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Clinics in Sports Medicine Jul 2019
Topics: Humans; Knee Joint; Osteotomy; Periodicals as Topic
PubMed: 31079776
DOI: 10.1016/j.csm.2019.03.002 -
Facial Plastic Surgery Clinics of North... Feb 2021Dorsal preservation rhinoplasty requires precise management of the osseocartilaginous vault. Ultrasonic piezo instruments offer several advantages compared with... (Review)
Review
Dorsal preservation rhinoplasty requires precise management of the osseocartilaginous vault. Ultrasonic piezo instruments offer several advantages compared with traditional tools such as hand saws, rasps, and osteotomes. As always, an understanding of the dynamics of manipulation of the vault, anatomy, and proper technique are paramount and are reviewed herein.
Topics: Humans; Nasal Cartilages; Nasal Septum; Osteotomy; Piezosurgery; Rhinoplasty
PubMed: 33220846
DOI: 10.1016/j.fsc.2020.09.004 -
Neuro-Chirurgie Nov 2019From its first descriptions in the early 1920s to today's use of cutting guides via computer-assisted surgery, surgical techniques to address hypertelorism have... (Review)
Review
From its first descriptions in the early 1920s to today's use of cutting guides via computer-assisted surgery, surgical techniques to address hypertelorism have progressed. The present article aims to provide historical background and an overview of the development of surgical techniques during the late 20th century and in recent years. First, a historical overview identifies the most important surgical advances leading to the present state of the art. Each major surgical innovation is described, to explain the changes in this surgical field, according to the type of approach. Then, a precise description of today's most recent practices is provided, with particular emphasis on the spectacular advances deriving from computer-assisted surgery. A thorough description of the use of cutting guides throughout the surgical phase is given.
Topics: History, 20th Century; Humans; Hypertelorism; Neurosurgery; Neurosurgical Procedures; Orbit; Osteotomy; Surgery, Computer-Assisted
PubMed: 31557491
DOI: 10.1016/j.neuchi.2019.09.007 -
Sportverletzung Sportschaden : Organ... Dec 2021Anterior knee pain and patellofemoral instability are the two major symptoms of patellofemoral dysbalance. Various pathologies can cause these symptoms. In recent years,...
Anterior knee pain and patellofemoral instability are the two major symptoms of patellofemoral dysbalance. Various pathologies can cause these symptoms. In recent years, axis deviations have been increasingly discussed as a cause of patellofemoral dysbalance. In the frontal axis, valgus deformities are a major risk factor, but torsional deformities may be a cause as well. Increased femoral internal rotation or increased tibial external rotation are the key pathologies. Osteotomy is the treatment of choice. Valgus deformities require varisation osteotomy, which is either performed on the femur or tibia depending on the location of the deformity. Torsional deformities are treated by external femoral or internal tibial torsional osteotomy. Femoral osteotomies are located above the femoral condyles, tibial osteotomies above the tibial tuberosity. Tibial internal torsional correction must not exceed 15° because this would jeopardise structures such as the peroneal nerve. Rehabilitation includes partial weight-bearing for four to six weeks. Hardware removal can be performed half a year after osteotomy. The relevance of axis deviations and treatment by osteotomy in patellofemoral dysbalance has been highlighted in recent reviews. Several publications report promising results after osteotomy, including significant pain relief and achievement of patellofemoral stability.
Topics: Femur; Humans; Knee Joint; Osteotomy; Pain; Tibia; Torsion Abnormality
PubMed: 34883520
DOI: 10.1055/a-1486-1804 -
Foot and Ankle Clinics Sep 2020Minimally invasive procedures to treat lesser toes deformities are among the main surgeries of percutaneous techniques and considered mature techniques due to technical... (Review)
Review
Minimally invasive procedures to treat lesser toes deformities are among the main surgeries of percutaneous techniques and considered mature techniques due to technical versatility and high correction potential, with low rates of complications. Although they seem technically simple procedures, there are important technical details for each of them to obtain a reliable correction. To achieve success in lesser toes percutaneous treatment, it is imperative to follow minimally invasive basic principles, especially postoperative care with specific bandages for unfixed osteotomies. Practical training is mandatory before starting the experience; the foot surgeon must learn theoretic and practical aspects to master this surgery.
Topics: Foot Deformities; Humans; Minimally Invasive Surgical Procedures; Osteotomy; Tenotomy; Toes
PubMed: 32736742
DOI: 10.1016/j.fcl.2020.05.008 -
The Journal of the American Academy of... May 2020Adolescent idiopathic scoliosis represents a complex, three-dimensional deformity of the spine. Posterior spinal fusion is commonly performed in severe cases to avoid... (Review)
Review
Adolescent idiopathic scoliosis represents a complex, three-dimensional deformity of the spine. Posterior spinal fusion is commonly performed in severe cases to avoid the long-term adverse sequelae associated with progressive spinal deformity. The goals of spinal fusion include halting the progression of deformity, optimizing spinal balance, and minimizing complications. Recent advances in short-segment spinal fixation have allowed for improved three-dimensional deformity correction. Preoperative planning and assessment of spinal flexibility is essential for successful deformity correction and optimization of long-term outcomes. Judicious use of releases and/or spinal osteotomies may allow for increased mobility of the spine but are associated with increased surgical time, blood loss, and risk of complications. Appreciation of implant design and material properties is critical for safe application of correction techniques. Although multiple reduction techniques have been described, no single technique is optimal for every patient.
Topics: Adolescent; Humans; Osteotomy; Scoliosis; Spinal Fusion
PubMed: 31633657
DOI: 10.5435/JAAOS-D-18-00399 -
Foot and Ankle Clinics Mar 2020Health care costs are increasing. Funding is not increasing at a commensurate rate. Demonstrable cost-effectiveness is critical when selecting operation and implant... (Review)
Review
Health care costs are increasing. Funding is not increasing at a commensurate rate. Demonstrable cost-effectiveness is critical when selecting operation and implant type. Clinicians must justify their decision on surgery and implant type, providing patient-reported outcome measures (PROM). Providing such data on cost and PROM forms the basis of future cost-effectiveness analysis (CEA). Such analysis is complex. Future research should analyze cost variables individually. Day case surgery, multimodal analgesia, and simultaneous surgery for bilateral cases show promise in reducing cost. With evidence of increased recurrence, requirement for additional equipment and more expensive implants it is unlikely to demonstrate superior cost-effectiveness.
Topics: Cost-Benefit Analysis; Hallux Valgus; Humans; Minimally Invasive Surgical Procedures; Osteotomy; Treatment Outcome
PubMed: 31997744
DOI: 10.1016/j.fcl.2019.10.005 -
Medicina (Kaunas, Lithuania) Mar 2022Introduction: Minimally invasive surgical techniques for hallux valgus have gained popularity, showing good results characterized by smaller postoperative scars, less... (Randomized Controlled Trial)
Randomized Controlled Trial
Introduction: Minimally invasive surgical techniques for hallux valgus have gained popularity, showing good results characterized by smaller postoperative scars, less pain, lower infection risk, and fewer wound complications. Given the lack of evidence available in our country regarding this subject, especially about this type of surgical technique, our paper aims to compare open and MIS approaches for chevron osteotomy. We evaluated the outcome and complications after 12 months. Materials and Methods: We undertook a prospective, randomized, controlled, single-center study between October 2017 and December 2020. The patients were randomized into two groups: one group that received percutaneous chevron osteotomy (MIS), and the other, open chevron osteotomy (OC). For clinical assessment, we determined the function and the level of pain using the Visual Analogue Scale (VAS) and The American Orthopaedic Foot and Ankle Surgery score (AOFAS). The VAS scale was measured before the surgical procedure, at discharge, and at 3 weeks, 6 weeks, 6 months, and 12 months after surgery. The AOFAS score was calculated preoperatively and after 6 months. The hallux angle (HVA) and intramedullary angle (IMA) were measured preoperatively, and at 6 weeks, 6 months and 12 months. Results: We included 26 cases in the open chevron osteotomy group (24 female, 2 male) and 24 in the MIS group (24 female, 0 male). Both groups demonstrated improvements regarding the IMA and HVA at the last follow-up without any significant differences between the groups at the final assessment. The VAS showed significantly better post-operative results for the MIS group at discharge (p < 0.001) and 3 weeks (p < 0.001), 6 weeks (p < 0.001), and 6 months (p = 0.004) post-surgery. The AOFAS showed no significant differences either before or after surgery. Four cases with screw prominence were reported, three of which belonged to the MIS group. Only one case with metatarsalgia was found in the OC group. Conclusions: This paper demonstrates that minimally invasive chevron osteotomy has comparable results with open chevron osteotomy, even though surgical time and radiological exposure are significantly longer. More studies are required to evaluate the complications and the risk of recurrences.
Topics: Female; Hallux Valgus; Humans; Male; Osteotomy; Prospective Studies; Radiography; Treatment Outcome
PubMed: 35334535
DOI: 10.3390/medicina58030359 -
Clinics in Podiatric Medicine and... Apr 2022The correction of the flexible pes planovalgus foot and ankle is a complicated and somewhat controversial topic. After conservative methods fail, there is a wide range... (Review)
Review
The correction of the flexible pes planovalgus foot and ankle is a complicated and somewhat controversial topic. After conservative methods fail, there is a wide range of possible soft tissue and bony procedures. The appropriate work up and understanding of the pathomechanics are vital to the correct choice of procedures to correct these deformities. Once the work up and procedure selection are done, the operation must also be technically performed well and with efficiency, as most often the condition is corrected with a variety of procedures. This article discusses some of the most common procedures necessary to fully correct the pes planovalgus foot and discusses the authors' technique and pearls.
Topics: Ankle Joint; Flatfoot; Humans; Osteotomy
PubMed: 35365324
DOI: 10.1016/j.cpm.2021.11.010 -
Oral and Maxillofacial Surgery Clinics... Aug 2022Patients with syndromic and nonsyndromic synostosis may have end-stage skeletal discrepancies involving the lower midface and mandible, with associated malocclusion.... (Review)
Review
Patients with syndromic and nonsyndromic synostosis may have end-stage skeletal discrepancies involving the lower midface and mandible, with associated malocclusion. While orthognathic surgical procedures in this population can be reliably executed, the surgeon must be aware of the unique morphologic characteristics that accompany the primary diagnoses as well as the technical challenges associated with performing Le Fort I osteotomies in patients who have undergone prior subcranial midface distraction.
Topics: Craniosynostoses; Facial Bones; Humans; Orthognathic Surgery; Orthognathic Surgical Procedures; Osteotomy, Le Fort
PubMed: 35787829
DOI: 10.1016/j.coms.2022.01.003