimensional measurement of lower limb alignment for knee osteotomy using a three-dimensional method and to determine whether this 3-D simulation method could help with planning of knee osteotomy. We developed computer software to calculate femorotibial angle (FTA) and hip-knee-ankle angle (HKA) and simulate knee osteotomy from a CT-based 3-D bone model of the lower limb. Lower limb rotation on anteroposterior long-standing radiographs was measured by superimposing the 3-D bone models. Changes in alignment with limb rotation were calculated using the software. FTA after virtual closed-wedged osteotomy was measured for a hypothetical case of a rotation error of the osteotomy plane in reattaching the proximal cutting surface to the distal cutting surface. For 31 varus knees in 20 patients with medial compartment arthritis, the mean rotation angle, relative to the epicondylar axis, with variable limb position was 7.4 +/- 3.9 degrees of internal rotation (mean +/- SD), ranging from 8 degrees of external rotation to 14 degrees of internal rotation; the mean changes in FTA and HKA were 3.5 +/- 2.2 degrees (range, 0.4-8.6) and 1.6 +/- 1.3 degrees (range, 0.2-4.9), respectively. The FTA "flexion angle" (lateral view alignment from neutral AP) and the absolute HKA "flexion angle" correlated with the change in FTA and HKA with limb rotation, respectively (FTA, R = 0.999; HKA, R = 0.993). The mean change in FTA after virtual closed-wedged osteotomy was 3.2 degrees for internal and external 10 degrees rotation errors in reattaching the osteotomy plane. Rotation may affect measurement of lower limb alignment for knee osteotomy, and 3-D methods are preferable for surgical planning.

  15. Comparative Study of Skeletal Stability between Postoperative Skeletal Intermaxillary Fixation and No Skeletal Fixation after Bilateral Sagittal Split Ramus Osteotomy: an 18 Months Retrospective Study

    Directory of Open Access Journals (Sweden)

    Jens Hartlev

    2014-04-01

    Full Text Available Objectives: The purpose of the present study was to evaluate skeletal stability after mandibular advancement with bilateral sagittal split osteotomy. Material and Methods: Twenty-six patients underwent single-jaw bilateral sagittal split osteotomy (BSSO to correct skeletal Class II malocclusion. One group (n = 13 were treated postoperatively with skeletal elastic intermaxillary fixation (IMF while the other group (n = 13 where threated without skeletal elastic IMF. Results: The mean advancement at B-point and Pog in the skeletal elastic IMF group was 6.44 mm and 7.22 mm, respectively. Relapse at follow-up at B-point was -0.74 mm and -0.29 mm at Pog. The mean advancement at B-point and Pog in the no skeletal elastic IMF group was 6.30 mm and 6.45 mm, respectively. Relapse at follow-up at B-point was -0.97 mm and -0.86 mm at Pog. There was no statistical significant (P > 0.05 difference between the skeletal IMF group and the no skeletal group regarding advancement nor relapse at B-point or Pog. Conclusions: Bilateral sagittal split osteotomy is characterized as a stable treatment to correct Class II malocclusion. This study demonstrated no difference of relapse between the skeletal intermaxillary fixation group and the no skeletal intermaxillary fixation group. Because of selection-bias and the reduced number of patients it still remains inconclusive whether to recommend skeletal intermaxillary fixation or not in the prevention of relapse after mandibular advancement.

  16. Orbital change following Le Fort III advancement in syndromic craniosynostosis: quantitative evaluation of orbital volume, infra-orbital rim and globe position.

    Science.gov (United States)

    Nout, Erik; van Bezooijen, Jine S; Koudstaal, Maarten J; Veenland, Jifke F; Hop, Wim C J; Wolvius, Eppo B; van der Wal, Karel G H

    2012-04-01

    Patients with syndromic craniosynostosis suffering from shallow orbits due to midface hypoplasia can be treated with a Le Fort III advancement osteotomy. This study evaluates the influence of Le Fort III advancement on orbital volume, position of the infra-orbital rim and globe. In pre- and post-operative CT-scans of 18 syndromic craniosynostosis patients, segmentation of the left and right orbit was performed and the infra-orbital rim and globe were marked. By superimposing the pre- and post-operative scans and by creating a reference coordinate system, movements of the infra-orbital rim and globe were assessed. Orbital volume increased significantly, by 27.2% for the left and 28.4% for the right orbit. Significant anterior movements of the left infra-orbital rim of 12.0mm (SD 4.2) and right infra-orbital rim of 12.8mm (SD 4.9) were demonstrated. Significant medial movements of 1.7mm (SD 2.2) of the left globe and 1.5mm (SD 1.9) of the right globe were demonstrated. There was a significant correlation between anterior infra-orbital rim movement and the increase in orbital volume. Significant orbital volume increase has been demonstrated following Le Fort III advancement. The position of the infra-orbital rim was moved forward significantly, whereas the globe position remained relatively unaffected. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  17. Determination of muscle effort at the proximal femur rotation osteotomy

    Science.gov (United States)

    Sachenkov, O.; Hasanov, R.; Andreev, P.; Konoplev, Yu

    2016-11-01

    The paper formulates the problem of biomechanics of a new method for treatment of Legg-Calve-Perthes disease. Numerical calculations of the rotational flexion osteotomy have been carried out for a constructed mathematical model of the hip joint, taking into account the main set of muscles. The work presents the results of the calculations and their analysis. The results have been compared with the clinical data. The calculations of the reactive forces arising in the acetabulum and the proximal part of the femur allowed us to reveal that this reactive force changes both in value and direction. These data may be useful for assessing the stiffness of an external fixation device used in orthopedic intervention and for evaluating the compression in the joint.

  18. Computer and robotic assisted osteotomy around the knee.

    Science.gov (United States)

    Phillips, R; Hafez, M A; Mohsen, A M; Sherman, K P; Hewitt, J R; Browbank, I; Bouazza-Marouf, K

    2000-01-01

    The outcome variability and failures of conventional osteotomy have been attributed to lack of preoperative planning and inaccuracy in performing the correction. We present a computer and robotic assisted surgery system that can aid in accurate surgical planning for realignment, and in precisely implementing the plan in theatre. The approach seeks to avoid the cost and risks associated with the use of CT, and the insertion of fiducial markers, which are characteristic of existing computer assisted surgical systems. The paper details the architecture of the system as a whole, placing particular emphasis on planning technique. It is anticipated that the increased accuracy possible with the system will prove particularly useful for correcting multi-plane deformities, which are more problematic with conventional techniques.

  19. Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy

    Directory of Open Access Journals (Sweden)

    Erol Cansiz

    2016-01-01

    Full Text Available Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth.

  20. [Imaging and preoperative planning for osteotomies around the knee].

    Science.gov (United States)

    Pape, D; Hoffmann, A; Seil, R

    2017-08-01

    Physiologic alignment of the human lower leg is well defined. The etiology for malalignment comprises constitutional, degenerative and posttraumatic conditions. Osteotomies around the knee can correct the malalignment, provided that the origin of deviation is in proximity of the knee center. Crucial factors for the evaluation of axis deviation are the weight-bearing line, the mechanical axes of femur and tibia, the joint line angles and the center of the hip, knee and upper ankle joint. Careful preoperative planning is mandatory for reproducible clinical results. For the treatment of varus osteoarthritis of the knee, a slight overcorrection to the 62% width of the lateral tibial plateau is frequently advocated. In valgus knees, a correction of the postoperative weight-bearing line to physiologic conditions (44% of the lateral tibial width) is regarded to be sufficient. Recently, individualized planning of the correction angle is advocated to better address the underlying pathology of each patient.

  1. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    Science.gov (United States)

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Inspection Summary : Fort Niobrara/Valentine NWR Complex

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — An operations/administrative inspection and biological review was conducted at the Fort Niobrara/Valentine NWR Complex (Complex) in July 1993. The inspection team...

  3. [Fort Peck Game Range: Narrative report: February-April 1941

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR outlines Refuge accomplishments from February through April of 1941. The report begins by summarizing the weather conditions...

  4. Wilderness study summary : Fort Niobrara National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This summary describes the Fort Niobrara National Wildlife Refuge which has been studied by the Bureau of Sport Fisheries and Wildlife at the direction of the...

  5. Fort Niobrara National Wildlife Refuge Narrative report, 1966

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1966 calendar year. The report begins by...

  6. Fort Niobrara National Wildlife Refuge Narrative report, 1968

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1968 calendar year. The report begins by...

  7. Fort Niobrara National Wildlife Refuge Narrative report, 1970

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1970 calendar year. The report begins by...

  8. Fort Niobrara National Wildlife Refuge Narrative report, 1967

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1967 calendar year. The report begins by...

  9. Fort Niobrara National Wildlife Refuge Narrative report, 1969

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1969 calendar year. The report begins by...

  10. Fort Peck Game Range: Narrative report: September - December 1961

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from September through December of 1961. The report begins by...

  11. Fort Peck Game Range: Narrative report: September - December 1962

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from September through December of 1962. The report begins by...

  12. Fort Peck Game Range: Narrative report: May - August 1960

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from May through August of 1960. The report begins by summarizing...

  13. [Fort Niobrara National Wildlife Refuge: November, 1940 to January, 1941

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from November, 1940 to January of 1941. The report begins by...

  14. Folds--Offshore of Fort Ross Map Area, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for folds for the geologic and geomorphic map of the Offshore of Fort Ross map area, California. The vector data file is included...

  15. Faults--Offshore of Fort Ross Map Area, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for faults for the geologic and geomorphic map of the Offshore of Fort Ross map area, California. The vector data file is included...

  16. [Fort Peck Game Range: Narrative report: August-October, 1941

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR outlines Refuge accomplishments from August through October of 1941. The report begins by summarizing the weather conditions...

  17. [Fort Niobrara National Wildlife Refuge Narrative report: 1916

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes animal life and public relations, including hunting on Fort Niobrara NWR in 1916. Resource management is outlined; topics include haying and...

  18. [Fort Niobrara National Wildlife Refuge Narrative report: 1915

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes animal life and resource management, including haying on Fort Niobrara NWR in 1915. The public relations section of the report describes...

  19. [Fort Niobrara National Wildlife Refuge Narrative report: 1917

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes animal life and physical developments on Fort Niobrara NWR in 1917. The public relations section of the report describes Refuge visitors.

  20. [Fort Niobrara National Wildlife Refuge Narrative report: 1921

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes animal life and physical developments on Fort Niobrara NWR in 1921. Resource management is outlined; topics include haying.

  1. Fort Niobrara National Wildlife Refuge Narrative Report, 1974

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1974 fiscal year. The report begins by summarizing...

  2. Fort Niobrara National Wildlife Refuge Narrative Report, 1972

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1972 calendar year. The report begins by...

  3. Fort Niobrara National Wildlife Refuge Narrative Report, 1976

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments for the 1976 calendar year. The report begins by giving a brief...

  4. Backscatter A [8101]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate grids...

  5. [Fort Niobrara National Wildlife Refuge: November, 1939 to January, 1940

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from November, 1939 to January, 1940. The report begins by...

  6. Fort Niobrara National Wildlife Refuge Narrative Report, 1971

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1971 calendar year. The report begins by...

  7. Fort Niobrara National Wildlife Refuge Narrative Report, 1975

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1975 fiscal year. The report begins by summarizing...

  8. Fort Peck Game Range: Quarterly report: February, March, April 1942

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR outlines Refuge accomplishments from February through April of 1942. The report begins by summarizing the weather conditions...

  9. Fort Niobrara National Wildlife Refuge Narrative report, 1965

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments during the 1965 calendar year. The report begins by...

  10. Fort Peck Game Range: Narrative report: September - December 1960

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from September through December of 1960. The report begins by...

  11. Backscatter B [7125]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate grids...

  12. Backscatter C [Swath]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate grids...

  13. Fort Niobrara National Wildlife Refuge Narrative report -- May -- Aug., 1954

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from May through August of 1954. The report begins by summarizing...

  14. Fort Peck Game Range: Narrative report: May - August 1959

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from May through August of 1959. The report begins by summarizing...

  15. Fort Peck Game Range: Narrative report: January - April 1961

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from January through April of 1961. The report begins by...

  16. RadNet Air Data From Fort Worth, TX

    Science.gov (United States)

    This page presents radiation air monitoring and air filter analysis data for Fort Worth, TX from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  17. Fort Niobrara National Wildlife Refuge: Comprehensive Conservation Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Comprehensive Conservation Plan (CCP) was written to guide management on Fort Niobrara NWR for the next 15 years. This plan outlines the Refuge vision and...

  18. Backscatter A [8101]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate grids...

  19. Bison GIS data analysis protocol : Fort Niobrara National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Standard operating procedure/protocol for analyzing GIS data for the Fort Niobrara National Wildlife Refuge bison herd. This SOP is used in part of a study to...

  20. Bison spatial mapping protocol : Fort Niobrara National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Standard operating procedure/protocol for spatially mapping the Fort Niobrara National Wildlife Refuge bison herd. This SOP is used in part of a study to analyze...

  1. Background Contaminants Evaluation of Fort Niobrara and Valentine National Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The objectives of this study were to determine background concentrations of metals and organic compounds in biotic and abiotic components of the Fort...

  2. Elk population research update : Fort Niobrara National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Update on research implemented by Nebraska Game and Parks Commission and the U.S. Fish and Wildlife Service on the management of elk on Fort Niobrara National...

  3. Fort Niobrara National Wildlife Refuge Narrative report -- May -- Aug., 1953

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from May through August of 1953. The report begins by summarizing...

  4. VASCULAR FLORA OF FORT MCCLELLAN CALHOUN COUNTY, ALABAMA

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Fort McClellan is a military base located in the mountains of northeast Alabama (see Fig.1). Municipalities and communities surrounding Main Post include the City of...

  5. Bathymetry Hillshade--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the bathymetry and shaded-relief maps of the Offshore of Fort Ross map area, California. Raster data file is included in...

  6. Backscatter B [7125]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate...

  7. Backscatter C [Swath]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate...

  8. Backscatter A [8101]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate...

  9. Winter population numbers [Fort Niobrara NWR fenced animal program

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This data set is for winter population numbers for bison, elk and longhorn from January 1st of the calendar year and is part of the Fort Niobrara Fenced Animal...

  10. Backscatter C [Swath]--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the acoustic-backscatter map of the Offshore of Fort Ross map area, California. Backscatter data are provided as separate grids...

  11. Bathymetry Hillshade--Offshore of Fort Ross, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for the bathymetry and shaded-relief maps of the Offshore of Fort Ross map area, California. Raster data file is included in...

  12. Fort Niobrara National Wildlife Refuge River Recreation Management Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Fort Niobrara National Wildlife Refuge River Recreation Management Plan is to provide guidance and direction for management of recreational...

  13. Faults--Offshore of Fort Ross Map Area, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for faults for the geologic and geomorphic map of the Offshore of Fort Ross map area, California. The vector data file is included...

  14. Folds--Offshore of Fort Ross Map Area, California

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This part of DS 781 presents data for folds for the geologic and geomorphic map of the Offshore of Fort Ross map area, California. The vector data file is included...

  15. [Fort Niobrara National Wildlife Refuge: July to October, 1938

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from August through October of 1938. Photographs are attached.

  16. 2010 vegetation survey of the Fort Niobrara National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Fort Niobrara National Wildlife Refuge (FNNWR) is located on the Niobrara River in north central Cherry County, NE. There is little detailed information available...

  17. Fort Niobrara National Wildlife Refuge, Nebraska : Master Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Master plan for the recreational and public use development of Fort Niobrara National Wildlife Refuge, near Valentine, Nebraska. This plan outlines the development...

  18. [Fort Niobrara National Wildlife Refuge: May to July, 1940

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from May through July of 1940. The report begins by summarizing the...

  19. [Fort Niobrara National Wildlife Refuge: November, 1938 to January, 1939

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from November, 1938 to January, 1939. The report begins by...

  20. [Fort Niobrara National Wildlife Refuge: November, 1941 - January, 1942

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from November, 1941 through January of 1942. The report begins by...

  1. [Fort Niobrara National Wildlife Refuge: August to October, 1939

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from August through October of 1939. The report begins by...

  2. [Fort Niobrara National Wildlife Refuge February - April, 1942

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from February through April of 1942. The report begins by...

  3. [Fort Niobrara National Wildlife Refuge: August to October, 1940

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from August through October of 1940. The report begins by...

  4. [Fort Niobrara National Wildlife Refuge August - October, 1941

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from August through October of 1941. The report begins by...

  5. [Fort Niobrara National Wildlife Refuge: May to July, 1939

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from May through July of 1939. The report begins by summarizing the...

  6. [Fort Niobrara National Wildlife Refuge February - April, 1941

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from February through April of 1941. The report begins by...

  7. 77 FR 24579 - Establishment of the Fort Ord National Monument

    Science.gov (United States)

    2012-04-25

    ... from areas near and far, these lands support a growing travel and tourism sector that is a source of.... The protection of the Fort Ord area will maintain its historical and cultural significance,...

  8. Narrative report: Fort Peck Game Range: May - August 1943

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR outlines Refuge accomplishments from May through August of 1943. The report begins by summarizing the weather conditions and...

  9. Fort Peck Game Range: Narrative report: January - April, 1956

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from January through April of 1956. The report begins by summarizing...

  10. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year 1931

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes weather, water conditions, wildlife, infrastructural improvements, habitat management, and revenue on Fort Niobrara NWR during the 1931 fiscal...

  11. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year 1932

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes weather, water conditions, wildlife, infrastructural improvements, habitat management, and revenue on Fort Niobrara NWR during the 1932 fiscal...

  12. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year 1928

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes weather, water conditions, wildlife, infrastructural improvements, habitat management, and revenue on Fort Niobrara NWR during the 1928 fiscal...

  13. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year 1929

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes weather, water conditions, wildlife, infrastructural improvements, habitat management, and revenue on Fort Niobrara NWR during the 1929 fiscal...

  14. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year 1927

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes weather, water conditions, wildlife, infrastructural improvements, habitat management, and revenue on Fort Niobrara NWR during the 1927 fiscal...

  15. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year 1930

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes weather, water conditions, wildlife, infrastructural improvements, habitat management, and revenue on Fort Niobrara NWR during the 1930 fiscal...

  16. Baseline vegetation mapping : Fort Niobrara National Wildlife Refuge

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Final report for the baseline vegetation mapping project on Fort Niobrara National Wildlife Refuge. This project aims to create a vegetation map showing the...

  17. Narrative report: Fort Peck Game Range: January - April 1948

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR outlines Refuge accomplishments from January through April of 1948. The report begins by summarizing the weather conditions...

  18. Fort Peck Game Range: Narrative report: September - December, 1959

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR and the easement refuges outlines Refuge accomplishments from September through December of 1959. The report begins by...

  19. Fort Peck Game Range: January - April 1945: Narrative report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Peck NWR outlines Refuge accomplishments from January through April of 1945. The report begins by summarizing the weather conditions...

  20. [Fort Niobrara National Wildlife Refuge Narrative Report: fiscal year, 1947

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This narrative report for Fort Niobrara National Wildlife Refuge outlines Refuge accomplishments from the 1947 fiscal year. The report summarizes weather conditions,...

  1. Oblique Du-Fort Frankel Beam Propagation Method

    Directory of Open Access Journals (Sweden)

    Ken Chan

    2011-01-01

    Full Text Available The oblique BPM based on the Du-Fort Frankel method is presented. The paper demonstrates the accuracy and the computational improvements of the scheme compared to the oblique BPM based on Crank-Nicholson (CN scheme.

  2. Measurement of tibial slope angle after medial opening wedge high tibial osteotomy: case series

    Directory of Open Access Journals (Sweden)

    Ricardo Hideki Yanasse

    Full Text Available CONTEXT AND OBJECTIVE: In the past, changes in tibial slope were not considered when planning or evaluating osteotomies, and success in high tibial osteotomy was related to the alignment and amount of femorotibial angular correction. The aim here was to measure changes in tibial slope after medial opening wedge tibial osteotomy and investigate the effect of tibial slope angle on the clinical results. DESIGN AND SETTING: Retrospective review study on a series of cases, at the Department of Orthopedics and Traumatology, Faculdade de Medicina de Marília (Famema, Marília, Brazil. METHODS: Twenty-eight patients were studied, and a total of thirty-one knees. Lateral roentgenograms of the tibia were used pre and postoperatively to measure the tibial slope based on the proximal tibial anatomical axis. The clinical results were measured using the Lysholm knee score. RESULTS: There was an average increase in tibial slope angle after surgery of 2.38° (95% confidence interval: ± 0.73°. There was no correlation (r = -0.28 between the postoperative Lysholm knee score and the difference in tibial slope angle from before to after surgery (P = 0.13. CONCLUSION: Medial opening wedge tibial osteotomy led to a small increase in tibial slope. No significant correlation was found between increased tibial slope and short-term clinical results after high tibial osteotomy. Other clinical studies are needed in order to establish whether extension or flexion osteotomy could benefit patients with medial compartment gonarthrosis.

  3. Effect of Osteoporosis on Bone Density of Orthognathic Osteotomy Sites in Maxillofacial Region.

    Science.gov (United States)

    On, Sung Woon; Kim, Hyun Jun; Kim, Jayoun; Choi, Jin Wook; Jung, Young Wook; Song, Seung Il

    2016-10-01

    The aims of this study were to investigate the availability of Hounsfield unit (HU) measurement of computed tomography (CT) in evaluating the bone density of certain sites by comparing bone density between CT and dual-energy x-ray absorptiometry (DEXA), and to evaluate the effects of osteoporosis on osteotomy sites in orthognathic surgery. This retrospective study included 80 patients who had undergone both facial CT and DEXA at our hospital. We selected 7 regions of interest from among the osteotomy sites in bimaxillary orthognathic surgery. The patients were assigned to either the normal (control) group (n = 40) or the abnormal group (n = 40), and HU values were measured in each region of interest. There were statistically significant differences in the mean HU values between 2 groups at all the osteotomy sites in the maxilla and mandible, with the normal group showing higher values than the abnormal group (P osteotomy sites (P osteotomy sites except for 1 maxillary area, as compared with the normal group. Measurement of HU values on CT can be valuable in assessing bone density of the maxilla and mandible. It is suggested that osteoporosis may affect bone density at the osteotomy sites in orthognathic surgery, and the preoperative measurement of HU values might be useful in predicting unfavorable fracture or the risks involved in such surgery.

  4. Laser-Assisted Osteotomy for Implant Site Preparation: A Literature Review.

    Science.gov (United States)

    Moslemi, Neda; Shahnaz, Aysan; Masoumi, Samane; Torabi, Sepehr; Akbari, Solmaz

    2017-02-01

    The aim of this study was to review the scientific evidence about the laser osteotomy in implant bed preparation. An electronic search was performed on relevant English articles up to April 2016 in the PubMed, Scopus, and Google Scholar databases. Twenty-two articles (1 clinical, 13 animal, and 8 ex vivo studies) were included. Implant sites prepared by erbium family lasers and drill showed comparable results regarding the percentage of bone-to-implant contact, values of biomechanical tests, and healing process. Selection of proper laser wavelength and parameters was of paramount importance to minimize the risk of thermal bone damage. Lack of depth control and long time needed for implant site osteotomy with laser were the most challenging concerns for its clinical applicability. Computer-guided laser osteotomy showed promise for future use of laser osteotomy in clinical settings. Evidence from animal studies shows promising results regarding laser osteotomy in implant site preparation. However, because of the lack of clinical studies, it is not possible to make a conclusive result whether there is superiority of laser osteotomy in clinical practice.

  5. The comparison of edema and ecchymosis after piezoelectric and conventional osteotomy in rhinoplasty.

    Science.gov (United States)

    Taşkın, Ümit; Batmaz, Timur; Erdil, Mehmet; Aydın, Salih; Yücebaş, Kadir

    2017-02-01

    The basic aim of our study is to compare the results of the conventional and piezoelectric osteotomy in rhinoplasty by complete subperiosteal degloving of nasal bone to minimize soft-tissue injury. The study was designed as a prospective, double-blind, randomized, and controlled study. Setting is a tertiary referral hospital in Turkey. Ninety patients who underwent primary open rhinoplasty with osteotomy, performed by either the conventional instruments or the piezoelectric device. The complete subperiosteal degloving of the entire nasal bone was done up to the nasal maxillary sulcus, medial canthus, and nasion in all patients, independent of the type of osteotomy device used. Patients subsequently underwent median-oblique and lateral osteotomy, either with an ultrasonic device or a conventional 2-mm guarded, straight osteotome. The postoperative edema and ecchymosis were evaluated by another surgeon who was blinded to the osteotomy procedure on postoperative days 2 and 7. The edema scores were significantly increased on the second day compared with the seventh day in both groups 1 and 2. However, there was no significant difference between groups. The ecchymosis scores were slightly higher in postoperative day 2, compared with day 7, in both groups 1 and 2, but statistically not significant. This study showed that the main reason edema and ecchymosis are seen post-rhinoplasty is related to soft-tissue injury during osteotomy.

  6. How to Calculate the Exact Angle for Two-level Osteotomy in Ankylosing Spondylitis?

    Science.gov (United States)

    Zheng, Guoquan; Song, Kai; Yao, Ziming; Zhang, Yonggang; Tang, Xiangyu; Wang, Zheng; Zhang, Xuesong; Mao, Keya; Cui, Geng; Wang, Yan

    2016-09-01

    A prospective case series study. To describe and assess a two-level osteotomy method for the management of severe thoracolumbar kyphosis (TLK) in patients with ankylosing spondylitis (AS). To achieve better postoperative outcomes in these patients, a sophisticated preoperative surgical plan is required. Most deformities are managed using a one-level osteotomy and a two-level osteotomy is seldomly reported. Till date, no study has described a two-level osteotomy for these cases. From January 2011 to December 2012, 10 consecutive patients with ankylosing spondylitis who underwent two-level spinal osteotomy were studied. Pre- and postoperative full-length free-standing radiographs, including the whole spine and pelvis, were available for all patients. Pre- and postoperative radiological parameters, including T5-S1 Cobb angles, TLK, lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope, and sagittal vertical axis were measured. Health related quality of life , including Oswestry Disability Index and Scoliosis Research Society-22 surveys were administered before surgery and at 1-year follow up. The preoperative and postoperative T5-S1 Cobb angles was 51.3° and -7.1°, respectively (P osteotomy provides an accurate and reproducible method for ankylosing spondylitis correction. By which, we can obtain satisfactory radiological parameters and clinical outcomes. 4.

  7. A reciprocating ledge technique in closing wedge osteotomy for genu valgum in adolescents.

    Science.gov (United States)

    Dhar, Shabir Ahmed; Butt, Mohammed Farooq; Mir, Mohammed Ramzan; Dar, Tahir Ahmed; Sultan, Asif

    2009-12-01

    To describe a technique that preserves anterior and posterior alternate ledges in a closing wedge osteotomy. Five patients aged 14 to 19 years underwent a closing wedge osteotomy for genu valgum in 8 limbs using a reciprocating ledge technique. A unicortical wedge of bone was removed, with the anterior and posterior cortices spared. The anterior cortex at the proximal level and the posterior cortex at the distal level were cut through. With a wobbling action, the osteotomy site was rotated, and the distal fragment externally rotated. Manual force was applied to close the osteotomy site ensuring overlapping of the reciprocal ledges. The distal fragment was translated laterally to prevent club deformity. The osteotomy site was held with one or 2 staples. Stability was tested by flexion and extension of knee. All 8 limbs attained bone union within 12 weeks, and full range of motion within a mean of 13 (range, 12-15) weeks. The mean correction of the tibiofemoral angle was 13 degrees. At a mean follow-up of 12 months, all patients were pain-free and none developed club deformity. Sparing reciprocal ledges in a closing wedge osteotomy for genu valgum may increase stability in the flexion-extension axis, enable early range-of-motion exercises, and facilitate early bone union.

  8. Opening- and Closing-Wedge Distal Femoral Osteotomy

    Science.gov (United States)

    Chahla, Jorge; Mitchell, Justin J.; Liechti, Daniel J.; Moatshe, Gilbert; Menge, Travis J.; Dean, Chase S.; LaPrade, Robert F.

    2016-01-01

    Background: Lateral compartment osteoarthritis of the knee can be a challenging pathology in the younger, active population due to limited treatment options and high patient expectations. Distal femoral osteotomy (DFO) has been reported to be a potential treatment option. Purpose: To perform a systematic review on the survival, outcomes, and complications of DFO for treatment of genu valgum with concomitant lateral compartment osteoarthritis of the knee. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed using the Cochrane Database of Systematic Reviews, the Cochrane Central Registry of Controlled Trials, PubMed, and MEDLINE from 1980 to present. Inclusion criteria were as follows: outcomes of opening- and closing-wedge DFOs performed for treatment of genu valgum with concomitant lateral compartment osteoarthritis of the knee, English language, minimum 2-year follow-up, and human studies. Data abstracted from the selected studies included type of osteotomy (opening vs closing), survival rate, patient-reported and radiographic outcomes, and complications. Results: Fourteen studies met the inclusion criteria and were considered for the review. A total of 9 closing-wedge and 5 opening-wedge DFO studies were included. All were retrospective studies and reported good to excellent patient-reported outcomes after DFO. Survival decreased with increasing time from surgery, with 1 study reporting a 100% survival rate at 6.5 years, compared with 21.5% at 20 years in another study. A low rate of complications was reported throughout the review. Conclusion: Highly heterogeneous literature exists for both opening- and closing-wedge DFOs for the treatment of isolated lateral compartment osteoarthritis with valgus malalignment. A mean survival rate of 80% at 10-year follow-up was reported, supporting that this procedure can be a viable treatment option to delay or reduce the need for joint arthroplasty. A low

  9. ASSESSMENT OF HYDROCARBON SEEPAGE DETECTION METHODS ON THE FORT PECK RESERVATION, NORTHEAST MONTANA

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence M. Monson

    2003-06-30

    Surface exploration techniques have been employed in separate study areas on the Fort Peck Reservation in northeastern Montana. Anomalies associated with hydrocarbon seepage are documented in all three areas and a variety of surface exploration techniques can be compared. In a small area with established production, Head Gas and Thermal Desorption methods best match production; other methods also map depletion. In a moderate-size area that has prospects defined by 3D seismic data, Head Gas along with Microbial, Iodine, and Eh soil anomalies are all associated with the best hydrocarbon prospect. In a large area that contains many curvilinear patterns observed on Landsat images, that could represent micro-seepage chimneys, results are inconclusive. Reconnaissance mapping using Magnetic Susceptibility has identified a potential prospect; subsequent Soil Gas and Head Gas surveys suggest hydrocarbon potential. In the final year of this project the principle contractor, the Fort Peck Tribes, completed a second survey in the Wicape 3D Seismic Prospect Area (also known as Area 6 in Phase I of the project) and sampled several Landsat image features contained in the Smoke Creek Aeromag Anomaly Area (also known as Area 1 in Phase II of the project). Methods determined to be most useful in Phases I and II, were employed in this final Phase III of the study. The Southwest Wicape seismic anomaly was only partially confirmed. The abundant curvilinears proposed to be possible hydrocarbon micro-seepage chimneys in the Smoke Creek Area were not conclusively verified as such. Insufficient sampling of background data precludes affirmative identification of these mostly topographic Landsat features as gas induced soil and vegetation anomalies. However relatively higher light gas concentrations were found associated with some of the curvilinears. Based on the findings of this work the Assiniboine & Sioux Tribes of the Fort Peck Reservation intend to utilize surface hydrocarbon

  10. Undervisning mellem fortælling og feedback

    DEFF Research Database (Denmark)

    Andersen, Kirsten Margrethe

    2016-01-01

    Feedback gør det muligt for den enkelte at forstå, hvordan jeg kan blive bedre til det, jeg er ved at lære. Fortællinger gør det muligt for den enkelte at udvide horisonten og derved komme til en forståelse af, hvilke mulige perspektiver der er for at forholde sig til den verden, som fortællingen...

  11. [The development and clinical evaluation of the probiotic Bifidumbacterin forte].

    Science.gov (United States)

    Grigor'ev, A V; Bondarenko, V M; Abramov, N A; Murashova, A O; Feklisova, L V; Chuprinina, R P

    1997-01-01

    A new probiotic "Bifidumbacterin forte" containing bifidobacteria immobilized on carbon sorbent has been developed. The results of extensive clinical observation on the use of the preparation in patients (children and adults) with the infectious and surgical pathology of the gastrointestinal tract are presented. The clinico-bacteriological effect thus obtained makes it possible to recommend this new probiotic "Bifidumbacterin forte" for medical practice for the complex treatment of children and adults with acute and chronic diseases of the gastrointestinal tract.

  12. The role of fibular for supramalleolar osteotomy in treatment of varus ankle arthritis: a biomechanical and clinical study.

    Science.gov (United States)

    Zhao, Hongmou; Liang, Xiaojun; Li, Yi; Yu, Guangrong; Niu, Wenxin; Zhang, Yan

    2016-10-24

    Supramalleolar osteotomy (SMOT) is a well-accepted treatment method for mid-stage varus ankle osteoarthritis (OA). However, few studies have examined the role of fibular osteotomy in SMOT. The objective of the current study was to compare the biomechanical and clinical outcomes of SMOT with and without fibular osteotomy. Eight cadaveric lower legs with 10° varus/valgus SMOT models were tested using a Tekscan ankle sensor. Tibiotalar joint contact with and without fibular osteotomy conditions were compared. Forty-one varus ankle OA patients treated with SMOT were included; 22 underwent fibular osteotomy, and 19 did not. The Maryland foot score and radiological angles were used for clinical evaluation. The mean contact area and pressure did not differ significantly between normal and varus/valgus conditions with the fibula preserved. After fibular osteotomy, the mean contact area decreased and the mean contact pressure increased significantly in varus and valgus conditions (P osteotomy in varus/valgus conditions. After a mean follow-up of 36.6 months (range 17-61), there was no significant difference in the Maryland scores of the two groups. However, in the fibular osteotomy group, the talar tilt angle decreased (P osteotomy facilitates the translation of tibiotalar contact pressure and is helpful for varus ankle realignment in patients with large talar tilts and small tibiocrural angles.

  13. An investigation on the incidence of neurosensory disturbances of inferior alveolar nerve and condylardisplacement with Choung (IVSRO osteotomy

    Directory of Open Access Journals (Sweden)

    Shirani Gh

    2004-02-01

    Full Text Available The choung osteotomy (Intraoral Vertico- Sagittal Ramus Osteotomy has developed"nsince 1992 in the treatment of mandibular prognathism. In IVSRO, osteotomy plane is theoretically parallel to"nthe original sagittal plane and thereby attempting to decrease the incidence of condylar dispacement. This"nosteotomy designed additionally to decrease neurosensory disturbances."nPurpose: The aim of this study was to evaluate the incidence of neurosensory deficit and condylar"ndisplacement with IVSRO and Sagittal Split Ramus Osteotomy (SSRO."nMaterials and Methods: In this study, mandibular set back surgery was accomplished upon 7 patients by"nchoung osteotomy. In addition to choung osteotomy, in 2 patients Lefort 1 osteomy was performed for"nmaxillary protrusion and for 2 other patients, chain surgery was performed. Variables such as the"nneurosensory disturbances of inferior alveolar nerve and condylar displacement following choung osteotomy"nwere investigated. All the patients were followed up one year after osteotomy. OPG, Lateral Cephalogram and"nSubmentovertex radiographies were take pre and postoperatively for all patients."nResults: No statistically significant differences were found in condylar displacement (P>0.5. However, Mc"nNemar analysis showed significant difference of neurosensory deficit between IVSRO and SSRO (P=0.001."nConclusion: It is suggested that choung osteotomy is a safe procedure for mandibular surgery.

  14. En fortælling om fortællingens værdi

    DEFF Research Database (Denmark)

    Hansen, Morten Anker; Thorvardarson, Hanne

    2003-01-01

    Udviklingsarbejde om forældresamarbejde i en daginstitution. Daginstitutionen er modtage institution for indvandre børn. I udviklingsarbejdet tages udgangspunkt i fortællingen som metode til at skabe nye vinkler på værdierne omkring forældresamarbejdet samt på den daglige organisering omkring for...... forældre-samarbejdet. I udviklingsarbejdet blev der bl.a.lagt vægt på praksisfortællinger og Kolbs læringscirkel....

  15. Prospective evaluation of clinical and radiographic outcomes of Pem-berton osteotomy in patients with developmental dysplasia of hip

    Directory of Open Access Journals (Sweden)

    Saeid Tabatabai

    2016-08-01

    Full Text Available Background: Acetabular dysplasia is a well-known cause of early osteoarthritis of hip which may appear at any time (perinatal, breast-feeding and childhood. The aim of this study was to evaluate the clinical and radiographic outcomes of children with de-velopmental dysplasia of hip (DDH after undergoing open reduction, capsulorrhaphy and Pemberton osteotomy procedures. Methods: This study prospectively conducted on 13 patients with DDH who attended to Razi Hospital at Ahvaz Jundishapur University of Medical Sciences at Ahvaz, Iran, from April 2012 to March 2015. Inclusion criteria were children with age range of 18 months to 8 years and acetabular index≥ 40 degree. Exclusion criteria were the age less than 18 months or above 8 years, connective tissue diseases, secondary dislocation due to previous infection, and acetabular dysplasia with specific syndrome. All patients were evaluated before surgery and at least one year after surgery in terms of clinical evaluations, dislocation or subluxation of hip, congruity of hip and radiological out-comes according to grading systems of McKay, Tonnis grading system, Severin classi-fication and acetabular index, respectively. All patients underwent open reduction, capsulorrhaphy, and Pemberton’s osteotomy in single-stage surgery and if necessary femoral shortening was performed. Results: Ten patients (12 hips were evaluated. Of those, 4 patients (40% had right hip involvement. The mean age score was 38.92±12.37 months (range: 24-65 months. Acetabular index showed significant reduction after surgery in compare to before sur-gery (P= 0.002. According to Tonnis grading, 91.6% of cases were in I-II classes. Moreover, 66.6% of cases at clinical examinations of McKay criteria had excellent and good results after surgery. According to Severin radiographic findings criteria, 83.2% of cases were in I-III classes after surgery. There was statistically significant improvement in patients according to different

  16. Paleoenvironment of Fort Union Formation, South Dakota

    Energy Technology Data Exchange (ETDEWEB)

    Goodrum, C.

    1983-08-01

    Rocks of Paleocene age are represented in the Cave Hills of northwestern South Dakota by the Ludlow, Cannonball, and Tongue River members of the Fort Union Formation. The Cave Hills are situated within the southern margin of the Williston basin, 80 mi (130 km) north of the Black Hills, South Dakota. Numerous fine-grained, fining-upward sedimentary sequences comprise the Ludlow Member and are attributed to meandering streams occupying a low-gradient lower alluvial to upper deltaic plain. The Cannonball Member is 130 ft (40 m) thick in the North Cave Hills and is represented by two fine-grained, coarsening-upward sandstone mudstone sequences. A distinct vertical succession of sedimentary facies occur within each sequence representing offshore/lower shoreface through upper shoreface/foreshore depositional environment. A north to northeast depositional strike for the Cannonball shoreline is inferred from ripple crest and cross-bed orientations. The basal part of the Tongue River consists of approximately 40 to 50 ft (12 to 15 m) of lenticular sandstone, siltstone, mudstone, thin-bedded lignite, and kaolinite beds representing thin broad channels, point-bar, levee, overbank, and nearshore swamp depositional environments. Massive fluvial channel sandstones measuring several tens of ft in thickness overlie the fine-grained basal Tongue River lithologies. These channel sandstones represent the continued progradation of continental/fluvial/coastal plain depositional environments eastward over the marine sandstones of the Cannonball Member.

  17. US Army hangar, Fort Carson, Colorado, USA

    Energy Technology Data Exchange (ETDEWEB)

    Hollick, J. [Solar Wall International Ltd., Downsview (Canada)

    1999-07-01

    The US Army's first solar-ventilated hangar is located at Fort Carson, Colorado. Fumes from the fuel tanks of up to 30 helicopters stored in the building are displaced with solar-warmed fresh air. A conventional gas-heated ventilation system had been specified, but a value engineering analysis done for the Corps of Engineers showed that a solar-heated ventilation system would be comparable in cost to what was specified, so the design was changed. The fans were installed with the original building in 1992, but the solar cladding system was installed later, in 1995. The panels had to be supplied later as a retrofit project because of scheduling concerns at the time of construction. The solar-transpired collectors cover 725 m{sup 2} of the south wall above the hangar doors and heat 107,000 m{sup 3}/h of ventilation air. Cost savings have been calculated at US $14,000 (ECU 12,600) a year based on energy savings of 974,000 kWh a year. (author)

  18. Viscoelastic struts for vibration mitigation of FORTE

    Science.gov (United States)

    Maly, Joseph R.; Butler, Thomas A.

    1996-05-01

    FORTE is a small satellite being developed by Los Alamos National Laboratory (LANL) and Sandia National Laboratories Albuquerque (SNLA). It will be placed into orbit via a Pegasus launch in 1996. Testing a full-scale engineering model of the structure using the proto- qualification, system-level vibration spectrum indicated that acceleration levels caused by structural resonances exceed component levels to which certain sensitive components had previously been qualified. Viscoelastic struts were designed to reduce response levels associated with these resonances by increasing the level of damping in key structural modes of the spacecraft. Four identical shear-lap struts were fabricated and installed between the two primary equipment decks. The struts were designed using a system finite element model (FEM) of the spacecraft, a component FEM of the strut, and measured viscoelastic properties. Direct complex stiffness testing was performed to characterize the frequency-dependent behavior of the struts, and these measured properties (shear modulus and loss factor) were used to represent the struts in the spacecraft model. System-level tests were repeated with the struts installed and the response power spectral densities at critical component locations were reduced by as much as 10 dB in the frequency range of interest.

  19. Long-Term Outcome of Step-Cut Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome.

    Science.gov (United States)

    Papatheodorou, Loukia K; Baratz, Mark E; Bougioukli, Sofia; Ruby, Tyler; Weiser, Robert W; Sotereanos, Dean G

    2016-11-02

    Extra-articular ulnar shortening osteotomy is a common procedure for the surgical treatment of ulnar impaction syndrome. Several techniques for this osteotomy have been developed to avoid the morbidity associated with a standard transverse osteotomy. However, these techniques require special instrumentation and are expensive. The purpose of this study was to evaluate the outcome of step-cut ulnar shortening osteotomy without special jigs for ulnar impaction syndrome. A retrospective study of 164 consecutive patients who underwent step-cut ulnar shortening osteotomy between 2000 and 2010 was performed. The long arm of the step-cut osteotomy was oriented in the coronal plane parallel to the long axis of the ulna. The short arms of the osteotomy were perpendicular to the long axis in the axial plane. Fixation was performed with a palmar 3.5-mm standard neutralization plate and a lag screw. The goal of the osteotomy was to reduce ulnar variance, which was assessed in all patients with pronated grip-view radiographs preoperatively and postoperatively. Preoperative ulnar variance ranged from +1 to +6 mm. All patients were followed for at least 24 months. Union of the osteotomy site was achieved at a mean of 8.2 weeks. The union rate was 98.8%. There were 2 cases of nonunion, which required additional surgery. The mean postoperative ulnar variance was +0.2 mm (range, -1 to +1.5 mm) after a mean overall ulnar shortening of 2.5 mm. All patients returned to their previous work, in a mean of 4 months. The plate was removed from 12 patients because of plate-related symptoms. No other complications were encountered. The step-cut ulnar shortening osteotomy provides ample bone-to-bone contact and simplifies control of rotation. Stable internal fixation with standard techniques allowed an early return to functional activities. Palmar placement of the plate diminishes the need for plate removal. This is a simple and less expensive technique for ulnar shortening that does not

  20. Safe Zone for Neural Structures in Medial Displacement Calcaneal Osteotomy: A Cadaveric and Radiographic Investigation.

    Science.gov (United States)

    Talusan, Paul G; Cata, Ezequiel; Tan, Eric W; Parks, Brent G; Guyton, Gregory P

    2015-12-01

    We aimed to define reference lines on standard lateral ankle radiographs that could be used intraoperatively to minimize iatrogenic nerve injury risk in medial displacement calcaneal osteotomy. Forty cadaveric specimens were used. In 20 specimens, the sural, medial plantar (MP), and lateral plantar (LP) nerves were sutured to radiopaque wire, and a lateral ankle radiograph was obtained. On the radiograph, a line was drawn from the posterior superior apex of the calcaneal tuberosity to the origin of the plantar fascia and labeled as the "landmark line." A parallel line was drawn 2 mm posterior to the most posterior nerve, and the area between these lines was defined as the safe zone. In 20 additional specimens, an osteotomy was performed 1 cm anterior to the landmark line using a percutaneous or open technique. Dissection was performed to assess for laceration of the sural, MP, LP, medial calcaneal (MC), or lateral calcaneal (LC) nerves. The safe zone was determined to be within the area 11.2 ± 2.7 mm anterior to the landmark line. After open osteotomy, lacerations were found in 3 of 10 MC nerves and 3 of 10 LC nerves. After percutaneous osteotomy, lacerations were found in 2 of 10 MC nerves and 1 of 10 LC nerves. No lacerations of the sural, MP, or LP nerves were found with either osteotomy. The safe zone extended 11.2 ± 2.7 mm anterior to the described landmark line. The MC and LC nerves were always at risk during medial displacement calcaneal osteotomy. Nerve injury to both major and minor sensory nerves is likely underrecognized as a source of morbidity after calcaneal osteotomy. The current study provides a ready intraoperative guideline for minimizing this risk. © The Author(s) 2015.

  1. Neurologic Deficit Associated With Lateralizing Calcaneal Osteotomy for Cavovarus Foot Correction.

    Science.gov (United States)

    VanValkenburg, Scott; Hsu, Raymond Y; Palmer, Daniel S; Blankenhorn, Brad; Den Hartog, Bryan D; DiGiovanni, Christopher W

    2016-10-01

    Lateralizing calcaneal osteotomy (LCO) is a frequently used technique to correct hindfoot varus deformity. Tibial nerve palsy following this osteotomy has been described in case reports but the incidence has not been quantified. Eighty feet in 72 patients with cavovarus foot deformity were treated over a 6-year span by 2 surgeons at their respective institutions. Variations of the LCO were employed for correction per surgeon choice. A retrospective chart review analyzed osteotomy type, osteotomy location, amount of translation, and addition of a tarsal tunnel release in relation to the presence of any postoperative tibial nerve palsy. Tibial nerve branches affected and the time to resolution of any deficits was also noted. The incidence of neurologic deficit following LCO was 34%. With an average follow-up of 19 months, a majority (59%) resolved fully at an average of 3 months. There was a correlation between the development of neurologic deficit and the location of the osteotomy in the middle third as compared to the posterior third of the calcaneal tuber. We found no relationship between the osteotomy type, amount of correction, or addition of a tarsal tunnel release and the incidence of neurologic injury. Tibial nerve palsy was not uncommon following LCO. Despite the fact that deficits were found to be transient, physicians should be more aware of this potential problem and counsel patients accordingly. To decrease the risk of this complication, we advocate extra caution when performing the osteotomy in the middle one-third of the calcaneal tuberosity. Although intuitively the addition of a tarsal tunnel release may protect against injury, no protective effect was demonstrated in this retrospective study. Level III, retrospective cohort study. © The Author(s) 2016.

  2. Fixation of Intertrochanteric Valgus Osteotomy with T Plate in Treatment of Developmental Coxa Vara.

    Science.gov (United States)

    Elzohairy, Mohamed Mansour; Khairy, Hosam Mohamed

    2016-09-01

    Although the valgus subtrochanteric osteotomy is considered as a standard surgical treatment for coxa vara, there is no consensus on the optimal method of fixation and osteotomy technique. Fixation of the osteotomy has been achieved by various methods including external fixation and internal fixation with pins and cerclage and a variety of plates. The aim of this study is the evaluation of the results of developmental coxa treated by Y intertrochanteric valgus osteotomy fixed with a T-buttress plate compared with other methods of fixation in the literature. Eighteen corrective valgus intertrochanteric femoral osteotomies were performed in 18 patients (18 hips) for treatment of unilateral developmental coxa vara deformity and fixed with a T plate. There were 12 males and 6 females. The right hip was affected in 10 patients and the left hip in 8 patients. Clinically, patients were evaluated by Larson hip score. Radiographically, anteroposterior view of the pelvis and frog leg lateral views of the affected hip were taken preoperatively and compared with the findings at the final follow-up. The average follow-up was 29 months (range, 24 to 36 months). Clinical results showed improvement of the mean Larson hip score from 57.8 to 97.0 (p osteotomies were completely united in 2.4 months (range, 2 to 3 months) with the achievement of the planned correction angle. The average correction of Hilgenreiner's epiphyseal angle improved from 78.2° to 27.8° (p osteotomy of the proximal femur fixed with a T plate may be efficient for treatment of developmental coxa vara. With careful planning, it can result in a low complication rate and insignificant or minimal recurrence rate.

  3. Rate of Malunion Following Bi-plane Chevron Medial Malleolar Osteotomy.

    Science.gov (United States)

    Bull, Patrick E; Berlet, Gregory C; Canini, Cameron; Hyer, Christopher F

    2016-06-01

    Access to the medial half of the talus can be challenging even with an osteotomy. Although several techniques are presented in the literature, critical evaluation of fixation, union, and alignment is lacking. The chevron medial malleolar osteotomy provides advantages of perpendicular instrumentation access and wide exposure to the medial talus. Postoperative displacement resulting in malunion, and possibly provoking ankle osteoarthritis, is a known complication. The present study describes our experience with the osteotomy. A consecutive series cohort of 50 bi-plane chevron osteotomies performed from 2004 to 2013 were evaluated. Forty-six were secured using 2 lag screws, and 4 were secured using 2 lag screws and a medial buttress plate. Radiographic studies performed at 2, 6, and 12 weeks and at final follow-up were analyzed for postoperative displacement, malunion, non-union, and hardware-related complications. At initial postoperative follow-up, 47 of 50 had adequate radiographs for review, and 18 of 47 (38.3%) showed some displacement when compared to the initial osteotomy fixation position. By final follow-up, 15 of 50 (30.0%) had measurable incongruence. Hardware removal was performed in 13 (26.0%) cases at an average of 2.4 years postoperation. Bi-plane medial malleolar chevron osteotomy fixed with 2 lag screws showed a 30.0% malunion rate with an average of 2 mm of incongruence on final follow-up radiographs, which is higher than what has been reported in the literature. In our practice, we now use a buttress plate and more recently have eliminated postoperative osteotomy displacement. Level IV, retrospective case series. © The Author(s) 2016.

  4. The dawn of computer-assisted robotic osteotomy with ytterbium-doped fiber laser.

    Science.gov (United States)

    Sotsuka, Yohei; Nishimoto, Soh; Tsumano, Tomoko; Kawai, Kenichiro; Ishise, Hisako; Kakibuchi, Masao; Shimokita, Ryo; Yamauchi, Taisuke; Okihara, Shin-ichiro

    2014-05-01

    Currently, laser radiation is used routinely in medical applications. For infrared lasers, bone ablation and the healing process have been reported, but no laser systems are established and applied in clinical bone surgery. Furthermore, industrial laser applications utilize computer and robot assistance; medical laser radiations are still mostly conducted manually nowadays. The purpose of this study was to compare the histological appearance of bone ablation and healing response in rabbit radial bone osteotomy created by surgical saw and ytterbium-doped fiber laser controlled by a computer with use of nitrogen surface cooling spray. An Ytterbium (Yb)-doped fiber laser at a wavelength of 1,070 nm was guided by a computer-aided robotic system, with a spot size of 100 μm at a distance of approximately 80 mm from the surface. The output power of the laser was 60 W at the scanning speed of 20 mm/s scan using continuous wave system with nitrogen spray level 0.5 MPa (energy density, 3.8 × 10(4) W/cm(2)). Rabbits radial bone osteotomy was performed by an Yb-doped fiber laser and a surgical saw. Additionally, histological analyses of the osteotomy site were performed on day 0 and day 21. Yb-doped fiber laser osteotomy revealed a remarkable cutting efficiency. There were little signs of tissue damage to the muscle. Lased specimens have shown no delayed healing compared with the saw osteotomies. Computer-assisted robotic osteotomy with Yb-doped fiber laser was able to perform. In rabbit model, laser-induced osteotomy defects, compared to those by surgical saw, exhibited no delayed healing response.

  5. Double pelvic osteotomy for the treatment of hip dysplasia in young dogs.

    Science.gov (United States)

    Vezzoni, A; Boiocchi, S; Vezzoni, L; Vanelli, A B; Bronzo, V

    2010-01-01

    The aim of this study was to evaluate the feasibility of the double pelvic osteotomy (DPO) (osteotomy of the ilium and pubis) to treat clinical cases of hip dyplasia in young dogs instead of performing a triple pelvic osteotomy (TPO) (osteotomy of the ilium, pubis, and ischium). Candidates for DPO were 4.5- to nine-month-old dogs with coxofemoral joint subluxation and laxity, indicative of susceptibility to future development of severe hip dysplasia. The angle of reduction (AR) and angle of subluxation (AS) with Ortolani's sign, Norberg angle (NA), percentage of femoral head (PC) covered by the acetabulum, and the pelvic diameters and their relationships were measured clinically and radiographically before and after surgery. The surgical technique was similar to the TPO technique, but excluded ischiatic osteotomy. A DPO was carried out in 53 joints of 34 dogs; AR and AS values immediately postoperatively and at the one- and two-month follow-up examinations were significantly lower than the preoperative values (p table (7.5%). Changes in PC and NA values obtained immediately after surgery and at the first and second follow-up examinations were significantly greater (p surgery. Sufficient acetabular ventroversion was achieved to counteract joint subluxation and the modifications of AR and AS. The NA and PC direct postoperative values reflected a significant improvement in the dorsal acetabular coverage. Restoration of normal joint congruity (PC from 50 to 72%) and maintenance of the pelvic geometry without pelvic narrowing were the most intriguing features of DPO. The complications observed were greatly reduced when using dedicated DPO plates. Based on our experience, the morbidity after unilateral and bilateral DPO was lower than after TPO because elimination of the ischiatic osteotomy allowed for increased stability of the pelvis. The surgical technique of DPO was a little more demanding than TPO because of the difficulty in handling and rotating the acetabular

  6. Biomechanical consequences of adding plantar fascia release to metatarsal osteotomies: Changes in forefoot plantar pressures.

    Science.gov (United States)

    Aydogan, Umur; Roush, Evan P; Moore, Blake E; Andrews, Seth H; Lewis, Gregory S

    2017-04-01

    Destruction of the normal metatarsal arch by a long metatarsal is often a cause for metatarsalgia. When surgery is warranted, distal oblique, or proximal dorsiflexion osteotomies of the long metatarsal bones are commonly used. The plantar fascia has anatomical connection to all metatarsal heads. There is controversial scientific evidence on the effect of plantar fascia release on forefoot biomechanics. In this cadaveric biomechanical study, we hypothesized that plantar fascia release would augment the plantar metatarsal pressure decreasing effects of two common second metatarsal osteotomy techniques. Six matched pairs of foot and ankle specimens were mounted on a pressure mat loading platform. Two randomly assigned surgery groups, which had received either distal oblique, or proximal dorsiflexion osteotomy of the second metatarsal, were evaluated before and after plantar fasciectomy. Specimens were loaded up to a ground reaction force of 400 N at varying Achilles tendon forces. Average pressures, peak pressures, and contact areas were analyzed. Supporting our hypothesis, average pressures under the second metatarsal during 600 N Achilles load were decreased by plantar fascia release following proximal osteotomy (p fascia release following modified distal osteotomy, under multiple Achilles loading conditions (p < 0.05). Plantar fasciotomy should not be added to distal metatarsal osteotomy in the treatment of metatarsalgia. If proximal dorsiflexion osteotomy would be preferred, plantar fasciotomy should be approached cautiously not to disturb the forefoot biomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:800-804, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  7. 唇腭裂上颌复合体不同类型截骨块的抗力中心%Localization of the centre of resistance in different osteotomy pattern for maxillary complex with cleft lip and palate

    Institute of Scientific and Technical Information of China (English)

    侯敏; 张兰成; 石广玉; 宋大立; 张丽萍; 柳春明

    2010-01-01

    Objective To explore the location of the centre of resistance for the maxillary complex in cleft lip and palate by the use of finite element analysis. Methods Combining spiral CT scanning technology with the three-dimensional finite element method, a three-dimensional FEM model of LeFort Ⅰ , Ⅱ , and Ⅲ complex and soft tissue in cleft lip and palate was developed for analysis. Anteriorly and inferiorly directed forces of 9.8N were applied at five different levels parallel to the functional occlusal plane and four different levels perpendicular to the functional occlusal plane, respectively.For each loading condition, horizontal and vertical displacements of different anatomic points in the complex and on the maxillary dentition were analysed. Location of the centre of resistance in different osteotomy complex were studied. Results The resistant center of the LeFort Ⅱ complex in cleft lip and palate was located on intersection between basis nasi and medium of apertura piriforms vertically,apex of the canine and posterior point of the first bicuspid horizontally. The resistant center of the LeFort Ⅲ complex in cleft lip and palate was located on intersection between anterior of the nasion and medium of apertura piriforms vertically, posterior point of the first molar and first bicuspid horizontally. Conclusion Knowledge of the resistant center of different osteotomy complex could establish a basis for biomechanical studies of craniofacial complex distraction osteogenesis in cleft lip and palate.%目的 探讨唇腭裂上颌复合体不同类型截骨块的抗力中心,以便为临床牵引截骨提供理论指导.方法 采用螺旋CT扫描与三维有限元方法相结合,建立唇腭裂上颌复合体LeFort Ⅰ、Ⅱ、Ⅲ型截骨骨块及相应软组织有限元模型,分别在5个不同垂直高度加载水平向力和4个不同水平距离加载垂直向力,力值均为9.8 N,根据骨块不同观察点位移情况确定不同

  8. Sagittal accuracy of tibial osteotomy position during in vivo tibial plateau levelling osteotomy performed without an alignment jig and cutting guide.

    Science.gov (United States)

    Craig, Andrew; Witte, Philip Georg; Scott, Harry William

    2017-01-16

    To assess the accuracy of tibial osteotomy location for tibial plateau levelling osteotomy (TPLO) in the sagittal plane and its effect on the postoperative tibial plateau angle (TPA), when performed without an alignment jig and saw guide. Also, to document the improvement gained with experience. Medical records and stifle radiographs of dogs undergoing TPLO, without the use of an alignment jig and saw guide, by one surgeon were reviewed (2010-2014). Postoperative radiographs were reviewed to record the distance and direction of eccentricity. Postoperative TPA was also recorded. In a series of 401 TPLO procedures, 231 met the inclusion criteria. The absolute distance of eccentricity (DOE) for all dogs was 3.0 ± 1.6 mm. When evaluating surgical experience, the DOE for the final 77 cases (2.72 ± 1.43 mm), the middle 77 cases (3.18 ± 1.49 mm), and the first 77 cases (3.24 ± 1.7 mm) were not significantly different (p = 0.07157). There was a very weak correlation between DOE and postoperative TPA (R = 0.029). The location of the tibial osteotomy when performing TPLO without an alignment jig and saw guide compared favourably with previously documented use of an alignment jig and saw guide. Whilst the location of the tibial osteotomy has a theoretical impact on the postoperative TPA, other factors appear to be of greater importance. Surgeon experience did not result in significant improvement in accuracy up to 231 procedures.

  9. Column flotation of bitumen at Fort Hills

    Energy Technology Data Exchange (ETDEWEB)

    Lizama, H.M. [Teck Cominco, Vancouver, BC (Canada); Romero, D. [UTS Energy Corp., Calgary, AB (Canada); Armour, M. [Petro-Canada, Calgary, AB (Canada)

    2008-05-15

    Flotation columns are used by mineral processors to separate mineral species. The separation is based on the premise that different mineral particles have different surface hydrophobicities. There are 2 carrier phases, notably air bubbles moving up and aqueous pulp moving down. Hydrophobic particles predominantly adhere to rising air bubbles and form a froth, while hydrophilic particles remain in aqueous suspension and flow down and out the bottom of the column. This paper described a demonstration plant near Fort McMurray where bitumen extraction was tested. The plant included 2 columns for bitumen flotation. Oil sands material was passed through a roll sizer and fed to a countercurrent drum separator, where it was mixed with water at 75 degrees C. Column data from the demonstration plant provided the opportunity to examine the separation behaviour during flotation of bitumen. The bitumen grade was described only in terms of bitumen content and solids content in order to simplify the interpretation of the bitumen flotation data. Bitumen/solids separation in the first column was successful at 50 to 60 degrees C, with feeds having bitumen grades between 1 and 19 per cent, and where the solids had about 60 per cent fines. Bitumen/solids separation did not occur in the second column at 50 to 60 degrees C, with feeds having bitumen grades between 8 and 63 per cent, and where the solids had about 90 per cent fines. The lack of separation was probably due to high solids entrainment in the flotation froth. It was concluded that bitumen column flotation data can be analyzed and interpreted by adopting mineral processing principles. Bitumen/solids separation can be evaluated and predicted by plotting solids recovery as a function of bitumen recovery. 7 refs., 1 tab., 6 figs.

  10. Trans trochanteric approach with coronal osteotomy of the great trochanter

    Directory of Open Access Journals (Sweden)

    Steffann Francois

    2015-01-01

    Full Text Available Several surgical approaches could be used in hip arthroplasty or trauma surgery: anterior, anterolateral, lateral, posterior (with or without trochanterotomy, using or not an orthopedic reduction table. Subtrochanteric and extra-capsular trochanteric fractures (ECTF are usually treated by internal fixation with mandatory restrictions on weight bearing. Specific complications have been widely described. Mechanical failures are particularly high in unstable fractures. Hip fractures are a major public health issue with a mortality rate of 12%–23% at 1 year. An alternative option is to treat ECTF by total hip arthroplasty (THA to prevent decubitus complications, to help rapid recovery, and to permit immediate weight bearing as well as quick rehabilitation. However, specific risks of THA have to be considered such as dislocation or cardiovascular failure. The classical approach (anterior or posterior requires the opening of the joint and capsule, weakening hip stability and the repair of the great trochanter is sometimes hazardous. For 15 years, we have been treating unstable ECTF by THA with cementless stem, dual mobility cup (DMC, greater trochanter (GT reattachment, and a new surgical approach preserving capsule, going through the fracture and avoiding joint dislocation. Bombaci first described a similar approach in 2008; our trans fractural digastric approach (medial gluteus and lateral vastus is different. A coronal GT osteotomy is performed when there is no coronal fracture line. It allows easy access to the femoral neck and acetabulum. The THA is implanted without femoral internal rotation to avoid extra bone fragment displacement. With pre-operative planning, cup implantation is easy and stem positioning is adjusted referring to the top of the GT after trial reduction and preoperative planning. The longitudinal osteotomy and trochanteric fracture are repaired with wires and the digastric incision is closed. This variant of Bombaci

  11. Precise and feasible measurements of lateral calcaneal lengthening osteotomies by radiostereometric analysis in cadaver feet

    Science.gov (United States)

    Martinkevich, P.; Rahbek, O.; Møller-Madsen, B.; Søballe, K.; Stilling, M.

    2015-01-01

    Objectives Lengthening osteotomies of the calcaneus in children are in general grafted with bone from the iliac crest. Artificial bone grafts have been introduced, however, their structural and clinical durability has not been documented. Radiostereometric analysis (RSA) is a very accurate and precise method for measurements of rigid body movements including the evaluation of joint implant and fracture stability, however, RSA has not previously been used in clinical studies of calcaneal osteotomies. We assessed the precision of RSA as a measurement tool in a lateral calcaneal lengthening osteotomy (LCLO). Methods LCLO was performed in six fixed adult cadaver feet. Tantalum markers were inserted on each side of the osteotomy and in the cuboideum. Lengthening was done with a plexiglas wedge. A total of 24 radiological double examinations were obtained. Two feet were excluded due to loose and poorly dispersed markers. Precision was assessed as systematic bias and 95% repeatability limits. Results Systematic bias was generally below 0.10 mm for translations. Precision of migration measurements was below 0.2 mm for translations in the osteotomy. Conclusion RSA is a precise tool for the evaluation of stability in LCLO. Cite this article: Bone Joint Res 2015;4:78–83. PMID:25957380

  12. L5 pedicle subtraction osteotomy for high-grade isthmic spondylolisthesis.

    Science.gov (United States)

    Radcliff, Kristen E; Jakoi, Andre M

    2015-04-01

    To the authors' knowledge, this is the first article to present a pedicle subtraction osteotomy in the lumbar spine to correct and stabilize a high-grade isthmic spondylolisthesis, which poses many challenges with regard to treatment options and outcomes. The optimal surgical treatment for high-grade spondylolisthesis is controversial, but the goals of treatment are to stabilize the affected spinal levels and to decompress the neural elements. A pedicle subtraction osteotomy is a reconstructive procedure that addresses fixed sagittal imbalance by increasing lumbar lordosis through posterior spinal column shortening. The authors report a 46-year-old patient with chronic, progressively worsening back and leg radiculopathy accompanied by sagittal plane malalignment and for which a pedicle subtraction osteotomy was performed. The procedure yielded stabilization of the patient's lumbar spondylolisthesis and sagittal plane alignment was restoration. At 3 months postoperatively, the patient's pain had fully resolved and her motor and neurologic examination exhibited no deficits. At 24 months postoperatively, she was still symptom-free and ambulating without assistance. This report is the first documented successful pedicle subtraction osteotomy in the treatment of high-grade spondylolisthesis. This report indicates that certain patient populations may be amenable to pedicle subtraction osteotomy as a treatment option for pathology involving high-grade isthmic spondylolisthesis.

  13. An Anatomic Study of the Percutaneous Endoscopically Assisted Calcaneal Osteotomy Technique to Correct Hindfoot Malalignment.

    Science.gov (United States)

    Veljkovic, Andrea; Tennant, Joshua; Rungprai, Chamnanni; Abbas, Kaniza Zahra; Phisitkul, Phinit

    2017-02-01

    Open calcaneal osteotomy using traditional methods is associated with complications such as sural nerve injury and potential wound healing problems. We hypothesized that by using novel minimally invasive techniques, these potential risks could be mitigated. This anatomic cadaveric study serves to assess the safety of percutaneous endoscopically assisted calcaneal osteotomy (PECO) compared to a traditional open osteotomy technique. Anatomic safety of PECO was assessed using 8 fresh-frozen cadaver below-knee specimens. Lateral calcaneal nerve (LCN) damage was primarily noted and then secondly compared to a potential open surgical incision approach. Only 1 of 11 LCN branches (n = 8 limbs) was transected using PECO, compared to up to 8 of 10 LCN branches (n = 6 limbs) that potentially would have been injured during open surgery. Percutaneous endoscopically assisted calcaneal osteotomy is a minimally invasive technique that had fewer nerve injuries in this cadaveric model than traditional open surgery. Percutaneous endoscopically assisted calcaneal osteotomy due to its less invasive nature may result in fewer neurovascular injuries relative to an open procedure.

  14. Virtual Bernese osteotomy using three-dimensional computed tomography in hip dysplasia.

    Science.gov (United States)

    Suh, Dong Hun; Lee, Dae Hee; Jeong, Woong Kyo; Park, Sang Won; Kang, Chang Ho; Lee, Soon Hyuck

    2012-04-01

    Accurate assessment of acetabular morphology and its relationship to the femoral head is essential for planning a periacetabular osteotomy. We observed the acetabular coverage after virtual Bernese osteotomy using computer-aided technique. Three-dimensional computed tomography of 18 normal hips and 3 symptomatic dysplastic hips were analyzed. Through the center of the femoral head, vertical images were obtained at 10° intervals from 0° to 180° of rotation, using multiplanar reformation technique. Subsequently we measured 19 center-edge angles (CEAs) from each acetabulum. Four types of virtual osteotomy were performed on the three dysplastic hips. The adequacy of acetabular coverage after osteotomy was determined by comparing CEAs after correction with normal CEAs. Pearson correlation coefficients between the CEAs measured from normal cases and postoperative cases after lateral rotation of osteotomized fragments were 0.906 in case 1, 0.975 in case 2, 0.976 in case 3. Additional anterior rotation increased anterior acetabular coverage and simultaneously decreased posterior coverage in all three cases. Computer-aided virtual surgery technique based on three-dimensional computed tomography information enabled acetabular coverage to be quantified preoperatively in Bernese osteotomy. Lateral rotation of osteotomized acetabular fragments improved anterior and posterior coverage as well as lateral coverage.

  15. Complications associated with the Bernese periacetabular osteotomy for hip dysplasia in adolescents.

    Science.gov (United States)

    Thawrani, Dinesh; Sucato, Daniel J; Podeszwa, David A; DeLaRocha, Adriana

    2010-07-21

    The Bernese (Ganz) periacetabular osteotomy is an effective surgical procedure to reorient the acetabulum, allowing restoration of anatomic femoral head coverage and medial translation of the hip in adults with hip dysplasia. However, it is a challenging surgical procedure, and we know of no study that has specifically analyzed the complications and associated factors seen with this procedure in adolescent patients. A retrospective clinical and radiographic review of a consecutive series of adolescent patients who underwent a Bernese periacetabular osteotomy for hip dysplasia was conducted. Eighty-three osteotomies were performed in seventy-six patients with an average age (and standard deviation) of 15.6 +/- 2.4 years. Significant improvement from the preoperative to the two-year follow-up evaluation was seen radiographically with regard to the lateral center-edge angle (-0.14 degrees to 35.5 degrees), the ventral center-edge angle (-5.13 degrees to 31.3 degrees), and the femoral head extrusion index (38.4% to 7.7%) (p Bernese periacetabular osteotomy is a joint-preserving procedure that very effectively corrects acetabular dysplasia in adolescent patients, providing improved radiographic results and a low rate of complications. Although the rate of minor complications is increased when there is an underlying diagnosis other than developmental dysplasia, no other predictors were identified. However, a major complication is more likely with a longer duration of surgery and with a concomitant femoral varus osteotomy.

  16. Midterm results following medial closed wedge distal femoral osteotomy stabilized with a locking internal fixation device.

    Science.gov (United States)

    Forkel, Philipp; Achtnich, Andrea; Metzlaff, Sebastian; Zantop, Thore; Petersen, Wolf

    2015-07-01

    Aim of this study was to evaluate the subjective and radiological outcome and to evaluate the complications of a medial closing wedge osteotomy at the femur for lateral osteoarthritis with genu valgum. Twenty-three patients with grade III to IV cartilage damage and valgus knee alignment were treated with medial closing wedge osteotomy at the distal femur. The osteotomy was stabilized with an internal plate fixator. Age varied between 25 and 55 years (mean 47 years). One patient was lost to final follow-up. After 3.5 years, all Knee Osteoarthritis Outcome Score (KOOS) subitems increased significantly. There was no significant difference in the subgroup analysis of KOOS subitems for patients with and without microfracture or age (>50 vs. <50 years). There were no perioperative complications. One patient had an overcorrection. All, but one osteotomy, showed stable bone healing. There was a loss of correction due to delayed bone healing in one case. Possible explanations for this complication were injury of the lateral cortex or smoking. This case required revision with bone graft and an additional lateral plate. In no case, a conversion to an endoprosthesis was necessary. The femoral medial closing wedge osteotomy is a surgical method for improving symptoms of lateral osteoarthritis in the valgus knee. IV.

  17. Piezoelectric osteotomy in hand surgery: first experiences with a new technique

    Directory of Open Access Journals (Sweden)

    Kaenel Oliver Von

    2006-04-01

    Full Text Available Abstract Background In hand and spinal surgery nerve lesions are feared complications with the use of standard oscillating saws. Oral surgeons have started using a newly developed ultrasound bone scalpel when performing precise osteotomies. By using a frequency of 25–29 kHz only mineralized tissue is cut, sparing the soft tissue. This reduces the risk of nerve lesions. As there is a lack of experience with this technique in the field of orthopaedic bone surgery, we performed the first ultrasound osteotomy in hand surgery. Method While performing a correctional osteotomy of the 5th metacarpal bone we used the Piezosurgery® Device from Mectron [Italy] instead of the usual oscillating saw. We will report on our experience with one case, with a follow up time of one year. Results The cut was highly precise and there were no vibrations of the bone. The time needed for the operation was slightly longer than the time needed while using the usual saw. Bone healing was good and at no point were there any neurovascular disturbances. Conclusion The Piezosurgery® Device is useful for small long bone osteotomies. Using the fine tip enables curved cutting and provides an opportunity for new osteotomy techniques. As the device selectively cuts bone we feel that this device has great potential in the field of hand- and spinal surgery.

  18. Valgus osteotomy of the tibia with a Puddu plate combined with anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Albuquerque Roberto Freire da Mota e

    2003-01-01

    Full Text Available Anterior knee instability associated with a varus deformity is a complex condition with several treatment possibilities. Among these, anterior cruciate ligament (ACL associated to a simultaneous valgus tibial osteotomy is a increasing indication. This simultaneous procedure adds technical issues to those related to the isolated surgeries. Thus, the osteotomy plane and location of fixation hardware shouldn?t conflict with tibial tunnel and ACL graft fixation. Authors analyze the relations between a opening tibial valgus osteotomy stabilized with a Puddu plate and ACL reconstruction with a patellar tendon graft fixated with interference screws in 10 human cadaver knees. A straight oblique tibial osteotomy starting on the medial tibial cortex and oriented laterally and proximally was performed on all knees with a 10mm opening medially and stabilized with a Puddu plate on the most posterior aspect of the medial tibia, and a tibial tunnel drilled 50° to tibial plateau. With this technique there was no intersection between tibial tunnel or interference screw and the osteotomy or the plate fixation screws.

  19. Mechanism of bone incorporation of beta-TCP bone substitute in open wedge tibial osteotomy in patients.

    NARCIS (Netherlands)

    Gaasbeek, R.D.A.; Toonen, H.G.; Heerwaarden, R.J. van; Buma, P.

    2005-01-01

    A histological study was performed of bone biopsies from 16 patients (17 biopsies) treated with open wedge high tibial osteotomies for medial knee osteoarthritis. The open wedge osteotomies were filled with a wedge of osteoconductive beta tricalcium phosphate (beta-TCP) ceramic bone replacement. At

  20. Comparison of Postoperative Height Changes of the Second Metatarsal Among 3 Osteotomy Methods for Hallux Valgus Deformity Correction.

    Science.gov (United States)

    Choi, Jun Young; Suh, Yu Min; Yeom, Ji Woong; Suh, Jin Soo

    2017-01-01

    We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO). We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015. Each osteotomy was performed with 20 degrees of plantar ward obliquity. Along with lateral translation and rotation of the distal fragment to correct the deformity, lowering of the first metatarsal head was made by virtue of the oblique metatarsal osteotomy. Significant postoperative change in the second metatarsal height was observed on axial radiographs in all groups; this value was greatest in the PCMO group (vs scarf: P = .013; vs DCMO: P = .008) but did not significantly differ between the scarf and DCMO groups ( P = .785). The power for second metatarsal height correction was significantly greater in the PCMO group (vs scarf: P = .0005; vs DCMO: P = .0005) but did not significantly differ between the scarf and DCMO groups ( P = .832). Among the 3 osteotomy techniques commonly used to correct hallux valgus deformity, we observed that PCMO yielded the most effective height change of the second metatarsal head. Level III, retrospective comparative series.

  1. Postoperative volume increase of facial soft tissue after percutaneous versus endonasal osteotomy technique in rhinoplasty using 3D stereophotogrammetry

    NARCIS (Netherlands)

    Loon, B. van; Heerbeek, N. van; Maal, T.J.J.; Borstlap, W.A.; Ingels, K.J.A.O.; Schols, J.G.J.H.; Berge, S.J.

    2011-01-01

    BACKGROUND: When lateral osteotomies are performed as part of a rhinoplasty, the nose and paranasal region invariably change in three dimensions. The PURPOSE of this study is to compare the effect of the percutaneous perforating and endonasal continuous osteotomy techniques concerning the degree of

  2. A Preliminary Three-Dimensional Analysis of Nasal Aesthetics Following Le Fort I Advancement in Patients With Cleft Lip and Palate.

    Science.gov (United States)

    Davidson, Edward; Kumar, Anand R

    2015-10-01

    Nasal aesthetic changes after cleft orthognathic surgery remain understudied. Previous scarring associated with prior cleft surgery may affect the predictability of outcomes after jaw surgery. This study evaluates changes in nasal aesthetics using three-dimensional photography after Le Fort I advancement in patients with nonsyndromic cleft-related maxillary hypoplasia. Cephalometric parameters were recorded pre- and postoperatively. Three-dimensional photogrammetric imaging analyzed changes in interalar width (IAW), internostril width (INW), nasal tip projection (NTP), collumelar length (CL), nasal labial angle (NLA), and nasal length (NL). Statistical significance between pre- and postoperative data was determined using T-tests for each parameter. Eleven patients underwent either single piece Le Fort I osteotomy and advancement, (3 bilateral, 4 unilateral cleft lip, and palate), or 2-piece advancement (2 bilateral, 2 unilateral). Average nasal soft tissue changes were IAW 1.9 mm (0.4-4.2), INW -0.2 mm (-2.8 to 1.6), NTP -1.0 mm (-4.0 to 2.0), CL -0.7 mm (-2.9 to 1.5), NLA -0.2° (-13.9 to 15.1), and NL -0.7 mm (-4.3 to 1.5), (P = 0.001, 0.6, 0.08, 0.01, 0.9, 0.2). For single-piece osteotomy alone changes were IAW 2.1 mm (0.6-4.1), INW -0.6 mm (-2.8 to 1.7), NTP -1.9 mm (-4.0 to 0.3), CL -1.2 mm (-2.9 to 0.03), NLA -1.3° (-13.9 to 15.0), and NL -1.1 mm (-4.3 to 0.7), (P = 0.007, 0.3, 0.009, 0.0002, 0.7, 0.2). For 2-piece osteotomy alone changes were IAW 1.6 mm (-0.4 to 3.3), INW 0.5 mm (0.4-1.6), NTP 0.5 mm (-1.1-2.0), CL 0.2 mm (-1.4 to 1.5), NLA 2.8° (-7.6 to 10.1), and NL -0.1 mm (-1.4 to 1.5), (P = 0.2, 0.4, 0.5, 0.6, 0.5, 0.9). Cleft-related scarring and malposition affect changes in nasal aesthetics following maxillary advancement that are different to the noncleft population. Two-piece Le Fort I increases variability of changes in nasal aesthetics compared with single-piece advancement.

  3. Inflammatory Neuropathy of the Lumbosacral Plexus following Periacetabular Osteotomy

    Directory of Open Access Journals (Sweden)

    Stijn Ghijselings

    2016-01-01

    Full Text Available Introduction. During periacetabular osteotomy (PAO, the sciatic, femoral, and obturator nerves are at risk. Most frequently nerve lesions can be attributed to a mechanical cause; however, in the absence of a clear mechanical cause surgeons are faced with a diagnostic problem and in many cases no diagnosis will be established. We report a case of inflammatory neuropathy of the lumbosacral plexus following a PAO. Case Presentation. A 31-year-old female developed weakness of ankle and knee flexion and extension 6 months after a PAO. Electrophysiological studies revealed damage to the obturator, femoral, and sciatic nerve consistent with an inflammatory lumbosacral plexopathy. MRI of the lumbosacral plexus was normal. The patient was treated with multimodal pain therapy and prolonged physiotherapy; nevertheless, symptoms worsened over time. At 2-year follow-up, there were no signs of recovery. Discussion. Inflammatory neuropathy of the lumbosacral plexus is a potential cause of pain and weakness after ipsilateral orthopaedic procedures. It should be distinguished from more frequently encountered mechanical causes of postsurgical neuropathy based on clinical suspicion, electrophysiological studies, MRI, and nerve biopsy. It is important that the orthopaedic community is aware of this complication since there is some evidence that early recognition and initiation of immunosuppressive therapy can lead to improved clinical outcome.

  4. Ulnar or radial shortening osteotomy with a single saw cut.

    Science.gov (United States)

    Sraj, Shafic A; Budoff, Jeffrey E

    2009-09-01

    To determine which currently commercially available saw blades could be held at 45 degrees to the bone to reproducibly provide 2.0, 2.5, and 3.0 mm of ulna or radius shortening. Commercially available saw blades were tested for their ability to achieve the osseous shortening at a 45 degrees angle cut. When held at a 45 degrees angle to the bone, 2 Stryker 0.64-mm-thick blades achieved a mean shortening of 2.0 mm. A single Linvatec 1.2-mm-thick blade achieved a mean osseous shortening of 2.1 mm. Two Dyonics 0.65-mm-thick blades achieved a mean osseous shortening of 2.7 mm. Two Dyonics 0.89-mm-thick saw blades achieved a mean osseous shortening of 3.1 mm. Three Stryker 0.38-mm-thick saw blades mounted with the middle blade "upside down" with regard to the 2 outer blades achieved a mean osseous shortening of 3.2 mm. Two Linvatec 0.8-mm-thick saw blades achieved a mean osseous shortening of 3.1 mm. The findings of this study can help guide surgeons who desire to reproducibly shorten the ulna or radius by 2.0, 2.7, or 3.2 mm using a single saw cut to ensure a parallel osteotomy gap.

  5. Osteotomies through a fusion mass in the lumbar spine.

    Science.gov (United States)

    Vital, Jean-Marc; Boissière, Louis; Bourghli, Anouar; Castelain, Jean-Etienne; Challier, Vincent; Obeid, Ibrahim

    2015-01-01

    Flat-back syndrome is one of the main causes of surgical failure after lumbar fusion and can lead to a revision surgery to correct it. Three-column pedicle subtraction osteotomy is an efficient technique to restore lumbar lordosis (LL) for fixed sagittal malalignment. The fusion mass stemming from the past surgeries makes the procedure demanding as most anatomical landmarks are missing. This review article will focus on the correction of this lack of LL through the fusion mass. We will successively review the preoperative management, the surgical specificities, and various types of clinical cases that can be encountered in flat-back syndromes. PSO in the fixed fusion mass is technically demanding. Preoperative CT-scan and preoperative navigation allow us to push the limits when anatomical landmarks disappear. Bleeding and neurologic are the two major complications feared by the surgeon. The best way to avoid these revision surgeries is to restore a proper lumbar lordosis at the time of initial surgery by considering lumbo-pelvic indexes.

  6. Bone scintigraphy and magnetic resonance imaging after transtrochanteric rotational osteotomy

    Energy Technology Data Exchange (ETDEWEB)

    Iwasada, Seiki; Hasegawa, Yukiharu; Iwase, Tosiki; Kitamura, Shinji; Iwata, Hisashi [Department of Orthopaedic Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466 (Japan)

    1999-05-01

    Objective. To assess the ability of bone scintigraphy and magnetic resonance imaging (MRI) to predict the outcome of transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). Design. This study was a prospective evaluation of imaging techniques. Patients and methods. MRI and bone scintigraphy were performed on 20 hips in 18 patients at 3 months after TRO. The radiographic findings at 3 months after TRO, and the MRI and bone scintigraphic findings, were compared with the radiographic findings at final follow-up (mean 39 months). Results and conclusions. On MRI a low-intensity area or a low-intensity band in the new weight-bearing area extending over the acetabular edge on T1-weighted images was related to the presence of collapse on the radiographs at final follow-up. In hips with an area of absent activity in the new weight-bearing surface on bone scintigraphy, collapse was seen more frequently on radiographs at final follow-up than in hips without this feature. Bone scintigraphy was no more specific than radiography in predicting the outcome after TRO. We consider MRI to be superior to bone scintigraphy in predicting the occurrence of collapse, which is one of the major short-term problems after TRO. (orig.) With 8 figs., 4 tabs., 15 refs.

  7. Prediction of neurosensory alterations after sagittal split ramus osteotomy.

    Science.gov (United States)

    Kuroyanagi, N; Miyachi, H; Ochiai, S; Kamiya, N; Kanazawa, T; Nagao, T; Shimozato, K

    2013-07-01

    Prediction of neurosensory deficit in the lower lip and chin after sagittal split ramus osteotomy (SSRO) is challenging. This study aimed to elucidate factors related to the development and improvement of neurosensory disturbance (NSD) after SSRO with respect to surgical procedure and the anatomical and structural characteristics of the craniomaxillofacial skeleton. Subjects comprised 50 patients treated by a single experienced surgeon. Anatomical data and landmarks were obtained by computed tomography (CT) imaging. There was a significant difference between patients with or without NSD for the surgical space on the medial side of mandibular ramus 1 week after SSRO (P=0.006). Less than 15.0mm between the lingula and mandibular notch (relative risk, 6.7; 95% CI, 1.7-33.8) and 195.0mm(2) or more space on the medial side of the mandibular ramus (relative risk, 17.2; 95% CI, 3.9-100.4) indicated a significant risk of NSD development at 6 months postoperatively. These results suggested that the development of NSD is related to the surgical space on the medial side of the mandibular ramus and subsequent manipulation of the inferior alveolar nerve (IAN) in that region. Limited periosteal degloving prevents excessive stretching of the IAN during SSRO, thus lowering NSD incidence.

  8. Cholesteatoma after lateral bulla osteotomy in two brachycephalic dogs.

    Science.gov (United States)

    Schuenemann, Riccarda Martina; Oechtering, Gerhard

    2012-01-01

    This report describes a French bulldog and a pug that presented to the authors' hospital following total ear canal ablation (TECA) and lateral bulla osteotomy (LBO), with signs of recurring otitis media and difficulty opening their mouths. The bulldog also had unilateral facial paralysis and sensory deficits of the trigeminal nerve on the ipsilateral side. Computed tomography and MRI scans suggested cholesteatoma in the bulldog, but showed only slight enlargement of the bulla in the pug. Histopathologic examination of samples yielded cholesteatoma in both cases. The authors suspect that development of the cholesteatomas was linked to the TECA/LBO surgery in both cases. Cholesteatomas may occur more frequently than currently thought. Even if only slight changes of the bulla wall are detected on CT, early-stage cholesteatoma should be considered. The narrow anatomic conditions in brachycephalic dogs possibly predispose such breeds to develop cholesteatoma after middle ear surgery because complete removal of all inflammatory and epithelial tissue can be more difficult than in other breeds. To the authors' knowledge, this is the first report of an aural cholesteatoma causing sensory deficits of the trigeminal nerve.

  9. Effect of the Osteotomy Length on the Change of the Posterior Tibial Slope With a Simple Distraction of the Posterior Gap in the Uni- and Biplanar Open-Wedge High Tibial Osteotomy.

    Science.gov (United States)

    Lee, Yong Seuk; Kang, Jong Yeal; Lee, Myung Chul; Oh, Won Seok; Elazab, Ashraf; Song, Min Kyu

    2016-02-01

    To (1) determine the length of the osteotomy at the anterior and posterior cortex, (2) compare between uni- and biplanar osteotomy, and (3) evaluate the relationship between the extent of the osteotomy and change of the posterior tibial slope. A prospective comparative study of 24 uniplanar and 30 biplanar osteotomies was performed. To evaluate the length of osteotomy, osteotomy lines of the anterior and posterior cortex were analyzed in the 3-dimensional surface models. For slope measurement, the intramedullary axis of the proximal tibia (slope P), posterior cortical line of the proximal tibia (slope C), and anterior cortical line of the proximal fibula (slope F) were used. An analysis of the changes in the posterior tibial slope was performed independently using a pre- and postoperative lateral plane radiograph. In the uniplanar osteotomy, ratios of the osteotomized length to the total cortical length aligned with the osteotomized plane were larger in the anterior cortex (0.91 in uniplanar v 0.46 in biplanar; P = 0) and posterior cortex (0.97 in uniplanar v 0.79 ratio in biplanar; P = 0). Furthermore, the posterior tibial slope was maintained in both groups and the ratios between the anterior and posterior gap in both groups were 0.57 and 0.63, respectively. The maintenance of the slope was not related to any specific variables. Additionally, these phenomena did not differ between those patients who underwent uni- and those who underwent biplanar osteotomy. Increase in the posterior tibial slope was prevented with appropriate uni- or biplanar osteotomy with a simple distraction at the most posterior gap. However, in the uniplanar osteotomy, the ratio of the osteotomized length to the total cortical length was larger in both the anterior and posterior cortex. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  10. Central Energy System Modernization at Fort Jackson, South Carolina

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Daryl R.; Chvala, William D.; Dirks, James A.

    2006-11-29

    An evaluation of technology options was conducted for the central energy systems at Fort Jackson, South Carolina. There were two objectives in conducting this study. From a broader viewpoint, the Army would like to develop a systematic approach to management of its central energy systems and selected Fort Jackson for this ''pilot'' study for a prospective Central Energy System Modernization Program. From a site-specific perspective, the objective was to identify the lowest life-cycle cost energy supply option(s) at Fort Jackson for buildings currently served by central boilers and chillers. This study was co-funded by the Army's Southeast Region and the U.S. Department of Energy's Federal Energy Management Program.

  11. Fortælling og fortolkning i Jyske Bank

    DEFF Research Database (Denmark)

    Albrechtsen, Charlotte

    Afhandlingen præsenterer en undersøgelse af et konkret eksempel på storytelling brugt som strategisk ledelses- og kommunikationsredskab i en organisations interne kommunikation. Eksemplet er fortællingen "Slaget ved Vejle", som stammer fra Jyske Bank og udgør under afhandlingens case. De overordn...... fortællinger i organisationers interne kommunikation.......Afhandlingen præsenterer en undersøgelse af et konkret eksempel på storytelling brugt som strategisk ledelses- og kommunikationsredskab i en organisations interne kommunikation. Eksemplet er fortællingen "Slaget ved Vejle", som stammer fra Jyske Bank og udgør under afhandlingens case. De...

  12. Targeting Net Zero Energy at Fort Carson: Assessment and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, K.; Markel, T.; Simpson, M.; Leahey, J.; Rockenbaugh, C.; Lisell, L.; Burman, K.; Singer, M.

    2011-10-01

    The U.S. Army's Fort Carson installation was selected to serve as a prototype for net zero energy assessment and planning. NREL performed the comprehensive assessment to appraise the potential of Fort Carson to achieve net zero energy status through energy efficiency, renewable energy, and electric vehicle integration. This report summarizes the results of the assessment and provides energy recommendations. This study is part of a larger cross-laboratory effort that also includes an assessment of renewable opportunities at seven other DoD Front Range installations, a microgrid design for Fort Carson critical loads and an assessment of regulatory and market-based barriers to a regional secure smart grid.

  13. En fascinerende fortælling om det 20. århundredes musik

    DEFF Research Database (Denmark)

    Bonde, Lars Ole

    2011-01-01

    Anmeldelse af Karl Aage Rasmussen: Musik i det tyvende århundrede: En fortælling. Gyldendal 2011.......Anmeldelse af Karl Aage Rasmussen: Musik i det tyvende århundrede: En fortælling. Gyldendal 2011....

  14. Fort Collins Science Center-Fiscal year 2009 science accomplishments

    Science.gov (United States)

    Wilson, Juliette T.

    2010-01-01

    Public land and natural resource managers in the United States are confronted with increasingly complex decisions that have important ramifications for both ecological and human systems. The scientists and technical professionals at the U.S. Geological Survey Fort Collins Science Center?many of whom are at the forefront of their fields?possess a unique blend of ecological, socioeconomic, and technological expertise. Because of this diverse talent, Fort Collins Science Center staff are able to apply a systems approach to investigating complicated ecological problems in a way that helps answer critical management questions. In addition, the Fort Collins Science Center has a long record of working closely with the academic community through cooperative agreements and other collaborations. The Fort Collins Science Center is deeply engaged with other U.S. Geological Survey science centers and partners throughout the Department of the Interior. As a regular practice, we incorporate the expertise of these partners in providing a full complement of ?the right people? to effectively tackle the multifaceted research problems of today's resource-management world. In Fiscal Year 2009, the Fort Collins Science Center's scientific and technical professionals continued research vital to Department of the Interior's science and management needs. Fort Collins Science Center work also supported the science needs of other Federal and State agencies as well as non-government organizations. Specifically, Fort Collins Science Center research and technical assistance focused on client and partner needs and goals in the areas of biological information management and delivery, enterprise information, fisheries and aquatic systems, invasive species, status and trends of biological resources (including human dimensions), terrestrial ecosystems, and wildlife resources. In the process, Fort Collins Science Center science addressed natural-science information needs identified in the U

  15. Renewable Energy Opportunities at Fort Drum, New York

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Scott A.; Orrell, Alice C.; Solana, Amy E.; Williamson, Jennifer L.; Hand, James R.; Russo, Bryan J.; Weimar, Mark R.; Rowley, Steven; Nesse, Ronald J.

    2010-10-20

    This document provides an overview of renewable resource potential at Fort Drum, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Drum took place on May 4 and 5, 2010.

  16. Molecular genetics at the Fort Collins Science Center

    Science.gov (United States)

    Oyler-McCance, S.J.; Stevens, P.D.

    2011-01-01

    The Fort Collins Science Center operates a molecular genetic and systematics research facility (FORT Molecular Ecology Laboratory) that uses molecular genetic tools to provide genetic information needed to inform natural resource management decisions. For many wildlife species, the data generated have become increasingly important in the development of their long-term management strategies, leading to a better understanding of species diversity, population dynamics and ecology, and future conservation and management needs. The Molecular Ecology Lab serves Federal research and resource management agencies by developing scientifically rigorous research programs using nuclear, mitochondrial and chloroplast DNA to help address many of today's conservation biology and natural resource management issues.

  17. Renewable Energy Opportunities at Fort Campbell, Tennessee/Kentucky

    Energy Technology Data Exchange (ETDEWEB)

    Hand, James R.; Horner, Jacob A.; Kora, Angela R.; Orrell, Alice C.; Russo, Bryan J.; Weimar, Mark R.; Nesse, Ronald J.

    2011-03-31

    This document provides an overview of renewable resource potential at Fort Campbell, based primarily upon analysis of secondary data sources supplemented with limited on-site evaluations. This effort focuses on grid-connected generation of electricity from renewable energy sources and also on ground source heat pumps for heating and cooling buildings. The effort was funded by the U.S. Army Installation Management Command (IMCOM) as follow-on to the 2005 Department of Defense (DoD) Renewables Assessment. The site visit to Fort Campbell took place on June 10, 2010.

  18. New Technique: A Novel Femoral Derotation Osteotomy for Malrotation following Intramedullary Nailing

    Directory of Open Access Journals (Sweden)

    S. Jagernauth

    2012-01-01

    Full Text Available A 19-year-old female patient sustained a closed spiral midshaft femoral fracture and subsequently underwent femoral intramedullary nail insertion. At followup she complained of difficulty in walking and was found to have a unilateral in-toeing gait. CT imaging revealed 30 degrees of internal rotation at the fracture site, which had healed. A circumferential osteotomy was performed distal to the united fracture site using a Gigli saw with the intramedullary femoral nail in situ. The static distal interlocking screws were removed and the malrotation was corrected. Two further static distal interlocking screws were inserted to secure the intramedullary nail in position. The osteotomy went on to union and her symptoms of pain, walking difficulty, and in-toeing resolved. Our paper is the first to describe a technique for derotation osteotomy following intramedullary malreduction that leaves the intramedullary nail in situ.

  19. Triple pelvic osteotomy: Report of our mid-term results and review of literature

    Science.gov (United States)

    Mimura, Tomohiro; Mori, Kanji; Kawasaki, Taku; Imai, Shinji; Matsusue, Yoshitaka

    2014-01-01

    A wide variety of pelvic osteotomies have been developed for the treatment of developmental dysplasia of the hip (DDH). In the present paper, we present a detailed review of previous studies of triple osteotomy as an alternative treatment for DDH. We also report our experience treating 6 adult cases of DDH by triple osteotomy in order to highlight the various aspects of this procedure.The mean age of our patients was 31.2 years with a mean follow-up period of 6 years. We assessed range of motion, center-edge angle, acetabular index angle, Sharp angle, acetabulum head index, head lateralization index, Japanese Orthopedic Association score, Harris hip score, patient satisfaction, and the difference between lower limb lengths before and after the procedure. At final follow-up, clinical scores were significantly improved and radiographic parameters also showed good correction of acetabulum. PMID:24649410

  20. Bone repair inhibited by indomethacin. Effects on bone metabolism and strength of rabbit osteotomies

    Energy Technology Data Exchange (ETDEWEB)

    Keller, J.; Buenger, C.; Andreassen, T.T.; Bak, B.; Lucht, U.

    1987-01-01

    We measured mineral content, maximum bending strength, and regional blood flow after tibial osteotomy fixed with a small metal plate in 38 rabbits. Half of the animals were treated with indomethacin (10 mg/kg/day) while the other half served as controls. After 2 and 6 weeks, the bone mineral content and maximum bending strength were lower in the indomethacin group when compared with the controls. Compared with the controls, the blood flow at the osteotomy site was decreased after 2 weeks and increased after 6 weeks in the indomethacintreated animals. Inhibition of blood flow increase by indomethacin medication in the early period following osteotomy, as well as retarded bone healing, are probably caused by inhibition of the inflammatory reaction.

  1. Reconstruction of neglected developmental dysplasia by total hip arthroplasty with subtrochanteric shortening osteotomy.

    Science.gov (United States)

    Atilla, Bülent

    2016-03-01

    Patients with neglected developmental dysplasia (DDH) face with early osteoarthritis of the hip, limb length inequality and marked disability while total hip reconstruction is the only available choice.DDH has severe morphologic consequences, with distorted bony anatomy and soft tissue contractures around the hip. It is critical to evaluate patients thoroughly before surgery.Anatomic reconstruction at the level of true acetabulum with uncemented implant is the mainstay of treatment. This requires a subtrochanteric shortening osteotomy, which can be realised using different osteotomy and fixation options.Although a demanding technique with a high rate of related complications, once anatomic reconstruction of the hip is achieved, patients have a remarkably good functional capacity and implant survival during long follow-up periods. Cite this article: Atilla B. Reconstruction of neglected developmental dysplasia by total hip arthroplasty with subtrochanteric shortening osteotomy. EFORT Open Rev 2016;1:65-71. DOI: 10.1302/2058-5241.1.000026.

  2. Single-Tooth Osteotomy Using Piezoelectric Devices to Treat an Ankylosed Maxillary Molar.

    Science.gov (United States)

    You, Tae Min; Kang, Joon Hyun; Kim, Kee-Deog; Park, Wonse

    2016-01-01

    Single-tooth osteotomy is a surgical technique in which the tooth and adjacent bone with sufficient soft tissue are repositioned in a single step or moved orthodontically. It is not used in the maxillary posterior region because of poor accessibility, bleeding complications, and anatomical limitations such as the maxillary sinus. However, the development of piezoelectric surgical devices and the popularization of the sinus floor elevation procedure have simplified the approach to the posterior maxillary area. This article reports two cases of single-tooth osteotomy of ankylosed teeth that were performed safely in the posterior maxilla with the use of a piezoelectric device and a sinus membrane elevation. In addition, several merits of this approach as compared with conventional osteotomy are described.

  3. One-Stage Computer-Assisted Total Knee Arthroplasty and Tibial Osteotomy.

    Science.gov (United States)

    Denjean, S; Chatain, F; Tayot, O

    2017-03-02

    Same-stage tibial osteotomy may deserve consideration in candidates to total knee arthroplasty (TKA) who have severe bone deformities, particularly at extra-articular sites. This strategy obviates the need for either a major and technically difficult ligament release procedure, which may compromise ligament balancing, or the use of a semi-constrained prosthesis. This technical note describes a one-stage, computer-assisted technique consisting in TKA followed by corrective tibial osteotomy to obtain an overall mechanical axis close to 180° without extensive ligament balancing. This technique provided satisfactory outcomes in 8 patients followed-up for at least 3 years, with no specific complications or ligament instability and with a hip-knee-ankle angle close to 180°. After planning, intra-operative computer assistance ensures accurate determination of both implant position and the degree of correction achieved by the osteotomy.

  4. The horizontal and stepped osteotomy technique for mandibular reconstruction using fibular free flap.

    Science.gov (United States)

    Aleid, Wesam; Jones, Keith; Laugharne, David

    2011-09-01

    The mandible is an important component of the orofacial skeleton, and resection of part of the mandible as part of head and neck oncological procedures can have dramatic impact on both function and cosmesis. In this article, we describe a new technique in the resection osteotomy and flap fixation that improves the stability and aesthetic outcome of the reconstruction. The mandibular resection is performed utilizing a horizontal osteotomy above the mandibular angle on one side and a stepped body or angle osteotomy on the other side. Our technique is unique as it allows flexibility in adjusting the chin point projection to give the best possible aesthetic outcome; it allows more bone-to-bone contact, which increases the stability; it reduces rotation; and it allows for use of miniplate fixation, facilitating future rehabilitation with implants. We have been using this technique with great success in our hospital, and we recommend its use for its improved flexibility, stability, and aesthetic outcome.

  5. Pseudoarthrosis of the ilium after periacetabular osteotomy that was treated by cemented total hip arthroplasty: a case report.

    Science.gov (United States)

    Kanaji, Arihiko; Nishiwaki, Toru; Oya, Akihito; Maehara, Kazuyuki; Maehara, Hideki; Oishi, Teruyo; Yamada, Harumoto; Suda, Yasunori; Nakamura, Masaya; Matsumoto, Morio

    2016-05-06

    Preserving the hip joint to delay arthroplasty for patients with acetabular dysplasia-associated early-stage osteoarthritis has become more common, and several surgical procedures have demonstrated pain relief and improved hip joint function. Periacetabular osteotomy, one of the joint-preserving surgical procedures of the hip, provides favorable outcomes, although there are no reports of total hip arthroplasty being used to treat pseudoarthrosis of the periacetabular osteotomy segment. Therefore, we report a case of pseudoarthrosis in the osteotomy segment after periacetabular osteotomy. The patient was treated using modified total hip arthroplasty and achieved a favorable short-term outcome. A 62-year-old Japanese woman was diagnosed with bilateral acetabular dysplasia at the age of 50 years, and underwent right and left periacetabular osteotomy at the ages of 52 and 55 years, respectively. When she was 61-years old, she experienced repeated episodes of left coxalgia during walking, with increasing pain at rest, and subsequently visited our department. Plain radiography and computed tomography of her left hip joint confirmed pseudoarthrosis of the periacetabular osteotomy segment. In addition, narrowing of her left hip joint space was observed, which indicated advanced osteoarthritis of the hip. Therefore, she underwent left total hip arthroplasty when she was 62-years old. During the surgery, fibrous fusion of the periacetabular osteotomy segment was confirmed via fluoroscopy, although no abnormal mobility was observed. Thus, the osteotomy segment was fixed with one absorbable screw and two bone pegs (which were prepared using allogeneic bone), and the acetabular cup was fixed using cement. Her postoperative course was generally favorable and bone fusion of the periacetabular osteotomy segment was confirmed at 3 years and 6 months after surgery. Her modified Harris hip score was 43 before the surgery and had improved to 90 at the final follow-up. Modified total

  6. The effect of femoral neck osteotomy on femoral component position of a primary cementless total hip arthroplasty.

    Science.gov (United States)

    Dimitriou, Dimitris; Tsai, Tsung-Yuan; Kwon, Young-Min

    2015-12-01

    The aim of this study was to quantify the femoral canal diameter and version at different femoral neck osteotomy locations, and to investigate the effect of the osteotomy plane on femoral component position in total hip arthroplasty (THA). Preoperative and postoperative three-dimensional models were reconstructed in 15 patients (19 hips) who underwent primary cementless THA with tapered non-anatomical femoral stem. On the pre-operative models, the osteotomy plane was simulated at different levels (-5, 0, 5, and 10 mm from the femoral saddle [piriformis fossa]) and angles (30, 40, 50, and 60° from the femoral anatomical axis). Medullary canal version and mediolateral diameter were measured on the osteotomy surfaces. On the postoperative models, the femoral neck osteotomy plane, stem anteversion and alignment were measured. The average canal diameter ranged from 22.8 to 26.3 mm at different osteotomy levels and from 20.8 to 29.0 mm at different osteotomy angles. The average canal version ranged from 11.4 to 23.2° at different resection levels and from 12.8 to 21° at different resection angles. The femoral stem anteversion was correlated with neck osteotomy angle (R = 0.72), whereas stem alignment in frontal plane (varus/valgus) was correlated with neck osteotomy level (R = 0.87). The femoral neck osteotomy plane in THA affects the postoperative stem position due to the complex morphology of the proximal femoral medullary canal, suggesting that both femoral neck resection level and angle should be considered in optimizing femoral component alignment in THA patients.

  7. Combined Femoral and Acetabular Osteotomy in Children of Walking Age for Treatment of DDH; A Five Years Follow-Up Report

    Directory of Open Access Journals (Sweden)

    Mahdi Mazloumi

    2015-01-01

    Full Text Available Background: The prevalence of neglected developmental dysplasia of the hip (DDH has been decreasing. Nowadays, the disease is rarely seen in walking age children. The purpose of this study is to assess the results of simultaneous osteotomy of femur and pelvic bones in such children. Method: We performed a retrospective study on 30 children aged 3.8±0.9 (range: 1.5-7 years old, with DDH who underwent surgical operation in our hospital from August 2001 to September 2006. Tönnis and Severin grading systems were used to classify the radiographic status of the hip in pre- and postoperative era, respectively. Improvement in function and limp was also evaluated by the modified McKay’s classification. Results: From the 30 cases, six patients excluded in the course of the study and among the remaining patients, 12 had bilateral involvement. The mean follow-up period was 7.6±0.8 (range: 5.1-11.3 years. During the last visit, radiographic status of the operated joints, according to Severin classification was as follows: Class I: 12 patients; Class II: 20 patients; Class III: 3 patients; Class IV: 1 patient; and Class VI: 1 patient. Conclusion: Although through the follow-up, two hips subluxated, necrosis happened in three and one joint was re-dislocated, simultaneous femoral and innominate osteotomy in the walking age children with DDH has relatively good clinical outcomes.

  8. Results of Corrective Osteotomy and Treatment Strategy for Ankylosing Spondylitis with Kyphotic Deformity.

    Science.gov (United States)

    Kim, Ki-Tack; Park, Dae-Hyun; Lee, Sang-Hun; Lee, Jung-Hee

    2015-09-01

    To report the radiological and clinical results after corrective osteotomy in ankylosing spondylitis patients. Furthermore, this study intended to classify the types of deformity and to suggest appropriate surgical treatment options. We retrospectively analyzed ankylosing spondylitis patients who underwent corrective osteotomy between 1996 and 2009. The radiographic assessments included the sagittal vertical axis (SVA), spinopelvic alignment parameters, correction angle, correction loss, type of deformity related to the location of the apex, and the craniocervical range of motion (CCROM). The clinical outcomes were assessed by the Oswestry Disability Index (ODI) scores. A total of 292 corrective osteotomies were performed in 248 patients with a mean follow-up of 40.1 months (range, 24 to 78 months). There were 183 cases of single pedicle subtraction osteotomy (PSO), 19 cases of multiple Smith-Petersen osteotomy (SPO), 17 cases of PSO + SPO, 14 cases of single SPO, six cases of posterior vertebral column resection (PVCR), five cases of PSO + partial pedicle subtraction osteotomy (PPSO), and four cases of PPSO. The mean correction angles were 31.9° ± 11.7° with PSO, 14.3° ± 8.4° with SPO, 38.3° ± 12.7° with PVCR, and 19.3° ± 7.1° with PPSO. The thoracolumbar type was the most common. The outcome analysis showed a significant improvement in the ODI score (p ankylosing spondylitis, resulting in satisfactory outcomes with acceptable complications. The CCROM and postoperative SVA were important factors in determining the outcome.

  9. Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers.

    Science.gov (United States)

    Tamir, Eran; Finestone, Aharon S; Avisar, Erez; Agar, Gabriel

    2016-07-11

    Patients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the metatarsal heads in patients with diabetes mellitus (DM) related neuropathy. Computerized medical files of patients with diabetic neuropathy treated with an osteotomy during 2013 and 2014 were retrospectively reviewed. There were 20 osteotomies performed on 17 patients (mean age 58 years). The patients had a diagnosis of DM for a mean of 17 years. All ulcers were University of Texas grade 1A; mean ulcer age was 19 months. After 17/20 operations, the ulcer completely resolved after 6 weeks and did not recur after a mean follow-up of 11.5 months. One patient developed an early post-operative infection with osteomyelitis at the osteotomy site (proximal shaft of the fifth metatarsal) that needed debridement and IV antibiotics. In the other 19 cases, the surgical wound healed within 1 week. Asymptomatic radiological non-union developed in six cases (30 %). Mini-invasive floating metatarsal osteotomy can cure resistant and recurrent University of Texas grade 1A ulcerations plantar to the metatarsal heads in neuropathic patients.

  10. Variables Prognostic for Delayed Union and Nonunion Following Ulnar Shortening Fixed With a Dedicated Osteotomy Plate.

    Science.gov (United States)

    Gaspar, Michael P; Kane, Patrick M; Zohn, Ralph C; Buckley, Taylor; Jacoby, Sidney M; Shin, Eon K

    2016-02-01

    To examine potential risk factors for the development of delayed or nonunion following elective ulnar shortening osteotomy using a dedicated osteotomy plating system. We performed a retrospective review of all patients who underwent elective ulnar shortening using the TriMed single osteotomy dynamic compression plating system by 1 of 2 fellowship-trained hand surgeons over a 5-year period. Demographic data and medical, surgical, and social histories were reviewed. Time to bony union was determined radiographically by a blinded reviewer. Bivariate statistical analysis was performed to examine the effect of explanatory variables on the time to union and the incidence of delayed or nonunion. Those variables associated with the development of delayed or nonunion were used in a multivariate logistic regression model. Complications, including the need for additional surgery, were also recorded. Seventy-two ulnar shortening osteotomy procedures were performed in 69 patients. Delayed union, defined as ≥ 6 months to union, occurred in 8 of 72 cases (11%). Of 72 surgeries, 4 (6%) resulted in nonunions, all of which required additional surgery. Hardware removal was performed in 13 of 72 (18%) of the cases. Time to union was significantly increased in smokers (6 ± 3 months) versus nonsmokers (3 ± 1 months). On multivariable analysis, diabetics and active smokers demonstrated a significantly higher risk of developing delayed union or nonunion. Patient age, sex, body mass index, thyroid disease, worker's compensation status, alcohol use, and amount smoked daily did not have an effect on the time to union or the incidence of delayed or nonunion. Despite the use of an osteotomy-specific plating system, smokers and diabetics were at significantly higher risk for both delayed union and nonunion following elective ulnar shortening osteotomy. Other known risk factors for suboptimal bony healing were not found to have a deleterious effect. Copyright © 2016 American Society for

  11. Surgical Reconstruction of Metatarsal Type Preaxial Polydactyly Using an Amalgamating Osteotomy.

    Science.gov (United States)

    Boyle, Matthew J; Hogue, Grant D; Kasser, James R

    2016-09-01

    Polydactyly of the foot is a relatively common condition. Approximately 15% of cases are preaxial, with one third of these cases involving duplication of the metatarsal [metatarsal type preaxial polydactyly (MTPP)].Surgical reconstruction of polydactyly is indicated to improve shoe tolerance. Reconstruction of MTPP has traditionally involved resection of the hypoplastic lateral ray in addition to soft tissue reconstruction to correct hallux varus. Poor postoperative results have frequently been reported, primarily due to residual hallux varus. We present a novel surgical technique for the treatment of children with MTPP presenting with a cosmetic lateral hallux, involving an amalgamating osteotomy that permits retention of the stable medial metatarsotarsal joint while avoiding the complication of residual hallux varus. This was a retrospective case series describing the surgical technique of an amalgamating osteotomy in the treatment of patients with MTPP and a cosmetic lateral hallux. The surgical technique involves corresponding metatarsal osteotomies of the medial and lateral halluces, with amalgamation of the metatarsals and ablation of the residual medial hallux, without the need for extensive soft tissue reconstruction. Clinical and radiologic outcomes were evaluated at a minimum of 2 years postoperatively in 2 patients who underwent this technique. Two children, 1 female and 1 male, underwent an amalgamating osteotomy at the age of 31 and 18 months, respectively. At latest follow-up, 7.3 and 2.8 years after osteotomy, respectively, both patients displayed an excellent functional result according to the Phelps and Grogan clinical outcome scale. Plain radiographs in both cases demonstrated a well-aligned first ray with no growth abnormality and no hallux varus. We have presented a novel surgical technique for the reconstruction of MTPP presenting with a cosmetic lateral hallux, involving an amalgamating osteotomy without extensive soft tissue reconstruction

  12. Calcaneal "Z" osteotomy effect on hindfoot varus after triple arthrodesis in a cadaver model.

    Science.gov (United States)

    Zanolli, Diego H; Glisson, Richard R; Utturkar, Gangadhar M; Eckel, Tobin T; DeOrio, James K

    2014-12-01

    Triple arthrodesis involves subtalar, talonavicular, and calcaneocuboid joint fusion and is performed to relieve pain and correct deformity. Complications include malunion resulting in equinovarus and lateral column overload, which can lead to painful callosities and stress fractures. This study quantified the effectiveness of a closing-wedge calcaneal "Z" osteotomy for correction of the varus condition and reduction of abnormal loading of the lateral border of the foot. Ten fresh-frozen feet were used. Angle meters were attached to the calcaneus and second cuneiform to measure hindfoot and midfoot varus, and pressure sensors were placed under the first and fifth metatarsal heads to document loading of the borders of the foot. Tensile loads were applied to ten extrinsic tendons and the Achilles tendon while an 1187 N axial foot load was applied. Calcaneus and second cuneiform coronal plane angles and medial and lateral plantar pressures were measured initially, after triple fusion-induced varus, and after "Z" osteotomy. The calcaneal "Z" osteotomy had no significant corrective effect, with hindfoot alignment virtually identical before and after the procedure under the described foot loading conditions. Similarly, second cuneiform inclination, representative of midfoot alignment, showed no change from the osteotomy. Medial and lateral peak plantar pressures after calcaneal "Z" osteotomy did not differ from those measured after varus triple fusion. In this cadaver model of varus malunited triple arthrodesis, the closing-wedge calcaneal "Z" osteotomy was ineffective for correction of bone alignment and lateral forefoot overloading under the tested conditions. The results provide additional information on which to base treatment after triple arthrodesis with varus malunion. © The Author(s) 2014.

  13. High tibial closing wedge osteotomy for medial compartment osteoarthrosis of knee

    Directory of Open Access Journals (Sweden)

    Tuli S

    2008-01-01

    Full Text Available Background: Most patients of symptomatic osteoarthrosis of knee are associated with varus malalignment that is causative or contributory to painful arthrosis. It is rational to correct the malalignment to transfer the functional load to the unaffected or less affected compartment of the knee to relieve symptoms. We report the outcome of a simple technique of high tibial osteotomy in the medial compartment of osteoarthrosis of the knee. Materials and Methods: Between 1996 and 2004 we performed closing wedge osteotomy in 78 knees in 65 patients. The patients selected for osteotomy were symptomatic essentially due to medial compartment osteoarthrosis associated with moderate genu varum. Of the 19 patients who had bilateral symptomatic disease 11 opted for high tibial osteotomy of their second knee 1-3 years after the first operation. Preoperative grading of osteoarthrosis and postoperative function was assessed using Japanese Orthopaedic Association (JOA rating scale. Results: At a minimum follow-up of 2 years (range 2-9 years 6-10° of valgus correction at the site of osteotomy was maintained, there was significant relief of pain while walking, negotiating stairs, squatting and sitting cross-legged. Walking distance in all patients improved by two to four times their preoperative distance of 200-400 m. No patient lost any preoperative knee function. The mean JOA scoring improved from preoperative 54 (40-65 to 77 (55-85 at final follow-up. Conclusion: Closing wedge high tibial osteotomy performed by our technique can be undertaken in any setup with moderate facilities. Operation related complications are minimal and avoidable. Kirschner wire fixation is least likely to interfere with replacement surgery if it becomes necessary.

  14. 76 FR 1511 - Amendment of Class D Airspace; Fort Worth NAS JRB (Carswell Field), TX

    Science.gov (United States)

    2011-01-11

    ... Administration 14 CFR Part 71 Amendment of Class D Airspace; Fort Worth NAS JRB (Carswell Field), TX AGENCY... coordinates within the Fort Worth Naval Air Station (NAS) JRB (Carswell Field), TX, area and renames the... Regulations (14 CFR) part 71 by adjusting the geographic coordinates of the Fort Worth NAS JRB (Carswell...

  15. 76 FR 22338 - Proposed Fort Ross-Seaview Viticultural Area; Comment Period Reopening

    Science.gov (United States)

    2011-04-21

    ... Alcohol and Tobacco Tax and Trade Bureau 27 CFR Part 9 RIN 1513-AB44 Proposed Fort Ross-Seaview... the Fort Ross-Seaview viticultural area in western Sonoma County, California. Through this notice, TTB is soliciting comments on the establishment of the Fort Ross-Seaview viticultural area as proposed...

  16. 75 FR 2153 - Certificate of Alternative Compliance for the Tractor Tug FORTE

    Science.gov (United States)

    2010-01-14

    ... SECURITY Coast Guard Certificate of Alternative Compliance for the Tractor Tug FORTE AGENCY: Coast Guard... was issued for the tractor tug FORTE as required by 33 U.S.C. 1605(c) and 33 CFR 81.18. DATES: The... Purpose The tractor tug FORTE will be used for offshore supply operations. The horizontal distance...

  17. 76 FR 72969 - Proclaiming Certain Lands as Reservation for the Fort Sill Apache Indian Tribe

    Science.gov (United States)

    2011-11-28

    ... Bureau of Indian Affairs Proclaiming Certain Lands as Reservation for the Fort Sill Apache Indian Tribe... acres, more or less, as the Fort Sill Apache Indian Reservation for the Fort Sill Apache Tribe of... Apache Indian Reservation for the exclusive use of Indians entitled by enrollment or by tribal...

  18. Case Study: Fort Mill High School--A Culture of Continuous Improvement

    Science.gov (United States)

    Southern Regional Education Board (SREB), 2014

    2014-01-01

    This is the latest in a series of case studies highlighting best practices High Schools That Work (HSTW) network schools and districts are implementing to prepare students better for further studies and careers. Fort Mill High School is in Fort Mill, South Carolina, an outlying suburb of Charlotte, North Carolina. Fort Mill links high quality…

  19. Partial Necrosis of the Mandibular Proximal Segment Following Transoral Vertical Ramus Osteotomy.

    Science.gov (United States)

    Kim, Somi; Kim, Sang Yoon; Kim, Gi-Jung; Jung, Hwi-Dong; Jung, Young-Soo

    2014-05-01

    Transoral vertical ramus osteotomy (TOVRO) procedure can result in a variety of complications. Complications commonly reported include extensive bleeding due to major blood vessel injury, unpredictable fracture, postoperative infection, neurosensory deficit related Inferior alveolar nerve, insufficient osteosynthesis, and temporomandibular joint problem. The authors describe a case of partial necrosis of the mandibular proximal segment following TOVRO, a rarely reported complication. A 37-year-old otherwise healthy woman underwent Lefort l osteotomy and TOVRO to correct mandibular prognathism. Postoperatively, she developed pain and swelling in the right submandibular region and was found to have a partial necrosis of proximal segment.

  20. Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft

    Directory of Open Access Journals (Sweden)

    Ankit Desai

    2013-09-01

    Full Text Available A 16-year-old girl presented with left fourth metatarsal shortening causing significant psychological distress. She underwent lengthening scarf osteotomy held with an Omnitech® screw (Biotech International, France with the addition of two 1 cm cancellous cubes (RTI Biologics, United States. A lengthening z-plasty of the extensor tendons and skin were also performed. At 6 weeks the patient was fully weight bearing and at one-year follow up, the patient was satisfied and discharged. A modified technique of lengthening scarf osteotomy is described for congenital brachymatatarsia. This technique allows one stage lengthening through a single incision with graft incorporation by 6 weeks.

  1. Analysis of Knee Joint Line Obliquity after High Tibial Osteotomy.

    Science.gov (United States)

    Oh, Kwang-Jun; Ko, Young Bong; Bae, Ji Hoon; Yoon, Suk Tae; Kim, Jae Gyoon

    2016-11-01

    The aim of this study was to evaluate which lower extremity alignment (knee and ankle joint) parameters affect knee joint line obliquity (KJLO) in the coronal plane after open wedge high tibial osteotomy (OWHTO). Overall, 69 knees of patients that underwent OWHTO were evaluated using radiographs obtained preoperatively and from 6 weeks to 3 months postoperatively. We measured multiple parameters of knee and ankle joint alignment (hip-knee-ankle angle [HKA], joint line height [JLH], posterior tibial slope [PS], femoral condyle-tibial plateau angle [FCTP], medial proximal tibial angle [MPTA], mechanical lateral distal femoral angle [mLDFA], KJLO, talar tilt angle [TTA], ankle joint obliquity [AJO], and the lateral distal tibial ground surface angle [LDTGA]; preoperative [-pre], postoperative [-post], and the difference between -pre and -post values [-Δ]). We categorized patients into two groups according to the KJLO-post value (the normal group [within ± 4 degrees, 56 knees] and the abnormal group [greater than ± 4 degrees, 13 knees]), and compared their -pre parameters. Multiple logistic regression analysis was used to examine the contribution of the -pre parameters to abnormal KJLO-post. The mean HKA-Δ (-9.4 ± 4.7 degrees) was larger than the mean KJLO-Δ (-2.1 ± 3.2 degrees). The knee joint alignment parameters (the HKA-pre, FCTP-pre) differed significantly between the two groups (p knee joint alignment and knee joint convergence angle evaluated by HKA-pre and FCTP-pre angle, respectively, were significant predictors of abnormal KJLO after OWHTO. However, -pre ankle joint parameters were not significantly associated with abnormal KJLO after OWHTO.

  2. Fort Irwin Integrated Resource Assessment. Volume 2, Baseline detail

    Energy Technology Data Exchange (ETDEWEB)

    Richman, E.E.; Keller, J.M.; Dittmer, A.L.; Hadley, D.L.

    1994-01-01

    This report documents the assessment of baseline energy use at Fort Irwin, a US Army Forces Command facility near Barstow, California. It is a companion report to Volume 1, Executive Summary, and Volume 3, Integrated Resource Assessment. The US Army Forces Command (FORSCOM) has tasked the US Department of Energy (DOE) Federal Energy Management Program (FEMP), supported by the Pacific Northwest Laboratory (PNL), to identify, evaluate, and assist in acquiring all cost-effective energy projects at Fort Irwin. This is part of a model program that PNL has designed to support energy-use decisions in the federal sector. This program (1) identifies and evaluates all cost-effective energy projects; (2) develops a schedule at each installation for project acquisition considering project type, size, timing, and capital requirements, as well as energy and dollar savings; and (3) targets 100% of the financing required to implement energy efficiency projects. PNL applied this model program to Fort Irwin. This analysis examines the characteristics of electric, propane gas, and vehicle fuel use for a typical operating year. It records energy-use intensities for the facilities at Fort Irwin by building type and energy end use. It also breaks down building energy consumption by fuel type, energy end use, and building type. A complete energy consumption reconciliation is presented that accounts for all energy use among buildings, utilities, and applicable losses.

  3. 36 CFR 7.61 - Fort Caroline National Memorial.

    Science.gov (United States)

    2010-07-01

    ... Memorial. 7.61 Section 7.61 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.61 Fort Caroline National Memorial. (a) Fishing. Fishing is prohibited within the Memorial. ...

  4. Fort Stewart integrated resource assessment. Volume 2, Baseline detail

    Energy Technology Data Exchange (ETDEWEB)

    Keller, J.M.; Sullivan, G.P.; Wahlstrom, R.R.; Larson, L.L.

    1993-08-01

    This report documents the assessment of baseline energy use at Fort Stewart, a US Army Forces Command facility located near Savannah, Georgia. This is a companion report to Volume 1, Executive Summary, and Volume 3, Integrated Resource Assessment. The US Army Forces Command (FORSCOM) tasked Pacific Northwest Laboratory (PNL) to identify, evaluate, and assist in acquiring all cost-effective energy projects at Fort Stewart. PNL, in support of the US Department of Energy (DOE) Federal Energy Management Program (FEMP), has designed a model program applicable to the federal sector for this purpose. The model program (1) identifies and evaluates all cost-effective energy projects; (2) develops a schedule at each installation for project acquisition considering project type, size, timing, and capital requirements, as well as energy and dollar savings; and (3) targets 100% of the financing required to implement energy efficiency projects. PNL applied this model program to Fort Stewart. The analysis examines the characteristics of electric, natural gas, oil, propane, and wood chip use for fiscal year (FY) 1990. The results include energy-use intensities for the facilities at Fort Stewart by building type, fuel type, and energy end use. A complete energy consumption reconciliation is presented that accounts for the distribution of all major energy uses and losses among buildings, utilities, and central systems.

  5. Comprehensive Plan, Report #5. Fort Lincoln New Town Education System.

    Science.gov (United States)

    General Learning Corp., Washington, DC.

    This is the final report of the General Learning Corporation's planning effort for the Fort Lincoln New Town school system. Designed as a "Comprehensive Plan", it summarizes the educational plans developed to date, and presents some new elements of planning while it serves to "tie together" all previous planning to provide the reader with a broad…

  6. At fortælle sig til modstandskraft

    DEFF Research Database (Denmark)

    Bo, Inger Glavind

    2016-01-01

    I artiklen argumenterer jeg for, hvordan en sammenhængs- og meningsskabende fortælling skaber modstandskraft, idet jeg kobler den narrative tilgang med den medicinske sociolog Aron Antonovskys teori om sundhedsfremmende meningsskabelse. Modstandskraft forstås her som handleringer, der gør det...

  7. A rhinoceros from the late miocene of Fort Ternan, Kenya

    NARCIS (Netherlands)

    Hooijer, D.A.

    1968-01-01

    SYNOPSIS A rhinoceros from the Fort Ternan site, Kenya, Late Miocene in age, represents a form distinctly more advanced than the genera and species known from the Early Miocene although it is not directly ancestral to the Quaternary forms. It is a collaterally developed tuskless, two-horned, browsin

  8. Calculation of Void in the Fort Saint Vrain Material

    Energy Technology Data Exchange (ETDEWEB)

    Potter, David Charles [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Taylor, Craig Michael [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Coons, James Elmer [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-05-11

    The percent void of the Fort Saint Vrain (FSV) material is estimated to be 21.1% based on the volume of the gap at the top of the drums, the volume of the coolant channels in the FSV fuel element, and the volume of the fuel handling channel in the FSV fuel element.

  9. A Brief History of Fort Leavenworth, 1827-1983

    Science.gov (United States)

    1983-01-01

    voyageurs who were eager to acquire beaver pelts. The fort fell in disrepair because of age and storm damage. The commandant was ordered to repair the...control of Louisiana would damage commerce on the Mississippi River. President Thomas Jefferson encouraged negotiations with the French which led to a

  10. 76 FR 68625 - Establishment of the Fort Monroe National Monument

    Science.gov (United States)

    2011-11-07

    ...'' by Captain John Smith in 1607 when the first English colonists came to America. It was here that the... generations escaping enslavement. During the Civil War, Fort Monroe stood as a foremost Union outpost in the... freedom for thousands of enslaved people during the Civil War and served as a forerunner of...

  11. Fort Collins Science Center: Species and Habitats of Federal Interest

    Science.gov (United States)

    Stevens, Patty

    2004-01-01

    Ecosystem changes directly affect a wide variety of plant and animal species, floral and faunal communities, and groups of species such as amphibians and grassland birds. Appropriate management of public lands plays a crucial role in the conservation and recovery of endangered species and can be a key element in preventing a species from being listed under the Endangered Species Act. The Species and Habitats of Federal Interest Branch of the Fort Collins Science Center (FORT) conducts research on the ecology, habitat requirements, distribution and abundance, population dynamics, and genetics and systematics of many species facing threatened or endangered status or of special concern to resource management agencies. FORT scientists develop reintroduction and restoration techniques, technologies for monitoring populations, and novel methods to analyze data on population trends and habitat requirements. FORT expertise encompasses both traditional and specialized natural resource disciplines within wildlife biology, including population dynamics, animal behavior, plant and community ecology, inventory and monitoring, statistics and computer applications, conservation genetics, stable isotope analysis, and curatorial expertise.

  12. Assessment of Soft Tissue Changes by Cephalometry and Two-Dimensional Photogrammetry in Bilateral Sagittal Split Ramus Osteotomy Cases

    Directory of Open Access Journals (Sweden)

    Jan Rustemeyer

    2011-07-01

    Full Text Available Objectives: We aimed to compare the standard methods of cephalometry and two-dimensional photogrammetry, to evaluate the reliability and accuracy of both methods.Material and Methods: Twenty-six patients (mean age 25.5, standard deviation (SD 5.2 years with Class II relationship and 23 patients with Class III relationship (mean age 26.4, SD 4.7 years who had undergone bilateral sagittal split ramus osteotomy were selected, with a median follow-up of 8 months between pre- and postsurgical evaluation. Pre- and postsurgical cephalograms and lateral photograms were traced and changes were recorded.Results: Pre- and postsurgical measurements of hard tissue angles and distances revealed higher correlations with cephalometrically performed soft tissue measurements of facial convexity (Class II: N-PG, r = - 0.50, P = 0.047; Class III: ANB, r = 0.73, P = 0.005; NaPg , r = 0.71, P = 0.007; and labiomental angle (Class II: SNB, r = 0.72, P = 0.002; ANB, r = - 0.72, P = 0.002; N-B, r = - 0.68, P = 0.004; ANS-Gn, r = 0.71, P = 0.002; Class III: ANS-Gn, r = 0.65, P = 0.043 compared with two-dimensional photogrammetry. However, two-dimensional photogrammetry revealed higher correlation between lower lip length and cephalometrically assessed angular hard tissue changes (Class II: SNB, r = 0.98, P = 0.007; N-B, r = 0.89, P = 0.037; N-Pg, r = 0.90, P = 0.033; Class III: SNB, r = - 0.54, P = 0.060; NAPg, r = - 0.65, P = 0.041; N-Pg, r = 0.58, P = 0.039.Conclusions: Our findings suggest that cephalometry and two-dimensional photogrammetry offer the possibility to complement one another.

  13. Comparison between two angular stable locking plates for medial opening-wedge high tibial osteotomy: Decisive wedge locking plate versus TomoFix™.

    Science.gov (United States)

    Shin, Young-Soo; Kim, Keong-Ho; Sim, Hyun-Bo; Yoon, Jung-Ro

    2016-11-01

    An adequate stable fixation implant should be used for medial opening-wedge high tibial osteotomy (MOWHTO) to promote rapid bone healing without complications. This study compared the radiographic and clinical outcomes as well as plate-specific complications between two angular stable locking plates in patients following MOWHTO. This prospective study involved 97 patients (50 with DWL(®), group I; 47 with TomoFix™, group II) undergoing MOWHTO for primary medial compartment osteoarthritis between 2010 and 2013. Clinical and radiographic evaluations were performed by using the HSS and WOMAC scores, and calculating mechanical femorotibial angle (mFTA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), and posterior tibial slope (PTS) on radiographs both preoperatively and after 3 years. A statistically significant difference was observed for the MPTA at the last follow-up between the two groups (P = 0.033). Additionally, the last follow-up MPTA of group I was associated with the osteotomy technique (P = 0.004) and preoperative JLCA (P = 0.034) whereas the last follow-up MPTA of group II was associated with gender (P = 0.001) and BMI (P = 0.008). Furthermore, the results showed that group I had a higher rate of non-union (4%) compared to that in group II (0%). Both locking plates are useful tools in the treatment of medial compartment knee osteoarthritis with varus deformity in young, active patients. However, under special consideration of the complication we found in present study, the TomoFix™ seems to be a better alternative in using the MOWHTO for highly demanding patients. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  14. Fort Bragg and the Red-Cockaded Woodpecker: A Content Analysis of Selected Local Newspapers’ Coverage of Fort Bragg’s Endangered Species Protection Efforts

    Science.gov (United States)

    1993-11-01

    woodpecker species? 3) How did the amount and tone of coverage differ between Fort Bragg’s command information newspaper, the Paraglide , and the civilian...to Fort * Bragg and its potential to offer a sample of local newspaper articles not inspired by a prepared media release. The Paraglide , a weekly...newspapers yielded 15 stories (241 paragraphs, 15 headlines) from the Fort Bragg Paraglide , 37 stories (666 paragraphs, 36 headlines) from the

  15. Characterization plan for Fort St. Vrain and Peach Bottom graphite fuels

    Energy Technology Data Exchange (ETDEWEB)

    Maarschman, S.C.; Berting, F.M.; Clemmer, R.G.; Gilbert, E.R.; Guenther, R.J.; Morgan, W.C.; Sliva, P.

    1993-09-01

    Part of Fort St. Vrain (FSV) and most of the Peach Bottom (PB) reactor spent fuels are currently stored at INEL and may remain in storage for many years before disposal. Three disposal pathways have been proposed: intact disposal, fuels partially disassembled and the high-level waste fraction conditioned prior to disposal, and fuels completed disassembled and conditioned prior to disposal. Many options exist within each of these pathways. PNL evaluated the literature and other reference to develop a fuels characterization plan for these fuels. This plan provides guidance for the characteristics of the fuel which will be needed to pursue any of the storage or disposal pathways. It also provides a suggested fuels monitoring program for the current storage facilities. This report recommends a minimum of 7 fuel elements be characterized: PB Core 1 fuel: one Type II nonfailed element, one Type II failed element, and one Type III nonfailed element; PB Core 2 fuel: two Type II nonfailed fuel elements; and FSV fuel: at least two fuel blocks from regions of high temperature and fluence and long in-reactor performance (preferably at reactor end-of- life). Selection of PB fuel elements should focus on these between radial core position 8 and 14 and on compacts between compact numbers 10 and 20. Selection of FSV fuel elements should focus on these from Fuel Zones II and III, located in Core Layers 6, 7, and possibly 8.

  16. Single-Tooth Osteotomy Combined Wide Linear Corticotomy Under Local Anesthesia for Correcting Anterior Protrusion With Ectopically Erupted Canine.

    Science.gov (United States)

    Iskenderoglu, Nur Serife; Choi, Byung-Joon; Seo, Kyung Won; Lee, Yeon-Ji; Lee, Baek-Soo; Kim, Seong-Hun

    2017-01-01

    This article presents the alternative surgical treatments of both anterior protrusion by carrying out retraction on mandibular anterior fragment, meanwhile applying retraction force on maxilla anterior teeth and ectopically erupted canine with using platelet-rich fibrin (PRF). Anterior segmental osteotomy was combined with linear corticotomy under local anesthesia. The correction of right ectopic canine was achieved through 2 stages. First, dento-osseous osteotomy on palatal side was performed. Then second osteotomy with immediate manual repositioning of the canine with concomitant first premolar extraction was enhanced with PRF, which was prepared by centrifuging patient's blood, applied into buccal side of high canine during osteotomy. Mandibular retraction was accomplished by anterior segmental osteotomy. Single-tooth osteotomy is a more effective surgical method for ankylosed or ectopically erupted tooth in orthodontic treatment. It can reduce the total orthodontic treatment time and root resorption, 1 common complication. Significant improved bone formation was seen with the addition of PRF on noncritical size defects in the animal model. It is reasonable to think that PRF can promote bone regeneration. So early bone formation also can reduce the complication such as postoperative infection. As an alternative to anterior protrusion and ectopically erupted canine treatment, segmental osteotomy and corticotomy combined platelet-rich plasma can enhance orthodontic treatment outcome.

  17. In vitro comparison of tibial plateau leveling osteotomy with and without use of a tibial plateau leveling jig.

    Science.gov (United States)

    Schmerbach, Kay Ingo; Boeltzig, Christian Konrad Matthias; Reif, Ullrich; Wieser, Jan Carsten; Keller, Thomas; Grevel, Vera

    2007-02-01

    To evaluate the influence of a tibial plateau leveling jig on osteotomy orientation, fragment reduction, and postoperative tibial plateau angle (TPA) during tibial plateau leveling osteotomy (TPLO). In vitro experimental study. Large-breed canine cadavers (n=20). TPLO was performed on 40 hindlimbs using 4 methods. Group 1: Jig; dogs in dorsal recumbency with the osteotomy parallel to the distal jig pin. Groups 2-4: No jig; dogs in lateral recumbency with the osteotomy in a vertical orientation (group 2: tibia parallel to the table top; group 3: controlled superimposition of the femoral condyles; group 4: internal rotation of the tibia). Postoperative TPA, fragment reduction, and osteotomy orientation relative to the tibial plateau were compared. Positive or negative values denoted deviation from parallel relative to the tibial plateau. Postoperative TPA, fragment reduction, and proximodistal osteotomy orientation were not significantly different between groups. Craniocaudal osteotomy orientation was significantly different (Ptable surface. TPLO without use of a jig reduces surgical trauma, is less time consuming, and reduces cost.

  18. Percutaneous pelvic osteotomy and intertrochanteric varus shortening osteotomy in nonambulatory GMFCS level IV and V cerebral palsy patients: preliminary report on 30 operated hips.

    Science.gov (United States)

    Canavese, Federico; Gomez, Horacio; Kaelin, André; Ceroni, Dimitri; de Coulon, Geraldo

    2013-01-01

    This study evaluated the outcome of severe cerebral palsy patients (Gross Motor Function Classification System level IV and V) treated by simultaneous percutaneous pelvic osteotomy and intertrochanteric varus shortening osteotomy for hip subluxation or dislocation between 2002 and 2011. Twenty-four patients (30 hips) with an average age of 9.4 years (5-16.5) were reviewed at a mean follow-up of 35.9 months (6-96). Percutaneous pelvic osteotomy lasted on average 30 min/patient per side (25-40) and was always performed through a skin incision of 2-3 cm. The migration percentage and acetabular angle were assessed on plain radiographs. The mean Reimers' migration percentage improved from 67.1% (42-100) preoperatively to 7.7% (0-70) at the last follow-up and the mean acetabular angle improved from 31.8° (22-48) to 15.7° (5-27). Five patients presented complications: one redislocation, one bone graft dislodgement, and three with avascular necrosis of the femoral head. This study should be considered as a pilot study. These results indicate that this combined approach is an effective, reliable, and minimally invasive alternative method for the treatment of spastic dislocated hips in severe cerebral palsy patients with an outcome similar to standard techniques reported in the literature.

  19. Pterygoid plate fracture in Le Fort I osteotomy with and without pterygoid chisel: a computed tomography scan evaluation of 58 patients.

    Science.gov (United States)

    Precious, D S; Goodday, R H; Bourget, L; Skulsky, F G

    1993-02-01

    The incidence of pterygoid plate fracture as determined by computed tomography (CT) scan is much higher than that determined at surgery. This observation is irrespective of whether a chisel is used to effect pterygo-maxillary separation.

  20. Three-dimensional virtual simulation of alar width changes following bimaxillary osteotomies

    NARCIS (Netherlands)

    Liebregts, J.; Xi, T.; Schreurs, R; Loon, B. van; Berge, S.; Maal, T.

    2016-01-01

    The aim of this study was to evaluate the accuracy of three-dimensional (3D) soft tissue simulation of nose width changes following bimaxillary osteotomies and to identify patient- and surgery-related factors that may affect the accuracy of simulation. Sixty patients (mean age 26 years) who