View
35
Download
0
Category
Tags:
Preview:
DESCRIPTION
Talar morphologic changes after tendo -Achilles lengthening for long-standing equinus deformity in patients with residual poliomyelitis. Ki Hyuk Sung, MD Department of Orthopaedic Surgery Seoul National University Bundang Hospital. Introduction. - PowerPoint PPT Presentation
Citation preview
Ki Hyuk Sung, MD
Department of Orthopaedic SurgerySeoul National University Bundang HospitalTalar morphologic changes after tendo-Achilles lengthening for long-standing equinus deformity in patients with residual poliomyelitis
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
IntroductionCoronal angular deformity of the lower limb is a common finding in growing childrenPermanent (irreversible) hemiepiphysiodesisTemporary (reversible) hemiepiphysiodesis using staples, percutaneous screws, or a tension band plate (eight-plate)
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
IntroductionMeasuring the rate of correction is necessary to predict the time to end pointThe rate of angular correction has been calculated simply by averaging.Other factors (age, surgical method, direction of deformity, etiology, physis) must be considered while estimating the rate of correction
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
IntroductionA linear mixed model (LMM) is useful in settings where multiple correlated measurements are made on the same statistical units LMM consists of fixed effects and random effectsEstimation of the correction rate by using a mixed model application may confer more practical information to clinicians
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
PurposeTo investigate the talar morphologic changes after TAL for long-standing equinus deformity in patients with RP To investigate whether the severity of preoperative equinus deformity affect occurrence of symptomatic anterior impingement.
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Material and methods
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Inclusion criteria
Consecutive patients with residual poliomyelitis, who underwent tendo-Achilles lengthening for equinus foot deformity since 2003Patients who had preoperative and postoperative weight bearing lateral foot-ankle radiographsPatients with a minimum follow-up of 6 months
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Exclusion criteria
Patients with inadequate foot-ankle radiographs for measurementPatients with history of previous foot surgery Patients who had concomitant anterior bony spur excision with TAL
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Radiographic measurement
Lateral foot weight bearing radiographTalocalcaneal angle Plantigrade angle McDermott grade Presence of anterior blocking spur
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Talocalcaneal angle
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Plantigrade angle
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
McDermott gradegrade 1, anterior tibial spur measuring less than 3mmgrade 2, anterior tibial spur measuring more than 3mmgrade 3, anterior tibial spur with secondary talar spur (kissing lesion)grade 4, panarthritis
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
McDermott grade
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Anterior blocking spur
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Statistical analysisComparison between preoperative and postoperative McDermott grade Wilcoxon signed ranks test
Comparison of preoperative radiographic measurements between the patients with and without anterior ankle pain, and between the patients with and without anterior blocking spurIndependent t-test
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Results
SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL SEOUL NATIONAL UNIVERSITY BUNDANG HOSPITAL
Patients demographics and radiographic measurementsGender (M / F)13 / 14Age at operation (year)43.89.4 (range 21.7 to 63.3)Right/ Left17 / 10Follow-up duration (year)2.92.2 (range 0.6 to 8.4)Foot deformity E/ EC/ EV/ ECV/ EPV7/ 2/ 2/ 14/ 2Preoperative talocalcaneal angle ()78.514.2Preoperative plantigrade angle ()99.514.3McDermott grade* Preoperative0 (range, 0 to 4) Latest follow-up3 (range, 0 to 4) p-value
Recommended