Lengthening by Distraction Osteogenesis in Congenital Shortening of Metacarpals
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The Role of Orthodontist in Distraction Osteogenesis
Original Research Article DOI: 10.18231/2455-6785.2017.0028 The role of orthodontist in distraction osteogenesis Vedavathi H.K.1, Chirag Arora2,*, Bharath Reddy3, Sowmya K.S.4, Goutham N5 1,3,4,5Reader, 2PG Student, Dept. of Orthodontics, V.S. Dental College & Hospital, Bengaluru, Karnataka *Corresponding Author: Email: [email protected] Abstract Although orthognathic surgery has gained recognition over the last few decades it still has not overcome several limitations like acute advancement of bone segments and adaptation of soft tissue relative to the new position. With the advent of distraction osteogenesis these limitations have been omitted. Recently, several experimental and clinical investigations have established that controlled progressive mechanical traction of bone segments at an osteotomy site created in the craniofacial region can form new bone parallel to the direction of traction. Thorough planning, careful evaluation and communication between the orthodontist and maxillofacial surgeon is the key to a successful outcome of the treatment and resolution of malocclusion. In addition, management of dentition prior to distraction need careful assessment for better finish of occlusion after distraction osteogenesis has been performed. Hence, the purpose of this article is to review the historic development and biologic foundation of mandibular distraction osteogenesis, and role of orthodontist in distraction osteogenesis. Keyword: Distraction osteogenesis, Soft tissue capsule, Neuromuscular Introduction distraction. By applying distraction forces sequence of Facial asymmetry, mandibular hypoplasia, and adaptive changes surrounding periosteal matrix is congenital malformation of jaws are common propagated, termed as distraction histogenesis. Due to abnormalities of the craniofacial complex. the influence of tensional stresses generated by gradual Traditionally, skeletal deformities have been corrected distraction, active histogenesis occurs in surrounding via functional orthopedics in growing patients or tissues. -
UNMH Orthopedic Surgery Clinical Privileges
UNMH Orthopedic Surgery Clinical Privileges Name: Effective Dates: To: o Initial privileges (initial appointment) o Renewal of privileges (reappointment) o Expansion of privileges (modification) All new applicants must meet the following requirements as approved by the UNMH Board of Trustees effective: 05/30/2014 INSTRUCTIONS Applicant: Check off the "Requested" box for each privilege requested. Applicants have the burden of producing information deemed adequate by the Hospital for a proper evaluation of current competence, current clinical activity, and other qualifications and for resolving any doubts related to qualifications for requested privileges. Department Chair: Check the appropriate box for recommendation on the last page of this form. If recommended with conditions or not recommended, provide condition or explanation on the last page of this form. OTHER REQUIREMENTS 1. Note that privileges granted may only be exercised at UNM Hospitals and clinics that have the appropriate equipment, license, beds, staff, and other support required to provide the services defined in this document. Site-specific services may be defined in hospital or department policy. 2. This document defines qualifications to exercise clinical privileges. The applicant must also adhere to any additional organizational, regulatory, or accreditation requirements that the organization is obligated to meet. Qualifications for Orthopedic Surgery Practice Area Code: 42 Version Code: 05-2014a Initial Applicant - To be eligible to apply for privileges in orthopedic -
06-1733 ) Issued: October 17, 2006 DEPARTMENT of the NAVY, MARINE ) CORPS, Camp Lejeune, NC, Employer ) ______)
United States Department of Labor Employees’ Compensation Appeals Board __________________________________________ ) L.S., Appellant ) ) and ) Docket No. 06-1733 ) Issued: October 17, 2006 DEPARTMENT OF THE NAVY, MARINE ) CORPS, Camp LeJeune, NC, Employer ) __________________________________________ ) Appearances: Case Submitted on the Record Appellant, pro se Office of Solicitor, for the Director DECISION AND ORDER Before: ALEC J. KOROMILAS, Chief Judge MICHAEL E. GROOM, Alternate Judge JAMES A. HAYNES, Alternate Judge JURISDICTION On July 24, 2006 appellant filed a timely appeal from the Office of Workers’ Compensation Programs’ June 9, 2006 merit decision terminating her compensation. Pursuant to 20 C.F.R. §§ 501.2(c) and 501.3(d)(2), the Board has jurisdiction over the merits of this case. ISSUE The issue is whether the Office met its burden of proof to terminate appellant’s compensation effective June 10, 2006 on the grounds that she no longer had residuals of her employment injury after that date. FACTUAL HISTORY On May 5, 2000 appellant, then a 52-year-old registered dental hygienist, filed an occupational disease claim alleging that she sustained a ganglion cyst on the dorsum of her right wrist due to repeatedly grasping instruments at work. The Office accepted that appellant sustained a ganglion cyst of her right wrist. She stopped work on May 5, 2000 to undergo an excision of the mass of her ganglion cyst and repair of the extensor tendon of the right long finger. The surgery was performed by Dr. Richard S. Bahner, an attending Board-certified orthopedic surgeon, and was authorized by the Office. In July 2000, appellant returned to light-duty work on a full-time basis for the employing establishment. -
POST-OPERATIVE INSTRUCTIONS for HAND / UPPER EXTREMITY SURGERY Department of Orthopaedics ------After Your Surgery, Follow the Instructions As Checked Below
POST-OPERATIVE INSTRUCTIONS FOR HAND / UPPER EXTREMITY SURGERY Department of Orthopaedics --------------------------------------------------------------------------------------------------------------------------------------------------------------- After your surgery, follow the instructions as checked below. Instructions following anesthesia or sedation The medicines and/or anesthesia that you received today are strong and will affect your body for at least the next few hours. You may have trouble with coordination or thinking because of these medicines. For your safety, follow these instructions carefully for the next 24 hours: Do not drive at all. You must be taken home today by a responsible adult. Do not drink any alcoholic beverages You should rest today. Do not go to work. You should not do things that require you to think and act quickly. You should not do things that require careful work. For example, avoid cooking, sewing, and operating machinery or electrical appliances. You should not make important decisions or sign legal papers today. The medicines may make you feel drowsy or sick to your stomach. Or you may have a poor appetite. If these problems last longer than 24 hour or if they are severe, call your doctor. Medicines Refer to separate “Patient Medication List” Pain and Prescription Medicine You have been given a prescription for pain medicine. Take it as directed. Do not drive or drink alcohol while you are taking “narcotic” pain medicines. This includes medicine like: Percocet® (oxycodone hydrochloride; acetaminophen), Tylenol #3® (acetaminophen; codeine) and Vicodin® (hydrocodone bitartrate; acetaminophen). Nausea, dizziness and drowsiness are normal side effects of prescribed pain medicine. If you have these symptoms and can not tolerate them, stop taking the medicine. -
Multidirectional Cranial Distraction Osteogenesis Technique for Treating Bicoronal Synostosis
Journal of Cranio-Maxillo-Facial Surgery 47 (2019) 1436e1440 Contents lists available at ScienceDirect Journal of Cranio-Maxillo-Facial Surgery journal homepage: www.jcmfs.com Multidirectional cranial distraction osteogenesis technique for treating bicoronal synostosis * Ataru Sunaga a, b, , Yasushi Sugawara c, Akira Gomi d, Daekwan Chi b, Hideaki Kamochi e, Hirokazu Uda b, Kotaro Yoshimura b a Department of Pediatric Plastic Surgery, Jichi Children's Medical Center Tochigi, 3311-1, Yakushiji, Shimotsuke, 329-0498 Tochigi, Japan b Department of Plastic Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, 329-0498, Tochigi, Japan c Lilla Craniofacial Clinic Tokyo, 1-7-17, Ginza, Chuo-ku, 104-0061, Tokyo, Japan d Department of Pediatric Neurosurgery, Jichi Children's Medical Center Tochigi, 3311-1, Yakushiji, Shimotsuke, 329-0498, Tochigi, Japan e Department of Plastic Surgery, Shizuoka Children's Hospital, 860, Urushiyama, Aoi, Shizuoka, 420-8660, Shizuoka, Japan article info abstract Article history: Fronto-orbital advancement by distraction osteogenesis is a useful means of surgically correcting Paper received 6 March 2019 bicoronal synostosis. However, the scope for morphological revision is limited. To address this issue, we Accepted 19 June 2019 developed a multidirectional cranial distraction osteogenesis (MCDO) technique that we quantitatively Available online 25 June 2019 assessed in patients with bicoronal synostosis. In this case series, five patients with bicoronal synostosis were treated with MCDO at a mean age of Keywords: 13.4 months (range 9e22 months). Distraction started 5 days after surgery and the activation period was Bicoronal synostosis 11.2 days (range 10e14 days). The distraction devices were removed 47.2 days (range 33e67 days) after Distraction osteogenesis fi Apert syndrome completing distraction. -
The Role of Bone Morphogenetic Protein 2 in SMA-Directed Angiogenesis During Distraction Osteogenesis
Boston University OpenBU http://open.bu.edu Theses & Dissertations Boston University Theses & Dissertations 2015 The role of bone morphogenetic protein 2 in SMA-directed angiogenesis during distraction osteogenesis https://hdl.handle.net/2144/16261 Boston University BOSTON UNIVERSITY SCHOOL OF MEDICINE Thesis THE ROLE OF BONE MORPHOGENETIC PROTEIN 2 IN SMA-DIRECTED ANGIOGENESIS DURING DISTRACTION OSTEOGENESIS by THOMAS W. CHENG B.S., Johns Hopkins University, 2013 Submitted in partial fulfillment of the requirements for the degree of Master of Science 2015 © 2015 by THOMAS W. CHENG All rights reserved Approved by First Reader Dr. Louis C. Gerstenfeld, Ph.D. Professor, Department of Orthopaedic Surgery Second Reader Dr. Beth Bragdon, Ph.D. Postdoctoral Research Fellow, Department of Orthopaedic Surgery ACKNOWLEDGMENTS I will like to thank my family for their support. I will like to express special appreciation to Dr. Gerstenfeld and Dr. Bragdon for giving me the opportunity to conduct research in the laboratory and being close mentors throughout this project. iv THE ROLE OF BONE MORPHOGENETIC PROTEIN 2 IN SMA-DIRECTED ANGIOGENESIS DURING DISTRACTION OSTEOGENESIS THOMAS W. CHENG ABSTRACT Bone is one of the few organs capable of regeneration after a substantial injury. As the bone heals itself after trauma, the coupling of angiogenesis to osteogenesis is crucial for the restoration of the skeletal tissue. In prior studies we have shown that Bone Morphogenetic Protein 2 (BMP2), a potent agonist for skeletal formation is expressed by vessels making it a prime candidate that links the morphogenesis of the two tissues. To investigate the role of BMP2 in the coordination of vessel and bone formation, we used a tamoxifen inducible Smooth Muscle Actin (SMA) promoter that conditionally expresses Cre recombinases crossed with a BMP2 floxed mouse in order to conditionally delete the BMP2 gene in smooth muscle actin (SMA) expressing cells. -
Basic Standards for Fellowship Training in Orthopedic Hand Surgery BOT 7/2011, Effective 7/2012 Page 2
Basic Standards for Fellowship Training in Orthopedic Hand Surgery American Osteopathic Association and American Osteopathic Academy of Orthopedics TABLE OF CONTENTS Article I: Introduction .................................................................................................. 3 Article II: Mission ........................................................................................................... 3 Article III Educational Program Goals/Core Competencies .................................... 3 Article IV: Institutional Requirements .......................................................................... 3 Article V: Program Requirements and Content .......................................................... 4 Article VI: Program Director / Faculty Qualifications ............................................... 5 Article VII: Fellow Requirements ..................................................................................... 5 Article VIII: Evaluation ....................................................................................................... 5 Basic Standards for Fellowship Training in Orthopedic Hand Surgery BOT 7/2011, Effective 7/2012 Page 2 Basic Standards for Fellowship Training in Orthopedic Hand Surgery This is an amendment to the Basic Standards for Residency Training in Orthopedic Surgery which governs and defines orthopedic surgical training. The Basic Standards are, therefore, incorporated into this document. SECTION I - INTRODUCTION These are the Basic Standards for Fellowship Training in Orthopedic -
Distraction Osteogenesis: Evolution and Contemporary Applications in Orthodontics
IBIMA Publishing Journal of Research and Practice in Dentistry http://www.ibimapublishing.com/journals/DENT/dent.html Vol. 2014 (2014), Article ID 798969, 20 pages DOI: 10.5171/2014.798969 Research Article Distraction Osteogenesis: Evolution and Contemporary Applications in Orthodontics George Jose Cherackal and Navin Oommen Thomas Department of Orthodontics, Pushpagiri College of Dental Sciences, Medicity, Tiruvalla, Kerala, India Correspondence should be addressed to: George Jose Cherackal; [email protected] Received Date: 30 June 2013; Accepted Date: 31 July 2013; Published Date: 31 January 2014 Academic Editor: Doǧan Dolanmaz Copyright © 2014 George Jose Cherackal and Navin Oommen Thomas. Distributed under Creative Commons CC-BY 3.0 Abstract Orthodontic tooth movement is brought about by the biomechanical utilization of the physiological mechanisms for bone remodeling in order to achieve optimal occlusion and thereby maximize the esthetic outcome. Distraction osteogenesis is a biomechanical process of bone tissue formation, where the distraction forces which act between the bone segments effect the biological potential of the bone. Though initially used in long bones, through the past years the technique has undergone significant advancements and innovations, that it has had increasing applications in the facial skeleton. The gradual evolution of compact internal appliances has lately led to the use of this concept in the field of orthodontics for moving tooth segments rapidly for an accelerated treatment outcome, and for novel modalities in the treatment of ankylosed teeth. This article is presented under the light of current literature to review the history, evolution and role of distraction in contemporary orthodontics. Keywords: Distraction Osteogenesis; Dentoalveolar Distraction; Canine Retraction; Ankylosed Tooth. -
Hand Surgery: a Guide for Medical Students
Hand Surgery: A Guide for Medical Students Trevor Carroll and Margaret Jain MD Table of Contents Trigger Finger 3 Carpal Tunnel Syndrome 13 Basal Joint Arthritis 23 Ganglion Cyst 36 Scaphoid Fracture 43 Cubital Tunnel Syndrome 54 Low Ulnar Nerve Injury 64 Trigger Finger (stenosing tenosynovitis) • Anatomy and Mechanism of Injury • Risk Factors • Symptoms • Physical Exam • Classification • Treatments Trigger Finger: Anatomy and MOI (Thompson and Netter, p191) • The flexor tendons run within the synovial tendinous sheath in the finger • During flexion, the tendons contract, running underneath the pulley system • Overtime, the flexor tendons and/or the A1 pulley can get inflamed during finger flexion. • Occassionally, the flexor tendons and/or the A1 pulley abnormally thicken. This decreases the normal space between these structures necessary for the tendon to smoothly glide • In more severe cases, patients can have their fingers momentarily or permanently locked in flexion usually at the PIP joint (Trigger Finger‐OrthoInfo ) Trigger Finger: Risk Factors • Age: 40‐60 • Female > Male • Repetitive tasks may be related – Computers, machinery • Gout • Rheumatoid arthritis • Diabetes (poor prognostic sign) • Carpal tunnel syndrome (often concurrently) Trigger Finger: Subjective • C/O focal distal palm pain • Pain can radiate proximally in the palm and distally in finger • C/O finger locking, clicking, sticking—often worse during sleep or in the early morning • Sometimes “snapping” during flexion • Can improve throughout the day Trigger Finger: -
Metacarpal Lengthening in Adults with Brachymetacarpia
HANXXX10.1177/1558944717736859HANDLam et al 736859research-article2017 Surgery Article HAND 1 –7 Metacarpal Lengthening in © The Author(s) 2017 Reprints and permissions: sagepub.com/journalsPermissions.nav Adults With Brachymetacarpia DOI:https://doi.org/10.1177/1558944717736859 10.1177/1558944717736859 hand.sagepub.com Aaron Lam1, Austin T. Fragomen2, and S. Robert Rozbruch2 Abstract Background: Metacarpal lengthening by distraction osteogenesis has been well documented in pediatric patients but limited in older patients. Fewer studies have assessed the success of the procedure through outcome measure scores. The purpose of this study is to assess the outcomes of distraction osteogenesis in skeletally mature adults with brachymetacarpia and patients’ perspectives on their satisfaction through outcome measure scores. Methods: Retrospective chart review of a consecutive series of metacarpal lengthenings for the treatment of brachymetacarpia was performed. Key parameters collected include starting metacarpal length, amount lengthened, range of motion of metacarpophalangeal joint, type of fixator used, distraction time, and total time in fixator. Relevant comorbidities and complications encountered were recorded as well. The Body Image Quality of Life Inventory (BIQLI) and Limb Deformity Modified Scoliosis Research Society (LD-SRS) score were given to evaluate patients’ perspectives on their satisfaction of surgery. Results: Seven metacarpal lengthenings were performed in 4 adult females (average age: 22.8 years) between 2005 and 2016. The average amount lengthened was 1.5 cm (range, 1.2-2.1 cm), corresponding to a mean percent lengthening of 44.4% (range, 33.3%- 57.1%). The mean distraction rate was 0.432 mm/day (range, 0.286-0.724 mm/day). The mean distraction time was 38 days (range, 28-55 days). -
The Potential Roles of Nanobiomaterials in Distraction Osteogenesis Asim M
CLINICAL SIGNIFICANCE Nanomedicine: Nanotechnology, Biology, and Medicine 11 (2015) 1–18 Regenerative Nanomedicine (Ed. A. Seifalian) nanomedjournal.com The potential roles of nanobiomaterials in distraction osteogenesis Asim M. Makhdom, MD, MSca,b, Lamees Nayef, PhDc,1, ⁎ Maryam Tabrizian, PhDc, , Reggie C. Hamdy, MB, ChB, MSc, FRCSCd aDivision of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada bDepartment of Orthopedic Surgery, King AbdulAziz University, Jeddah, Saudi Arabia cDepartment of Biomedical Engineering, McGill University, Montreal, Quebec, Canada dDivision of Orthopaedic Surgery, Shriners Hospital for Children, Montreal Children Hospital, McGill University, Montreal, Quebec, Canada Received 19 January 2014; accepted 16 May 2014 Abstract Distraction osteogenesis (DO) technique is used worldwide to treat many orthopedic conditions. Although successful, one limitation of this technique is the extended period of fixators until the bone is consolidated. The application of growth factors (GFs) is one promising approach to accelerate bone regeneration during DO. Despite promising in vivo results, its use is still limited in the clinic. This is secondary to inherent limitations of these GFs. Therefore, a development of delivery systems that allow sustained sequential release is necessary. Nanoparticles and nanocomposites have prevailing properties that can overcome the limitations of the current delivery systems. In addition, their use can overcome the current challenges associated with the insufficient mechanical -
Plastic Surgery Essentials for Students Handbook to All Third Year Medical Students Concerned with the Effect of the Outcome on the Entire Patient
AMERICAN SOCIETY OF PLASTIC SURGEONS YOUNG PLASTIC SURGEONS STEERING COMMITTEE Lynn Jeffers, MD, Chair C. Bob Basu, MD, Vice Chair Eighth Edition 2012 Essentials for Students Workgroup Lynn Jeffers, MD Adam Ravin, MD Sami Khan, MD Chad Tattini, MD Patrick Garvey, MD Hatem Abou-Sayed, MD Raman Mahabir, MD Alexander Spiess, MD Howard Wang, MD Robert Whitfield, MD Andrew Chen, MD Anureet Bajaj, MD Chris Zochowski, MD UNDERGRADUATE EDUCATION COMMITTEE OF THE PLASTIC SURGERY EDUCATIONAL FOUNDATION First Edition 1979 Ruedi P. Gingrass, MD, Chairman Martin C. Robson, MD Lewis W.Thompson, MD John E.Woods, MD Elvin G. Zook, MD Copyright © 2012 by the American Society of Plastic Surgeons 444 East Algonquin Road Arlington Heights, IL 60005 All rights reserved. Printed in the United States of America ISBN 978-0-9859672-0-8 i INTRODUCTION PREFACE This book has been written primarily for medical students, with constant attention to the thought, A CAREER IN PLASTIC SURGERY “Is this something a student should know when he or she finishes medical school?” It is not designed to be a comprehensive text, but rather an outline that can be read in the limited time Originally derived from the Greek “plastikos” meaning to mold and reshape, plastic surgery is a available in a burgeoning curriculum. It is designed to be read from beginning to end. Plastic specialty which adapts surgical principles and thought processes to the unique needs of each surgery had its beginning thousands of years ago, when clever surgeons in India reconstructed individual patient by remolding, reshaping and manipulating bone, cartilage and all soft tissues.