53 research outputs found
Femoral derotation osteotomy in spastic diplegia
We describe the results of a prospective study of 28
children with spastic diplegia and in-toed gait,
who had bilateral femoral derotation osteotomies
undertaken at either the proximal intertrochanteric or
the distal supracondylar level of the femur. Preoperative
clinical evaluation and three-dimensional movement
analysis determined any additional soft-tissue surgery.
Distal osteotomy was faster with significantly lower
blood loss than proximal osteotomy. The children in the
distal group achieved independent walking earlier than
those in the proximal group (6.9 ± 1.3 v 10.7 ± 1.7 weeks;
p < 0.001). Transverse plane kinematics demonstrated
clinically significant improvements in rotation of the hip
and the foot progression angle in both groups.
Correction of rotation of the hip was from 17 ± 11°
internal to 3 ± 9.5° external in the proximal group and
from 9 ± 14° internal to 4 ± 12.4° external in the distal
group. Correction of the foot progression angle was from
a mean of 10.0 ± 17.3° internal to 13.0 ± 11.8° external in
the proximal group (p < 0.001) compared with a mean of
7.0 ± 19.4° internal to 10.0 ± 12.2° external in the distal
group (p < 0.001). Femoral derotation osteotomy at both
levels gives comparable excellent correction of rotation
of the hip and foot progression angles in children with
spastic diplegia
Walking speed in children and young adults with neuromuscular disease : comparison between two assessment methods
Summary: Self-selected walking speed is being increasingly
used as a primary outcome measure in the management of
neuromuscular disease. It would be useful if the speed recorded in the gait laboratory represented the child’s walking speed in the community. This study investigated the difference in self selected walking speeds between a 10-meter walk, as measured during instrumented gait analysis, and a 10-minute walk. The authors found that self-selected walking speed during the 10- minute walk was slower than the self-selected walking speed recorded during the 10-meter walk. The former may be more representative of walking speed in the community setting.
Walking speed measured during walks of 10 minutes or more
should become an integral part of gait laboratory evaluation
Intra- and interobserver reliabilities of two common radiographic methods of carpal height measurement
Chronic perilunate dislocations treated with open reduction and internal fixation: results of medium-term follow-up
The purpose of this study was to evaluate the medium-term follow-up results of a series of ten perilunate dislocations treated operatively at least three weeks following injury. The intervals from injury to treatment of the delayed and the chronic groups were four weeks (range, three to six weeks) and 17 weeks (range, 11–25 weeks), respectively. The average follow-up time was 90 months. Surgical procedures included open reduction, internal fixation, grafting, ligament repair, and external fixation. Clinical function was evaluated by the Cooney clinical scoring system. The radiological assessment included the radiolunate angle, scapholunate angle, the revised carpal height ratio, and presence or absence of midcarpal arthritis. In the delayed group, there were two excellent, one good and one poor results. The average postoperative clinical score was 81 (good). In the chronic group, there were four good, one fair, and one poor results. At the last follow-up, the average postoperative clinical score was 76.7 (good). Our results indicate that open reduction and internal fixation can be applied in the treatment of delayed and some of the chronic perilunate dislocations and achieve satisfactory results
Local distal radius bone graft versus iliac crest bone graft for scaphoid nonunion: a comparative study
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