Slipped Capital Femoral Epiphysis is the leading cause of limp in the adolescent population. This study aimed to discuss that intertrochanteric Imhäuser osteotomy led to an improved functional outcome, and discussing indications, contraindications and surgical technique of Imhäuser osteotomy. In moderate and severe slips, residual growth and remodeling after in situ stabilization are unable to compensate for the remaining femoral neck deformity. In these slips, a modified Dunn procedure might be more effective in order to reduce the risk of early onset hip osteoarthritis but carries high risk for avascular necrosis.Subtrochentric Imhauser osteotomy provides excellent option for correction of the residual deformities in chronic or healed SCFE.The Imhauser osteotomy is Subtrochentric valgus, flexion and internal rotation so correct the deformities in the chronic cases of SCFE. In consideration of our 23-year follow-up and in regard to other studies, we still consider the Imhauser ¨user osteotomy to be indicated for SCFE with angles of displacement >40°.
Background: relapsed Clubfoot has been a clinical challenge for the orthopedic surgeons. There is no single modality of treatment till date. Tibialis anterior tendon transfer was described as a good procedure in restoring muscle balance and correcting this deformity. Aim of the work: to evaluate the results of tibialis anterior tendon transfer after walking age in children with residual dynamic supination after correction of congenital clubfoot with ponseti technique. Patients and methods: The current study is an interventional study that was conducted between 2016 and 2019 at Benha University hospitals, Zagazig general hospital, and Zagazig university hospitals. About (30 feet) in 22 patients with residual dynamic clubfoot deformity underwent transfer of the anterior tibial tendon were enrolled in the study. The follow up period ranged from 12 months to 19 months. Results: The patients' age ranged from 2.5 years to 6.5 years old at the time of the operation with mean age was (4.22±1.26) and the majority of them were males (60%). About 9 feet (30%) required further preoperative recasting and tendoachilles lengthening. There was statistically significant improvement between pre and post operative results regarding observational gate analysis, range of motion, foot posture index, X ray measured angles, eversion muscles power and parents satisfaction (p value <0.05). Conclusion: Tibialis anterior tendon transfer has been shown to be an effective procedure in dynamic supination deformity correction. Ankle and foot range of motion and muscle function of the children definitely improved with the procedure.
Tendons are vital component of our musculoskeletal system that link between the dynamic and the static part transmitting the forces generated by muscles to bony attachments producing joint motion and stabilize joints. Chronic painful tendon disorders are common in athletic and sedentary individuals. Tendon degeneration may occur when tissue breakdown exceeds the rate of tissue healing due to extrinsic factors such as tendon overload, excessive mechanical stimulation, training errors, fatigue or chemical stresses. Choices of treatment often change in parallel with physiopathological discoveries regarding tendinopathy. Platelets Riched plasma (PRP) is defined as a volume of the plasma fraction of autologous blood having a platelet concentration of 5 times more than base line. Injection of platelet-rich plasma (PRP) is considered a promising new treatment in management of tendinopathy. Platelet-rich plasma (PRP) injections are widely accepted by patients because the injection is produced from the patient's own blood and the risk of adverse effects is minimal. The aim of this Syistimic Review is to highlight on the recent trends in management of tendinopathy, especially platelet rich plasma.
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