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Supracondylar Femoral Extension Osteotomy and Patellar Tendon Advancement in the Management of Persistent Crouch Gait in Cerebral Palsy
Original Article Supracondylar femoral extension osteotomy and patellar tendon advancement in the management of persistent crouch gait in cerebral palsy Sakti Prasad Das, Sudhakar Pradhan, Shankar Ganesh1, Pabitra Kumar Sahu, Ram Narayan Mohanty, Sanjay Kumar Das ABSTRACT Background: Severe crouch gait in adolescent cerebral palsy is a difficult problem to manage. The patients develop loading of patellofemoral joint, leading to pain, gait deviation, excessive energy expenditure and progressive loss of function. Patella alta and avulsion of patella are the other complications. Different treatment options have been described in the literature to deal with this difficult problem. We evaluated outcome of supracondylar femoral extension osteotomy (SCFEO) and patellar tendon advancement (PTA) in the treatment of crouch gait in patients with cerebral palsy. Materials and Methods: Fourteen adolescents with crouch gait were operated by SCFEO and PTA. All subjects were evaluated pre and postoperatively. Clinical, radiographic, observational gait analysis and functional measures were included to assess the changes in knee function. Results: Cases were followed up to 3 years. The patients walked with increased knee extension and improvement in quadriceps muscle strength. Knee pain was decreased and improvements in functional mobility and radiologic improvement were found. Conclusion: SCFEO and PTA for adolescent crouch gait is effective in improving knee extensor strength, reducing knee pain and improving function. Key words: Crouch gait, patellar -
Thieme: Teaching Atlas of Musculoskeletal Imaging
Teaching Atlas of Musculoskeletal Imaging Teaching Atlas of Musculoskeletal Imaging Peter L. Munk, M.D., C.M., F.R.C.P.C. Professor Departments of Radiology and Orthopaedics University of British Columbia Head Section of Musculoskeletal Radiology Vancouver General Hospital and Health Science Center Vancouver, British Columbia, Canada Anthony G. Ryan, M.B., B.C.H., B.A.O., F.R.C.S.I., M.Sc. (Engineering and Physical Sciences in Medicine), D.I.C., F.R.C.R., F.F.R.R.C.S.I. Consultant Musculoskeletal and Interventional Radiologist Waterford Regional Teaching Hospital Ardkeen, Waterford City, Republic of Ireland Radiologic Tutor and Clinical Instructor in Radiology The Royal College of Surgeons in Ireland Dublin, Republic of Ireland Thieme New York • Stuttgart [email protected] 66485438-66485457 Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Editor: Birgitta Brandenburg Assistant Editor: Ivy Ip Vice President, Production and Electronic Publishing: Anne T. Vinnicombe Production Editor: Print Matters, Inc. Vice President, International Marketing: Cornelia Schulze Sales Director: Ross Lumpkin Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Compositor: Compset, Inc. Printer: The Maple-Vail Book Manufacturing Group Library of Congress Cataloging-in-Publication Data Munk, Peter L. Teaching atlas of musculoskeletal imaging / Peter L. Munk, Anthony G. Ryan. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-1-58890-372-3 (alk. paper) ISBN-10: 1-58890-372-9 (alk. paper) ISBN-13: 978-3-13-141981-1 (alk. paper) ISBN-10: 3-13-141981-4 (alk. paper) 1. Musculoskeletal system—Diseases—Imaging—Atlases. 2. Musculoskeletal system—Diseases—Case studies. -
Orthopedic Neurology] Page | 1
[Orthopedic Neurology] Page | 1 Neuro-Anatomy Neuron: Is the specialized cell of the nervous system that capable of electrical exciation (action potential) along their axons 2 | Page [Orthopedic Neurology] Peripheral nerve has a mixture of neurons: 1]. Motor 2]. Sensory 3]. Reflex 4]. Sympathetic 5]. Parasympathetic Types of fibers: A (α, , γ, δ), B, C Motor Sensory Ms reflex sympathetic Parasymp Neuron AHC Dorsal root ganglia AHC IHC relay at organ Root Anterior Dorsal root Ant Ant Ant Tract 1- Direct pyramidal 1- Spinothalamic (Pain, temp, Stretch reflex crude) arc from ms 2- Indirect pyramid 2- Lemniscal (DC) spindle (proprioception, fine touch) Fibre α Motor (12-20 μm) α Propriocep (12-20 μm) γ fibers B preganglionic B fibres Touch, vib (5-12 μm) C Postganglionic δ fast pain, temp (2-5μm) C Slow pain, crude (0.2-2µm) A fibers are most affected by pressure C fibers are most affected by anesthesia and are the principle fibers in the dorsal root Neurons are surrounded by endoneurium GroupToFor m fascicles surrounded by perineurium GroupToFor m nerve surrounded by epineurium Muscle: Motor unit is the unit responsible for motion and formed of the group of ms fibers and neuromuscular junction and feeding neuron Ms fibers types: 1- Smooth ms fibers 2- Cardiac ms fibers 3- Skeletal ms fibers: . Type I: slow twitching, slow fatiguability, posture . TypeII: fast twitiching, fast fatigue MS CONTRACTION: is the active state of a ms, in which there is response to the neuron action potential either by isometric or iso tonic contraction -
Balneo Research Journal DOI: Vol.11, No.1, February 2020 P: 574–579
BALNEO RESEARCH JOURNAL Vol 11 No. 1, February 2020 Climatology Balneology Medical Hydrology Physical and Rehabilitation Medicine Website http://bioclima.ro/Journal.htm E-mail: [email protected] ISSN: 2069-7597 / eISSN: 2069-7619 Balneo Research Journal is part of the international data bases ﴾BDI﴿ as follow: EBSCOhost. CrossRef, DOAJ, Electronic ﴿Journals Library ﴾GIGA﴿, USA National Library of Medicine - NLM, Emerging Sources Citation Index ﴾Thomson Reuters ﴿Publisher: Romanian Association of Balneology ﴾Bucharest Asociatia Romana de Balneologie / Romanian Association of Balneology Editura Balneara Balneo Reserch Journal Table of Contents: Vol 11 No. 1, February 2020 (307) Effectiveness of pulmonary rehabilitation in improving quality of life in patients with different COPD stages - MARC Monica, PESCARU Camelia, ILIE Adrian Cosmin, CRIȘAN Alexandru, HOGEA STANCA Patricia, TRĂILĂ Daniel Balneo Research Journal. 2020;11(1):3–8 Full Text DOI 10.12680/balneo.2020.307 (308) A review of antimicrobial photodynamic therapy (aPDT) in periodontitis - CONDOR Daniela, CULCITCHI Cristian, BARU Oana, CZINNA Julia, BUDURU Smaranda Balneo Research Journal. 2020;11(1):9–13 Full Text DOI 10.12680/balneo.2020.308 (309) Effect of Low Level Laser Therapy (LLLT) on muscle pain in temporomandibular disorders – an update of literature - KUI Andreea, TISLER Corina, CIUMASU Alexandru, ALMASAN Oana, CONDOR Daniela, BUDURU Smaranda Balneo Research Journal. 2020;11(1):14–19 Full Text DOI 10.12680/balneo.2020.309 (310) The control of cardiovascular risk factors – an essential component of the rehabilitation of patients with ischemic heart disease. What are the current targets? - POP Dana, DĂDÂRLAT-POP Alexandra, CISMARU Gabriel, ZDRENGHEA Dumitru Balneo Research Journal. 2020;11(1):20–23 Full Text DOI 10.12680/balneo.2020.310 (311) Clinical-evolutive particularities and therapeutic-rehabilitative approach in the rare case of acute disseminated encephalomyelitis following an episode of viral meningitis of unknown etiology - ILUȚ Silvina, VACARAS Vitalie, RADU M. -
SSE – MSD Booklet
MSD Musculoskeletal Disorder covers any injury, damage or disorder of the joints or other tissues in the upper/lower limbs or the back. Musculoskeletal Disorders Size of the problem . Over 200 types of MSD . 1 in 4 UK adults affected by chronic MSDs . Low back pain is reported by 80% of people at some time in their life . MSDs are the most common reason for repeated GP consultation . 60% of people on long term sick leave cite MSDs as cause Approximately 70% of all sickness absence is due to psychological ill health or musculoskeletal disorders. MSD 2 Abdominal musculature absent with microphthalmia and joint laxity - Achard syndrome - Acropachy Ankylosing hyperostosis - Arterial tortuosity syndrome - Attenuated patella alta - Baker's cyst - Bone cyst - Bone disease - Cervical spinal stenosis - Cervical spine disorder - Chondrocalcinosis - Condylar resorption - CopenhagenSECTION disease - Costochondritis - Dead arm syndrome - Dentomandibular Sensorimotor Dysfunction - Diffuse idiopathic skeletal hyperostosis - Disarticulation - Dolichostenomelia - Du Bois sign - Emacs pinky - Enthesopathy - Enthesophyte - FACES syndrome - Facet syndrome - Foot drop - Genu recurvatum - Giant-1.cell tumorOperational of the tendon sheath - Grisel'sStaff syndrome - Hanhart syndrome Hill–Sachs lesion - Injection fibrosis - Intersection syndrome - Intervertebral disc disorder - Jersey Finger - Joint effusion - Khan Kinetic Treatment - Knee effusion - Knee pain - Lumbar disc disease - Mallet finger - Meromelia - Microtrauma2. Office - Myelonecrosis Based - Neuromechanics -
Treatment of Patellar Dislocation in Children
Petri Sillanpää MD PhD Treatment of Patellar Dislocation in Children Introduction Lateral patellar dislocation is a common knee injury in pediatric population1, and is the most common acute knee injury in the skeletally immature. Over half of the cases cause recurrent patellar dislocations and pain. The mechanism of injury is most often with the foot planted and tibia external rotated. It can also occur with jump landing and/or decelerating. The medial patellofemoral ligament (MPFL) is frequently injured in an acute patellar dislocation.2-7 Initial management of the pediatric patellar dislocation is mainly nonoperative. Surgery is indicated if a large osteochondral fragment is present or patella is highly unstable or extensively lateralized due to massive medial restraint injury. Surgical stabilization is recommended if redislocations are frequent and cause pain or inability to attend sports acitivites. Reconstruction of the MPFL is a preferred surgical option in the skeletally immature knee, as operations that involve bone are contraindicated. MPFL reconstruction techniques that do not involve drilling or disruption of the periosteum near the femoral physes are safe for the skeletally immature knee. Treatment of patellar dislocation in the skeletally immature patient is presented with specific discussion of surgical technique and results of double bundle MPFL reconstruction. Epidemiology and predisposing factors A population-based study have estimated annual incidence rate of first-time (primary) patellar dislocations in children,1 resulting in 43 / 100 000. Buchner et al11 reported a 52% redislocation rate in patients aged <15 years compared with 26% for the entire group. Similarly, Cash and Hughston12 showed a 60% incidence of redislocation in children aged 11-14 years compared with 33% in those aged 15-18 years. -
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430 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 Morphometric Study of Dry Human Patella with Its Clinical Correlation Pratima Baisakh1, Lopamudra Nayak2, B Shanta Kumari2, Saurjya Ranjan Das3 1Associate Professor, 2Assistant Professor, Dept of Anatomy, 3Associate Professor, Dept of Anatomy, IMS & SUM Hospital, SOA (Deemed to be University), Bhubaneswar, Odisha, India Abstract Background- Patella is the largest sesamoid bone and forms the femuro-patellar component of the knee joint. Dimensions and classification of patellae are important anthropologically as well as clinically. Aims & Objectives- Morphometry of patella has a definite role in implant design and reconstructive surgeries of knee joint. The present study aims to find out different dimensions of patella and its facets on both sides and compared. Material & Methods- The morphometric study comprised of sixty (30 left and 30 right) dry human patella collected from department museum by using sliding digital calliper. The different parameters studied are height, width, thickness of patella, length and width of medial and lateral facets. Classification of patella was done by using the measurements of its articular facets. Observations- The mean height, width, thickness of patella of left side were found to be 37.79mm, 38.26mm, 19.35mm and that of right side were 35.72mm, 34.91mm, 17.64mm respectively. The mean width of medial and lateral articular facet of left side were 19.42mm, 21.21mm and that of right side were 18.33mm,20.97mm respectively. Width of lateral articular facet is significantly larger than that of medial articular facet of same side(p<0.05) and 85% of patella belongs to Wiberg typeB.The mean patellar thickness on left and right side is 19.35mm & 17.64mm respectively,left side being significantly more than(P<0.05) that of right side. -
Surgical Treatment of a Chronically Fixed Lateral Patella Dislocation in an Adolescent Patient
See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/252325604 Surgical Treatment of a Chronically Fixed Lateral Patella Dislocation in an Adolescent Patient Article in Orthopedic Reviews · June 2013 DOI: 10.4081/or.2013.e9 · Source: PubMed CITATIONS READS 5 159 6 authors, including: Xinning Li Boston University 104 PUBLICATIONS 867 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Commentary & Perspective Total Hip Arthroplasty View project All content following this page was uploaded by Xinning Li on 03 June 2014. The user has requested enhancement of the downloaded file. Orthopedic Reviews 2013; volume 5:e9 Surgical treatment Introduction Correspondence: Xinning Li, Hospital for Special of a chronically fixed lateral Surgery, Department of Orthopedic Surgery, patella dislocation Acute patellar dislocation or subluxation is a Division of Sports Medicine, New York, NY 10021, common cause for knee injuries in the United USA. in an adolescent patient E-mail: [email protected] States and accounts for 2% to 3% of all injuries.1 Xinning Li,1 Natalie M. Nielsen,2 Up to 49% of patients will have recurrent sublux- Key words: pediatric orthopedics, patella disloca- ations or dislocations.2-4 Importance of both soft Hanbing Zhou,2 Beth Shubin Stein,1 tion, Faulkerson procedure, MPFL reconstruction. tissue [predominantly, the medial Yvonne A. Shelton,2 Brian D. Busconi2 patellofemoral ligament (MPFL), which is Contributions: XL contributed to the conception, 1Department of Orthopaedic Surgery, responsible for 60% of the resistance to lateral drafting, revision, and collection of the patient Division of Sports Medicine and Shoulder dislocation] and bony constraint of femoral data and radiographs of this study. -
MNAAP Introduction to Pediatric Sports Injuries, the Lower Extremity
Introduction to Pediatric Sports Injuries: The Lower Extremity Dr. Michael Priola Pediatric Orthopedic Surgeon Minnesota Chapter of the American Academy of Pediatrics Disclosures: None Objectives Following this presentation, the motivated learner will be able to understand: • The risks & how lower extremity injuries in pediatric sports injuries occur • The treatment of specific lower extremity pediatric sports injuries • Prevention strategies Who Is Participating? • Over 45 million children ages 6-21 engage in a sports program held outside of school (6) • 75% of U.S. families have at least one child in a high school sport (6) Positive Impact of Sports • Physical activity • The CDC estimates approximately 50% of children are engaged in regular exercise • More than 1/3 of children born after 2000 will develop diabetes • Childhood obesity has tripled in last 40 years • Childhood obesity is a good predictor of adult obesity • Diminished quality of life: social discrimination, heart disease, decreased self-confidence Merkel, Donna L. Youth Sport: Positive and Negative Impact on Young Athletes. Open Access J Sports Med. 2013; 4: 151-160. Positive Impact of Sports • Improved Academic Achievement • In 2010, the CDC reported a positive correlation with sports participation and higher grades; obesity correlated with learning difficulties • Decreased High-Risk Activities • Smoking • Illicit drug use • Carrying a weapon • Binge drinking the exception Merkel, Donna L. Youth Sport: Positive and Negative Impact on Young Athletes. Open Access J Sports Med. 2013; 4: 151-160. Positive Impact of Sports • Overall Health Benefits for Girls • Decreased risk for developing: • Breast cancer • Osteoporosis • Future obesity • Heart disease • Decreased rates of: • Teen pregnancy • Unprotected sexual intercourse • Smoking • Drug use • Depression • Suicide Merkel, Donna L. -
Us 2018 / 0305689 A1
US 20180305689A1 ( 19 ) United States (12 ) Patent Application Publication ( 10) Pub . No. : US 2018 /0305689 A1 Sætrom et al. ( 43 ) Pub . Date: Oct. 25 , 2018 ( 54 ) SARNA COMPOSITIONS AND METHODS OF plication No . 62 /150 , 895 , filed on Apr. 22 , 2015 , USE provisional application No . 62/ 150 ,904 , filed on Apr. 22 , 2015 , provisional application No. 62 / 150 , 908 , (71 ) Applicant: MINA THERAPEUTICS LIMITED , filed on Apr. 22 , 2015 , provisional application No. LONDON (GB ) 62 / 150 , 900 , filed on Apr. 22 , 2015 . (72 ) Inventors : Pål Sætrom , Trondheim (NO ) ; Endre Publication Classification Bakken Stovner , Trondheim (NO ) (51 ) Int . CI. C12N 15 / 113 (2006 .01 ) (21 ) Appl. No. : 15 /568 , 046 (52 ) U . S . CI. (22 ) PCT Filed : Apr. 21 , 2016 CPC .. .. .. C12N 15 / 113 ( 2013 .01 ) ; C12N 2310 / 34 ( 2013. 01 ) ; C12N 2310 /14 (2013 . 01 ) ; C12N ( 86 ) PCT No .: PCT/ GB2016 /051116 2310 / 11 (2013 .01 ) $ 371 ( c ) ( 1 ) , ( 2 ) Date : Oct . 20 , 2017 (57 ) ABSTRACT The invention relates to oligonucleotides , e . g . , saRNAS Related U . S . Application Data useful in upregulating the expression of a target gene and (60 ) Provisional application No . 62 / 150 ,892 , filed on Apr. therapeutic compositions comprising such oligonucleotides . 22 , 2015 , provisional application No . 62 / 150 ,893 , Methods of using the oligonucleotides and the therapeutic filed on Apr. 22 , 2015 , provisional application No . compositions are also provided . 62 / 150 ,897 , filed on Apr. 22 , 2015 , provisional ap Specification includes a Sequence Listing . SARNA sense strand (Fessenger 3 ' SARNA antisense strand (Guide ) Mathew, Si Target antisense RNA transcript, e . g . NAT Target Coding strand Gene Transcription start site ( T55 ) TY{ { ? ? Targeted Target transcript , e . -
Treatment of Chondral Defects in the Patellofemoral Joint
Treatment of Chondral Defects in the Patellofemoral Joint Andreas H. Gomoll, MD Tom Minas, MD, MS Jack Farr, MD Brian J. Cole, MD, MBA INTRODUCTION Patellofemoral pain, as a subset of anterior knee pain, is typically multifactorial and to achieve success in treat- Anterior knee pain is a common musculoskeletal ment, each contributing factor requires management indi- complaint seen daily in the practices of primary care vidually and in conjunction with the other factors. physicians, rheumatologists, and orthopedic surgeons. In The key to successful treatment in this group of patients the past, the term “chondromalacia” was misused inter- lies not only in the correct diagnosis of a chondral defect, changeably with anterior knee pain or patellofemoral pain but more importantly, in the accurate identifi cation of asso- syndrome. The implication that cartilage is the source of ciated pathomechanical factors, such as patella alta, troch- symptoms is incorrect as the majority of patients present- lea dysplasia, increased lateral position of the tibial tubercle ing with anterior knee pain do not have cartilage defects to the femoral sulcus (previously assessed as a “Q” angle), and cartilage is aneural. The prevalence of patellofemoral and secondary soft-tissue problems, such as a weakened or cartilage defects is controversial, as it is unknown what hypoplastic vastus medialis muscle with a contracted lat- percentage of lesions become symptomatic enough to eral retinaculum. These pathomechanics lead to abnormal prompt evaluation. Several studies have reported the pres- forces of the patellofemoral joint, which can cause injury ence of high-grade focal chondral defects in 11%-20% of to the articular cartilage in itself through repetitive micro- knee arthroscopies. -
Isakos/Esska Standard Terminology, Definitions, Classification and Scoring Systems for Arthroscopy
ISAKOS/ESSKA STANDARD TERMINOLOGY, DEFINITIONS, CLASSIFICATION AND SCORING SYSTEMS FOR ARTHROSCOPY KNEE, SHOULDER AND ANKLE JOINT Editor: C. Niek van Dijk MD PhD, NETHERLANDS Chapter Chairs: Roger Hackney FRCS, UNITED KINGDOM Bent W. Jakobsen MD, DENMARK C. Niek van Dijk MD, PhD NETHERLANDS Contributors: Allen F. Anderson MD, USA Gianluigi Canata MD, ITALY Mark Clatworthy FRCS, NEW ZEALAND Patrick Djian MD, FRANCE David DomE MD, USA Björn Engström MD PhD, SWEDEN John Fulkerson MD, USA Anastasios Georgoulis MD, GREECE Alberto Gobbi MD, ITALY Philippe P. Hardy MD, FRANCE Jon Karlsson MD PhD, SWEDEN William Benjamin Kibler MD, USA Erik A.F. Klint MD, SWEDEN Rover Krips MD, NETHERLANDS Marc Safran MD, USA Romain Seil MD, LUXEMBOURG 8-8-2008 1 Index Page Preface 3-4 Shoulder Joint 1. Introduction 5-8 2. Asymptomatic Joint 9-11 3. Subacromial Impingement 11-14 4. Rotator Cuff Lesions 14-19 5a. Long Head of Biceps Lesions 19-21 5b. Slap Lesions 21-23 6a. Traumatic Anterior Instability 23-25 6b. Traumatic Posterior Instability 25-26 6c. Atraumatic Shoulder Instability 26-28 6d. Multidirectional Instability 28-30 7. Glenoid fracture 30-31 8. Osteoarthosis/Articular cartilage lesions 31-32 9. Loose bodies 32 10. Synovitis/Capsulitis 32-34 11. Acromio-Clavicular joint pathology 34-35 12. Septic arthritis 35-36 Ankle Joint 1. Introduction 42-43 2. Asymptomatic ankle 43-45 3. Anterior ankle impingement (bony/soft tissue) 46-48 4. Synovitis 49-53 5. (Osteo-) chondral defect 54-58 6. Loose bodies 59-60 7. Arthrosis 61-62 8. Posterior ankle impingement 63-65 9.