Metatarsal Osteotomies: Complications.

Science.gov (United States)

Reddy, Veerabhadra Babu

2018-03-01

Metatarsal osteotomies can be divided into proximal and distal. The proximal osteotomies, such as the oblique, segmental, set cut, and Barouk-Rippstein-Toullec (BRT) osteotomy, all provide the ability to significantly change the position of the metatarsal head without violating the joint. These osteotomies, however, have a high rate of nonunion when done without internal fixation and can lead to transfer metatarsalgia when done without regard to the parabola of metatarsal head position. Distal osteotomies such as the Weil and Helal offer superior healing but have an increased incidence of recurrent metatarsalgia, joint stiffness, and floating toe. Copyright © 2017 Elsevier Inc. All rights reserved.

Identification tibia and fibula bone fracture location using scanline algorithm

Science.gov (United States)

Muchtar, M. A.; Simanjuntak, S. E.; Rahmat, R. F.; Mawengkang, H.; Zarlis, M.; Sitompul, O. S.; Winanto, I. D.; Andayani, U.; Syahputra, M. F.; Siregar, I.; Nasution, T. H.

2018-03-01

Fracture is a condition that there is a damage in the continuity of the bone, usually caused by stress, trauma or weak bones. The tibia and fibula are two separated-long bones in the lower leg, closely linked at the knee and ankle. Tibia/fibula fracture often happen when there is too much force applied to the bone that it can withstand. One of the way to identify the location of tibia/fibula fracture is to read X-ray image manually. Visual examination requires more time and allows for errors in identification due to the noise in image. In addition, reading X-ray needs highlighting background to make the objects in X-ray image appear more clearly. Therefore, a method is required to help radiologist to identify the location of tibia/fibula fracture. We propose some image-processing techniques for processing cruris image and Scan line algorithm for the identification of fracture location. The result shows that our proposed method is able to identify it and reach up to 87.5% of accuracy.

Concurrent periosteal chondroma and enchondroma of the fibula mimicking chondrosarcoma

International Nuclear Information System (INIS)

Yamamoto, Yasuhiro; Washimi, Osuke; Yamada, Harumoto; Washimi, Yuki; Itoh, Masato; Kuroda, Makoto

2006-01-01

We present a rare concurrence of enchondroma and periosteal chondroma in the right distal fibula that mimicked chondrosarcoma in a 13-year-old boy. Radiographs and CT scans showed a periosteal lesion producing saucerization without periosteal reaction and calcification in the distal metaphysis of the right fibula. MRI showed an intramedullary lesion adjacent to the periosteal lesion, although it was invisible at CT. There was no cortical breach on imaging and gross examination. Because both lesions represented benign cartilaginous tumors on histology, concurrent periosteal chondroma and enchondroma of the fibula was diagnosed. This combination in the same bone in a patient without enchondromatosis is exceedingly rare. Such imaging features may be confused with those of chondrosarcoma. (orig.)

Concurrent periosteal chondroma and enchondroma of the fibula mimicking chondrosarcoma

Energy Technology Data Exchange (ETDEWEB)

Yamamoto, Yasuhiro; Washimi, Osuke; Yamada, Harumoto; Washimi, Yuki; Itoh, Masato [Fujita Health University, Department of Orthopedic Surgery, Toyoake City, Aichi (Japan); Kuroda, Makoto [Fujita Health University, Department of Pathology, Toyoake City, Aichi (Japan)

2006-05-15

We present a rare concurrence of enchondroma and periosteal chondroma in the right distal fibula that mimicked chondrosarcoma in a 13-year-old boy. Radiographs and CT scans showed a periosteal lesion producing saucerization without periosteal reaction and calcification in the distal metaphysis of the right fibula. MRI showed an intramedullary lesion adjacent to the periosteal lesion, although it was invisible at CT. There was no cortical breach on imaging and gross examination. Because both lesions represented benign cartilaginous tumors on histology, concurrent periosteal chondroma and enchondroma of the fibula was diagnosed. This combination in the same bone in a patient without enchondromatosis is exceedingly rare. Such imaging features may be confused with those of chondrosarcoma. (orig.)

Ground reaction vector re-adjustment-the secret of success in treatment of medial compartment knee osteoarthritis by novel high fibular osteotomy.

Science.gov (United States)

Xie, Wenjun; Zhang, Yu; Qin, Xiaodong; Song, Lijun; Chen, Qun

2018-03-01

High fibular osteotomy has been preliminarily proved to be an effective treatment of knee osteoarthritis by excising a segment of bone at the proximal part of fibula. This imaginative procedure is clinical validated by its instant and explicit knee pain resorption and eventually deformity correction. The rationale of this treatment is named non-uniform settlement of the tibial plateau and used to elucidate the cause of knee joint degeneration, but cannot illuminate the reason of prompt postoperative pain resorption faithfully. To assist in better understanding of this therapeutic method and raising alert to possible unexpected complications, we proposed a new theory to elucidate the pain relief mechanism.

BIOMATERIAL IMPLANTS IN BONE FRACTURES PRODUCED IN RATS FIBULAS

OpenAIRE

Shirane, Henrique Yassuhiro; Oda, Diogo Yochizumi; Pinheiro, Thiago Cerizza; Cunha, Marcelo Rodrigues da

2010-01-01

To evaluate the importance of collagen and hydroxyapatite in the regeneration of fractures experimentally induced in the fibulas of rats. Method: 15 rats were used. These were subjected to surgery to remove a fragment from the fibula. This site then received a graft consisting of a silicone tubes filled with hydroxyapatite and collagen. Results: Little bone neoformation occurred inside the tubes filled with the biomaterials. There was more neoformation in the tubes with collagen. Conclusion: ...

Alignment After Intramedullary Nailing of Distal Tibia Fractures Without Fibula Fixation.

Science.gov (United States)

De Giacomo, Anthony F; Tornetta, Paul

2016-10-01

To evaluate the efficacy of intramedullary nailing of distal tibia fractures using modern techniques, without fibula fixation, in obtaining and maintaining alignment. Retrospective case review. Level-I academic trauma center. One hundred thirty-two consecutive patients with distal tibia fractures. Intramedullary nail of distal tibia fracture, without fibula fixation, was performed in consecutive patients using modern reduction techniques. Malalignment and malunion were defined as >5 degrees of varus/valgus angulation or anterior/posterior angulation on the initial postoperative or final anteroposterior and lateral x-rays. There were 122 consecutive patients (86 men and 36 women) 16-93 years of age (average, 43 years) with 36 (30%) open and 85 (70%) closed fractures with complete follow-up. Mechanism of injury did not predict the presence or level of fibula fracture. Upon presentation, varus/valgus and procurvatum/recurvatum angulation was greatest when the fibula was fractured at the level of the tibia fracture (P = 0.001 and 0.028). The most common intraoperative reduction aids were nailing in relative extension, transfixion external fixation, and clamps at the fracture site. The OTA fracture type or level/presence of fibula fracture did not influence malalignment (P = 0.86 and 0.66), malunion (P = 0.81 and 0.79), or the change in alignment during union, which averaged 0.9 degrees. We found an overall low rate of both malalignment (2%) and malunion (3%) after intramedullary nailing of distal tibial shaft fracture without fibula fixation. We conclude that when modern nailing techniques are used, which allow for confirmation of reduction by visualization in fluoroscopy, from nail placement to distal interlocking, fibula fixation is not necessary to obtain or maintain alignment. Furthermore, standard 2 medial to lateral screws distally afford adequate stability to hold the reduction during union with a 0.9-degree difference in the initial postoperative and final

Comparative Evaluation of Cell Viability Immediately After Osteotomy for Implants With Drills and Piezosurgery: Immunohistochemistry Analysis.

Science.gov (United States)

Pereira, Cassiano Costa Silva; Batista, Fábio Roberto de Souza; Jacob, Ricardo Garcia Mureb; Nogueira, Lamis Meorin; Carvalho, Abrahão Cavalcante Gomes de Souza; Gealh, Walter Cristiano; Garcia-Júnior, Idelmo Rangel; Okamoto, Roberta

2018-05-08

To evaluate the effect of reusing drills and piezosurgery tips during implant osteotomy on immediate bone cell viability through immunohistochemical analysis. Six male rabbits were divided into 2 groups and then divided into 5 subgroups-correspond to drills and tips used 10, 20, 30, 40, and 50 times, respectively. All animals received 10 osteotomies in each tibia, by use of the classic drilling procedure in one group (G1) and the piezosurgery device in the other group (G2). For immunohistochemical technique were utilized the osteoprotegerin, RANKL, osteocalcin, and caspase 3. Control procedures were performed by omitting the primary antibodies (negative control). Bone formation and resorption responses presented in more intense way during the piezosurgery. The expression of osteocalcin had become quite intense in piezosurgery groups, but with reduced immunostaining from the 30th osteotomy. The caspase 3 showed the viability of the osteoblast from the 20th osteotomy with piezosurgery and remained constant until the 50th. Piezosurgery provides greater osteoblastic cell viability than the system of conventional drilling. This study will provide data so that the authors can recycle the drills and tips for implant placement, thus enabling a better cell viability for osseointegration.

Specific variants of gold and silver early zwiebelknopf fibulae from eastern Serbia

Directory of Open Access Journals (Sweden)

Popović Ivana M.

2003-01-01

Full Text Available The discovery of fragmented silver fibula with twice bent bow in the necropolis by the castellum Ravna (Timacum Minus as well as inspection of some specimens of gold zwiebelknopf fibulae from the collections of the National Museum in Belgrade and Museum of Krajina in Negotin have drawn our attention to some finds of gold and silver fibulae from eastern Serbia and Romania that, according to their shape and decoration, represent specific variants in the initial phase of development of the zwiebelknopf fibulae. They are classified into three groups on the basis of their typological traits and their production is connected to Aurelian’s withdrawal from Dacia (group I, Diocletian’s victories over barbarians in the Danube basin (group II and Constantine’s decennalia, i.e. his preparations for encounter with Licinius (group III.

Anatomy and Surgical Approaches to the Rabbit Nasal Septum.

Science.gov (United States)

Badran, Karam W; Chang, John C; Kuan, Edward C; Wong, Brian J F

2017-09-01

The rabbit is the primary animal model used to investigate aspects of nasal surgery. Although several studies have used this model, none has provided a comprehensive analysis of the surgical anatomy and techniques used to gain access to the rabbit nasal fossae and septum. To describe and optimize the surgical anatomy and approach to the rabbit nasal vault and septal cartilage. In an ex vivo animal study conducted at an academic medical center, preliminary cadaveric dissections were performed on rabbit head specimens to establish familiarity with relevant anatomy and rehearse various approaches. Live Pasteurella-free New Zealand white rabbits (3.5-4.0 kg) were used to further develop this surgical technique developed here. Access of the nasal vault was gained through a midline nasal dorsum incision and creation of an osteoplastic flap with a drill. Submucosal resection was performed with preservation of the mucoperichondrium. All rabbits were monitored daily for 4 weeks in the postoperative period for signs of infection, pain, and complications. The study was conducted from June 1, 2014, to December 1, 2014. Surgical anatomy and techniques used to gain access to the rabbit nasal vault and harvest septal cartilage. Four Pasteurella-free New Zealand white rabbits (Western Organ Rabbit Co), ranging in age from 9 to 12 months and weighing between 3.5 and 4.0 kg, were used in this study. Initial dissections demonstrated the feasibility of harvesting septal cartilage while preserving the mucoperichondrial envelope. Access to the nasal vault through this 3-osteotomy approach allowed for maximal exposure to the nasal cavity bilaterally while maintaining the integrity of the mucoperichondrium following septal cartilage harvest. The maximum amount of bulk, en bloc, cartilage harvested was 1.0 × 2.5 cm. Following surgical dissection, all animals maintained adequate airway patency and support to midface structures. Furthermore, all specimens preserved the integrity of the

Intraosseous neurilemmoma of the fibula

Energy Technology Data Exchange (ETDEWEB)

Aoki, J. [Department of Radiology, Shinshu University School of Medicine, Asahi, Matsumoto (Japan); Tanikawa, H. [Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto (Japan); Fujioka, F. [Department of Orthopedic Surgery, Shinshu University School of Medicine, Matsumoto (Japan); Ishii, K. [Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto (Japan); Seo, G.S. [Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Karakida, O. [Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan); Sone, S. [Department of Radiology, Shinshu University School of Medicine, Matsumoto (Japan)

1997-01-01

We present a case of intraosseous neurilemmoma of the fibula in a 56-year-old woman. This case showed the typical radiographic appearance except for the presence of spotted calcifications that mimicked a cartilaginous tumor. Enhanced MR images revealed the heterogeneity of the tumor, which consisted of Antoni type A and B tissue. (orig.). With 4 figs.

Intraosseous neurilemmoma of the fibula

International Nuclear Information System (INIS)

Aoki, J.; Tanikawa, H.; Fujioka, F.; Ishii, K.; Seo, G.S.; Karakida, O.; Sone, S.

1997-01-01

We present a case of intraosseous neurilemmoma of the fibula in a 56-year-old woman. This case showed the typical radiographic appearance except for the presence of spotted calcifications that mimicked a cartilaginous tumor. Enhanced MR images revealed the heterogeneity of the tumor, which consisted of Antoni type A and B tissue. (orig.). With 4 figs

Comparative study of bridge plate associated to the intramedullary pin and the dynamic compression plate on the experimental osteotomy fixation of femoral in rabbits (Oryctolagus cuniculus). Clinical, radiographic, histological and scintigraphy analyses; Estudo comparativo da placa em ponte associada ao pino intramedular e da placa de compressao dinamica na fixacao de osteotomia experimental em femur de coelhos (Oryctolagus cuniculus). Analises clinica, radiografica, histologica e cintilografica

Energy Technology Data Exchange (ETDEWEB)

Borges, Natalie Ferreira

2011-07-01

The objectives were to benchmark and monitor the fracture healing of femoral osteotomy in rabbits after fixation with dynamic compression plate and bridge plate associated with intramedullary pin. Were used 14 New Zealand rabbits, four months old with mean weight of 3.5 pounds, from the Experimental Farm Professor Helio Barbosa of the Veterinary School of Minas Gerais Federal Univ. (UFMG). The animals were randomly divided into two groups (I and II). All rabbits underwent osteotomy across the middle third of right femur. In the group I was made to fix the osteotomy with the bridge plate (BP) associated with intramedullary pin, introduced the technique of minimal invasion. In group II, we used dynamic compression plate (DCP) via the conventional approach. Both groups were evaluated clinical, radiographic, histologic and scintigraphic findings. Clinical assessments were performed weekly until the 12{sup th} postoperative week and radiographic examinations were performed before, immediately after, at 15, 30, 45, 60 and 90 days. The bone scintigraphy were performed before and at 20, 50 and 90 days after surgery to monitor the bone metabolism qualitatively and quantitatively. Observed perfusion and bone healing process. After 90 days of study, there was histopathologic evaluation of the osteotomized area and the insertion of screws. In the region of the osteotomy was observed predominance of trabecular bone in group I and group II, the predominance of bone osteons, compatible with the original bone. On insertion of the screws did not differ between groups and there was cortical discontinuity, little necrosis and local hemorrhage. The two types of fixation have led to consolidation within the scheduled period, maturing in early fixation with DCP fixation compared with BP. Scintigraphy demonstrated by the indices of activity and image characteristics, the process of bone healing was significantly greater in animals undergoing early fixation with DCP. (author)

Study of mandible reconstruction using a fibula flap with application of additive manufacturing technology.

Science.gov (United States)

Tsai, Ming-June; Wu, Ching-Tsai

2014-05-06

This study aimed to establish surgical guiding techniques for completing mandible lesion resection and reconstruction of the mandible defect area with fibula sections in one surgery by applying additive manufacturing technology, which can reduce the surgical duration and enhance the surgical accuracy and success rate. A computer assisted mandible reconstruction planning (CAMRP) program was used to calculate the optimal cutting length and number of fibula pieces and design the fixtures for mandible cutting, registration, and arrangement of the fibula segments. The mandible cutting and registering fixtures were then generated using an additive manufacturing system. The CAMRP calculated the optimal fibula cutting length and number of segments based on the location and length of the defective portion of the mandible. The mandible cutting jig was generated according to the boundary surface of the lesion resection on the mandible STL model. The fibular cutting fixture was based on the length of each segment, and the registered fixture was used to quickly arrange the fibula pieces into the shape of the defect area. In this study, the mandibular lesion was reconstructed using registered fibular sections in one step, and the method is very easy to perform. The application of additive manufacturing technology provided customized models and the cutting fixtures and registered fixtures, which can improve the efficiency of clinical application. This study showed that the cutting fixture helped to rapidly complete lesion resection and fibula cutting, and the registered fixture enabled arrangement of the fibula pieces and allowed completion of the mandible reconstruction in a timely manner. Our method can overcome the disadvantages of traditional surgery, which requires a long and different course of treatment and is liable to cause error. With the help of optimal cutting planning by the CAMRP and the 3D printed mandible resection jig and fibula cutting fixture, this all

Minimally Invasive Surgical Approach to Distal Fibula Fractures: A Technique Tip

Directory of Open Access Journals (Sweden)

Tyler A. Gonzalez

2017-01-01

Full Text Available Wound complications following ankle fracture surgery are a major concern. Through the use of minimally invasive surgical techniques some of these complications can be mitigated. Recent investigations have reported on percutaneous fixation of distal fibula fractures demonstrating similar radiographic and functional outcomes to traditional open approaches. The purpose of this manuscript is to describe in detail the minimally invasive surgical approach for distal fibula fractures.

Hajdu-Cheney syndrome associated with serpentine fibulae and polycystic kidney disease

International Nuclear Information System (INIS)

Currarino, Guido

2009-01-01

Six patients who presented with craniofacial anomalies, musculoskeletal anomalies including elongated and bowed (serpentine) fibulae, and polycystic kidneys are reported. This association of anomalies is referred to as serpentine fibula polycystic kidney syndrome (SFPKS) and is currently interpreted as a manifestation of Hajdu-Cheney syndrome (HCS). We report a new instance of this association of anomalies and review the clinical and radiographic features of HCS and of the reported cases of SFPKS. (orig.)

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...... and 12 months after the operation. RESULTS: 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...

Vascularized Fibula Flaps for Mandibular Reconstruction: An ...

African Journals Online (AJOL)

For decades, osseous vascularised flaps have been used for reconstruction of the mandible with the vascularised fibula flap (VFF) remaining the commonly used osseous free flap, reasons ranging from its adequate bone and pedicle length to its receptive dental implant placement quality. This report considers a modest use ...

Reconstruction of lower end of radius using vascularized upper end of fibula

Directory of Open Access Journals (Sweden)

Koul Ashok

2007-01-01

Full Text Available Background: Giant cell tumor is a fairly common locally invasive tumor in young adults. The lower end of the radius is the second commonest site for this tumor. The most common treatment for this tumor is curettage with or without bone grafting but it carries a significant rate of recurrence. Excision is the treatment of choice, especially for cases in which the cortex has been breached. After excision of the distal end of the radius, different procedures have been described to reconstruct the defect of distal radius. These include partial arthrodesis and hemiarthroplasty using the upper end of the fibula. The upper end of the fibula has a morphological resemblance to the lower end of the radius and has been used to replace the latter. Traditionally it was used as a ′free′ (non-vascularized graft. More recently the upper end of the fibula has been transferred as a vascularized transfer for the same purpose. Though vascularized transfer should be expected to be more physiological, its superiority over the technically simpler non-vascularized transfer has not been conclusively proven. Materials and Methods: Two patients are presented who had giant cell tumor of distal radius. They underwent wide local excision and reconstruction with free vascularized upper end of the fibula. Result: Follow-up period was two and a half years and 12 months respectively. Both patients have returned to routine work. One patient has excellent functional result and the other has a good result. Conclusion: Vascularized upper end of fibula transfer is a reliable method of reconstruction for loss of the distal end of the radius that restores local anatomy and physiology.

Distal tibial fractures are a poorly recognised complication with fibula free flaps.

Science.gov (United States)

Durst, A; Clibbon, J; Davis, B

2015-09-01

The fibula free flap is ideal for complex jaw reconstructions, with low reported donor and flap morbidity. We discuss a distal tibial stress fracture two months following a vascularised fibula free flap procedure. Despite being an unrecognised complication, a literature review produced 13 previous cases; only two were reported in the reconstructive surgery literature, with the most recent claiming to be the first. The majority of these studies treated this fracture non-operatively; none reported their patient follow-up. Each case presented with ipsilateral leg pain, which has been cited as an early donor site morbidity in as many as 40% of fibula free flap cases. It is known that the fibula absorbs at least 15% of leg load on weight bearing. Studies have shown severe valgus deformities in up to 25% of patients with fibulectomies. We treated our patient operatively, first correcting his worsening valgus deformity with an external fixator, then reinforcing his healed fracture with a long distal tibial plate. We believe that this complication is underreported, unexpected and not mentioned during the consenting process. By highlighting the management of our case and the literature, we aim to increase awareness (and thus further reporting and appropriate management) of this debilitating complication.

Sports activities after lower limb osteotomy.

Science.gov (United States)

Gougoulias, Nikolaos; Khanna, Anil; Maffulli, Nicola

2009-01-01

Active sports participation can be important in some patients with degenerative joint disease in the lower limb. We investigated whether this is possible after an osteotomy for osteoarthritis of the hip, knee and ankle joints. We performed a literature search using Medline, Cochrane, CINAHL and Google Scholar with no restriction to time period or language using the keywords: 'osteotomy and sports'. Eleven studies (all level IV evidence) satisfied our inclusion and exclusion criteria. Nine reported on high tibial osteotomies, one on periacetabular osteotomies and one on distal tibial osteotomies. The Coleman Methodology Score to assess the quality of studies showed much heterogeneity in terms of study design, patient characteristics, management methods and outcome assessment. Participation in recreational sports is possible in most patients who were active in sports before lower limb osteotomy. In no study were patients able to participate in competitive sports. Intensive participation in sports after osteotomy may adversely affect outcome and lead to failures requiring re-operation. Patients may be able to remain active in selected sports activities after a lower limb osteotomy for osteoarthritis. More rapid progression of arthritis is however a possibility. Prospective comparative studies investigating activities and sports participation in age-matched patients undergoing osteotomy or joint replacement could lead to useful conclusions. Increased activity and active sports participation may lead to progression of arthritis and earlier failure requiring additional surgery.

Osteotomy of the knee

Science.gov (United States)

... joint. A tibial osteotomy may make you look "knock-kneed." A femoral osteotomy may make you look " ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Posterior column reconstruction improves fusion rates at the level of osteotomy in three-column posterior-based osteotomies.

Science.gov (United States)

Lewis, Stephen J; Mohanty, Chandan; Gazendam, Aaron M; Kato, So; Keshen, Sam G; Lewis, Noah D; Magana, Sofia P; Perlmutter, David; Cape, Jennifer

2018-03-01

To determine the incidence of pseudarthrosis at the osteotomy site after three-column spinal osteotomies (3-COs) with posterior column reconstruction. 82 consecutive adult 3-COs (66 patients) with a minimum of 2-year follow-up were retrospectively reviewed. All cases underwent posterior 3-COs with two-rod constructs. The inferior facets of the proximal level were reduced to the superior facets of the distal level. If that was not possible, a structural piece of bone graft either from the local resection or a local rib was slotted in the posterior column defect to re-establish continual structural posterior bone across the lateral margins of the resection. No interbody cages were used at the level of the osteotomy. There were 34 thoracic osteotomies, 47 lumbar osteotomies and one sacral osteotomy with a mean follow-up of 52 (24-126) months. All cases underwent posterior column reconstructions described above and the addition of interbody support or additional posterior rods was not performed for fusion at the osteotomy level. Among them, 29 patients underwent one or more revision surgeries. There were three definite cases of pseudarthrosis at the osteotomy site (4%). Six revisions were also performed for pseudarthrosis at other levels. Restoration of the structural integrity of the posterior column in three-column posterior-based osteotomies was associated with > 95% fusion rate at the level of the osteotomy. Pseudarthrosis at other levels was the second most common reason for revision following adjacent segment disease in the long-term follow-up.

X-Ray Exam: Lower Leg (Tibia and Fibula)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español X-Ray Exam: Lower Leg (Tibia and Fibula) KidsHealth / For ... Muscles, and Joints Broken Bones Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

Short Lingual Osteotomy Using a Piezosurgery Ultrasonic Bone-Cutting Device During Sagittal Split Ramus Osteotomy.

Science.gov (United States)

Kawase-Koga, Yoko; Mori, Yoshiyuki; Kanno, Yuki; Hoshi, Kazuto; Takato, Tsuyoshi

2015-10-01

Short lingual osteotomy is a useful method for the performance of sagittal split ramus osteotomy involving interference between the proximal and distal bone fragments when lateral differences exist in the setback distance. However, this procedure occasionally results in abnormal fracture and nerve injury; expert surgical skill is thus required. We herein describe a novel technique involving the use of an ultrasonic bone-cutting device (Piezosurgery; Mectron Medical Technology, Carasco, Italy) for vertical osteotomy posterior to the mandibular foramen. Successful short lingual osteotomy was performed using this technique with avoidance of abnormal fracture and neurovascular bundle damage.

Ankle joint pressure changes in a pes cavovarus model: supramalleolar valgus osteotomy versus lateralizing calcaneal osteotomy.

Science.gov (United States)

Schmid, Timo; Zurbriggen, Sebastian; Zderic, Ivan; Gueorguiev, Boyko; Weber, Martin; Krause, Fabian G

2013-09-01

A fixed cavovarus foot deformity can be associated with anteromedial ankle arthrosis due to elevated medial joint contact stresses. Supramalleolar valgus osteotomies (SMOT) and lateralizing calcaneal osteotomies (LCOT) are commonly used to treat symptoms by redistributing joint contact forces. In a cavovarus model, the effects of SMOT and LCOT on the lateralization of the center of force (COF) and reduction of the peak pressure in the ankle joint were compared. A previously published cavovarus model with fixed hindfoot varus was simulated in 10 cadaver specimens. Closing wedge supramalleolar valgus osteotomies 3 cm above the ankle joint level (6 and 11 degrees) and lateral sliding calcaneal osteotomies (5 and 10 mm displacement) were analyzed at 300 N axial static load (half body weight). The COF migration and peak pressure decrease in the ankle were recorded using high-resolution TekScan pressure sensors. A significant lateral COF shift was observed for each osteotomy: 2.1 mm for the 6 degrees (P = .014) and 2.3 mm for the 11 degrees SMOT (P = .010). The 5 mm LCOT led to a lateral shift of 2.0 mm (P = .042) and the 10 mm LCOT to a shift of 3.0 mm (P = .006). Comparing the different osteotomies among themselves no significant differences were recorded. No significant anteroposterior COF shift was seen. A significant peak pressure reduction was recorded for each osteotomy: The SMOT led to a reduction of 29% (P = .033) for the 6 degrees and 47% (P = .003) for the 11 degrees osteotomy, and the LCOT to a reduction of 41% (P = .003) for the 5 mm and 49% (P = .002) for the 10 mm osteotomy. Similar to the COF lateralization no significant differences between the osteotomies were seen. LCOT and SMOT significantly reduced anteromedial ankle joint contact stresses in this cavovarus model. The unloading effects of both osteotomies were equivalent. More correction did not lead to significantly more lateralization of the COF or more reduction of peak pressure but a trend was

Accuracy of secondary maxillofacial reconstruction with prefabricated fibula grafts using 3D planning and guided reconstruction

NARCIS (Netherlands)

Schepers, Rutger H.; Kraeima, Joep; Vissink, Arjan; Lahoda, Lars U.; Roodenburg, Jan L. N.; Reintsema, Harry; Raghoebar, Gerry M.; Witjes, Max J.

Background: We compared the pre-operative 3D-surgical plan with the surgical outcome of complex two-stage secondary reconstruction of maxillofacial defects using inserted implants in the prefabricated fibula graft. Methods: Eleven reconstructions of maxillofacial defects with prefabricated fibulas

Congenital (infantile) pseudarthrosis of the fibula associated with osteofibrous dysplasia

International Nuclear Information System (INIS)

Hisaoka, Masanori; Hashimoto, Hiroshi; Ohguri, Takayuki; Aoki, Takatoshi; Okamoto, Sumika; Ishida, Tsuyoshi; Tanaka, Hidetoshi; Okimoto, Nobukazu; Nakamura, Toshitaka

2004-01-01

We describe a recently noted association of congenital (infantile) pseudarthrosis of the lower leg with osteofibrous dysplasia. The patient was a 2-year-old boy who presented with a deformed left ankle joint and three cutaneous cafe-au-lait spots. Radiography demonstrated pseudarthrosis of the left distal fibula and a round lucent lesion adjacent to the proximal part of the pseudarthrosis. Histologically, the surgically removed fibula with pseudarthrosis showed a fibromatosis-like fibrovascular proliferation and nonspecific reparative changes. The focal lucent area demonstrated a fibro-osseous lesion, which was histologically identical to osteofibrous dysplasia. This case provides further evidence that osteofibrous dysplasia may be associated with congenital (infantile) pseudarthrosis of the lower leg. (orig.)

[Application of computer-aided osteotomy template design in treatment of developmental dysplasia of the hip with steel osteotomy].

Science.gov (United States)

Tong, Kuang; Zhang, Yuanzhi; Zhang, Sheng; Yu, Bin

2013-06-01

To provide an accurate method for osteotomy in the treatment of developmental dysplasia of the hip with steel osteotomy by three-dimensional reconstruction and Reverse Engineering technique. Between January 2011 and December 2012, 13 children with developmental dysplasia of the hip underwent steel osteotomy. 3D CT scan pelvic images were obtained and transferred via a DICOM network into a computer workstation to construct 3D models of the hip using Materialise Mimics 14.1 software in STL format. These models were imported into Imageware 12.0 software for steel osteotomy simulation until a stable hip was attained in the anatomical position for dislocation or subluxation of the hip in older children. The osteotomy navigational templates were designed according to the anatomical features after a stable hip was reconstructed. These navigational templates were manufactured using a rapid prototyping technique. The reconstruction hips in these children show good matching property and acetabulum cover. The computer-aided design of osteotomy template provides personalized and accurate solutions in the treatment of developmental dysplasia of the hip with steel osteotomy in older children.

A histologic analysis of the effects of stainless steel and titanium implants adjacent to tendons: an experimental rabbit study.

Science.gov (United States)

Nazzal, Adam; Lozano-Calderón, Santiago; Jupiter, Jesse B; Rosenzweig, Jaime S; Randolph, Mark A; Lee, Sang Gil P

2006-09-01

The current trend is to treat distal radius fractures with open reduction and internal fixation with either titanium or stainless steel plates. Both provide stable fixation; however, there is minimal evidence concerning the soft-tissue response to these materials. Our objective was to evaluate the response of adjacent extensor tendons to titanium and stainless steel in a rabbit in vivo model and to evaluate the influence of time. Forty rabbits were divided into 5 groups of 8 rabbits each. Groups I and II had unilateral osteotomy of the distal radius followed by dorsal fixation with titanium and stainless steel plates, respectively. Groups III and IV had fixation with titanium and stainless steel, respectively, but without osteotomy. Group V had surgical dissection without osteotomy or plates. Two animals per group were killed at 1, 4, 12, and 24 weeks. The specimens (distal radius, plate, overlying soft tissue, and extensor tendon) were harvested en bloc for histologic analysis. For interface preservation between implant and tissues the specimens were embedded in methylmethacrylate, sectioned, and stained with hematoxylin-eosin. Histologic analysis showed a fibrous tissue layer formed over both implants between the plate and the overlying extensor tendons in the groups treated with plating independently of the material and the presence or absence of osteotomy. This fibrous layer contained the majority of debris. Metallic particles were not observed in the tendon or muscle substance of any animals; however, they were visualized in the tenosynovium. Hematoxylin-eosin-stained sections of groups I through IV showed proliferative fibroblasts and metallic particles; however, this layer was not observed in group V. Statistical analysis did not show differences between the groups regarding the number of cells or metallic particles. Our results indicate that both implants generated adjacent reactive inflammatory tissue and particulate debris. There was no difference in cell

[Surgery guided by customized devices: reconstruction with a free fibula flap].

Science.gov (United States)

Schouman, T; Bertolus, C; Chaine, C; Ceccaldi, J; Goudot, P

2014-02-01

The reconstruction of jaws with a free fibula flap can be anticipated virtually. The simulation can be transferred to the operating theater using customized devices obtained from computer-assisted design and manufacturing in a complete digital workflow. Several alternatives are available, from cutting guides to customized titanium osteosynthesis plates, to obtain the best accuracy and reproducibility of reconstruction. Moreover, these new processes allow integrating prosthetic planning concomitantly with reconstruction. We present the virtual three-dimensional planning method for jaw reconstruction with a free fibula flap and the various alternatives of surgery guided by customized devices provided by this planning. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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′.

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

Directory of Open Access Journals (Sweden)

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.

Avoiding secondary skin graft donor site morbidity in the fibula free flap harvest.

Science.gov (United States)

Kim, Paul D; Fleck, Terry; Heffelfinger, Ryan; Blackwell, Keith E

2008-12-01

To compare donor site morbidity in patients who have undergone fibula free flap reconstruction in which the skin graft was taken from the expected cutaneous paddle of the fibula with the known complications of the popular technique of obtaining a split-thickness skin graft (STSG) from a secondary donor site. Cohort study. The tertiary care centers at Loma Linda University Medical Center and University of California, Los Angeles, Medical Center. From September 1, 2006, to March 30, 2007, 30 patients underwent fibula free flap harvest by 2 surgeons at separate tertiary care centers. Twenty-one of those procedures took place at the University of California, Los Angeles, and 9 at Loma Linda University. Patients included 15 men (50%) and 15 women (50%), with a mean age of 58 (range, 19-88) years. All 30 patients underwent fibula free flap harvest with a split-thickness skin graft (graft thickness, 0.04 cm), obtained from osteocutaneous paddle using a 5.1-cm-wide dermatome, as well as oral cavity and oropharyngeal reconstruction with the de-epithelialized skin paddle. Measures of donor site morbidity, including graft failure and wound breakdown, and measures of recipient site morbidity, including flap failure, hardware complications, intraoral complications, and the need for additional surgery. Of the 30 patients who underwent this procedure, 4 had partial skin graft failures, for a complete skin graft survival of 87%. There were no complete skin graft losses. Regarding the fibula osteocutaneous free flap, there were no complete flap losses, 1 skin paddle necrosis that required debridement, 2 postoperative orocutaneous fistulas, 1 case of infected/extruded hardware, and 1 adhesion formation that required additional surgery for lysis of adhesion and placement of the split-thickness skin graft. The outlined novel technique has similar rates of free flap survival and skin graft take compared with previously described methods. Harvesting the skin graft over the expected

Fractures of the shafts of the tibia and fibula

International Nuclear Information System (INIS)

Bender, C.E.; Campbell, D.C.

1985-01-01

Fractures of the shafts of the tibia and fibula are the most common long bone fractures. This chapter discusses tibial and fibular shaft fractures. Treatment of tibial and fibular fractures is similar and, therefore, reference is primarily made to the tibia. Diagnostic techniques are also evaluated

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

Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

Directory of Open Access Journals (Sweden)

Marcus Jaeger

2009-05-01

Full Text Available Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years. Surgical indications were: intermetatarsal angle (IMA of 12-23°; increased proximal articular angle (PAA>8°, and range of motion of the metatarsophalangeal joint in flexion and extension >40°. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM of the great toe post-surgery was 0.8±1.73 points (0: full ROM, 10: total stiffness. The mean subjective cosmetic result was 2.7±2.7 points (0: excellent, 10: poor. The overall post-operative patient satisfaction with the result was high (2.1±2.5 points (0: excellent, 10: poor. The mean hallux valgus angle improvement was 16.6° (pre-operative mean value: 37.5° which was statistically significant (p<0.01. The IMA improved by an average of 5.96° from a pre-operative mean value of 15.4° (p<0.01. Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

Tibial rotational osteotomy for idiopathic torsion. A comparison of the proximal and distal osteotomy levels.

Science.gov (United States)

Krengel, W F; Staheli, L T

1992-10-01

A retrospective analysis was done of 52 rotational tibial osteotomies (RTOs) performed on 35 patients with severe idiopathic tibial torsion. Thirty-nine osteotomies were performed at the proximal or midtibial level. Thirteen were performed at the distal tibial level with a technique previously described by one of the authors. Serious complications occurred in five (13%) of the proximal and in none of the distal RTOs. For severe and persisting idiopathic tibial torsion, the authors recommend correction by RTO at the distal level. Proximal level osteotomy is indicated only when a varus or valgus deformity required concurrent correction.

Effectiveness of Percutaneous Proximal Closing Wedge Osteotomy With Akin Osteotomy to Correct Severe Hallux Valgus Determined by Radiographic Parameters.

Science.gov (United States)

Kurashige, Toshinori; Suzuki, Seiichi

2017-04-01

Some authors reported the results from percutaneous distal metatarsal osteotomy for hallux valgus recently. On the other hand, there are few reports of percutaneous proximal metatarsal osteotomy. The purpose of the present study was to evaluate the radiographic results of percutaneous proximal closing wedge osteotomy with Akin osteotomy for correction of severe hallux valgus and increasing longitudinal arch height. Consecutive 17 feet (mean age = 70.8 years) were investigated. The mean follow-up was 22 months. Excision of medial eminence, distal soft tissue release, and Akin osteotomy were all performed percutaneously and concurrently. Weight-bearing anteroposterior and lateral radiographs of the feet were acquired preoperatively and at final follow-up. On the anteroposterior radiographs, hallux valgus angle, intermetatarsal angle, and first metatarsal shortening were measured. On the lateral radiographs, talometatarsal angle, calcaneal pitch angle, and first metatarsal dorsiflexion were measured. The average improvements in hallux valgus angle and intermetatarsal angle were 27.6° and 9.9°, respectively. The average first metatarsal shortening was 2.7 mm. The first metatarsal dorsiflexion improved by 2.2°; however, other parameters did not improve significantly. In conclusion, percutaneous proximal closing wedge osteotomy with Akin osteotomy corrects severe hallux valgus; however, the procedure does not increase the medial longitudinal arch. Therapeutic, Level IV: Case series.

Relative strength of tailor's bunion osteotomies and fixation techniques.

Science.gov (United States)

Haddon, Todd B; LaPointe, Stephan J

2013-01-01

A paucity of data is available on the mechanical strength of fifth metatarsal osteotomies. The present study was designed to provide that information. Five osteotomies were mechanically tested to failure using a materials testing machine and compared with an intact fifth metatarsal using a hollow saw bone model with a sample size of 10 for each construct. The osteotomies tested were the distal reverse chevron fixated with a Kirschner wire, the long plantar reverse chevron osteotomy fixated with 2 screws, a mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, the mid-diaphyseal sagittal plane osteotomy fixated with 2 screws, and an additional cerclage wire and a transverse closing wedge osteotomy fixated with a box wire technique. Analysis of variance was performed, resulting in a statistically significant difference among the data at p chevron was statistically the strongest construct at 130 N, followed by the long plantar osteotomy at 78 N. The chevron compared well with the control at 114 N, and they both fractured at the proximal model to fixture interface. The other osteotomies were statistically and significantly weaker than both the chevron and the long plantar constructs, with no statistically significant difference among them at 36, 39, and 48 N. In conclusion, the chevron osteotomy was superior in strength to the sagittal and transverse plane osteotomies and similar in strength and failure to the intact model. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

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

[Treatment of Pilon fractures complicated with fractures of fibula with titanic elastic nailing].

Science.gov (United States)

Liu, Yi-jun; Lin, Fu-qing; Guo, Yu-xiang

2010-02-01

To explore the effect of titanic elastic nailing (TEN) fixing for Pilon fractures complicated with fractures of fibula. From March 2007 to March 2009, 20 patients with Pilon fractures complicated with fractures of fibula were surgically treated with TEN. There were 14 males and 7 females with an average age of 42.6 years ranging from 35 to 70 years. Among them, 12 cases were on the left, 8 cases were on the right. All patients were followed-up for from 6 to 23 months (averaged 11.6 months). The symptoms of all patients had primarily relieved and the patients coulde ambulate at 2 to 3 months after treatment. According to Johner-Wruhs critera, the therapeutic results were excellent in 10 cases, good in 8 cases, fair in 2 cases. No case had skin infection and skin necrosis. Treatment of Pilon fractures complicated with fractures of fibula with TEN has the advantages such as less invasion, high rate of bone union and less soft tissue complication, it is a safe and effective procedure.

[Mandibular reconstruction with fibula free flap. Experience of virtual reconstruction using Osirix®, a free and open source software for medical imagery].

Science.gov (United States)

Albert, S; Cristofari, J-P; Cox, A; Bensimon, J-L; Guedon, C; Barry, B

2011-12-01

The techniques of free tissue transfers are mainly used for mandibular reconstruction by specialized surgical teams. This type of reconstruction is mostly realized in matters of head and neck cancers affecting mandibular bone and requiring a wide surgical resection and interruption of the mandible. To decrease the duration of the operation, surgical procedure involves generally two teams, one devoted to cancer resection and the other one to raise the fibular flap and making the reconstruction. For a better preparation of this surgical procedure, we propose here the use of a medical imaging software enabling mandibular reconstructions in three dimensions using the CT-scan done during the initial disease-staging checkup. The software used is Osirix®, developed since 2004 by a team of radiologists from Geneva and UCLA, working on Apple® computers and downloadable free of charge in its basic version. We report here our experience of this software in 17 patients, with a preoperative modelling in three dimensions of the mandible, of the segment of mandible to be removed. It also forecasts the numbers of fragments of fibula needed and the location of osteotomies. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

Assessment of trochanteric osteotomy fragment union after acetabular fracture surgery.

Science.gov (United States)

Dubina, Andrew G; Wickramaratne, Niluka; O'Toole, Robert V; Manson, Theodore T

2017-02-01

Trochanteric osteotomies are performed in conjunction with standard approaches to improve surgical exposure during open reduction and internal fixation (ORIF) of acetabular fractures. The literature on total hip arthroplasty reports nonunion rates as high as 30% associated with trochanteric osteotomies; however, few data exist regarding the outcomes of trochanteric osteotomies for acetabular fracture surgery. Our hypotheses were 1) patients receiving trochanteric osteotomies during ORIF of acetabular fractures have a low rate of nonunion of the osteotomy fragment, and 2) hip abduction precautions are not necessary with digastric type osteotomies. A retrospective review was conducted to identify patients with acetabular fractures between July 2002 and June 2010 (n=734 fractures) who required trochanteric osteotomies (n=64, 9% of fractures). Forty-seven met inclusion criteria of adequate follow-up (>56days). No excluded patient experienced a complication. Fractures were classified using the Letournel-Judet classification system. Only seven (20%) of 35 patients who received digastric osteotomies had hip abduction precautions applied during the postoperative period. All study patients were shown to have radiographic union at the trochanteric osteotomy site (100% union rate, n=47). Hip abduction precautions intended to protect the osteotomy site and reduce the risk of nonunion and fixation failure were infrequently applied to patients with digastric osteotomies (20%) in this cohort. Multiple protective factors against nonunion were present in this study population compared with previous arthroplasty studies from other institutions. Trochanteric osteotomies are not associated with a significant nonunion rate, and digastric osteotomies might be safely managed without hip abduction precautions. Copyright © 2016. Published by Elsevier Ltd.

Fine needle aspiration cytology of chondroblastoma of the fibula

Directory of Open Access Journals (Sweden)

Kamal Malukani

2014-01-01

Full Text Available Chondroblastoma is a rare benign cartilaginous tumor typically seen in long bones, especially femur, tibia and proximal humerus. Extracortical soft tissue invasion or metastasis is rarely seen. We report here a unique case of chondroblastoma of the fibula with extracortical soft tissue invasion. Differential diagnosis on cytology is discussed.

Spinal pedicle subtraction osteotomy for fixed sagittal imbalance patients

Science.gov (United States)

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

2013-01-01

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. PMID:24340276

Health-related quality of life after segmental resection of the lateral mandible: Free fibula flap versus plate reconstruction.

Science.gov (United States)

van Gemert, Johannes; Holtslag, Irene; van der Bilt, Andries; Merkx, Matthias; Koole, Ron; Van Cann, Ellen

2015-06-01

Segmental resection of the mandible causes functional, aesthetic and social problems affecting health-related quality of life (HRQoL). It is often assumed that reconstruction with composite free flaps guarantees better function and aesthetics than bridging the defect with reconstruction plates. Using the European Organization for Research and Treatment of Cancer questionnaires (EORTC QLQ-C30 version 3.0 and EORTC QLQ-H&N35), we compared HRQoL in patients who received free fibula flaps versus reconstruction plates after segmental resection of the lateral mandible. Thirty-seven completed questionnaires (18 fibula reconstructions and 19 patients with reconstruction plates) were available. Reconstruction with a free fibula flap did not provide clear additional benefit to bridging the defect with a reconstruction plate after segmental resection of the lateral mandible. In particular aspects known to have the most impact on HRQoL like swallowing, speech and chewing were not influenced by the type of reconstruction. Reconstruction of segmental defects of the lateral mandible with free fibula flap and reconstruction plate resulted in comparable HRQoL. If dental rehabilitation by means of dental implants is not anticipated in the fibula, then plate reconstruction with adequate soft tissue remains a suitable technique for the reconstruction of segmental defects of the lateral mandible. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

2015-01-01

Purpose The aim of this study was to compare clinical and radiographic outcomes of proximal opening wedge osteotomy using a straight versus oblique osteotomy. Materials and Methods 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. Results 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 (p<0.001). There was no difference in the mean IMA correction between the 2 groups (6.1±2.7° in group A and 6.0±2.1° in group B). However, a greater correction in the HVA and distance from the first to the second metatarsal were found in group B (HVA, 13.2±8.2°; distance, 25.1±0.2 mm) compared to group A (HVA, 20.9±7.7°; distance, 28.1±0.3 mm; p<0.001). AOFAS scores were improved in both groups. However, group B demonstrated a greater improvement relative to group A (p=0.005). Conclusion Compared with a straight first metatarsal osteotomy, an oblique first metatarsal osteotomy yielded better clinical and radiological outcomes. PMID:25837181

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.

Repair of femoral trochanteric osteotomy in the dog

International Nuclear Information System (INIS)

Whitelock, R.G.; Dyce, J.; Houlton, J.E.F.

1997-01-01

The records and radiographs of 24 dogs that underwent femoral trochanteric osteotomy repair were reviewed. Osteotomy repair was performed with either a pin and tension band wire or a lag screw technique. Significant clinical complications associated with the osteotomy were identified in one dog (4 per cent) six weeks after surgery, although abnormal radiographic changes were evident in 15 dogs (62 per cent). The method of repair did not influence healing and there were comparable radiographic complication rates. It is concluded that femoral trochanteric osteotomy is not associated with significant clinical problems, despite a high incidence of abnormal radiographic findings

External osteotomy in rhinoplasty: Piezosurgery vs osteotome.

Science.gov (United States)

Tirelli, Giancarlo; Tofanelli, Margherita; Bullo, Federica; Bianchi, Max; Robiony, Massimo

2015-01-01

To achieve the desired outcome in rhinoplasty depends on many factors. Osteotomy and surgical reshaping of nasal bones are important steps that require careful planning and execution. The availability of different tools raises the question of which one provides significant advantages for both technique and surgical outcome. Our prospective randomized pilot study compared the outcome of post-traumatic rhinoplasty performed with two different external techniques: ultrasound osteotomic cut using the Piezosurgery Medical Device (Mectron, Carasco, Italy) and traditional external osteotomy. Forty-four lateral osteotomies of the nasal wall were performed in twenty-two patients. In twelve patients the osteotomies were conducted with a 2-mm traditional osteotome (control group), while in the remaining ten patients these were done with the Piezosurgery Medical Device (experimental group). At the postoperative evaluation, significantly lower pain, edema and ecchymosis were noticed in the experimental group (pPiezosurgery Medical Device allowed for safe lateral osteotomies in rhinoplasty preliminarily demonstrating the potential to reduce some of the most frequent complications of rhinoplasty. Copyright © 2015 Elsevier Inc. All rights reserved.

Periacetabular osteotomy

DEFF Research Database (Denmark)

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

2013-01-01

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 to...

The effects of femoral external derotational osteotomy on frontal plane alignment.

Science.gov (United States)

Nelitz, M; Wehner, T; Steiner, M; Dürselen, L; Lippacher, S

2014-11-01

Femoral osteotomies are the preferred treatment in significant torsional deformity of the femur. The influence of torsional osteotomies on frontal plane alignment is poorly understood. Therefore, the aim of the present study was to evaluate the effects of external derotational osteotomies on proximal, mid-shaft and distal levels onto frontal plane alignment. The effect of rotation around the anatomical axis of the femur on frontal plane alignment was determined with a 3D computer model, created from CT data of a right human cadaver femur. Virtual torsional osteotomies of 10°, 20° and 30° were performed at proximal, mid-shaft and distal levels under five antecurvatum angles of the femur. The change of the frontal plane alignment was expressed by the mechanical lateral femoral angle. Proximal derotational osteotomies resulted in an increased mechanical lateral distal femoral angle (mLDFA) of 0.8°-2.6° for 10°, of 1.6°-5.1° for 20° and of 2.3-7.9° for 30° derotational osteotomy, indicating an increased varus angulation. Supracondylar derotational osteotomy resulted in a decreased mLDFA of -0.1° to -1.7° for 10°, of -0.2 to -3.7° for 20° and of -0.7 to -6.9° for 30° derotational osteotomy, indicating an increased valgus angulation. The effect increased with the amount of torsional correction and virtually increased antecurvatum angles. Mid-shaft torsional osteotomies had the smallest effect on frontal plane alignment. This three-dimensional computer model study demonstrates the relationship between femoral torsional osteotomies and frontal plane alignment. Proximal external derotational osteotomies tend to result in an increased varus angulation, whilst distal external derotational osteotomies tend to result in an increased valgus angulation. As a clinical consequence, torsional osteotomies have an increased risk of unintentional implications on frontal plane alignment.

Tibial valgus aperture osteotomy

International Nuclear Information System (INIS)

De los Rios G, Adolfo Leon; Saavedra Abadia, Adolfo Leon; Palacios, Julio

2005-01-01

This study is based on work carried out a The knee clinic at the arthroscopic surgery unit of the Institute of osteo-articular diseases, Imbanaco Medical Centre, The University Hospital of the Valle (Cali-Colombia) and The Fractures Clinic Ltd. (Palmira-Valle). This is a descriptive study, which demonstrates very positive outcomes for aperture osteotomy, without detracting from the importance of, and the progress made in uni-compartmental and total joint articular replacements of the knee. 10 patients were treated with a highs tibial open osteotomy between November 1988 and December 2002: 3 had post-traumatic deformities, without arthrosic alterations; 1 had pseudo-arthrosis caused by a failed corrective procedure; 1 had complex instability of the knee with osseous varus; 6 had a degenerative lesion of the medial meniscus with medial condral alterations. Follow-up was form 12 to 54 months. Treatment involved a tibial valgus aperture osteotomy and osteo-synthesis. Evaluation was carried out using the International Knee Documentation Committee (IKDC) scale, the For Special Surgery and The Knee Society Score

A comparison of piezosurgery with conventional techniques for internal osteotomy.

Science.gov (United States)

Koçak, I; Doğan, R; Gökler, O

2017-06-01

To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p piezosurgery group than in the conventional osteotomy group (p piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.

Revisional Surgery for Hallux Valgus with Serial Osteotomies at Two Levels

Directory of Open Access Journals (Sweden)

Jason B. T. Lim

2011-01-01

Full Text Available The aetiology and form of hallux valgus (HV is varied with many corrective procedures described. We report a 39-year-old woman, previously treated with a Chevron osteotomy, who presented with recurrent right HV, metatarsus primus varus, and associated bunion. Osteotomies were performed at two levels as a revisional procedure. This report highlights (1 limitations of the Chevron osteotomy and (2 the revisional procedure of the two level osteotomies: (i proximal opening-wedge basal osteotomy and (ii distal short Scarf with medial closing wedges. If a Chevron osteotomy is used inappropriately, for example, in an attempt to correct too large a deformity, it may angulate laterally causing a malunion with an increased distal metatarsal articular angle. Secondly, it is feasible to correct this combined deformity using a combination of proximal opening-wedge and distal short Scarf osteotomies.

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. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

The influence of the anabolic agent flavichromin on osteotomy healing

International Nuclear Information System (INIS)

Schargus, G.

1982-01-01

In this work it was attempted to attain a quicker consolidation of bone fragments in rabbits after they had undergone a lower jaw osteotomy and fragment fixation and had been treated with the usual osteosynthetic medications as well as doses of the anabolic agent flavichromin to stimulate bone healing. The healing progress of the first four post-operative weeks was clinically, radiologically, and also histologically assessed and it was also attempted to test the value of densitometrically studying the X-ray pictures as a quantitative measurement of the re-mineralisation of the fracture line. Although animal-specific studies do not allow themselves to be directly applied to humans, because the osteogenesis rates differ too greatly from humans and though further studies on dogs should be undertaken, in order to make a more conclusive statement, flavichromin because of its easy applicability should be considered for future use on humans, especially in cases with healing complications. In the healing of bone defects, flavichromin should be considered. (TRV) [de

A new technique for mandibular osteotomy

Directory of Open Access Journals (Sweden)

Puricelli Edela

2007-03-01

Full Text Available Abstract Sagittal split osteotomy (SSO is a surgical technique largely employed for mandibular mobilizations in orthognatic procedures. However, the traditional design of buccal osteotomy, located at the junction of mandibular ramus and body, may prevent more extensive sliding between the bone segments, particularly on the advance, laterality and verticality of the mandibular body. The author proposes a new technical and conceptual solution, in which osteotomy is performed in a more distal region, next to the mental formamen. Technically, the area of contact between medullary-cancellous bone surfaces is increased, resulting in larger sliding rates among bone segments; it also facilitates the use of rigid fixation systems, with miniplates and monocortical screws. Conceptually, it interferes with the resistance arm of the mandible, seen as an interpotent lever of the third gender.

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.

Autotransplantation of two maxillary premolars in a free vascularized fibula reconstructed mandible

NARCIS (Netherlands)

Mensink, G.; Karagozoglu, K. H.; Strackee, S. D.; van Teeseling, R. A.; Smeele, L. E.; Becking, A. G.

2011-01-01

A 10-year-old female patient with a fibula transplant in her left hemimandible due to ameloblastoma treatment was referred for combined orthodontic and surgical planning and treatment to observe and prevent expected asymmetric facial development and malocclusion, because the premolars and molars on

Use of vascularised free fibula in limb reconstruction (for non-malignant defects).

Science.gov (United States)

Hameed, Shahid; Ehtesham-ul-haq, Rana Hassan Javaid; Ahmed, Rao Saood; Majid, Abdul; Waqas, Muhammad; Aslam, Ayesha; Yusuf, Omamah; Butt, Ahsin Masood; Ali, Ghazanfar

2013-12-01

The case series was conducted at the Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, from June 2009 to May 2011, and comprised 19 patients in whom free fibula flap was performed for upper and lower limb reconstruction, using SPSS 16. Results showed that flap survival was 100%. One (5.2%) flap was re-explored for venous congestion and was salvaged. One (5.2%) patient of congenital pseudoarthrosis of tibia had a fracture of the fibula and was treated with external fixation. Average follow up was 8 months. Mean union time and full weight-bearing was 6.5 +/- 1.34 months (range 3-8 months) and 9 months, respectively. No recurrence of pseudoathrosis was observed until the last follow up, with only a 1.5 cm length discrepancy in one patient. The results proved that a microvascular free fibular flap heals rapidly, causes early functional recovery and it can be raised as an osteocutaneous flap.

Distal Metatarsal Osteotomy in Hallux Valgus Surgery: Chevron Osteotomy

Directory of Open Access Journals (Sweden)

Fatih Dogar

2016-04-01

Full Text Available Aim: Hallux valgus is a complex foot deformity resulting from medial deviation of first metatarsal and lateral deviation of toe. Radiographic and functional outcomes of chevron type distal metatarsal osteotomy applied to symptomatic hallux valgus patients with moderate deformity were assessed in the present study. Chevron osteotomy was applied to 27 feet (13 left, 14 right of 22 patients (12 women and 10 men; mean age: 45±16.7 years. Mean follow-up was 15.4± 4.71 months (range, 10%u201324. Material and Method: The average preoperative AOFAS score of 39.1 ± 8.55 (range, 32%u201357 improved (p < 0.0001 to 87.8 ± 4.7 (range, 82%u201397. The average preoperative hallux valgus angle (HVA of 37.4 ± 5.8 (range, 29%u201350 improved (p < 0.0001 to 14.8 ± 3.1 (range, 10%u201320 , and the average preoperative intermetatarsal 1-2 angle (IMA of 13.1 ± 1.5 (range, 11%u201317 improved (p < 0.0001 to 7.1 ± 1.4 (range, 5%u20139 . The average sesamoid position improved from 2.9 ± 0.2 (range, 2-3 preoperatively to 1.2 ± 0.4 (range, 1-2 (p < 0.0001. Toe hypoesthesia was developed in one patient as a complication. At the end of follow-up, patient satisfaction was found to be excellent in 16 feet (59.2% and good in 11 feet (40.8%. Results: The results of the study that chevron osteotomy yields good radiological result, high degree of postoperative patient satisfaction with minimal complications. Chevron ostoetomy is most effective method in the treatment of moderate hallux valgus.

The True Ponte Osteotomy: By the One Who Developed It.

Science.gov (United States)

Ponte, Alberto; Orlando, Giuseppe; Siccardi, Gian Luigi

2018-01-01

Technique and applications. To define the anatomy, biomechanics, indications, and surgical technique of the true Ponte osteotomy. The Ponte osteotomy, originally developed for thoracic kyphosis, was the first one to obtain posterior shortening of the thoracic spine, maintaining the anterior column load-sharing capacity. It has become a widely applied technique in various types of spine deformities and a frequent topic of presentations at meetings and in scientific articles. Several of them offer unquestionable evidence of an incorrect execution, with consequently distorted outcomes and erroneous conclusions. A clearing up became essential. Our original experience is based on a series of 240 patients with thoracic hyperkyphosis operated in the years 1969-2015, at first with a standard posterior Harrington technique and then by using the Ponte osteotomy with different instrumentations. A series of 78 of them, operated in the years 1987-1997, who had Ponte osteotomies at every level, is presented. The average preoperative kyphosis has been corrected from 80° (range 61°-102°) to 31° (range 15°-50°) by a substantial posterior shortening. A number of publications use the term Ponte osteotomy loosely for by far incomplete resections and mixing it up with Smith-Petersen's osteotomy. The true Ponte osteotomy is capable of producing marked flexibility in extension, flexion and rotation, justifying its wide use in thoracic deformities, mainly in scoliosis. An exact performance of the osteotomy with adequate bony resections, including the laminae, is an absolute condition to take full advantage of its properties. Level IV, therapeutic study. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

Cranial nerve injury after Le Fort I osteotomy.

Science.gov (United States)

Kim, J-W; Chin, B-R; Park, H-S; Lee, S-H; Kwon, T-G

2011-03-01

A Le Fort I osteotomy is widely used to correct dentofacial deformity because it is a safe and reliable surgical method. Although rare, various complications have been reported in relation to pterygomaxillary separation. Cranial nerve damage is one of the serious complications that can occur after Le Fort I osteotomy. In this report, a 19-year-old man with unilateral cleft lip and palate underwent surgery to correct maxillary hypoplasia, asymmetry and mandibular prognathism. After the Le Fort I maxillary osteotomy, the patient showed multiple cranial nerve damage; an impairment of outward movement of the eye (abducens nerve), decreased vision (optic nerve), and paraesthesia of the frontal and upper cheek area (ophthalmic and maxillary nerve). The damage to the cranial nerve was related to an unexpected sphenoid bone fracture and subsequent trauma in the cavernous sinus during the pterygomaxillary osteotomy. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

tibialization of the fibula in a child with chronic osteomyelitis of the ...

African Journals Online (AJOL)

used in tibial reconstruction after resection of Ewing's sarcoma (6). A case report from Congo detailed how a 10-centimeter tibial bone loss was treated by inter- tibiofibula bone grafting, resulting in tibialization of the fibula. The patient was reviewed after 10 years; and the clinical result was satisfactory and stable (7).

Single absorbable polydioxanone pin fixation for distal chevron bunion osteotomies.

Science.gov (United States)

Deorio, J K; Ware, A W

2001-10-01

The distal chevron osteotomy is a well-established technique for correction of symptomatic mild to moderate metatarsus primus varus with hallux valgus deformity. Fixation of the osteotomy ranges from none to bone pegs, Kirschner wires, screws, or absorbable pins. We evaluated one surgeon's (J.K.D.) results of distal chevron osteotomy fixation with a single, nonpredrilled, 1.3-mm poly-p-dioxanone pin and analyzed any differences in patients with unilateral or bilateral symptomatic metatarsus primus varus with hallux valgus deformities. All osteotomies healed without evidence of infection, osteolysis, nonunion, or necrosis. Equal correction was achieved in unilateral and bilateral procedures. The technique is quick and easy, and adequate fixation is achieved.

Effect of amino acids lysine and arginine on fracture healing in rabbits: A radiological and histomorphological analysis

Directory of Open Access Journals (Sweden)

Sinha Shivam

2009-01-01

Full Text Available Background: Amino acids like arginine and lysine have been suggested to hasten the process of fracture healing by improving the local blood supply, supplementing growth factors, and improving collagen synthesis. We studied the role of lysine and arginine in the fracture repair process with regard to the rate of healing, probable mechanisms involved in the process, and mutual synergism between these agents. Materials and Methods: In an experimental study, 40 rabbits were subjected to ulnar osteotomy. They were distributed in control (14 and test groups (26. Twenty-six animals in the test group were fed with a diet rich in lysine and arginine. Both the groups were followed radiologically and histologically till union. Results: There was better healing of osteotomy in terms of better vascularization, callus formation, and mineralization in the test group. The time of healing in the test group was reduced by a period of 2 weeks. Conclusion: We conclude that amino acids like arginine and lysine may hasten fracture healing.

Bamboo Osteotomy for Blount’s Disease

Directory of Open Access Journals (Sweden)

PU Siregar

2010-03-01

Full Text Available Blount disease is a common childhood condition that requires surgical correction. The conventional method of osteotomy and acute correction is associated with risk of neurovascular complications and occasionally displacement of the intra operative alignment. This case report describes a new technique that involves multiple longitudinal osteotomies over the proximal tibia without loss of cortical continuity between the proximal and distal tibia. It simulates an incomplete (greenstick fracture that allows plastic deformation at the site of correction. This correction is more stable, and can be expected to heal more rapidly than conventional treatments.

Computer assisted SCFE osteotomy planning

International Nuclear Information System (INIS)

Drapikowski, Pawel; Tyrakowski, Marcin; Czubak, Jaroslaw; Czwojdzinski, Adam

2008-01-01

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.)

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.)

Data for the study of fibulae pivot in the Iberian Peninsula. The piece of Cerro de la Mora (Moraleda de Zafayona, Granada

Directory of Open Access Journals (Sweden)

Javier CARRASCO RUS

2016-07-01

Full Text Available Due to the complexity of the archaic elbow fibulae of the Iberian Peninsula, our work traits to organize the pivot group. First, its mechanics and conceptualization are defined precisely. Later, an analysis of the previous known facts is done, taking into account its cultural ascription, its chronology, its territorial distribution, its morphology and its technology. This analysis is made with the idea of advancing a viable typologic organisation. To realise the work some representative fibulae are considered, especially those more relevant. The criteria used to select these are its contextualization, its metalic composition, internal relation and time and space characteristics. There are no references to fibulae from out of the Peninsula. The main conclusion of the article is that these pieces are older than what was though in the traditional interpretations.

New modified technique of osteotomy for hallux valgus.

Science.gov (United States)

Oh, I S; Kim, M K; Lee, S H

2004-12-01

To improve the technique of osteotomy for hallux valgus (bunion). 38 cases of a new modified osteotomy procedure for hallux valgus were performed for 22 patients (21 women and one man). During a 3-year (range, 2-5 years) follow-up, the patients underwent physical examination; and their American Orthopedic Foot and Ankle Society hallux-metatarso-phalangeal-interphalangeal scale scores and standard foot radiographic measurements were recorded. 20 of the 22 patients (38 cases) had no pain, achieved good cosmesis, and were completely satisfied with the results of the operation. The remaining 2 patients had occasional mild discomfort. The mean hallux-metatarso-phalangeal-interphalangeal scale score was 93 points (range, 78-100 points). The mean preoperative and postoperative metatarsophalangeal angles were 34 degrees and 11 degrees, respectively. The mean postoperative reduction of the intermetatarsal angle and metatarsophalangeal angle were 6 degrees and 23 degrees, respectively. The new technique of osteotomy achieved even greater stability and accurate correction of the deformity in our 38 cases. Furthermore, it was more effective than conventional 'chevron' osteotomy in terms of correction of the deformity. Therefore, it should be used more widely.

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.

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.

Flow-Through Free Fibula Osteocutaneous Flap in Reconstruction of Tibial Bone, Soft Tissue, and Main Artery Segmental Defects.

Science.gov (United States)

Li, Zonghuan; Yu, Aixi; Qi, Baiwen; Pan, Zhenyu; Ding, Junhui

2017-08-01

The aim of this report was to present the use of flow-through free fibula osteocutaneous flap for the repair of complex tibial bone, soft tissue, and main artery segmental defects. Five patients with bone, soft tissue, and segmental anterior tibial artery defects were included. The lengths of injured tibial bones ranged from 4 to 7 cm. The sizes of impaired soft tissues were between 9 × 4 and 15 × 6 cm. The lengths of defect of anterior tibial artery segments ranged from 6 to 10 cm. Two patients had distal limb perfusion problems. Flow-through free fibula osteocutaneous flap was performed for all 5 patients. Patients were followed for 12 to 18 months. All wounds healed after 1-stage operation, and all flow-through flaps survived. The distal perfusion after vascular repair was normal in all patients. Superficial necrosis of flap edge was noted in 1 case. After the local debridement and partial thickness skin graft, the flap healed uneventfully, and the surgical operation did not increase injury to the donor site. Satisfactory bone union was achieved in all patients in 2 to 4 months postoperation. Enlargement of fibula graft was observed during follow-up from 12 to 18 months. The functions of adjacent joints were recovered, and all patients were able to walk normally. Flow-through free fibula osteocutaneous flap was shown to be an effective and efficient technique for repairing composite tibial bone, soft tissue, and main artery segmental defects. This 1-stage operation should be useful in clinical practice for the treatment of complex bone, soft tissue, and vessel defects.

Comparative Outcomes Between Step-Cut Lengthening Calcaneal Osteotomy vs Traditional Evans Osteotomy for Stage IIB Adult-Acquired Flatfoot Deformity.

Science.gov (United States)

Saunders, Stuart M; Ellis, Scott J; Demetracopoulos, Constantine A; Marinescu, Anca; Burkett, Jayme; Deland, Jonathan T

2018-01-01

The forefoot abduction component of the flexible adult-acquired flatfoot can be addressed with lengthening of the anterior process of the calcaneus. We hypothesized that the step-cut lengthening calcaneal osteotomy (SLCO) would decrease the incidence of nonunion, lead to improvement in clinical outcome scores, and have a faster time to healing compared with the traditional Evans osteotomy. We retrospectively reviewed 111 patients (143 total feet: 65 Evans, 78 SLCO) undergoing stage IIB reconstruction followed clinically for at least 2 years. Preoperative and postoperative radiographs were analyzed for the amount of deformity correction. Computed tomography (CT) was used to analyze osteotomy healing. The Foot and Ankle Outcome Scores (FAOS) and lateral pain surveys were used to assess clinical outcomes. Mann-Whitney U tests were used to assess nonnormally distributed data while χ 2 and Fisher exact tests were used to analyze categorical variables (α = 0.05 significant). The Evans group used a larger graft size ( P lengthening. Level III, retrospective cohort study.

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.

Funzionalizzazione della mandibola dopo ricostruzione con lembo libero rivascolarizzato di fibula "single strut". Al di là del deficit di verticalità.

OpenAIRE

Gessaroli, Manlio

2009-01-01

Obiettivi: Valutare la modalità  più efficace per la riabilitazione funzionale del limbo libero di fibula "single strut", dopo ampie resezioni per patologia neoplastica maligna del cavo orale. Metodi: Da una casistica di 62 ricostruzioni microvascolari con limbo libero di fibula, 11 casi sono stati selezionati per essere riabilitati mediante protesi dentale a supporto implantare. 6 casi sono stati trattati senza ulteriori procedure chirurgiche ad eccezione dell'implantologia (gruppo 1), a...

Percutaneous Intramedullary Screw Fixation of Distal Fibula Fractures: A Case Series and Systematic Review.

Science.gov (United States)

Loukachov, Vladimir V; Birnie, Merel F N; Dingemans, Siem A; de Jong, Vincent M; Schepers, Tim

The current reference standard for unstable ankle fractures is open reduction and internal fixation using a plate and lag screws. This approach requires extensive dissection and wound complications are not uncommon. The use of intramedullary screw fixation might overcome these issues. The aim of our study was to provide an overview of the published data regarding intramedullary screw fixation of fibula fractures combined with a small consecutive case series. We performed a search of published studies to identify the studies in which fibula fractures were treated with percutaneous intramedullary screw fixation. Additionally, all consecutive patients treated for an unstable ankle fracture in a level 1 trauma center using an intramedullary screw were retrospectively included. The literature search identified 6 studies with a total of 180 patients. Wound infection was seen in 1 patient (0.6%), anatomic reduction was achieved in 168 patients (93.3%), and a loss of reduction was seen in 2 patients (1.1%). Implant removal was deemed necessary in 3 patients (1.7%) and nonunion was seen is 2 patients (1.1%). A total of 11 patients, in whom no wound complications occurred, were included in our study. The follow-up duration was a minimum of 12 months. A secondary dislocation was seen in 1 patient, and delayed union was observed after 7.5 months in 1 other patient. In conclusion, intramedullary screw fixation is a safe and adequate method to use for fibula fractures, with a low risk of wound complications. Additional research regarding functional outcome is warranted. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Postoperative dysesthesia in lumbar three-column resection osteotomies.

Science.gov (United States)

Zhang, Zhengfeng; Wang, Honggang; Zheng, Wenjie

2016-08-01

Three-column lumbar spinal resection osteotomies including pedicle subtraction osteotomy (PSO), vertebral column resection (VCR), and total en bloc spondylectomy (TES) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in lumbar spinal resection osteotomies. Between January 2009 and December 2013, 64 patients were treated with lumbar three-column spinal resection osteotomies (PSO, n = 31; VCR, n = 29; TES, n = 4) in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central none-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD. There were 5 cases of POD (5/64, 7.8 %), which consisted of 1 patient in PSO (1/31, 3.2 %), 3 patients in PVCR (3/29, 10.3 %), and 1 patient in TES (1/4, 25 %). After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 8 to 38 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end. Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in lumbar spinal resection osteotomies, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovering may be used as a sign for the good prognosis.

Periacetabulaer osteotomi og hoftedysplasi hos yngre voksne

DEFF Research Database (Denmark)

Troelsen, Anders; Søballe, Kjeld

2009-01-01

% of cases for more than ten years following surgery. A new minimally invasive technique is safe and reduces blood loss, transfusion requirements and duration of surgery. Overall, the results support the use of periacetabular osteotomy, though further documentation of long-term effects is warranted.......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...

Alphabet Soup: Sagittal Balance Correction Osteotomies of the Spine-What Radiologists Should Know.

Science.gov (United States)

Takahashi, T; Kainth, D; Marette, S; Polly, D

2018-04-01

Global sagittal malalignment has been demonstrated to have correlation with clinical symptoms and is a key component to be restored in adult spinal deformity. In this article, various types of sagittal balance-correction osteotomies are reviewed primarily on the basis of the 3 most commonly used procedures: Smith-Petersen osteotomy, pedicle subtraction osteotomy, and vertebral column resection. Familiarity with the expected imaging appearance and commonly encountered complications seen on postoperative imaging studies following correction osteotomies is crucial for accurate image interpretation. © 2018 by American Journal of Neuroradiology.

Piezosurgery versus conventional osteotomy in orthognathic surgery: a paradigm shift in treatment.

Science.gov (United States)

Bertossi, Dario; Lucchese, Alessandra; Albanese, Massimo; Turra, Matteo; Faccioni, Fiorenzo; Nocini, Pierfrancesco; Rodriguez Y Baena, Ruggero

2013-01-01

The aim of the study was to compare in a randomized controlled clinical trial the use of the piezoelectric osteotomy as an alternative to the conventional approach in terms of surgery time, intraoperative blood loss, cut quality, nerve injury, and costs.One hundred ten patients who had orthognathic surgery procedures with bimaxillary osteotomy were divided into 2 groups: group A was treated with a piezosurgery device, and group B, with a reciprocating saw and bur.The piezosurgical bone osteotomy permitted individualized cut designs. The surgical time in group A was reduced, with a mean for the mandibular osteotomy (1 side) between 3 minutes 31 seconds and 5 minutes 2 seconds, whereas in group B, the surgical time was between 7 minutes 23 seconds and 10 minutes 22 seconds. The surgical time in group A for the Le Fort I osteotomy was between 5 minutes 17 seconds and 7 minutes 55 seconds in group A and between 8 minutes 38 seconds and 15 minutes 11 seconds in group B. All patients in group A had a low blood loss (500 mL). Inferior alveolar nerve sensation was retained in 98.2% of group A versus 92.7% in group B at 6 months postoperative testing.Piezoelectric osteotomy reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Absence of macrovibrations makes the instrument more manageable and easy to use and allows greater intraoperative control with higher safety in cutting in difficult anatomical regions.

Youngswick-Austin versus distal oblique osteotomy for the treatment of Hallux Rigidus.

Science.gov (United States)

Viladot, Antonio; Sodano, Luca; Marcellini, Lorenzo; Zamperetti, Marco; Hernandez, Elsa Sanchez; Perice, Ramon Viladot

2017-08-01

Hallux Rigidus is the most common degenerative joint pathology of the foot. Several procedures are described for the management of this deformity. In this prospective study we compared Youngswick-Austin and distal oblique osteotomy in the treatment of grade II Hallux Rigidus, in terms of clinical outcomes, efficacy and complications. Forty-six patients (50 feet) with moderate Hallux Rigidus (Regnauld grade II) were recruited and operated between March 2009 and December 2012. Surgical technique was Youngswick-Austin osteotomy (Group A) or distal oblique osteotomy (Group B). Mean follow-up was 42.7 ±12.2 (range, 24-70) months. Both groups achieved significant improvement of AOFAS score and first metatarsophalangeal joint range of motion (p value Austin and distal oblique osteotomies provides subjective patient improvement and increases the first metatarsophalangeal joint range of motion. The results of grade II Hallux Rigidus treatment were comparable when using a Youngswick-Austin or distal oblique osteotomy. Level II, prospective comparative study. Copyright © 2017 Elsevier Ltd. All rights reserved.

The history, evolution and basic science of osteotomy techniques

Directory of Open Access Journals (Sweden)

John Dabis

2017-10-01

Full Text Available Abstract Osteotomy techniques date back to Hippocrates circa 415 BC (Jones Hippocrates collected works I, Harvard University Press, Cambridge, 2006; Brorson in Clin Orthop Relat Res 467(7:1907–1914, 2009. There is debate about the best way to divide the bone surgically and which technique yields the best bone regenerate in lengthening; ensuring predictable new bone formation and healing of the osteotomy are the primary goals. We review the history and techniques of the osteotomy and consider the evidence for optimum bone formation. Methods discussed include variants of the ‘drill and osteotome’ technique, use of the Gigli saw and use of a power saw. Differences in bone formation through the different techniques are covered.

Clinical accuracy of a patient-specific femoral osteotomy guide in minimally-invasive posterior hip arthroplasty.

Science.gov (United States)

Schneider, Adrian K; Pierrepont, Jim W; Hawdon, Gabrielle; McMahon, Stephen

2018-04-01

Patient specific guides can be a valuable tool in improving the precision of planned femoral neck osteotomies, especially in minimally invasive hip surgery, where bony landmarks are often inaccessible. The aim of our study was to validate the accuracy of a novel patient specific femoral osteotomy guide for THR through a minimally invasive posterior approach, the direct superior approach (DSA). As part of our routine preoperative planning 30 patients underwent low dose CT scans of their arthritic hip. 3D printed patient specific femoral neck osteotomy guides were then produced. Intraoperatively, having cleared all soft tissue from the postero-lateral neck of the enlocated hip, the guide was placed and pinned onto the posterolateral femoral neck. The osteotomy was performed using an oscillating saw and the uncemented hip components were implanted as per routine. Postoperatively, the achieved level of the osteotomy at the medial calcar was compared with the planned level of resection using a 3D/2D matching analysis (Mimics X-ray module, Materialise, Belgium). A total of 30 patients undergoing uncemented Trinity™ acetabular and TriFit TS™ femoral component arthroplasty (Corin, UK) were included in our analysis. All but one of our analysed osteotomies were found to be within 3 mm from the planned height of osteotomy. In one patient the level of osteotomy deviated 5 mm below the planned level of resection. Preoperative planning and the use of patient specific osteotomy guides provides an accurate method of performing femoral neck osteotomies in minimally invasive hip arthroplasty using the direct superior approach. IV (Case series).

Open wedge high tibial osteotomy using three-dimensional printed models: Experimental analysis using porcine bone.

Science.gov (United States)

Kwun, Jun-Dae; Kim, Hee-June; Park, Jaeyoung; Park, Il-Hyung; Kyung, Hee-Soo

2017-01-01

The purpose of this study was to evaluate the usefulness of three-dimensional (3D) printed models for open wedge high tibial osteotomy (HTO) in porcine bone. Computed tomography (CT) images were obtained from 10 porcine knees and 3D imaging was planned using the 3D-Slicer program. The osteotomy line was drawn from the three centimeters below the medial tibial plateau to the proximal end of the fibular head. Then the osteotomy gap was opened until the mechanical axis line was 62.5% from the medial border along the width of the tibial plateau, maintaining the posterior tibial slope angle. The wedge-shaped 3D-printed model was designed with the measured angle and osteotomy section and was produced by the 3D printer. The open wedge HTO surgery was reproduced in porcine bone using the 3D-printed model and the osteotomy site was fixed with a plate. Accuracy of osteotomy and posterior tibial slope was evaluated after the osteotomy. The mean mechanical axis line on the tibial plateau was 61.8±1.5% from the medial tibia. There was no statistically significant difference (P=0.160). The planned and post-osteotomy correction wedge angles were 11.5±3.2° and 11.4±3.3°, and the posterior tibial slope angle was 11.2±2.2° pre-osteotomy and 11.4±2.5° post-osteotomy. There were no significant differences (P=0.854 and P=0.429, respectively). This study showed that good results could be obtained in high tibial osteotomy by using 3D printed models of porcine legs. Copyright © 2016 Elsevier B.V. All rights reserved.

Modified french osteotomy for cubitus varus deformity

International Nuclear Information System (INIS)

Ahmad, I.; Idrees, M.

2007-01-01

To evaluate the outcome of Modified French Osteotomy for correction of cubitus varus deformity. All children, aged 3-12 years, with cubitus varus deformity were included in the study. Pre-operative clinical as well as radiological assessment of upper extremities were done in all cases. Modified French osteotomy was done to correct the deformity. All patients were followed for seven months. Physical examination for the range of motion, scar and post-operative complications were assessed. Antero-posterior and lateral radiographs of the elbow were obtained, and the carrying angles and lateral condylar prominence index were measured and recorded. Out of the total 30 patients, 26 were male and four female. Left side was involved in 24 cases and the right side in six. The average age at the time of osteotomy was seven years (range 3.5-12 years). The average pre-operative carrying angle was 25.2 degree (range 18-30 degree) and the post-operative angle 8.7 degree (range 5-13 degree valgus). The average pre- operative range of motion was 122.6 degree (range 105-135 degree) and the post-operative range 123.86 degree (range 90-135 degree). The average pre-operative lateral condylar prominence index (LCPI) was 175.56 (range 128-232) and the post-operative lateral condylar prominence 156 (range 100-240). Based on Bellmore criteria, 25 patients showed excellent, three good and two a poor result. Modified French technique of supracondylar osteotomy has excellent results in the management of cubitus varus in terms of cosmesis, radiological findings and fewer complications. (author)

Clinical Comparison of Sinus Lift via Summers Osteotomy and Piezosurgery

Directory of Open Access Journals (Sweden)

Mehrdad Radvar

2017-12-01

Full Text Available Introduction: Sinus lift is a process that could be performed by two methods. In the closed sinus lift, hybrid materials enter a suitable position through a created cavity. Afterwards, the materials are pressed without damaging the sinus membrane, and the implants are usually placed at the same time. Closed sinus lift is carried out via osteotomy and piezosurgery, and each of the techniques has certain advantages and limitations. The present study aimed to compare the clinical results of closed sinus lift using the summers osteotomy and piezosurgery. Materials and Methods: In this study, 20 patients requiring dental implants in the posterior segment of the maxilla via sinus lift surgery were randomly divided into two groups. The first group received piezosurgery, and the second group underwent summers osteotomy for sinus lift. Postoperative Schneiderian membrane perforation, inflammation, pain, bone gain, and bone loss were compared between the groups six months after the surgery using Mann-Whitney U test and two-sample t-test. Results: In the groups receiving piezosurgery and summers osteotomy, mean sinus lift was 3.6±0.9 and 4.0±2.2 mm, pain score was 1.1±1.2 and 0.9±0.8, bone gain was 2.2±0.8 and 3.1±1.3 mm, and crestal bone loss was 1.1±1.2 and 0.9±0.8 mm, respectively. Moreover, no Schneiderian membrane perforation was observed in the two methods, and the differences between the groups were not considered significant (P>0.05. Conclusion: According to the results, the clinical outcomes of piezosurgery in sinus lift are similar to those of summers osteotomy. Therefore, piezosurgery could be a proper alternative to summers osteotomy in sinus lift surgery.

Evaluation of Hallux Valgus Correction With Versus Without Akin Proximal Phalanx Osteotomy.

Science.gov (United States)

Shibuya, Naohiro; Thorud, Jakob C; Martin, Lanster R; Plemmons, Britton S; Jupiter, Daniel C

2016-01-01

Although the efficacy of Akin proximal phalanx closing wedge osteotomy as a sole procedure for correction of hallux valgus deformity is questionable, when used in combination with other osseous corrective procedures, the procedure has been believed to be efficacious. However, a limited number of comparative studies have confirmed the value of this additional procedure. We identified patients who had undergone osseous hallux valgus correction with first metatarsal osteotomy or first tarsometatarsal joint arthrodesis with (n = 73) and without (n = 81) Akin osteotomy and evaluated their radiographic measurements at 3 points (preoperatively, within 3 months after surgery, and ≥6 months after surgery). We found that those people who had undergone the Akin procedure tended to have a larger hallux abduction angle and a more laterally deviated tibial sesamoid position preoperatively. Although the radiographic correction of the deformity was promising immediately after corrective surgery with the Akin osteotomy, maintenance of the correction was questionable in our cohort. The value of additional Akin osteotomy for correction of hallux valgus deformity is uncertain. Published by Elsevier Inc.

Chondromyxoid fibroma of distal 1/3 rd of fibula a rare tumour at rare ...

African Journals Online (AJOL)

Chondromyxoid fibromas are rare, benign tumours account for <1% of primary bone neoplasms. Most commonly affected in 2nd and 3rdof life. We report one such case of chondromyxoid fibroma in distal fibula of a 15-year-old girl. The patient was managed with lower 3rd fibulectomy and fibular turnoplasty from middle 3rd ...

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

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.

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

OpenAIRE

Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

2013-01-01

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.

Free fibula flap: assessment of quality of life of patients with head and neck cancer who have had defects reconstructed.

Science.gov (United States)

Zhang, Xu; Li, Meng-Jie; Fang, Qi-Gen; Li, Zhen-Ning; Li, Wen-Lu; Sun, Chang-Fu

2013-11-01

This study investigated the quality of life (QoL) of patients with head and neck cancer undergoing immediate reconstruction of the mandible with free fibula flap. From March 2006 to January 2011, the QoL of 42 patients was assessed using the Medical Outcomes Study Short Form 36 and the University of Washington QoL (version 4) questionnaires. The assessments were performed at least 24 months after surgery. A total of 31 of the 42 questionnaires (73.8%) were returned. The length of harvested fibula varied from 17.5 to 26.1 cm. In the Short Form 36, the lowest-scoring domain was vitality, whereas the highest scores occurred in physical role. According to the University of Washington QoL, the key domains affected by surgery are chewing, speech, and appearance. The domain of pain has the best score. There was a significant effect on the QoL of patients with head and neck cancer with resections of the mandible who had undergone free fibula flap reconstruction. Data from this study may provide useful information for physicians and patients, which may be of value during discussion of treatment modalities for head and neck cancers.

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

Science.gov (United States)

Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

2013-01-01

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. PMID:23853472

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

Directory of Open Access Journals (Sweden)

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.

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.

Comparison of maxillary stability after Le Fort I osteotomy for occlusal cant correction surgery and maxillary advanced surgery.

Science.gov (United States)

Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Yoshida, Kan; Shimizu, Chika; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

2007-07-01

To compare postoperative maxillary stability following Le Fort I osteotomy for the correction of occlusal cant as compared with conventional Le Fort I osteotomy for maxillary advancement. The subjects were 40 Japanese adults with jaw deformities. Of these, 20 underwent a Le Fort I osteotomy and intraoral vertical ramus osteotomy (IVRO) to correct asymmetric skeletal morphology and inclined occlusal cant. The other 20 patients underwent a Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO) to advance the maxilla. Lateral and posteroanterior cephalograms were taken postoperatively and assessed statistically. Thereafter, the 2 groups were followed for time-course changes. There was no significant difference between the 2 groups with regard to time-course changes during the immediate postoperative period. This suggests that maxillary stability after Le Fort I osteotomy for cant correction does not differ from that after Le Fort I osteotomy for maxillary advancement.

Piezoelectric osteotomy in hand surgery: first experiences with a new technique

Science.gov (United States)

Hoigne, Dominik J; Stübinger, Stefan; Kaenel, Oliver Von; Shamdasani, Sonia; Hasenboehler, Paula

2006-01-01

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. PMID:16611362

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.

Minimizing the Translation Error in the Application of an Oblique Single-Cut Rotation Osteotomy: Where to Cut?

Science.gov (United States)

Dobbe, Johannes G G; Strackee, Simon D; Streekstra, Geert J

2018-04-01

An oblique single cut rotation osteotomy enables correcting angular bone alignment in the coronal, sagittal, and transverse planes, with just a single oblique osteotomy, and by rotating one bone segment in the osteotomy plane. However, translational malalignment is likely to exist if the bone is curved or deformed and the location of the oblique osteotomy is not obvious. In this paper, we investigate how translational malalignment depends on the osteotomy location. We further propose and evaluate by simulation in 3-D, a method that minimizes translational malalignment by varying the osteotomy location and by sliding the distal bone segment with respect to the proximal bone segment within the oblique osteotomy plane. The method is finally compared to what three surgeons achieve by manually selecting the osteotomy location in 3-D virtual space without planning in-plane translations. The minimization method optimized for length better than the surgeons did, by 3.2 mm on average, range (0.1, 9.4) mm, in 82% of the cases. A better translation in the axial plane was achieved by 4.1 mm on average, range (0.3, 14.4) mm, in 77% of the cases. The proposed method generally performs better than subjectively choosing an osteotomy position along the bone axis. The proposed method is considered a valuable tool for future alignment planning of an oblique single-cut rotation osteotomy since it helps minimizing translational malalignment.

Intravenous Tranexamic Acid Decreases Allogeneic Transfusion Requirements in Periacetabular Osteotomy.

Science.gov (United States)

Bryan, Andrew J; Sanders, Thomas L; Trousdale, Robert T; Sierra, Rafael J

2016-01-01

Bernese (Ganz) periacetabular osteotomy is associated with significant blood loss and the need for perioperative transfusion. Tranexamic acid decreases blood loss and minimizes transfusion rates in total joint arthroplasty. However, no reports have described its use in patients undergoing Bernese periacetabular osteotomy. This study reports the use of intravenous tranexamic acid in these patients. The study included 137 patients (150 hips) who underwent isolated periacetabular osteotomy at a single institution between 2003 and 2014. Of these, 68 patients (75 hips) received intravenous tranexamic acid 1 g at the time of incision and 1 g at the time of closure. A group of 69 patients (75 hips) served as control subjects who underwent periacetabular osteotomy without administration of intravenous tranexamic acid. Thromboembolic disease was defined as deep venous thrombosis or pulmonary embolism occurring within 6 weeks of surgery. Outcomes measured included transfusion requirements, pre- and postoperative hemoglobin values, operative times, and thromboembolic disease rates. Aspirin was used as the thromboembolic prophylactic regimen in 95% of patients. The rate of allogeneic transfusion was 0 in the tranexamic acid group compared with 21% in the control group (P=.0001). No significant difference was found in the autologous cell salvage requirement (.96 vs 1.01; P=.43) or the thromboembolic disease rate between the tranexamic acid group and the control group (2.67% vs 1.33%; P=.31). The use of intravenous tranexamic acid led to a decreased transfusion requirement with no increased risk of thromboembolic disease in this contemporary cohort of patients undergoing periacetabular osteotomy. Copyright 2016, SLACK Incorporated.

Lengthening of the shortened first metatarsal after Wilson's osteotomy for hallux valgus.

Science.gov (United States)

Singh, D; Dudkiewicz, I

2009-12-01

Metatarsalgia is a recognised complication following iatrogenic shortening of the first metatarsal in the management of hallux valgus. The traditional surgical treatment is by shortening osteotomies of the lesser metatarsals. We describe the results of lengthening of iatrogenic first brachymetatarsia in 16 females. A Scarf-type osteotomy was used in the first four cases and a step-cut of equal thicknesses along the axis of the first metatarsal was performed in the others. The mean follow-up was 21 months (19 to 26). Relief of metatarsalgia was obtained in the six patients in whom 10 mm of lengthening had been achieved, compared to only 50% relief in those where less than 8 mm of lengthening had been gained. One-stage step-cut lengthening osteotomy of the first metatarsal may be preferable to shortening osteotomies of the lesser metatarsals in the treatment of metatarsalgia following surgical shortening of the first metatarsal.

Outcome of Distal Both Bone Leg Fractures Fixed by Intramedulary Nail for Fibula & MIPPO in Tibia.

Science.gov (United States)

Gupta, Anil; Anjum, Rashid; Singh, Navdeep; Hackla, Shafiq

2015-04-01

Fractures of the distal third of the tibia are mostly associated with a fibular fracture that often requires fixation. The preferred treatment of distal tibial fracture is the minimally invasive percutaneous plate osteosynthesis (MIPPO) procedure. However, there are no clear cut guidelines on fixation of the fibular fracture and currently most orthopedic surgeons use a plate osteosynthesis for the fibula as well. A common complication associated with dual plating is an increased chance of soft tissue necrosis, infection, and in some cases resulting in an exposed implant. We conducted a prospective study to analyze the results of fractures of the distal in both leg bones managed by the MIPPO procedure for tibial fractures and a rush nail for fibular fractures. The study was conducted in a tertiary care hospital from November 2012 to May 2014, a total of 30 fractures in 30 patients (18 males, 12 females) with a mean age of 42.4 years (26-60 years) were treated in our institution in the aforesaid time period with MIPPO for tibia and rush nail for fibular fractures. All the cases were operated on by a single surgeon in emergency within 24 hours. The patients with skin blistering and compound fractures were excluded from this study. Rehabilitative measures were proceeded as per patient's pain profile, isometric and isotonic exercises were started on the first post-operative day, with full weight bearing at 10-12 weeks after assessing clinical and radiological union. Regular follow up of patients was done, radiographs were taken at the immediate post-operative period and at 3, 6, 12 and 24 weeks. All the patients were available for regular follow up. Radiological and clinical union proceeded normally in all the patients, no patients had signs of any deep infection, delayed union or nonunion, three patients had a superficial infection of the tibial incision that healed with a change in antibiotic. The use of dual plating for fixation of the lower tibia and fibula

Limb salvage with microvascular free fibula following primary bone sarcoma resection

Directory of Open Access Journals (Sweden)

Sahasrabudhe Parag

2016-01-01

Full Text Available Background: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. Materials and Methods: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015. Results: Of the ten cases in the study, there were two females and eight males. There were nine patients with lower limb malignancies and one patient with upper limb malignancy. There were four patients with Ewing's sarcoma of femur, five patients with osteosarcoma of femur and one patient with chondrosarcoma of the humerus. The follow-up period ranged from 1.2 to 6.2 years with mean follow-up of 3.1 years. There were two deaths during follow-up, both were due to distant metastasis. The assessment of the function was done on the basis of Musculoskeletal Tumour Society functional score. Maximum score was 30 and minimum score was 24, the average score being 26. Of the eight surviving patients, three patients had full weightbearing, four patients had partial weightbearing at end of 2 years and one patient of upper limb reconstruction had complete upper limb function. None of the patients had to undergo limb amputation. Conclusion: Limb salvage with vascularised fibula graft offers good functional outcome along with good disease-free survival rates.

Acetabular osteotomy for double boarding in lateral decubitus. Anatomical bases and surgical technique

International Nuclear Information System (INIS)

Lazennec, J Y; Del Vecchio, R; Saillant, G

2001-01-01

The periacetabular osteotomies of reorientation of the eotilo have a reputation of being difficult from the technical point of view. The authors present a technique of juxta acetabular osteotomy that respects the posterior column of the acetabulo the same as the GANZ technique. The osteotomy is of simpler realization thanks to an installation that allows carrying out two simultaneous boarding. The osteotomy lines, their rectilinear and controllable in permanency through of images intensificator and they don't constitute any risk for the essential vascular contribution of the obturatriz artery and their branches. Their other interest comes represented by the possibility of correcting easily the parasitic retroversion associated to the descent of the whole eotilo, that it allows to avoid the bad positions that they affect the center of the articulation and the widths acetabular

Simple prosthesis for a cancer patient with a segmental mandibulectomy and free fibula flap reconstruction: a clinical report.

Science.gov (United States)

Dholam, Kanchan; Kharade, Pankaj; Bhirangi, Pravin

2015-01-01

Tumors of the mandible often necessitate the resection of a major portion of the body of the mandible as well as tissue from the tongue. Resection of the body of the mandible often leads to discontinuity of the mandible, affecting function to a large extent. While the rehabilitation of such defects with free fibula flaps may provide a certain level of stability to the mandible and aid in the prosthetic rehabilitation of these patients, the bulk of these flaps may create difficulties during prosthetic rehabilitation. The economic constraints of patients and/or their fear of implant surgery may also rule out prosthetic rehabilitation with implant-retained prostheses. This case report describes a simple and cost-effective method of prosthetic rehabilitation for a cancer patient who had undergone a segmental mandibulectomy followed by reconstruction with a free fibula flap.

Valgusdeformitet i anklen som følge af distal fibula-epifysefraktur

DEFF Research Database (Denmark)

Al-Aubaidi, Zaid

2011-01-01

Ankle fracture with involvement of the growth plate is the second most common paediatric fracture after the distal radius. The most common fracture type according to Salter Harris (SH) is type II of the distal tibia combined with green stick of the fibula. Isolated fracture of the distal fibular...... growth plate is not common and as a rule it does not give any growth arrest. We describe a case of isolated fibular fracture SH type II in a ten year-old girl which ended with symptomatic valgus deformity of the ankle. The patient was operated with good results....

Optimizing Functional Outcomes in Mandibular Condyle Reconstruction With the Free Fibula Flap Using Computer-Aided Design and Manufacturing Technology.

Science.gov (United States)

Lee, Z-Hye; Avraham, Tomer; Monaco, Casian; Patel, Ashish A; Hirsch, David L; Levine, Jamie P

2018-05-01

Mandibular defects involving the condyle represent a complex reconstructive challenge for restoring proper function of the temporomandibular joint (TMJ) because it requires precise bone graft alignment for full restoration of joint function. The use of computer-aided design and manufacturing (CAD/CAM) technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap without the need for additional adjuncts. The purpose of this study was to analyze clinical and functional outcomes after reconstruction of mandibular condyle defects using only a free fibula graft with the help of virtual surgery techniques. A retrospective review was performed to identify all patients who underwent mandibular reconstruction with only a free fibula flap without any TMJ adjuncts after a total condylectomy. Three-dimensional modeling software was used to plan and execute reconstruction for all patients. From 2009 through 2014, 14 patients underwent reconstruction of mandibular defects involving the condyle with the aid of virtual surgery technology. The average age was 38.7 years (range, 11 to 77 yr). The average follow-up period was 2.6 years (range, 0.8 to 4.2 yr). Flap survival was 100% (N = 14). All patients reported improved facial symmetry, adequate jaw opening, and normal dental occlusion. In addition, they achieved good functional outcomes, including normal intelligible speech and the tolerance of a regular diet with solid foods. Maximal interincisal opening range for all patients was 25 to 38 mm with no lateral deviation or subjective joint pain. No patient had progressive joint hypomobility or condylar migration. One patient had ankylosis, which required release. TMJ reconstruction poses considerable challenges in bone graft alignment for full restoration of joint function. The use of CAD/CAM technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap through precise

Outcomes of a Stepcut Lengthening Calcaneal Osteotomy for Adult-Acquired Flatfoot Deformity.

Science.gov (United States)

Demetracopoulos, Constantine A; Nair, Pallavi; Malzberg, Andrew; Deland, Jonathan T

2015-07-01

Lateral column lengthening is used to correct abduction deformity at the midfoot and improve talar head coverage in patients with flatfoot deformity. It was our hypothesis that following a stepcut lengthening calcaneal osteotomy (SLCO), patients would have adequate correction of the deformity, a high union rate of the osteotomy, and improvement in clinical outcome scores. We retrospectively reviewed 37 consecutive patients who underwent SLCO for the treatment of stage IIB flatfoot deformity with a minimum 2-year follow-up. Deformity correction was assessed using preoperative and postoperative weight-bearing radiographs. Healing of the osteotomy was assessed by computed tomography. Clinical outcomes included the FAOS and SF-36 questionnaires. The Wilcoxon signed-rank test was used to compare clinical outcome scores. An alpha level of .05 was deemed statistically significant. Healing of the osteotomy occurred at a mean of 7.7 weeks postoperatively. The talonavicular (TN) coverage angle improved from 34.0 to 8.8 (P lengthening. Level IV, retrospective case review. © The Author(s) 2015.

Torsional osteotomies of the tibia in patellofemoral dysbalance.

Science.gov (United States)

Dickschas, Jörg; Tassika, Aliki; Lutter, Christoph; Harrer, Jörg; Strecker, Wolf

2017-02-01

Anterior knee pain or patellofemoral instability is common symptom of patellofemoral dysbalance or maltracking. Tibial torsional deformities can be the reason of this pathology. After appropriate diagnostic investigation, the treatment of choice is a torsional osteotomy. This study addresses the diagnostic investigation, treatment, and the outcome of torsional osteotomies of the tibia. Does this treatment result in patellofemoral stability and provide pain relief? Forty-nine tibial torsional osteotomies were included. The major symptoms were patellofemoral instability in 19 cases and anterior knee pain in 42 cases. In addition to clinical and radiographic analysis, a torsional angle CT scan was performed pre-operatively. A visual analog scale (VAS), the Japanese Knee Society score, the Tegner activity score, and the Lysholm score were assessed pre-operatively and at the 42-month follow-up. Mean tibial external torsion was 47.4° (SD 5.41; range 37°-66°; standard value 34°). Surgical treatment consisted of an acute supratuberositary tibial internal torsional osteotomy (mean 10.8°; SD 3.01°; range 5°-18°). At the follow-up investigation, the Tegner activity score was increased 0.4 points (p value 0.014) from 3.9 (SD 1.33; range 2-7) to 4.3 (SD 1.25; range 0-7). The Lysholm score increased 26 points (SD 16.32; p value 0.001) from 66 (SD 14.94; range 32-94) to 92 (SD 9.29; range 70-100) and the Japanese Knee Society score increased 18 points (SD 14.70; p value 0.001) from 72 (SD 13.72, range 49-100) to 90 (SD 9.85, range 60-100). VAS was reduced 3.4 points (SD 2.89; p value 0.001) from 5.7 (SD 2.78; range 0-10) to 2.3 (SD 1.83; range 0-7). As regards patellofemoral instability, no redislocation occurred in the follow-up period. The results of this study show that in cases of tibial maltorsion, a torsional osteotomy can lead to patellofemoral stability and pain relief, and should be considered as a treatment option. The improved clinical scores in the present

Intraoperative blood loss in bimaxillary orthognathic surgery with multisegmental Le Fort I osteotomies and additional procedures.

Science.gov (United States)

Kretschmer, W B; Baciut, G; Bacuit, Mihaela; Zoder, W; Wangerin, K

2010-06-01

Autologous blood donation is not currently recommended by most authors for routine bimaxillary osteotomies. There are few data about bimaxillary procedures with multisegmental maxillary osteotomies. Our aim was to investigate the effect of additional osteotomies and iliac crest grafts on operative blood loss. A total of 225 consecutive patients having bimaxillary multisegmental osteotomies during a three-year period (January 2006-January 2009) were examined to see if their haemoglobin concentration and packed cell volume were reduced. The influence of iliac crest grafts, additional osteotomies (genioplasty, malar osteotomy, iliac crest graft, anterior mandibular segmental osteotomy), operating time, age, and sex were assessed. Neither age nor sex influenced blood loss, whereas operating time correlated significantly with reductions in haemoglobin concentration and packed cell volume. Blood loss was significantly higher in the group who had additional procedures (p 0.001 for haemoglobin concentration and packed cell volume) than in the group who had no additional procedures, whereas there were no significant differences among the three subgroups who had additional procedures (additional osteotomies, iliac crest grafts, or both procedures). Four patients who had additional procedures required transfusion, whereas no blood was given in the group who had no additional procedures. Because the transfusion rate was so low, we could make no general recommendation for preoperative blood donation in such cases. Copyright 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Temperature and time variations during osteotomies performed with different piezosurgical devices: an in vitro study.

Science.gov (United States)

Delgado-Ruiz, R A; Sacks, D; Palermo, A; Calvo-Guirado, J L; Perez-Albacete, C; Romanos, G E

2016-09-01

The aim of this experimental in vitro study was to evaluate the effects of the piezoelectric device in temperature and time variations in standardized osteotomies performed with similar tip inserts in bovine bone blocks. Two different piezosurgical devices were used the OE-F15(®) (Osada Inc., Los Angeles, California, USA) and the Surgybone(®) (Silfradent Inc., Sofia, Forli Cesena, Italy). Serrated inserts with similar geometry were coupled with each device (ST94 insert/test A and P0700 insert/test B). Osteotomies 10 mm long and 3 mm deep were performed in bone blocks resembling type II (dense) and type IV (soft) bone densities with and without irrigation. Thermal changes and time variations were recorded. The effects of bone density, irrigation, and device on temperature changes and time necessary to accomplish the osteotomies were analyzed. Thermal analysis showed significant higher temperatures during piezosurgery osteotomies in hard bone without irrigation (P  0.05). Time analysis showed that the mean time values necessary to perform osteotomies were shorter in soft bone than in dense bone (P piezosurgery osteotomies in dense bone without irrigation; the time to perform the osteotomy with piezosurgery is shorter in soft bone compared to hard bone; and the piezosurgical device have a minimal influence in the temperature and time variations when a similar tip design is used during piezosurgery osteotomies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[APPLICATION OF PHOTOSHOP CS16.0 SOFTWARE IN PREOPERATIVE OSTEOTOMY DESIGN OF ANKYLOSING SPONDYLITIS KYPHOSIS].

Science.gov (United States)

Wang, Fei; Tao, Huiren; Liu, Zhibin; Zhang, Jianhua; Han, Fangmin

2015-02-01

To introduce the application of Photoshop CS16.0 (PS) software in preoperative osteotomy design of ankylosing spondylitis kyphosis (ASK), and to investigate applied values of the preoperative design. Between March 2009 and March 2013, 21 cases of ASK were treated through preoperative osteotomy design by using PS software. There were 16 males and 5 females, aged from 23 to 50 years (mean, 34.2 years). The deformity included thoracolumbar kyphosis in 14 cases, thoracic kyphosis in 2 cases, and lumbar kyphosis in 5 cases. The ultimate osteotomy angle of preoperative plans and the location and extent of osteotomy were determined by the osteotomy design, which guided operation procedures of the surgeon. The actual osteotomy angle was obtained by measuring Cobb angle of osteotomy segment before and after operation. The sagittal parameters of spine and pelvis including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), and chin brow-vertical angle (CBVA) were measured at preoperation, at 1 week after operation, and last follow-up. The clinical outcomes were assessed by simplified Chinese Scoliosis Research Society-22 (SRS-22) questionnaire and Oswestry disability index (ODI). No complications occurred in the other cases except 1 case of dural tear during operation and 1 case of nerve injury after operation, and primary healing of incision was obtained. All patients were followed up 14 to 45 months (mean, 26.3 months). The SRS-22 and ODI scores at 1 week after operation and last follow-up were significantly improved when compared with preoperative scores (P 0.05). The preoperative planned osteotomy angle and the postoperative actual osteotomy angle were (34.2 ± 10.5) degrees and (33.7 ± 9.7) degrees respectively, showing no significant difference (t = 0.84, P = 0.42). The CBVA, GK, SVA, PT, and LL were significantly improved when compared with the preoperative values (P 0.05). At last follow-up, no failures

The Gibson and Piggott osteotomy for adult hallux valgus.

Science.gov (United States)

Rangrez, Arshad Bashir; Dar, Tahir Ahmed; Badoo, Abdul Rashid; Wani, Sharief Ahmed; Dhar, Shabir Ahmed; Mumtaz, Imran; Ahmed, Muzzaffar

2012-01-01

The Gibson and Piggott procedure for hallux valgus is based on sound surgical principles addressing the basic pathologies of this disorder. However, this procedure has not been studied extensively in the literature in comparison to the Mitchell and Chevron osteotomies. We report a prospective study conducted on 50 adult feet with hallux valgus. The Gibson and Piggot osteotomy was done on all the feet. We obtained 76% excellent and 18% good results with this procedure. The results bear out the fact that this procedure is a useful procedure for the management of this disorder.

Posterior trochanteric osteotomy in acetabular fractures for 32 cases.

Science.gov (United States)

Niu, Yunfei; An, Xiaofei; Xu, Shuogui; Wu, Dajiang; Zhang, Chuncai; Li, Ming

2014-11-01

The aim of this study is to explore the method and clinical outcome of posterior trochanteric osteotomy in acetabular fractures. From January 2000 to January 2008, 32 cases of acetabular fractures involving the dome of acetabulum underwent posterior trochanteric osteotomy for a better exposure and internal fixation with acetabular tridimensional memory fixation system. 28 cases (16 men and 12 women, mean age 39.9 years, range 16-73 years) were followed up with an average of 48.9 months (range of 19-95 months) and four were lost during follow up. Of 28 cases, 19 were fresh fractures and 9 were old fractures. The reduction was evaluated with Matta criteria. Clinical evaluation was based on modified Merle d'Aubigne and Postel scoring. Motor strength of the abductors was evaluated according to the Medical Research Council grading system. Ectopic ossification was classified according to Brooker criteria. Anatomical reduction was achieved in 17 cases and satisfied reduction in 10 patients. Poor reduction happened in an old fracture. All acetabular fractures got a direct bone union and no displacement and deep infection occurred. All osteotomies healed within 3.5 months without any nonunion, proximal migration of the greater trochanter, loosing or broken of instrumentation, and deep infection. Two superficial infections were healed with a regular dressing. Two patients underwent removal of implants from greater trochanter because of irritation. The strength of the abductors was of Grade 3/5 in two patients, Grade 4/5 in five patients, and normal in the rest. Clinical scoring was excellent to good in 84 %. Ectopic ossification occurred in five patients, grade 1 in two patients, grade 2 in two, and grade 3 in one. But function of hip joint was not seriously affected. Posterior trochanteric osteotomy can provide an adequate exposure of the dome of acetabulum without the associated complications like nonunion, proximal replacement, and weak of the abductors which often occur

Application of a novel bone osteotomy plate leads to reduction in heat-induced bone tissue necrosis in sheep.

Science.gov (United States)

Bekić, Marijo; Davila, Slavko; Hrskanović, Mato; Bekić, Marijana; Seiwerth, Sven; Erdeljić, Viktorija; Capak, Darko; Butković, Vladimir

2008-12-01

Previous studies have shown substantial effect thermal damage can have on new bone formation following osteotomy. In this study we evaluated the extent of thermal damage which occurs in four different methods of osteotomy and the effects it can have on bone healing. We further wanted to test whether a special osteotomy plate we constructed can lead to diminished heat generation during osteotomy and enhanced bone healing. The four methods evaluated included osteotomy performed by chisel, a newly constructed osteotomy plate, Gigly and oscillating saw. Twelve adult sheep underwent osteotomy performed on both tibiae. Bone fragments were stabilized using a fixation plate. Callus size was assessed using standard radiographs. Densitometry and histological evaluation were performed at 8 weeks following osteotomy. Temperature measurements were performed both in vivo during the operation, and ex vivo on explanted tibiae. The defects healed without complications and showed typical course of secondary fracture healing with callus ingrowth into the osteotomy gap. Radiographic examination of bone healing showed a tendency towards more callus formation in bones osteotomized using Gigly and oscillating saw, but this difference lacked significance. Use of Gigly and oscillating saw elicited much higher temperatures at the bone cortex surface, which subsequently lead to slightly impaired bone healing according to histological analysis. BMD was equal among all bones. In conclusion, the time required for complete healing of the defect differed depended greatly on the instruments used. The newly constructed osteotomy plate showed best results based on histological findings of capillary and osteoblast density.

Reliability of the imaging software in the preoperative planning of the open-wedge high tibial osteotomy.

Science.gov (United States)

Lee, Yong Seuk; Kim, Min Kyu; Byun, Hae Won; Kim, Sang Bum; Kim, Jin Goo

2015-03-01

The purpose of this study was to verify a recently developed picture-archiving and communications system-photoshop method by comparing reliabilities between real-size paper template and the PACS-photoshop methods in preoperative planning of open-wedge high tibial osteotomy. A prospective case series was conducted, including patients with medial osteoarthritis undergoing open-wedge high tibial osteotomy. In the preoperative planning, the picture-archiving and communications system-photoshop method and real-size paper template method were used simultaneously in all patients. Preoperative hip-knee-ankle angle, height, and angle of the osteotomy were evaluated. The reliability of this newly devised method was evaluated, and the consistency between the two methods was also evaluated using intra-class correlation coefficient. Using the picture-archiving and communications system-photoshop method, the mean correction angle and height of osteotomy gap of rater-1 were 11.7° ± 3.6° and 10.7 ± 3.6 mm, respectively. The mean correction angle and height of osteotomy gap of rater-2 were 12.0 ± 2.6 and 10.8 ± 3.6, respectively. The inter- and intra-rater reliabilities of the correction angle were 0.956 ~ 0.979 and 0.980 ~ 0.992, respectively. The inter- and intra-rater reliabilities of the height of the osteotomy gap were 0.968 ~ 0.985 and 0.971 ~ 0.994, respectively (p photoshop method, mean values of the correction angle and height of the osteotomy gap were 11.9° ± 3.6° and 10.8 ± 3.6 mm, respectively. Consistency between the two methods by comparing the means of the correction angle and the height of the osteotomy gap were 0.985 and 0.985, respectively (p photoshop method enables direct measurement of the height of the osteotomy gap with high reliability.

Minimizing the translation error in the application of an oblique single-cut rotation osteotomy: Where to cut?

NARCIS (Netherlands)

Dobbe, Johannes G. G.; Strackee, Simon D.; Streekstra, Geert J.

2017-01-01

An oblique single cut rotation osteotomy enables correcting angular bone alignment in the coronal, sagittal and transverse planes, with just a single oblique osteotomy, and by rotating one bone segment in the osteotomy plane. However, translational malalignment is likely to exist if the bone is

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.

Cementoma of the fibula: imaging findings with histopathologic correlation and review of the literature

International Nuclear Information System (INIS)

Mellado, J.M.; Camins, A.; Sauri, A.; Mayayo, E.; Fernandez, F.; Perez del Palomar, L.

2005-01-01

Bone tumors containing fibrous tissue and cementum-like spherules are typically found in the maxilla and mandible. However, such lesions are extremely infrequent in the long bones. We report the complete radiologic assessment of a cementoma of the fibula in a 42-year-old man. We also correlate the findings with data provided by histopathologic analysis, and review the English-language literature on tumors of long bones that may contain cementum-like material. (orig.)

Percutaneous dorsal closing wedge osteotomy of the metatarsal neck in management of metatarsalgia.

Science.gov (United States)

Lui, Tun Hing

2014-12-01

Metatarsalgia can be caused by plantarflexion of a central metatarsal or discrepancies in the metatarsals' length. Nonsurgical management is usually sufficient to achieve satisfactory results. For those recalcitrant cases, metatarsal osteotomy is needed to relieve the pain. We describe a technique of percutaneous dorsal closing wedge osteotomy of the metatarsal to manage the recalcitrant metatarsalgia. A case series was reviewed retrospectively. From March 2010 to March 2013, percutaneous dorsal closing wedge osteotomy of the metatarsal neck has been performed in 33 patients. Thirty six feet with 63 metatarsals were operated on. Thirty two second metatarsals, 22 third metatarsals, 5 fourth metatarsals and 4 fifth metatarsals were operated on. All the osteotomy sites healed up without any transverse plane deformity. The painful callosities subsided except in one operated metatarsal. Recurrence of painful callosities occurred in 2 operated metatarsals. Transfer metatarsalgia occurred in 2 feet. Floating toe deformity occurred in 2 operated rays. There was no nerve injury noted. Two patients had delayed wound healing with serous discharge and the wounds were eventually healed up with wound dressing. Percutaneous dorsal closing wedge osteotomy of the metatarsal neck is an effective and safe surgical treatment of recalcitrant metatarsalgia. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

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

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 loading of

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 plantar fascia release following modified distal osteotomy, under multiple Achilles loading conditions (p 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.

[The minimally invasive Chevron and Akin osteotomy (MICA)].

Science.gov (United States)

Altenberger, Sebastian; Kriegelstein, Stefanie; Gottschalk, Oliver; Dreyer, Florian; Mehlhorn, Alexander; Röser, Anke; Walther, Markus

2018-04-18

Percutaneous correction of a hallux valgus deformity with or without transfer metatarsalgia. Hallux valgus deformity up to 20° intermetatarsal angle, without instability of the first tarsometatarsal joint. Symptomatic arthritis of the first metatarsophalangeal joint, as well as instability of the first tarsometatarsal joint. Percutaneous performed osteotomy of the distal metatarsal 1 in combination with a medial closing wedge osteotomy of the proximal phalanx of the first toe. The use of a postoperative shoe with a rigid sole allows adapted weight bearing in the first 6 weeks. Active and passive mobilization can start immediately after surgery. The method is very effective to treat even severe deformities with or without metatarsalgia. The amount of correction is similar to open procedures. We recommend cadaver training to become familiar with this technique. Thus, complications such as nerve, vessel or tendon injuries can be avoided. The intraoperative radiation exposure remains significantly elevated even for experienced surgeons. In addition to the aesthetic benefits, there is less soft tissue traumatization compared to conventional open procedures. There is no need of bloodlessness. The minimally invasive Chevron and Akin osteotomy is a safe and powerful technique for the treatment of hallux valgus deformity.

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.

Comparison between piezosurgery and conventional osteotomy in cranioplasty with fronto-orbital advancement.

Science.gov (United States)

Martini, Markus; Röhrig, Andreas; Reich, Rudolf Hermann; Messing-Jünger, Martina

2017-03-01

Cranioplasty of patients with craniosynostosis requires rapid, precise and gentle osteotomy of the skull to avoid complications and benefit the healing process. The aim of this prospective clinical study was to compare two different methods of osteotomy. Piezosurgery and conventional osteotomy were compared using an oscillating saw and high speed drill while performing cranioplasties with fronto-orbital advancement. Thirty-four children who required cranioplasty with fronto-orbital advancement were recruited consecutively. The operations were conducted using piezosurgery or a conventional surgical technique, alternately. Operative time, blood count, CRP and transfusion rate, as well as soft tissue injuries, postoperative edema, pain development and secondary bone healing were investigated. The average age of patients was 9.7 months. The following indications for craniosynostosis were surgically corrected: trigonocephaly (23), anterior plagiocephaly (8), brachycephaly (1), and syndromic craniosynostosis (2). Piezosurgery was utilized in 18 cases. There were no group differences with regard to the incidence of soft tissue injuries (dura, periorbita), pain, swelling, blood loss or bony integration. The duration of osteotomy was significantly longer in the piezosurgery group, leading to slightly increased blood loss, while the postoperative CRP increase was higher using the conventional method. The piezosurgery method is a comparatively safe surgical method for conducting osteotomy during cranioplasty. With regard to soft tissue protection and postoperative clinical course, the same procedural precautions and controls are necessary as those needed for conventional methods. The osteotomy duration is considerably longer using piezosurgery, although it is accompanied by lower initial postoperative CRP values. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Bilateral Complex Regional Pain Syndrome after Fracture of Bilateral Tibia and Fibula

Directory of Open Access Journals (Sweden)

Senem Şaş

2017-04-01

Full Text Available Complex regional syndrome type 1 (CRPS-1 is a painful clinical condition. It occurs after a painful event and characterized by allodynia, hyperalgesia, edema, abnormalities in skin blood flow and abnormal sudomotor activity. When CRPS-1 is associated with nerve injury, it is defined as CRPS-2. Central and peripheral theory are responsible in etiopathogenesis of CRPS-1. Generally it occurs in the injured limb. But, it may ocur in the opposite extremities. In this article, we present a case developing bilateral CRPS-1 after bilateral tibia and fibula fracture by reviewing current literatüre.

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.

Radiographic evaluation for AVN following distal metatarsal Stoffella bunion osteotomy.

Science.gov (United States)

Klein, Christian; Zembsch, Alexander; Dorn, Ulrich

2009-01-01

Avascular necrosis of the metatarsal head, delayed bone healing and nonunion are complications that may occur after distal first metatarsal osteotomies. Intraoperative damage to the extraosseous blood supply, the location of the osteotomy and postoperative vasospasm have been cited as possible causes of such changes. We evaluated Stoffella's subcapital osteotomies which were performed at our department for the correction of moderate to severe hallux valgus deformities. Standardized radiographs of 300 feet, taken 6weeks, 3 months, and 6 months postoperatively and at the final followup were examined with regard to postoperative AVN or signs of delayed bone healing. Of 228 patients, 202 were women and 26 were men. The patients' mean age was 49 years, and the mean followup was 12 months. In 278 cases the radiographs revealed an unremarkable first metatarsal head. Seventeen cases showed diffuse or localized osteopenia or small cysts in the subchondral bone. These changes fully resolved on subsequent radiographs. The X-rays of two patients revealed progressive narrowing of the joint space, irregular contours on the surface of the joint and an abnormal bone structure. The patients subsequently developed a characteristic picture of avascular necrosis, in one case combined with nonunion. Three patients had delayed bone healing, but ultimately healed successfully. Ischemic changes in bone are known to occur after distal first metatarsal osteotomies. There is a very low incidence of postoperative perfusion problems after Stoffella;s technique, even with lateral soft tissue release.

[Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate].

Science.gov (United States)

Hou, Min; Shi, Guang-Yu; Pu, Li-Chen; Song, Da-Li; Zhang, Xi-Zhong; Liu, Chun-Ming

2009-09-01

To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP). 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied. The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy. 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

Experimental Fracture Model versus Osteotomy Model in Metacarpal Bone Plate Fixation

Directory of Open Access Journals (Sweden)

S. Ochman

2011-01-01

Full Text Available Introduction. Osteotomy or fracture models can be used to evaluate mechanical properties of fixation techniques of the hand skeleton in vitro. Although many studies make use of osteotomy models, fracture models simulate the clinical situation more realistically. This study investigates monocortical and bicortical plate fixation on metacarpal bones considering both aforementioned models to decide which method is best suited to test fixation techniques. Methods. Porcine metacarpal bones (=40 were randomized into 4 groups. In groups I and II bones were fractured with a modified 3-point bending test. The intact bones represented a further control group to which the other groups after fixation were compared. In groups III and IV a standard osteotomy was carried out. Bones were fixated with plates monocortically (group I, III and bicortically (group II, IV and tested for failure. Results. Bones fractured at a mean maximum load of 482.8 N ± 104.8 N with a relative standard deviation (RSD of 21.7%, mean stiffness was 122.3 ± 35 N/mm. In the fracture model, there was a significant difference (=0.01 for maximum load of monocortically and bicortically fixed bones in contrast to the osteotomy model (=0.9. Discussion. In the fracture model, because one can use the same bone for both measurements in the intact state and the bone-plate construct states, the impact of inter-individual differences is reduced. In contrast to the osteotomy model there are differences between monocortical and bicortical fixations in the fracture model. Thus simulation of the in vivo situation is better and seems to be suitable for the evaluation of mechanical properties of fixation techniques on metacarpals.

Anesthetic consideration in a postchemotherapy pediatric patient for segmental mandibulectomy with free fibula reconstruction

Directory of Open Access Journals (Sweden)

Amit Kumar Mittal

2017-01-01

Full Text Available We report successful anesthetic management of a postchemotherapy pediatric patient having Ewing's Sarcoma mandible who underwent segmental mandibulectomy with free fibula reconstruction. The main challenges were securing difficult airway due to fragile mandible and maintenance of ideal blood rheostatic properties in an attempt to ensure optimal fluidity in microcirculation for the viability of flap. Other aspects of care like prevention of postoperative thrombosis of anastomotic vessels and need of tracheostomy for postoperative elective ventilation are being discussed.

Gravity Reduction View: A Radiographic Technique for the Evaluation and Management of Weber B Fibula Fractures

Directory of Open Access Journals (Sweden)

Lauren Ehrlichman

2017-03-01

Full Text Available Background: While various radiographic parameters and application of manual/gravity stress have been proposed to elucidate instability for Weber B fibula fractures, the prognostic capability of these modalities remains unclear. Determination of anatomic positioning of the mortise is paramount. We propose a novel view, the Gravity Reduction View (GRV, which helps elucidate non-anatomic positioning and reducibility of the mortise.Methods: The patient is positioned lateral decubitus with the injured leg elevated on a holder with the fibula directed superiorly. The x-ray cassette is placed posterior to the heel, with the beam angled at 15˚ of internal rotation to obtain a mortise view. Our proposed treatment algorithm is based upon the measurement of the medial clear space (MCS on the GRV versus the static mortise view (and in comparison to the superior clear space (SCS and is based on reducibility of the MCS. A retrospective review of patients evaluated utilizing the GRV was performed.Results: 26 patients with Weber B fibula fractures were managed according to this treatment algorithm. Mean age was 50.57 years old (range: range:18-81, SD=19. 17 patients underwent operative treatment and 9 patients were initially treated nonoperatively. 2 patients demonstrated late displacement and were treated surgically. Using this algorithm, at a mean follow-up of 26 weeks, all patients had a final MCS that was less than the SCS (final mean MCS 2.86 mm vs. mean SCS of 3.32 indicating effectiveness of the treatment algorithm.Conclusion: The GRV is a novel radiographic view in which deltoid competency, reducibility and initial positioning of the mortise are assessed by comparing a static mortise view with the appearance of the mortise on the GRV. We have developed a treatment algorithm based on the GRV and have found it to be useful in guiding treatment and successful at achieving anatomic mortise alignment.

Predicted osteotomy planes are accurate when using patient-specific instrumentation for total knee arthroplasty in cadavers: a descriptive analysis.

Science.gov (United States)

Kievit, A J; Dobbe, J G G; Streekstra, G J; Blankevoort, L; Schafroth, M U

2018-06-01

Malalignment of implants is a major source of failure during total knee arthroplasty. To achieve more accurate 3D planning and execution of the osteotomy cuts during surgery, the Signature (Biomet, Warsaw) patient-specific instrumentation (PSI) was used to produce pin guides for the positioning of the osteotomy blocks by means of computer-aided manufacture based on CT scan images. The research question of this study is: what is the transfer accuracy of osteotomy planes predicted by the Signature PSI system for preoperative 3D planning and intraoperative block-guided pin placement to perform total knee arthroplasty procedures? The transfer accuracy achieved by using the Signature PSI system was evaluated by comparing the osteotomy planes predicted preoperatively with the osteotomy planes seen intraoperatively in human cadaveric legs. Outcomes were measured in terms of translational and rotational errors (varus, valgus, flexion, extension and axial rotation) for both tibia and femur osteotomies. Average translational errors between the osteotomy planes predicted using the Signature system and the actual osteotomy planes achieved was 0.8 mm (± 0.5 mm) for the tibia and 0.7 mm (± 4.0 mm) for the femur. Average rotational errors in relation to predicted and achieved osteotomy planes were 0.1° (± 1.2°) of varus and 0.4° (± 1.7°) of anterior slope (extension) for the tibia, and 2.8° (± 2.0°) of varus and 0.9° (± 2.7°) of flexion and 1.4° (± 2.2°) of external rotation for the femur. The similarity between osteotomy planes predicted using the Signature system and osteotomy planes actually achieved was excellent for the tibia although some discrepancies were seen for the femur. The use of 3D system techniques in TKA surgery can provide accurate intraoperative guidance, especially for patients with deformed bone, tailored to individual patients and ensure better placement of the implant.

Osteotomy around young deformed knees: 38-year super-long-term follow-up to detect osteoarthritis.

Science.gov (United States)

Koshino, Tomihisa

2010-02-01

Since 1969 corrective osteotomy has been performed at our institute in young patients (under 40 years) with bowlegs, knock knees and flexion or rotational deformities around the knee. Fifty-seven knees (29 left, 28 right) of 45 patients (19 boys, 26 girls) were followed-up for a period ranging from 30 to 38 years in seven patients with seven knees, from 20 to 29 years in nine patients with 11 knees, and from ten to 19 years in 29 patients with 39 knees. Supracondylar femoral osteotomy was performed on 12 knees (11 patients), high tibial osteotomy above the tibial tuberosity on eight knees (six patients) and below the tuberosity on 37 knees (28 patients). At the final follow-up (age range 42-73 years), all of the deformities were satisfactorily corrected, with no symptoms apart from nine knees, seven of which had dull pain after strenuous sport with osteophytes, etc. in the radiograph. Total knee arthroplasty was performed in the remaining two knees, at ten and 26 years, respectively, after the initial osteotomy. Osteoarthritis developed in the contralateral knee to the initial osteotomy in two patients after 34 years at age 73 and after 33 years at age 67.

Patellofemoral dysbalance and genua valga: outcome after femoral varisation osteotomies.

Science.gov (United States)

Dickschas, Jörg; Ferner, Felix; Lutter, Christoph; Gelse, Kolja; Harrer, Jörg; Strecker, Wolf

2018-01-01

Patellofemoral dysbalance may be caused by trochlear dysplasia, an elevated TTTG distance, femoral or tibial torsional deformities, patella alta, or a genu valgum. The surgical procedure for the treatment of a genu valgum is varisation osteotomy, usually in the femoral aspect. Several authors believe that a genu valgum is one cause of patellofemoral dysbalance, but studies about the outcome of the treatment with a varisation osteotomy are rare. Nineteen knees in 18 patients, aged on average 28 (16-52) years were investigated in a retrospective study. The patients had symptoms of patellofemoral instability or anterior knee pain due to a genu valgum, without symptoms of a lateral femorotibial compartment. All patients underwent a femoral varisation osteotomy. The diagnostic investigation prior to surgery included full-leg radiographs and torsional angle CT scans. The pre-surgery and follow-up investigation included the visual analog scale (VAS), the Kujala score, the Japanese Knee Society score, the Lysholm score. The mean duration of follow-up was 44(10-132) months. The mean preoperative mechanical valgus was 5.6° (range 4-10°). Twelve patients mentioned patellar instability as the main symptom while 14 mentioned anterior knee pain. No redislocation occurred in the follow-up period. Anterior knee pain on the VAS (p value patellofemoral dysbalance, treatment of this condition is femoral varisation osteotomy. In this study, patellofemoral stability was achieved and anterior knee pain was significantly reduced. Significant improvements in clinical scores proved the success of the treatment. IV, case series.

Proximal supination osteotomy of the first metatarsal for hallux valgus.

Science.gov (United States)

Yasuda, Toshito; Okuda, Ryuzo; Jotoku, Tsuyoshi; Shima, Hiroaki; Hida, Takashi; Neo, Masashi

2015-06-01

Risk factors for hallux valgus recurrence include postoperative round-shaped lateral edge of the first metatarsal head and postoperative incomplete reduction of the sesamoids. To prevent the occurrence of such conditions, we developed a proximal supination osteotomy of the first metatarsal. Our aim was to describe this novel technique and report the outcomes in this report. Sixty-six patients (83 feet) underwent a distal soft tissue procedure combined with a proximal supination osteotomy. After the proximal crescentic osteotomy, the proximal fragment was pushed medially, and the distal fragment was abducted, and then the distal fragment of the first metatarsal was manually supinated. Outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score and radiographic examinations. The average follow-up duration was 34 (range, 25 to 52) months. The mean AOFAS score improved significantly from 58.0 points preoperatively to 93.8 points postoperatively (P hallux valgus and intermetatarsal angle decreased significantly from 38.6 and 18.0 degrees preoperatively to 11.0 and 7.9 degrees postoperatively, respectively (both, P hallux valgus, defined as a hallux valgus angle ≥ 25 degrees. The rates of occurrence of a positive round sign and incomplete reduction of the sesamoids significantly decreased postoperatively, which may have contributed to the low hallux valgus recurrence rates. We conclude that a proximal supination osteotomy was an effective procedure for correction of hallux valgus and can achieve a low rate of hallux valgus recurrence. Level IV, retrospective case series. © The Author(s) 2015.

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...

Does longstanding nicotine exposure impair bone healing and osseointegration? An experimental study in rabbits

DEFF Research Database (Denmark)

Gotfredsen, Klaus; Lindh, Christian H; Berglundh, Tord

2009-01-01

OBJECTIVES: The aim of this study was to analyze the effect of longstanding nicotine exposure on bone healing and osseointegration of titanium implants. MATERIALS AND METHODS: 20 female rabbits received either nicotine (n = 10) or saline (n = 10) administered subcutaneously via mini-osmotic pumps...... for 32 weeks. The pump delivered 6 microg/kg/min of nicotine for the animals in the test group. Blood samples were collected and plasma cotinine levels were measured monthly. Six months after the commencement of nicotine or saline administration three osteotomy preparations, one in right, femoral condyle...... increase in RMT between 2 and 4 weeks within each group. The histomorphometric analysis of bone-to-implant contact and bone density in the bone defects revealed no differences between the test and the control group after 2 or 4 weeks of healing. CONCLUSION: Longstanding (6 months) nicotine exposure did...

Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report.

Science.gov (United States)

Santagata, Mario; Sgaramella, Nicola; Ferrieri, Ivo; Corvo, Giovanni; Tartaro, Gianpaolo; D'Amato, Salvatore

2017-12-01

A three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible. A 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue

Condylar cartilaginous changes after mandibular distraction osteogenesis in rabbits.

Science.gov (United States)

Ahn, Sin-Young; Kim, Su-Gwan

2011-10-01

The purpose of this study was to evaluate histologic and immunohistochemical changes in the condylar articular surface in response to distraction osteogenesis (DO) of the mandibular body in rabbits. A unilateral osteotomy of the mandible at the premolar area was performed in 16 rabbits. The animals were divided into 4 groups based on different distraction parameters (rate and rhythm). After a 5-day latency, the mandible was lengthened by 0.5 mm daily for 6 days (group 1); 0.5 mm twice daily for 3 days (group 2); 0.5 mm once daily for 10 days (group 3); or 0.5 mm twice daily for 5 days (group 4). All 4 groups underwent a 14-day consolidation period. Four rabbits were included in the control group. The specimens were stained with hematoxylin-eosin for histologic examination. Immunohistochemical analysis was performed to evaluate the expression of growth factors. None of the groups demonstrated any degenerative changes in the temporomandibular joint (TMJ). On the distraction side in all groups, the histopathological examination revealed a hypertrophic thickening of the cartilage zone. Prominent endochondral ossification and high active osteoblasts were observed in groups 3 and 4. On the nondistraction side, no major changes were observed excluding the appearance of osteoclasts in groups 3 and 4. The immunohistochemical analysis revealed tenascin immunoreactivity in bone marrow mesenchymal cells on the distraction side in group 4. Connexin immunoreactivity did not display a marked change in any of the groups. Osteocalcin was observed on the distraction side in group 2, which suggested that bone formation is increased. Nitric oxide synthase 2 immunoreactivity was observed on the distraction side in group 2, which is associated with stress and inflammation. The results indicated that the hypertrophy of the cartilage zone and endochondral ossification became more pronounced as the extent and rate of distraction increased. Copyright © 2011 Mosby, Inc. All rights reserved.

Biomechanical study: resistance comparison of posterior antiglide plate and lateral plate on synthetic bone models simulating Danis-Weber B malleolar fractures

Directory of Open Access Journals (Sweden)

Bruna Buscharino

2013-06-01

Full Text Available OBJECTIVE : The purpose of this study was to compare different positions of plates in lateral malleolar Danis-Weber B fractures on synthetic bone: a lateral plate and a posterior antiglide plate. METHODS : Short oblique fractures of distal fibula at the level of the syndesmosys were simulated with a fibular osteotomy in sixteen synthetic fibula bones (Synbone®. Eight fractures were fixed with lateral plating associated with an independent lag screw, and the other eight were fixed with posterior antiglide plating with a lag screw through the plate. A strain gage was installed at the center of each plate at the osteotomy site. Supination and external rotation forces were applied to each of the two groups at the bend. RESULTS : The lateral position plate group suffered more deformity in response to supination forces compared to the group with the posterior antiglide plate, but this result was not statistically significant. In the tests with external rotation forces, the posterior antiglide plating group had significantly higher resistance (p < 0.05. CONCLUSION : When subjected to external rotation forces, osteosynthesis with posterior antiglide plate models simulating type B fractures of the lateral malleolus of the ankle is more resistant than that of the neutralization plate.

Extraction of impacted mandibular third molars - the effect of osteotomy at two speeds on peripheral bone: a histopathological analysis.

Science.gov (United States)

Siroraj, A Pearlcid; Giri G V V; Ramkumar, Subramaniam; Narasimhan, Malathi

2016-05-01

The aim of this study was to find out the ideal speed for making a precise osteotomy with minimal damage to the surrounding bone. Thirty-six patients were divided into two groups (n=18 in each) depending on the speed of the handpiece used for osteotomy (slow=20000rpm and fast=40000rpm). Samples were taken from the peripheral bone and examined histologically to measure the margins of the osteotomy, the amount of debris produced, and the degree of thermal osteonecrosis. The osteotomy made with the high speed handpiece was better than that made with the low speed one on all counts. The margins in the high speed group were more or less precisely as required, with less debris and no thermal necrosis, which illustrated the efficacy of a high speed osteotomy. These findings can apply to other procedures that involve osteotomies in maxillofacial surgery. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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 ...

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.

The proportion of distal fibula Salter-Harris type I epiphyseal fracture in the paediatric population with acute ankle injury

DEFF Research Database (Denmark)

Hofsli, Mikael; Torfing, Trine; Al-Aubaidi, Zaid

2016-01-01

Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter-Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All...

Intra-articular osteotomy for distal humerus malunion

NARCIS (Netherlands)

Marti, René K.; Doornberg, Job

2009-01-01

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

Hindfoot Valgus following Interlocking Nail Treatment for Tibial Diaphysis Fractures: Can the Fibula Be Neglected?

Directory of Open Access Journals (Sweden)

Metin Uzun

2014-01-01

Full Text Available Purpose. We evaluated whether intramedullary nail fixation for tibial diaphysis fractures with concomitant fibula fractures (except at the distal one-third level managed conservatively with an associated fibula fracture resulted in ankle deformity and assessed the impact of the ankle deformity on lower extremity function. Methods. Sixty middle one-third tibial shaft fractures with associated fibular fractures, except the distal one-third level, were included in this study. All tibial shaft fractures were anatomically reduced and fixed with interlocking intramedullary nails. Fibular fractures were managed conservatively. Hindfoot alignment was assessed clinically. Tibia and fibular lengths were compared to contralateral measurements using radiographs. Functional results were evaluated using the Knee Injury and Osteoarthritis Outcome Score (KOOS and the Foot and Ankle Disability Index Score (FADI. Results. Anatomic union, defined as equal length in operative and contralateral tibias, was achieved in 60 fractures (100%. Fibular shortening was identified in 42 fractures (68%. Mean fibular shortening was 1.2 cm (range, 0.5–2 cm. Clinical exams showed increased hindfoot valgus in 42 fractures (68%. The mean KOOS was 88.4, and the mean FADI score was 90. Conclusion. Fibular fractures in the middle or proximal one-third may need to be stabilized at the time of tibial intramedullary nail fixation to prevent development of hindfoot valgus due to fibular shortening.

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

. METHODS: The gait pattern of 9 women (median age 39 years) with hip dysplasia who were treated with unilateral periacetabular osteotomy was analyzed before periacetabular osteotomy and an average of 1.5 years afterwards. Data were collected using 5 video cameras and 2 force plates. An inverse dynamics...... upright walking pattern but continued to relieve the hip joint by maintaining a reduced flexor moment....

Achievability of 3D planned bimaxillary osteotomies: maxilla-first versus mandible-first surgery

OpenAIRE

Liebregts, Jeroen; Baan, Frank; de Koning, Martien; Ongkosuwito, Edwin; Berg?, Stefaan; Maal, Thomas; Xi, Tong

2017-01-01

The present study was aimed to investigate the effects of sequencing a two-component surgical procedure for correcting malpositioned jaws (bimaxillary osteotomies); specifically, surgical repositioning of the upper jaw?maxilla, and the lower jaw?mandible. Within a population of 116 patients requiring bimaxillary osteotomies, the investigators analyzed whether there were statistically significant differences in postoperative outcome as measured by concordance with a preoperative digital 3D vir...

Case report - curved femoral osteotomy for management of medial patellar luxation

DEFF Research Database (Denmark)

Allpass, Maja; Miles, James Edward

2015-01-01

Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation.......Medial patellaluxation kan forårsages af femoral varus hos hund. Førhen har patienter med excessiv femoralvarus været korrigeret ved en lateralt placeret femoral kile-ostektomi. Her præsenteres en case, hvor en buet osteotomi blev anvendt til behandling af medial patellaluxation....

Piezosurgical osteotomy for harvesting intraoral block bone graft

Science.gov (United States)

Lakshmiganthan, Mahalingam; Gokulanathan, Subramanium; Shanmugasundaram, Natarajan; Daniel, Rajkumar; Ramesh, Sadashiva B.

2012-01-01

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. PMID:23066242

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.

Neurosensory changes of palatal mucousa following Le Fort I osteotomy

Directory of Open Access Journals (Sweden)

Bijan Movahedian Attar

2009-09-01

Full Text Available

• BACKGROUND: This study evaluated the sensation of palatal ucosa before and after Le Fort I osteotomy and compared it based on whether greater palatine nerve has been dissected or not.
• METHODS: Sixteen patients were studied within one week before  urgery and then one week, 6 weeks, 3 months and 6 months after surgery. Four tests including sharp-blunt discrimination, cold perception, pin prick sensation and electrical stimulation were performed.
• RESULTS: Mean values of electrical stimulation were significantly higher 6 months after surgery (p < 0.05, on the other hand mean values of pin-prick sensation were significantly lower (p < 0.05. All patients regardless of the condition of greater palatine nerve were responsive to cold perception and sharp-blunt discrimination 6 months after surgery.
• CONCLUSIONS: Following Le Fort I osteotomy, palatal  esponsiveness to electrical stimulation decreases and mechanical hyper sensitization occurs. Dissection of greater palatine nerve was shown to have no effect on the results.
• KEYWORDS: Lefort I Osteotomy, Palatal Mocousa, Nerve Recovery.

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.

The role of trochanteric flip osteotomy in fixation of certain acetabular fractures.

Science.gov (United States)

Gupta, Sandeep; Singh, Jagdeep; Virk, Jagandeep Singh

2017-06-01

Complete visualization of certain acetabular fractures of posterior wall or column with cranial extension involving superior dome from standard surgical exposures is a challenge. Osteotomy of the greater trochanter has been used to enhance fracture visualization, especially the dome, in posterior and lateral exposures of the acetabulum. It also decreases the need for excessive muscle retraction. The purpose of the study was to investigate the outcome associated with trochanteric flip osteotomy in the management of certain acetabulum fractures. From January 2011 to December 2013, 25 displaced acetabular fractures were treated by open reduction and internal fixation. The fractures were managed using a Kocher-Langenbeck approach along with trochanteric flip osteotomy. At 3rd, 6th and 24th month follow-up, all patients had radiographic examination and underwent a final clinical evaluation based on the modified Merle d'Aubigne and Postel score. The strength of the abductors was assessed according to the Medical Research Council (MRC) grading system. Congruent reduction was achieved in all patients and all osteotomies healed within an average period of 3.8 months. All our patients were allowed full weight bearing at the end of 3 months and with no abductor lurch at the end of 6 months follow-up. There were no cases of avascular necrosis of femoral head. None of the patients had any neurovascular complication or infection by the end of the follow-up period. Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

[Austin's horizontal V-shaped sliding osteotomy of the metatarsal head [Chevron-osteotomy) in the treatment of hallux valgus].

Science.gov (United States)

Steinböck, G

1996-08-01

From 1983 to 1995, 1587 patients suffering from hallux abductovalgus were treated with the Austin bunionectomy. The operation consists of a medial exostosis removal, a V-shaped laterally directed displacement osteotomy of the metatarsal head, lateral release and medial reefing of the capsulo-ligamentous structures. Lateral transposition is facilitated by performing a sufficient lateral release consisting of dissection of the lateral metatarsophalangeal ligament and separation of the adductor tendon from the base of the phalanx and the lateral sesamoid. In the case of intermetatarsal angles greater than 15 degrees, the metatarsal-sesamoid ligament is also severed just above the lateral sesamoid. The periosteum is stripped in a limited fashion dorsally and toward the plantar, leaving its insertion at the metatarsal head intact. After this procedure, reposition of the metatarsal head onto the sesamoids is usually possible and is maintained by reconstruction of the medial metatarsal-sesamoid ligament. In the author's own research material, metatarsophalangeal angles larger than 50 degrees and intermetatarsal angles of over 20 degrees could be corrected. Pronation of the toe is usually corrected by tenotomy of the abductor tendon near the base of the phalanx. Avascular necrosis is extremely rare with a careful operative technique. In our extensive research material, four cases of AVN were recognized. Provided there is free motion of the joint (60-0-20), mild radiological signs of osteoarthritis are no contraindication for the operation. Even in the aged, good results can be achieved provided there are no trophic problems. The Austin bunionectomy has proved to be a versatile method for treating bunion problems. The possibility of transposing the metatarsal head laterally, toward the plantar, proximally and distally by altering the direction of the osteotomy, as well as tilting it medially or laterally, has made this osteotomy an invaluable tool for addressing various

Will immediate postoperative imbalance improve in patients with thoracolumbar/lumbar degenerative kyphoscoliosis? A comparison between Smith-Petersen osteotomy and pedicle subtraction osteotomy with an average 4 years of follow-up.

Science.gov (United States)

Bao, Hongda; He, Shouyu; Liu, Zhen; Zhu, Zezhang; Qiu, Yong; Zhu, Feng

2015-03-01

A retrospective radiographical study. To compare compensatory behavior of coronal and sagittal alignment after pedicle subtraction osteotomy (PSO) and Smith-Petersen osteotomy (SPO) for degenerative kyphoscoliosis. There was a paucity of literature paying attention to the postoperative imbalance after PSO or SPO and natural evolution of the imbalance. A retrospective study was performed on 68 consecutive patients with degenerative kyphoscoliosis treated by lumbar PSO (25 patients) or SPO (43 patients) procedures at a single institution. Long-cassette standing radiographs were taken preoperatively, postoperatively, and at the last follow-up and radiographical parameters were measured. The lower instrumented vertebral level and level of osteotomy were compared between the patients with and without improvement. Negative sagittal vertical axis (SVA) was observed in the PSO group postoperatively, implying an overcorrection of SVA. This negative SVA improved spontaneously during follow-up (P imbalance (P = 0.027), whereas no difference in term of levels of osteotomy was found (P > 0.05). The overcorrection of SVA is more often seen in the PSO group. The coronal imbalance is more likely to occur in the SPO group. The postoperative sagittal imbalance often spontaneously improves with time. Lower instrumented vertebra at S1 or with pelvic fixation should be regarded as potential risk factors for persistent coronal imbalance in patients with SPO. 3.

The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy.

Directory of Open Access Journals (Sweden)

Samuel P Franklin

Full Text Available The purpose of this study was to investigate whether platelet-rich plasma (PRP enhances osseous healing in conjunction with a high tibial osteotomy in dogs.Randomized controlled trial.Sixty-four client-owned pet dogs with naturally occurring rupture of the anterior cruciate ligament and that were to be treated with a high tibial osteotomy (tibial plateau leveling osteotomy were randomized into the treatment or control group. Dogs in the treatment group received autologous platelet-rich plasma activated with calcium chloride and bovine thrombin to produce a well-formed PRP gel that was placed into the osteotomy at the time of surgery. Dogs in the control group received saline lavage of the osteotomy. All dogs had the osteotomy stabilized with identical titanium alloy implants and all aspects of the surgical procedure and post-operative care were identical among dogs of the two groups. Bone healing was assessed at exactly 28, 49, and 70 days after surgery with radiography and ultrasonography and with MRI at day 28. The effect of PRP on bone healing was assessed using a repeated measures analysis of covariance with radiographic and ultrasonographic data and using a t-test with the MRI data.Sixty dogs completed the study. There were no significant differences in age, weight, or gender distribution between the treatment and control groups. Twenty-seven dogs were treated with PRP and 33 were in the control group. The average platelet concentration of the PRP was 1.37x106 platelets/μL (±489x103 with a leukocyte concentration of 5.45x103/μL (±3.5x103. All dogs demonstrated progressive healing over time and achieved clinically successful outcomes. Time since surgery and patient age were significant predictors of radiographic healing and time since surgery was a significant predictor of ultrasonographic assessment of healing. There was no significant effect of PRP treatment as assessed radiographically, ultrasonographically, or with MRI.The PRP used

Trichostatin A (TSA) improves the development of rabbit-rabbit intraspecies cloned embryos, but not rabbit-human interspecies cloned embryos.

Science.gov (United States)

Shi, Li-Hong; Miao, Yi-Liang; Ouyang, Ying-Chun; Huang, Jun-Cheng; Lei, Zi-Li; Yang, Ji-Wen; Han, Zhi-Ming; Song, Xiang-Fen; Sun, Qing-Yuan; Chen, Da-Yuan

2008-03-01

The interspecies somatic cell nuclear transfer (iSCNT) technique for therapeutic cloning gives great promise for treatment of many human diseases. However, the incomplete nuclear reprogramming and the low blastocyst rate of iSCNT are still big problems. Herein, we observed the effect of TSA on the development of rabbit-rabbit intraspecies and rabbit-human interspecies cloned embryos. After treatment with TSA for 6 hr during activation, we found that the blastocyst rate of rabbit-rabbit cloned embryos was more than two times higher than that of untreated embryos; however, the blastocyst rate of TSA-treated rabbit-human interspecies cloned embryos decreased. We also found evident time-dependent histone deacetylation-reacetylation changes in rabbit-rabbit cloned embryos, but not in rabbit-human cloned embryos from fusion to 6 hr after activation. Our results suggest that TSA-treatment does not improve blastocyst development of rabbit-human iSCNT embryos and that abnormal histone deacetylation-reacetylation changes in iSCNT embryos may account for their poor blastocyst development. (c) 2008 Wiley-Liss, Inc.

Implantes de biomateriais em falha óssea produzida na fíbula de ratos Biomaterial implants in bone fractures produced in rat fibulas

Directory of Open Access Journals (Sweden)

Henrique Yassuhiro Shirane

2010-01-01

Full Text Available OBJETIVO: Avaliar a importância do colágeno e hidroxiapatita na regeneração de fraturas provocadas experimentalmente na fíbula de ratos. MÉTODOS: Utilizou-se 15 ratos nos quais foram submetidos à cirurgia para retirada de um fragmento da fíbula sendo o local enxertado com tubos de silicone preenchidos com hidroxiapatita e colágeno. RESULTADOS: Ocorreu pouca neoformação óssea no interior dos tubos preenchidos com os biomateriais sendo em maior quantidade naqueles com colágeno. CONCLUSÃO: Os biomateriais usados apresentaram biocompatibilidade e capacidade osteocondutora capaz de estimular a osteogênese mesmo nos ossos com funções mecânicas e morfológicas secundárias como a fíbula de ratos.OBJECTIVE: To evaluate the importance of collagen and hydroxyapatite in the regeneration of fractures experimentally induced in the fibulas of mice. METHOD: 15 rats were submitted to a surgery for the removal of a fragment of the fibula. The fragment was replaced by a silicone tube filled with hydroxyapatite and collagen. RESULTS: Little bone neoformation occurred inside the tubes filled with biomaterials, the largest amount occurring in those with collagen. CONCLUSION: The biomaterials used demonstrated biocompatibility and osteoconductive capacity capable of stimulating osteogenesis, even in bones with secondary mechanical and morphological functions such as the fibula of the rat.

Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews.

Directory of Open Access Journals (Sweden)

Su Keng Tan

Full Text Available Mandibular setback osteotomies potentially lead to narrowing of the pharyngeal airways, subsequently resulting in post-surgical obstructive sleep apnea (OSA.To summarize current evidence from systematic reviews that has evaluated pharyngeal airway changes after mandibular setback with or without concomitant upper jaw osteotomies.PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched with no restriction of language or date. Systematic reviews studying changes in pharyngeal airway dimensions and respiratory parameters after mandibular setback with or without concomitant upper jaw osteotomies have been identified, screened for eligibility, included and analyzed in this study.Six systematic reviews have been included. While isolated mandibular setback osteotomies result in reduced oropharyngeal airway dimensions, the reduction is lesser in cases with concomitant upper jaw osteotomies. Only scarce evidence exists currently to what happens to naso- and hypo-pharyngeal airways. There is no evidence for post-surgical OSA, even though some studies reported reduced respiratory parameters after single-jaw mandibular setback with or without concomitant upper jaw osteotomies.Although mandibular setback osteotomies reduce pharyngeal airway dimensions, evidence confirming post-surgical OSA was not found. Nevertheless, potential post-surgical OSA should be taken into serious consideration during the treatment planning of particular orthognathic cases. As moderate evidence exists that double-jaw surgeries lead to less compromised post-surgical pharyngeal airways, they should be considered as the method of choice especially in cases with severe dentoskeletal Class III deformity.PROSPERO (registration number: CRD42016046484.

Hepatitis E Virus in Farmed Rabbits, Wild Rabbits and Petting Farm Rabbits in the Netherlands

NARCIS (Netherlands)

Burt, S.A.; Veltman, Jorg; Hakze-van der Honing, Renate; Schmitt, Heike; van der Poel, Wim H.M.

2016-01-01

Rabbits have been suggested as a zoonotic source of Hepatitis E virus. Phylogenetic analysis of HEV isolates from farmed, wild and pet rabbits in the Netherlands (23, 0, and 60 % respectively) showed them to be grouped amongst published rabbit HEV sequences and distinct from most human isolates.

Fixation methods in mandibular reconstruction using fibula grafts: a comparative study into the relative strength of three different types of osteosynthesis

NARCIS (Netherlands)

Strackee, S. D.; Kroon, F. H.; Bos, K. E.

2001-01-01

Bone staples made of a nickel titanium alloy exert dynamic compression, require little dissection, and may provide an alternative to conventional fixation in mandibular reconstruction with a free vascularized fibula graft. To evaluate its stability relative to conventional methods of fixation with

Hepatitis E Virus in Farmed Rabbits, Wild Rabbits and Petting Farm Rabbits in the Netherlands

NARCIS (Netherlands)

Burt, Sara A.; Veltman, Jorg; Hakze-van der Honing, Renate; Schmitt, Heike; Poel, van der Wim H.M.

2016-01-01

Rabbits have been suggested as a zoonotic source of Hepatitis E virus. Phylogenetic analysis of HEV isolates from farmed, wild and pet rabbits in the Netherlands (23, 0, and 60 % respectively) showed them to be grouped amongst published rabbit HEV sequences and distinct from most human isolates.

Application of computer-aided design osteotomy template for treatment of cubitus varus deformity in teenagers: a pilot study.

Science.gov (United States)

Zhang, Yuan Z; Lu, Sheng; Chen, Bin; Zhao, Jian M; Liu, Rui; Pei, Guo X

2011-01-01

Treatment of cubitus varus deformity from a malunited fracture is a challenge. Anatomically accurate correction is the key to obtaining good functional outcomes after corrective osteotomy. The aim of this study was to attempt to increase the accuracy of treatment by use of 3-dimensional (3D) computer-aided design. We describe a novel method for ensuring an accurate osteotomy method in the treatment of cubitus varus deformity in teenagers by means of 3D reconstruction and reverse engineering. Between January 2006 and May 2008, 12 male and 6 female patients with cubitus varus deformities underwent scanning with spiral computed tomography (CT) preoperatively. The mean age was 15.7 years, ranging from 13 to 19 years. Three-dimensional CT image data of the affected and contralateral normal bones of cubitus were transferred to a computer workstation. Three-dimensional models of cubitus were reconstructed by use of MIMICS software. The 3D models were then processed by Imageware software. An osteotomy template that best fitted the angle and range of osteotomy was "reversely" built from the 3D model. These templates were manufactured by a rapid prototyping machine. The osteotomy templates guide the osteotomy of cubitus. An accurate angle of osteotomy was confirmed by postoperative radiography. After 12 to 24 months' follow-up, the mean postoperative carrying angle in 18 patients with cubitus varus deformity was 7.3° (range, 5° to 11°), with a mean correction of 21.9° (range, 12° to 41°). The patient-specific template technique is easy to use, can simplify the surgical act, and generates highly accurate osteotomy in cubitus varus deformity in teenagers. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation.

Science.gov (United States)

Köhnke, Robert; Kolk, Andreas; Kluwe, Lan; Ploder, Oliver

2017-09-01

To evaluate piezosurgery for bilateral sagittal split osteotomy (BSSO) for its duration and inferior alveolar nerve (IAN) perturbation. In this prospective randomized study, the authors evaluated 100 BSSO procedures in 50 patients. Piezoelectric (group I) and conventional (group II) osteotomies were carried out on each side of the mandible of a patient by 2 specialists. The surgeons had at least 1 year of experience using piezosurgery. The period from incision to complete splitting of the mandibular bone was recorded (ie, procedure duration). The intraoperative status (visibility and relocation) of the IAN also was recorded. The neurosensory function of the IAN was measured by the 2-point discrimination threshold and static light touch methods before surgery and postoperatively (1, 3, and 6 weeks and 6 and 12 months). Parameters were compared between the test groups by the paired t, nonparametric Wilcoxon, or χ 2 test. Intergroup comparison showed the mean duration of osteotomy was significantly shorter for group I (17 ± 6 vs 25 ± 9 minutes; P < .001). The rate of intraoperative exposures of the IAN was slightly lower for group I (68%) compared with group II (81%). However, the difference was not relevant. Neurosensory disturbance and recovery of the IAN did not differ between groups. Piezoelectric osteotomy requires considerably less time than conventional mechanical approaches, but shows no advantage in preventing neurosensory perturbation. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Do stress fractures induce hypertrophy of the grafted fibula? A report of three cases received free vascularized fibular graft treatment for tibial defects.

Science.gov (United States)

Qi, Yong; Sun, Hong-Tao; Fan, Yue-Guang; Li, Fei-Meng; Lin, Zhou-Sheng

2016-06-01

The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.

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; phallux valgus deformities with no transfer metatarsalgia. Copyright © 2016 Elsevier Ltd. All rights reserved.

[The use of Piezosurgery osteotomy in treatment of long-standing maxillary fractures: report of 12 consecutive patients].

Science.gov (United States)

Guo, Zhao-Zhong; Liu, Xue; Li, Yan; Deng, Yan-Fang; Wang, Yang

2007-02-01

To evaluate the clinical applicability of Piezosurgery osteotomy: a new safe technique in managing long standing maxillary fractures. 12 patients with long-standing maxillary fractures were surgically treated using Le Fort I osteotomy. During operation, Piezosurgery osteotomy was used for bone cutting and splitting. After repositioning, the bone segments were rigidly fixed with micro Ti-plate, Ti-mesh. All the patients were followed up for 6 to 12 months, and the functional and esthetic results were evaluated. Ultrasonic microvibrations allow accurate bone cutting without oscillating injuries to the soft tissue. All the wounds healed primarily without complications. The postoperative occlusion and appearance were satisfactory. Maximal recovery of mastication and appearance can be achieved by using Piezosurgery osteotomy with fixation materials such as Ti-plates and Ti-meshes in selected patients with long-standing maxillary fractures.

Brachymetatarsia of the fourth metatarsal, lengthening scarf osteotomy with bone graft.

Science.gov (United States)

Desai, Ankit; Lidder, Surjit; R Armitage, Andrew; S Rajaratnam, Samuel; D Skyrme, Andrew

2013-01-01

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 zplasty 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.

Primary stability of different plate positions and the role of bone substitute in open wedge high tibial osteotomy.

Science.gov (United States)

Takeuchi, Ryohei; Woon-Hwa, Jung; Ishikawa, Hiroyuki; Yamaguchi, Yuichiro; Osawa, Katsunari; Akamatsu, Yasushi; Kuroda, Koichi

2017-12-01

The purpose of this study was to compare the mechanical fixation strengths of anteromedial and medial plate positions in osteotomy, and clarify the effects of bone substitute placement into the osteotomy site. Twenty-eight sawbone tibia models were used. Four different models were prepared: Group A, the osteotomy site was open and the plate position was anteromedial; Group B, bone substitutes were inserted into the osteotomy site and the plate position was anteromedial; Group C, the osteotomy site was open and the plate position was medial; and Group D, bone substitutes were inserted into the osteotomy site and the plate position was medial. The loading condition ranged from 0 to 800N and one hertz cycles were applied. Changes of the tibial posterior slope angle (TPS), stress on the plate and lateral hinge were measured. The changes in the TPS and the stress on the plate were significantly larger in Group A than in Group C. These were significantly larger in Group A than in Group B, and in Group C than in Group D. There was no significant difference between Group B and Group D, and no significant difference between knee flexion angles of 0° and 10°. Stress on the lateral hinge was significantly smaller when bone substitute was used. A medial plate position was biomechanically superior to an anteromedial position if bone substitute was not used. Bone substitute distributed the stress concentration around the osteotomy gap and prevented an increase in TPS angle regardless of the plate position. Copyright © 2017. Published by Elsevier B.V.

Staple fixation for akin proximal phalangeal osteotomy in the treatment of hallux valgus interphalangeus.

Science.gov (United States)

Neumann, Julie A; Reay, Kathleen D; Bradley, Kendall E; Parekh, Selene G

2015-04-01

The Akin proximal phalangeal osteotomy is commonly used in conjunction with metatarsal osteotomies to treat hallux valgus. Multiple fixation methods including suture, wire, screw, and staple fixation have been described. The aims of this study were to assess the intraoperative and postoperative complications and to evaluate short-term postoperative outcomes in patients who underwent Akin osteotomy with staple fixation. Forty-four patients (51 feet) with painful hallux valgus were retrospectively reviewed at an average of 40.4 ± 15.8 (range, 25.9 to 79.9) weeks following an Akin osteotomy with staple fixation. Patient reported preoperative and postoperative Visual Analog Score (VAS) (0 to 10, 0 = no pain) was recorded. Level of activity was reported postoperatively. Hallux valgus angles (HVAs), intermetatarsal angles (IMAs), and hallux valgus interphalangeus angles (IPAs) were evaluated on preoperative as well as final postoperative radiographs. Postoperative clinical and radiographic examinations were used to evaluate for complications. Mean VAS improved from 4.4 ± 2.6 to 1.0 ± 1.2 (P hallux valgus correction with improvement in pain and hallux valgus deformity with a low risk for complications. Level IV, case series. © The Author(s) 2014.

Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible.

Science.gov (United States)

Wang, Tongyue; Han, Jeong Joon; Oh, Hee-Kyun; Park, Hong-Ju; Jung, Seunggon; Park, Yeong-Joon; Kook, Min-Suk

2016-07-01

This study aimed to identify risk factors associated with bad splits during sagittal split ramus osteotomy by using three-dimensional computed tomography. This study included 8 bad splits and 47 normal patients without bad splits. Mandibular anatomic parameters related to osteotomy line were measured. These included anteroposterior width of the ramus at level of lingula, distance between external oblique ridge and lingula, distance between sigmoid notch and inferior border of mandible, mandibular angle, distance between inferior outer surface of mandibular canal and inferior border of mandible under distal root of second molar (MCEM), buccolingual thickness of the ramus at level of lingula, and buccolingual thickness of the area just distal to first molar (BTM1) and second molar (BTM2). The incidence of bad splits in 625 sagittal split osteotomies was 1.28%. Compared with normal group, bad split group exhibited significantly thinner BTM2 and shorter sigmoid notch and inferior border of mandible (P bad splits. These anatomic data may help surgeons to choose the safest surgical techniques and best osteotomy sites.

Surgical risk factors and maxillary nerve function after le fort I osteotomy

DEFF Research Database (Denmark)

Thygesen, Torben Henrik; Jensen, Allan Bardow; Norholt, SE

2009-01-01

PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes with a nu......PURPOSE: Data on intraoperative risk factors for long-term postoperative complications after Le Fort I osteotomy (LFO) are limited. The aim of this study was to describe prospectively the overall postoperative changes in maxillary nerve function after LFO, and to correlate these changes...

Proximal Opening Wedge Osteotomy Provides Satisfactory Midterm Results With a Low Complication Rate.

Science.gov (United States)

Oravakangas, Rami; Leppilahti, Juhana; Laine, Vesa; Niinimäki, Tuukka

2016-01-01

Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus. Thirty-one consecutive adult patients (35 feet) with severe hallux valgus underwent proximal open wedge osteotomy. Twenty patients (35.5%) and 23 feet (34.3%) were available for the final follow-up examination. The mean follow-up duration was 5.8 (range 4.6 to 7.0) years. The radiologic measurements and American Orthopaedic Foot and Ankle Society hallux-metatarsophalangeal-interphalangeal scores were recorded pre- and postoperatively, and subjective questionnaires were completed and foot scan analyses performed at the end of the follow-up period. The mean hallux valgus angle decreased from 38° to 23°, and the mean intermetatarsal angle correction decreased from 17° to 10°. The mean improvement in the American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal score increased from 52 to 84. Two feet (5.7%) required repeat surgery because of recurrent hallux valgus. No nonunions were identified. Proximal open wedge osteotomy provided satisfactory midterm results in the treatment of severe hallux valgus, with a low complication rate. The potential instability of the first tarsometatarsal joint does not seem to jeopardize the midterm results of the operation. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Different Recipient Vessels for Free Microsurgical Fibula Flaps in the Treatment of Avascular Necrosis of the Femoral Head: A Systematic Review and Meta-analysis.

Science.gov (United States)

Tu, Yiji; Chen, Zenggan; Lineaweaver, William Charles; Zhang, Feng

2017-12-01

Several recipient vessels can be used in free microsurgical fibula flaps (MFFs) for the treatment of avascular necrosis of the femoral head (ANFH). Few articles investigate the influence of different recipient vessels on outcomes of MFF for ANFH. A comprehensive literature search of databases including PubMed-Medline, Ovid-Embase, and Cochrane Library was performed to collect the related studies. The Medical Subject Headings used were "femur head necrosis" and "bone transplantation." The relevant words in title or abstract included but not limited to "fibula flap," "fibular flap," "vascularized fibula," "vascularized fibular," "free fibula," "free fibular," "femoral head necrosis," "avascular necrosis of femoral head," and "ischemic necrosis of femoral head." The methodological index for nonrandomized studies was adopted for assessing the studies included in this review. Finally, 15 studies encompassing a total of 1267 patients (1603 hips) with ANFH were pooled in the overall analysis. Recipient vessels for MFF included the ascending branch of the lateral circumflex femoral artery and vein in 8 studies, descending branch of the lateral circumflex femoral artery and vein in 2 studies, second perforating branch of the deep femoral artery and vein in 4 studies, and inferior gluteal artery and vein in 1 study. Preoperative and postoperative average Harris hip score and pooled analyses of the rate of conversion, radiographic progression, and hip surgery-related complications showed no significant difference on the outcomes of MFF on ANFH between using different recipient vessels. Different recipient vessels did not affect outcomes in MFF procedures for ANFH. High-quality randomized controlled trials and prospective studies would be necessary to clarify reliable advantages and disadvantages between different recipient vessels. Until then, surgeons are justified in using ascending branch of the lateral circumflex femoral artery and vein, descending branch of the lateral

Effects of long-term administration of carprofen on healing of a tibial osteotomy in dogs.

Science.gov (United States)

Ochi, Hiroki; Hara, Yasushi; Asou, Yoshinori; Harada, Yasuji; Nezu, Yoshinori; Yogo, Takuya; Shinomiya, Kenichi; Tagawa, Masahiro

2011-05-01

To evaluate effects of long-term administration of carprofen on healing of a tibial osteotomy in dogs. 12 healthy female Beagles. A mid-diaphyseal transverse osteotomy (stabilized with an intramedullary pin) of the right tibia was performed in each dog. The carprofen group (n = 6 dogs) received carprofen (2.2 mg/kg, PO, q 12 h) for 120 days; the control group (6) received no treatment. Bone healing and change in callus area were assessed radiographically over time. Dogs were euthanized 120 days after surgery, and tibiae were evaluated biomechanically and histologically. The osteotomy line was not evident in the control group on radiographs obtained 120 days after surgery. In contrast, the osteotomy line was still evident in the carprofen group. Callus area was significantly less in the carprofen group, compared with the area in the control group, at 20, 30, and 60 days after surgery. At 120 days after surgery, stiffness, elastic modulus, and flexural rigidity in the carprofen group were significantly lower than corresponding values in the control group. Furthermore, histologic evaluation revealed that the cartilage area within the callus in the carprofen group was significantly greater than that in the control group. Long-term administration of carprofen appeared to inhibit bone healing in dogs that underwent tibial osteotomy. We recommend caution for carprofen administration when treating fractures that have delays in healing associated with a reduction in osteogenesis as well as fractures associated with diseases that predispose animals to delays of osseous repair.

SURGICAL TREATMENT OF MALUNITED COLLES’ FRACTURE BY CORRECTIVE OSTEOTOMY

Directory of Open Access Journals (Sweden)

Gopinath

2015-12-01

Full Text Available BACKGROUND Malunion occurs more often after Colles fracture than any other and can result in considerable disability. Multiple techniques for corrective osteotomy have been developed in recent years with objective of restoring the normal anatomy of distal end of radius and also to evaluate the results with respect to pain, restoration of function of wrist and forearm. MATERIALS AND METHODS A prospective randomized controlled study was conducted in 20 cases of malunited Colles fracture who underwent Corrective osteotomy with a Dorsal Ellis T plate and bone graft. Post operatively all patients were immobilized on a Sugar-Tong splint and followed up at 4, 6 and 12 weeks. RESULTS All measurements of Pain, final range of motion and grip strength significantly improved compared with preoperative measurements. Based on Fernandez et al scoring system we obtained Excellent results in 8 cases, Good in 7 cases, Fair in 3 cases and Poor in 2 cases which was attributed to infection in 1 case and RSD in the other case. Radiologically a mean radial length of 6.14mm (N:10mm, Radial Angle of 21.25⁰ (N:22⁰ and Volar angle of -3.4⁰ (N: +4⁰ was achieved. CONCLUSION Corrective Osteotomy with Bone graft is a preferred and an Ideal procedure if performed after Proper selection of patients i.e in young adults and extra articular malunions with good range of movements.

Triple pelvic osteotomy: effect on limb function and progression of degenerative joint disease

International Nuclear Information System (INIS)

Johnson, A.L.; Smith, C.W.; Pijanowski, G.J.; Hungerford, L.L.

1998-01-01

The objective of this study was to evaluate prospectively the outcome of 21 clinical patients treated with triple pelvic osteotomies during the year following surgery. Specific aims included documenting the time of and extent of improved limb function as measured by force plate analysis, evaluating the progression of degenerative joint disease (DJD) in the treated and untreated coxofemoral joints, and determining whether or not triple pelvic osteotomy resulted in degenerative joint changes in the ipsilateral stifle and hock. Twelve dogs were treated unilaterally and nine dogs were treated bilaterally with triple pelvic osteotomies. There were no differences in mean anteversion angles, angles of inclination, or preoperative DJD between treated hips and untreated hips. Degenerative joint disease progressed significantly in all hips regardless of treatment. Two cases developed hyperextension of their hocks after the triple pelvic osteotomies. However, no radiographic evidence of DJD was observed for any of the stifles or hocks at any observation time. A significant increase in vertical peak force (VPF) scores was noted for treated legs by two-to-three months after surgery, which continued over time. Untreated legs did not show a significant change in VPF scores over time. No differences were found in progression to higher scores when unilaterally treated legs, first-side treated legs, and second-side treated legs were compared

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.

Triple pelvic osteotomy in Legg-Calve-Perthes disease using a single anterolateral incision: a 4-year review.

LENUS (Irish Health Repository)

Conroy, Eimear

2010-07-01

Femoral head incongruency at skeletal maturity is associated with the development of osteoarthritis in early adulthood. Containment of the femoral head provides a larger surface area for remodelling of the collapsed femoral head and the development of spherical congruency. Triple pelvic osteotomy has a role to play in Legg-Calve-Perthes\\' disease by improving femoral head containment and preventing subluxation. This is traditionally a two-incision approach with significant associated morbidity. In our unit we perform triple osteotomies through a single anterolateral incision. To retrospectively review the clinical and radiographic outcome of children who had triple osteotomies performed through a single incision over a 4-year period. In our unit from 2003 to 2006 we performed eight triple osteotomies through a single incision in children aged between 6 and 12 years with Legg-Calve-Perthes\\' disease. The procedure was performed through a single anterolateral incision made beneath the middle of the iliac crest and carried forward according to Salter\\'s osteotomy. Image intensification was used to confirm iliac, pubic and ischial cuts. After performing a standard Salter\\'s osteotomy the acetabular fragment was free to rotate anteriorly and laterally. None of the children were casted and all were allowed immediate mobilization nonweight bearing with crutches for 6 weeks. Clinical results and hip function were measured preoperatively and postoperatively using the modified Harris hip score. The average length of hospital stay was 4.7 days. None of the children had a nonunion. The centre edge angle of Wiberg was measured on all preoperative and postoperative anteroposterior pelvic radiographs. In all our patients there was an improvement in the centre edge angle of Wiberg and in the modified Harris hip score. The preoperative modified Harris hip scores ranged from 38 to 60 and postoperatively ranged from 77 to 92. The preoperative centre edge angle of Wiberg ranged

Midterm outcome after correction of hallux valgus deformity using scarf osteotomy in adult population

Directory of Open Access Journals (Sweden)

Laura Ibrahim Alolayan

2017-01-01

Full Text Available Context: Determining the efficacy of any surgical treatment is the key to achieve better practice and best outcomes for patients. Aims: This study is designed to address midterm outcome in adult patients with moderate-to-severe hallux valgus (HV, who underwent scarf osteotomy from 2012 to 2014. Settings and Design: This is a retrospective cohort study in which charts of all adult patients with moderate-to-severe HV who underwent scarf osteotomy from 2011 to 2014 were reviewed. Subjects and Methods: Between 2011 and 2014, 39 patients (41 feet who underwent scarf osteotomy for correction of HV deformity were retrospectively evaluated. Standard weight-bearing dorsoplantar radiographs were obtained pre- and postoperatively. HV angle (HVA, intermetatarsal angle (IMA and distal metatarsal articular angles (DMAA were measured pre- and postoperatively to evaluate the efficacy of the surgery. The complication rate was reported. The average follow-up was 13.5 months, and the patients' mean age was 37 years. Statistical Analysis Used: Data were compared using Chi-square test or Fisher's exact test whichever was appropriate. All tests were two-sided, and a P> 0.01 was considered statistically significant. Results: The average preoperative HVA and IMA were 32° and 14.3°, which improved to 11° and 7.9°, respectively. The changes were statistically significant (P 0.18. Conclusions: This study suggests that scarf osteotomy surgery is a very versatile osteotomy in correcting moderate-to-severe HV deformity. It offers a greater degree of correction and stability, lower rate of complications and good outcome. However, long-term follow-up studies are still needed.

No midterm benefit from low intensity pulsed ultrasound after chevron osteotomy for hallux valgus.

Science.gov (United States)

Zacherl, Max; Gruber, Gerald; Radl, Roman; Rehak, Peter H; Windhager, Reinhard

2009-08-01

Chevron osteotomy is a widely accepted method for correction of symptomatic hallux valgus deformity. Full weight bearing in regular shoes is not recommended before 6 weeks after surgery. Low intensity pulsed ultrasound is known to stimulate bone formation leading to more stable callus and faster bony fusion. We performed a randomized, placebo-controlled, double-blinded study on 44 participants (52 feet) who underwent chevron osteotomy to evaluate the influence of daily transcutaneous low intensity pulsed ultrasound (LIPUS) treatment at the site of osteotomy. Follow-up at 6 weeks and 1 year included plain dorsoplantar radiographs, hallux-metatarsophalangeal-interphalangeal scale and a questionnaire on patient satisfaction. There was no statistical difference in any pre- or postoperative clinical features, patient satisfaction or radiographic measurements (hallux valgus angle, intermetatarsal angle, sesamoid index and metatarsal index) except for the first distal metatarsal articular angle (DMAA). The DMAA showed statistically significant (p = 0.046) relapse in the placebo group upon comparison of intraoperative radiographs after correction and fixation (5.2 degrees) and at the 6-week follow-up (10.6 degrees). Despite potential impact of LIPUS on bone formation, we found no evidence of an influence on outcome 6 weeks and 1 year after chevron osteotomy for correction of hallux valgus deformity.

Ratio of lumbar 3-column osteotomy closure: patient-specific deformity characteristics and level of resection impact correction of truncal versus pelvic compensation.

Science.gov (United States)

Diebo, Bassel G; Lafage, Renaud; Ames, Christopher P; Bess, Shay; Obeid, Ibrahim; Klineberg, Eric; Cunningham, Matthew E; Smith, Justin S; Hostin, Richard; Liu, Shian; Passias, Peter G; Schwab, Frank J; Lafage, Virginie

2016-08-01

The resection point of a lumbar three-column osteotomy (3CO) creates separation of the spino-pelvic complex. This study investigates the impact of patients' baseline deformity and level of 3CO resection on the distribution of correction between the trunk and the pelvis following osteotomy closure. Patients who underwent single lumbar 3CO, upper instrumented vertebra (UIV) T1-T10, and 6 month follow-up were included. The truncal and pelvic closures were calculated based on the vertebrae adjacent to the osteotomy level and the impact of radiographic parameters and level of 3CO on the closures were analyzed. 113 patients were included. Patients who experienced more pelvic correction had significantly higher Pelvic Tilt and lower Sagittal Vertical Axis at baseline. Patients who underwent more caudal osteotomies with higher pelvic compensation with modest SVA sustained more pelvic correction. The osteotomy closure is driven by patient's specific deformity. More caudal osteotomy level leads to greater pelvic tilt improvement. III.

Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers

OpenAIRE

Tamir, Eran; Finestone, Aharon S.; Avisar, Erez; Agar, Gabriel

2016-01-01

Background 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 ...

Comparative quantitative monitoring of rabbit haemorrhagic disease viruses in rabbit kittens.

Science.gov (United States)

Matthaei, Markus; Kerr, Peter J; Read, Andrew J; Hick, Paul; Haboury, Stephanie; Wright, John D; Strive, Tanja

2014-06-09

Only one strain (the Czech CAPM-v351) of rabbit haemorrhagic disease virus (RHDV) has been released in Australia and New Zealand to control pest populations of the European rabbit O. cuniculus. Antigenic variants of RHDV known as RHDVa strains are reportedly replacing RHDV strains in other parts of the world, and Australia is currently investigating the usefulness of RHDVa to complement rabbit biocontrol efforts in Australia and New Zealand. RHDV efficiently kills adult rabbits but not rabbit kittens, which are more resistant to RHD the younger they are and which may carry the virus without signs of disease for prolonged periods. These different infection patterns in young rabbits may significantly influence RHDV epidemiology in the field and hence attempts to control rabbit numbers. We quantified RHDV replication and shedding in 4-5 week old rabbits using quantitative real time PCR to assess their potential to shape RHDV epidemiology by shedding and transmitting virus. We further compared RHDV-v351 with an antigenic variant strain of RHDVa in kittens that is currently being considered as a potential RHDV strain for future release to improve rabbit biocontrol in Australia. Kittens were susceptible to infection with virus doses as low as 10 ID50. Virus growth, shedding and transmission after RHDVa infection was found to be comparable or non-significantly lower compared to RHDV. Virus replication and shedding was observed in all kittens infected, but was low in comparison to adult rabbits. Both viruses were shed and transmitted to bystander rabbits. While blood titres indicated that 4-5 week old kittens mostly clear the infection even in the absence of maternal antibodies, virus titres in liver, spleen and mesenteric lymph node were still high on day 5 post infection. Rabbit kittens are susceptible to infection with very low doses of RHDV, and can transmit virus before they seroconvert. They may therefore play an important role in RHDV field epidemiology, in

Home-based Exercise on Functional Outcome of the Donor Lower Extremity in Oral Cancer Patients after Fibula Flap Harvest

Directory of Open Access Journals (Sweden)

Ting-Yuan Liu

2013-04-01

Full Text Available Background: After harvesting the fibula flap, pain, sensory disturbance, weakness of donor leg, reduced walking endurance, ankle instability, and lower walking speed had been reported. The aim of this study was to quantitatively assess functional outcome of regular home-based exercise on donor ankle strength, endurance, and walking ability after free fibula flap for mandibular reconstruction. Methods: Fourteen patients were recruited. Objective isokinetic testing and a 6-min walk test (6MWT were used to evaluate ankle strength/endurance and walking ability, respectively. Results: There was a significant increase in the peak torque of ankle dorsiflexion/foot inversion of the healthy leg and ankle dorsiflexion/foot eversion of the donor leg after exercise (p < 0.05. After home-based exercise, there was reduced asymmetry in the peak torques of ankle dorsiflexion and foot eversion and the total work of foot eversion between the donor and healthy legs. In 6MWT, no significant difference was found between the walking distances before and after exercise. Conclusion: Regular home-based exercise could improve the strength of ankle dorsiflexion and foot eversion of the donor leg, and get more symmetric ankle motor function between the donor and healthy legs.

A minimally invasive technique using a modified stoppa approach for periacetabular osteotomy: A preliminary cadaveric study

Directory of Open Access Journals (Sweden)

Turgut Akgul

2017-01-01

Full Text Available Background: Developmental hip dysplasia is diagnosed when the femoral head is not sufficiently covered by the acetabulum. Anterior and lateral cover deficiency is seen, as a result a dysplastic hip joint. Various incision modifications have been developed because of the muscle dissection and wide wound scar in Smith-Peterson incision, which was originally used in Bernese osteotomy. This study evaluates applicability of the modified Stoppa approach in the performance of Bernese periacetabular osteotomy (PAO. Materials and Methods: Ten hemipelvises of five donor cadavers were used. The transverse Stoppa incision was made 2 cm over the symphysis pubis for quadrilateral surface exposure and pubic and ischial bone osteotomies. The second skin incision, a few centimeters lateral to the original incision, was made along the tensor fascia lata. Iliac bone osteotomy was performed starting just above the rectus femoris insertion. The displacement of the osteotomy was measured clinically and radiographically. Results: The mean anterior coverage calculated with center-edge angle was improved from 22.8° ±2.8 (range 20° min–28° max preoperatively to 44.1° ± 3.7 (range 36° min–48° max. The displacement of the osteotomy at the iliopectineal line calculated on the iliac inlet view radiographs was 22.1 ± 3.4 mm (range 15 mm min–26 mm max. The clinical amount of the anterior displacement on the cadavers was 17.8 ± 3.35 mm (range 11 mm–21 mm and lateral displacement was 20.3 ± 3.23 mm (range 15 mm–24 mm. The amount of the posterior intact bone enlargement at the quadrilateral surface was 5.3 ± 0.48 mm. Conclusion: This less traumatic two-incision exposure is an adequate technique for Bernese PAO, allowing the bone to be cut under direct visual observation and reducing the need to use fluoroscopy.

Accumulation of 125I-factor XI in atheroma of rabbit with hereditary hyperlipidemia (WHHL-rabbit)

International Nuclear Information System (INIS)

Komiyama, Y.; Masuda, M.; Murakami, T.; Nishikado, H.; Egawa, H.; Nishimura, T.; Morii, S.; Murata, K.

1989-01-01

We have studied the turnover and accumulation of rabbit factor XI (F.XI) in atherosclerotic lesion in Watanabe-hereditable hyperlipidemic rabbit (WHHL rabbit) to reveal the participation of blood coagulation in atherosclerotic lesion. Rabbit F.XI was iodinated and administered intravenously to WHHL rabbits and Japanese white rabbits. The turnover of 125 I-rabbit F.XI was significantly faster in WHHL rabbits (T1/2 = 2.84 +/- 0.44 days) than in normal rabbits (T1/2 = 4.44 +/- 0.42 days). The thoracic aorta of WHHL rabbit was strongly labelled with 125 I-rabbit F.XI, in sections obtained after 5 days by en-face autoradiography, whereas no radioactivity was detected in normal aorta. By an immunohistochemical study of WHHL rabbit aorta, we confirmed that many F.XI- and fibrin-related compounds existed in the atheroma, whereas albumin did not in these area. These results suggest that the activation of F.XI proceeds on the atherosclerotic lesions of WHHL rabbits

Allergy to Rabbits. 1

International Nuclear Information System (INIS)

Price, J.A.; Longbottom, J.L.

1986-01-01

Investigations have been carried out into the presence of antibody light chains in rabbit allergenic extracts and the interference in RAST and crossed-radioimmunoelectrophoresis (XRIE) caused by antibodies directed against them. A ''non-specific'' uptake of radioactivity in XRIE has been demonstrated to be caused by direct cross-linking of the 125 I rabbit anti-human IgE by the sheep antibodies in the immunoprecipitate of rabbit light chains. Preincubation with normal rabbit serum blocked this direct uptake of the labelled antibody and enabled specific IgE uptake on the light chains to be demonstrated for rabbit allergic sera. Verification of the allergenicity of the light chains was obtained from a specific light chain RAST. Elution from a Sephacryl S-200 gel filtration column indicated a MW of approx. 50Kd and confirmation of the components as light chain dimers, not Fab fragments, was obtained by allotyping for loci present on heavy chains and light chains in the Fab region. Light chains were detected in urine from rabbits of all ages and in an extract of dust collected in a rabbit housing area. No background staining was observed in XRIE using rabbit antisera, either with rabbit allergic sera with specific IgE or with a human serum containing specific IgG antibodies to rabbit IgG. This latter serum also showed no evidence of uptake on all immunoprecipitates in systems using rabbit antisera, and did not give false positive RAST results when the labelled rabbit anti-human IgE contained unlabelled rabbit IgG. Those sera with specific IgE to light chains showed no uptake in XRIE using rabbit antisera, indicating that the IgE was possibly specific for epitopes revealed by the dissociation on the whole IgG molecule. (author)

The early functional outcome of Mau osteotomy for the correction of moderate-severe hallux valgus

Directory of Open Access Journals (Sweden)

Tanujan Thangarajah

2013-11-01

Full Text Available Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS scoring system and radiologically by measuring the first intermetatarsal (IM and hallux abductovalgus angles (HAV. The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01. Additionally, preoperative HAV and IM angles improved from 39° and 15° respectively to 15° and 9° respectively (P<0.01. There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union.

Fully 3-dimensional digitally planned reconstruction of a mandible with a free vascularized fibula and immediate placement of an implant-supported prosthetic construction

NARCIS (Netherlands)

Schepers, Rutger H.; Raghoebar, Gerry M.; Vissink, Arjan; Lahoda, Lars U.; Van der Meer, W. Joerd; Roodenburg, Jan L.; Reintsema, Harry; Witjes, Max J.

Background Reconstruction of craniofacial defects becomes complex when dental implants are included for functional rehabilitation. We describe a fully 3-dimensional (3D) digitally planned reconstruction of a mandible and immediate prosthetic loading with a fibula graft in a 2-step surgical approach.

Pedicle subtraction osteotomy in elderly patients with degenerative sagittal imbalance.

Science.gov (United States)

Cho, Kyu-Jung; Kim, Ki-Tack; Kim, Whoan-Jeang; Lee, Sang-Hoon; Jung, Jae-Hoon; Kim, Young-Tae; Park, Hae-Bong

2013-11-15

Retrospective, radiographical analysis. To evaluate pedicle subtraction osteotomy (PSO) as a means of correcting severe degenerative sagittal imbalance in elderly patients. PSO in patients with degenerative sagittal imbalance is likely to cause more complications than in patients with iatrogenic flatback deformity. This study analyzed 34 patients who underwent fusion to the sacrum, with a minimum 2-year follow-up. Age of the patients were in the range from 58 to 73 with the mean at 65.5 years. PSO was performed at one segment in all cases, consisting of L3 (n = 26), L4 (n = 4), L2 (n = 3), and L1 (n = 1). The average number of levels fused was 8.15. Ten patients had structural interbody fusion at the lumbosacral junction. Applying PSO at one segment, the mean correction of the lordotic angle at the osteotomy site was 33.3°, of which the loss of correction (LOC) was 4.0° at the last visit. The correction of lumbar lordosis was 33.7° and the LOC was 8.5°. The sagittal C7 plumb was 215.9 mm before surgery, corrected to 35.1 mm after surgery, and changed to 95.9 mm by the last visit. The correction of the sagittal C7 plumb was 119.9 mm and the LOC was 60.9 mm. There was substantial LOC in lumbar lordosis and sagittal C7 plumb. In 10 patients with addition of posterior lumbar interbody fusion, the LOC of lumbar lordosis was 7.4°, which was less than 9° in those without it. PSO for the correction of degenerative sagittal imbalance in elderly patients resulted in correction of sagittal alignment with a significant LOC of lumbar lordosis and sagittal C7 plumb. The LOC of lumbar lordosis occurred at both the osteotomy and non-osteotomy site. The addition of anterior column support is helpful to maintain correction and reduce complications. N/A.

Rabbit analgesia.

Science.gov (United States)

Barter, Linda S

2011-01-01

With the increasing popularity of rabbits as household pets, the complexity of diagnostic and surgical procedures performed on rabbits is increasing, along with the frequency of routine surgical procedures. More practitioners are faced with the need to provide adequate analgesia for this species. Preemptive analgesia prior to planned surgical interventions may reduce nervous system changes in response to noxious input, as well as reduce postoperative pain levels and analgesic drug requirements. Concurrent administration of analgesic drugs to anesthetized rabbits undergoing painful procedures is warranted both pre- and intraoperatively as well as postoperatively. This article discusses the neuropharmacologic and pharmacologic aspects of pain in rabbits, and reviews current protocols for the use of analgesic drugs. Published by Elsevier Inc.

Modified Wilson’s Osteotomy for Hallux Valgus Deformity. A New Approach

Science.gov (United States)

Xarchas, Konstantinos C; Mavrolias, Dimitrios; Kyriakopoulos, Georgios

2014-01-01

We introduce a new set of modifications and present the results from 48 patients (a total of 60 feet operated), who underwent this modified Wilson’s osteotomy for the correction of Hallux Valgus. Patients were of an average age of 52 years old (from 21 to 75 years of age) and were followed up for a mean of 12 months post-operatively. Patient evaluation was made with the symptom scoring system as presented by Kataraglis et al., with the final outcome being satisfactory in all of the cases. This set of modifications introduced to the original Wilson’s osteotomy, proved to offer a stable, predictable and satisfactory outcome in all cases and we strongly recommend it. PMID:25352929

Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee.

Science.gov (United States)

Eid, Ahmed Salem; Nassar, Wael Ahmed Mohamed; Fayyad, Tamer Abdelmeguid Mohamed

2016-11-01

Total knee arthroplasty (TKA) is a well-proven modality that can provide pain relief and restore mobility for rheumatoid arthritis (RA) patients with advanced joint destruction. Patellar ligament avulsion, especially in presence of poor bone quality and knee stiffness, is one of the special considerations that must be addressed in this unique population of patients. This study aimed to determine the functional results in a series of rheumatoid patients with stiff knee and end-stage joint destruction who underwent tibial tubercle osteotomy during TKA. Twenty-three knees in 20 patients (16 women; four men) at a mean age of 54 years with end-stage arthritis and knee stiffness due to RA were operated upon for TKA using tibial tubercle osteotomy as a step during the operation. Patients were reviewed clinically and radiographically with a minimum follow-up of two years. Complications were noted. Hospital for Special Surgery (HSS) score was recorded pre-operatively and at six and 12 months postoperatively. Union occurred at the osteotomy site in 21 of 23 cases. One case had deep venous thrombosis (DVT). There was no infection or periprosthetic fracture, and at last follow-up, no patient required revision. HSS score improved from 46 (15-60) pre-operatively to 85 (71-96) post-operatively. Tibial tubercle osteotomy during TKA in patients with RA and stiff knee is technically demanding yet proved to be effective in improving post-operative range of movement and minimising the complication of patellar ligament avulsion.

A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus.

Science.gov (United States)

Vasso, Michele; Del Regno, Chiara; D'Amelio, Antonio; Schiavone Panni, Alfredo

2016-03-01

The purpose of this brief paper is to present the preliminary results of a modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. In this procedure, the dorsal arm of the osteotomy is performed orthogonal to the horizontal plane of the first metatarsal, the main advantage being that this allows much easier and more accurate multiplanar correction of first metatarsal deformities. From 2010 to 2013, 184 consecutive patients with symptomatic hallux valgus and 48 patients with hallux rigidus without severe metatarsophalangeal joint degeneration underwent such modified chevron osteotomy. Mean patient age was 54.9 (range 21-70) years, and mean follow-up duration was 41.7 (range 24-56) months. Ninety-three percent of patients were satisfied with the surgery. Mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 56.6 preoperatively to 90.6 at last follow-up, and mean visual analog scale (VAS) pain score decreased from 5.7 preoperatively to 1.6 at final follow-up (p hallux valgus, mean hallux valgus angle decreased from 34.1° preoperatively to 6.2° at final follow-up, and mean intermetatarsal angle decreased from 18.5° preoperatively to 4.1° at final follow-up (p < 0.05). One patient developed postoperative transfer metatarsalgia, treated successfully with second-time percutaneous osteotomy of the minor metatarsals, whilst one patient had wound infection that resolved with systemic antibiotics. Level IV.

Salter%u2019s Innominate Osteotomy in the Treatment of Congenital Hip Dislocation

Directory of Open Access Journals (Sweden)

Eyup Cagatay Zengin

2014-03-01

Full Text Available Aim: Developmental displazy of hip is much seenillness which interest orthopaedic surgery in Turkey and around the world. In early times of illness conservative treatment is succesful but late times of illness surgery is necessary. Salter’s innominate osteotomy, since its initial description in 1961, has become a well-established surgical procedure in the treatment of congenital dislocation of the hip.Material and Method: We reviewed 59 patients with 74 congenitally dislocated hips, all managed by open reduction and Salter’s innominate osteotomy. Mean follow-up period was 4,2 years (range, 2 to 7 years; %82,4 of the hips had a excellent clinical result, and %75,7 were excellent radiologically. The patients who underwent Salter’s innominate osteotomy before the age of 3 had beter clinical and radiological results (%90,4 and %82,5, respectively. The radiographs of the unilateral normal hips were compared to the surgically treated hips according to their acetabular index angles, center-edge angles of Wiberg and femoral neck-shaft angles. No statistical differences were found between these two groups. The Kalamchi-McEwen classification of avascular necrosis. The late radiographic signs of types 2, 3 and 4 avasculer necrosis were seen in %10,8 of this series. Discussion: The results show that Salter’s innominate osteotomy provides good lateral coverage of the femoral head. The results are beter if the operation is performed between the ages 18 months and 3 years.

Hallux valgus with Scarf Osteotomy - A revision of 82 cases

International Nuclear Information System (INIS)

Mendez Gonzalez, Mauricio; Gamba Sanchez, Carlos Enrique

2005-01-01

Descriptive observational study, type series of cases, whose objective was to describe the treatment of hallux valgus with Scarf Osteotomy; this study reviewed the clinical, radiological and subjective aspects of 82 feet, mean age of 49 years, and a mean of 14 degrades and 31 degrades to 9 degrades and 14 degrades (p<0,0001). The mean of the AOFAS scale improved from 49 points preoperatively to 92 points (p<0,0001). 61% of the patients were very satisfied, 34% were satisfied and 5% were not satisfied with the procedure. The recurrence of the deformity appeared in 3% of the patients. The rate of complications was of 6%. The SCARF osteotomy is a safe procedure. We recommended it like an effective technique for the correction of hallux valgus mild, moderate and severe

[Prophylactic osteotomy of pelvis in dysplastic acetabulum.].

Science.gov (United States)

Richtr, M; Sosna, A

1998-01-01

Acetabular dysplasia and anatomical changes of pelvis accompanied with gracility of iliac bone pose a problem for a reliable fixation of acetabular component. In extreme cases the bone stock is not sufficient to accommodate the smallest size of the cup. Sometimes even reaming of the bed down to lamina interna is not sufficient for an adequate covering of the implant. Consequently, weakening of the bottom of acetabulum may be not only one of the causes of the failure of the implant but it makes difficult also the following revision surgeries. Therefore in acetabular dysplasia the authors recommend acetabuloplasty of the bottom of acetabulum preserving its original thickness including inner cortex. They recommend to perform osteotomy of the full thickness of the medial wall of acetabulum and move the massive bone graft created in this way farther into pelvis. At the same time they take care to preserve blood supply of the bone graft by retaining corticoperiostal bridge by means of osteoclasia. The suggested procedure allows full coverage of the implant by iliac bone and at the same time preserves a firm support of acetabular fossa. The original thickness of the medial wall of acetabulum is considered by authors as a significant antimigration barrier. In the period 1991 -1994 the authors used this method at Ist Orthopaedic Clinic of 1st Medical Faculty, Charles University in Prague in total in 16 patients. In all of them after 6 months the bone graft was fully absorbed. Remodelling of the bone graft occurred 1 to 2 years after the surgery and after that the thickness of the graft remained the same. Neither any change of the structure nor reduction of the thickness of the graft was found between 3rd and 4th year after the surgery. The nature of trabecular remodelling of the bone graft corresponds to the transfer of forces in loading the graft by acetabular cup. Key words: acetabuloplasty, osteotomy of the medial wall of acetabulum, osteotomy of pelvis, THR, acetabular

Radiographic evaluation of fracture healing after rigid plate fixation

International Nuclear Information System (INIS)

Paavolainen, P.; Karaharju, E.; Slaetis, P.; Waris, P.

1981-01-01

Experimental osteotomies were made in 35 rabbit tibio-fibular bones and fixed with rigid stainless steel osteosynthesis plates (DCP/ASIF). The radiographic and histopathologic appearances in the healing osteotomies and adjacent bone were analysed at intervals from 3 up to 24 weeks postoperatively. Radiologically the osteotomy had closed at 9 weeks and microscopically this could be confirmed as longitudinal orientation of the cutter heads across the osteotomy gap with longitudinal orientation of the bone structure. The healing of the osteotomy was accompanied by gross structural changes in the adjacent cortical bone with loss of intracortical and subendosteal osteons, cementing lines and intermediate tissue between the osteons. This was characterized by decreasing attenuation of the cortical bone after healing of the osteotomy and should clinically be regarded as an indication for removal of the implant. (Auth.)

Boomerang proximal tibial osteotomy for the treatment of severe varus gonarthrosis.

Science.gov (United States)

Sangkaew, Chanchit; Piyapittayanun, Peerapong

2013-06-01

The purpose of the study was to review the results of modified infratubercle displacement osteotomy in patients with severe varus gonarthrosis and to determine the factors influencing outcomes. A total of 177 knees in 133 patients with severe varus gonarthrosis were treated with infratubercle boomerang-shaped osteotomy, stabilised with dual plates. The mean age of the patients was 63.8 years (range 43-80 years), and the mean follow-up period was 61.4 months (range 24 -139 months). The factors associated with clinical and survival outcomes were analysed including age, gender, body mass index (BMI), preoperative and post-operative femorotibial angle and femorotibial angle at one year after surgery. Using the Knee Society clinical rating system 149 knees or 84.2 % were rated as having good to excellent results and 21 knees or 15.8 % as having fair to poor results. Overall, the mean preoperative knee score of 33.6 points had improved significantly to 80.7 points at the final follow-up (p boomerang osteotomy can create adequate valgus alignment in severe varus gonarthrosis. The one-year post-operative knee alignment of 11° valgus provided the most satisfactory results and that between six and 15° valgus the longest survival time.

Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy.

Science.gov (United States)

Lucas y Hernandez, J; Golanó, P; Roshan-Zamir, S; Darcel, V; Chauveaux, D; Laffenêtre, O

2016-03-01

The aim of this study was to report a single surgeon series of consecutive patients with moderate hallux valgus managed with a percutaneous extra-articular reverse-L chevron (PERC) osteotomy. A total of 38 patients underwent 45 procedures. There were 35 women and three men. The mean age of the patients was 48 years (17 to 69). An additional percutaneous Akin osteotomy was performed in 37 feet and percutaneous lateral capsular release was performed in 22 feet. Clinical and radiological assessments included the type of forefoot, range of movement, the American Orthopedic Foot and Ankle (AOFAS) score, a subjective rating and radiological parameters. The mean follow-up was 59.1 months (45.9 to 75.2). No patients were lost to follow-up. The mean AOFAS score increased from 62.5 (30 to 80) pre-operatively to 97.1 (75 to 100) post-operatively. A total of 37 patients (97%) were satisfied. At the last follow up there was a statistically significant decrease in the hallux valgus angle, the intermetatarsal angle and the proximal articular set angle. The range of movement of the first metatarsophalangeal joint improved significantly.. There was more improvement in the range of movement in patients who had fixation of the osteotomy of the proximal phalanx. Preliminary results of this percutaneous approach are promising. This technique is reliable and reproducible. Its main asset is that it maintains an excellent range of movement. The PERC osteotomy procedure is an effective approach for surgical management of moderate hallux valgus which combines the benefits of percutaneous surgery with the versatility of the chevron osteotomy whilst maintaining excellent first MTPJ range of motion. ©2016 The British Editorial Society of Bone & Joint Surgery.

Risks in surgery-first orthognathic approach: complications of segmental osteotomies of the jaws. A systematic review.

Science.gov (United States)

Pelo, S; Saponaro, G; Patini, R; Staderini, E; Giordano, A; Gasparini, G; Garagiola, U; Azzuni, C; Cordaro, M; Foresta, E; Moro, A

2017-01-01

To date, no systematic review has been undertaken to identify the complications of segmental osteotomies. The aim of the present systematic review was to analyze the type and incidence of complications of segmental osteotomies, as well as the time of subjective and/or clinical onset of the intra- and post-operative problems. A search was conducted in two electronic databases (MEDLINE - Pubmed database and Scopus) for articles published in English between 1 January 2000 and 30 August 2015; only human studies were selected. Case report studies were excluded. Two independent researchers selected the studies and extracted the data. Two studies were selected, four additional publications were recovered from the bibliography search of the selected articles, and one additional article was added through a manual search. The results of this systematic review demonstrate a relatively low rate of complications in segmental osteotomies, suggesting this surgical approach is safe and reliable in routine orthognathic surgery. Due to the small number of studies included in this systematic review, the rate of complication related to surgery first approach may be slightly higher than those associated with traditional orthognathic surgery, since the rate of complications of segmental osteotomies must be added to the complication rate of basal osteotomies. A surgery-first approach could be considered riskier than a traditional one, but further studies that include a greater number of subjects should be conducted to confirm these findings.

Imaging features of iBalance, a new high tibial osteotomy: what the radiologist needs to know.

Science.gov (United States)

Alaia, Erin FitzGerald; Burke, Christopher J; Alaia, Michael J; Strauss, Eric J; Ciavarra, Gina A; Rossi, Ignacio; Rosenberg, Zehava Sadka

2017-01-01

To describe the post-surgical imaging appearance and complications of high tibial osteotomy in patients with the iBalance implant system (iHTO; Arthrex, Naples, FL, USA). Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant review of imaging after 24 iBalance procedures was performed with attention to: correction of varus malalignment, healing at the osteotomy site, resorption of the osteoinductive compound, and complications. Immediate correction of the varus deformity was present in all cases. Lobular radiolucency was present in all cases, more pronounced on the lateral knee radiograph, simulating infection or erosive disease. Four radiographic signs of healing were observed: blurring at the opposing osteotomy bony margins and at the osteoinductive compound and the adjacent bone interface, callus formation, and resorption of the osteoinductive compound. Complications were present in 33 % of cases, including fracture through the lateral tibial cortex (21 %), genu varum recurrence (8 %), painful exuberant bone formation (4 %), persistent pain, requiring total knee arthroplasty (4 %), and non-union (after >6 months' follow-up), with suspected infection (4 %). Radiologists should be aware of the normal radiographic appearance following iBalance high tibial osteotomy, which may be confused with infection. Radiologists should also be aware of potential post-operative complications and compare all post-operative radiographs with the immediate post-operative examination to detect collapse of the osteotomy site and recurrence of varus angulation.

Accuracy of fibula reconstruction using patient-specific CAD/CAM reconstruction plates and dental implants : A new modality for functional reconstruction of mandibular defects

NARCIS (Netherlands)

Schepers, Rutger H.; Raghoebar, Gerry M.; Vissink, Arjan; Stenekes, Martin W.; Kraeima, Joep; Roodenburg, Jan L.; Reintsema, Harry; Witjes, Max J.

Background: The purpose of this study was to analyze the accuracy of mandibular reconstruction using patient-specific computer-aided designed and computer-aided manufactured (CAD/CAM) reconstruction plates as a guide to place fibula grafts and dental implants in a one-stage procedure using

A new algorithm for finite element simulation of wedge osteotomies in voxel models with application to the tibia

Directory of Open Access Journals (Sweden)

Thomas Pressel

2010-01-01

Full Text Available Thomas Pressel1, Markus D Schofer1, Jörg Meiforth2, Markus Lengsfeld1, Jan Schmitt11Department of Orthopaedics and Rheumatology, University Hospital Marburg, Marburg, Germany; 2St. Vincentius Kliniken, Klinik für Orthopädie, Karlsruhe, GermanyAbstract: Wedge osteotomies are used to correct bone deformities or change the forces acting on bones and joints in the human body. Finite element models can be employed to simulate the effect of such operations on the bone or adjacent joints. The automatic generation of voxel models derived from computed tomography data is a common procedure, but the major drawback of the method lies in irregular model surfaces. Therefore, the concept of hybrid models combining voxel and tetrahedron meshes was developed. We present an algorithm to simulate wedge osteotomies in voxel models by adding tetrahedron to brick elements. Applicability of the procedure was tested by performing a parametric study using a tibia model created from computed tomography scans taken in vivo applying individually calculated force conditions. The osteotomy angle largely affected maximum stresses: at 2.5 degrees valgus, the stresses at the medial and lateral tibial plateau were equivalent, while increasing valgus angles reduced medial stresses. The algorithm described here is an improvement of former mesh generation procedures and allows a better representation of the geometry at the osteotomy level. The algorithm can be used for all wedge osteotomies and is not limited to the tibia.Keywords: finite element/osteotomy/voxel/pre-operative planning, simulation, mesh algorithm

Secondary Subacromial Impingement after Valgus Closing-Wedge Osteotomy for Proximal Humerus Varus

Directory of Open Access Journals (Sweden)

Hirotaka Sano

2015-01-01

Full Text Available A 31-year-old construction worker had been suffering from both the motion pain and the restriction of elevation in his right shoulder due to severe varus deformity of humeral neck, which occurred after proximal humeral fracture. The angle for shoulder flexion and abduction was restricted to 50 and 80 degrees, respectively. Valgus closing-wedge osteotomy followed by the internal fixation using a locking plate was carried out at 12 months after injury. Postoperatively, the head-shaft angle of the humerus improved from 65 to 138 degrees. Active flexion and abduction angles improved from 80 to 135 degrees and from 50 to 135 degrees, respectively. However, the patient complained from a sharp pain with a clicking sound during shoulder abduction even after removal of the locking plate. Since subacromial steroid injection temporarily relieved his shoulder pain, we assumed that the secondary subacromial impingement was provoked after osteotomy. Thus, arthroscopic subacromial decompression was carried out at 27 months after the initial operation, which finally relieved his symptoms. In the valgus closing-wedge osteotomy, surgeons should pay attention to the condition of subacromial space to avoid causing the secondary subacromial impingement.

Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication

International Nuclear Information System (INIS)

Gumerman, L.W.; Fogel, S.R.; Goodman, M.A.; Hanley, E.N. Jr.; Kappakas, G.S.; Rutkowski, R.; Levine, G.

1978-01-01

Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: (a) control--immobilization; (b) control--immobilization plus periosteal stripping; (c) simple fracture--osteotomy; (d) delayed union--osteotomy plus periosteal stripping; and (e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The non-union group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning the quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment

Improvement of the knee center of rotation during walking after opening wedge high tibial osteotomy.

Science.gov (United States)

Kim, Kyungsoo; Feng, Jun; Nha, Kyung Wook; Park, Won Man; Kim, Yoon Hyuk

2015-06-01

Accurate measurement of the center of rotation of the knee joint is indispensable for prediction of joint kinematics and kinetics in musculoskeletal models. However, no study has yet identified the knee center of rotations during several daily activities before and after high tibial osteotomy surgery, which is one surgical option for treating knee osteoarthritis. In this study, an estimation method for determining the knee joint center of rotation was developed by applying the optimal common shape technique and symmetrical axis of rotation approach techniques to motion-capture data and validated for typical activities (walking, squatting, climbing up stairs, walking down stairs) of 10 normal subjects. The locations of knee joint center of rotations for injured and contralateral knees of eight subjects with osteoarthritis, both before and after high tibial osteotomy surgery, were then calculated during walking. It was shown that high tibial osteotomy surgery improved the knee joint center of rotation since the center of rotations for the injured knee after high tibial osteotomy surgery were significantly closer to those of the normal healthy population. The difference between the injured and contralateral knees was also generally reduced after surgery, demonstrating increased symmetry. These results indicate that symmetry in both knees can be recovered in many cases after high tibial osteotomy surgery. Moreover, the recovery of center of rotation in the injured knee was prior to that of symmetry. This study has the potential to provide fundamental information that can be applied to understand abnormal kinematics in patients, diagnose knee joint disease, and design a novel implants for knee joint surgeries. © IMechE 2015.

BILATERAL SAGITAL SPLIT OSTEOTOMY PADA MANDIBULA PROGNATI

Directory of Open Access Journals (Sweden)

Pradono Pradono

2015-07-01

Full Text Available A young girl 20 years old with mandibular prognathism, has been treated with orthodontics and surgical treatment in between. Mandibular set back was done intra orally 5 mm length and bilateral sagital split ramus osteotomy method. And rigid fixation was done by inserting three 2 mm bicortical screws for stabilizing the fragment. This method allowed the bony segments to heal properly and allowed the patients to function sooner.

Monoplanar versus biplanar medial open-wedge proximal tibial osteotomy for varus gonarthrosis: a comparison of clinical and radiological outcomes.

Science.gov (United States)

Elmalı, Nurzat; Esenkaya, Irfan; Can, Murat; Karakaplan, Mustafa

2013-12-01

We compared clinical and radiological results of two proximal tibial osteotomy (PTO) techniques: monoplanar medial open-wedge osteotomy and biplanar retrotubercle medial open-wedge osteotomy, stabilised by a wedged plate. We evaluated 88 knees in 78 patients. Monoplanar medial open-wedge PTO was performed on 56 knees in 50 patients with a mean age of 55 ± 9 years. Biplanar retrotubercle medial open-wedge PTO was performed on 32 knees in 28 patients with a mean age of 57 ± 7 years. Mean follow-up periods were 40.6 ± 7 months for the monoplanar PTO group and 38 ± 5 months for the biplanar retrotubercle PTO group. Clinical outcome was evaluated using the hospital for special surgery scoring system, and radiological outcome was evaluated by the measurements of femorotibial angle (FTA), patellar height and tibial slope changes. In both groups, post-operative HSS scores increased significantly. No significant difference was found between groups in FTA alteration, but the FTA decreased significantly in both groups. Patellar index ratios decreased significantly in the monoplanar PTO group (Insall-Salvati Index by 0.07, Blackburne-Peel Index by 0.07), but not in the biplanar retrotubercle PTO group. Tibial slopes were increased significantly in the monoplanar PTO group, but not in the retrotubercle PTO group. Biplanar retrotubercle medial open-wedge osteotomy and monoplanar medial open-wedge osteotomy are both clinically effective for the treatment for varus gonarthrosis. Retrotubercle osteotomy also prevents patella infera and tibial slope changes radiologically.

Blount disease in a case of Prader-Willi syndrome: why is it not as prevalent as in obesity without Prader-Willi syndrome?

Science.gov (United States)

Dulka, Susan; Choudhary, Arabinda Kumar; Methratta, Sosamma; Fortuna, Kristine

2013-05-01

Prader-Willi syndrome (PWS) is a genetic disorder causing multisystem abnormalities with obesity. Obesity is a well established cause of Blount disease. A 7-year-old girl with PWS presented with genu varum of the left knee with deformity of the proximal medial tibial condyle, which was consistent with Blount disease. A lateral physeal stapling and subsequent osteotomy for the left proximal tibia and fibula were performed with improved anatomical alignment. Blount disease has not been reported in the literature in association with PWS despite excessive obesity.

W/M serrated osteotomy for infantile Blount's disease in Ghana ...

African Journals Online (AJOL)

2015-10-30

Oct 30, 2015 ... surgical treatment is well suited for developing countries. This study describes .... with infantile Blount's are included for analysis. In this study, we are ... To increase the stability of the osteotomy, the teeth had to be pointed (at ...

Minimally invasive distal first metatarsal osteotomy can be an option for recurrent hallux valgus.

Science.gov (United States)

Magnan, Bruno; Negri, Stefano; Maluta, Tommaso; Dall'Oca, Carlo; Samaila, Elena

2018-01-12

Recurrence rate of surgical treatment of hallux valgus ranges in the literature from 2.7% to 16%, regardless of used procedure. In this study, long-term results of a minimally invasive distal osteotomy of the first metatarsal bone for treatment of recurrent hallux valgus are described. 32 consecutive percutaneous distal osteotomies of the first metatarsal were performed in 26 patients for treatment of recurrent hallux valgus. Primary surgery had been soft tissue procedures in 8 cases (25%), first metatarsal or phalangeal osteotomies in 19 cases (59.4%) and Keller procedures in 5 cases (15.6%). Patients were assessed with a mean follow-up of 9.8±4.3 years. All patients reported the disappearance or reduction of the pain. The mean overall AOFAS score improved from 46.9±17.8 points to 85.2±14.9 at final follow-up. The mean hallux valgus angle decreased from 26.1±9.1 to 9.7±5.4°, the intermetatarsal angle decreased from 11.5±4.5 to 6.7±4.0°. No major complications were recorded with a re-recurrence rate of 3.1% (1 case). Percutaneous distal osteotomy of the first metatarsal can be a reliable and safe surgical option in the recurrent hallux valgus with low complication rate and the advantages of a minimally invasive surgery. IV, Retrospective Case Series. Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Modern Microsurgical Resection of Olfactory Groove Meningiomas by Classical Bicoronal Subfrontal Approach without Orbital Osteotomies.

Science.gov (United States)

Farooq, Ghulam; Rehman, Lal; Bokhari, Irum; Rizvi, Syed Raza Hussain

2018-01-01

The olfactory groove meningioma has always been surgically challenging. The common microscopic surgical procedures exercised involve modification of pterional or sub-frontal approaches with or without orbital osteotomies. However, we believe that orbital osteotomies are not mandatory to achieve gross total resection. Hence, this study was performed to evaluate the surgical outcomes of olfactory groove meningioma with bicoronal sub frontal approach but without orbital osteotomies. The study was performed by reviewing the medical charts, neuroimaging data, and follow-up data of 19 patients who were treated micro surgically for olfactory groove meningioma without orbital osteotomies in our department. Mean overall follow up period of our study was 5 years. Statistical analysis was done by means of IBM SPSS Software version 19. Nineteen patients (1 male and 18 female patients, with an age range of 35-67 years; average age of patients' 51±7.5 years) of OGM were managed in our department. All patients were evaluated by MRI Brain with and without Gadolinium, CTA, CT Scan both axial and Coronal sequences. Most common symptom reported was head ache (80%), others include; urinary incontinence (26%), seizures (78%), decreased visual acuity (79%), papilledema (74%), personality changes (68%) and olfactory loss was reported in 57% of the patients. Post-operative complications include; CSF accumulation (5%), hematoma at tumor bed (10%), skin infection (5%) and mild post-operative brain edema (26%). Mortality rate was 5%. During 5 years of follow-up, we recorded one recurrence which was after 26 months and successfully removed in reoperation. Bi-coronal sub frontal approach appears to be an excellent technique for Olfactory Meningioma removal as practiced by most neurosurgeons. Nevertheless, it is not mandatory to carry out orbital osteotomy to acquire optimal surgical outcome as is advocated by some Authors.

Correction of moderate to severe hallux valgus with combined proximal opening wedge and distal chevron osteotomies: a reliable technique.

Science.gov (United States)

Jeyaseelan, L; Chandrashekar, S; Mulligan, A; Bosman, H A; Watson, A J S

2016-09-01

The mainstay of surgical correction of hallux valgus is first metatarsal osteotomy, either proximally or distally. We present a technique of combining a distal chevron osteotomy with a proximal opening wedge osteotomy, for the correction of moderate to severe hallux valgus. We reviewed 45 patients (49 feet) who had undergone double osteotomy. Outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and the Short Form (SF) -36 Health Survey scores. Radiological measurements were undertaken to assess the correction. The mean age of the patients was 60.8 years (44.2 to 75.3). The mean follow-up was 35.4 months (24 to 51). The mean AOFAS score improved from 54.7 to 92.3 (p hallux valgus and intermetatarsal angles were improved from 41.6(o) to 12.8(o) (p < 0.001) and from 22.1(o) to 7.1(o), respectively (p < 0.001). The mean distal metatarsal articular angle improved from 23(o) to 9.7(o). The mean sesamoid position, as described by Hardy and Clapham, improved from 6.8 to 3.5. The mean length of the first metatarsal was unchanged. The overall rate of complications was 4.1% (two patients). These results suggest that a double osteotomy of the first metatarsal is a reliable, safe technique which, when compared with other metatarsal osteotomies, provides strong angular correction and excellent outcomes with a low rate of complications. Cite this article: Bone Joint J 2016;98-B:1202-7. ©2016 The British Editorial Society of Bone & Joint Surgery.

Early weight bearing versus delayed weight bearing in medial opening wedge high tibial osteotomy: a randomized controlled trial.

Science.gov (United States)

Lansdaal, Joris Radboud; Mouton, Tanguy; Wascher, Daniel Charles; Demey, Guillaume; Lustig, Sebastien; Neyret, Philippe; Servien, Elvire

2017-12-01

The need for a period of non-weight bearing after medial opening wedge high tibial osteotomy remains controversial. It is hypothesized that immediate weight bearing after medial opening wedge high tibial osteotomy would have no difference in functional scores at one year compared to delayed weight bearing. Fifty patients, median age 54 years (range 40-65), with medial compartment osteoarthritis, underwent a medial opening wedge high tibial osteotomy utilizing a locking plate without bone grafting. Patients were randomized into an Immediate or a Delayed (2 months) weight bearing group. All patients were assessed at one-year follow-up and the two groups compared. The primary outcome measure was the IKS score. Secondary outcome measures included the IKDC score, the VAS pain score and rate of complications. The functional scores significantly improved in both groups. The IKS score increased from 142 ± 31 to 171 ± 26 in the Immediate group (p bearing after medial opening wedge high tibial osteotomy had no effect on functional scores at 1 year follow-up and did not significantly increase the complication rate. Immediate weight bearing after medial opening wedge high tibial osteotomy appears to be safe and can allow some patients a quicker return to activities of daily living and a decreased convalescence period. II.

A systematic review of functional outcome and quality of life following reconstruction of maxillofacial defects using vascularized free fibula flaps and dental rehabilitation reveals poor data quality

NARCIS (Netherlands)

Wijbenga, Johan G.; Schepers, Rutger H.; Werker, Paul M. N.; Witjes, Max J. H.; Dijkstra, Pieter U.

Background: Reconstruction and oral rehabilitation of segmental maxillofacial defects resulting from ablative surgery is commonly achieved by osteocutaneous vascularized free fibula (VFFF) transplantation combined with implant-supported dental prostheses. We systematically reviewed the literature

Comparison of fixed-bearing and mobile-bearing total knee arthroplasty after high tibial osteotomy.

Science.gov (United States)

Hernigou, Philippe; Huys, Maxime; Pariat, Jacques; Roubineau, François; Flouzat Lachaniette, Charles Henri; Dubory, Arnaud

2018-02-01

There is no information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in the same patients previously treated by high tibial osteotomy. The purpose was therefore to compare fixed-bearing and mobile-bearing total knee replacements in patients treated with previous high tibial osteotomy. We compared the results of 57 patients with osteoarthritis who had received a fixed-bearing prosthesis after high tibial osteotomy with the results of 41 matched patients who had received a rotating platform after high tibial osteotomy. The match was made for length of follow-up period. The mean follow-up was 17 years (range, 15-20 years). The patients were assessed clinically and radiographically. The pre-operative knee scores had no statistically significant differences between the two groups. So was the case with the intra-operative releases, blood loss, thromboembolic complications and infection rates in either group. There was significant improvement in both groups of knees, and no significant difference was observed between the groups (i.e., fixed-bearing and mobile-bearing knees) for the mean Knee Society knee clinical score (95 and 92 points, respectively), or the Knee Society knee functional score (82 and 83 points, respectively) at the latest follow-up. However, the mean post-operative knee motion was higher for the fixed-bearing group (117° versus 110°). In the fixed-bearing group, one knee was revised because of periprosthetic fracture. In the rotating platform mobile-bearing group, one knee was revised because of aseptic loosening of the tibial component. The Kaplan-Meier survivorship for revision at ten years of follow-up was 95.2% for the fixed bearing prosthesis and 91.1% for the rotating platform mobile-bearing prosthesis. Although we did manage to detect significant differences mainly in clinical and radiographic results between the two groups, we found no superiority or inferiority of the mobile

Endoscopic-assisted osteotomies for the treatment of craniosynostosis.

Science.gov (United States)

Hinojosa, J; Esparza, J; Muñoz, M J

2007-12-01

The development of multidisciplinar units for Craniofacial Surgery has led to better postoperative results and a considerable decrease in morbidity in the treatment of complex craniofacial patients. Standard correction of craniosynostosis involves calvarial remodeling, often considerable blood losses that need to be replaced and lengthy hospital stay. The use of minimally invasive techniques for the correction of some of these malformations are widespread and allows the surgeon to minimize the incidence of complications by means of a decreased surgical time, blood salvage, and shortening of postoperative hospitalization in comparison to conventional craniofacial techniques. Simple and milder craniosynostosis are best approached by endoscopy-assisted osteotomies and render the best results. Extended procedures other than simple suturectomies have been described for more severe patients. Different osteotomies resembling standard fronto-orbital have been developed for the correction, and the use of postoperative cranial orthesis may improve the final cosmetic appearance. Thus, endoscopic-assisted procedures differ from the simple strategy of single suture resection that rendered insufficient results in the past, and different approaches can be tailored to solve these cases in patients in the setting of a case-to-case bases.

Heat generated by dental implant drills during osteotomy-a review: heat generated by dental implant drills.

Science.gov (United States)

Mishra, Sunil Kumar; Chowdhary, Ramesh

2014-06-01

Osseointegration is the more stable situation and results in a high success rate of dental implants. Heat generation during rotary cutting is one of the important factors influencing the development of osseointegration. To assess the various factors related to implant drills responsible for heat generation during osteotomy. To identify suitable literature, an electronic search was performed using Medline and Pubmed database. Articles published in between 1960 to February 2013 were searched. The search is focused on heat generated by dental implant drills during osteotomy. Various factors related to implant drill such effect of number of blades; drill design, drill fatigue, drill speed and force applied during osteotomies which were responsible for heat generation were reviewed. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. The initial literature search resulted in 299 articles out of which only 70 articles fulfils the inclusion criteria and were included in this systematic review. Many factors related to implant drill responsible for heat generation were found. Successful preparation of an implant cavity with minimal damage to the surrounding bone depends on the avoidance of excessive temperature generation during surgical drilling. The relationship between heat generated and implant drilling osteotomy is multifactorial in nature and its complexity has not been fully studied. Lack of scientific knowledge regarding this issue still exists. Further studies should be conducted to determine the various factors which generate less heat while osteotomy such as ideal ratio of force and speed in vivo, exact time to replace a drill, ideal drill design, irrigation system, drill-bone contact area.

The effect of tibial plateau leveling osteotomy position on cranial tibial subluxation: an in vitro study.

Science.gov (United States)

Kowaleski, Michael P; Apelt, Detlef; Mattoon, John S; Litsky, Alan S

2005-01-01

To compare centered versus distal tibial plateau leveling osteotomy (TPLO) position on cranial tibial subluxation, postoperative tibial plateau angle (TPA), and tibial long axis shift (TLAS). In vitro biomechanical evaluation. Six pairs of canine cadaveric hind limbs. One limb of each pair was randomly assigned to the distal (TPLO-D) or centered (TPLO-C) osteotomy group. Cranial tibial subluxation (CTS) under load was quantified sequentially under 3 conditions: intact, after cranial cruciate ligament transection, and after TPLO; a corrected CTS value was also calculated. Postoperative TPA and TLAS were measured. Comparisons were made using 1-way repeated measures ANOVA with a Tukey's multiple comparison post hoc test for CTS, and a Wilcoxon's sign rank test for TPA and TLAS. Significance was set at Pcranial tibial thrust. The centered osteotomy position is geometrically more precise, and biomechanically more effective than the distal position.

Limb shortening osteotomy in a patient with achondroplasia and leg length difference after total hip arthroplasty

Directory of Open Access Journals (Sweden)

Christian L. Galata

2013-07-01

Full Text Available Introduction: Achondroplasia is the most common reason for disproportionate short stature. Normally, orthopedic limb lengthening procedures must be discussed in the course of this genetic disorder and have been successful in numerous achondroplastic patients in the past. In some cases, the disease may lead to leg length differences with need for surgical correction. Case Report: We report a case of achondroplastic dysplastic coxarthrosis with symptomatic leg length difference after bilateral total hip arthroplasty in a 52-year-old female patient, in which a distal femoral shortening osteotomy was successfully performed. Conclusion: Femoral shortening osteotomy is very uncommon in patients with achondroplasia. We conclude, however, that in rare cases it can be indicated and provide the advantage of shorter operation time, less perioperative complications and faster recovery compared to leg lengthening procedures. Keywords: Achondroplasia, dysplastic coxarthrosis, limb shortening, distal femur osteotomy.

Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis

NARCIS (Netherlands)

Govaert, L. H. M.; van der Vis, H. M.; Marti, R. K.; Albers, G. H. R.

2003-01-01

We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a

Bilateral sagittal split osteotomy versus distraction osteogenesis for mandibular advancements

NARCIS (Netherlands)

Baas, E.M.

2015-01-01

The aim of this thesis was to compare the treatment modality of distraction osteogenesis (DO) with the gold standard for mandibular advancement surgery. In fact we compare distraction osteogenesis with the standard of care, which is a conventional bilateral sagittal split osteotomy as described by

Comparison of clinical outcomes using a Piezosurgery device vs. a conventional osteotome for lateral osteotomy in rhinoplasty.

Science.gov (United States)

Koc, Bulent; Koc, Eltaf Ayca; Erbek, Selim

2017-08-01

Our aim for this study was to evaluate and compare the clinical outcomes in patients who underwent lateral osteotomy with a Piezosurgery device or a conventional osteotome in open-technique rhinoplasty. This cohort trial involved 65 patients (36 women and 29 men; average age: 23.6 ± 5.71 yr) who underwent surgery between May 2015 and January 2016. Piezosurgery was used for lateral osteotomy in 32 patients, whereas 33 patients underwent conventional external osteotomy. These 2 groups were compared for duration of surgery, perioperative bleeding, postoperative edema, ecchymosis, pain, and patient satisfaction on the first and seventh postoperative days. The Piezosurgery group revealed significantly more favorable outcomes in terms of edema, ecchymosis, and hemorrhage on the first day postoperatively (p Piezosurgery group. Hemorrhage was similar in both groups on the seventh postoperative day (p = 0.67). The Piezosurgery group not only experienced less pain on the first postoperative day (p Piezosurgery may be a promising, safe, and effective method for lateral osteotomy, a critical step in rhinoplasty. The time interval necessary for the learning curve is counteracted by the comfort and satisfaction of both patients and surgeons.

Comparative Study of Skeletal Stability between Postoperative Skeletal Intermaxillary Fixation and No Skeletal Fixation after Bilateral Sagittal Split Ramus Osteotomy

DEFF Research Database (Denmark)

Hartlev, Jens; Godtfredsen, Erik; Andersen, Niels Trolle

2014-01-01

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....

Local application of a gentamicin-loaded thermo-responsive hydrogel allows for fracture healing upon clearance of a high Staphylococcus aureus load in a rabbit model

Directory of Open Access Journals (Sweden)

G-JA ter Boo

2018-03-01

Full Text Available ntibiotic-loaded biomaterials (ALBs have emerged as a potential useful adjunctive antimicrobial measure for the prevention of infection in open fracture care. A biodegradable thermo-responsive poly(N-isopropylacrylamide grafted hyaluronic acid (HApN hydrogel loaded with gentamicin has recently been shown to prevent implant-related infection in a rabbit osteosynthesis model. The primary aim of this study was to determine the influence of this HApN hydrogel on bone healing at an early stage (4 weeks. A rabbit humeral osteotomy model with plating osteosynthesis was used to compare fracture healing in rabbits receiving the hydrogel as compared with control animals. The secondary aim was to observe fracture healing in groups treated with and without antibiotic-loaded hydrogel in the presence of bacterial contamination. In all groups, outcome measures were mechanical stability and histological score, with additional quantitative bacteriology in the inoculated groups. Application of the HApN hydrogel in non-inoculated rabbits did not significantly influence humeral stiffness or histological scores for fracture healing in comparison to controls. In the inoculated groups, animals receiving the bacterial inoculum without hydrogel were culture-positive at euthanasia and found to display lower humeral stiffness values and higher histopathological scores for bacterial presence in comparison with equivalents receiving the gentamicin-loaded HApN hydrogel, which were also infection-free. In summary, our data showed that HApN was an effective antibiotic carrier that did not affect fracture healing. This data supported its suitability for application in fracture care. Addition of osteopromotive compounds could provide further support for accelerating fracture healing in addition to successful infection prophylaxis.

Four osteotomy methods with piezosurgery to remove complicated mandibular third molars: a retrospective study.

Science.gov (United States)

Ge, Jing; Yang, Chi; Zheng, Jia-Wei; He, Dong-Mei; Zheng, Ling-Yan; Hu, Ying-Kai

2014-11-01

Piezosurgery has been used widely in oral and maxillofacial surgery, but there has been no report systematically describing an osteotomy method with piezosurgery for complicated mandibular third molar removal. The aim of this study was to introduce 4 osteotomy methods using piezosurgery and evaluate their effects. A retrospective study was conducted of patients with a complicated impacted mandibular third molar requiring extraction. The predictor variable was the extraction technique. Four osteotomy methods using piezosurgery were tested according to different impaction types: method 1 involved complete bone removal; method 2 involved segmental bone removal; method 3 involved bone removal combined with tooth splitting; and method 4 involved block bone removal. Outcome variables were success rate, operative time, major complications (including nerve injury, mandible fracture, severe hematoma, or severe edema), and serious pyogenic infection. Data were analyzed using descriptive statistics. The study was composed of 55 patients with 74 complicated impacted mandibular third molars. All impacted mandibular third molars were removed successfully. The average surgical time was 15 minutes (range, 8 to 26 minutes). Thirty-eight molars (51.4%) were extracted by method 1, 18 molars (24.3%) by method 2, 12 molars (16.2%) by method 3, and 6 molars (8.1%) by method 4. Two cases (2.7%) developed postoperative infections and recovered within 1 week using drainage and antibiotic administration. The 4 osteotomy methods with piezosurgery provide effective ways of removing complicated impacted mandibular third molars. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Three-dimensional translations following posterior three-column spinal osteotomies for the correction of severe and stiff kyphoscoliosis.

Science.gov (United States)

Li, Xueshi; Huang, Zifang; Deng, Yaolong; Fan, Hengwei; Sui, Wenyuan; Wang, Chongwen; Yang, Junlin

2017-12-01

Posterior three-column spinal osteotomies were shown to be effective to treat severe and stiff kyphoscoliosis. Translations at the site of osteotomy after deformity correction were commonly seen intraoperatively, which might cause potential neurologic deficits. However, this phenomenon was not thoroughly discussed in the current literature. This study aimed to evaluate the three-dimensional (3D) translations at the three-column osteotomy site and their effects on neurologic outcome in the surgical correction of severe and stiff kyphoscoliosis. A retrospective study was carried out. Sixty-nine patients treated by posterior three-column spinal osteotomy for severe kyphoscoliosis of idiopathic, congenital, neuromuscular, neurofibromatosis, and tuberculosis origin were included. General, coronal, and sagittal translations were graded three-dimensionally according to the theory of Meyerding. The charts of 69 clinical patients with severe and stiff kyphoscoliosis treated by posterior three-column osteotomy from January 2013 to June 2015 were reviewed. There were 35 male patients with an average age of 21.5 years and 34 female patients with an average age of 22.5 years. The etiologies of these spinal deformities were idiopathic, congenital, neuromuscular, neurofibromatosis, and tuberculosis. According to our classification system of spinal cord neurologic function, there were 41 type A, 13 type B, and 15 type C cases. The 3D spine models were reconstructed from thin-sliced computed tomography (CT) scan, and the 3D translations at the three-column osteotomy site were graded and analyzed. The incidences of general translation (GT), frontal translation (FT), and sagittal translation (ST) were 62.3%, 52.2%, and 26.1%. The incidence of evoked potential (EP) change in cases with GT/FT being or more than grade II (GT, 42.9%; FT, 50.0%) was significantly higher than that with GT/FT being less than grade II (GT, 16.7%; FT, 18.2%), whereas the incidence of EP change in cases with

Skull base tumors: a comprehensive review of transfacial swing osteotomy approaches.

Science.gov (United States)

Moreira-Gonzalez, Andrea; Pieper, Daniel R; Cambra, Jorge Balaguer; Simman, Richard; Jackson, Ian T

2005-03-01

Numerous techniques have been proposed for the resection of skull base tumors, each one unique with regard to the region exposed and degree of technical complexity. This study describes the use of transfacial swing osteotomies in accessing lesions located at various levels of the cranial base. Eight patients who underwent transfacial swings for exposure and resection of cranial base lesions between 1996 and 2002 were studied. The mandible was the choice when wide exposure of nasopharyngeal and midline skull base tumors was necessary, especially when they involved the infratemporal fossa. The midfacial swing osteotomy was an option when access to the entire clivus was necessary. An orbital swing approach was used to access large orbital tumors lying inferior to the optic nerve and posterior to the globe, a region that is often difficult to visualize. Gross total tumor excision was possible in all patients. Six patients achieved disease control and two had recurrences. The complications of cerebrospinal fluid leak, infection, hematoma, or cranial nerve damage did not occur. After surgery, some patients experienced temporary symptoms caused by local swelling. The aesthetic result was considered good. Transfacial swing osteotomies provide a wide exposure to tumors that occur in the central skull base area. Excellent knowledge of the detailed anatomy of this region is paramount to the success of this surgery. The team concept is essential; it is built around the craniofacial surgeon and an experienced skull base neurosurgeon.

Effect of surgical shoes on brake response time after first metatarsal osteotomy?a prospective cohort study

OpenAIRE

Dammerer, Dietmar; Braito, Matthias; Biedermann, Rainer; Ban, Michael; Giesinger, Johannes; Haid, Christian; Liebensteiner, Michael C.; Kaufmann, Gerhard

2016-01-01

Background The aim of this study is to assess patients? driving ability when wearing surgical shoes following right-sided first metatarsal osteotomy. Methods From August 2013 to August 2015, 42 consecutive patients (mean age 54.5?years) with right-sided hallux valgus deformity underwent first metatarsal osteotomy. Patients were tested for brake response time (BRT) 1?day preoperatively (control run) and at 2 and 6?weeks postoperatively. Two different types of foot orthosis were investigated. B...

Neck osteotomy for malunion of neglected radial neck fractures in children: a report of 2 cases.

Science.gov (United States)

Ceroni, Dimitri; Campos, José; Dahl-Farhoumand, Agnes; Holveck, Jérôme; Kaelin, André

2010-01-01

Radial neck fractures are a common injury in children as a result of a fall on an extended and supinated outstretched hand. We present 2 cases of osteotomy of the neck of the radius performed in 2 children with neglected radial neck fractures. Preoperatively, both patients complained of pain and severely reduced mobility of the elbow. Surgery was performed at 6 weeks and 3 months, respectively, after the initial injury and the 2 children were reviewed at 6 and 16 months follow-up. Osteotomies healed within the usual time and no avascular necrosis of the radial head, proximal radioulnar synostosis, or myositis ossificans were observed. The Mayo Elbow Performance Index Score improved significantly after the operation with the 2 patients rated as excellent. In this small series, we present a novel technique of proximal osteotomy of the radius to correct this deformity in children. Case series, level IV evidence.

Does intraoperative navigation improve the accuracy of mandibular angle osteotomy: Comparison between augmented reality navigation, individualised templates and free-hand techniques.

Science.gov (United States)

Zhu, Ming; Liu, Fei; Zhou, Chaozheng; Lin, Li; Zhang, Yan; Chai, Gang; Xie, Le; Qi, Fazhi; Li, Qingfeng

2018-04-11

Augmented reality (AR)-based navigation surgery has evolved to be an advanced assisted technology. The aim of this study is to manifest the accuracy of AR navigation for the intraoperative mandibular angle osteotomy by comparing the navigation with other interventional techniques. A retrospective study was conducted with 93 post-surgical patients with mandibular angle hypertrophy admitted at our plastic and reconstructive surgery department between September 2011 and June 2016. Thirty-one patients received osteotomy conducted using a navigation system based on augmented reality (AR group), 28 patients received osteotomy conducted using individualised templates (IT group) and the remaining 34 patients received osteotomy performed by free hand (free-hand group). The post-operative computed tomography (CT) images were reviewed and analysed by comparing with pre-surgical planning generated by three-dimensional (3D) software. The preparation time, cutting time, whole operating time and discrepancy in osteotomy lines were measured. The preparation time was much shorter for the free-hand group than that for the AR group and the IT group (P  0.05). In addition, the discrepancy in osteotomy lines was lower for the AR group and in the IT group than for the free-hand group (P < 0.01). The navigation system based on AR has a higher accuracy, more reliability and better user friendliness for some particular clinical procedures than for other techniques, which has a promising clinical prospect. Copyright © 2018. Published by Elsevier Ltd.

[Posterior partial trochanteric osteotomy for the treatment of the roof involved acetabular fractures].

Science.gov (United States)

Wang, Pan-Feng; Xu, Shuo-Gui; Zhang, Chun-Cai; Fu, Qing-Ge; Zhang, Yun-Tong; Liu, Xin-Wei; Niu, Yun-Fei; Tang, Yang

2013-11-01

To introduce a new trochanteric osteotomy,and evaluate the outcome of the procedure combined a posterior lateral approach in treating acetabular fractures which involving the roof. Between March 2007 and Novmber 2010,30 patients with displaced acetabular fractures involving the dome need trochanteric osteotomy were retrospectively reviewed. There were 21 males and 9 females,ranging in age from 18 to 70 years with an average of 35.2 years at the time of injury. According to Letournel-Judet classification, there were 10 posterior wall fractures,7 posterior column fractures,5 transverse fractures, 2 T-shape fractures, 1 transverse associated with posterior wall fracture, 3 posterior column and wall fractures and 2 bicolumn fractures. The standards of Matta,the modified Merle d'Aubigne-Postel, Medical Research Council were respectively used to evaluate the reduction result, function of hip joint and the strength of hip abduction. All patients were followed up with an average time of 25 months (18 to 40) and all osteotomy sites obtained bone union with an average time of 8.4 weeks (6 to 12). No bone non-union, bone block displaceing, internal fixation looseing and breaking,infection of deep part were found. Seventeen patients got anatomic reduction, 12 got satisfied reduction, and 1 got unsatisfied result according to the criteria of Matta. At final follow-up, function of hip joint obtained excellent results in 11 cases, good in 15, fair in 3 and poor in 1. The strength of the abductors of 3 patients were grade 4 and 27 patients were grade 5. Posterior partial great trochanteric osteotomy can enhance the exposure and provide a more accurate reduction and degrade the difficulty of acetabular fracture fixation without increasing the risk of complications. The method provide a new way for the treatment of the roof involved acetabular fractures.

The results of high tibial open wedge osteotomy in patients with varus deformity

Directory of Open Access Journals (Sweden)

Mahmood Jabalameli

2013-07-01

Full Text Available Background: High tibial open wedg osteotomy is one of the most important modality for treatment of varus deformity in order to correct deformity and improving signs and symptoms of patients with primary degenerative osteoarthritis. The aim of this study was to investigate the results of high tibial open wedge osteotomy in patients with varus deformities.Methods: This retrospective study conducted on twenty nine patients (36 knees undergone proximal tibial osteotomy operation in Shafa Yahyaian University Hospital from 2004 to 2010. Inclusion criteria were: age less than 60 years, high physical activity, varus deformity and involvement of medical compartment of knee. Patients with obesity, smoking, patelofemoral pain, lateral compartment lesion, deformity degree more than 20 degree, extension limitation and range of motion less than 90 degree were excluded. The clinical and radiologic characteristics were measured before and after operation.Results: Fourteen patients were females. All of them were younger than 50 years, with mean (±SD 27.64 (±10.88. The mean (±SD of follow up time was 4.33 (±1.7. All the patients were satisfied with the results of operation. Tenderness and pain decreased in all of them. In all patients autologus bone graft were used, in 15 cases (42.5% casting and in the rest T.Buttress plate were used for fixation of fractures. In both groups of primary and double varus the International knee documentation committee (IKDC and modified Larson indices were improved after operation, but there was no significant difference between two groups.Conclusion: High tibial open wedge osteotomy can have satisfying results in clinical signs and symptoms of patients with primary medial joint degenerative osteoarthritis. This procedure also may correct the deformity and improves the radiologic parameters of the patients.

Distal femoral osteotomy in genovalgum: internal fixation with blade plate versus casting.

Science.gov (United States)

Makhmalbaf, Hadi; Moradi, Ali; Ganji, Saeid

2014-10-01

To compare the results of two different ways of distal femoral osteotomy stabilization in patients suffering from genuvalgum: internal fixation with plate, and casting. In a non-randomized prospective study, after distal femoral osteotomy with the zigzag method, patients were divided into two groups: long leg casting, and internal fixation with blade plate. For all patients, questionnaires were filled to obtain data. Information such as range of motion, tibiofemoral anatomical angle and complications were recorded. 38 knees with valgus deformity underwent distal femoral supracondylar osteotomy. (8 with plaster cast and 30 with internal fixation using a blade plate). Preoperative range of motion was 129±6° and six months later it was 120±14°. The preoperative tibiofemoral angle was 32±6°; postoperative tibiofemoral angles were 3±3°, 6±2°, and 7±3° just after operation, six months, and two years later, respectively. Although this angle was greater among the group stabilized with a cast, this difference was not statistically significant. In postoperative complications, over-correction was found in five, recorvatom deformity in one, knee stiffness in three and superficial wound infection was recorded in three knees. There is no prominent difference in final range of motion and alignment whether fixation is done with casting or internal fixation. However, the complication rate seems higher in the casting method.

Minimally Invasive Distal Metatarsal Osteotomy for Mild-to-Moderate Hallux Valgus Deformity

Directory of Open Access Journals (Sweden)

Yu-Chuan Lin

2009-08-01

Full Text Available Minimally invasive surgery has recently been introduced for foot and ankle surgery, and hallux valgus surgery is no exception. The purpose of our study was to analyze the early results and to present our experience of minimally invasive distal metatarsal osteotomy in correcting mild-to-moderate hallux valgus deformities. Between September 2005 and December 2006, 31 consecutive patients (47 feet with mild-to-moderate hallux valgus deformities underwent minimally invasive distal metatarsal osteotomies. The clinical and radiographic outcomes were assessed. The satisfaction rate was 90.32%. The mean total American Orthopedic Foot and Ankle Society halluxmetatarsophalangeal-interphalangeal scale was 92.7 points. Complications included two (4.26% episodes of stiffness, six (12.77% episodes of pin tract infection, and one (2.13% deep infection. There were no cases with nonunion, malunion, overcorrection, transfer metatarsalgia or osteonecrosis. On weight-bearing anteroposterior foot radiographs, the mean hallux valgus angle and first intermetatarsal angle corrections were 11.8° and 6.3°, respectively, which is a statistically significant difference (p < 0.001 between the preoperative and postoperative status. Here, minimally invasive distal metatarsal osteotomy was associated with good satisfaction, functional improvement and low complication rates. This technique offers an effective, safe and simple way to treat hallux valgus with a first intermetatarsal angle less than 15°.

Triple osteotomy for the correction of severe hallux valgus deformity: Patient reported outcomes and radiological evaluation.

Science.gov (United States)

Booth, Sean; Bhosale, Abhijit; Mustafa, Abubakar; Shenoy, Ravi; Pillai, Anand

2016-08-01

Symptomatic Hallux valgus can be treated with metatarsal osteotomy combined with proximal phalangeal osteotomy, however this might not be sufficient to treat severe HV deformities. Fifteen feet in eleven female patients treated with double first metatarsal and proximal phalanx osteotomies without lateral release were prospectively studied and outcome measures including radiological angles and validated patient reported outcome scores collected. Mean radiological follow up was 15 months and PROMs data 17 months. Mean hallux valgus and intermetatarsal angles were corrected from 45 to 24.7° and 18.7 to 7.4° respectively. There was an eight degree recurrence of hallux valgus angle. There was no wound problems, non-unions or evidence of avascular necrosis. The EQ-5D descriptive index showed a non-statistically significant improvement. All three elements of the MOxFQ score showed a statistically significant improvement: Forefoot pain (59-26.8), Walking and Stability (49.9-29.6) and Social Interaction (56.4-33.1) CONCLUSION: Triple osteotomy, without a lateral soft tissue release, leads to good radiological and functional outcomes in those with severe hallux valgus deformity. Patients need to be warned of the recovery time and potential for future metalwork removal. The risk of early recurrence suggests that a lateral release should be included in order to maintain a long lasting correction. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

The role of trochanteric flip osteotomy in fixation of certain acetabular fractures

Directory of Open Access Journals (Sweden)

Sandeep Gupta

2017-06-01

Conclusion: Trochanteric flip osteotomy is a very effective technique to fix certain acetabular fractures especially those with dome involvement. It is more accurate and associated with no significant complications compared with conventional way.

Comparison of two Methods of Lateral Osteotomies withwithout Subperiosteal Tunnel creation on Edema and Ecchymosis after Rhinoplasty.

Directory of Open Access Journals (Sweden)

MR As’habyamin

2016-05-01

Full Text Available Introduction: Postoperative periorbital edema and ecchymosis is one of the main complication of rhinoplasty. This complication is mostly due to lateral osteotomy. During performing the endonasal lateral osteotomy, with the goal of reducing injury to surrounding tissues and reducing the postoperative edema and ecchymosis. The aim of this study goal was to determine whether creating a subperiosteal tunnel before lateral osteotomy had an effect on postoperative periorbital edema and ecchymosis. Methods: 102 patients were included in the study. They were underwent rhinoplasty. In each patients lateral osteotomies were carried out bilaterally, after creating a subperiosteal tunnel with periosteum elevator on a randomly chosen side and without creating a subperiosteal tunnel on the other side. The rest of the procedure was similar bilaterally. The patients were examined on the 2nd and 7th days after surgery. The levels of edema and periorbital ecchymosis were score by a different surgery who was unaware of the side with the periosteal tunnel, and the results were compared together. Results: According to the data analysis, there was no statistically significant difference between the severity of periorbital edema at the side with subperiosteal tunnel and the side without it on the 2nd and 7th days after surgery (P value=0/096 and Pvalue=0/252, respectively. There was not found any statistical significant between periorbital ecchymosis at the side with subperiosteal tunnel and the side without it on the 2nd and 7th days after surgery (P value=0/783 and Pvalue=0/094, respectively. Conclusions: Creating a subperiostal tunnel before lateral osteotomy in rhinoplasty does not influence on the severity of postoperative edema and ecchymosis.

Bone repair after osteotomy with diamond burs and CVD ultrasonic tips – histological study in rats

OpenAIRE

Matuda, Fábio S.; Pagani, Clovis; Miranda, Carolina B.; Crema, Aline A. S.; Brentel, Aline S.; Carvalho, Yasmin R.

2010-01-01

This study histologically evaluated the behavior of bone tissue of rats submitted to osteotomy with conventional diamond burs in high speed and a new ultrasonic diamond tips system (CVD – Chemical Vapor Deposition), at different study periods. The study was conducted on 24 Wistar rats. Osteotomy was performed on the posterior paws of each rat, with utilization of diamond burs in high speed under thorough water cooling at the right paw, and CVD tips at the left paw. Animals were killed a...

Use of the 3D surgical modelling technique with open-source software for mandibular fibula free flap reconstruction and its surgical guides.

Science.gov (United States)

Ganry, L; Hersant, B; Quilichini, J; Leyder, P; Meningaud, J P

2017-06-01

Tridimensional (3D) surgical modelling is a necessary step to create 3D-printed surgical tools, and expensive professional software is generally needed. Open-source software are functional, reliable, updated, may be downloaded for free and used to produce 3D models. Few surgical teams have used free solutions for mastering 3D surgical modelling for reconstructive surgery with osseous free flaps. We described an Open-source software 3D surgical modelling protocol to perform a fast and nearly free mandibular reconstruction with microvascular fibula free flap and its surgical guides, with no need for engineering support. Four successive specialised Open-source software were used to perform our 3D modelling: OsiriX ® , Meshlab ® , Netfabb ® and Blender ® . Digital Imaging and Communications in Medicine (DICOM) data on patient skull and fibula, obtained with a computerised tomography (CT) scan, were needed. The 3D modelling of the reconstructed mandible and its surgical guides were created. This new strategy may improve surgical management in Oral and Craniomaxillofacial surgery. Further clinical studies are needed to demonstrate the feasibility, reproducibility, transfer of know how and benefits of this technique. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Supracondylar corrective osteotomy for cubitus varus--the internal rotation component and its importance. An unique bone experiment.

Directory of Open Access Journals (Sweden)

Jimulia T

1994-10-01

Full Text Available In 20 patients with cubitus varus, a clinical test suggested by Yamamoto et al (1985 was carried out to measure the internal rotation. Average internal rotation was found to be 37.5 +/- 9.390. A correction for internal rotation was carried out for all the patients having angle more than 20 degrees. Following osteotomy, post-operative Yamamoto′s angle was measured and was found to be 8.85 +/- 6.5. An experiment was carried out on postmortem human humerus with cubitus varus. The internal rotation was measured with Kirschner wires and was found to be 30 degrees. Osteotomy was carried out to eliminate varus and correct internal rotation. Radiographs taken before and after the osteotomy confirmed the correction. We conclude that this derotation has to be corrected and Yamamoto′s test should be used to assess the correction.

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

Outcomes in chevron osteotomy for Hallux Valgus in a large cohort

NARCIS (Netherlands)

van Groningen, B. (Bart); M.C.M. (Marieke) van der Steen,; M. Reijman (Max); Bos, J. (Janneke); Hendriks, J.G.E. (Johannes G.E.)

2016-01-01

textabstractClinical and radiological related outcomes have been reported for Chevron osteotomy as correction for mild to moderate hallux valgus, but only for relatively small patient series. Moreover, evaluation of the patient's point of view has mostly been conducted by means of more

Ipsilateral stress fracture of the proximal fibula after total knee arthroplasty in a patient with severe valgus knee deformity on a background of Rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Hirokazu Takai

Full Text Available Introduction: Previous studies have reported a lower extremity stress fracture after total knee arthroplasty (TKA. However, a fibular fracture after TKA is quite rare. We report a case of proximal fibula fracture after TKA in a patient with rheumatoid arthritis (RA. Presentation of case: A 45 year old woman with RA had severe knee and foot pain with an antalgic gait disturbance. There was a significant joint deformity in many of lower limb joints. Interval bilateral TKAs were performed two weeks apart. Right TKA was performed using a constraint-type prosthesis, through lateral parapatellar approach. Left TKA was performed using a posterior-stabilized (PS prosthesis through the more commonly employed, medial parapatellar approach. Seven weeks after the right TKA, the patient was found to have an atraumatic proximal fibular fracture. The fracture went on to heal conservatively. Discussion: The fracture was considered to have occurred after the TKA. The callus appeared eleven weeks after the TKA. The factors that contributed to the fracture were thought to be overload of the fragile bone secondarily to disuse osteopaenia, RA or potentially the significant valgus malalignment correction. The surgical approach, the implant or implantation or the persisting joint deformity, were thought to be contributing factors to the aetiology of the stress fracture. The resultant change in clinical outcome/course is outlined in this case report. Conclusion: A stress fracture of the proximal fibula has the potential in the aetiology of may cause other stress fractures, joint other instability, and/or malalignment of the total lower extremity. Keywords: Stress fracture, Insufficiency fracture, Total knee arthroplasty, Fibula fracture, Valgus deformity, Rheumatoid arthritis

Pre-operative simulation of periacetabular osteotomy via a three-dimensional model constructed from salt

Directory of Open Access Journals (Sweden)

Fukushima Kensuke

2017-01-01

Full Text Available Introduction: Periacetabular osteotomy (PAO is an effective joint-preserving procedure for young adults with developmental dysplasia of the hip. Although PAO provides excellent radiographic and clinical results, it is a technically demanding procedure with a distinct learning curve that requires careful 3D planning and, above all, has a number of potential complications. We therefore developed a pre-operative simulation method for PAO via creation of a new full-scale model. Methods: The model was prepared from the patient’s Digital Imaging and Communications in Medicine (DICOM formatted data from computed tomography (CT, for construction and assembly using 3D printing technology. A major feature of our model is that it is constructed from salt. In contrast to conventional models, our model provides a more accurate representation, at a lower manufacturing cost, and requires a shorter production time. Furthermore, our model realized simulated operation normally with using a chisel and drill without easy breakage or fissure. We were able to easily simulate the line of osteotomy and confirm acetabular version and coverage after moving to the osteotomized fragment. Additionally, this model allowed a dynamic assessment that avoided anterior impingement following the osteotomy. Results: Our models clearly reflected the anatomical shape of the patient’s hip. Our models allowed for surgical simulation, making realistic use of the chisel and drill. Our method of pre-operative simulation for PAO allowed for the assessment of accurate osteotomy line, determination of the position of the osteotomized fragment, and prevented anterior impingement after the operation. Conclusion: Our method of pre-operative simulation might improve the safety, accuracy, and results of PAO.

Planning for corrective osteotomy of the femoral bone using 3D-modeling. Part I

Directory of Open Access Journals (Sweden)

Alexey G Baindurashvili

2016-09-01

Full Text Available Introduction. In standard planning for corrective hip osteotomy, a surgical intervention scheme is created on a uniplanar paper medium on the basis of X-ray images. However, uniplanar skiagrams are unable to render real spatial configuration of the femoral bone. When combining three-dimensional and uniplanar models of bone, human errors inevitably occur, causing the distortion of preset parameters, which may lead to glaring errors and, as a result, to repeated operations. Aims. To develop a new three-dimensional method for planning and performing corrective osteotomy of the femoral bone, using visualizing computer technologies. Materials and methods. A new method of planning for corrective hip osteotomy in children with various hip joint pathologies was developed. We examined the method using 27 patients [aged 5–18 years (32 hip joints] with congenital and acquired femoral bone deformation. The efficiency of the proposed method was assessed in comparison with uniplanar planning using roentgenograms. Conclusions. Computerized operation planning using three-dimensional modeling improves treatment results by minimizing the likelihood of human errors and increasing planning and surgical intervention  accuracy.

Effect of intertrochanteric osteotomy on the proximal femur of rabbits: assessment with power Doppler sonography and scintigraphy Efeito da osteotomia intertrocantérica no femur proximal de coelhos: avaliação com utra-sonografia power Doppler e cintilografia

Directory of Open Access Journals (Sweden)

Andrea S. Doria

2007-01-01

Full Text Available OBJECTIVE: In bone injury, repair results in local increased vascularity and bone marrow remodeling. Characterizing the vascular and metabolic imaging patterns of the proximal femur following an intertrochanteric osteotomy may help clinicians decide proper management of the patient. Our objective was to measure Doppler sonography and scintigraphy interval changes in the proximal femur following intertrochanteric osteotomy and compare imaging and histomorphometric measurements in the late post-operative stage (6 weeks after surgery in a rabbit model of bone injury. MATERIALS AND METHODS: Both hips of 12 adult rabbits were imaged with power Doppler sonography and scintigraphy prior to and after (7 days and 6 weeks unilateral osteotomy. Accuracy of the imaging methods was evaluated using hip operative status and histomorphometric results (vascular fractional area and number of vessels per area unit as reference standard measures. RESULTS: A significant difference in the mean number of pixels was noted between operated and non-operated femura in late post-operative power Doppler examinations (P=0.049. Although without reaching statistical significance, the AUC of Doppler measurements (AUC=0.99 was numerically greater than the AUC of scintigraphy measurements (AUC=0.857±0.099 (P=0.15 in differentiating proximal femura with regard to their fractional vascular areas in the late post-operative stage. In contrast, scintigraphy tended to perform better (AUC=0.984±0.022 than Doppler ultrasound (AUC=0.746±0.131 to demonstrate the vascularity intensity per area unit (P=0.07 in the late stage. CONCLUSION: Our results warrant further investigation to determine the value of different imaging modalities for assessment of pathologic changes following hip surgery. Power Doppler sonography demonstrated larger AUCs (representing higher accuracy for the discrimination of vascular fractional areas and scintigraphy, for discrimination of the number of vessels per

One-stage lengthening and derotational osteotomy of the femur stabilised with a gamma nail.

Science.gov (United States)

van Doorn, R; Leemans, R; Stapert, J W

1999-12-01

To study the results of a one-stage lengthening and derotational osteotomy stabilised with a Gamma nail. Retrospective study. 2 hospitals, The Netherlands. 5 patients after failed osteosynthesis of femoral fractures. Mean lengthening of 3 cm and derotation of 30 degrees. Complications and functional results, after a mean follow-up of 43 months (range 30-57). Two patients required dynamisation and a cancellous bone graft to achieve union, which resulted in 1 and 1.5 cm loss of length. One patient had a temporary peroneal neurapraxy. No infections were observed. Our method is not an ultimate solution, but is suitable for one-stage lengthening and derotation osteotomies.

Primary radical ablative surgery and fibula free-flap reconstruction for T4 oral cavity squamous cell carcinoma with mandibular invasion: oncologic and functional results and their predictive factors.

Science.gov (United States)

Camuzard, Olivier; Dassonville, Olivier; Ettaiche, Marc; Chamorey, Emmanuel; Poissonnet, Gilles; Berguiga, Riadh; Leysalle, Axel; Benezery, Karen; Peyrade, Frédéric; Saada, Esma; Hechema, Raphael; Sudaka, Anne; Haudebourg, Juliette; Demard, François; Santini, José; Bozec, Alexandre

2017-01-01

The aims of this study were to evaluate clinical outcomes and to determine their predictive factors in patients with oral cavity squamous cell carcinoma (OCSCC) invading the mandibular bone (T4) who underwent primary radical surgery and fibula free-flap reconstruction. Between 2001 and 2013, all patients who underwent primary surgery and mandibular fibula free-flap reconstruction for OCSCC were enrolled in this retrospective study. Predictive factors of oncologic and functional outcomes were assessed in univariate and multivariate analysis. 77 patients (55 men and 22 women, mean age 62 ± 10.6 years) were enrolled in this study. Free-flap failure and local and general complication rates were 9, 31, and 22 %, respectively. In multivariate analysis, ASA score (p = 0.002), pathologic N-stage (p = 0.01), and close surgical margins (p = 0.03) were independent predictors of overall survival. Six months after therapy, oral diet, speech intelligibility, and mouth opening functions were normal or slightly impaired in, respectively, 79, 88, and 83 % of patients. 6.5 % of patients remaining dependent on enteral nutrition 6 months after therapy. With acceptable postoperative outcomes and satisfactory oncologic and functional results, segmental mandibulectomy with fibula free-flap reconstruction should be considered the gold standard primary treatment for patients with OCSCC invading mandible bone. Oncologic outcomes are dependent on three main factors: ASA score, pathologic N-stage, and surgical margin status.

PROXIMAL FEMURAL VALGUS SUBTROCHANTERIC OSTEOTOMY FOR NON UNION OF TROCHANTERIC FRACTURES.

Science.gov (United States)

Silva, Paulo; Coelho, Danilo Lopes; Curi, Calim; de Oliveira, Leandro Alves; de Moraes, Frederico Barra; do Amaral, Rogério Andrade; Rebello, Percival Rosa

2012-01-01

To evaluate valgus subtrochanteric osteotomy for the treatment of trochanteric non-union. A retrospective study of cases series. From 1998 September to 2009 January, seventeen (17) cases with a diagnosis of non-union of trochanteric fracture were re-operated by the hip group of the Ortophaedic And Traumatology service of the Hospital Geral de Goiania (HGG). The patients presented pain at the fracture site, a femoral varus angle of less than 120°, and non-union of the fracture in the 3(rd) months after the initial surgery. Patients with ages ranging from 30 to 73 years, with a maximum follow-up of 09 years and minimum of 09 years. The mean time from first surgery to osteotomy was six months. Bone union was observed in 16 patients, with a mean union time of 12 weeks after surgery. The mean hip varus angle was 105(0) (120(0) to 90(0)). After surgery, the mean hip valgus angle was 144(0) (155(0) to 135(0)). We had one unsuccessful case; a 78-year old patient who had osteogtomy, fixed with DHS of 150(0), with valgization to 154(0). After six months of follow-up without union of the fracture, it was decided to perform total cemented hip artroplasthy, without complications. Valgus subtrochanteric osteotomies can be indicated for the treatment of trochanteric treatment of pseudoarthroses, with good final results for bone union, avoiding the need for total hip artroplasthy and maintaining biological fixation, as well as reestablishing the mechanical and anatomical axis of the affected limb.

Correction of a mandibular asymmetry after fibula reconstruction using a custom-made polyetheretherketone (PEEK) onlay after implant supported occlusal rehabilitation.

Science.gov (United States)

Berrone, M; Aldiano, C; Pentenero, M; Berrone, S

2015-10-01

This study describes an unusual case of mandibular asymmetry after fibula free flap reconstruction in a young man following major facial trauma that was corrected using a custom-made polyetheretherketone prosthesis. There is little information in the literature on the use of alloplasts to correct mandibular asymmetry as interest in 'aesthetic re-modelling' has traditionally focused on nasal, zygomatic and chin regions. This report demonstrates that this technique can be used successfully to address selected cases of mandibular asymmetry.

Changes in patellofemoral alignment do not cause clinical impact after open-wedge high tibial osteotomy.

Science.gov (United States)

Lee, Yong Seuk; Lee, Sang Bok; Oh, Won Seok; Kwon, Yong Eok; Lee, Beom Koo

2016-01-01

The objectives of this study were (1) to evaluate the clinical and radiologic outcomes of open-wedge high tibial osteotomy focusing on patellofemoral alignment and (2) to search for correlation between variables and patellofemoral malalignment. A total of 46 knees (46 patients) from 32 females and 14 males who underwent open-wedge high tibial osteotomy were included in this retrospective case series. Outcomes were evaluated using clinical scales and radiologic parameters at the last follow-up. Pre-operative and final follow-up values were compared for the outcome analysis. For the focused analysis of the patellofemoral joint, correlation analyses between patellofemoral variables and pre- and post-operative weight-bearing line (WBL), clinical score, posterior slope, Blackburn Peel ratio, lateral patellar tilt, lateral patellar shift, and congruence angle were performed. The minimum follow-up period was 2 years and median follow-up period was 44 months (range 24-88 months). The percentage of weight-bearing line was shifted from 17.2 ± 11.1 to 56.7 ± 12.7%, and it was statistically significant (p patellofemoral malalignment, the pre-operative weight-bearing line showed an association with the change in lateral patellar tilt and lateral patellar shift (correlation coefficient: 0.3). After open-wedge high tibial osteotomy, clinical results showed improvement, compared to pre-operative values. The patellar tilt and lateral patellar shift were not changed; however, descent of the patella was observed. Therefore, mild patellofemoral problems should not be a contraindication of the open-wedge high tibial osteotomy. Case series, Level IV.

The Rabbit Stream Cipher

DEFF Research Database (Denmark)

Boesgaard, Martin; Vesterager, Mette; Zenner, Erik

2008-01-01

The stream cipher Rabbit was first presented at FSE 2003, and no attacks against it have been published until now. With a measured encryption/decryption speed of 3.7 clock cycles per byte on a Pentium III processor, Rabbit does also provide very high performance. This paper gives a concise...... description of the Rabbit design and some of the cryptanalytic results available....

Posterior Femoral Single Limb Osteotomy for the Removal of Well-Fixed Modular Femoral Neck Components

Directory of Open Access Journals (Sweden)

Keith A Fehring

2017-07-01

Full Text Available Modular neck femoral components were introduced to optimize femoral neck anteversion, leg length, offset, and stability in total hip arthroplasty. However, concerns have been raised in recent years regarding early failure of these implants due to corrosion, pseudotumor, as well as fracture of the modular neck. Removing modular neck femoral implants is challenging as removal of the modular femoral neck leaves a proximally coated femoral stem level with the proximal bone of the femoral neck. We describe a posterior femoral single limb osteotomy  (posterior cut of an extended trochanteric osteotomy for the removal of a modular neck femoral component.

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.

Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

DEFF Research Database (Denmark)

Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen

2010-01-01

We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4....../3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...

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.

What factors predict failure 4 to 12 years after periacetabular osteotomy?

DEFF Research Database (Denmark)

Hartig-Andreasen, Charlotte; Troelsen, Anders; Thillemann, Theis Muncholm

2012-01-01

The goal of periacetabular osteotomy (PAO) is to delay or prevent osteoarthritic development in dysplastic hips. However, it is unclear whether the surgical goals are achieved and if so in which patients. This information is essential to select appropriate patients for a durable PAO that achieves...

Can Double Osteotomy Be a Solution for Adult Hallux Valgus Deformity With an Increased Distal Metatarsal Articular Angle?

Science.gov (United States)

Park, Chul Hyun; Cho, Jae Ho; Moon, Jeong Jae; Lee, Woo Chun

2016-01-01

No previous study has reported the results of double metatarsal osteotomy for adult hallux valgus deformity with an increased distal metatarsal articular angle (DMAA). The purpose of the present study was to evaluate the results after double metatarsal osteotomy in adult patients with incongruent hallux valgus deformity. We retrospectively reviewed 16 cases of consecutive first metatarsal double metatarsal osteotomy without lateral soft tissue release in 14 patients with symptomatic hallux valgus associated with an increased DMAA (≥15° after proximal chevron osteotomy on intraoperative radiographs). Clinical results were assessed using the American Orthopaedic Foot and Ankle Society scale and the visual analog scale. The radiographic results were assessed over time, and changes in the DMAA and the relative length of the first metatarsal were assessed by measuring each value preoperatively and at the last follow-up visit. The American Orthopaedic Foot and Ankle Society and visual analog scale scores were significantly improved after surgery. The hallux valgus angle and intermetatarsal angle were stabilized >3 months after surgery. The sesamoid position did not increase significantly beyond the immediate postoperative period. The mean DMAA was corrected from 21.6° (range 15° to 29°) preoperatively to 11.1° (range -2° to 17°) at the last follow-up visit. The mean amount of shortening of the first metatarsal after surgery was 5.5 (range 4 to 7) mm. In conclusion, double metatarsal osteotomy without lateral soft tissue release in adult hallux valgus deformity results in high postoperative recurrence and complication rates. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Proximal fibular osteotomy: a new surgery for pain relief and improvement of joint function in patients with knee osteoarthritis.

Science.gov (United States)

Wang, Xiaohu; Wei, Lei; Lv, Zhi; Zhao, Bin; Duan, Zhiqing; Wu, Wenjin; Zhang, Bin; Wei, Xiaochun

2017-02-01

Objective To explore the effects of proximal fibular osteotomy as a new surgery for pain relief and improvement of medial joint space and function in patients with knee osteoarthritis. Methods From January 2015 to May 2015, 47 patients who underwent proximal fibular osteotomy for medial compartment osteoarthritis were retrospectively followed up. Preoperative and postoperative weight-bearing and whole lower extremity radiographs were obtained to analyse the alignment of the lower extremity and ratio of the knee joint space (medial/lateral compartment). Knee pain was assessed using a visual analogue scale, and knee ambulation activities were evaluated using the American Knee Society score preoperatively and postoperatively. Results Medial pain relief was observed in almost all patients after proximal fibular osteotomy. Most patients exhibited improved walking postoperatively. Weight-bearing lower extremity radiographs showed an average increase in the postoperative medial knee joint space. Additionally, obvious correction of alignment was observed in the whole lower extremity radiographs in 8 of 47 patients. Conclusions The present study demonstrates that proximal fibular osteotomy effectively relieves pain and improves joint function in patients with medial compartment osteoarthritis at a mean of 13.38 months postoperatively.

Planning corrective osteotomy of the femoral bone using three-dimensional modeling. Part II

Directory of Open Access Journals (Sweden)

Vladimir E. Baskov

2017-10-01

Full Text Available Introduction. Three-dimensional (3D modeling and prototyping are increasingly being used in various branches of surgery for planning and performing surgical interventions. In orthopedics, this technology was first used in 1990 for performing knee-joint surgery. This was followed by the development of protocols for creating and applying individual patterns for navigation in the surgical interventions for various bones. Aim. The study aimed to develop a new 3D method for planning and performing corrective osteotomy of the femoral bone using an individual pattern and to identify the advantages of the proposed method in comparison with the standard method of planning and performing surgical intervention. Materials and methods. A new method for planning and performing corrective osteotomy of the femoral bone in children with various pathologies of the hip joint is presented. The outcomes of planning and performing corrective osteotomy of the femoral bone in 27 patients aged 5 to 18 years (32 hip joints with congenital and acquired deformity of the femoral bone were analyzed. Conclusion. The use of computer 3D modeling for planning and implementing corrective interventions on the femoral bone improves the treatment results owing to an almost perfect performance accuracy achieved by the minimization of possible human errors reduction in the surgery duration; and reduction in the radiation exposure for the patient.

Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.

Science.gov (United States)

Strbac, Georg D; Schnappauf, Albrecht; Giannis, Katharina; Moritz, Andreas; Ulm, Christian

2017-03-01

Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection. A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach. This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth. The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

RabbitMQ essentials

CERN Document Server

Dossot, David

2014-01-01

This book is a quick and concise introduction to RabbitMQ. Follow the unique case study of Clever Coney Media as they progressively discover how to fully utilize RabbitMQ, containing clever examples and detailed explanations.Whether you are someone who develops enterprise messaging products professionally or a hobbyist who is already familiar with open source Message Queuing software and you are looking for a new challenge, then this is the book for you. Although you should be familiar with Java, Ruby, and Python to get the most out of the examples, RabbitMQ Essentials will give you the push y

The treatment of an unstable slipped capital femoral epiphysis by either intracapsular cuneiform osteotomy or pinning in situ: a comparative study.

Science.gov (United States)

Walton, R D M; Martin, E; Wright, D; Garg, N K; Perry, D; Bass, A; Bruce, C

2015-03-01

We undertook a retrospective comparative study of all patients with an unstable slipped capital femoral epiphysis presenting to a single centre between 1998 and 2011. There were 45 patients (46 hips; mean age 12.6 years; 9 to 14); 16 hips underwent intracapsular cuneiform osteotomy and 30 underwent pinning in situ, with varying degrees of serendipitous reduction. No patient in the osteotomy group was lost to follow-up, which was undertaken at a mean of 28 months (11 to 48); four patients in the pinning in situ group were lost to follow-up, which occurred at a mean of 30 months (10 to 50). Avascular necrosis (AVN) occurred in four hips (25%) following osteotomy and in 11 (42%) following pinning in situ. AVN was not seen in five hips for which osteotomy was undertaken > 13 days after presentation. AVN occurred in four of ten (40%) hips undergoing emergency pinning in situ, compared with four of 15 (47%) undergoing non-emergency pinning. The rate of AVN was 67% (four of six) in those undergoing pinning on the second or third day after presentation. Pinning in situ following complete reduction led to AVN in four out of five cases (80%). In comparison, pinning in situ following incomplete reduction led to AVN in 7 of 21 cases (33%). The rate of development of AVN was significantly higher following pinning in situ with complete reduction than following intracapsular osteotomy (p = 0.048). Complete reduction was more frequent in those treated by emergency pinning and was strongly associated with AVN (p = 0.005). Non-emergency intracapsular osteotomy may have a protective effect on the epiphyseal vasculature and should be undertaken with a delay of at least two weeks. The place of emergency pinning in situ in these patients needs to be re-evaluated, possibly in favour of an emergency open procedure or delayed intracapsular osteotomy. Non-emergency pinning in situ should be undertaken after a delay of at least five days, with the greatest risk at two and three days after

Operative treatment of hallux valgus – the effect of three osteotomy types on the first metatarsal, hallux valgus and metatarsal distal articulation angles

Directory of Open Access Journals (Sweden)

Andrej Prlja

2007-11-01

Full Text Available Background: Modern approach to hallux valgus deformations enables not only the stage treatment considering the magnitude of the deformity but also the objective evaluation of the results.We investigated the influence of the three most commonly used osteotomies on three most common demonstrative factors, especially proximal osteotomy on the distal metatasal articulation angle.Methods: Three groups were created regarding the magnitude of the deformation. X rays of 15 corrections in each group were reviewed (45 cases, 34 women, 2 men. Each group was treated with only one of the three osteotomies: distal chevron osteotomy (Ch, distal chevron osteotomy with medial edge (ChM and proximal osteotomy (POT. The effect on the three most comonly used demonstrative factors were noted: first intermetatarsal angle (IM, hallux valgus angle (HV, distal metatarsal articulation angle (DMAA. The age and the demonstrative factors were compared pre- and postoperative, in and between the groups.Results: The correct, graded selection of the patients for the treatment was confirmed and false negative results excluded. Preoperative values of HV and DMAA are significantely different between three groups (p < 0.001 while IM are not (p = 0.118. Postoperative values of the HV and IM are significantely lower in all three groups (p < 0.001. DMAA is statisticaly different (positive postoperatively in the ChM group (p < 0.001 but not in the Ch and POT groups (P = 0.398; p = 0.456.Conclusions: Modern approach on hallux valgus deformations enables stage treatment and objective evaluation of the results what is demonstrated by the effect of the osteotomies on the demonstrative factors. Further investigations of the factors not yet considered or even unknown are also possible as shown on the example of the difference between the expected and measured effect of POT on DMAA.

Serological Survey for RHD Antibodies in Rabbits from Two Types of Rabbit Breeding Farms.

Science.gov (United States)

Fitzner, A; Niedbalski, W

2016-09-01

Seroprevalence studies of RHDV antibodies in domestic rabbits were conducted between 2008-2014. A total of 12,169 sera from the provinces of central, southern and south-east Poland, including 7,570 samples collected from mixed-breed rabbits reared in smallholder farms and nearly 4,600 sera taken mainly from unvaccinated rabbits kept in industrial farms, were examined using ELISA tests. Additionally, cross-reactivity of selected tested and control archival sera using both classic RHDV and RHDVa antigens was determined by HI assay. The overall seroprevalence was 13.3%. In rabbits with unkown history of immunisation or RHD infection which came from small farms, RHDV antibodies were detected in 6.1% ranging between 1.0% to 17.2% of animals. In rabbits of the same group, but with a declared vaccination status, or confirmed exposure to an infectious virus, or coming from exposed females, the seroprevalence ranged from 83% to 100%. Among unvaccinated meat rabbits aged 71 to 90 days from industrial farms, low (1.85%, 4.17%, 11%), medium (34%, 54%) or high rates (98.7%) of seropositivity were detected. The seroconversion recorded in adult vaccinated females from industrial farms was 70% and 95%. Generally, the antibody levels examined by ELISAs and HI were comparable. However, a number of sera from the rabbits from small farms, as well as archival sera, showed clear differences. Several-fold differences in antibody titers, evidenced mainly in the postoutbreak sera, indictaed the contact of animals with RHDVa antigen. The overall results of the survey revealed a great proportion of seronegative rabbits potentially highly susceptible to RHD infection. In combination with the emergence of a novel pathogenic RHD virus type (RHDV2), it poses a severe risk of a next wave of fatal disease cases spreading in the native population of domestic rabbits, especially in farms with a traditional system of husbandry.

Biomechanical analysis of the effect of occlusal force on osteosynthesis following sagittal split ramus osteotomy

International Nuclear Information System (INIS)

Okuda, Katsuya; Nakajima, Masahiro; Kakudo, Kenji

2009-01-01

Relapse is sometimes observed during the postoperative course following sagittal split ramus osteotomy which is widely used to correct jaw deformities. Relapse may be caused by biomechanical factors such as the postoperative occlusal force. We evaluated serial changes in the stress distribution associated with postoperative occlusal force and jaw-closing pressure on the mandible and osteosynthesis plate using three-dimensional finite element analysis. Based on CT data, we produced mandibular models 1, 3, 6, and 12 months after sagittal split ramus osteotomy, and subjected them to simulated occlusal force and jaw-closing pressure. Changes in equivalent stress in the proximal and distal segments, at the osteosynthesis site, and the fixation plate were evaluated by three-dimensional finite element analysis. The equivalent stresses in the proximal and distal segments slightly increased over time from 1 to 12 months after the operation. In particular, marked stress concentration was observed at the anterior border of the ramus at each measurement area. Stress at the osteosynthesis site increased from 1 to 6 months after the operation, but decreased after 12 months. As a result of postoperative occlusal forces and jaw-closing pressure, stress was concentrated at the anterior border of the ramus in the proximal segment. Between 3 and 6 months after the operation, tensile stress was concentrated at the upper and lower ends of the osteotomy line at the osteosynthesis site. These biomechanical findings indicate the application of clockwise stress on the distal segment up to 6 months after the operation. We concluded that sagittal split ramus osteotomy runs the risk of relapse between 3 and 6 months after the operation. (author)

Minimally invasive (MIS) Tönnis osteotomy- A technical annotation and review of short term results.

Science.gov (United States)

Balakumar, Balasubramanian; Racy, Malek; Madan, Sanjeev

2018-03-01

We detail a modified single incision approach to perform the Tonnis triple pelvic osteotomy by a minimally invasive approach. 12 children underwent minimally invasive Tonnis Osteotomy. There were five boys and seven girls in this study group. Average age was 11 years (9-15 years) at the time of surgery. Mean follow-up was 20.5 months (13-39 months). The average preoperative Antero-Posterior (AP) Centre Edge (CE) angle was -8.8° (-38.6°-18°), the average post-operative AP CE angle was 29.7° (25.1°-43.7°). The average preoperative lateral CE angle was -4.7° (-16°-0°), the average postoperative Lateral CE angle was 28.5° (21.3°-37.4°). The Sharp's angle before and after surgery were 55.7° (51.3°-66°) and 32.4° (16.1°-40.1°) respectively. The mean Tönnis angle before and after the osteotomy were 28.86° (19.7°-43.4°) and 6.3° (0.5°-9.4°) respectively. There was one major complication with sciatic nerve palsy which is in the recovery phase on followup and six minor complications including two cases of transient lateral femoral cutaneous nerve injury, two cases of ischial non-union, over granulation of the wound in one case, and metalwork irritation in one case. We have described a minimally invasive Tonnis osteotomy as a viable option based on our results. This technique is recommended for those who are conversant with the traditional pelvicosteotomies.

Segmental osteotomies of the maxilla.

Science.gov (United States)

Rosen, H M

1989-10-01

Multiple segment Le Fort I osteotomies provide the maxillofacial surgeon with the capabilities to treat complex dentofacial deformities existing in all three planes of space. Sagittal, vertical, and transverse maxillomandibular discrepancies as well as three-dimensional abnormalities within the maxillary arch can be corrected simultaneously. Accordingly, optimal aesthetic enhancement of the facial skeleton and a functional, healthy occlusion can be realized. What may be perceived as elaborate treatment plans are in reality conservative in terms of osseous stability and treatment time required. The close cooperation of an orthodontist well-versed in segmental orthodontics and orthognathic surgery is critical to the success of such surgery. With close attention to surgical detail, the complication rate inherent in such surgery can be minimized and the treatment goals achieved in a timely and predictable fashion.

Cost, operation and hospitalization times in distraction osteogenesis versus sagittal split osteotomy

NARCIS (Netherlands)

van Strijen, P. J.; Breuning, K. H.; Becking, A. G.; Perdijk, F. B. T.; Tuinzing, D. B.

2003-01-01

Distraction osteogenesis in 'common' surgical orthodontics is mentioned as an alternative for conventional sagittal split osteotomy. After a 'learning curve' in the surgical skills of distraction, the two techniques can be compared concerning time and cost aspects. Forty-seven patients (male n=28,

Simple Additive Weighting to Diagnose Rabbit Disease

Science.gov (United States)

Ramadiani; Marissa, Dyna; Jundillah, Muhammad Labib; Azainil; Hatta, Heliza Rahmania

2018-02-01

Rabbit is one of the many pets maintained by the general public in Indonesia. Like other pet, rabbits are also susceptible to various diseases. Society in general does not understand correctly the type of rabbit disease and the way of treatment. To help care for sick rabbits it is necessary a decision support system recommendation diagnosis of rabbit disease. The purpose of this research is to make the application of rabbit disease diagnosis system so that can help user in taking care of rabbit. This application diagnoses the disease by tracing the symptoms and calculating the recommendation of the disease using Simple Additive Weighting method. This research produces a web-based decision support system that is used to help rabbit breeders and the general public.

A Modified Technique of Fixation for Proximal Femoral Valgus Osteotomy in Abnormal Bone: A Report of Two Cases

Directory of Open Access Journals (Sweden)

Logheswaren S

2017-07-01

Full Text Available The ideal size of intramedullary device to fix corrective osteotomy of proximal femur in abnormal bone in children and small patients may not be easily available. We report the successful use of Rush rod in combination with multiple Kirschner wires to fix the corrective osteotomy of coxa vara and shepherd crook deformity in two patients with osteogenesis imperfecta and fibrous dysplasia. The union was achieved on time, neck shaft angle and rotation were maintained.

Varus femoral osteotomy improves sphericity of the femoral head in older children with severe form of Legg-Calvé-Perthes disease.

Science.gov (United States)

Terjesen, Terje; Wiig, Ola; Svenningsen, Svein

2012-09-01

In the Norwegian prospective study on Legg-Calvé-Perthes disease (LCPD), we found varus femoral osteotomy gave better femoral head sphericity at a mean of 5 years postoperative than physiotherapy in children older than 6.0 years at diagnosis with femoral head necrosis of more than 50%. That study did not include separate analyses for hips with 100% necrosis and those with a percentage of necrosis between 50% and 100%. We asked whether (1) femoral osteotomy improves femoral head sphericity at followup in all patients with more than 50% femoral head necrosis or in selected groups only and (2) there is a critical age between 6.0 and 10.0 years over which femoral osteotomy does not improve the prognosis. We treated 70 patients with unilateral LCPD, age at diagnosis of more than 6.0 years, and femoral head necrosis of more than 50% with varus femoral osteotomy between 1996 and 2000. We classified necrosis using the Catterall classification. We established a control group of 51 similar children who received physiotherapy. At the 5-year followup visit, the hips were graded according to femoral head shape: spherical, ovoid, or flat. At 5-year followup, there was no difference between the treatment groups in radiographic outcome in Catterall Group 3 hips. In Catterall Group 4 hips, femoral head sphericity was better in the osteotomy group, with flat femoral heads in 14% compared to 75% after physiotherapy. The same trend toward better head sphericity occurred when the lateral pillar classification was used. In children aged 6.0 to 10.0 years, in whom the whole femoral head is affected, femoral head sphericity 5 years after femoral osteotomy was better than that after physiotherapy.

Anterior versus posterior approach in reconstruction of infected nonunion of the tibia using the vascularized fibular graft: potentialities and limitations.

Science.gov (United States)

Amr, Sherif M; El-Mofty, Aly O; Amin, Sherif N

2002-01-01

the anterior aspect of the bone lest it should become devitalized. Any exposed bone on the anterior aspect should be left to granulate alone. This occurs readily when stability has been regained at the fracture site after transfer of the free fibula. The popliteal and posterior tibial vessels are exposed, and the microvascular anastomosis placed in an end-to-side fashion onto either of them, depending on the length of the pedicle and the condition of the vessels themselves. To obtain the maximal length of the pedicle of the graft, the proximal osteotomy is placed at the neck of the fibula after decompressing the peroneal nerve. The distal osteotomy is placed as distally as possible. After detaching the fibula from the donor site, the proximal part of the graft is stripped subperiosteally, osteotomized, and discarded. Thus, a relatively long pedicle could be obtained. To facilitate subperiosteal stripping, the free fibula is harvested without a skin paddle. In this way, the use of a vein graft could be avoided. Patients presenting with infected nonunions of the tibia with extensive scarring of the lower extremity, excessively large areas of skin loss, and with questionable patency of the anterior and posterior tibial vessels are not suitable candidates for the free vascularized fibular graft. Although a vein graft could be used between the recipient popliteal and the donor peroneal vessels, its use decreases flow to the graft considerably. These patients are better candidates for the Ilizarov bone transport method with or without free latissimus dorsi transfer. Copyright 2002 Wiley-Liss, Inc.

Multiple Osteochondral Allograft Transplantation with Concomitant Tibial Tubercle Osteotomy for Multifocal Chondral Disease of the Knee.

Science.gov (United States)

Cotter, Eric J; Waterman, Brian R; Kelly, Mick P; Wang, Kevin C; Frank, Rachel M; Cole, Brian J

2017-08-01

Symptomatic patellofemoral chondral lesions are a challenging clinical entity, as these defects may result from persistent lateral patellar maltracking or repetitive microtrauma. Anteromedializing tibial tubercle osteotomy has been shown to be an effective strategy for primary and adjunctive treatment of focal or diffuse patellofemoral disease to improve the biomechanical loading environment. Similarly, osteochondral allograft transplantation has proven efficacy in physiologically young, high-demand patients with condylar or patellofemoral lesions, particularly without early arthritic progression. The authors present the surgical management of a young athlete with symptomatic tricompartmental focal chondral defects with fresh osteochondral allograft transplantation and anteromedializing tibial tubercle osteotomy.

Axial loading screw fixation for chevron type osteotomies of the distal first metatarsal: a retrospective outcomes analysis.

Science.gov (United States)

Murphy, Ryan M; Fallat, Lawrence M; Kish, John P

2014-01-01

The distal chevron osteotomy is a widely accepted technique for the treatment of hallux abductovalgus deformity. Although the osteotomy is considered to be stable, displacements of the capital fragment has been described. We propose a new method for fixation of the osteotomy involving the axial loading screw (ALS) used in addition to single screw fixation. We believe this method will provide a more mechanically stable construct. We reviewed the charts of 46 patients in whom 52 feet underwent a distal chevron osteotomy that was fixated with either 1 screw or 2 screws that included the ALS. We hypothesized that the ALS group would have fewer displacements and would heal more quickly than the single screw fixation group. We found that the group with ALS fixation had healed at a mean of 6.5 weeks and that the group with single screw fixation had healed at 9.53 weeks (p = .001). Also, 8 cases occurred of displacement of the capital fragment in the single screw, control group compared with 2 cases of displacement in the ALS group. However, this finding was not statistically significant. The addition of the ALS to single screw fixation allowed the patients to heal approximately 3 weeks earlier than single screw fixation alone. The ALS is a fixation option for the surgeon to consider when osseous correction of hallux abducto valgus is performed. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[Double Osteotomy of the First Metatarsal for Treatment of Juvenile Hallux Valgus Deformity - Our Experience].

Science.gov (United States)

Jochymek, J; Peterková, T

2016-01-01

The aim of the study was to evaluate the mid-term results in a group of selected patients undergoing corrective surgery for juvenile hallux valgus, using double osteotomy of the first metatarsal. The group included eight patients, seven girls and one boy, with a more severe form of this deformity treated by double osteotomy of the first metatarsal between 2010 and 2013. The indication for corrective surgery was serious pain when walking; all patients had previously undergone conservative treatment with no effect. All patients had pre-operative clinical examination, the affected foot was X-rayed with the patient standing and radiographic assessments of the intermetatarsal and hallux valgus angles were made. The evaluation of treatment outcomes was based on the scoring system of the American Orthopaedic Foot and Ankle Society (AOFAS) and X-ray images of the foot. The average follow-up was 37 months. Post-operatively, none of the patients reported pain while walking, only two of them experienced pain during sports activities. The average post-operative AOFAS score was 92 points. Both the intermetatarsal angle and the hallux valgus angle improved after surgery in all patients, with two reporting only mild hallux valgus deformity. One patient showed postoperative restriction of motion at the first metatarsophalangeal joint. This was the only complication recorded in association with the surgery. Almost all authors dealing with the treatment of hallux valgus deformity primarily prefer conservative therapy. However, this treatment is usually not very effective in severe forms of the disorder. Surgical management is indicated in symptomatic patients or in those with severe juvenile hallux valgus deformity. In paediatric patients it is necessary to respect the presence of an epiphyseal growth plate in the first proximal metatarsal and therefore it is often preferred to use distal first metatarsal osteotomy. At our department, Mitchell's osteotomy for hallux valgus deformity

Simple Additive Weighting to Diagnose Rabbit Disease

Directory of Open Access Journals (Sweden)

Ramadiani

2018-01-01

Full Text Available Rabbit is one of the many pets maintained by the general public in Indonesia. Like other pet, rabbits are also susceptible to various diseases. Society in general does not understand correctly the type of rabbit disease and the way of treatment. To help care for sick rabbits it is necessary a decision support system recommendation diagnosis of rabbit disease. The purpose of this research is to make the application of rabbit disease diagnosis system so that can help user in taking care of rabbit. This application diagnoses the disease by tracing the symptoms and calculating the recommendation of the disease using Simple Additive Weighting method. This research produces a web-based decision support system that is used to help rabbit breeders and the general public.

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

Computer assistance in femoral derotation osteotomy: a bottom-up approach

Directory of Open Access Journals (Sweden)

Auer Christoph

2016-09-01

Full Text Available Severe gait abnormalities in patients with cerebral palsy are often treated by correction osteotomy. The established procedure of femoral derotation osteotomy (FDO has proven effective to realign femur anteversion. Nevertheless, studies have revealed that therapy outcome is subject to substantial inter-patient variability and systematic loss of correction. Our previous work suggests that practical limitations in FDO may significantly contribute to this effect. In this work, we propose a novel computer assisted measurement system to support FDO with objective measurement (desired accuracy: ∼ ± 3° and continuous monitoring of derotation. A prototype system based on the clinically emerging electromagnetic tracking technology is demonstrated which incorporates technical and operational considerations to enable continuous measurement in OR conditions while preserving the conventional workflow without disruptions. In phantom studies, the achieved measurement accuracy (standard error ≅±1.6∘$\\cong\\pm 1.6{}^{\\circ}$ proved high potential and may hugely benefit the quality of surgical execution. Currently, the prototype system is assessed under OR conditions in an in-vivo study with CP patients. Early experience shows high appreciation among surgeons and good potential for future application.

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

OpenAIRE

Zhou, Haichao; Ren, Haoyang; Li, Chunguang; Xia, Jiang; Yu, Guangrong; Yang, Yunfeng

2017-01-01

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...

Assessment of pterygomaxillary separation in Le Fort I Osteotomy in class III patients.

Science.gov (United States)

Ueki, Koichiro; Hashiba, Yukari; Marukawa, Kohei; Okabe, Katsuhiko; Alam, Shamiul; Nakagawa, Kiyomasa; Yamamoto, Etsuhide

2009-04-01

To examine the separation of the pterygomaxillary region at the posterior nasal spine level after Le Fort I osteotomy in Class III patients. The study group consisted of 37 Japanese patients with mandibular prognathism and asymmetry, with maxillary retrognathism or asymmetry. A total of 74 sides were examined. Le Fort I osteotomy was performed without a pterygoid osteotome, with an ultrasonic curette used to remove interference at the pterygomaxillary region. Postoperative computed tomography (CT) was analyzed for all patients. The separation of the pterygomaxillary region and the location of the descending palatine artery were assessed. Although acceptable separation between the maxilla and pterygoid plates was achieved in all patients, an exact separation of the pterygomaxillary junction at the posterior nasal spine level was found in only 18 of 74 sides (24%). In 29 of 74 sides (39.2%), the separation occurred anterior to the descending palatine artery. In 29 of 74 sides (39.2%), complete separation between the maxilla and lateral and/or medial pterygoid plate was not achieved, but lower level separation of the maxilla and pterygoid plate was always complete. The maxillary segments could be moved to the postoperative ideal position in all cases. Le Fort I osteotomy without an osteotome does not always induce an exact separation at the pterygomaxillary junction at the posterior nasal spine level, but the ultrasonic bone curette can remove the interference between maxillary segment and pterygoid plates more safely.

Use of steroids in rhinoplasty with lateral osteotomies for reducing post operative oedema

International Nuclear Information System (INIS)

Sanober, A.; Rashid, M.; Khan, M.I.; Rehman, S.U.; Fatima, S.; Hussain, A.

2018-01-01

Postoperative periorbital edema is a commonly encountered side effect of rhinoplasties in which lateral osteotomies have been incorporated. It dissatisfies the surgeon as well as the patient. Osteotomies are done at the end of all soft tissue manipulation to reduce the development of edema. The aim of this study was to determine the efficacy of intravenous dexamethasone in reducing edema in patients who undergo rhinoplasty with lateral osteotomies. Methods A Prospective randomized controlled trial was done at department of plastic and reconstructive surgery, Shifa International Hospital Islamabad. Sixty patients age between 16- 55 requiring open rhinoplasty were taken for this study and divided in two groups. One group received dexamethasone 8mg intravenously peroperatively and second dose 4 hours postoperatively. The second group did not receive anything. Both groups were assessed on first post operative day and 7th day for periorbital edema. Result The overall decrease in edema in patients who received steroid was by 50% while in control group was 33.3%. By the 7th day control group 13.3% patients had grade III edema as compared to 3.33% in steroid group. Chi test was applied and p value of 0.0289 was obtained which was found to be statistically very significant. Conclusion Dexamethasone used in minimal dosage showed significant advantage in reducing periorbital edema after rhinoplasty with no evidence of any side effects secondary to steroid administration. (author)

Biomechanical comparison between titanium and cobalt chromium rods used in a pedicle subtraction osteotomy model

Directory of Open Access Journals (Sweden)

Kalpit N. Shah

2018-03-01

Full Text Available Instrumentation failure is a common complication following complex spinal reconstruction and deformity correction. Rod fracture is the most frequent mode of hardware failure and often occurs at or near a 3-column osteotomy site. Titanium (Ti rods are commonly utilized for spinal fixations, however, theoretically stiffer materials, such as cobalt-chrome (CoCr rods are also available. Despite ongoing use in clinical practice, there is little biomechanical evidence that compares the construct ability to withstand fatigue stress for Ti and Co-Cr rods. Six models using 2 polyethylene blocks each were used to simulate a pedicle subtraction osteotomy. Within each block 6.0×45 mm polyaxial screws were placed and connected to another block using either two 6.0×100 mm Ti (3 models or CoCr rods (3 models. The rods were bent to 40° using a French bender and were secured to the screws to give a vertical height of 1.5 cm between the blocks. The blocks were fatigue tested with 700N at 4 Hz until failure. The average number of cycles to failure for the Ti rod models was 12840 while the CoCr rod models failed at a significantly higher, 58351 cycles (P=0.003. All Ti models experienced rod fracture as the mode of failure. Two out of the three CoCr models had rod fractures while the last sample failed via screw fracture at the screw-tulip junction. The risk of rod failure is substantial in the setting of long segment spinal arthrodesis and corrective osteotomy. Efforts to increase the mechanical strength of posterior constructs may reduce the occurrence of this complication. Utilizing CoCr rods in patients with pedicle subtraction osteotomy may reduce the rate of device failure during maturation of the posterior fusion mass and limit the need for supplemental anterior column support.

Coccidian and nematode infections influence prevalence of antibody to myxoma and rabbit hemorrhagic disease viruses in European rabbits.

Science.gov (United States)

Bertó-Moran, Alejandro; Pacios, Isabel; Serrano, Emmanuel; Moreno, Sacramento; Rouco, Carlos

2013-01-01

The interaction among several parasites in European rabbits (Oryctolagus cuniculus) is crucial to host fitness and to the epidemiology of myxomatosis and rabbit hemorrhagic disease. These diseases have caused significant reductions in rabbit populations on the Iberian Peninsula. Most studies have focused on the epidemiology and pathogenesis of these viruses individually, and little is known about interactions between these viruses and other parasites. Taking advantage of an experimental restocking program in Spain, the effects of coccidian and nematode infections on the probability of having detectable antibody to myxoma and rabbit hemorrhagic disease viruses were tested in European wild rabbits. For 14 mo, we monitored rabbit abundance and parasite loads (coccidia and nematodes) in three reintroduced rabbit populations. While coccidian and nematode loads explained seasonal antibody prevalences to myxoma virus, the pattern was less clear for rabbit hemorrhagic disease. Contrary to expectations, prevalence of antibody to myxoma virus was inversely proportional to coccidian load, while nematode load seemed to play a minor role. These results have implications for viral disease epidemiology and for disease management intended to increase rabbit populations in areas where they are important for ecosystem conservation.

Prostaglandin synthesis and catabolism in the gastric mucosa: studies in normal rabbits and rabbits immunized with prostaglandin E2

International Nuclear Information System (INIS)

Redfern, J.S.

1988-01-01

Antral and fundic mucosal homogenates obtained from prostaglandin E2-immunized rabbits converted 14C-arachidonic acid to prostaglandin E2, 6-keto prostaglandin F1 alpha, prostaglandin F2 alpha, and prostaglandin D2. Percentage conversion of 14C-arachidonic acid to these prostaglandin products was not significantly different in prostaglandin E2-immunized rabbits compared with control rabbits (thyroglobulin-immunized and unimmunized rabbits combined). Synthesis of 6-keto prostaglandin F1 alpha, prostaglandin E2 and 13,14-dihydro 15-keto prostaglandin E2 from endogenous arachidonic acid after vortex mixing fundic mucosal homogenates was similar in prostaglandin E2 immunized rabbits and control rabbits. Both in prostaglandin E2-immunized rabbits and controls, 3H-prostaglandin E2 was catabolized extensively by the fundic mucosa, whereas 3H-6-keto prostaglandin F1 alpha, 3H-prostaglandin F2 alpha, and 3H-prostaglandin D2 were not catabolized to any appreciable extent. The rate of catabolism of PGs was not significantly different in prostaglandin E2-immunized rabbits and control rabbits, with the exception of prostaglandin F2 alpha which was catabolized slightly more rapidly in prostaglandin E2-immunized rabbits. These results indicate that development of gastric ulcers in prostaglandin E2-immunized rabbits is not associated with an alteration in the capacity of the gastric mucosa to synthesize or catabolize prostaglandins

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.).

Dermatophytes in pet Guinea pigs and rabbits.

Science.gov (United States)

Kraemer, A; Mueller, R S; Werckenthin, C; Straubinger, R K; Hein, J

2012-05-25

The frequency of dermatophytes in pet Guinea pigs and rabbits. To determine the frequency and types of dermatophytes in pet Guinea pigs and rabbits. First, 2153 samples collected from pet Guinea pigs (n=1132) and rabbits (n=1021) with suspected dermatophytosis and submitted to three different laboratories for fungal culture were analysed. Subsequently, healthy Guinea pigs and rabbits, animals with skin lesions and with noncutaneous diseases were examined prospectively for dermatophytes. Trichophyton (T.) mentagrophytes was the most common fungal species isolated (91.6% and 72.3% of positive cultures from Guinea pigs (n=431) and rabbits (n=83), respectively). Animals with positive fungal culture did not show any gender predisposition, but affected animals were younger than those with negative fungal culture (PGuinea pigs and 0/140 healthy rabbits. In addition, fungal cultures of Guinea pigs with skin lesions (n=26) and other diseases (n=25) were positive in 7.7% and 8.0% respectively. Samples collected from 17 rabbits with skin lesions and 32 rabbits with noncutaneous disease were all negative in culture. T. mentagrophytes is the most common dermatophyte in pet Guinea pigs and rabbits, asymptomatic carriers are regularly seen in Guinea pigs, but not in rabbits. Copyright © 2011 Elsevier B.V. All rights reserved.

Evidence-Based Advances in Rabbit Medicine.

Science.gov (United States)

Summa, Noémie M; Brandão, João

2017-09-01

Rabbit medicine has been continuously evolving over time with increasing popularity and demand. Tremendous advances have been made in rabbit medicine over the past 5 years, including the use of imaging tools for otitis and dental disease management, the development of laboratory testing for encephalitozoonosis, or determination of prognosis in rabbits. Recent pharmacokinetic studies have been published, providing additional information on commonly used antibiotics and motility-enhancer drugs, as well as benzimidazole toxicosis. This article presents a review of evidence-based advances for liver lobe torsions, thymoma, and dental disease in rabbits and controversial and new future promising areas in rabbit medicine. Copyright © 2017 Elsevier Inc. All rights reserved.

The effects of Mandibular Osteotomy on articulation and resonance

Directory of Open Access Journals (Sweden)

Delsa Geffen

1978-11-01

Full Text Available Pre- and post-operative speech samples were studied in nine adult cases who received Mandibular Osteotomy. Lateral cephalograms were taken during sustained production of selected sounds and trained listeners judged recordings. In most cases there was an improvement in the general quality of the speech. Considering that the functional  relationships between the speech organs had altered, it would appear that some form of adaptation by the speaker had in fact taken place.

Modified Chevron osteotomy for hallux valgus deformity in female athletes. A 2-year follow-up study.

Science.gov (United States)

Giotis, Dimitrios; Paschos, Nikolaos K; Zampeli, Franceska; Giannoulis, Dionisios; Gantsos, Apostolos; Mantellos, George

2016-09-01

Hallux valgus is an increasingly common deformity in young female athletes that constricts their daily athletic activities and influences foot cosmesis. The aim of this study was to evaluate the outcome of modified Chevron osteotomy for hallux valgus deformity in this specific population. Forty-two cases of modified Chevron osteotomies were carried out in 33 patients with mild to moderate hallux valgus deformity. Each participant was evaluated for AOFAS score, pain, range of motion, cosmetic and radiological outcome. Mean AOFAS score improved to 96.3 (phallux valgus deformity in young female athletes, with excellent clinical outcome. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Is there a difference between hare syphilis and rabbit syphilis? Cross infection experiments between rabbits and hares

NARCIS (Netherlands)

Lumeij, J.T.|info:eu-repo/dai/nl/073286826; Mikalová, L.; Smajs, D.

2013-01-01

Abstract Cross infection of rabbits and hares with Treponema paraluiscuniculi from rabbits and the related microorganism from hares, which was provisionally named "Treponema paraluisleporis", revealed that T. paraluiscuniculi affects rabbits clinically, but only causes seroconversion in hares

How does ulnar shortening osteotomy influence morphologic changes in the triangular fibrocartilage complex?

Science.gov (United States)

Yamanaka, Yoshiaki; Nakamura, Toshiyasu; Sato, Kazuki; Toyama, Yoshiaki

2014-11-01

Ulnar shortening osteotomy often is indicated for treatment of injuries to the triangular fibrocartilage complex (TFCC). However, the effect of ulnar shortening osteotomy on the changes in shape of the TFCC is unclear. In our study, quantitative evaluations were performed using MRI to clarify the effect of ulnar shortening on triangular fibrocartilage (TFC) thickness attributable to disc regeneration of the TFC and TFC angle attributable to the suspension effect of ulnar shortening on the TFC. The purposes of this study were (1) to compare preoperative and postoperative TFC thickness and TFC angle on MR images to quantitatively evaluate the effect of ulnar shortening osteotomy on disc regeneration and the suspension effect on the TFC; and (2) to assess whether changes in TFC thickness and TFC angle correlated with the Mayo wrist score. Between 1995 and 2008, 256 patients underwent ulnar shortening osteotomy for TFCC injuries. The minimum followup was 24 months (mean, 51 months; range, 24-210 months). A total of 79 patients (31%) with complete followup including preoperative and postoperative MR images and the Mayo wrist score was included in this retrospective study. Evaluation of the postoperative MR images and the Mayo wrist score were performed at the final followup. The remaining 177 patients did not undergo postoperative MRI, or they had a previous fracture, large tears of the disc proper, or were lost to followup. Two orthopaedists, one of whom performed the surgeries, measured the TFC thickness and the TFC angle on coronal MR images before and after surgery for each patient. Correlations of the percent change in the TFC thickness and the magnitude of TFC angle change with age, sex, postoperative MR images, extent of ulnar shortening, preoperative ulnar variance, and postoperative Mayo wrist score were assessed. Stepwise regression analysis showed a correlation between the percent change in TFC thickness and preoperative ulnar variance (R2=0.21; β=-0.33; 95

Comparison of Clinical Outcomes of Scarf and Chevron Osteotomies and the McBride Procedure in the Treatment of Hallux Valgus Deformity

Directory of Open Access Journals (Sweden)

Mohammad Fakoor

2014-03-01

Full Text Available Background:   Hallux valgus deformity is a common chronic problem in middle age and elderly. Different surgical procedures have been introduced so far with their proposed indications for each. This study aimed to compare three   current procedures namely Chevron osteotomy, Scarf osteotomy and McBride technique.     Methods:   In this study, 44 patients were included from 2010 to 2013. All patients had been undergone one of the three current procedures including Chevron, Scarf or McBride techniques. Preoperative and follow-up radiographies     were evaluated in terms of hallux valgus and intermetatarsal angles. Foot Ankle Disability Index was filled to assess the functional. A Visual Analogue Scale evaluated pain. Also, satisfaction, aesthetic and the rate of recurrence were evaluated. Results:   Functional score, aesthetic and satisfaction level were higher in Scarf technique rather than Chevron and McBride techniques. Also, pain score and recurrence rate were lower in Scarf Technique rather the other two techniques.     Conclusions:   With respect to better results with Scarf osteotomy in this study, we recommend Scarf osteotomy as   a first choice for treatment of moderate hallux valgus deformity.

Low-intensity pulsed ultrasound increases bone volume, osteoid thickness and mineral apposition rate in the area of fracture healing in patients with a delayed union of the osteotomized fibula

NARCIS (Netherlands)

Rutten, S.; Nolte, P.A.; Korstjens, C.M.; van Duin, M.A.; Klein-Nulend, J.

2008-01-01

Introduction Low-intensity pulsed ultrasound (LIPUS) accelerates impaired fracture healing, but the exact mechanism is unknown. The aim of this study was to investigate how LIPUS affects bone healing at the tissue level in patients with a delayed union of the osteotomized fibula, by using histology

Unstable recent intracapsular femoral neck fractures in young adults: Osteosynthesis and primary valgus osteotomy using broad dynamic compression plate

Directory of Open Access Journals (Sweden)

Singh M

2008-01-01

Full Text Available Background: Displaced intracapsular femoral neck fractures continue to be a difficult problem to treat. Various treatment modalities and their modifications have been proposed to improve the outcome. Osteosynthesis and primary valgus angulation osteotomy is one of them. Technique and outcome in a consecutive series of recent intracapsular femoral neck fractures in young adults, from a single center, is presented. Materials and Methods: Fifty-five patients of recent (< 3 weeks old displaced intracapsular fracture neck femur (Garden III and IV, Pauwels III, with or without comminution in the age group 20-50 years (mean 35.4±10.4 years were subjected to osteosynthesis and primary valgus intertrochanteric osteotomy using contoured broad dynamic compression plate (DCP. The patients were followed up from two to six years (mean 4.6 years. Results: Fifty-one fractures united by six months of the index procedure (92.7% union range. Avascular necrosis (AVN developed in six patients (11%. The other complications were shortening (six, coxa vara (two, infection (two and delayed union at osteotomy site (one. Excellent results were achieved in 48, good/fair in four and poor in three patients. Conclusion: Osteosynthesis with cancellous screw and primary valgus intertrochanteric osteotomy stabilized by a contoured broad DCP is a simple, easy to perform, biological treatment. Failure in a particular case can be treated with any appropriate second procedure. Level of Evidence: IV

Complete Cranial Iliac Osteotomy to Approach the Lumbosacral Foramen

Directory of Open Access Journals (Sweden)

Barbara Dyall

2017-05-01

Full Text Available An approach using a complete cranial iliac osteotomy (CCIO to access the lumbosacral (LS foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS. The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina. In addition, there was lateral spondylosis with consequential stenosis of the right LS foramen. The right L7 nerve had lost its fat attenuation and appeared thickened. After a routine L7S1 dorsal laminectomy with a partial discectomy, a CCIO was performed, providing good access to the LS foramen and the adhesions around the proximal L7 nerve caudoventral to the foramen. The osteotomy was stabilized with a locking plate and a cerclage wire. The dog recovered well from the procedures and after 36 h, the dog walked normally and was discharged from the hospital. Eight and 16 weeks later, the signs of the DLSS had markedly improved. From these data, it can be concluded that the CCIO is a useful approach to the LS foramen and intervertebral disk in selected patients with DLSS, giving good access to the structures around the LS foramen.

Detection and localization of rabbit hepatitis e virus and antigen in systemic tissues from experimentally intraperitoneally infected rabbits.

Directory of Open Access Journals (Sweden)

Jingjing Mao

Full Text Available Rabbit hepatitis E virus (HEV is a novel genotype of HEV, and is considered to pose a risk of zoonotic transmission. Research into the systemic distribution of rabbit HEV in rabbits during different periods of infection has rarely been reported. To better understand this virus, we infected rabbits with second-passage rabbit HEV via an intraperitoneal route. After inoculation, the infection showed two types, temporary and constant infection. The detection of HEV RNA in the feces varied with time, and serum antigen correlated with fecal HEV RNA. Viremia only appeared 72 days after inoculation. The rabbits remained antibody negative throughout the experimental period. When HEV was localized, several organs besides the liver were HEV RNA positive. Tissue antigen was observed immunohistochemically in the different cells of various organs, especially in parts of the small intestine and the characteristic rabbit gut-associated lymphoid tissue. These data provide valuable information for future research into the pathogenesis of HEV.

Rabbit haemorrhagic disease: are Australian rabbits (Oryctolagus cuniculus) evolving resistance to infection with Czech CAPM 351 RHDV?

Science.gov (United States)

Elsworth, P G; Kovaliski, J; Cooke, B D

2012-11-01

Rabbit haemorrhagic disease is a major tool for the management of introduced, wild rabbits in Australia. However, new evidence suggests that rabbits may be developing resistance to the disease. Rabbits sourced from wild populations in central and southeastern Australia, and domestic rabbits for comparison, were experimentally challenged with a low 60 ID50 oral dose of commercially available Czech CAPM 351 virus - the original strain released in Australia. Levels of resistance to infection were generally higher than for unselected domestic rabbits and also differed (0-73% infection rates) between wild populations. Resistance was lower in populations from cooler, wetter regions and also low in arid regions with the highest resistance seen within zones of moderate rainfall. These findings suggest the external influences of non-pathogenic calicivirus in cooler, wetter areas and poor recruitment in arid populations may influence the development rate of resistance in Australia.

Various bio-mechanical factors affecting heat generation during osteotomy preparation: A systematic review.

Science.gov (United States)

Chauhan, Chirag J; Shah, Darshana N; Sutaria, Foram B

2018-01-01

As implant site preparation and bone are critical precursors to primary healing, thermal and mechanical damage to the bone must be minimized during the preparation of the implant site. Moreover, excessively traumatic surgery can adversely affect the maturation of bone tissue at the bone/implant interface and consequently diminish the predictability of osseointegration. So, this study was carried out to evaluate the various biological and mechanical factors responsible for heat generation during osteotomy site preparation to reduce the same for successful osseointegration of dental implants. A broad search of the dental literature in PubMed added by manual search was performed for articles published between 1992 and December 2015. Various bio-mechanical factors related to dental implant osteotomy preparation such as dental implant drill designs/material/wear, drilling methods, type of irrigation, and bone quality were reviewed. Titles and abstracts were screened and articles which fulfilled the inclusion criteria were selected for a full-text reading. The initial database search yielded 123 titles, of which 59 titles were discarded after reading the titles and abstracts, 30 articles were again excluded based on inclusion and exclusion criteria, and finally 34 articles were selected for data extraction. Many biological and mechanical factors responsible for heat generation were found. Literatures of this review study have indicated that there are various bio-mechanical reasons, which affect the temperature rise during osteotomy and suggest that the amount of heat generation is a multifactorial in nature and it should be minimized for better primary healing of the implant site.

First Metatarsophalangeal Contact Properties Following Proximal Opening Wedge and Scarf Osteotomies for Hallux Valgus Correction: A Biomechanical Study.

Science.gov (United States)

Kia, Cameron; Yoshida, Ryu; Cote, Mark; DiVenere, Jessica; Geaney, Lauren E

2017-04-01

Proximal opening wedge osteotomy (POWO) is an established procedure for moderate to severe hallux valgus. A common concern of this procedure is that it results in lengthening of the first metatarsal, which could cause increased intra-articular pressure of the first metatarsophalangeal joint (MTP) and may ultimately lead to arthritis because of these altered mechanics. The purpose of this study was to use a cadaveric model to compare intra-articular pressures and articulating contact properties of the MTP joint following either scarf osteotomy or POWO. Fresh-frozen cadaveric below-knee specimens with pre-existing hallux valgus (n = 12) and specimens without hallux valgus (n = 6, control group) were used. The hallux valgus specimens were stratified into 2 groups (n = 6 each): POWO or scarf osteotomy. The groups were matched based on the degree of deformity. Peak intra-articular pressure, force, and area were measured in all normal, preoperative, and postoperative specimens with a simulated weightbearing model. These measurements were made with a pressure transducer placed within the first MTP joint. Postoperatively POWO group had slightly higher contact forces and pressures compared to the scarf group and lower contact forces and pressures than those of the normal group but were not statistically significant ( P > .05). Normal specimens had higher intra-articular force, pressure, and area than postoperative specimens but the difference was not found to be significant. First metatarsal lengthening was found in both the scarf and POWO specimens; however, neither increase was found to be significant ( P > .05). The results from this study show that after operative correction, contact properties of the fist MTP joint among normal, POWO, and scarf osteotomy groups revealed no significant differences. First MTP joints in those with hallux valgus had significantly lower contact force and pressure compared to those without hallux valgus. With little long-term outcomes of

Subjective alveolar nerve function after bilateral sagittal split osteotomy or distraction osteogenesis of mandible

NARCIS (Netherlands)

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

2012-01-01

Purpose: The present retrospective cohort study compared the subjective inferior alveolar nerve (IAN) function after distraction osteogenesis (DOG) and bilateral sagittal split osteotomy (BSSO) in mandibular advancement surgery. Materials and Methods: Treatment consisted of correction of a

Subjective Alveolar Nerve Function After Bilateral Sagittal Split Osteotomy or Distraction Osteogenesis of Mandible

NARCIS (Netherlands)

Baas, Erik M.; Horsthuis, Roy B. G.; de Lange, Jan

2012-01-01

Purpose: The present retrospective cohort study compared the subjective inferior alveolar nerve (IAN) function after distraction osteogenesis (DOG) and bilateral sagittal split osteotomy (BSSO) in mandibular advancement surgery. Materials and Methods: Treatment consisted of correction of a

Rabbit haemorrhagic disease: advantages of cELISA in assessing immunity in wild rabbits (Oryctolagus cuniculus).

Science.gov (United States)

Zheng, Tao; Parkes, John P

2011-12-15

Rabbit haemorrhagic disease (RHD) is an acute fatal disease of domestic and wild European rabbits (Oryctolagus cuniculus) caused by RHD virus (RHDV). Accurate assessment of immunity is of great importance for the conservation and control of wild rabbits. We evaluated a competitive ELISA (cELISA) against isotype ELISAs for assessing the protective immunity against the disease by challenging 50 wild-caught rabbits with a lethal dose of RHDV. Death or survival to the challenge was used as a criterion to determine the performance characteristics of the assay for the assessment of immunity in rabbits. At 1:10 dilution, a serum exhibiting ≥ 25% inhibition (1:10(25)) was regarded as the presence of RHDV-specific antibodies. Eleven of 16 (68.8%) rabbits with antibodies at 1:10(25) (<1:40) died of RHD. When the cut-off was moved from 25% to 50% inhibition (1:10(50)) at 1:10 serum dilution, the assay sensitivity, specificity and accuracy for the protective immunity were improved from 84%, 54.2% and 69.4% to 84%, 100% and 91.8%, respectively. We also demonstrated at the epitope amino acid sequence level why the presence of the RHDV-cross reactive benign rabbit calicivirus, which interfered with isotype ELISAs, had little impact on the specificity of the cELISA for the diagnosis of RHDV infection. The presence of RHDV-specific antibody at 1:10(50) by the cELISA is a reliable indicator for the protective immunity. In contrast to isotype ELISAs, the cELISA is a valuable specific tool for monitoring the herd immunity to RHD for the conservation and management of wild rabbits in the field. Copyright © 2011 Elsevier B.V. All rights reserved.

High rabbit abundance proves detrimental to the population growth rate in European rabbit (Oryctolagus cuniculus L. extensive breeding enclosures

Directory of Open Access Journals (Sweden)

L. Ruiz-Aizpurua

2014-09-01

Full Text Available The European rabbit (Oryctolagus cuniculus L. is a key prey species in Mediterranean ecosystems that has declined in its natural ranges as a result of diseases and loss of habitat. This situation has led to the production of wild rabbits in enclosures in which they can acclimate and breed. The efficiency of these enclosures as extensive breeding systems is defined by their population growth rate (PGR. The aim of this study is to analyse the effect of rabbit abundance on the PGR. This has been done by creating general linear models to explain autumn and spring PGR with the use of rabbit abundance estimates, enclosure size, aerial predation and previous PGR as possible explanatory variables. Rabbit abundance and enclosure size negatively affected the autumn PGR, while only rabbit abundance affected the spring PGR in the best-fit models. It is suggested that maintaining rabbit densities at fewer than 30 rabbits per hectare might help to optimise the efficiency inside enclosures.

Comparison of Puddu osteotomy with or without autologous bone grafting: a prospective clinical trial

Directory of Open Access Journals (Sweden)

Marcus Ceregatti Passarelli

Full Text Available ABSTRACT Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial , osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. , Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes., Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8 and the graftless group (61.6 ± 17.3; p= 0.309. There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft, = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; p= 1.0, indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group (p= 0.005 . Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

Internal Distraction Osteogenesis With Piezosurgery Oblique Osteotomy of Supraorbital Margin of Frontal Bone for the Treatment of Unilateral Coronal Synostosis.

Science.gov (United States)

Shen, Weimin; Cui, Jie; Chen, Jianbing; Ji, Yi; Kong, Liangliang

2017-05-01

To assess the utility of internal distraction osteogenesis with Piezosurgery oblique osteotomy of supraorbital margin of frontal bone for the treatment of unilateral coronal synostosis and to study the outcome and complications of this procedure. Oblique osteotomy allows for entry into the cranial cavity, and along with parallel cut to the roof of the orbit, avoids the need to cut into the orbit which forms the frontal flap. Oblique osteotomy was performed along the supraorbital rim to do a frontal suture of the glabella (ages of patients were less than 1 year) or on the opposite side of the supraorbital rim (ages of patients were older than 1 year) after performing a suturectomy of the effected coronal suture. Two internal distraction devices were subsequently placed across the osteotomized, fused coronal suture. Finally, the cranium pieces were divided in the middle and placed in the middle of the frontal bone using biological glue. Five days after the operation, a 0.6-mm distraction was done twice daily. The distraction was removed 6 months after reaching 2 to 3 cm. Internal distraction osteogenesis with supraorbital oblique osteotomy was performed in 9 patients suffering from unilateral coronal synostosis. Eight patients had no postoperative infections around the shaft puncture wounds. One patient had infection in the rods around the distraction during the period of fixed, but was cured with antibiotic treatment. During a mean follow-up period of 12 months (5-26 months), all patients were satisfied with the cosmetic and functional results. No complications, including fixed screw displacement, penetration of the cranium and dura mater or retraction of distraction devices, occurred. The devices were exposed in 1 patient, resulting in a postoperative scar. Despite these complications, the cranium was successfully expanded in all patients. Use of this procedure avoids the need for frontal osteotomy to move the orbit forward. Adding 2 cranium strips can be used to

Radiographic appearance of the middle ear after ventral bulla osteotomy in five dogs with otitis media

International Nuclear Information System (INIS)

Holt, D.E.; Walker, L.

1997-01-01

Radiographs of the middle ear were made in five dogs 60 to 78 months after ventral bulla osteotomy was performed to treat otitis media. The clinical results of surgery were considered satisfactory in four dogs and unsatisfactory in one. In 4 dogs with satisfactory results, radiographs demonstrated complete reformation of the bulla in 3 operated middle ears (3 dogs), with partial bulla reformation in the three middle ears (3 dogs). Radiographs in one dog with unsatisfactory results showed complete bulla reformation with no increase in lumen opacity. The proliferative bony response obliterating the middle ear previously reported in normal dogs after ventral bulla osteotomy was not seen in any of these patients

Short-Term Radiographic Outcome After Distal Chevron Osteotomy for Hallux Valgus Using Intramedullary Plates With an Amended Algorithm for the Surgical Management of Hallux Valgus.

Science.gov (United States)

Matsumoto, Takumi; Gross, Christopher E; Parekh, Selene G

2018-03-01

Distal Chevron osteotomy is a well-established surgical procedure for mild to moderate hallux valgus deformity. Many methods have been described for fixation of osteotomy site; secure fixation, enabling large displacement of the metatarsal head, is one of the essentials of this procedure. The purpose of the present study was to evaluate the short-term radiographic outcome of a distal Chevron osteotomy using an intramedullary plate for the correction of hallux valgus deformity. The present study evaluated 37 patients (40 feet) who underwent distal Chevron osteotomy using an intramedullary plate by periodic radiographs obtained preoperatively and at 4 weeks, 8 weeks, 3 months, and 6 months postoperatively. Correction of the hallux valgus angle averaged 17.8°, intermetatarsal angle 7.4°, distal metatarsal articular angle 2.7°, and sesamoid position 1.4 stages at 3 months postoperatively. The average lateral shift of the capital fragment was 6.5 mm. All patients achieved bone union, and there were no cases of dislocation, displacement, or avascular necrosis of the metatarsal head fragment. In conclusion, a distal Chevron osteotomy using an intramedullary plate was a favorable method for the correction of mild to moderate hallux valgus deformity. Level IV: Case series.

[Lateral column lengthening osteotomy of calcaneus].

Science.gov (United States)

Hintermann, B

2015-08-01

Lengthening of the lateral column for adduction of forefoot and restoration of the medial arch. Stabilization of the ankle joint complex. Supple flatfoot deformity (posterior tibial tendon dysfunction stage II). Instability of the medial ankle joint complex (superficial deltoid and spring ligament). Posttraumatic valgus and pronation deformity of the foot. Rigid flatfoot deformity (posterior tibial tendon dysfunction stage III and IV). Talocalcaneal and naviculocalcaneal coalition. Osteoarthritis of calcaneocuboid joint. Exposition of calcaneus at sinus tarsi. Osteotomy through sinus tarsi and widening until desired correction of the foot is achieved. Insertion of bone graft. Screw fixation. Immobilization in a cast for 6 weeks. Weight-bearing as tolerated from the beginning. In the majority of cases, part of hindfoot reconstruction. Reliable and stable correction. Safe procedure with few complications.

Early outcomes of one-stage combined osteotomy in Legg-Calve´-Perthes disease

Directory of Open Access Journals (Sweden)

Basant Kumar Bhuyan

2016-01-01

Conclusions: The surgical treatment of LCPD with the best expected outcome is still a challenge. Advanced containment methods by one-stage combined osteotomy can be considered as an alternative treatment where femoral head subluxation or deformity which makes containment difficult or impossible by more conventional methods.

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.

Evaluation of Bone Healing After Osteotomies Prepared With Er:YAG Laser in Contact and Noncontact Modes and Piezosurgery--An Animal Study.

Science.gov (United States)

Gabrić, Dragana; Blašković, Marko; Gjorgijevska, Elizabeta; Mladenov, Mitko; Tašič, Blaž; Jurič, Ivona Bago; Ban, Ticijana

2016-01-01

To analyze the healing of bone tissue treated with Er:YAG laser contact and noncontact modes of and piezosurgery in a rat model using triangular laser profilometry. Twenty-four 10-week-old adult male Wistar rats were used in the study. Three osteotomies on the medial part of tibia were performed in each animal, 1 in the right tibia and 2 in the left tibia. The osteotomies were performed with a piezoelectric device set at maximal power and the Er:YAG laser in contact mode (power, 7.5 W; pulse energy, 375 mJ; repetition rate, 20 Hz; MSP mode) and noncontact mode (power, 7.5 W; pulse energy, 750 mJ; repetition rate, 10 Hz; QSP mode) with a novel type of circular, digitally controlled handpiece (x-Runner). After surgery, 6 animals were immediately euthanized (group 1), and the others were euthanized after 1 week (group 2, n = 6), 2 weeks (group 3, n = 6), and 3 weeks (group 4, n = 6). Bone healing after osteotomy was analyzed using a 3-dimensional laser scanning technique (ie, laser triangulation profilometry). The volume reduction rates are similar for all 3 techniques (0.2 to 0.25 mm(3) per week). Greater volume reduction of 0.25 mm3 per week was observed for the Er:YAG laser in noncontact mode (x-Runner). After 3 weeks, almost complete healing of the prepared osteotomy was observed. Within the limitations of this study, the osteotomies performed by the Er:YAG laser in digitally controlled noncontact mode healed the fastest. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The preclinical sheep model of high tibial osteotomy relating basic science to the clinics: standards, techniques and pitfalls.

Science.gov (United States)

Pape, Dietrich; Madry, Henning

2013-01-01

To develop a preclinical large animal model of high tibial osteotomy to study the effect of axial alignment on the lower extremity on specific issues of the knee joint, such as in articular cartilage repair, development of osteoarthritis and meniscal lesions. Preoperative planning, surgical procedure and postoperative care known from humans were adapted to develop a HTO model in the adult sheep. Thirty-five healthy, skeletally mature, female Merino sheep between 2 and 4 years of age underwent a HTO of their right tibia in a medial open-wedge technique inducing a normal (group 1) and an excessive valgus alignment (group 2) and a closed-wedge technique (group 3) inducing a varus alignment with the aim of elucidating the effect of limb alignment on cartilage repair in vivo. Animals were followed up for 6 months. Solid bone healing and maintenance of correction are most likely if the following surgical principles are respected: (1) medial and longitudinal approach to the proximal tibia; (2) biplanar osteotomy to increase initial rotatory stability regardless of the direction of correction; (3) small, narrow but long implant with locking screws; (4) posterior plate placement to avoid slope changes; (5) use of bicortical screws to account for the brittle bone of the tibial head and to avoid tibial head displacement. Although successful high tibial osteotomy in sheep is complex, the sheep may--because of its similarities with humans--serve as an elegant model to induce axial malalignment in a clinically relevant environment, and osteotomy healing under challenging mechanical conditions.

Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns.

Science.gov (United States)

Steenen, S A; Becking, A G

2016-07-01

An unfavourable and unanticipated pattern of the mandibular sagittal split osteotomy is generally referred to as a 'bad split'. Few restorative techniques to manage the situation have been described. In this article, a classification of reported bad split pattern types is proposed and appropriate salvage procedures to manage the different types of undesired fracture are presented. A systematic review was undertaken, yielding a total of 33 studies published between 1971 and 2015. These reported a total of 458 cases of bad splits among 19,527 sagittal ramus osteotomies in 10,271 patients. The total reported incidence of bad split was 2.3% of sagittal splits. The most frequently encountered were buccal plate fractures of the proximal segment (types 1A-F) and lingual fractures of the distal segment (types 2A and 2B). Coronoid fractures (type 3) and condylar neck fractures (type 4) have seldom been reported. The various types of bad split may require different salvage approaches. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Opening wedge trapezial osteotomy as possible treatment for early trapeziometacarpal osteoarthritis: a biomechanical investigation of radial subluxation, contact area, and contact pressure.

Science.gov (United States)

Cheema, Tahseen; Salas, Christina; Morrell, Nathan; Lansing, Letitia; Reda Taha, Mahmoud M; Mercer, Deana

2012-04-01

Radial subluxation and cartilage thinning have been associated with initiation and accelerated development of osteoarthritis of the trapeziometacarpal joint. Few investigators have reported on the benefits of opening wedge trapezial osteotomy for altering the contact mechanics of the trapeziometacarpal joint as a possible deterrent to the initiation or progression of osteoarthritis. We used cadaveric specimens to determine whether opening wedge osteotomy of the trapezium was successful in reducing radial subluxation of the metacarpal base and to quantify the contact area and pressure on the trapezial surface during simulated lateral pinch. We used 8 fresh-frozen specimens in this study. The flexor pollicis longus, abductor pollicis longus, adductor pollicis, abductor pollicis brevis, and flexor pollicis brevis/opponens pollicis tendons were each loaded to simulate the thumb in lateral pinch position. We measured radial subluxation from anteroposterior radiographs before and after placement of a 15° wedge. We used real-time sensors to analyze contact pressure and contact area distribution on the trapezium. Center of force in the normal joint under lateral pinch loading was primarily located in the dorsal region of the trapezium. After wedge placement, contact pressure increased in the ulnar-dorsal region by 76%. Mean contact area increased in the ulnar-dorsal region from 0.05 to 0.07 cm(2), and in the ulnar-volar region from 0.003 to 0.024 cm(2). The average reduction in joint subluxation was 64%. The 15° opening wedge osteotomy of the trapezium reduced radial subluxation of the metacarpal on the trapezium and increased contact pressure and contact area away from the diseased compartments of the trapezial surface. Trapezial osteotomy addresses the 2 preeminent theories about the initiation and progression of osteoarthritis. By reducing radial subluxation and altering contact pressure and contact area, trapezial osteotomy may prove an alternative to first

Complex Osteotomies of Tibial Plateau Malunions Using Computer-Assisted Planning and Patient-Specific Surgical Guides.

Science.gov (United States)

Fürnstahl, Philipp; Vlachopoulos, Lazaros; Schweizer, Andreas; Fucentese, Sandro F; Koch, Peter P

2015-08-01

The accurate reduction of tibial plateau malunions can be challenging without guidance. In this work, we report on a novel technique that combines 3-dimensional computer-assisted planning with patient-specific surgical guides for improving reliability and accuracy of complex intraarticular corrective osteotomies. Preoperative planning based on 3-dimensional bone models was performed to simulate fragment mobilization and reduction in 3 cases. Surgical implementation of the preoperative plan using patient-specific cutting and reduction guides was evaluated; benefits and limitations of the approach were identified and discussed. The preliminary results are encouraging and show that complex, intraarticular corrective osteotomies can be accurately performed with this technique. For selective patients with complex malunions around the tibia plateau, this method might be an attractive option, with the potential to facilitate achieving the most accurate correction possible.

Outcomes in chevron osteotomy for Hallux Valgus in a large cohort.

Science.gov (United States)

van Groningen, Bart; van der Steen, M C Marieke; Reijman, Max; Bos, Janneke; Hendriks, Johannes G E

2016-12-01

Clinical and radiological related outcomes have been reported for Chevron osteotomy as correction for mild to moderate hallux valgus, but only for relatively small patient series. Moreover, evaluation of the patient's point of view has mostly been conducted by means of more physician-based outcome measures. The goal of this study was to evaluate the effect of the Chevron osteotomy for hallux valgus on patients' daily lives using the Foot and Ankle Outcome Score (FAOS) as a validated and a hallux valgus specific patient reported outcome measure (PROM). Secondary outcome measures were radiological correction, complication rate, and re-operations. All 438 Chevron procedures (336 patients), at two surgical hospital sites in the period between January 2010 and October 2014, were retrospectively evaluated with a follow-up of at least 6 months. Patients were invited to fill in a cross-sectional online FAOS. For the FAOS, a total response of 60% was achieved. The FAOS ranged between 71 and 88 with a follow-up of on average 36 months. Patients with an undercorrection of their hallux valgus (11.6% of the procedures) scored significantly lower on three subscales of the FAOS (range between 61 and 77 versus 72-84). Patients who had a reoperation (12.6% of the procedures) also scored significantly lower on four subscales: 58-100 versus 73-89. Postoperative radiological measurements improved significantly with a mean difference of 6.1 (5.9; 6.4) degrees for the intermetatarsal angle and 13.7 (13.0; 14.5) degrees for the hallux valgus angle. In this large study cohort, Chevron osteotomy for hallux valgus offers good PROM scores on FAOS. These scores were significantly lower in patients with radiological undercorrection or with a reoperation. Results of the FAOS appear to modulate with physician based outcomes and therapeutic incidents. Improvement of outcome may therefore well be possible by increased attention on these surgical details. Copyright © 2016 Elsevier Ltd. All rights

Rehabilitación implantosoportada en el colgajo libre de peroné Implant-supported rehabilitation using the fibula free flap

Directory of Open Access Journals (Sweden)

C. Navarro Cuéllar

2006-10-01

Full Text Available El colgajo de peroné ha demostrado ser el más versatil para la reconstrucción oromandibular, gracias a la gran longitud ósea que podemos utilizar y a la posibilidad de incorporar una amplia paleta cutánea para cobertura de tejidos blandos intraorales. El uso de implantes dentales osteointegrados proporciona un importante método terapéutico para la rehabilitación oral de estos pacientes. Los implantes osteointegrados proporcionan la forma más rígida de estabilización protésica para soportar las fuerzas masticatorias. Estos implantes pueden ser insertados de forma inmediata o diferida. A la hora de utilizar el colgajo libre de peroné realizamos la implantología de forma diferida a los 6-12 meses debido a la gran cantidad de material de osteosíntesis necesaria para la fijación del colgajo. Cuatro o seis meses después, cuando el proceso de osteointegración ha ocurrido, los implantes son cargados con una rehabilitación dental. Analizamos 12 casos de reconstrucción mandibular con colgajo libre de peroné y su rehabilitación estética y funcional con implantes osteointegrados y un seguimiento mínimo de 2 años. Se han colocado un total de 56 implantes, presentando todos ellos excepto uno, una correcta osteointegración. Todos estos pacientes han recuperado la función masticatoria, y mejorado de forma considerable la competencia labial, la continencia salival, la pronunciación y la armonía facial.Free fibula flap has proved to be one of the most versatile for oromandibular reconstruction due to the available length of bone and the possibility of incorporating a long skin paddle to cover intraoral soft tissues. The use of osseointegrated dental implants is an important technique for the oral rehabilitation of these patients. Osseointegrated implants provide the most rigid prosthetic stabilization available to withstand masticatory forces.These implants can be placed immediately or in a second time procedure.In our case

Three-dimensional computed tomographic evaluation of bilateral sagittal split osteotomy lingual fracture line and le fort I pterygomaxillary separation in orthognathic surgery using cadaver heads: ultrasonic osteotome versus conventional saw.

Science.gov (United States)

Dammous, Sophie; Dupont, Quentin; Gilles, Roland

2015-06-01

The purpose of this study was to observe the quality of the fracture line on the lingual side of the mandible after sagittal split osteotomy and the quality of pterygomaxillary separation after Le Fort I osteotomy using the BoneScalpel ultrasonic osteotome. Bimaxillary procedures, according to the standard protocol, were performed using 10 fresh cadaver heads. The ultrasonic osteotome was used in the study group, and a reciprocating saw was used in the control group. Three-dimensional reconstructions of postoperative computed tomographic scans were obtained. The lingual ramus fracture pattern and the pterygomaxillary separation pattern were observed, classified, and compared. Postoperative dissections of the skulls were performed to assess the integrity of the infra-alveolar nerve and the descending palatine artery. No significant differences were found in the cutting time of bone between the BoneScalpel and the sagittal saw. Of the sagittal split osteotomies in the study group, 90% showed a good pattern (vertical pattern of fracture line extending to the inferior border of the mandible running behind the mandibular canal) compared with 50% of the sagittal split osteotomies in the control group. Ideal separation of the pterygoid plates without fractures was observed in 80% of the Le Fort I osteotomies in the study group compared with 50% of the osteotomies in the control group. High-level fractures occurred in 30% of cases in the control group compared with none in the study group. The integrities of the infra-alveolar nerve and the descending palatine artery were preserved in all cases. Use of the ultrasonic BoneScalpel did not require more time than the conventional method. An improved pattern of lingual fracture lines in mandibular sagittal split osteotomy procedures and the pattern of pterygomaxillary separation in Le Fort I osteotomy procedures were observed. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc

Some factors affecting rabbit production under egyptian environment

International Nuclear Information System (INIS)

Nessim, M.Z.

1994-01-01

The present work was carried out in the rabbit of the department of animal production, faculty of agriculture, Zagazig University, Zagazig, Egypt, Blood biochemical analysis and hormonal assay were conducted in tracer bio climatology Unit., Department of radiobiology, nuclear research centre, Atomic Energy Authority, Cairo, Egypt. Eighty male New Zealand white (NZW) and 80 male californian (Cal) rabbits aged 5-6 weeks were used. The animals were housed in rabbit building, naturally ventilated. Rabbits cages were provided with automatic nipple drinkers and drinking and drinking water ad libitum.Rabbits were fed ad libitum on balanced growing pelted rabbit ration. 21 tabs.,13 figs.,158 refs

Celecoxib does not significantly delay bone healing in a rat femoral osteotomy model: a bone histomorphometry study

Directory of Open Access Journals (Sweden)

Iwamoto J

2011-12-01

Full Text Available Jun Iwamoto1, Azusa Seki2, Yoshihiro Sato3, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan; 2Hamri Co, Ltd, Tokyo, Japan; 3Department of Neurology, Mitate Hospital, Fukuoka, JapanBackground and objective: The objective of the present study was to determine whether celecoxib, a cyclo-oxygenase-2 inhibitor, would delay bone healing in a rat femoral osteotomy model by examining bone histomorphometry parameters.Methods: Twenty-one 6-week-old female Sprague-Dawley rats underwent a unilateral osteotomy of the femoral diaphysis followed by intramedullary wire fixation; the rats were then divided into three groups: the vehicle administration group (control, n = 8, the vitamin K2 administration (menatetrenone 30 mg/kg orally, five times a week group (positive control, n = 5, and the celecoxib administration (4 mg/kg orally, five times a week group (n = 8. After 6 weeks of treatment, the wires were removed, and a bone histomorphometric analysis was performed on the bone tissue inside the callus. The lamellar area relative to the bone area was significantly higher and the total area and woven area relative to the bone area were significantly lower in the vitamin K2 group than in the vehicle group. However, none of the structural parameters, such as the callus and bone area relative to the total area, lamellar and woven areas relative to the bone area, or the formative and resorptive parameters such as osteoclast surface, number of osteoclasts, osteoblast surface, osteoid surface, eroded surface, and bone formation rate per bone surface differed significantly between the vehicle and celecoxib groups.Conclusion: The present study implies that celecoxib may not significantly delay bone healing in a rat femoral osteotomy model based on the results of a bone histomorphometric analysis.Keywords: femoral osteotomy, bone healing, callus, rat, celecoxib

Light colour preference of growing rabbits

Directory of Open Access Journals (Sweden)

Zsolt Szendrő

2010-01-01

Full Text Available The objective of the experiment was to evaluate the light colour preference of growing rabbits placed in a free-choice cage. The experiment was carried out on 128 Pannon White growing rabbits weaned at the age of 5 weeks and placed into blocks (2m2 of four cages. The rabbits could move freely among the four cages (0.5m2 each through swing doors. The cages differed only in the colour of the light applied (white, yellow, green or blue. The lighting schedule was 16L: 8D. From 6 until 10 weeks of age, infrared video recording was performed once a week (24 hours. The number of rabbits in each cage was counted every 15 minutes. Feed consumption was measured weekly. Between 6 and 10 weeks of age the rabbits significantly preferred white light (28.0%. The preference order was the following: yellow (26.3%, blue (23.4% and green (22.3% (P<0.001. No significant differences were recorded in the feed consumption among the cages. In conclusion, the cage preference of the rabbits was slightly affected by the light colour.

Comparing fixation used for calcaneal displacement osteotomies: a look at removal rates and cost.

Science.gov (United States)

Lucas, Douglas E; Simpson, G Alex; Philbin, Terrence M

2015-02-01

The calcaneal displacement osteotomy is a procedure frequently used by foot and ankle surgeons for hindfoot angular deformity. Traditional techniques use compression screw fixation that can result in prominent hardware. While the results of the procedure are generally good, a common concern is the development of plantar heel pain related to prominent hardware. The primary purpose of this study is to retrospectively compare clinical outcomes of 2 fixation methods for the osteotomy. Secondarily a cost analysis will compare implant costs to hardware removal costs. Records were reviewed for patients who had undergone a calcaneal displacement osteotomy fixated with either lag screw or a locked lateral compression plate (LLCP). Neuropathy, previous ipsilateral calcaneus surgery, heel pad trauma, or incomplete radiographic follow-up were exclusionary. Thirty-two patients (19.4%) required hardware removal from the screw fixation group compared to 1 (1.6%) of the LLCP group, which is significant (P cost was remarkably different with screw fixation costing on average $247.12, compared to the LLCP costing $1175.59. Although the LLCP cost was significantly higher, cost savings were identified when the cost of removal and removal rates were included. This study demonstrates that this device provides adequate stabilization for healing in equivalent time to screw fixation. The LLCP required decreased rates of hardware removal with fewer postoperative visits over a shorter period of time. Significant savings were demonstrated in the LLCP group despite the higher implant cost. Therapeutic, Level III, Retrospective Comparative Study. © 2014 The Author(s).

[Osteotomies for treating developmental disorders of the neurocranium and visceral cranium].

Science.gov (United States)

Mühling, J

1991-02-01

Craniofacial deformities are primarily caused by premature synostosis of cranial sutures. Depending on the involved sutures, typical deformities of the neuro- and visceral cranium are produced. They result in severe functional and aesthetic disturbances. Several osteotomies, which do not only make an aesthetic improvement possible but a correction of severe malfunction, are available for therapy. Preoperative planning and postoperative treatment require the combination of orthodontics and maxillofacial surgery.

A comparison of proximal and distal Chevron osteotomy, both with lateral soft-tissue release, for moderate to severe hallux valgus in patients undergoing simultaneous bilateral correction: a prospective randomised controlled trial.

Science.gov (United States)

Lee, K B; Cho, N Y; Park, H W; Seon, J K; Lee, S H

2015-02-01

Moderate to severe hallux valgus is conventionally treated by proximal metatarsal osteotomy. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include moderate to severe hallux valgus. The purpose of this prospective randomised controlled trial was to compare the outcome of proximal and distal Chevron osteotomy in patients undergoing simultaneous bilateral correction of moderate to severe hallux valgus. The original study cohort consisted of 50 female patients (100 feet). Of these, four (8 feet) were excluded for lack of adequate follow-up, leaving 46 female patients (92 feet) in the study. The mean age of the patients was 53.8 years (30.1 to 62.1) and the mean duration of follow-up 40.2 months (24.1 to 80.5). After randomisation, patients underwent a proximal Chevron osteotomy on one foot and a distal Chevron osteotomy on the other. At follow-up, the American Orthopedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal interphalangeal (MTP-IP) score, patient satisfaction, post-operative complications, hallux valgus angle, first-second intermetatarsal angle, and tibial sesamoid position were similar in each group. Both procedures gave similar good clinical and radiological outcomes. This study suggests that distal Chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting moderate to severe hallux valgus as proximal Chevron osteotomy with a distal soft-tissue procedure. ©2015 The British Editorial Society of Bone & Joint Surgery.

Evaluation of instability after transtrochanteric anterior rotational osteotomy for nontraumatic osteonecrosis of the femoral head

International Nuclear Information System (INIS)

Hiranuma, Yasunari; Atsumi, Takashi; Kajiwara, Toshihisa; Tamaoki, Satoshi; Asakura, Yasuhiro

2009-01-01

Transtrochanteric anterior rotational osteotomy results in improvement of joint congruity and prevention of progressive collapse and osteoarthritic changes in patients with femoral head osteonecrosis. However, this procedure remains controversial for patients with extensive collapse due to potential osteoarthritis caused by postoperative instability. The purpose of this study was to evaluate hip instability after osteotomy and determine the relation between instability and radiological and clinical outcomes. In all, 27 hips of 24 patients that were followed up for a mean period of 3.8 years were included. Instability was defined as more than 1 mm translation of the femoral head in transverse computed tomography scans obtained at 0 deg and 45 deg flexion of the hip joint. Hips were divided into instability and stability groups. Eleven hips (40%) developed instability after surgery. Osteophytes on the femoral head in 10 hips of the instability group and 2 hips of the stability group had increased in size at follow-up. There was a significant relation between postoperative instability and osteophyte formation. Joint space narrowing was not seen in any of the cases. There was no significant difference between the groups in either the postoperative intact ratio of the femoral head or the Japanese Orthopaedic Association hip score. Neither instability nor osteophyte formation on the femoral head after transtrochanteric anterior rotational osteotomy correlated with progressive osteoarthritic changes or clinical outcome in the presence of an adequate femoral head intact ratio facing the weight-bearing area. (author)

Chevron osteotomy for the treatment of hallux valgus.

Science.gov (United States)

Horne, G; Tanzer, T; Ford, M

1984-03-01

Seventy-six chevron osteotomies with follow-up periods ranging from six months to eight years were reviewed. The majority of patients had pain over the bunion prior to operation, and 27 also presented with second metatarsalgia. After surgery there was a marked decrease of pain in the first metatarsophalangeal joint, and in 18 feet the second metatarsalgia was either eliminated or markedly decreased. Most patients were pleased with the appearance of the feet after surgery, but almost one-third of the women complained of difficulty in wearing high heels. The surgical technique is straightforward, but careful attention to detail is necessary to obtain a consistent and satisfactory result.

Possible interaction between myxomatosis and calicivirosis related to rabbit haemorrhagic disease affecting the European rabbit.

Science.gov (United States)

Marchandeau, S; Bertagnoli, S; Peralta, B; Boucraut-Baralon, C; Letty, J; Reitz, F

2004-11-06

Serological data on myxoma virus, rabbit haemorrhagic disease (RHD) virus and RHD-like viruses in juvenile rabbits (Oryctolagus cuniculus) trapped in 1995, 1996 and 1997 in two areas of France were analysed. For each disease, the effects of bodyweight, year, month and seropositivity for the other disease were modelled by using logistic regressions. In one area, a model including RHD seropositivity was selected to explain the myxoma virus seropositivity. Models including myxoma virus seropositivity were selected to explain the RHD seropositivity in both areas, and the odds of a rabbit being seropositive to both viruses were 5.1 and 8.4 times higher than the odds of a rabbit being seronegative to myxoma virus and seropositive to RHD. The year and bodyweight had significant effects for myxomatosis in one area and for RHD in both areas.

A Systematic Review on Effect of Single-Dose Preoperative Antibiotics at Surgical Osteotomy Extraction of Lower Third Molars

DEFF Research Database (Denmark)

Marcussen, Karoline Brørup; Laulund, Anne Sofie; Jørgensen, Henrik L

2016-01-01

PURPOSE: We conducted a systematic review of randomized controlled trials (RCTs) to evaluate the effectiveness of a single dose of preoperative antibiotic administered perorally, intravenously, intramuscularly, or topically for preventing infection and alveolar osteitis in lower third molar...... that penicillin V was effective in reducing the incidence of alveolar osteitis (OR = 0.1; 95% CI, 0.03 to 0.30; P ≤ .0001). CONCLUSIONS: A single oral dose of 2 g of amoxicillin before lower third molar osteotomy surgical extraction significantly decreased the incidence of SSI. A single dose of 0.8 g...... of penicillin V before lower third molar osteotomy surgical extraction significantly decreased the incidence of alveolar osteitis....

High Rate of Recurrence Following Proximal Medial Opening Wedge Osteotomy for Correction of Moderate Hallux Valgus.

Science.gov (United States)

Iyer, Sravisht; Demetracopoulos, Constantine A; Sofka, Carolyn M; Ellis, Scott J

2015-07-01

The proximal medial opening wedge (PMOW) osteotomy has become more popular to treat moderate to severe hallux valgus with the recent development of specifically designed, low-profile modular plates. Despite the promising results previously reported in the literature, we have noted a high incidence of recurrence in patients treated with a PMOW. The purpose of this study was to report the clinical and radiographic outcomes of an initial cohort of patients treated with a PMOW osteotomy for moderate hallux valgus. We retrospectively analyzed prospectively gathered data on a cohort of 17 consecutive patients who were treated by the senior author using a PMOW osteotomy for moderate hallux valgus deformity. Average time to follow-up was 2.4 years (range, 1.0-3.5 years). The intermetatarsal angle (IMA), the hallux valgus angle (HVA), and the distal metatarsal articular angle (DMAA) were assessed on standard weightbearing radiographs of the foot preoperatively and at all follow-up visits. The Foot and Ankle Outcome Score (FAOS) was collected on all patients preoperatively and at final follow-up. Despite demonstrating good correction of their deformity initially, 11 of the 17 patients (64.7%) had evidence of recurrence of their hallux valgus deformity at final follow-up. Patients who recurred had a greater preoperative HVA (P = .023) and DMAA (P = .049) than patients who maintained their correction. Improvement in the quality-of-life subscale of the FAOS was noted at final follow-up for all patients (P = .05). There was no significant improvement in any of the other FAOS subscales. There was a high rate of recurrence of the hallux valgus deformity in this cohort of patients. Recurrence was associated with greater preoperative deformity and an increased preoperative DMAA. The PMOW without a concomitant distal metatarsal osteotomy may be best reserved for patients with mild hallux valgus deformity without an increased DMAA. Level IV, retrospective case series. © The Author

Acute Reciprocal Changes Distant from the Site of Spinal Osteotomies Affect Global Postoperative Alignment

Directory of Open Access Journals (Sweden)

Eric Klineberg

2011-01-01

Full Text Available Introduction. Three-column vertebral resections are frequently applied to correct sagittal malalignment; their effects on distant unfused levels need to be understood. Methods. 134 consecutive adult PSO patients were included (29 thoracic, 105 lumbar. Radiographic analysis included pre- and postoperative regional curvatures and pelvic parameters, with paired independent t-tests to evaluate changes. Results. A thoracic osteotomy with limited fusion leads to a correction of the kyphosis and to a spontaneous decrease of the unfused lumbar lordosis (−8°. When the fusion was extended, the lumbar lordosis increased (+8°. A lumbar osteotomy with limited fusion leads to a correction of the lumbar lordosis and to a spontaneous increase of the unfused thoracic kyphosis (+13°. When the fusion was extended, the thoracic kyphosis increased by 6°. Conclusion. Data from this study suggest that lumbar and thoracic resection leads to reciprocal changes in unfused segments and requires consideration beyond focal corrections.

Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

Science.gov (United States)

Brogan, Kit; Lindisfarne, Edward; Akehurst, Harold; Farook, Usama; Shrier, Will; Palmer, Simon

2016-11-01

Minimally invasive surgical (MIS) techniques are increasingly being used in foot and ankle surgery but it is important that they are adopted only once they have been shown to be equivalent or superior to open techniques. We believe that the main advantages of MIS are found in the early postoperative period, but in order to adopt it as a technique longer-term studies are required. The aim of this study was to compare the 2-year outcomes of a third-generation MIS distal chevron osteotomy with a comparable traditional open distal chevron osteotomy for mild-moderate hallux valgus. Our null hypothesis was that the 2 techniques would yield equivalent clinical and radiographic results at 2 years. This was a retrospective cohort study. Eighty-one consecutive feet (49 MIS and 32 open distal chevron osteotomies) were followed up for a minimum 24 months (range 24-58). All patients were clinically assessed using the Manchester-Oxford Foot Questionnaire. Radiographic measures included hallux valgus angle, the intermetatarsal angle, hallux interphalangeal angle, metatarsal phalangeal joint angle, distal metatarsal articular angle, tibial sesamoid position, shape of the first metatarsal head, and plantar offset. Statistical analysis was done using Student t test or Wilcoxon rank-sum test for continuous data and Pearson chi-square test for categorical data. Clinical and radiologic postoperative scores in all domains were substantially improved in both groups (P .05). There were no significant differences in complications between the 2 groups ( > .5). The midterm results of this third-generation technique show that it was a safe procedure with good clinical outcomes and comparable to traditional open techniques for symptomatic mild-moderate hallux valgus. Level III, retrospective comparative study. © The Author(s) 2016.

A case of low success of blind vaccination campaigns against myxomatosis and rabbit haemorrhagic disease on survival of adult European wild rabbits.

Science.gov (United States)

Rouco, Carlos; Moreno, Sacramento; Santoro, Simone

2016-10-01

Vaccination campaigns against myxomatosis and rabbit haemorrhagic disease (RHD) are commonly used in translocation programs conducted for the purpose of recovering wild European rabbit populations in Iberian Mediterranean ecosystems. In most cases rabbits are vaccinated 'blind' (i.e. without assessing their prior immunological status) for economic and logistic reasons. However, there is conflicting evidence on the effectiveness of such an approach. We tested whether blind vaccination against myxomatosis and rabbit haemorrhagic disease improved rabbit survival in a rabbit translocation program where wild rabbits were kept in semi-natural conditions in three enclosures. We conducted nine capture sessions over two years (2008-2010) and used the information collected to compare the survival of vaccinated (n=511) versus unvaccinated (n=161) adult wild rabbits using capture-mark-recapture analysis. Average monthly survival was no different for vaccinated versus unvaccinated individuals, both in the period between release and first capture (short-term) and after the first capture onward (long-term). Rabbit survival was lower in the short term than in the long term regardless of whether rabbits were vaccinated or not. Lower survival in the short-term could be due to the stress induced by the translocation process itself (e.g. handling stress). However, we did not find any overall effect of vaccination on survival which could be explained by two non-exclusive reasons. First, interference of the vaccine with the natural antibodies in the donor population. Due to donor populations have high density of rabbits with, likely, high prevalence of antibodies as a result of previous natural exposure to these diseases. Second, the lack of severe outbreaks during the study period. Based on our findings we argue that blind vaccination of adult rabbits in translocation programs may be often mostly ineffective and unnecessarily costly. In particular, since outbreaks are hard to predict

Characterization of Pasteurella multocida involved in rabbit infections

DEFF Research Database (Denmark)

Massacci, Francesca Romana; Magistrali, Chiara Francesca; Cucco, Lucilla

2018-01-01

In rabbit, P. multocida is considered a predominant pathogenic agent; despite this, few data on the molecular epidemiology are available so far. The aim of this work was to characterize P. multocida isolates from rabbit affected by various diseases in Italy. Comparison was made to reference strains...... belonged to the LPS genotypes 3 (22/39) or 6 (17/39). The clonal relationships of the Italian strains from rabbit had similarity to previously reported rabbit isolates that belonged to ST9, ST74, ST204 and ST206, however, they differed from other rabbit references strains that belonged to six other STs....... In particular, ST9 with capsular type F has been previously reported from diseased rabbit in Czech Republic and ST74 has been observed for older rabbit isolates. ST50 has probably been reported from Spain. ST9 and ST50 have previously also been reported from birds and pig, respectively, whereas ST74 has...

Rotational Osteotomy for Hallux Valgus. A New Technique for Primary and Revision Cases

Science.gov (United States)

Ortiz, Cristian; Wagner, Emilio

2017-01-01

More than 200 different surgical techniques exist for hallux valgus (HV). Some of them are designed for mild, moderate, or severe deformities depending on their correction power. Nevertheless, they all correct only the coronal and/or sagittal plane deformity. Just a handful of them correct the known axial malrotation that exists in most HV cases. This malrotation is one possible factor that could be the source of recurrence of an operated HV as it has been described. We describe a new technique which simultaneously corrects the metatarsal internal rotation and varus deformity by rotating the metatarsal through an oblique plane osteotomy. This is performed with no bone wedge resection. Also, there is a broader bone surface contact than on a transverse proximal osteotomy. This technique is easy to remember and relatively simple to perform in primary and revision cases. The authors results show that it is as safe and effective as other procedures, with some advantages to be discussed. Levels of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence. PMID:28286430

Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows

Directory of Open Access Journals (Sweden)

Rex Chadrabose

2011-12-01

Full Text Available Abstract Background Bony ankylosis of elbow is challenging and difficult problem to treat. The options are excision arthroplasty and total elbow replacement. We report our midterm results on nine patients, who underwent inverted 'V' osteotomy excision arthroplasty in our hospital with good functional results. Materials Our case series includes 9 patients (seven males and two females with the mean age of 34 years (13-56 years. Five patients had trauma, two had pyogenic arthritis, one had tuberculous arthritis, and one had pyogenic arthritis following surgical fixation. Results The average duration of follow up is 65 months (45 months-80 months. The mean Mayo's elbow performance score (MEPS preoperatively was 48 (35-70. The MEPS at final follow up was 80 (60-95. With no movement at elbow and fixed in various degrees of either flexion or extension preoperatively, the mean preoperative position of elbow was 64°(30°to 100°. The mean post operative range of motion at final follow up was 27°of extension (20-500, 116°of flexion (1100-1300, and the arc of motion was 88°(800-1000. One patient had ulnar nerve neuropraxia and another patient developed median nerve neuropraxia, and both recovered completely in six weeks. No patient had symptomatic instability of the elbow. All patients were asymptomatic except one patient, who had pain mainly on heavy activities. Conclusion We conclude that inverted 'V' osteotomy excision arthroplasty is a viable option in the treatment of bony ankylosis of the elbow in young patients.

Parasitic infections of wild rabbits and hares

Directory of Open Access Journals (Sweden)

Ilić Tamara

2014-01-01

Full Text Available The paper presents the most important parasitic infections of wild rabbits and hares, which harmful effect in this animal population is manifested as a gradual weakening of the immune system, reduction in fertility, weight loss and constant exhaustion. Order of Lagomorpha (hares or lagomorphs belongs to superorder of higher mammals which includes the family of rabbits (Leporidae which are represented in Europe as well as the family of whistleblowers (Ochotonidae which live only in North America and Northern regions of Asia. The most important representatives of Leporidae family are European hare (Lepus europeus and wild rabbit (Oryctolagus cuniculus. The most important endoparasitosis of hares and wild rabbits are: coccidiosis, encephalitozoonosis (nosemosis, toxoplasmosis, sarcocystosis, giardiasis, cryptosporidiosis, protostrongylosis, trichostrngylodosis, passalurosis, anoplocephalidosis, cysticercosis and fasciolosis. The most frequent ectoparasites of rabbits and wild hares are fleas, lice and ticks. Reduction in hare population, which is noticed in whole Europe including Serbia, is caused by changed living conditions, quantitatively and qualitatively insufficient nutrition, increased use of herbicides as well as various infectious diseases and the diseases of parasitic etiology. Since wild rabbits and hares pose a threat to health of domestic rabbits and people, knowledge of parasitic fauna of these wild animals is of extreme epizootiological and epidemiological importance.

Welfare aspects in rabbit rearing and transport

Directory of Open Access Journals (Sweden)

Claudio Cavani

2010-01-01

Full Text Available The review starts with the description of the rabbits’ (Oryctolagus cuniculus main habits and the current situation concerning the rabbit husbandry and management systems, as well as their effects on the welfare of these animals. As far as the intensive rabbit husbandry systems are concerned, the main problems are related to the time since rabbits have been domesticated and their adaptive capacity and coping styles as respects the farming environment and management systems. Both these aspects have implications in the present and future of rabbit rearing for different purposes. Examples are given on the effects of different housing and management systems on rabbit welfare, as well as examples of the ethological, physiological and productive indicators used to evaluate these effects. Transportation and, more generally, preslaughter phases including catching, fasting and lairage at the abattoir are considered major stressors for farmed rabbits and might have deleterious effects on health, well-being, performance, and finally, product quality. A general statement of the recent scientific studies considering the effects of pre-slaughter factors on physiological and productive measurements are reported. Finally, some indications in order to improve rabbit welfare, already present at the European level, are also outlined, together with the European Food Safety Authority opinions.

Blood Profile of Rabbits Infected with Eimeria magna

Directory of Open Access Journals (Sweden)

A Hana

2011-09-01

Full Text Available Abstract. The research aimed at determining the blood profile of local rabbits infected with different dose of Eimeria magna oocysts. This research used 45 male rabbits with the age of 4 month old, range from 1.5 to 1.8 kg, clinically healthy and free from coccidiosis. The rabbits were randomly divided into 3 groups, group I as control (K-0 was given 1.0 ml distilled water/rabbit orally, group II (K-10 was infected with single dose of 10x106 oocysts of E. magna/rabbit orally, and group III (K-20 was infected with single dose of 20x106 oocysts of E. magna/rabbit orally. After infection, rabbits were examined for clinical signs, body weight and temperature daily for five days. Blood samples were drawn from the vena marginalis to examine the number of erythrocytes, hemoglobine, packed cell volume (PCV, leukocytes and its deferent, total protein plasma (TPP and fibrinogen, activities of alkaline phosphatase (ALP, alanine amino transferase (ALT, and aspartat aminotransferase (AST. The data were statistically analyzed by two-way anova using factorial design. The results of this research showed that the infection of E. magna in rabbits caused fever and weight loss, accompanied by normochromic microcytic anemia (at doses of 10x106 oocysts, macrocytic normochromic (at doses of 20x106 oocysts, leukocytosis, lymphocytosis, hiperfibrinogenemia, and increased of ALP activity. There were correlations between clinical symptoms and blood profile of rabbits infected with E. magna for five days. The higher the dose and the longer the infection of E. magna in rabbits caused weight loss, increased body temperature, MCV (microcytic to macrocytic, leukocyte, fibrinogen and ALP activity. These findings were useful to have a better understanding of pathophysiology of E. magna infection in  rabbits. Key Words: Eimeria magna, oocyst, rabbit, blood profile A Hana et al/Animal Production 13(3:185-190 (2011

Computed Tomography Based Three-dimensional Measurements of Spine Shortening Distance After Posterior Three-column Osteotomies for the Treatment of Severe and Stiff Scoliosis.

Science.gov (United States)

Li, Xue-Shi; Huang, Zi-Fang; Deng, Yao-Long; Fan, Heng-Wei; Sui, Wen-Yuan; Wang, Chong-Wen; Yang, Jun-Lin

2017-07-15

Retrospective study. This study is to measure and analyze the changes of three-dimensional (3D) distances of spinal column and spinal canal at the three-column osteotomy sites and address their clinical and neurologic significance. Three-column osteotomies were developed to treat severe and stiff spine deformities with insufficient understanding on the safe limit of spine shortening and the relationship between the shortening distance of the spinal column and that of the spinal canal. Records of 52 continuous patients with severe and stiff scoliosis treated with three-column spine osteotomies at our institution from July 2013 to June 2015 were reviewed. The preoperative spinal cord function classification were type A in 31 cases, type B in 10 cases, and type C in 11 cases. The types of osteotomies carried out were extended pedicle subtraction osteotomy in nine patients and posterior vertebral column resection in 43 patients. Multimodality neuromonitoring strategies were adopted intraoperatively. 3D pre- and postoperative spine models were reconstructed from the computed tomography (CT) scans. The distances of convex and concave spinal column and the spinal canal shortening were measured and analyzed. The spinal column shortening distance (SCSD) measured on the 3D models (27.8 mm) were statistically shorter than those measured intraoperatively (32.8 mm) (P column strut graft than in those with bone-on-bone fusion (P column cannot represent that of the central spinal canal in patients with severe scoliosis. The spinal column shortening procedure in appropriately selected patient groups with bone-on-bone fusion is a viable option with the CCSD being significantly shorter than the convex SCSD. 4.

Total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and computer-aided designed and manufactured surgical splints: a favorable combination of three techniques in the management of severe mouth asymmetry in Parry-Romberg syndrome.

Science.gov (United States)

Scolozzi, Paolo; Herzog, Georges

2014-05-01

Although its pathogenesis remains obscure, Parry-Romberg syndrome (PRS) has been associated with the linear scleroderma en coup de sabre. PRS is characterized by unilateral facial atrophy of the skin, subcutaneous tissue, muscles, and bones with at least 1 dermatome supplied by the trigeminal nerve. Facial asymmetry represents the most common sequela and can involve the soft tissues, craniomaxillofacial skeleton, dentoalveolar area, and temporomandibular joint. Although orthognathic procedures have been reported for skeletal reconstruction, treatment of facial asymmetry has been directed to augmentation of the soft tissue volume on the atrophic side using different recontouring or volumetric augmentation techniques. Total mandibular subapical osteotomy has been used in the management of dentofacial deformities, such as open bite and mandibular dentoalveolar retrusion or protrusion associated with an imbalance between the lower lip and the chin. Management of orthognathic procedures has been improved by the recent introduction of stereolithographic surgical splints using computer-aided design (CAD) and computer-aided manufacturing (CAM) technology and piezosurgery. Piezosurgery has increased security during surgery, especially for delicate procedures associated with a high risk of nerve injury. The present report describes a combined total mandibular subapical osteotomy and Le Fort I osteotomy using piezosurgery and surgical splints fabricated using CAD and CAM for the correction of severe mouth asymmetry related to vertical dentoalveolar disharmony in a patient with PRS. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Protection against myxomatosis and rabbit viral hemorrhagic disease with recombinant myxoma viruses expressing rabbit hemorrhagic disease virus capsid protein.

Science.gov (United States)

Bertagnoli, S; Gelfi, J; Le Gall, G; Boilletot, E; Vautherot, J F; Rasschaert, D; Laurent, S; Petit, F; Boucraut-Baralon, C; Milon, A

1996-08-01

Two myxoma virus-rabbit hemorrhagic disease virus (RHDV) recombinant viruses were constructed with the SG33 strain of myxoma virus to protect rabbits against myxomatosis and rabbit viral hemorrhagic disease. These recombinant viruses expressed the RHDV capsid protein (VP60). The recombinant protein, which is 60 kDa in size, was antigenic, as revealed by its reaction in immunoprecipitation with antibodies raised against RHDV. Both recombinant viruses induced high levels of RHDV- and myxoma virus-specific antibodies in rabbits after immunization. Inoculations by the intradermal route protected animals against virulent RHDV and myxoma virus challenges.

Usefulness of high-resolution sonography in early diagnosis of rabbit clonorchiasis

International Nuclear Information System (INIS)

Lim, Jae Hoon; Choi, Don Gil; Chung, Il Gyu; Phyun, Lae Hyun; Pyeun, Yong Seon; Hong, Sung Tae; Lee, Me Jeong

1999-01-01

To determine the role of high-resolution sonography in the early diagnosis of experimentally induced clonorchiasis in rabbits. We performed sonographic examination weekly in 22 lightly-infected rabbits (10 rabbits infected with 10 metacercariae, 6 rabbits infected with 20 metacercariae, and 6 rabbits infected with 40 metacercariae), and 10 heavily-infected rabbits (500 metacercariae). The sonographic criterion of diagnosis with dilatation of the intrahepatic ducts. We sacrificed lightly-infected rabbits and counted numbers of adult worms of clonorchis sinensis 9 weeks after infection. Sonographic abnormalities were found 3 weeks after infection in 2 lightly-infected rabbits and 5 heavily-infected rabbits. On sonography at 9 weeks after infection, we observed dilatation of the intrahepatic ducts in 11 (65%) of 17 lightly-infected rabbits and all of 10 heavily-infected rabbits. High-resolution sonography is very useful in early diagnosis of rabbits clonorchiasis.

Usefulness of high-resolution sonography in early diagnosis of rabbit clonorchiasis

Energy Technology Data Exchange (ETDEWEB)

Lim, Jae Hoon; Choi, Don Gil; Chung, Il Gyu; Phyun, Lae Hyun; Pyeun, Yong Seon [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of); Hong, Sung Tae; Lee, Me Jeong [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1999-09-15

To determine the role of high-resolution sonography in the early diagnosis of experimentally induced clonorchiasis in rabbits. We performed sonographic examination weekly in 22 lightly-infected rabbits (10 rabbits infected with 10 metacercariae, 6 rabbits infected with 20 metacercariae, and 6 rabbits infected with 40 metacercariae), and 10 heavily-infected rabbits (500 metacercariae). The sonographic criterion of diagnosis with dilatation of the intrahepatic ducts. We sacrificed lightly-infected rabbits and counted numbers of adult worms of clonorchis sinensis 9 weeks after infection. Sonographic abnormalities were found 3 weeks after infection in 2 lightly-infected rabbits and 5 heavily-infected rabbits. On sonography at 9 weeks after infection, we observed dilatation of the intrahepatic ducts in 11 (65%) of 17 lightly-infected rabbits and all of 10 heavily-infected rabbits. High-resolution sonography is very useful in early diagnosis of rabbits clonorchiasis.

Comparison of the Modified McBride Procedure and the Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus.

Science.gov (United States)

Choi, Gi Won; Kim, Hak Jun; Kim, Taik Seon; Chun, Sung Kwang; Kim, Tae Wan; Lee, Yong In; Kim, Kyoung Ho

2016-01-01

Distal metatarsal osteotomy and the modified McBride procedure have each been used for the treatment of mild to moderate hallux valgus. However, few studies have compared the results of these 2 procedures for mild to moderate hallux valgus. The purpose of the present study was to compare the results of distal chevron osteotomy and the modified McBride procedure for treatment of mild to moderate hallux valgus according to the severity of the deformity. We analyzed the data from 45 patients (49.5%; 48 feet [49.0%]), who had undergone an isolated modified McBride procedure (McBride group), and 46 patients (50.5%; 50 feet [51.0%]), who had a distal chevron osteotomy (chevron group). We subdivided each group into those with mild and moderate deformity and compared the clinical and radiologic outcomes between the groups in relation to the severity of the deformity. The improvements in the American Orthopaedic Foot and Ankle Society scale score and the visual analog scale for pain were significantly better for the chevron group for both mild and moderate deformity. The chevron group experienced significantly greater correction in the hallux valgus angle and intermetatarsal angle for both mild and moderate deformity. The chevron group experienced a significantly greater decrease in the grade of sesamoid displacement for patients with moderate deformity. The McBride group had a greater risk of recurrence than did the chevron group for moderate deformity (odds ratio 14.00, 95% confidence interval 3.91 to 50.06, p hallux valgus recurrence than did the distal chevron group. Therefore, we recommend distal chevron osteotomy rather than a modified McBride procedure for the treatment of mild and moderate hallux valgus. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Use of a percutaneous osteotomy with plate fixation in hallux valgus correction.

Science.gov (United States)

Díaz Fernández, Rodrigo

2017-09-20

With hundreds of operative methods described for correction of hallux valgus we can state that the ideal surgical treatment is still controversial. The Bösch technique has been used as a percutaneous way of correcting hallux valgus deformities with the use of a pin fixation. The aim of this study is to evaluate a new method of fixation by using a percutaneous locking plate. Between June 2013 and January 2015, 24 consecutive percutaneous subcapital osteotomies of the first metatarsal bone were performed for the treatment of painful hallux valgus deformities in 24 patients. Additional surgical procedures included DMMO's (Distal Metatarsal Minimally-Invasive Osteotomies) in 12 of the operated feet (44.44%); minor digits were corrected in 7 cases (25.9%). An Akin procedure was performed in 81% of cases and all cases underwent an adductor hallucis tenotomy. All patients were clinically assessed using the AOFAS score. Radiographic measures included the preoperative and postoperative values of the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and the Distal Metatarsal Articular Angle (DMAA). The mean correction achieved improved for AHV from 36.57±7.1 to 12.22±8.69°, for IMA from 13.8±1.59 to 7.08±2.72 and for DMAA from 13.98±7.38 to 6.07±4.99. Clinically, scores on the AOFAS scale improved from a 45.8±9.6 to 91.29±9.8. Although healing of the osteotomies was observed radiographically within 6 to 12 weeks, two cases (8.3%) exhibited delayed healing. There were no cases of nonunion. There were no superficial or deep infections or wound healing problems. Plate had to be removed in 3 cases (12.5%). This technique modification is an acceptable procedure to correct hallux valgus in patients with a moderate level of deformity. Level IV. Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Innate resistance to myxomatosis in wild rabbits in England*

Science.gov (United States)

Ross, J.; Sanders, M. F.

1977-01-01

Wild rabbits (Oryctolagus cuniculus) from one study area in England have been used over a period of 11 years to investigate the possible appearance of innate resistance to myxomatosis. Rabbits of 4-6 weeks old were captured alive, retained in the laboratory until at least 4 months old, and then infected with a type of myxoma virus which kills 90-95% of laboratory rabbits. Observations were made of symptoms, mortality rate and survival times. In the first 4 years of the study (1966-9), mortality rates were not significantly different from those of laboratory rabbits, although survival times of wild rabbits were appreciably longer. In 1970, the mortality rate amongst wild rabbits was 59%, in 1974 it was 17%, and in 1976 it was 20%, thus showing that a considerable degree of inherited resistance to myxomatosis has developed. The types of myxoma virus most commonly isolated from wild rabbits in Great Britain in recent years have been those which cause 70-95% mortality in laboratory rabbits. Therefore, if the degree of innate resistance demonstrated is widespread in Great Britain, there are serious implications regarding the size of the rabbit population, because myxomatosis has been an important factor in holding rabbit numbers at a relatively low level. PMID:270526

Innate resistance to myxomatosis in wild rabbits in England.

Science.gov (United States)

Ross, J; Sanders, M F

1977-12-01

Wild rabbits (Oryctolagus cuniculus) from one study area in England have been used over a period of 11 years to investigate the possible appearance of innate resistance to myxomatosis. Rabbits of 4-6 weeks old were captured alive, retained in the laboratory until at least 4 months old, and then infected with a type of myxoma virus which kills 90-95% of laboratory rabbits. Observations were made of symptoms, mortality rate and survival times.In the first 4 years of the study (1966-9), mortality rates were not significantly different from those of laboratory rabbits, although survival times of wild rabbits were appreciably longer. In 1970, the mortality rate amongst wild rabbits was 59%, in 1974 it was 17%, and in 1976 it was 20%, thus showing that a considerable degree of inherited resistance to myxomatosis has developed.The types of myxoma virus most commonly isolated from wild rabbits in Great Britain in recent years have been those which cause 70-95% mortality in laboratory rabbits. Therefore, if the degree of innate resistance demonstrated is widespread in Great Britain, there are serious implications regarding the size of the rabbit population, because myxomatosis has been an important factor in holding rabbit numbers at a relatively low level.

A computed tomography study in the location of greater palatine artery in South Indian population for maxillary osteotomy

Directory of Open Access Journals (Sweden)

I Packiaraj

2016-01-01

Full Text Available Introduction: The greater palatine artery is one of the important feeding vessel to the maxilla. The surgeon should know the surgical anatomy of greater palatine artery to avoid trauma in maxilla which leads to ischemic problems. Aim: The CT evaluation of the distance between Pyriform aperture and the greater palatine foramen in various ages of both sexes. Result: The distance varies according to sex and age which are measured by CT and standardised. Discussion: The lateral nasal osteotomy can be done upto 25 mm depth, instead of 20 mm. Conclusion: By this study it shows that the lateral nasal wall osteotomy can be performed without injury to greater palatine artery.

Comparison between innominate osteotomy and arthrodistraction as a primary treatment for Legg-Calvé-Perthes disease: a prospective controlled trial.

Science.gov (United States)

Volpon, José Batista

2012-09-01

Legg-Calvé-Perthes (LCP) disease is currently managed by mechanical containment of the femoral head in the hip socket. As evidence suggests that hip distraction may offer a new treatment strategy, we used arthrodistraction as a primary treatment for active forms of LCP disease and prospectively compared the results with the Salter innominate osteotomy. A total of 54 children, six years or older of both genders with severe forms of LCP disease in the stages of necrosis or revascularisation, were enrolled. Patients were submitted to either Salter innominate osteotomy (n = 28) or hip arthrodistraction (n = 26). Final radiographs were used to evaluate the Mose index, Wiberg angle, extrusion index and the Stulberg et al. classification. There were no significant differences in gender, age, lateral pillar classification and average follow-up time between the two groups. The osteotomy group progressed without major complications, but children in the joint distraction group experienced episodes of pin tract pain and infection, leading to the early removal of the external device in one case. Two patients developed joint stiffness, treated by physiotherapy or manipulation, and one child developed subluxation of the femoral head. The average time in distraction was 4.44 months (2.53-7.23 months). In the final evaluation the osteotomy group showed better containment of the femoral head. The Mose index and the Stulberg et al. classification were statistically similar between the two groups. Despite similar final radiological results, arthrodistraction was associated with a higher morbidity. Consequently, we do not recommend hip distraction as a primary treatment for the early stages of LCP disease.

Welfare assessment in pet rabbits

NARCIS (Netherlands)

Schepers, F.; Koene, P.; Beerda, B.

2009-01-01

One million pet rabbits are kept in The Netherlands, but there are no data available on their behaviour and welfare. This study seeks to assess the welfare of pet rabbits in Dutch households and is a first step in the development of a welfare assessment system. In an internet survey, housing

Approaches and perioperative management in periacetabular osteotomy surgery

DEFF Research Database (Denmark)

Søballe, Kjeld; Troelsen, Anders

2012-01-01

.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...... (local infiltration analgesia), and a progressive mobilization and exercise program. The transsartorial approach coupled with a specific perioperative management program has proved successful for PAO surgery.......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...

Piezosurgery versus Rotatory Osteotomy in Mandibular Impacted Third Molar Extraction

Science.gov (United States)

Bhati, Bharat; Kukreja, Pankaj; Kumar, Sanjeev; Rathi, Vidhi C.; Singh, Kanika; Bansal, Shipra

2017-01-01

Aim: The aim of this study is to compare piezoelectric surgery versus rotatory osteotomy technique in removal of mandibular impacted third molar. Materials and Methods: Sample size of 30 patients 18 males, 12 females with a mean age of 27.43 ± 5.27. Bilateral extractions were required in all patients. All the patients were randomly allocated to two groups in one group, namely control group, surgical extraction of mandibular third molar was done using conventional rotatory osteotomy and in the other group, namely test group, extraction of lower third molar was done using Piezotome. Results: Parameters assessed in this study were – mouth opening (interincisal opening), pain (visual analog scale VAS score), swelling, incidence of dry socket, paresthesia and duration of surgery in both groups at baseline, 1st, 3rd, and 7th postoperative day. Comparing both groups pain scores with (P piezosurgery group (51.40 ± 17.9) minutes compared to the conventional rotatory group with a mean of (37.33 ± 15.5) minutes showing a statistically significant difference (P = 0.002). Conclusion: The main advantages of piezosurgery include soft tissue protection, optimal visibility in the surgical field, decreased blood loss, less vibration and noise, increased comfort for the patient, and protection of tooth structures. Therefore, the piezoelectric device was efficient in decreasing the short-term outcomes of pain and swelling although taking longer duration than conventional rotatory technique it significantly reduces the associated postoperative sequelae of third molar surgery. PMID:28713729

Market Driving to Develop Rabbit Meat Products in Indonesia

OpenAIRE

Atien Priyanti; Yono Cahyo Rahadjo

2012-01-01

Rabbit meat is a nutritional food containing high protein and low cholesterol, fat and sodium. Current research in rabbit production is aimed for developing production strategies to increase the nutritional and economic values of rabbit meat products as functional food. Nowadays, producing rabbit is a popular farming activity in many parts of Indonesia as a small and medium scale operation for food security and cash income. Rabbit farming is to produce meat, skin and hides, fur, organic ferti...

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

Science.gov (United States)

Zhou, Haichao; Ren, Haoyang; Li, Chunguang; Xia, Jiang; Yu, Guangrong; Yang, Yunfeng

2017-01-01

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 stage II B adult-acquired flatfoot deformity with a 3 mm lengthening in cadavers.

Brachymetatarsia of the Fourth Metatarsal, Lengthening Scarf Osteotomy with Bone Graft

OpenAIRE

Desai, Ankit; Lidder, Surjit; R. Armitage, Andrew; S. Rajaratnam, Samuel; D. Skyrme, Andrew

2013-01-01

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 modifie...

Combined orthognathic distraction procedure: Le Fort I maxillary osteotomy and mandibular curvilinear distraction osteogenesis. A new technique for craniofacial management.

Science.gov (United States)

Schendel, Stephen A; Hazan-Molina, Hagai; Aizenbud, Dror

2014-04-01

Dentofacial deformities are traditionally treated by maxillary and mandibular osteotomies conducted separately or simultaneously. Recently, distraction osteogenesis has become an irreplaceable part of the surgical armamentarium, for its ability to induce new bone formation between the surfaces of bone segments that are gradually separated by incremental traction, along with a simultaneous expansion of the surrounding soft-tissue envelope. The aim of this article is to describe a combined surgical technique consisting of simultaneous maxillary Le Fort I advancement and mandibular surgical repositioning by means of bilateral sagittal split osteotomy with a curvilinear distractor based on a preliminary computerized presurgical prediction.

Preliminary results of an anteverting triple periacetabular osteotomy for the treatment of hip instability in Down syndrome.

Science.gov (United States)

Maranho, D A; Kim, Y-J; Williams, K A; Novais, E N

2018-02-01

To investigate the outcomes of an anteverting triple periacetabular osteotomy for the treatment of hip instability in skeletally immature patients with Down syndrome. We evaluated 16 patients (21 hips) with Down syndrome and hip instability who underwent an anteverting triple periacetabular osteotomy between 2007 and 2016. There were nine females and seven males with an average age of 7.4 years SD 2.0. We assessed the level of hip pain, gait ability and clinical stability at a minimum of one year after surgery. Radiographic evaluation included pre- and postoperative lateral centre-edge angle (LCEA), Tönnis acetabular angle and extrusion index. After an average follow-up of 4.1 years SD 2.6, 20 of 21 hips (95%) remained clinically stable. In all, 12 of 16 (75%) patients had a full gait without a major limp, but three patients (19%) had a persistent limp. Of the 21 procedures, one hip (5%) was considered a failure due to persistent instability. There was a mean increase of 18.3º SD 15.3º of the LCEA (p treatment of an infection; which was considered a major complication. The anteverting triple periacetabular osteotomy provided global deformity correction and achieved hip stability in 95% of the hips after a mean follow-up of 4.1 years. Therapeutic level IV.

Confirmation and phylogenetic analysis of rabbit hemorrhagic disease virus in free-living rabbits from the Netherlands

NARCIS (Netherlands)

van de Bildt, M. W. G.; van Bolhuis, G. H.; van Zijderveld, F.; van Riel, D.; Drees, J. M.; Osterhaus, A. D. M. E.; Kuiken, T.

2006-01-01

The number of free-living European rabbits (Oryctolagus cuniculus) in the Netherlands has declined dramatically in recent years. Although rabbit hemorrhagic disease virus (RHDV) infection has been implicated as a possible cause of this decline, the definitive diagnosis has not been reported. We

Ultrastructure of Reissner's membrane in the rabbit

DEFF Research Database (Denmark)

Qvortrup, K.; Rostgaard, Jørgen; Bretlau, P.

1994-01-01

Anatomy, Reissner's membrane, electron microscopy, tubulocisternal endoplasmic reticulum, subsurface cisterns, rabbit......Anatomy, Reissner's membrane, electron microscopy, tubulocisternal endoplasmic reticulum, subsurface cisterns, rabbit...

The results of Scarf osteotomy combined with distal soft tissue procedure are mostly satisfactory in surgical management of moderate to severe hallux valgus.

Science.gov (United States)

Şaylı, Uğur; Akman, Budak; Tanrıöver, Altuğ; Kaspar, Çiğdem; Güven, Melih; Özler, Turhan

2017-05-29

Intrinsically stable diaphyseal osteotomy gained popularity in recent years for symptomatic hallux valgus deformities. In this study, Scarf osteotomy results, in surgical management of moderate to severe hallux valgus, are presented. Study group consisted of 40 feet of 32 (28 females, four males) patients surgically managed by Scarf osteotomy between September 2009 and 2011, with a mean age of 52,98 (range, 31-75) years at the time of surgery. Patient satisfaction and VAS were used for subjective evaluation while for objective measures AOFAS score, first metatarsophalangeal joint ROM and radiological measurements (intermetatarsal, hallux valgus and distal metatarsal articular angles) were evaluated. Mean follow-up period was 38 (range, 24-60) months. Sixteen feet (40%) were reported as very satisfied, 19 (47,5%) as satisfied and the remaining five (12,5%) as unsatisfied resulting with a total of 35 (87,5%) satisfaction. The mean preoperative VAS and AOFAS forefoot scores improved from 8,13±0,791 to 2,68±1,228 (p=0,0001) and from 58,25±6,15 to 78,25±8,13 (p=0,0001) on the final follow-up, respectively. The postoperative change of first metatarsophalangeal joint ROM was not statistically significant (p=0,281). On the radiological evaluation; intermetatarsal and hallux valgus angles improved from a mean value of 14,77±1,76 to 8,13±1,52° (p=0,0001) and from 35,28±5,86 to 20,10±5,55° (p=0,0001), respectively. Distal metatarsal articular angle did not show any statistically significant change (p=0,195). Scarf osteotomy combined with distal soft tissue procedure is a technically demanding procedure. The osteotomy is intrinsically stable and the correction power is high and the results are mostly satisfactory. Copyright © 2017. Published by Elsevier Ltd.

Treatment of humeroulnar subluxation with a dynamic proximal ulnar osteotomy: a review of 13 cases

International Nuclear Information System (INIS)

Gilson, S.D.; Piermattei, D.L.; Schwarz, P.D.

1989-01-01

Humeroulnar subluxation was treated surgically in 13 dogs with 18 affected elbows using a proximal osteotomy of the ulna that allowed the ulna to elongate dynamically. Distal humeroulnar subluxation was secondary to premature closure of the distal ulnar physis in 16 elbows. One distal subluxation was secondary to a radioulnar synostosis, and one proximal subluxation developed after premature closure of the distal radial physis. The mean follow-up time was 22 months. Twenty-eight percent of the elbows were judged to have excellent results, 22% good results, 50% fair results, and none was judged to have a poor outcome. The presenting lameness grade and the severity of preoperative and postoperative humeroulnar subluxation had significant correlations with the prognosis. Associated orthopedic abnormalities and complications of concurrent surgical procedures affected the outcome in several dogs. Overall, the dynamic proximal ulnar osteotomy was a simple and effective technique for the treatment of uncomplicated humeroulnar subluxation

Occurrence of Gastrointestinal Helminths in rabbits with special ...

African Journals Online (AJOL)

2013-09-25

Sep 25, 2013 ... droppings to digest their food further and extract sufficient nutrients (Oaktreevet, 2010). Rabbits are generally infected with numerous parasites. Parasitic infections have caused considerable losses to rabbits in the region. Numbers of parasites are responsible for illness of rabbits (Allan et al., 1999).

Market Driving to Develop Rabbit Meat Products in Indonesia

Directory of Open Access Journals (Sweden)

Atien Priyanti

2012-09-01

Full Text Available Rabbit meat is a nutritional food containing high protein and low cholesterol, fat and sodium. Current research in rabbit production is aimed for developing production strategies to increase the nutritional and economic values of rabbit meat products as functional food. Nowadays, producing rabbit is a popular farming activity in many parts of Indonesia as a small and medium scale operation for food security and cash income. Rabbit farming is to produce meat, skin and hides, fur, organic fertilizers and pet or fancy animals. Consumption of rabbit meat is considered very low, due partly to low meat supply and inavailability of marketing. In some tourist areas, such as Lembang (West Java, Tawangmangu (Central Java, Sarangan and Batu (East Java rabbit meat is a specific food. Attempt to create and drive rabbit markets will simultaneously increase meat production to fulfill the demand and meet economic scale of farming. Hence, this will give significant impact to the farmers’ welfare. Availability of good quality meat, dissemination and diversification of meat products, production efficiency toward competitive price along with its proper marketing strategy will drive consumers’ preferences to consume more rabbit meat. Market driving needs to be created in order to promote rabbit meat products by establishing food outlets. This program has been developed by a farmers group in Magelang, Central Java. During the period of 2006 – 2007 the food outlets had increased to 5 outlets, and in 2012 become 9 outlets. This market driving will also have an impact on changing orientation of rabbit farming from traditional to a small and medium economic scale that will influence the production efficiency.

Effects of a Short Drilling Implant Protocol on Osteotomy Site Temperature and Drill Torque.

Science.gov (United States)

Mihali, Sorin G; Canjau, Silvana; Cernescu, Anghel; Bortun, Cristina M; Wang, Hom-Lay; Bratu, Emanuel

2018-02-01

To establish a protocol for reducing the drilling sequence during implant site preparation based on temperature and insertion torque. The traditional conventional drilling sequence (used several drills with 0.6-mm increment each time) was compared with the proposed short drilling protocol (only used 2 drills: initial and final drill). One hundred drilling osteotomies were performed in bovine and porcine bones. Sets of 2 osteotomy sites were created in 5 bone densities using 2 types of drilling protocols. Thermographic pictures were captured throughout all drilling procedures and analyzed using ThermaCAM Researcher Professional 2.10. Torque values were determined during drilling by measuring electrical input and drill speed. There were statistically significant differences in bone temperature between the conventional and short drilling protocols during implant site preparation (analysis of variance P = 0.0008). However, there were no significant differences between the 2 types of drilling protocols for both implant diameters. Implant site preparation time was significantly reduced when using the short drilling protocol compared with the conventional drilling protocol (P drilling protocol proposed herein may represent a safe approach for implant site preparation.

Clinical and radiographic outcomes of medial open-wedge high tibial osteotomy with Anthony-K plate: prospective minimum five year follow-up data.

Science.gov (United States)

Altay, Mehmet Akif; Ertürk, Cemil; Altay, Nuray; Mercan, Ahmet Şükrü; Sipahioğlu, Serkan; Kalender, Ali Murat; Işıkan, Uğur Erdem

2016-07-01

The purpose of this study was to prospectively evaluate the clinical and radiographic outcomes, and complication rates, after a minimum of five years of follow-up after medial open wedge high tibial osteotomy (MOWHTO) using an Anthony-K plate. MOWHTO was performed on 35 knees of 34 consecutive patients. A visual analogue scale (VAS), and Western Ontario and McMaster University Osteoarthritis (WOMAC) and Lysholm scores, were used in clinical evaluation. Upon radiographic assessment, alignment was expressed as the femorotibial angle (FTA). The posterior tibial slope (PTS) and the Insall-Salvati Index (ISI) were also measured. VAS, WOMAC, and Lysholm scores improved significantly upon follow-up (p FTA was 4.68 ± 4.39° varus pre-operatively; at the last post-operative follow-up, the value was 8.43 ± 2.02° valgus. The mean correction angle was 13.1 ± 2.7°. A significant increase in PTS was evident (p < 0.01), as was a significant decrease in the ISI (p < 0.01). The overall complication rate was 8.6 %. The Anthony-K plate affords accurate correction, initially stabilises the osteotomy after surgery, and maintains such stability until the osteotomy gap is completely healed, without correction loss. The plate survival rate was 97.2 % after a minimum of five years of follow-up. The plate increased the PTS, as do other medial osteotomy fixation plates.

Achievability of 3D planned bimaxillary osteotomies: maxilla-first versus mandible-first surgery.

Science.gov (United States)

Liebregts, Jeroen; Baan, Frank; de Koning, Martien; Ongkosuwito, Edwin; Bergé, Stefaan; Maal, Thomas; Xi, Tong

2017-08-24

The present study was aimed to investigate the effects of sequencing a two-component surgical procedure for correcting malpositioned jaws (bimaxillary osteotomies); specifically, surgical repositioning of the upper jaw-maxilla, and the lower jaw-mandible. Within a population of 116 patients requiring bimaxillary osteotomies, the investigators analyzed whether there were statistically significant differences in postoperative outcome as measured by concordance with a preoperative digital 3D virtual treatment plan. In one group of subjects (n = 58), the maxillary surgical procedure preceded the mandibular surgery. In the second group (n = 58), the mandibular procedure preceded the maxillary surgical procedure. A semi-automated analysis tool (OrthoGnathicAnalyser) was applied to assess the concordance of the postoperative maxillary and mandibular position with the cone beam CT-based 3D virtual treatment planning in an effort to minimize observer variability. The results demonstrated that in most instances, the maxilla-first surgical approach yielded closer concordance with the 3D virtual treatment plan than a mandibular-first procedure. In selected circumstances, such as a planned counterclockwise rotation of both jaws, the mandible-first sequence resulted in more predictable displacements of the jaws.

Detection of the new emerging rabbit haemorrhagic disease type 2 virus (RHDV2) in Sicily from rabbit (Oryctolagus cuniculus) and Italian hare (Lepus corsicanus).

Science.gov (United States)

Camarda, A; Pugliese, N; Cavadini, P; Circella, E; Capucci, L; Caroli, A; Legretto, M; Mallia, E; Lavazza, A

2014-12-01

Rabbit haemorrhagic disease virus (RHDV), a member of the genus Lagovirus, causes rabbit haemorrhagic disease (RHD), a fatal hepatitis of rabbits, not previously reported in hares. Recently, a new RHDV-related virus emerged, called RHDV2. This lagovirus can cause RHD in rabbits and disease and mortality in Lepus capensis (Cape hare). Here we describe a case of RHDV2 infection in another hare species, Lepus corsicanus, during a concurrent RHD outbreak in a group of wild rabbits. The same RHDV2 strain infected rabbits and a hare, also causing a RHD-like syndrome in the latter. Our findings confirmed the capability of RHDV2 to infect hosts other than rabbits and improve the knowledge about the epidemiology and the host range of this new lagovirus. Copyright © 2014 Elsevier Ltd. All rights reserved.

Performance characteristics of Weaner rabbits fed Moringa oleifera ...

African Journals Online (AJOL)

This study was designed to investigate the utilization of Moringa oleifera (MO) and Moringa stenopetala (MS) by weaner rabbit. In a twelve week feeding trial, forty eight weaner rabbits of about five weeks old were allotted into three treatments with each treatment consisting of sixteen rabbits in a completely randomized ...

PHARMACOKINETIC VARIATIONS OF OFLOXACIN IN NORMAL AND FEBRILE RABBITS

Directory of Open Access Journals (Sweden)

M. AHMAD, H. RAZA, G. MURTAZA AND N. AKHTAR

2008-12-01

Full Text Available The influence of experimentally Escherichia coli-induced fever (EEIF on the pharmacokinetics of ofloxacin was evaluated. Ofloxacin was administered @ 20 mg.kg-1 body weight intravenously to a group of eight healthy rabbits and compared these results to values in same eight rabbits with EEIF. Pharmacokinetic parameters of ofloxacin in normal and febrile rabbits were determined by using two compartment open kinetic model. Peak plasma level (Cmax and area under the plasma concentration-time curve (AUC0-α in normal and febrile rabbits did not differ (P>0.05. However, area under first moment of plasma concentration-time curve (AUMC0-α in febrile rabbits was significantly (P<0.05 higher than that in normal rabbits. Mean values for elimination rate constant (Ke, elimination half life (t1/2β and apparent volume of distribution (Vd were significantly (P<0.05 lower in febrile rabbits compared to normal rabbits, while mean residence time (MRT and total body clearance (Cl of ofloxacin did not show any significant difference in the normal and febrile rabbits. Clinical significance of the above results can be related to the changes in the volume of distribution and elimination half life that illustrates an altered steady state in febrile condition; hence, the need for an adjustment of dosage regimen in EEIF is required.

Myxomatosis in farmland rabbit populations in England and Wales.

Science.gov (United States)

Ross, J; Tittensor, A M; Fox, A P; Sanders, M F

1989-10-01

The overall pattern and consequences of myxomatosis in wild rabbit populations were studied at three farmland sites in lowland southern England and upland central Wales between 1971 and 1978. When results from all years were combined, the disease showed a clear two-peaked annual cycle, with a main autumn peak between August and January, and a subsidiary spring peak during February to April. Rabbit fleas, the main vectors of myxomatosis in Britain, were present on full-grown rabbits in sufficient numbers for transmission to occur throughout the year, but the observed seasonal pattern of the disease appeared to be influenced by seasonal mass movements of these fleas. However other factors were also important including the timing and success of the main rabbit breeding season, the proportion of rabbits which had recovered from the disease and the timing and extent of autumn rabbit mortality from other causes. Significantly more males than females, and more adults and immatures than juveniles, were observed to be infected by myxomatosis. Only 25-27% of the total populations were seen to be infected during outbreaks. Using two independent methods of calculation, it was estimated that between 47 and 69% of infected rabbits died from the disease (much lower than the expected 90-95% for fully susceptible rabbits with the partly attenuated virus strains that predominated). Thus it was estimated that 12-19% of the total rabbit populations were known to have died directly or indirectly from myxomatosis. Although the effects of myxomatosis were much less than during the 1950s and 1960s, it continued to be an important mortality factor. It may still have a regulatory effect on rabbit numbers, with autumn/winter peaks of disease reducing the numbers of rabbits present at the start of the breeding season.

Visibility of mandibular canal on panoramic radiograph after bilateral sagittal split osteotomy (BSSO).

OpenAIRE

Politis, Constantinus; Ramirez, Xiomara Botero; Sun, Yi; Lambrichts, Ivo; Heath, Neil; Agbaje, Jimoh Olubanwo

2013-01-01

PURPOSE: This study aimed to assess the visibility of the mandibular canal (MC) on panoramic radiographs after bilateral sagittal split osteotomy (BSSO), and to investigate what factors affect this MC visibility. METHODS: We assessed MC visibility on panoramic radiographs of 200 BSSO patients. Images were acquired preoperatively (T0), immediately postoperatively (T1), 6 months postoperatively (T2), and 1 year postoperatively (T3), from three diffe...

Rabbit Model of Retinoblastoma

Directory of Open Access Journals (Sweden)

Shin Jeong Kang

2011-01-01

Full Text Available We created a rabbit model of retinoblastoma and confirmed the tumor clinically and histopathologically. Seventeen New Zealand rabbits were immunosuppressed with cyclosporin A at doses of 10–15 mg/kg. At day 3, the animals received a 30 μl subretinal injection of 1×106 cultured WERI retinoblastoma cells. Digital fundus images were captured before euthanasia, and the eyes were submitted for histopathology. Retinoblastoma cells grew in all the inoculated eyes and established a tumor under the retina and/or in the vitreous. New blood vessels in the tumor were observed starting at week 5. Cuffs of viable tumor cells surrounded the blood vessels with regions of necrosis present at 70–80 μm from nutrient vessels. Occasional tumor seeds in the vitreous histologically exhibited central necrosis. This rabbit model demonstrated similar fundus appearance and pathologic features to human retinoblastoma and may be used as a model to test various routes of drug delivery for retinoblastoma.

Posterior Vertebral Column Resection Through Unilateral Osteotomy Approach for Old Lumbar Fracture Combined with Kummell Disease.

Science.gov (United States)

Wang, Hui; Ding, Wenyuan

2018-01-01

Kummell disease is a clinical syndrome characterized by minor spinal trauma with a symptom-free period from months to years, followed by progressive painful kyphosis. Many surgical options for Kummell disease have been reported in the previous literature; however, no study has mentioned the surgical strategy for patients whose fractured vertebrae were severely compressed and only a slice of superior and inferior end plate was left. Here we report the case of a 69-year-old woman who suffered persistent severe back pain since she slipped and fell 1 year before medical consult. The patient presented with constrained body posture and pressure pain on the thoracolumbar region. Visual analog scale pain under weight bearing was 90/100, and her Oswestry Disability Index score was 74%. Kummell disease was diagnosed on the basis of clinical presentation, trauma history, radiograph, computed tomography, and magnetic resonance imaging. We performed the posterior vertebral column resection through the unilateral osteotomy approach for the patient, and the clinical outcome and radiologic restoration were recorded. One year after the surgery, outpatient follow-up review revealed that the visual analog scale reduced to 10/100 and Oswestry Disability Index reduced to 13%. The posteroanterior and lateral radiograph in the standing position showed bony fusion was achieved at the osteotomy site. No pseudarthrosis or instrumentation-related failure occurred. Posterior vertebral column resection through unilateral osteotomy approach is an effective method for patients with Kummell disease, especially when the fractured vertebrae compressed severely and only a slice of superior and inferior end plate was left. Copyright © 2017 Elsevier Inc. All rights reserved.

Tibial condylar valgus osteotomy (TCVO) for osteoarthritis of the knee: 5-year clinical and radiological results.

Science.gov (United States)

Chiba, Ko; Yonekura, Akihiko; Miyamoto, Takashi; Osaki, Makoto; Chiba, Goji

2017-03-01

Tibial condylar valgus osteotomy (TCVO) is a type of opening-wedge high tibial osteotomy for advanced medial knee osteoarthritis (OA) with subluxated lateral joint. We report the concept, the current surgical technique with a locking plate, and the short-term clinical and radiological results of this procedure. 11 knees with medial OA and a widened lateral joint were treated by TCVO (KL stage III: 6, IV: 5). In this procedure, by the L-shaped osteotomy from the medial side of the proximal tibia to the intercondylar eminence and the valgus correction, lateralization of the mechanical axis and reduction of the subluxated lateral joint are obtained with early postoperative weight-bearing. Before, 6 months, 1, and 5 years after the operation, a visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), alignment of the lower extremity, and congruency and stability of the femorotibial joint were investigated. The VAS improved from an average of 73 mm to 13 mm, and the total WOMAC score from 52 to 14 before to 5 years after the operation, respectively. The mechanical axis changed from 1 to 60%, and the FTA changed from 186° to 171°. The joint line convergence angle (JLCA) changed from 6° to 1°, and the angle difference of JLCA between varus and valgus stress improved from 8° to 4° after the procedure. Improvements in pain and activities of daily living were observed by TCVO along with valgus correction of the lower extremity and stabilization of the femorotibial joint.

Posterior all-pedicle screw instrumentation combined with multiple chevron and concave rib osteotomies in the treatment of adolescent congenital kyphoscoliosis.

Science.gov (United States)

Ayvaz, Mehmet; Olgun, Z Deniz; Demirkiran, H Gokhan; Alanay, Ahmet; Yazici, Muharrem

2014-01-01

Congenital kyphoscoliosis is a disorder that often requires surgical treatment. Although many methods of surgical treatment exist, posterior-only vertebral column resection with instrumentation and fusion seem to have become the gold standard for very severe and very rigid curves. Multiple chevron and concave rib osteotomies have been previously reported to be effective in the treatment of neglected severe idiopathic curves. We hypothesized that this method may also be used successfully in the treatment of congenital kyphoscoliosis. To evaluate the effectiveness and safety of multiple chevron osteotomies combined with concave rib osteotomy and posterior pedicle screw instrumentation. Retrospective chart review in the spine service of a large university hospital. Adolescent patients undergoing a specific surgical treatment for the indication of rigid congenital kyphoscoliotic deformity. Radiographic images were used for the measurement of deformity correction. The Turkish version of the Scoliosis Research Society 22 (SRS-22) Patient Questionnaire has been used as a clinical outcome measure in the patient population. A retrospective chart review was performed. Patients admitted to Hacettepe Hospital Spine Center during the period of 2005 to 2009 were included. Criteria for inclusion were as follows: adolescent age group (10-16 years); congenital kyphoscoliosis; formation and/or segmentation defect of at least two vertebral motion segments; surgical treatment of deformity by posterior all-pedicle screw instrumentation, multiple chevron osteotomies, and multiple concave rib osteotomies; follow-up of at least 24 months; and a complete set of preoperative, postoperative, and follow-up standing posteroanterior and lateral full spinal radiographs. The patients' hospital records and X-rays were reviewed. Duration of surgery, intraoperative blood loss, postoperative transfusion requirements, postoperative stay in postanesthesia care unit (PACU), time of hospitalization, and

Electroacupuncture analgesia in a rabbit ovariohysterectomy.

Science.gov (United States)

Parmen, Valentin

2014-02-01

This study investigated the effectiveness of electroacupuncture analgesia (EAA) at local and paravertebral acupoints for a rabbit undergoing an ovariohysterectomy. Twelve clinically healthy New Zealand white rabbits were chosen and divided into two groups: the control group (5 rabbits) and the experimental group (7 rabbits). A neuroleptanalgesic (ketamine + xylazine) was administered to the control group (NLA group); the experimental group received EAA treatment (EAA group). The EAA treatment includes one acupuncture formula for local stimulation at the incision site and systemic stimulation. Results of clinical research have shown postoperative analgesia using EAA treatment to be superior to that using NLA. The average postoperative recovery time was 5.2 times longer in the NLA group than in the EAA group. Because consciousness was maintained, EAA presented an advantage in thermoregulation. Animals administered NLA had prolonged thermal homeostasis because of neurovegetative disconnection. For the EAA group, the operative times were characterized as excellent (28%, p = 0.28) or good (72%, p = 0.72). Local stimulation at the incision site provided excellent analgesia of the abdominal wall (100%). In conclusion, EA can provide general analgesia with a considerable analgesic effect for a rabbit undergoing an ovariohysterectomy, resulting in a short postoperative recovery time. Copyright © 2014. Published by Elsevier B.V.

Performance evaluation and nutrient digestibility of rabbits fed ...

African Journals Online (AJOL)

A total of 32 weaned rabbits (56 days old; 586 ± 60.31g body weight) were selected to investigate the effect of dietary growth promoters on the growth performance, nutrient digestibility and carcass characteristics of rabbits. The rabbits were randomly assigned to four dietary treatments (n = 8) including a basal diet (control), ...

Protection against myxomatosis and rabbit viral hemorrhagic disease with recombinant myxoma viruses expressing rabbit hemorrhagic disease virus capsid protein

OpenAIRE

Bertagnoli, Stéphane; Gelfi, Jacqueline; Le Gall, Ghislaine; Boilletot, Eric; Vautherot, Jean-François; Rasschaert, Denis; Laurent, Sylvie; Petit, Frédérique; Boucraut-Baralon, Corine; Milon, Alain

1996-01-01

Two myxoma virus-rabbit hemorrhagic disease virus (RHDV) recombinant viruses were constructed with the SG33 strain of myxoma virus to protect rabbits against myxomatosis and rabbit viral hemorrhagic disease. These recombinant viruses expressed the RHDV capsid protein (VP60). The recombinant protein, which is 60 kDa in size, was antigenic, as revealed by its reaction in immunoprecipitation with antibodies raised against RHDV. Both recombinant viruses induced high levels of RHDV- and myxoma vir...

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 lengthening by means of calcaneus osteotomy rather than distraction arthrodesis of the calcaneocuboid joint, for correction of stage II posterior tibial tendon dysfunction. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Bee pollen supplementation in diets for rabbit does and growing rabbits - doi: 10.4025/actascianimsci.v35i4.18950

Directory of Open Access Journals (Sweden)

Daisa Mirelle Borges Dias

2013-10-01

Full Text Available It was evaluated the effects of bee pollen (BP on the doe and kits productivity and on the carcass and organs of the rabbits. Twenty White New Zealand does and their kits were used in a randomized block design, with four treatments and five blocks, in a factorial arrangement 2 x 2 with two supplementation levels for the doe and for the kits after the weaning. BP supplementation for the does did not influence (p > 0.05 the doe and kit productivity during the lactation, except by the kits survival rate (p 0.05 the rabbit performance from the weaning until the slaughter age, the slaughter weight, carcass characteristics, except by the spleen and small intestine weights, higher in supplemented rabbits. It was not recommended that BP supplementation for does and/or rabbits for not improving the rabbit productive performance.  

Carcass traits of four rabbit genotypes

Directory of Open Access Journals (Sweden)

Ajda Kermauner

2010-01-01

Full Text Available Seventy-three rabbits of four genotypes (A - SIKA maternal line; C - SIKA sire line; AxC - hybrids between line A and C; AxCal - crossbreds between line A and the Californian breed were used to evaluate the effect of genotype on carcass traits. Rabbits were weaned at 35 days and slaughtered at 93 days of age. Rabbits were fed standard feed mixture ad libitum. The highest live weight at slaughter and dressing percentage was achieved by line C, and the lowest in line A. Hybrids between line A and C exhibited slightly worse carcass traits than rabbits in line C, but the differences were not statistically significant. The Californian breed gave worse results than crossbreeding with line C, though in most cases the differences between AxC and AxCal were not significant. The differences between genotypes in hind leg tissue composition, pH and meat colour were not statistically significant.

Rabbit meat processing: historical perspective to future directions

Directory of Open Access Journals (Sweden)

Massimiliano Petracci

2013-12-01

Full Text Available In past centuries, because rabbits are relatively small, animals slaughtered for consumption were generally eaten immediately. However, since a single rabbit would offer little more product than could be consumed at one sitting, little effort was devoted to developing preserved rabbit products (such as salted or dried meat, sausages, etc.. For this reason, although there is a rich history of recipes using rabbit meat in the Mediterranean area, there are few traditional further-processed products. Nowadays, even though the processing industry is pushing more and more towards the introduction of more attractive products (i.e. ready meals, ready-to-cook, etc. for consumers with little time for meal preparation, most rabbit meat worldwide is still sold as whole carcass or cut-up parts. This review analyses the main strength and weakness factors regarding the use of rabbit meat to manufacture further processed products. Bearing in mind these considerations, it then describes the more promising processing technologies for raw meat materials to obtain added-value products (marinated, formed, emulsified, coated, etc. by exploiting rabbit meat’s intrinsic characteristics, such as high protein/low fat content coupled with a balanced n-6 to n-3 PUFA ratio, low cholesterol and heme-iron content. Major trends in meat product formulation (modulation of lipid content and composition, use of novel antioxidants and salt reduction are also discussed by highlighting strategies to provide healthier meat products meeting current nutritional needs. Finally, major packaging solutions for rabbit meat and meat products (ordinary and modified atmosphere, vacuum are considered.

Effects of myxoma virus and rabbit hemorrhagic disease virus on the physiological condition of wild European rabbits: Is blood biochemistry a useful monitoring tool?

Science.gov (United States)

Pacios-Palma, Isabel; Santoro, Simone; Bertó-Moran, Alejandro; Moreno, Sacramento; Rouco, Carlos

2016-12-01

Myxomatosis and rabbit hemorrhagic disease (RHD) are the major viral diseases that affect the wild European rabbit (Oryctolagus cuniculus). These diseases arrived in Europe within the last decades and have caused wild rabbit populations to decline dramatically. Both viruses are currently considered to be endemic in the Iberian Peninsula; periodic outbreaks that strongly impact wild populations regularly occur. Myxoma virus (MV) and rabbit hemorrhagic disease virus (RHDV) alter the physiology of infected rabbits, resulting in physical deterioration. Consequently, the persistence and viability of natural populations are affected. The main goal of our study was to determine if blood biochemistry is correlated with serostatus in wild European rabbits. We carried out seven live-trapping sessions in three wild rabbit populations over a two-year period. Blood samples were collected to measure anti-MV and anti-RHDV antibody concentrations and to measure biochemical parameters related to organ function, protein metabolism, and nutritional status. Overall, we found no significant relationships between rabbit serostatus and biochemistry. Our main result was that rabbits that were seropositive for both MV and RHDV had low gamma glutamyltransferase concentrations. Given the robustness of our analyses, the lack of significant relationships may indicate that the biochemical parameters measured are poor proxies for serostatus. Another explanation is that wild rabbits might be producing attenuated physiological responses to these viruses because the latter are now enzootic in the study area. Copyright © 2016 Elsevier Ltd. All rights reserved.

Creating a Long-Term Diabetic Rabbit Model

Directory of Open Access Journals (Sweden)

Jianpu Wang

2010-01-01

Full Text Available This study was to create a long-term rabbit model of diabetes mellitus for medical studies of up to one year or longer and to evaluate the effects of chronic hyperglycemia on damage of major organs. A single dose of alloxan monohydrate (100 mg/kg was given intravenously to 20 young New Zealand White rabbits. Another 12 age-matched normal rabbits were used as controls. Hyperglycemia developed within 48 hours after treatment with alloxan. Insulin was given daily after diabetes developed. All animals gained some body weight, but the gain was much less than the age-matched nondiabetic rabbits. Hyperlipidemia, higher blood urea nitrogen and creatinine were found in the diabetic animals. Histologically, the pancreas showed marked beta cell damage. The kidneys showed significantly thickened afferent glomerular arterioles with narrowed lumens along with glomerular atrophy. Lipid accumulation in the cytoplasm of hepatocytes appeared as vacuoles. Full-thickness skin wound healing was delayed. In summary, with careful management, alloxan-induced diabetic rabbits can be maintained for one year or longer in reasonably good health for diabetic studies.

Total hip arthroplasty (S-ROM stem and subtrochanteric osteotomy for Crowe type IV developmental dysplasia of the hip

Directory of Open Access Journals (Sweden)

Liangtao Li

2016-01-01

Conclusions: In the primary THA for the treatment of irreducible DDH, subtrochanteric oblique osteotomy combined with the freely-rotatable S-ROM stem provided favorable short term outcomes by affording both morphological and functional advantages.

Immune response in rabbit ovaries following infection of a recombinant myxoma virus expressing rabbit zona pellucida protein B

International Nuclear Information System (INIS)

Gu Wenyi; Holland, Michael; Janssens, Peter; Seamark, Robert; Kerr, Peter

2004-01-01

In this study, we investigated the autoimmune response in rabbit ovaries following infection with a recombinant myxoma virus expressing rabbit zona pellucida protein B (MV-ZPB). A specific IgG antibody response to ZPB was elicited in the serum of infected rabbits and the antibody strongly bound to the zona pellucida of oocytes in secondary and tertiary follicles. T cell infiltration in the ovary was detected in a small proportion of the infected rabbits. In spite of this, the mean number of preovulatory and tertiary follicles in the ovary was significantly reduced at 30 days postinfection compared with that of the infected and uninfected controls. Histological analysis revealed that the cortex and medulla of these ovaries had accumulated a large number of probably luteinized cells and there were no follicles in these areas, indicating the ovaries were in a severe pathological condition. The data suggest that the delivery of ZP antigens using a recombinant myxoma virus is a prospective way to develop immunocontraceptive vaccines for rabbit population control, but that more understanding of the kinetics of the autoimmune response induced by viral delivery is needed

Impact of Pregnancy on Zonisamide Pharmacokinetics in Rabbits

Directory of Open Access Journals (Sweden)

Kamal M. Matar

2013-01-01

Full Text Available Pregnancy is associated with various physiological changes which may lead to significant alterations in the pharmacokinetics of many drugs. The present study was aimed to investigate the potential effects of pregnancy on the pharmacokinetic profile of zonisamide (ZNM in the rabbit. Seven female rabbits were used in this study. The pregnant and nonpregnant rabbits received ZNM orally at a dose of 10 mg/kg and blood samples were collected from the animals just before receiving the drug and then serially for up to 24 h. The plasma samples were analyzed using tandem mass spectrometric method. Following a single oral dose of ZNM to the rabbits, the mean values of ZNM plasma concentrations at different times were consistently low in pregnant compared to nonpregnant rabbits. The mean values of ZNM’s Cmax and AUC0-∞ were significantly (P<0.05 decreased, whereas the CL/F exhibited substantial increase (P<0.05 in pregnant compared to nonpregnant rabbits. Tmax, t1/2abs, t1/2el, MRT, and Vd/F showed no significant differences between the two groups. The present study demonstrates that pregnancy decreased ZNM plasma concentrations in rabbits and that the decrease could be due to decreased extent of gastrointestinal absorption, induced hepatic metabolism, or enhanced renal elimination of the drug.

Treatment of ankylosed maxillary central incisors by segmental osteotomy with autogenous bone graft.

Science.gov (United States)

You, Kug-Ho; Min, Yon-Sook; Baik, Hyoung-Seon

2012-04-01

This case report describes the treatment of a 16-year-old girl with ankylosed maxillary central incisors that were noticeably infraoccluded and labially displaced. We performed a segmental osteotomy with an autogenous bone graft in a single-stage surgery to align and level the ankylosed teeth. The dento-osseous segment was successfully repositioned with satisfactory periodontal results. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Osteosynthesis techniques used for mandibular sagittal split osteotomy – history of orthognathic procedures and modern practice.

Science.gov (United States)

Nowak, Rafał; Trybek, Grzegorz

Choosing an appropriate fixation technique after maxillary or mandibular osteotomy is one of the key factors affecting the success of orthognathic surgery. In line with the development of new surgical methods and techniques, the surgeons’ approach to the fixation of bone fragments has evolved accordingly, varying from non-fusion to different osteosynthesis techniques. Advances in medical sciences and medical technologies, have changed our attitudes to bone fragment reduction in orthopaedics and traumatology, and also in maxillofacial surgery. The pivotal underlying principle which determines bone healing – that is proper positioning so as to ensure appropriate contact area and immobilisation so as to ensure osteosynthesis – has remained unchanged for centuries. However, over the years, patient comfort and the predictability of treatment outcomes have vastly improved. The paper provides an overview of the techniques and methods used for the fixation of osteotomized fragments after bilateral sagittal split osteotomy since its introduction by Hugo Obwegeser up to the present day.

Effect of surgical shoes on brake response time after first metatarsal osteotomy--a prospective cohort study.

Science.gov (United States)

Dammerer, Dietmar; Braito, Matthias; Biedermann, Rainer; Ban, Michael; Giesinger, Johannes; Haid, Christian; Liebensteiner, Michael C; Kaufmann, Gerhard

2016-01-20

The aim of this study is to assess patients' driving ability when wearing surgical shoes following right-sided first metatarsal osteotomy. From August 2013 to August 2015, 42 consecutive patients (mean age 54.5 years) with right-sided hallux valgus deformity underwent first metatarsal osteotomy. Patients were tested for brake response time (BRT) 1 day preoperatively (control run) and at 2 and 6 weeks postoperatively. Two different types of foot orthosis were investigated. BRT was assessed using a custom-made driving simulator. Preoperative BRT was 712 msec (standard deviation (SD), 221 msec). BRT was significantly slower at all tested postoperative times than preoperatively (p shoes. Mean global American Orthopaedic Foot and Ankle Society (AOFAS) outcome score and AOFAS pain and alignment subscores increased postoperatively (p shoe after bunionectomy. However, patients should have sufficient recovery, exercise, and training before resuming driving a car, because safety is always a priority. ClinicalTrials.gov, NCT02354066.

Rabbit Oncology : Diseases, Diagnostics, and Therapeutics

NARCIS (Netherlands)

van Zeeland, Yvonne

Neoplasia has long been reported as a rare finding in rabbits, but over the past decades the number of reports on neoplastic disease in rabbits has risen considerably. Similar to other animals, neoplastic changes may occur in any organ system, but the rate in which the organ systems are affected

Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

Science.gov (United States)

Seo, Yu-Jin; Lin, Lu; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

2016-01-01

This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

An Experimental Study for Radiation Nephritis in Rabbits

Energy Technology Data Exchange (ETDEWEB)

Kim, Myung Jae [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1972-09-15

Experimental radiation nephritis was produced in 15 rabbits by X-irradiation. About 2, 000gamma(tissue doses) were given to both kidneys of a rabbit in 5 days. Other tissues and organs except both kidneys were protected with 2 mm thickened lead plates. 5 weeks after the last irradiation, blood pictures, blood pressures, B.U.N., serum creatinine, Ca, Mg, Fe levels and serum erythropoietin activity of the irradiated rabbits were studied. After finishing above studies, rabbits were sacrificed and both kidneys were removed and examined histopathologically. Same laboratory and pathological studies were performed in 6 control rabbits. In this study, the author obtained following results. 1) Both kidneys of rabbits with experimental radiation nephritis showed marked histopathological changes, i.e.: renal tubules showed diffuse cloudy swelling, impacted intraluminal hyaline casts and focal precipitations of lime salts on the tubular epithelium. Diffuse interstitial fatty necrosis and various degrees of fibrotic infiltrations on the interstitium were also seen in association with focal lymphocytic infiltrations. Hyaline degenerations were observed on the glomeruli and small vessels. 2) Experimental radiation nephritis rabbits showed marked lowering in R.B.C. counts, decreased hemoglobin levels, low hematocrit values and leucopenia in comparison with those of control rabbits. (P<0.01). (Table 1 and 2). 3) Mild proteinuria were observed in experimental radiation nephritis in rabbits. 4) The levels of B.U.N. and serum creatinine increased in experimental radiation nephritis. (P<0.01). (Table 1, 3 and 4). 5) The levels of serum Ca and Mg Showed no statistical difference in comparison with those of control rabbits. (P>0.05). (Table 3 and 4). 6) No statistical correlations were observable between the levels of B.U.N. and Hb. values. (gamma=-0. 223). No close correlations (gamma=-0.338) were noticed between the levels of B.U.N. and serum iron levels. 7) Erythropoietin activity (R

A contact-free volumetric measurement of facial volume after third molar osteotomy: proof of concept.

Science.gov (United States)

Brüllmann, Dan; Jürchott, Lena Marie; John, Christoph; Trempler, Christina; Schwanecke, Ulrich; Schulze, Ralf K W

2014-01-01

The present study tested the reliability of an optical scanning device for the objective assessment of postoperative facial swelling. Twenty control subjects bearing a defined volume of water (10-30 mL) in an intraorally carried balloon were tested to assess the measurement accuracy of the device. As a proof of concept, facial volumes of 59 surgical cases were recorded before osteotomy and 1 and 7 days after intervention with the use of a structured light scanner. The median difference between the applied and the measured volumes was 0.67 mL for the control test with the artificial swelling simulated using water balloons. For subjects having third molar osteotomy, extraoral volume increased to 5.29 cm(3) 1 day after surgery (95% CI 5.22-8.52) and decreased to 0.00 mL (95% CI 0.85-2.55) after 7 days. Contact-free visible-light 3-dimensional scanning is reliable for the objective assessment of postoperative facial swelling. Copyright © 2014 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Paulose, Joby; Markose, Eldho

2014-12-01

This paper is a comparative photometric evaluation of soft tissue changes in patients with CLP associated with maxillary deficiency treated with conventional Le Fort I advancement osteotomy (ALO) 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. Frontal and profile photographs were used to ascertain the changes post-surgically. Photographs were obtained before treatment and 1 year after surgical correction in both groups. Vertical as well as horizontal changes in pronasale was well observed in both groups. A substantial increase in nasal parameters was noted in case of AMD group in comparison to ALO group. Though maxillary advancement was quite evident in AMD and ALO groups, a significant and consistent change was observed in AMD group. Significant vertical and horizontal changes were seen with respect to subnasale and labrale superius in AMD group. The hard and soft tissue changes produced by AMD by intra oral distractors were being evaluated so far. The results of the above studies have proved the excellence of AMD over conventional osteotomies. The present study goes hand in hand with the research outcomes till date.

[Exploration for micro-osteotomy assisted orthodontic treatment of skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region].

Science.gov (United States)

Wang, Bo; Shen, Guo-fang; Fang, Bing; Sun, Liang-yan; Wu, Yong; Jiang, Ling-yong; Zhu, Min

2012-10-01

To investigate the changes of periodontal conditions after micro-osteotomy assisted lower incisor decompensation for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region. The sample consisted of 22 cases diagnosed as skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region, selected from consecutive patients of Department of Oral & Cranio-maxillofacial Science of Shanghai Ninth People's Hospital during 2009-2012. The samples were divided into 2 groups; G1 comprised 10 patients who accepted micro-osteotomy assisted lower incisor decompensation; G2 comprised 12 patients who chose traditional pre-surgical decomposition. The changes of periodontal conditions of both groups were evaluated with the help of cone-beam CT(CBCT). Data was processed using SAS8.02 software package. For subjects in G1, during the micro-osteotomy assisted pre-surgical orthodontics, no significant difference was found in the amount of root resorption of lower incisors.But labial and lingual vertical alveolar bone loss were 2.60 mm and 2.22 mm; alveolar bone thickness increased by 3.05 mm on the labial side and decreased by 0.88 mm on the lingual side (Ppre-surgical orthodontics was much safer than traditional orthodontics for skeletal Class III malocclusions with alveolar hypoplasia in the lower anterior region.

Retinitis-pigmentosa-like tapetoretinal degeneration in a rabbit breed.

Science.gov (United States)

Reichenbach, A; Baar, U

1985-08-15

By chance, we found a rabbit strain with retinal dystrophy. The eyes of these rabbits were examined by ophthalmoscopy, electroretinography, histology, and cytology--the latter after retina dissociation with papaine. The results suggest this rabbit strain to be a possible animal model for human retinitis pigmentosa.

Piezosurgery for osteotomies in orbital surgery: Our experience and review of the literature

Science.gov (United States)

Iacoangeli, Maurizio; Neri, Piergiorgio; Balercia, Paolo; Lupi, Ettore; Di Rienzo, Alessandro; Nocchi, Niccolò; Alvaro, Lorenzo; Scerrati, Massimo

2012-01-01

INTRODUCTION Piezoelectric bone surgery, simply known as Piezosurgery®, is a new promising technique for bone cutting based on ultrasonic microvibrations that allows to perform precise and thin osteotomies with soft tissue sparing. PRESENTATION OF CASE A 45-years-old woman presenting with progressive left ocular pain, diplopia on the lateral left gaze, and visible exophthalmos was admitted to our department. CT scan and MRI images documented a left supero-lateral orbital lesion. A left lateral orbitotomy using the piezoelectric scalpel was performed. The tumour (lacrimal gland lymphoma) was completely removed with no injuries to the orbital structures and with a perfect realignment of the bone stumps. DISCUSSION High powered pneumatic osteotome are commonly used to perform craniotomies. Large bone cutting groove and high temperatures developing at the contact site could produce an uneasy bone healing. The use of a piezoelectric scalpel allows to realize precise and thin osteotomies, facilitating craniotomy's borders ossification and avoiding injuries to non-osseous structures. CONCLUSION Widely used in Oral and Maxillofacial Surgery, Piezosurgery® can also be useful in neurosurgical approaches in order to obtain a faster bone flap re-ossification, a better aesthetic result, and a lower risks of dural layer and soft tissue damage. PMID:23276764

[Open-wedge osteotomy of the glenoid for treatment of posterior shoulder instability with increased glenoid retroversion].

Science.gov (United States)

Pogorzelski, J; Braun, S; Imhoff, A B; Beitzel, K

2016-12-01

Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously failed conservative or surgical treatment. General contraindications against surgery. Relative contraindications: osteoporosis, nicotine abuse, or suspected patient noncompliance. Posterior approach with a 7 cm long incision starting medial of the posterolateral corner of the acromion heading to the posterior axillary fold and subsequent preparation of the deltoid muscle and the infraspinatus muscle. The posterior glenohumeral capsule is incised by performing a capsular T‑shift. The osteotomy is performed intracapsulary medial to the genoid rim. The wedge bone graft, harvested from spina scapulae or iliac spine, is placed "press fit" in position. Additional fixation of the graft is not necessary if the anterior cortex is intact. For reinforcing the posterior capsule, a posterior capsule shift should be performed. Insertion of extracapsular wound drainage. Successive wound closure. Postoperative immobilization in a 0° shoulder orthesis for 6 weeks; avoidance of horizontal abduction for 8 weeks. After removing the wound drainage, start of limited active-assisted range of motion. Over-head sports after 6 months. From 2009-2015, 6 posterior open wedge glenoid osteotomies were performed. Postoperative retroversion of the glenoid was 11.2 ± 9.4° compared to 26.0 ± 8.6° before surgery. Of 6 shoulders, 2 showed postoperative signs of persistent posterior instability; the other 4 shoulders were free of complaints. No revision surgery was needed.

Comparing rat and rabbit embryo-fetal developmental toxicity ...

Science.gov (United States)

A database of embryo-fetal developmental toxicity (EFDT) studies of 379 pharmaceutical compounds in rat and rabbit was analyzed for species differences based on toxicokinetic parameters of area under the curve (AUC) and maximum concentration (Cmax) at the developmental adverse effect level (dLOAEL). For the vast majority of cases (83% based on AUC of n=283), dLOAELs in rats and rabbits were within the same order of magnitude (less than 10-fold different) when compared based on available data on AUC and Cmax exposures. For 13.5% of the compounds the rabbit was more sensitive and for 3.5% of compounds the rat was more sensitive when compared based on AUC exposures. For 12% of the compounds the rabbit was more sensitive and for 1.3% of compounds the rat was more sensitive based on Cmax exposures. When evaluated based on human equivalent dose (HED) conversion using standard factors, the rat and rabbit were equally sensitive. The relative extent of embryo-fetal toxicity in the presence of maternal toxicity was not different between species. Overall effect severity incidences were distributed similarly in rat and rabbit studies. Individual rat and rabbit strains did not show a different general distribution of systemic exposure LOAELs as compared to all strains combined for each species. There were no apparent species differences in the occurrence of embryo-fetal variations. Based on power of detection and given differences in the nature of developmental effects betwe

Comparison of rat and rabbit embryo-fetal developmental ...

Science.gov (United States)

Regulatory non-clinical safety testing of human pharmaceutical compounds typically requires embryo fetal developmental toxicity (EFDT) testing in two species, (one rodent and one non-rodent, usually the rat and the rabbit). The question has been raised whether under some conditions EFDT testing could be limited to one species, or whether the need for testing in a second species could be decided on a case by case basis. As part of an RIVM/CBG-MEB/HESI/US EPA consortium initiative, we built and queried a database of 379 EFDT studies conducted for marketed and non-marketed pharmaceutical compounds. The animal models (rat and rabbit) were assessed for their potential for adverse developmental and maternal outcomes. The database was analyzed for the prevalence of EFDT incidence and the nature and severity of adverse findings in the two species. Some manifestation of EFDT in either one or both species (rat and rabbit) was demonstrated for 282 compounds (74%), and EFDT was detected in only one species (rat or rabbit) in almost a third (31%, 118 compounds), with approximately 58% rat and 42% rabbit studies identifying an EFDT signal among the 379 compounds tested. For 24 compounds (6%), fetal malformations were observed in one species (rat or rabbit) in the absence of any EFDT in the second species. In general, growth retardation, fetal variations, and malformations were more prominent in the rat, whereas embryo-fetal death was observed more often in the rabbit. Discor

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.

[Treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy of the first metatarsal bone].

Science.gov (United States)

Díaz Fernández, R

2015-01-01

To evaluate the clinical and radiological results in the surgical treatment of moderate and severe hallux valgus by performing percutaneous double osteotomy. A retrospective study was conducted on 45 feet of 42 patients diagnosed with moderate-severe hallux valgus, operated on in a single centre and by the same surgeon from May 2009 to March 2013. Two patients were lost to follow-up. Clinical and radiological results were recorded. An improvement from 48.14 ± 4.79 points to 91.28 ± 8.73 points was registered using the American Orthopedic Foot and Ankle Society (AOFAS) scale. A radiological decrease from 16.88 ± 2.01 to 8.18 ± 3.23 was observed in the intermetatarsal angle, and from 40.02 ± 6.50 to 10.51 ± 6.55 in hallux valgus angle. There was one case of hallux varus, one case of non-union, a regional pain syndrome type I, an infection that resolved with antibiotics, and a case of loosening of the osteosynthesis that required an open surgical refixation. Percutaneous distal osteotomy of the first metatarsal when performed as an isolated procedure, show limitations when dealing with cases of moderate and severe hallux valgus. The described technique adds the advantages of minimally invasive surgery by expanding applications to severe deformities. Percutaneous double osteotomy is a reproducible technique for correcting severe deformities, with good clinical and radiological results with a complication rate similar to other techniques with the advantages of shorter surgical times and less soft tissue damage. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Preoperative low level laser therapy in dogs undergoing tibial plateau levelling osteotomy: A blinded, prospective, randomized clinical trial.

Science.gov (United States)

Rogatko, Cleo P; Baltzer, Wendy I; Tennant, Rachel

2017-01-16

To evaluate the influence of preoperative low-level laser therapy (LLLT) on therapeutic outcomes of dogs undergoing tibial plateau levelling osteotomy (TPLO). Healthy dogs undergoing TPLO were randomly assigned to receive either a single preoperative LLLT treatment (800-900 nm dual wavelength, 6 W, 3.5 J/cm 2 , 100 cm 2 area) or a sham treatment. Lameness assessment and response to manipulation, as well as force plate analysis, were performed preoperatively, then again at 24 hours, two weeks, and eight weeks postoperatively. Radiographic signs of healing of the osteo-tomy were assessed at eight weeks postoperatively. Twenty-seven dogs (27 stifles) were included and no major complications occurred. At eight weeks postoperatively, a significant difference in peak vertical force analysis was noted between the LLLT (39.6% ± 4.7%) and sham groups (28.9% ± 2.6%), (p dogs in the LLLT group (6.6 ± 1.6 years) was greater than that for the sham group (4.5 ± 2.0, p dogs (5/8) had healed at the eight-week time point than in the sham group (3/12) despite the age difference (p = 0.11) Clinical significance: The results of this study demonstrate that improved peak vertical force could be related to the preoperative use of LLLT for dogs undergoing TPLO at eight weeks postoperatively. The use of LLLT may improve postoperative return to function following canine osteotomies and its use is recommended.

Rabbit tissue model (RTM) harvesting technique.

Science.gov (United States)

Medina, Marelyn

2002-01-01

A method for creating a tissue model using a female rabbit for laparoscopic simulation exercises is described. The specimen is called a Rabbit Tissue Model (RTM). Dissection techniques are described for transforming the rabbit carcass into a small, compact unit that can be used for multiple training sessions. Preservation is accomplished by using saline and refrigeration. Only the animal trunk is used, with the rest of the animal carcass being discarded. Practice exercises are provided for using the preserved organs. Basic surgical skills, such as dissection, suturing, and knot tying, can be practiced on this model. In addition, the RTM can be used with any pelvic trainer that permits placement of larger practice specimens within its confines.

Two-staged Bilateral, Femoral Alignment Osteotomy with Concomitant Total Knee Arthroplasty in an Achondroplasia Patient - A Case Report

Science.gov (United States)

Walter, Sebastian G; Schwering, Tobias; Preiss, Stefan

2017-01-01

Introduction: Achondroplasia is the most common form of dwarfism in humans and is orthopedically characterized by shortened extremities and an exaggerated lumbar lordosis. The surgical challenges are maintenance of axial alignment during limb lengthening as well as joint preservation and alignment restoration. Case Report: We present a 46-year-old female suffering from achondroplasia with severe pain in both knees. Severe varus deformities of both femurs and degeneration of both knee joints became apparent on clinical and radiological examination. On each femur, we performed one-staged, lateral closed-wedge osteotomy, and total knee arthroplasty (TKA). Subsequently, the patient was relieved of knee joint pain and gained a greater range of motion. Conclusion: One-staged valgization osteotomy and concomitant TKA represents a challenging, yet reasonable, surgical solution in axially severe malaligned and joint degenerated patients. PMID:28819598

Viral skin diseases of the rabbit.

Science.gov (United States)

Meredith, Anna L

2013-09-01

This article describes the viral skin diseases affecting the domestic rabbit, the most important being myxomatosis. Transmission and pathogenesis, clinical signs, diagnosis, treatment, and control are described and the article will be of interest to veterinary practitioners who treat rabbits. Shope fibroma virus, Shope papilloma virus, and rabbitpox are also discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment

DEFF Research Database (Denmark)

Niemeyer, Philipp; Schmal, Hagen; Hauschild, Oliver

2010-01-01

PURPOSE: Our purpose was to evaluate the 3-year clinical results of patients with medial-compartment osteoarthritis of the knee and varus malalignment who underwent open-wedge high tibial osteotomy (HTO) with an internal plate fixator (TomoFix; Synthes, Solothurn, Switzerland). Clinical results a...

Cutaneous lesions in pet rabbits following subcutaneous administration of a novel bivalent vaccine against myxomatosis and rabbit haemorrhagic disease.

Science.gov (United States)

Selleri, Paolo; Di Girolamo, Nicola; Vögtlin, Andrea; Fileccia, Ivan; Hoop, Richard; Bongiovanni, Laura

2014-12-01

A novel bivalent vaccine to protect against myxomatosis and rabbit haemorrhagic disease is commercially available for pet rabbits. To describe the appearance of cutaneous lesions arising in pet rabbits positive for myxoma virus (MV) by RT-PCR evaluation shortly after vaccination. Four pet rabbits presenting with papular, crusting skin lesions ~10 days after vaccination. Histological evaluation of formalin-fixed skin biopsies obtained from lesional skin (case 1). Real-time polymerase chain reaction (RT-PCR) evaluation of paraffin-embedded tissue from skin biopsies (case 1) and crusts obtained from the lesion surface (cases 2-4) for myxoma virus are reported as cycle threshold (Ct ) values. Lesions affecting the ear pinna, dorsal aspect of the nose, vulva and/or conjunctiva are reported. Histopathological findings included severe ulcerative, necrotizing dermatitis and intralesional cytoplasmic inclusion bodies in myxoma cells. DNA was amplified from all the paraffin-embedded skin biopsies (Ct  = 34-35) and crusts (Ct  = 20-24). Although a wild virus challenge cannot be definitively excluded, veterinarians and pet-owners should be aware that cutaneous lesions have been observed after vaccination with this novel vaccine in low numbers of rabbits. © 2014 ESVD and ACVD.

Combined rotation scarf and Akin osteotomies for hallux valgus: a patient focussed 9 year follow up of 50 patients

Directory of Open Access Journals (Sweden)

Kilmartin Timothy E

2010-02-01

Full Text Available Abstract Background The Cochrane review of hallux valgus surgery has disputed the scientific validity of hallux valgus research. Scoring systems and surrogate measures such as x-ray angles are commonly reported at just one year post operatively but these are of dubious relevance to the patient. In this study we extended the follow up to a minimum of 8 years and sought to address patient specific concerns with hallux valgus surgery. The long term follow up also allowed a comprehensive review of the complications associated with the combined rotation scarf and Akin osteotomies. Methods Between 1996 and 1999, 101 patients underwent rotation scarf and Akin osteotomies for the treatment of hallux valgus. All patients were contacted and asked to participate in this study. 50 female participants were available allowing review of 73 procedures. The average follow up was over 9 years and the average age at the time of surgery was 57. The participants were physically examined and interviewed. Results Post-operatively, in 86% of the participants there were no footwear restrictions. Stiffness of the first metatarsophalangeal joint was reported in 8% (6 feet; 10% were unhappy with the cosmetic appearance of their feet, 3 feet had hallux varus, and 2 feet had recurrent hallux valgus. There were no foot-related activity restrictions in 92% of the group. Metatarsalgia occurred in 4% (3 feet. 96% were better than before surgery and 88% were completely satisfied with their post-operative result. Hallux varus was the greatest single cause of dissatisfaction. The most common adverse event in the study was internal fixation irritation. Hallux valgus surgery is not without risk and these findings could be useful in the informed consent process. Conclusions When combined the rotation scarf and Akin osteotomies are an effective treatment for hallux valgus that achieves good long-term correction with a low incidence of recurrence, footwear restriction or metatarsalgia

Development of a Zealand white rabbit deposition model to study inhalation anthrax

Energy Technology Data Exchange (ETDEWEB)

Asgharian, Bahman; Price, Owen; Kabilan, Senthil; Jacob, Richard E.; Einstein, Daniel R.; Kuprat, Andrew P.; Corley, Richard A.

2016-01-28

Despite using rabbits in several inhalation exposure experiments to study diseases such as anthrax, there is a lack of understanding regarding deposition characteristics and fate of inhaled particles (bio-aerosols and viruses) in the respiratory tracts of rabbits. Such information allows dosimetric extrapolation to humans to inform human outcomes. The lung geometry of the New Zealand white rabbit (referred to simply as rabbits throughout the article) was constructed using recently acquired scanned images of the conducting airways of rabbits and available information on its acinar region. In addition, functional relationships were developed for the lung and breathing parameters of rabbits as a function of body weight. The lung geometry and breathing parameters were used to extend the existing deposition model for humans and several other species to rabbits. Evaluation of the deposition model for rabbits was made by comparing predictions with available measurements in the literature. Deposition predictions in the lungs of rabbits indicated smaller deposition fractions compared to those found in humans across various particle diameter ranges. The application of the deposition model for rabbits was demonstrated by extrapolating deposition predictions in rabbits to find equivalent human exposure concentrations assuming the same dose-response relationship between the two species. Human equivalent exposure concentration levels were found to be much smaller than those for rabbits.

Nutritional studies on growing rabbits

International Nuclear Information System (INIS)

Hassan, A.M.E.A.M.

2013-01-01

This work was carried out to study the effect of adding drinking water with either, copper sulfate, ascorbic acid or drinking cooled water on growth performance (live body weight,body weight gain, feed intake, feed conversion and water consumption), digestibility coefficients of nutrients, carcass traits, some physiological parameters and economical efficiency of growing NZW rabbits under Egyptian summer conditions. Ninety six weanling New Zealand White (NZW) male rabbits at five weeks of age and nearly similar average body weight (650.3 ±3.7 g) were randomly divided into eight treatment groups (twelve rabbits in each group), and then each group was subdivided into four replicates, each of three rabbits. The rabbits were assigned to drinking water as follow: the 1 st group was given fresh tap water without any additives as a control. The 2 n d, 3 r d and 4 t h groups were given tap fresh water supplemented with copper sulfate at levels of 40, 80 and 120 mg/L drinking water, respectively. The 5 t h, 6 t h and 7 t h groups were given tap fresh water supplemented with ascorbic acid at levels of 250, 500 and 750 mg/L drinking water, respectively. The 8 t h group was given cooled drinking water (CW) at 10-15 degree C. Results showed that supplementation of 40 or 80 mg copper sulfate/L or 500 mg ascorbic acid/L to heat-stressed rabbits drinking water improved final live body weight, body weight gain, daily water consumption, feed conversion ratio, performance index and economical efficiency. Hot carcass percentage was significantly (P<0.01) decreased with 80 mg/L copper sulfate and increased significantly (P<0.01) due to supplementation the drinking water with 250 mg ascorbic acid/L. Cooled water (10-15 degree C) improved significantly (P<0.01) each of final body weight, body weight gain, feed conversion ratio, performance index, economical efficiency and decreased significantly (P<0.01) each of hot carcass %, dressed weight %, heart %, total giblets %, rectal

Isolation and characterization of a novel Betacoronavirus subgroup A coronavirus, rabbit coronavirus HKU14, from domestic rabbits.

Science.gov (United States)

Lau, Susanna K P; Woo, Patrick C Y; Yip, Cyril C Y; Fan, Rachel Y Y; Huang, Yi; Wang, Ming; Guo, Rongtong; Lam, Carol S F; Tsang, Alan K L; Lai, Kenneth K Y; Chan, Kwok-Hung; Che, Xiao-Yan; Zheng, Bo-Jian; Yuen, Kwok-Yung

2012-05-01

We describe the isolation and characterization of a novel Betacoronavirus subgroup A coronavirus, rabbit coronavirus HKU14 (RbCoV HKU14), from domestic rabbits. The virus was detected in 11 (8.1%) of 136 rabbit fecal samples by reverse transcriptase PCR (RT-PCR), with a viral load of up to 10(8) copies/ml. RbCoV HKU14 was able to replicate in HRT-18G and RK13 cells with cytopathic effects. Northern blotting confirmed the production of subgenomic mRNAs coding for the HE, S, NS5a, E, M, and N proteins. Subgenomic mRNA analysis revealed a transcription regulatory sequence, 5'-UCUAAAC-3'. Phylogenetic analysis showed that RbCoV HKU14 formed a distinct branch among Betacoronavirus subgroup A coronaviruses, being most closely related to but separate from the species Betacoronavirus 1. A comparison of the conserved replicase domains showed that RbCoV HKU14 possessed N-protein-based Western blot assay, whereas neutralizing antibody was detected in 1 of these 20 rabbits.

Hypercholesterolemia Impaired Sperm Functionality in Rabbits

Science.gov (United States)

Monclus, Maria A.; Cabrillana, Maria E.; Clementi, Marisa A.; Espínola, Leandro S.; Cid Barría, Jose L.; Vincenti, Amanda E.; Santi, Analia G.; Fornés, Miguel W.

2010-01-01

Hypercholesterolemia represents a high risk factor for frequent diseases and it has also been associated with poor semen quality that may lead to male infertility. The aim of this study was to analyze semen and sperm function in diet-induced hypercholesterolemic rabbits. Twelve adult White New Zealand male rabbits were fed ad libitum a control diet or a diet supplemented with 0.05% cholesterol. Rabbits under cholesterol-enriched diet significantly increased total cholesterol level in the serum. Semen examination revealed a significant reduction in semen volume and sperm motility in hypercholesterolemic rabbits (HCR). Sperm cell morphology was seriously affected, displaying primarily a “folded head”-head fold along the major axe-, and the presence of cytoplasmic droplet on sperm flagellum. Cholesterol was particularly increased in acrosomal region when detected by filipin probe. The rise in cholesterol concentration in sperm cells was determined quantitatively by Gas chromatographic-mass spectrometric analyses. We also found a reduction of protein tyrosine phosphorylation in sperm incubated under capacitating conditions from HCR. Interestingly, the addition of Protein Kinase A pathway activators -dibutyryl-cyclic AMP and iso-butylmethylxanthine- to the medium restored sperm capacitation. Finally, it was also reported a significant decrease in the percentage of reacted sperm in the presence of progesterone. In conclusion, our data showed that diet-induced hypercholesterolemia adversely affects semen quality and sperm motility, capacitation and acrosomal reaction in rabbits; probably due to an increase in cellular cholesterol content that alters membrane related events. PMID:20976152

Rabbit dietary supplementation with pale purple coneflower. 2. Effects on the performances, bacterial community, blood parameters and immunity of growing rabbits.

Science.gov (United States)

Kovitvadhi, A; Gai, F; Dabbou, S; Ferrocino, I; Rotolo, L; Falzone, M; Vignolini, C; Gennero, M S; Bergagna, S; Dezzutto, Daniela; Barbero, R; Nebbia, P; Rosati, S; Cocolin, L; Zoccarato, I; Gasco, L

2016-07-01

Echinacea pallida (EPAL), a herbaceous flowering plant with immunomodulatory properties, has been chosen to determine the pre- and post-supplementary effects on the growth performances, bacterial community, blood parameters and immunity of growing rabbits. The same Grimaud does (14-week-old) from the studied in the first part of this study were randomly divided into two groups (n=50/group). The first group was fed a basal diet without supplementation (Control group, C) while the another group was fed a basal diet supplemented with 3 g EPAL/kg diet (Echinacea group, E). From the second parturition, 80 weaned kits (40 from the C does and 40 from the E does) were randomly assigned to four groups of 20 animals each and were fed a growing commercial diet supplemented with or without a 3 g EPAL/kg diet: the CC group (rabbits from the C does fed the control diet), CE group (rabbits from the C does fed the supplemented diet), EC (rabbits from the E does fed the control diet) and EE group (rabbits from the E does fed the supplemented diet). The dietary EPAL treatment did not affect the growth performance. Ten fattening rabbits from each group were selected to evaluate the bacterial community and blood parameters, while the remaining rabbits (n=10/group) were used to study phagocytosis and the humoral immune response. The variability was evaluated from hard faeces at 35, 49 and 89 days, and the caecal content at 89 days. The variability of the bacterial community of the EE group was higher than that of the other groups. The phagocytic activity was higher in the CE and EE groups than in the CC and EC ones (30.9 and 29.7 v. 21.2 and 21.8%; Pbacterial community, blood parameters or humoral immune responses in growing rabbits, except for an increase in phagocytic activities.

The relationship of older age and perioperative outcomes following thoracolumbar three-column osteotomy for adult spinal deformity: an analysis of 300 consecutive cases.

Science.gov (United States)

Lau, Darryl; Osorio, Joseph A; Deviren, Vedat; Ames, Christopher P

2018-04-06

OBJECTIVE Three-column osteotomies are increasingly being used in the elderly population to correct rigid spinal deformities. There is hesitation, however, in performing the technique in older patients because of the high risk for blood loss, longer operative times, and complications. This study assesses whether age alone is an independent risk factor for complications and length of stay. METHODS All patients with thoracolumbar adult spinal deformity (ASD) who underwent 3-column osteotomy (vertebral column resection or pedicle subtraction osteotomy) performed by the senior author from 2006 to 2016 were identified. Demographics, clinical baseline, and surgical details were collected. Outcomes of interest included perioperative complication, ICU stay, and hospital stay. Bivariate and multivariate analyses were used to assess the association of age with outcomes of interest. RESULTS A total of 300 patients were included, and 38.3% were male. The mean age was 63.7 years: 10.3% of patients were younger than 50 years, 36.0% were 50-64 years, 45.7% were 65-79 years, and 8.0% were 80 years or older. The overall mean EBL was 1999 ml. The overall perioperative complication rate was 24.7%: 18.0% had a medical complication and 7.0% had a surgical complication. There were no perioperative or 30-day deaths. Age was associated with overall complications (p = 0.002) and medical-specific complications (p column osteotomy for ASD. Comorbidities and other unknown variables that come with age are likely what put these patients at higher risk for complications. Older age, however, is independently associated with longer ICU and hospital stays.

Miniplate fixation of Le Fort I osteotomies.

Science.gov (United States)

Rosen, H M

1986-12-01

The use of rigid, internal, three-dimensional fixation using vitallium bone plates in 28 consecutive Le Fort I osteotomies is presented. A minimum follow-up period of 6 months was required for inclusion in this patient group. Maxillary movements included advancements (17), intrusions (9), lengthenings (5), and retrusions (2). The majority of maxillae were moved in more than one plane of space. Technical details, complications, and relapse potential are discussed. Advantages of rigid plate fixation include marked reductions in the length of intermaxillary fixation with light training elastics only. Immediate postoperative airway problems are thereby eliminated. Six months of follow-up would appear to indicate a low potential for osseous relapse when compared to wire osteosynthesis, regardless of the direction of maxillary movement. The major disadvantage is the decreased ability of postoperative orthodontics to move dento-osseous segments if skeletal occlusal disharmony persists postoperatively. For this reason, close attention to preoperative planning and operative technique is critical for the success of this fixation method.

Problems and prospects of rabbit production in Nigeria - a review ...

African Journals Online (AJOL)

Rabbits are characterized by small body size, short gestation period, high ... feeders and other equipment for rabbits can be made using readily available materials such as ... Limitations to rabbit production in developing countries include the ...

Mass transport properties of the rabbit aortic wall.

Directory of Open Access Journals (Sweden)

Emma L Bailey

Full Text Available Uptake of circulating macromolecules by the arterial wall may be a critical step in atherogenesis. Here we investigate the age-related changes in patterns of uptake that occur in the rabbit. In immature aortas, uptake was elevated in a triangle downstream of branch ostia, a region prone to disease in immature rabbits and children. By 16-22 months, uptake was high lateral to ostia, as is lesion prevalence in mature rabbits and young adults. In older rabbits there was a more upstream pattern, similar to the disease distribution in older people. These variations were predominantly caused by the branches themselves, rather than reflecting larger patterns within which the branches happened to be situated (as may occur with patterns of haemodynamic wall shear stress. The narrow streaks of high uptake reported in some previous studies were shown to be post mortem artefacts. Finally, heparin (which interferes with the NO pathway had no effect on the difference in uptake between regions upstream and downstream of branches in immature rabbits but reversed the difference in older rabbits, as does inhibiting NO synthesis directly. Nevertheless, examination of uptake all around the branch showed that changes occurred at both ages and that they were quite subtle, potentially explaining why inhibiting NO has only minor effects on lesion patterns in mature rabbits and contradicting the earlier conclusion that mechanotransduction pathways change with age. We suggest that recently-established changes in the patterns of haemodynamic forces themselves are more likely to account for the age-dependence of uptake patterns.

Radiological Outcome of Patients with Splay Foot Following First and Fifth Metatarsal Osteotomies Performed Simultaneously on the Same Foot

Directory of Open Access Journals (Sweden)

Hadi Mohammed

2012-12-01

Conclusion: The results suggest a very good radiological outcome in symptomatic patients following simultaneous first and fifth metatarsal osteotomies. All the angles measured postoperatively, except the distal metatarsal articular angle, showed a statistically significant reduction.

Evaluation of Qualitative Indices of Meat Production in Rabbits

Directory of Open Access Journals (Sweden)

Tatiana Dabija

2011-10-01

Full Text Available Meat, in most cases, is a basic production in rabbits. The influence on meat quality and quantity have such factors as breed, age, slaughter gain, sex, etc. By age, adult rabbits have a higher body weight compared with the young, but their meat is more expensive. The most convenient is intensive growth of youth as the age of 3 months to be 2.3 to 2.5 kg body weight, food and labor costs during this period was minimal. It is considered optimal as young rabbits are slaughtered when they reach 50-60% by weight of adult animals. The biological material which was used was represented in two groups of Chinchilla rabbit and Flanders breed, each one consisting of seven rabbits of various sex. Groups of rabbits had the same conditions of maintenance and nutrition. Carcass weight was determined at slaughter, carcass meat, bones, by-products, blood, head, skin of young rabbit. The largest share of the carcass of live weight was obtained at age 4 months - 59%, and meat in the carcass weight at 2 months of life - 71.2% at Chinchilla breed. On average 31.9% had bones, by-products - 6.23%, blood - 3.78% head - 8.21% and skin of young rabbit - 11.9%. Average of carcass weight from live weight was 52.76%, in Flanders breed the highest recorded at age 4 months and 66.78% of the carcass meat, the highest being at 2 months old. The average weight of bones was 33.21%, by-products - 6.25%, blood - 3.53%, the head - 7.86%, and the skin of young rabbit - 11.89%. Slaughter gain ranged from 47% to 59% at Chinchilla breed, and from 47% to 60% in Flanders breed. The highest index was recorded in both breeds at the age of four months.

Effect of Maxillary Osteotomy on Speech in Cleft Lip and Palate: Perceptual Outcomes of Velopharyngeal Function

Science.gov (United States)

Pereira, Valerie J.; Sell, Debbie; Tuomainen, Jyrki

2013-01-01

Background: Abnormal facial growth is a well-known sequelae of cleft lip and palate (CLP) resulting in maxillary retrusion and a class III malocclusion. In 10-50% of cases, surgical correction involving advancement of the maxilla typically by osteotomy methods is required and normally undertaken in adolescence when facial growth is complete.…

The value of the intra-operative clinical mechanical axis measurement in open-wedge valgus high tibial osteotomies

NARCIS (Netherlands)

van de Pol, G.J.; Verdonschot, Nicolaas Jacobus Joseph; van Kampen, A.

2012-01-01

Introduction: In high tibial osteotomies (HTO) the correction needs to be precise and intra-operative assessment is essential. The purpose of this study was to evaluate the use of the intra-operative clinical mechanical axis measurement and compare it to the post-operative weight bearing situation

Outcomes of the distal intraarticular humeral fractures treated by olecranon osteotomy

Directory of Open Access Journals (Sweden)

Erhan Yılmaz

2009-01-01

Full Text Available Objectives: To evaluate the management and outcome of intraarticular fractures of the distal humerus treated by open reduction and internal fixation using the olecranon osteotomy technique. Materials and methods: Twenty-one patients with in-traarticular fractures of the distal humerus were treated by open reduction and internal fixation. The mean age of the patients was 41.6 years and the mean follow-up pe-riod was 25.3 months. All fractures were type C accord-ing to the AO/ASIF fracture classification system. Chev-ron type olecranon osteotomy was performed within 12-24 h after the injury in all cases but 4 of them. Physical and radiological examination of patients with the appro-priate range checks were made.Results: All fractures united within average duration of 3.2 months. Excellent or good results were found in pa-tients less than 50 years-old, in women, when passing time from injury to surgery was within 12 hours and when early mobilization was achieved. The complica-tions were seen as 2 (9.6% transient neuropraxia of the ulnar nerve, 2 (9.6% failure of fixation, 1 (4.8% het-erotopic ossification and 1 (4.8% olecranon non-union. Fracture type (C1 and time from occurrence of injury to surgery (<12 hours are the main prognostic factors for achieving the excellent/ good functional results.Conclusions: The critical factors for a successful out-come of intraarticular fractures of the distal humerus in-cluded meticulous surgical technique, stable internal fix-ation, surgical experimentation and early controlled postoperative mobilization.

Surgical advances in periacetabular osteotomy for treatment of hip dysplasia in adults

DEFF Research Database (Denmark)

Troelsen, Anders

2009-01-01

Hip dysplasia is characterized by an excessively oblique and shallow acetabulum with insufficient coverage of the femoral head. It is a known cause of pain and the development of early osteoarthritis in young adults. The periacetabular osteotomy is the joint-preserving treatment of choice in young...... adults with symptomatic hip dysplasia. The surgical aim of this extensive procedure is to reorient the acetabulum to improve coverage and eliminate the pathological hip joint mechanics. Intraoperative assessment of the achieved acetabular reorientation is therefore crucial. The "classic" surgical...

Case series of 17 modified Weil's osteotomies for Freiberg's and Köhler's II AVN, with AOFAS scoring pre- and post-operatively.

Science.gov (United States)

Edmondson, M C; Sherry, K R; Afolayan, J; Armitage, A R; Skyrme, A D

2011-03-01

Treatment for metatarsal head avascular necrosis is largely conservative. For severe or refractory cases there are various surgical options. We have performed a 'modified Weil's osteotomy' of the distal metatarsal in order to manage this problem. We present the largest case series, to our knowledge, with 17 such cases. The patients were scored pre- and post-operatively using the AOFAS Forefoot scoring system. We found that this procedure provided a mean score improvement of 36 points, with a complication rate of 5.9%. We would advocate this modified osteotomy as an effective, reliable and safe treatment option. Copyright © 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Development of a Zealand White Rabbit Deposition Model to Study Inhalation Anthrax

Science.gov (United States)

Asgharian, Bahman; Price, Owen; Kabilan, Senthil; Jacob, Richard E.; Einstein, Daniel R.; Kuprat, A.P.; Corley, Richard A.

2016-01-01

Despite using rabbits in several inhalation exposure experiments to study diseases such as anthrax, there is a lack of understanding regarding deposition characteristics and fate of inhaled particles (bio-aerosols and viruses) in the respiratory tracts of rabbits. Such information allows dosimetric extrapolation to humans to inform human outcomes. The lung geometry of the New Zealand white rabbit (referred to simply as rabbits throughout the article) was constructed using recently acquired scanned images of the conducting airways of rabbits and available information on its acinar region. In addition, functional relationships were developed for the lung and breathing parameters of rabbits as a function of body weight. The lung geometry and breathing parameters were used to extend the existing deposition model for humans and several other species to rabbits. Evaluation of the deposition model for rabbits was made by comparing predictions with available measurements in the literature. Deposition predictions in the lungs of rabbits indicated smaller deposition fractions compared to those found in humans across various particle diameter ranges. The application of the deposition model for rabbits was demonstrated by extrapolating deposition predictions in rabbits to find equivalent human exposure concentrations assuming the same dose-response relationship between the two species. Human equivalent exposure concentration levels were found to be much smaller than those for rabbits. PMID:26895308

Proximal Intermetatarsal Divergence in Distal Chevron Osteotomy for Hallux Valgus: An Overlooked Finding.

Science.gov (United States)

Akpinar, Evren; Buyuk, Abdul Fettah; Cetinkaya, Engin; Gursu, Sarper; Ucpunar, Hanifi; Albayrak, Akif

2016-01-01

The goal of distal chevron osteotomy for hallux valgus is to restore proper first-toe joint alignment by performing lateral translation of the distal first metatarsal fragment (the metatarsal head). We hypothesized that in some patients this procedure might also result in involuntary medial translation of the proximal first metatarsal fragment, which we called proximal intermetatarsal divergence. The aim of the present study was to compare the pre- and postoperative radiographs of patients with hallux valgus to determine whether we could identify proximal intermetatarsal divergence. We retrospectively compared the pre- and postoperative radiographs of 29 feet in 28 patients treated with distal chevron osteotomy. Two different methods were used to measure the intermetatarsal angles: the anatomic intermetatarsal angle (aIMA) and the mechanical intermetatarsal angle (mIMA). The maximum intermetatarsal distance (MID) was also measured. We defined proximal intermetatarsal divergence as a postoperative increase in the aIMA or MID, coupled with a decrease in the mIMA. For data analysis, we divided the patients into low-angle (mild deformity) and high-angle (severe deformity) groups, according to their preoperative mIMA. The mean ± standard deviation patient age was 41 ± 14 years. In the low-angle group, the mean mIMA decreased (from 10.91° to 7.00°), the mean aIMA increased (from 11.80° to 13.55°), and the mean MID increased (from 17.97 mm to 20.60 mm; p = .001, for all). In the high-angle group, the mean mIMA decreased (from 14.30° to 6.90°; p = .001), the mean aIMA decreased (from 14.77° to 13.54°; p = .06), and the mean MID decreased (from 20.74 mm to 20.37 mm; p = .64). The results of our study suggest that proximal intermetatarsal divergence might occur after distal chevron osteotomy for hallux valgus, primarily in patients with a low preoperative mIMA. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All

Effect of Cigarette Smoke on Rabbit Testicular Lipid Peroxidation ...

African Journals Online (AJOL)

The effect of cigarette smoke on oxidative status of liver and testis was evaluated. Three groups of male weaned rabbits (1.0 – 1.5kg) were used. Group 1, the basal control group consisted of 2 rabbits which were sacrificed immediately after one week acclimatization (week O). Group 2 – (S) group consisted of 6 rabbits.

Performance and nutrient digestibility of rabbits fed urea treated ...

African Journals Online (AJOL)

The study was conducted to investigate the effect of varying levels of urea treated and untreated cowpea husk on the performance of weaner rabbits. Thirty-two mongrel weaner rabbits of both sexes, 6 – 8 weeks old with an average weight of 822g were randomly distributed to four dietary treatments with four rabbits per ...

Natural immunity factors in Polish mixed breed rabbits.

Science.gov (United States)

Tokarz-Deptuła, B; Niedźwiedzka-Rystwej, P; Adamiak, M; Hukowska-Szematowicz, B; Trzeciak-Ryczek, A; Deptuła, W

2015-01-01

Mixed-breed rabbits in Poland are widely used for diagnostic and scientific research and as utility animals, therefore there is a need to know their immunological status, as well as their haematological status. In this study natural immunity factors were analyzed in Polish mixed-breed rabbits and Polish mixed-breed rabbits with addition of blood of meet-breed, considering the impact of sex and season of the year (spring, summer, autumn, winter) using measurement of non-specific cellular and humoral immunity parameters in peripheral blood. The study has revealed that there is a variety between the two commonly used mixed-breed types of rabbits, especially when sex and season is concerned, which is crucial for using these animals in experiments.

Abstratcs of the 5th American Rabbit Congress

Directory of Open Access Journals (Sweden)

5th American Rabbit Congress Toluca, Estado de México, Mexico, September 8-11, 2014

2015-03-01

Full Text Available The 5th American Rabbit Congress was held in Toluca, Mexico State, Mexico from September 8th to the 11th, 2014. Research works representing 14 countries were accepted to take part at the congress, including papers from Algeria, Argentina, Brazil, China, Costa Rica, Cuba, Egypt, France, Hungary, Italy, México, Uruguay, the USA and Venezuela. These research works highlight the enormous interest, effort and commitment of the scientific community that bonds the trinomium of Research+Innovation+Technology Transfer, in favour of the integral development of rabbit rearing as an important primary activity that generates permanent employment, as well as healthy and nutritive meals for their respective countries for the XXI Century World. One major impact at this 5th American Rabbit Congress was the participation of Argentina, Brazil and China. The latter country’s report was presented by Laping Wu and Dong Wang (2014, showing that from 2005 to 2010, meat production of swine, beef and poultry underwent average growth of 2.6%, whereas rabbit meat production reported an annual average growth of 6.29%, reaching an annual volume of 761 000 tons, positioning China as the world’s main rabbit meat producer. This data highlights the great potential of rabbit production, both as an economic activity and a key strategy in the fight against hunger and poverty in many countries all over the world. During the congress, scientific works were presented related with the fields of Ethology, Housing & Welfare; Genetics; Reproduction; Digestive Physiology and Basic Nutrition; Feed Evaluation and Feeding; Pathology & Hygiene, Meat Quality, Safety & Dining; Management, Social & Economy. Furthermore, the meeting of the AB-WRSA chaired by the AB-WRSA founder, Dr. Steven Lukefahr, also took place at this congress, in which the new board of the American Branch was elected and the proposal put forward for the next American Rabbit Congress to be held in Costa

Teratology studies in the rabbit.

Science.gov (United States)

Allais, Linda; Reynaud, Lucie

2013-01-01

The rabbit is generally the non-rodent species or second species after the rat recommended by the regulatory authorities and is part of the package of regulatory reproductive studies for the detection of potential embryotoxic and/or teratogenic effects of pharmaceuticals, chemicals, food additives, and other compounds, including vaccines (see Chapters 1-7).Its availability, practicality in housing and in mating as well as its large size makes the rabbit the preferred choice as a non-rodent species. The study protocols are essentially similar to those established for the rat (Chapter 9), with some particularities. The study designs are well defined in guidelines and are relatively standardized between testing laboratories across the world.As for the rat, large litter sizes and extensive background data in the rabbit are valuable criteria for an optimal assessment of in utero development of the embryo or fetus and for the detection of potential external or internal fetal malformations.

Dentoalveolar Segmental Osteotomy Combined with Orthodontic Treatment for an Impacted and Ankylosed Upper Canine

DEFF Research Database (Denmark)

Aludden, Hanna Cecilia; Jensen, Thomas

2016-01-01

Ankylosis is the abnormal adhesion of alveolar bone to dentin or cementum and commonly seen after traumatic dental injuries. Treatment of impacted and ankylosed teeth solely by orthodontics alignment may be challenging. Consequently, several treatment alternatives have been proposed for the manag....... A dentoalveolar segmental osteotomy with immediate repositioning of an upper canine was performed. One year after final orthodontic treatment a satisfying occlusal and esthetic treatment outcome was obtained....

Pyrogenicity of polyadenylic.polyuridylic acid in rabbits.

Science.gov (United States)

Won, S J; Lin, M T

1991-05-01

Polyadenylic.polyuridylic acid injected intravenously into rabbits produced a rapid-onset, monophasic fever. Pyrogenic tolerance occurred in rabbits following daily injections of polyadenylic.polyuridylic acid. However, direct injection of the agent into the preoptic anterior hypothalamic region of rabbit's brain produced a markedly different fever. After an intrahypothalamic injection of polyadenylic.polyuridylic acid, fever was delayed in onset and persisted for a longer period. At room temperature, the fever was due to both increased metabolism and cutaneous vasoconstriction. In a colder atmosphere the fever was due solely to increased metabolism, whereas in the heat the fever was due to reduction in cutaneous blood flow and respiratory evaporative heat loss. In addition, the fever induced by intravenous polyadenylic.polyuridylic acid injection was reversed by a cyclooxygenase inhibitor, but not by a protein synthesis inhibitor. Polyadenylic.polyuridylic acid was shown to stimulate PGE2 production from rabbit's hypothalamus in vitro. The results reveal that this agent is a prostaglandin-dependent pyrogen.

Dynamics of bone healing after osteotomy with piezosurgery or conventional drilling - histomorphometrical, immunohistochemical, and molecular analysis.

Science.gov (United States)

Esteves, Jônatas Caldeira; Marcantonio, Elcio; de Souza Faloni, Ana Paula; Rocha, Fernanda Regina Godoy; Marcantonio, Rosemary Adriana; Wilk, Katarzyna; Intini, Giuseppe

2013-09-23

Piezosurgery is an osteotomy system used in medical and dental surgery. Many studies have proven clinical advantages of piezosurgery in terms of quality of cut, maneuverability, ease of use, and safety. However, few investigations have tested its superiority over the traditional osteotomy systems in terms of dynamics of bone healing. Therefore, the aim of this study was to evaluate the dynamics of bone healing after osteotomies with piezosurgery and to compare them with those associated to traditional bone drilling. One hundred and ten rats were divided into two groups with 55 animals each. The animals were anesthetized and the tibiae were surgically exposed to create defects 2 mm in diameter by using piezosurgery (Piezo group) and conventional drilling (Drill group). Animals were sacrificed at 3, 7, 14, 30 and 60 days post-surgery. Bone samples were collected and processed for histological, histomorphometrical, immunohistochemical, and molecular analysis. The histological analysis was performed at all time points (n = 8) whereas the histomorphometrical analysis was performed at 7, 14, 30 and 60 days post-surgery (n = 8). The immunolabeling was performed to detect Vascular Endothelial Growth Factor (VEGF), Caspase-3 (CAS-3), Osteoprotegerin (OPG), Receptor Activator of Nuclear Factor kappa-B Ligand (RANKL), and Osteocalcin (OC) at 3, 7, and 14 days (n = 3). For the molecular analysis, animals were sacrificed at 3, 7 and 14 days, total RNA was collected, and quantification of the expression of 21 genes related to BMP signaling, Wnt signaling, inflammation, osteogenenic and apoptotic pathways was performed by qRT-PCR (n = 5). Histologically and histomorphometrically, bone healing was similar in both groups with the exception of a slightly higher amount of newly formed bone observed at 30 days after piezosurgery (p piezosurgery are comparable to those observed with conventional drilling.

Evaluation of rabbit meat microbiota from the viewpoint of marketing method

Directory of Open Access Journals (Sweden)

Olga Cwiková

2017-01-01

Full Text Available Microbiological analysis was performed on carcasses of rabbits coming from domestic slaughter, purchased at butcher shops, vacuum-packaged and purchased in supermarkets, as well as frozen. The total number of analysed rabbits was 20. For all samples the following microbiological parameters were determined: total microorganisms count (TAC, the count of lactic acid bacteria (LAB, psychrotropic microorganisms, moulds and yeasts, as well as bacteria of the Enterobacteriaceae family. Total microorganisms count was the highest (p <0.05 in rabbit meat from butcher shops (5.34 log CFU.g-1. The counts of lactic acid bacteria (LAB in rabbit meat originating from domestic breeding was 2.58 log CFU.g-1, in vacuum-packaged rabbits 3.18 log CFU.g-1, in frozen rabbits 2.29 log CFU.g-1, and in rabbit meat purchased from butcher shops 3.58 log CFU.g-1. The highest count (p <0.05 of Enterobacteriaceae was observed in samples from butcher shops, namely 2.91 log CFU.g-1. In contrast the lowest count (p <0.05 was in rabbit meat from home slaughtering at 1.47 log CFU.g-1 and in frozen ones at 1.36 log CFU.g-1. The lowest counts (p <0.05 of moulds and yeasts were observed in rabbit meat from domestic slaughter, namely 1.12 log CFU.g-1. The highest counts (p <0.05 were in rabbit meat from butcher shops 2.97 log CFU.g-1. The highest counts (p <0.05 of psychrotrophic microorganisms were detected in rabbit meat from butcher shops, namely 4.98 log CFU g-1 and the lowest ones (p <0.05 in the meat of domestically slaughtered rabbits at 2.52 log CFU.g-1. In all monitored microbiological indicators, we have found differences (p <0.05 in their counts on the surface and inside the muscle tissue, both on the front and rear parts of the rabbit carcass

Knowledge and attitudes of 52 UK pet rabbit owners at the point of sale.

Science.gov (United States)

Edgar, J L; Mullan, S M

2011-04-02

The aim of this study was to determine the knowledge and attitudes of pet rabbit owners at the time of buying their rabbit(s) and to investigate factors influencing the planned husbandry and housing of their rabbit(s). A questionnaire was used to assess the impact of demographics, knowledge and attitudes on the likelihood that respondents would neuter their rabbit(s), feed them an appropriate diet, house them in appropriately sized housing and provide them with an appropriate companion. Knowledge and attitudes were significant factors in whether respondents planned to neuter their rabbit(s) and provide them with an appropriate companion. The attribution of secondary emotions to rabbits was associated with plans to feed a mix-type diet. The majority of owners had carried out prior research into pet rabbits, but owners had a limited knowledge of the needs of rabbits, particularly with respect to their diet and social needs. Respondents who had decided to purchase a rabbit on the day were less likely to intend to get their rabbit neutered than those who had taken more time to decide to buy a rabbit.

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

Directory of Open Access Journals (Sweden)

Vladimir E Baskov

2016-06-01

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.

Implants in free fibula flap supporting dental rehabilitation - Implant and peri-implant related outcomes of a randomized clinical trial.

Science.gov (United States)

Kumar, Vinay V; Ebenezer, Supriya; Kämmerer, Peer W; Jacob, P C; Kuriakose, Moni A; Hedne, Naveen; Wagner, Wilfried; Al-Nawas, Bilal

2016-11-01

The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants. Success rates of the implants were evaluated at 3 months, 6 months and 12 months following implant loading using marginal bone level changes as well as peri-implant indices (Buser et al., 1990). 52 patients were randomized into two treatment groups (26 each), out of which 18 patients (36 implants) of Group-I and 17 patients (68 implants) of Group-II were evaluated. One implant in Group-I was lost due to infective complications and one patient in the same group had superior barrel necrosis. There was a statistically significant increase at both time points (p = 0.03, p = 0.04 at 6 months, 12 months) in the amount of marginal bone loss in Group-I (0.4 mm, 0.5 mm at 6 months, 12 months) as compared to Group-II (0.1 mm, 0.2 mm at 6 months, 12 months). There were no clinically significant changes peri-implant parameters between both groups. Peri-implant soft tissue hyperplasia was seen in both groups, 32% of implants at 3-months, 26% at 6-months and 3% at 12-months follow-up. The results of this study show that patients with 2-implant-supported-overdentures had higher marginal bone loss as compared to patients with 4-implant-supported-overdentures. There were no clinically significant differences in peri-implant soft tissue factors in patients with 2- or 4-implant-supported-overdentures. Hyperplastic peri-implant tissues are common in the early implant

Histological analysis of femoral bones in rabbits administered by amygdalin

Directory of Open Access Journals (Sweden)

Veronika Kováčová

2016-07-01

Full Text Available Cyanogenic glycosides are present in several economically important plant foods. Amygdalin, one of the most common cyanoglucoside, can be found abundantly in the seeds of apples, bitter almonds, apricots, peaches, various beans, cereals, cassava and sorghum. Amygdalin has been used for the treatment of cancer, it shows killing effects on cancer cells by release of cyanide. However, its effect on bone structure has not been investigated to date. Therefore, the objective of this study was to determine a possible effect of amygdalin application on femoral bone microstructure in adult rabbits. Four month old rabbits were randomly divided into two groups of three animals each. Rabbits from E group received amygdalin intramuscularly at a dose 0.6 mg.kg-1 body weight (bw (group E, n = 3 one time per day during 28 days. The second group of rabbits without amygdalin supplementation served as a control (group C, n = 3. After 28 days, histological structure of femoral bones in both groups of rabbits was analysed and compared. Rabbits from E group displayed different microstructure in middle part of the compact bone and near endosteal bone surface. For endosteal border, an absence of the primary vascular longitudinal bone tissue was typical. This part of the bone was formed by irregular Haversian and/or by dense Haversian bone tissues. In the middle part of substantia compacta, primary vascular longitudinal bone tissue was observed. Cortical bone thickness did not change between rabbits from E and C groups. However, rabbits from E group had a significantly lower values of primary osteons' vascular canals and secondary osteons as compared to the C group. On the other hand, all measured parameters of Haversian canals did not differ between rabbits from both groups. Our results demonstrate that intramuscular application of amygdalin at the dose used in our study affects femoral bone microstructure in rabbits.

Environmental Bacteria Associated With an Institutional Rabbit House

African Journals Online (AJOL)

Rev Dr Olaleye

associated with rabbit houses was undertaken to determine the occurrence of bacteria in rabbit ... biomedical research since these latent organisms may produce clinical conditions when .... frequently incriminated in bovine mastitis by. Jones ...

Pharmacokinetics of orally administered tramadol in domestic rabbits (Oryctolagus cuniculus).

Science.gov (United States)

Souza, Marcy J; Greenacre, Cheryl B; Cox, Sherry K

2008-08-01

To determine the pharmacokinetics of an orally administered dose of tramadol in domestic rabbits (Oryctolagus cuniculus). 6 healthy adult sexually intact female New Zealand White rabbits. Physical examinations and plasma biochemical analyses were performed to ensure rabbits were healthy prior to the experiment. Rabbits were anesthetized with isoflurane, and IV catheters were placed in a medial saphenous or jugular vein for collection of blood samples. One blood sample was collected before treatment with tramadol. Rabbits were allowed to recover from anesthesia a minimum of 1 hour before treatment. Then, tramadol (11 mg/kg, PO) was administered once, and blood samples were collected at various time points up to 360 minutes after administration. Blood samples were analyzed with high-performance liquid chromatography to determine plasma concentrations of tramadol and its major metabolite (O-desmethyltramadol). No adverse effects were detected after oral administration of tramadol to rabbits. Mean +/- SD half-life of tramadol after administration was 145.4 +/- 81.0 minutes; mean +/- SD maximum plasma concentration was 135.3 +/- 89.1 ng/mL. Although the dose of tramadol required to provide analgesia in rabbits is unknown, the dose administered in the study reported here did not reach a plasma concentration of tramadol or O-desmethyltramadol that would provide sufficient analgesia in humans for clinically acceptable periods. Many factors may influence absorption of orally administered tramadol in rabbits.

Development and partial metabolic characterization of a dietary cholesterol-resistant colony of rabbits

International Nuclear Information System (INIS)

Overturf, M.L.; Smith, S.A.; Hewett-Emmett, D.; Loose-Mitchell, D.S.; Soma, M.R.; Gotto, A.M. Jr.; Morrisett, J.D.

1989-01-01

A colony of New Zealand white rabbits has been developed which, when fed a cholesterol-supplemented diet, exhibit unusual resistance to hypercholesterolemia and atherosclerosis, disorders usually observed in normal cholesterol-fed rabbits. When resistant rabbits (RT) were fed a normal low cholesterol diet (ND), their plasma lipoprotein patterns were significantly different from those of normal rabbits (NR) fed the same diet. The low density lipoprotein cholesterol (LDL-c)/high density lipoprotein cholesterol (HDL-c) ratio and LDL-c/very low density lipoprotein cholesterol (VLDL-c) ratio were lower in the resistant rabbits. The hydrated density of HDL of the normal-responsive rabbits was greater than that of the resistant rabbits. LDL from resistant rabbits contained a lower proportion of esterified cholesterol and protein than LDL from normal rabbits. Peripheral mononuclear cells from resistant rabbits bound about 30% more 125 I-labeled rabbit LDL than mononuclear cells from normal rabbits. These results demonstrate that the plasma cholesterol levels of these animals is at least partly under genetic control and that compositional differences exist between the major plasma lipoprotein classes of normal and resistant rabbits even during the ingestion of low-cholesterol diet. The results indicate that at least a part of the difference in the cholesterolemic responses between the two rabbit groups is due to an enhanced LDL uptake by the mononuclear cells, and presumably by other somatic cells of the resistant group

The modified tibial tubercle osteotomy for anterior knee pain due to chondromalacia patellae in adults

Science.gov (United States)

Jack, C. M.; Rajaratnam, S. S.; Khan, H. O.; Keast-Butler, O.; Butler-Manuel, P. A.; Heatley, F. W.

2012-01-01

Objectives To assess the effectiveness of a modified tibial tubercle osteotomy as a treatment for arthroscopically diagnosed chondromalacia patellae. Methods A total of 47 consecutive patients (51 knees) with arthroscopically proven chondromalacia, who had failed conservative management, underwent a modified Fulkerson tibial tubercle osteotomy. The mean age was 34.4 years (19.6 to 52.2). Pre-operatively, none of the patients exhibited signs of patellar maltracking or instability in association with their anterior knee pain. The minimum follow-up for the study was five years (mean 72.6 months (62 to 118)), with only one patient lost to follow-up. Results A total of 50 knees were reviewed. At final follow-up, the Kujala knee score improved from 39.2 (12 to 63) pre-operatively to 57.7 (16 to 89) post-operatively (p chondromalacia. Six patients required screw removal. There were no major complications. Conclusions We conclude that this modification of the Fulkerson procedure is a safe and useful operation to treat anterior knee pain in well aligned patellofemoral joints due to chondromalacia patellae in adults, when conservative measures have failed. PMID:23610687

[Clinical effect modified Chevron osteotomy combined with lateral tissue loosening in treating mild-moderate hallux valgus through internal signal approach].

Science.gov (United States)

Chen, Xue-Qiang; Wu, Qun-Feng; Dong, Wei-Qin; Yu, Li-Xin; Li, Xiong-Feng

2018-03-25

To explore clinical effect of modified Chevron osteotomy combined with lateral tissue loosening for the treatment of mild-moderate hallux valgus through internal signal approach. From July 2015 to June 2016, 26 patients with mild-moderate hallux valgus treated with modified Chevron osteotomy combined with lateral tissue loosening through internal signal approach, including 2 males and 24 females aged from 45 to 65 years old with an average of(54.6±4.8) years old;the courses of diseases ranged from 1 to 5 months with an average of (7.5±3.3) months. Hallux valgus angle(HVA), inter metatarsal angle(IMA) were measured at 12 months after operation, and AOFAS score was applied to evaluate clinical effect before and after operation. All incisions were healed at stage I. No incision occurred infection, metatarsal necrosis and recurrence of hallux valgus deformity. Two patients occurred skin numbness caused by musculocutaneous nerve injury. Twenty-six patients were followed up from 6 to 12 months with an average of(9.12±2.06) months. HVA, IMA were(30.01±3.71)°, (14.00±1.50)° before operation and(9.41±4.16)°, (7.00±0.60)° after operation, which had significant difference. There was statistical significance in AOFAS score before operation 54.77±9.59 and after operation 92.73±5.47, and 19 cases obtained excellent results and 7 moderate. Modified Chevron osteotomy combined with full thread headless pressure screw fixation and lateral tissue loosening for the treatment of mild-moderate hallux valgus has advantages of excellent exposure, simple operation, stable fixation, rapid recovery. Akin osteotomy with internal capsulorrhaphy were used with lateral loosening and could recover soft tissue balance between lateral and internal, and could receive satisfied clinical effects. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

Outcome of one stage combined open reduction, pelvic and derotation femoral osteotomy in congenital dislocated hips of children younger than three years age

International Nuclear Information System (INIS)

Bhatti, A.; Kumar, J.; Butt, S. A.

2014-01-01

Objective: To determine the outcome of one-stage combined operative management of congenital dislocation of hips in children aged 18-36 months. Methods: The descriptive case series study was conducted at the Department of Orthopaedic Surgery, Jinnah Postgraduate Medical Centre, Karachi, from January 2005 to December 2011. Children aged 18-36 months suffering from congenital dislocation of hips were included. Those with Tonnis stage III and IV were managed with one-stage operative procedure without preliminary traction. The operative procedure included adductor tenotomy, open reduction, capsulorraphy, Salter's osteotomy and a femoral derotation osteotomy. Catteral's 'Test of Stability' was used after open reduction as an indicator for need of pelvic and femoral osteotomies. Follow-up ranged between 1 and 7 years. The patients were evaluated clinically on McKay's criteria and radiologically on Severin's criteria. Klisic's overall rating was used to know mean of the assessments. Results: There were 38 patients with 50 congenital dislocations of hip. There were 26(68.42%) females and 12(31.57%) males with a female-to-male ratio of 2:1. Mean age at the time of operation was 24.26+-7.6 months. Of the total, 12(31.57%) patients had bilateral involvement, 11(28.94%) had right-sided and 15(39.47%) had left- sided involvement. Right side to Left ratio was 1:1.2. At the time of last follow-up, 25(50%) hips behaved excellent on McKay's criteria. According to radiographic classification on Severin's criteria, 24(48%) hips were in excellent class. Avascular necrosis of femoral head was noted in 3(6%) hips, re-subluxation/re-dislocations were observed in 3(6%) hips and 1(2.6%) patient had 1cm femoral lengthening. Conclusion: One-stage open reduction, capsulorrapyhy, Salter's osteotomy and femoral derotation osteotomy without preliminary traction to re-locate congenital dislocation of hips in late presenting children is a safe and highly effective method. It produces a low rate of

Energy partitioning for growth by rabbits fed groundnut and stylo ...

African Journals Online (AJOL)

Forty eight crossbred (California X New Zealand White) rabbits were used to evaluate energy partitioning of rabbits fed forages supplemented with concentrate. The rabbits were randomly allocated to three treatments consisting of sole Stylosanthes hamata (stylo),sole Arachis hypogea (groundnut) haulms and 50:50 mixture ...

The use of rabbits in atherosclerosis research. Diet and drug intervention in different rabbit models exposed to selected dietary fats and the calcium antagonist (-)-anipamil

DEFF Research Database (Denmark)

Mortensen, Alicja

Laboratory animal models play an important role in atherosclerosis research. One of the most popular laboratory animal species in this field of research is the rabbit. The rabbit fulfils most of the criteria for an animal model for human atherosclerosis. Three rabbit models were established...

COMPOSTING OF RABBIT MORTALITIES IMPLEMENTD IN THE EXPERIMENTAL FARM AT CHAPINGO AUTONOMOUS UNIVERSITY

OpenAIRE

Y. Jerónimo-Romero; L.A. Miranda-Romero; L.A. Saavedra-Jiménez

2014-01-01

In order to investigate the feasibility of composting rabbit carcasses with various substrates, six treatments were established according to the substrate used: oat straw-rabbit manure-dead rabbit (PAEC), wood shavings- rabbit manure- dead rabbit (EVC) and oat straw-dead rabbit (PAC), with or without the addition of 0.3 % ( v / w) mixed microbial inoculum consisting of Streptomyces spp, Aspergillus sp, Cladosporium sp. Temperature, pH, dry matter (DM ), moisture, organic matter (OM), ash and ...

Fattening and slaughter traits of four rabbit genotypes

Directory of Open Access Journals (Sweden)

Silvester Zgur

2010-01-01

Full Text Available Growth rate of 4 genotypes, two lines of Slovene SIKA meat rabbit (maternal line A and sire line C, both 50 rabbits, hybrid AxC (50 rabbits and crossbred AxCal (A and Californian, 38 rabbits was recorded from weaning (35 days of age to slaughter (93 days. Growth performance and slaughter traits of AxC were different from line A (live weight at 91st day: A 2720, C 3158, AxC 3043 g (P£0.05, heterosis effect (H +3.38%; carcass weight: A 1490, C 1787, AxC 1716 g (P£0.05, H +5.65%; dressing percentage: A 54.1, C 55.6, AxC 55.5% (P£0.05; H +1.26%. Weaning weight of AxCal was significantly lower than of AxC (AxCal 843, AxC 1050 g, P£0.05, but at the end of the experiment the weight of AxCal rabbits was very close to AxC (AxCal 2958, AxC 3043 g, P>0.05. Other growth and slaughter traits did not differ between AxC and AxCal group.

Detection of rabbit Haemorrhagic disease virus 2 during the wild rabbit (Oryctolagus cuniculus) eradication from the Berlengas archipelago, Portugal.

Science.gov (United States)

Abade Dos Santos, F A; Carvalho, C; Nuno, Oliveira; Correia, J J; Henriques, M; Peleteiro, M C; Fevereiro, M; Duarte, M D

2017-11-15

In the regular wildlife monitoring action carried out in the summer of the past few years at the Berlenga Island, wild rabbits (Oryctolagus cuniculus) have been repeatedly found dead. However, the origin of those deaths was never investigated. Our aim was to investigate the cause of death of 11 rabbits collected between April and May 2016. While screening samples from rabbit carcasses for the major viral rabbit pathogens, five tested positive to RHDV2 but all were negative for RHDV and myxoma virus (MYXV). For six RHDV2-negative specimens, emaciation and parasitism were considered the most probable cause of death. Lesions identified in the RHDV2-positive rabbits included non-suppurative diffuse hepatic necrosis and pulmonary lesions varying from congestion and oedema of the lungs to interstitial pneumonia. Sequencing analysis of the vp60 gene obtained from two specimens showed identical vp60 sequences. Comparison with other known RHDV2 strains from public databases through BLAST analysis revealed a closer similarity with strains from Alentejo collected during 2013. Maximum Likelihood and Bayesian phylogenetic analysis showed that the 2016 strains from the archipelago have a higher resemblance with a group of strains mostly collected in the South of Portugal between 2013 and 2014. The results suggest that RHDV2 may have been introduced on the Berlenga Island a few years ago, having evolved separately from mainland strains due to insularity.

Treatment of Brodie's Syndrome using parasymphyseal distraction through virtual surgical planning and RP assisted customized surgical osteotomy guide-A mock surgery report

Science.gov (United States)

Dahake, Sandeep; Kuthe, Abhaykumar; Mawale, Mahesh

2017-10-01

This paper aims to describe virtual surgical planning (VSP), computer aided design (CAD) and rapid prototyping (RP) systems for the preoperative planning of accurate treatment of the Brodie's Syndrome. 3D models of the patient's maxilla and mandible were separately generated based on computed tomography (CT) image data and fabricated using RP. During the customized surgical osteotmy guide (CSOG) design process, the correct position was identified and the geometry of the CSOG was generated based on affected mandible of the patient and fabricated by a RP technique. Surgical approach such as preoperative planning and simulation of surgical procedures was performed using advanced software. The VSP and RP assisted CSOG was used to avoid the damage of the adjacent teeth and neighboring healthy tissues. Finally the mock surgery was performed on the biomodel (i.e. diseased RP model) of mandible with reference to the normal maxilla using osteotomy bur with the help of CSOG. Using this CSOG the exact osteotomy of the mandible and the accurate placement of the distractor were obtained. It ultimately improved the accuracy of the surgery in context of the osteotomy and distraction. The time required in cutting the mandible and placement of the distractor was found comparatively less than the regular free hand surgery.

The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study.

Science.gov (United States)

Apipan, B; Rummasak, D; Narainthonsaenee, T

2018-05-01

The purpose of this study was to compare the effects of three dosage regimens of intravenous tranexamic acid and normal saline placebo on blood loss and the requirement for transfusion during bimaxillary osteotomy. A prospective, randomized, double-blind, placebo-controlled study was performed. Eighty patients scheduled for elective bimaxillary osteotomy were divided into four groups: a placebo group and three groups receiving a single dose of tranexamic acid 10, 15, or 20mg/kg body weight after the induction of anaesthesia. Demographic data, the anaesthetic time, the operative time, and the experience of the surgical team were similar in the four groups. Patients receiving placebo had increased blood loss compared to those receiving tranexamic acid. No significant difference in blood loss was found among those who received 10, 15, or 20mg/kg body weight of tranexamic acid. There was no significant difference in transfusion requirement, amount of 24-h postoperative vacuum drainage, length of hospital stay, or complications among the four groups. Prophylactic tranexamic acid decreased bleeding during bimaxillary osteotomy. Of the three dosages of tranexamic acid studied, the most efficacious and cost-effective dose to reduce bleeding was 10mg/kg body weight. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

REPLACEMENT IN RABBIT HERDS: A REVIEW

Directory of Open Access Journals (Sweden)

Ibrahim F.M. Marai

2010-08-01

Full Text Available Doe rabbit's replacement constitutes the annual renewal rate of new breeders that must be incorporated into the production stock. Criterion for culling non-productive animals differs significantly among fryer production colonies, foundation stocks and a colony with continuous enzootic disease or continuous malnourishment. In commercial rabbit production, good management improves the health and productivity of the entire herd, by reducing the all-time high replacement rates and improving economic viability. In the present article, a comprehensive review of numerous experiences in the rabbit production field of different countries, was presented. Basic recommendations for professional breeders were highlighted, covering critical issues such as the need for continuously upgrading the health status of the colony, the positive effect of   genetic selection and the nutritional conditioning and special treatment of young does being groomed as future replacements.

Transfracture abduction osteotomy: A solution for nonunion of femoral neck fractures

Directory of Open Access Journals (Sweden)

Jairamchander Pingle

2014-01-01

femur with or without bone graft, valgus osteotomy or hip arthroplasty. We conducted a retrospective analysis of cases of nonunion of femoral neck fracture treated by transfracture abduction osteotomy (TFAO. Materials and Methods: Over a period of 35 years (1974-2008, 30 patients with nonunion of femoral neck fractures were treated with TFAO over a period of 35 years (1974-2008, All patients were less than 50 years of age. Absence of clinical and radiological signs of union after four months was considered as nonunion. Patients more than 50 years of age were excluded from the study. Union was assessed at 6 months radiologically. Limb length was measured at six months. The mean duration of femoral neck fracture was 19 months (range 4 months 10 years. Results were analyzed in terms of radiological union at six months. Average followup was five years and six months. Results: Consistent union was noted at the followup after six months in 29 cases. One case was lost to followup after five and one-half months postoperatively. However, the fracture had united in this case at the last followup. Average shortening of the limb at six months was 1.9 cm. Average neck shaft angle was 127° (range 120-145°. Five cases went into AVN but were asymptomatic. Two cases required reoperation due to back out of Moore′s pins. These were reopened and cancellous screws were inserted in the same tracks. Conclusions: Consistent union of nonunion femoral neck fracture was noted at the followup after six months in 29 cases. The major drawback of the procedure is immobilization of the patient in the hip spica for eight weeks.

Atypical Chronic Ankle Instability in a Pediatric Population Secondary to Distal Fibula Avulsion Fracture Nonunion.

Science.gov (United States)

El Ashry, Saad R; El Gamal, Tarek A; Platt, Simon R

Chronic ankle instability is a disabling condition, often occurring as a result of traumatic ankle injury. A paucity of published data is available documenting chronic ankle instability in the pediatric population. Much of the data has been confined to the adult population. We present 2 cases of chronic ankle instability, 1 in a 12-year-old and 1 in a 9-year-old patient. Unlike the typical adult etiology, the cause of instability was a dysfunctional lateral ligamentous complex as a consequence of bony avulsion of the tip of the fibula. Both patients had sustained a twisting injury to the ankle. The fractures failed to unite. The nonunion resulted in dysfunction of the anterior talofibular ligament with consequent chronic ankle instability. At the initial clinical assessment, magnetic resonance imaging was requested for both patients. In patient 1 (12 years old), the fracture was fixed with 2 headless screws and was immobilized in a plaster cast for 6 weeks. In patient 2 (9 years old), because of the small size of the avulsed fragment, fixation was not possible. A modified Gould-Broström procedure was undertaken, facilitating repair of the avulsed fragment using anchor sutures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.