Purpose. To evaluate outcomes of wide resection and reconstruction of the distal radius with nonvascularised autogenous fibular grafts for giant cell tumour (GCT) of bone. Methods. Medical records of 7 men and 5 women aged 22 to 47 (mean, 31) years who underwent wide resection of the distal radius and reconstruction with non-vascularised autogenous fibular grafts for GCT of bone were reviewed. The mean length of the resected radius was 9 (range, 7-11) cm. The ipsilateral proximal fibula with a small portion of attached ligament was harvested. The articular surface of the graft was fixed to the scapholunate articular surface by Kirschner wires, and the ligament of the fibular head was sutured to the carpal ligaments. The graft was fixed to the proximal radius with a small dynamic compression plate. Iliac cancellous bone graft was added. Pain, instability, and functional status were assessed. Wrist joint movements were measured using a goniometer. The grip strength was measured.Reconstruction of the distal radius with nonvascularised fibular graft after resection of giant cell tumour of bone Journal of Orthopaedic Surgery 2014;22(3):356-9The operated and contralateral sides were compared. Results. The mean follow-up was 24 (range, 20-27) months. All patients achieved radiological union after a mean of 16 (range, 14-20) weeks. The mean active range of movement in the operated wrists was 32º dorsiflexion, 38º palmar flexion, 15º radial deviations, 12º ulnar deviations, 50º supination, and 60º pronation. Compared with the contralateral wrists, the operated wrists regained 60% of the function, with satisfactory grip strength, and normal finger and thumb movements and hand sensation. No patient had recurrence after 2 years. Two patients had minor dorsal subluxation, which was resolved with a wrist brace. Three patients had superficial infection, which was resolved with intravenous antibiotics and dressings. Two patients had peroneal nerve palsy, which recovered completely in 12 weeks. Conclusion. Non-vascularised fibular grafts for reconstruction of the distal radius after resection of a GCT of bone achieved good cosmetic and functional outcomes.
… Background: Ponseti technique for club foot treatment has become more popular during the last decade. But the most common problem following correction by Ponseti technique is the relapse of deformity. Setting: Dow University Hospital as well as other hospitals were included in the study. Period: April 2013 to April 2016. Methods: 335 children with idiopathic club foot presented in OPD with relapse, treated with Ponseti technique. Pirani scoring was used to assess the severity of relapse. Children with both unilateral and bilateral involvement, aged up to 5 years were included. 335 children with idiopathic club feet who underwent treatment with Ponseti technique, presented with relapse of deformity were enrolled in the study. Results: There were 207(59.7%) boys and 128(37%) girls. Mean age at presentation for casting (previous treatment age) was 5.98 months (SD ±6.07), and 153(44.2%) had Right sided involvement, 112 (32.4%) had left sided involvement and 69(19.9%) had bilateral involvement. Mean age at which relapse occurred was 24.7 months (SD ±7.35). The mean Pirani score was 4.78 (SD ±4.30). Percutaneous heel cord tenotomy was done in 286 (82.7%) children. Number of cast to maintain initial correction was 7.58 (SD ±1.19).Out of 335 patients 246(71.1) used brace and out of them 123 (50%) used brace up to one year, 70 (25.5%) used for1-2 years, 30 (15.5%) used for 2-3 years and 23 (9%) used for 3-4 years. Conclusion: Ponseti method is safe and effective method of treatment for club foot. Despite the proper use of Ponseti method, relapses and recurrences still occurs due to certain factors. The best treatment for recurrent club foot is prevention in the form of consistent primary treatment, constant use of braces and regular follow up
Background: Ponseti technique for club foot treatment has become morepopular during the last decade. But the most common problem following correction byPonseti technique is the relapse of deformity. Setting: Dow University Hospital as well asother hospitals were included in the study. Period: April 2013 to April 2016. Methods: 335children with idiopathic club foot presented in OPD with relapse, treated with Ponseti technique.Pirani scoring was used to assess the severity of relapse. Children with both unilateral andbilateral involvement, aged up to 5 years were included. 335 children with idiopathic club feetwho underwent treatment with Ponseti technique, presented with relapse of deformity wereenrolled in the study. Results: There were 207(59.7%) boys and 128(37%) girls. Mean age atpresentation for casting (previous treatment age) was 5.98 months (SD ±6.07), and 153(44.2%)had Right sided involvement, 112 (32.4%) had left sided involvement and 69(19.9%) hadbilateral involvement. Mean age at which relapse occurred was 24.7 months (SD ±7.35). Themean Pirani score was 4.78 (SD ±4.30). Percutaneous heel cord tenotomy was done in 286(82.7%) children. Number of cast to maintain initial correction was 7.58 (SD ±1.19).Out of 335patients 246(71.1) used brace and out of them 123 (50%) used brace up to one year, 70 (25.5%)used for1-2 years, 30 (15.5%) used for 2-3 years and 23 (9%) used for 3-4 years. Conclusion:Ponseti method is safe and effective method of treatment for club foot. Despite the proper use ofPonseti method, relapses and recurrences still occurs due to certain factors. The best treatmentfor recurrent club foot is prevention in the form of consistent primary treatment, constant use ofbraces and regular follow up
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