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Bone lengthening with extra-articular arthrodesis of the hip using external fixation.

Mesa PA - Strategies Trauma Limb Reconstr (2008)

Bottom Line: Clinical review indicated a significant improvement in physical function and psychological well-being.Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021).No additional operations were required to achieve the surgical objective.

View Article: PubMed Central - PubMed

Affiliation: Clinic of Niño ISS "Jorge Bejarano" and Clinic 104 Saludcoop "Jorge Piñeros", Calle 175 No. 17A-11(135), Bogotá, Colombia, pasm@clubcadera.com.

ABSTRACT
This is a case series of 11 children and adolescents who underwent femoral lengthening and percutaneous hip arthrodesis using a method of extra-articular joint compression in combination with callotasis. Clinical review indicated a significant improvement in physical function and psychological well-being. The average lengthening was 5.3 cm or 16% of the initial length. Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021). No additional operations were required to achieve the surgical objective.

No MeSH data available.


Stretching exercises program—basic postures and sleeping positions
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Fig4: Stretching exercises program—basic postures and sleeping positions

Mentions: The patient is discharged to out-patient (ambulatory) care when sufficiently recovered. In the first 2 weeks after surgery, compression of the hip is performed while adjusting for and maintaining the intended position for fusion. Femoral lengthening is commenced at day 15 post-surgery at an average rate of 1 mm a day (range 0.5–1.5 mm a day) by a quarter of turn of the distractor every 6 h. A physiotherapy programme is started to maintain joint range and function in the limb. Prone lying is encouraged for 1–2 h per day in the first few days after surgery, and exercise and limb posture are monitored to avoid joint contractures. The exercise program is carried out three times a day, divided into static and dynamic types, with active quadriceps muscle contraction and mild bending of the knee over a straight edge coupled to passive manipulation and holding for 3 s. This is repeated ten times in series of three until full flexion–extension of the knee is reached in the next 40 days. In addition, stretches of the hip flexors and dorsiflexion and plantar flexion of the ankle are practised (Fig. 4).Fig. 4


Bone lengthening with extra-articular arthrodesis of the hip using external fixation.

Mesa PA - Strategies Trauma Limb Reconstr (2008)

Stretching exercises program—basic postures and sleeping positions
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2553433&req=5

Fig4: Stretching exercises program—basic postures and sleeping positions
Mentions: The patient is discharged to out-patient (ambulatory) care when sufficiently recovered. In the first 2 weeks after surgery, compression of the hip is performed while adjusting for and maintaining the intended position for fusion. Femoral lengthening is commenced at day 15 post-surgery at an average rate of 1 mm a day (range 0.5–1.5 mm a day) by a quarter of turn of the distractor every 6 h. A physiotherapy programme is started to maintain joint range and function in the limb. Prone lying is encouraged for 1–2 h per day in the first few days after surgery, and exercise and limb posture are monitored to avoid joint contractures. The exercise program is carried out three times a day, divided into static and dynamic types, with active quadriceps muscle contraction and mild bending of the knee over a straight edge coupled to passive manipulation and holding for 3 s. This is repeated ten times in series of three until full flexion–extension of the knee is reached in the next 40 days. In addition, stretches of the hip flexors and dorsiflexion and plantar flexion of the ankle are practised (Fig. 4).Fig. 4

Bottom Line: Clinical review indicated a significant improvement in physical function and psychological well-being.Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021).No additional operations were required to achieve the surgical objective.

View Article: PubMed Central - PubMed

Affiliation: Clinic of Niño ISS "Jorge Bejarano" and Clinic 104 Saludcoop "Jorge Piñeros", Calle 175 No. 17A-11(135), Bogotá, Colombia, pasm@clubcadera.com.

ABSTRACT
This is a case series of 11 children and adolescents who underwent femoral lengthening and percutaneous hip arthrodesis using a method of extra-articular joint compression in combination with callotasis. Clinical review indicated a significant improvement in physical function and psychological well-being. The average lengthening was 5.3 cm or 16% of the initial length. Complications were more frequent in patients older than 14 years (P = 0.034) as was a higher maturation index (P = 0.021). No additional operations were required to achieve the surgical objective.

No MeSH data available.