Recovery of function after closed femoral shortening

Barker, Karen; Simpson, A. H. R. W.

doi:10.1302/0301-620x.86b8.15194

Cited by 16 publications

(8 citation statements)

References 18 publications

(23 reference statements)

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“… 14 - 16 In addition, post-operative function has been reported to reach pre-operative levels for TESS and number of sit-to-stand repetitions at one year and for number of stairs climbed at two years. 15 Although a simple comparison cannot be drawn from these reports due to performing muscle resections in the present study, we measured post-operative muscle strength and function at more than one year, at which time recovery of muscle strength is likely to have roughly plateaued. However, because the present study also includes measurements within two years of surgery, muscle strength and function may show further improvement.…”

Section: Discussionmentioning

confidence: 98%

“…In the present study, except for one case of femoral nerve trunk resection, there was no denervation or muscle atrophy of residual muscle on the post-operative magnetic resonance imaging. Reports on recovery of muscle strength after femoral limb lengthening 14 or shortening 15 , 16 state that post-operative muscle strength demonstrates the greatest improvement at three months to one year, 16 continues to improve at two years, but is unlikely to improve beyond two years. 14 - 16 In addition, post-operative function has been reported to reach pre-operative levels for TESS and number of sit-to-stand repetitions at one year and for number of stairs climbed at two years.…”

Section: Discussionmentioning

confidence: 99%

“…Reports on recovery of muscle strength after femoral limb lengthening 14 or shortening 15 , 16 state that post-operative muscle strength demonstrates the greatest improvement at three months to one year, 16 continues to improve at two years, but is unlikely to improve beyond two years. 14 - 16 In addition, post-operative function has been reported to reach pre-operative levels for TESS and number of sit-to-stand repetitions at one year and for number of stairs climbed at two years. 15 Although a simple comparison cannot be drawn from these reports due to performing muscle resections in the present study, we measured post-operative muscle strength and function at more than one year, at which time recovery of muscle strength is likely to have roughly plateaued.…”

Section: Discussionmentioning

confidence: 99%

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Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh

Tanaka

Yoshimura

Aoki

et al. 2016

Bone & Joint Research

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ObjectivesOur objective was to predict the knee extension strength and post-operative function in quadriceps resection for soft-tissue sarcoma of the thigh.MethodsA total of 18 patients (14 men, four women) underwent total or partial quadriceps resection for soft-tissue sarcoma of the thigh between 2002 and 2014. The number of resected quadriceps was surveyed, knee extension strength was measured with the Biodex isokinetic dynamometer system (affected side/unaffected side) and relationships between these were examined. The Musculoskeletal Tumor Society (MSTS) score, Toronto Extremity Salvage Score (TESS), European Quality of Life-5 Dimensions (EQ-5D) score and the Short Form 8 were used to evaluate post-operative function and examine correlations with extension strength. The cutoff value for extension strength to expect good post-operative function was also calculated using a receiver operating characteristic (ROC) curve and Fisher’s exact test.ResultsExtension strength decreased when the number of resected quadriceps increased (p < 0.001), and was associated with lower MSTS score, TESS and EQ-5D (p = 0.004, p = 0.005, p = 0.006, respectively). Based on the functional evaluation scales, the cutoff value of extension strength was 56.2%, the equivalent to muscle strength with resection of up to two muscles.ConclusionGood post-operative results can be expected if at least two quadriceps muscles are preserved.Cite this article: A. Tanaka, Y. Yoshimura, K. Aoki, M. Kito, M. Okamoto, S. Suzuki, T. Momose, H. Kato. Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh. Bone Joint Res 2016;5:232–238. DOI: 10.1302/2046-3758.56.2000631.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh

Tanaka

Yoshimura

Aoki

et al. 2016

Bone & Joint Research

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“…Limb-lengthening and limb-shortening surgeries are associated with a risk of infection, nonunion or malunion of the affected bone, joint dislocation, nerve injury, and fractures after removal of the lengthening apparatus [ 149 , 150 ]. Substantial decreases in strength, power, and function occur immediately after surgery; small residual deficits in muscle strength are likely to persist [ 151 , 152 , 153 ]. Physical therapy for children and adolescents undergoing leg-lengthening and leg-shortening procedures is required to strengthen muscle and maintain joint flexibility to ensure maximum recovery of function.…”

Section: Musculoskeletal Defectsmentioning

confidence: 99%

Impairments that Influence Physical Function among Survivors of Childhood Cancer

2015

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Children treated for cancer are at increased risk of developing chronic health conditions, some of which may manifest during or soon after treatment while others emerge many years after therapy. These health problems may limit physical performance and functional capacity, interfering with participation in work, social, and recreational activities. In this review, we discuss treatment-induced impairments in the endocrine, musculoskeletal, neurological, and cardiopulmonary systems and their influence on mobility and physical function. We found that cranial radiation at a young age was associated with a broad range of chronic conditions including obesity, short stature, low bone mineral density and neuromotor impairments. Anthracyclines and chest radiation are associated with both short and long-term cardiotoxicity. Although numerous chronic conditions are documented among individuals treated for childhood cancer, the impact of these conditions on mobility and function are not well characterized, with most studies limited to survivors of acute lymphoblastic leukemia and brain tumors. Moving forward, further research assessing the impact of chronic conditions on participation in work and social activities is required. Moreover, interventions to prevent or ameliorate the loss of physical function among children treated for cancer are likely to become an important area of survivorship research.

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“…b This radiograph of the same patient was taken 10 weeks after the index surgery, demonstrating broken hardware and a change in alignment at the osteotomy site. is rare [2,3,5]. In our cohort, three limbs were treated with an average resection of 2.5 cm, resulting in two un-united osteotomy sites and one union that took 14 weeks to heal.…”

Section: Discussionmentioning

confidence: 99%

Carbon-Fiber-Reinforced Polymer Intramedullary Nails Perform Poorly in Long-Bone Surgery

2018

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Background: Carbon-fiber-reinforced (CFR) polymer has produced great excitement in the orthopedic community as a material that will reduce bone healing times and provide improved image quality. Osteotomy stabilized with an intramedullary (IM) nail has become a common technique to address post-traumatic malalignment of the lower extremity. Purposes/Questions: The following questions were asked: (1) Did CFR polymer nails provide a rapid healing time after long bone osteotomy, shortening, or fracture? (2) Did the CFR polymer nails produce unexpected complications? Methods: A retrospective review was conducted in patients who received CFR polymer IM nails for various indications, from April 2016 to January 2017 in a deformity and trauma practice, using patient charts and radiographs. The primary outcomes were time to union and incidence of complications including nonunion, hardware failure, neurovascular injury, venous thromboembolism, and infection. Results: Twelve patients who received CFR polymer IM nails in 16 limbs for various indications were included in our analysis. Patients were followed for an average of 16.9 months. Eleven limbs underwent realignment and were corrected an average of 23°through a diaphyseal osteotomy. Three limbs underwent limb-shortening surgery, an average of 25 mm, through an open, excisional osteotomy of the femoral diaphysis. Two diaphyseal, closed tibia fractures underwent routine IM nailing. The average time to union was 107.6 days, which included all limbs that united (11/16, 69%). Nonunion occurred in 5/16 (31%) of limbs. Complications recorded included nonunion and hardware failure, most of which resulted in unplanned surgery. Conclusions: The use of the CFR polymer IM nail was associated with loss of fixation and nonunion after surgeries that have traditionally healed uneventfully. The increased elasticity of the CFR polymer allows for more motion at the osteotomy/fracture interface than the stiffer titanium counterparts, exposing longbone osteotomies to delayed union and nonunion, a finding seen with CFR polymer plates. The overwhelmingly poor early results of this device applied to a long-bone deformity practice have led these authors to abandon the use of this implant.

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Recovery of function after closed femoral shortening

Cited by 16 publications

References 18 publications

Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh

Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh

Impairments that Influence Physical Function among Survivors of Childhood Cancer

Carbon-Fiber-Reinforced Polymer Intramedullary Nails Perform Poorly in Long-Bone Surgery

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