Extracapsular proximal femur fractures
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
Ream by hand or with an awl in osteoporotic patients to avoid damage to the fragile trochanteric metaphyseal bone. In patients with good quality bone, use power reaming. Remove the guide wire after reaming. If the fracture passes through the guidewire entry site, a medially directed force applied to the lateral trochanteric region along with slow advancement of the power reamer helps prevent diastasis of the fracture site by displacing the greater trochanteric segment(s) laterally. This allows proper creation of a channel for the nail, so that its insertion does not distract the fracture and produce varus deformity. Avoiding varus deformity is important to improve fixation and to preserve functionally important anatomy. In most patients the nail, mounted on the insertion device, can be inserted manually. Use the image intensifier as a help and insert the nail to such a depth that it will allow the cephalomedullary fixation to be placed through the middle of the femoral neck.
Bones, joints, muscles and tendons
Kevin G Burnand, John Black, Steven A Corbett, William EG Thomas, Norman L Browse in Browse’s Introduction to the Symptoms & Signs of Surgical Disease, 2014
Malalignment of a joint in the coronal plane, the plane of abduction and adduction, is known as a valgus or a varus deformity: There is a valgus deformity if the limb below the joint is angled away from the midline (abducted) (Fig. 6.11). There is a varus deformity if the limb below the joint is angled towards the midline (adducted) (Fig. 6.11).
Clinical Management of Spasticity and Contractures in Stroke
Anand D. Pandyan, Hermie J. Hermens, Bernard A. Conway in Neurological Rehabilitation, 2018
In the swing phase, equinovarus of the ankle interferes with foot clearance and with appropriate prepositioning of the foot for initial contact and loading (Renzenbrink et al., 2012). In the sagittal plane, paresis of ankle dorsiflexors is the most prominent cause. It can be aggravated by pathological activity of the plantar flexor muscles (Figure 5.5). In the coronal plane, paresis of the lateral foot elevators and overactivity of the invertors constitute the main cause of the varus deformity.
Open-Wedge HTO with Absorbable β-TCP/PLGA Spacer Implantation and Proximal Fibular Osteotomy for Medial Compartmental Knee Osteoarthritis: New Technique Presentation
Published in Journal of Investigative Surgery, 2021
Ruipeng Zhang, Shilun Li, Yingchao Yin, Jialiang Guo, Wei Chen, Zhiyong Hou, Yingze Zhang
Meniscal changes including degenerative tears frequently occur gradually with aging, leading to the development of knee OA [28]. It was reported that approximately 80% of patients with knee OA had associated meniscal degenerative changes [29]. Several clinical trials reported that patients with meniscal lesions who underwent arthroscopy and physical treatment showed similar functional results [30,31]. Therefore, arthroscopy was not initially performed in this study. It was believed that both meniscal degenerative changes and knee OA were caused by asymmetrical subsidence (Asymmetrical Subsidence Video). Thus, the novel surgical procedures were performed to correct the varus deformity of the lower limb. In addition to the excision of the proximal fibula supporting the lateral tibial plateau, the subsidence of the medial tibial plateau was restored after the surgical procedures. Thereafter, the interval of the fibular osteotomy sites was narrowed after the implantation of the absorbable spacer (Figure 7).
Blount’s disease successfully treated with intraepiphyseal osteotomy with elevation of the medial plateau of the tibia—a case report with 65 years’ follow-up
Published in Acta Orthopaedica, 2018
Terje Terjesen, Darko Anticevic
Severe varus deformity should be surgically corrected; if left untreated, OA predictably occurs early in life (Hofmann et al. 1982). It is, however, difficult to evaluate the association between deformity following Blount’s disease and OA, because follow-up in most studies is too short. The longest previous follow-up after elevation osteotomy of the tibial plateau seems to be in a patient aged 41 years (Langenskiöld 1989). The follow-up time of our patient was 65 years (patient age 78 years) and thus more than long enough for a proper evaluation of OA. Surprisingly, only moderate OA had developed during this long time. This shows that a good result at skeletal maturity in a patient with severe preoperative varus (Støren 1969) can remain good even with long follow-up if the deformity has been adequately corrected.
Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke
Published in Topics in Stroke Rehabilitation, 2018
Christina Zong-Hao Ma, Yong-Ping Zheng, Winson Chiu-Chun Lee
Various interventions have been used to relieve varus deformity for patients with stroke, but with some limitations.9 Local botulinum toxin injection has limitations of high cost and transient nature that requires repetitive injections.22 Patients’ compliance of wearing ankle–foot orthosis has been low, thus leading to a high financial loss for society and a waste of therapeutic effort as reviewed in.23 Physiotherapy which provides repetitive verbal reminders of putting the foot in a better position during gait requires intensive manpower.24
Related Knowledge Centers
- Clubfoot
- Coxa Vara
- Genu Varum
- Valgus Deformity
- Genu Valgum
- Hallux Varus
- Cubitus Varus