1/5. Posttraumatic pediatric distal tibiofibular synostosis: a case report.INTRODUCTION: Posttraumatic pediatric distal tibiofibular synostosis is a rare complication of fractures at this level, unreported at this time. Implications include limb length discrepancy, angular malalignment, and gait and biomechanical abnormalities. MATERIALS AND methods: The authors present a case report of this complication in a 7-year-old child and review the relevant English literature. The patient was treated for a closed distal tibia-fibula fracture and developed a synostosis at that level, with valgus malalignment of the ankle joint. The synostosis was resected and latest follow-up 16 months postresection showed near normalization of the ankle malalignment. Possible etiologies, the anatomical and functional ramifications, and treatment recommendations for this condition are discussed. SUMMARY: Posttraumatic tibiofibular synostosis is a rare complication that has a potential effect on limb length and alignment, both at the ankle and the knee in the skeletally immature patient. Prevention, early recognition, and prompt treatment prevent the anatomic and functional abnormalities that could result from it.- - - - - - - - - - ranking = 1keywords = malalignment (Clic here for more details about this article) |
2/5. Long-term follow-up of a malunited, isolated fracture of the capitate in a 6-year-old boy.A 6-year-old boy with an isolated fracture of the capitate was presented. First radiograghs at our clinic revealed an oblique fracture with a displacement of 5 mm on the lateral view, which we successfully treated with immobilization. When complete union was recognized in the radiographs, the capitate had a deformity consisting of a large prominence on the palmar aspect. During follow-up, the capitate showed marked remodeling and at four and a half years after injury it had regained an almost normal shape. Eleven years after injury, there were no radiographic changes such as malalignment or arthrosis in the carpal bones.- - - - - - - - - - ranking = 0.33333333333333keywords = malalignment (Clic here for more details about this article) |
3/5. Neglected femoral diaphyseal fracture.Femoral diaphyseal fractures usually result after trauma of high magnitude and because of this, can be life-threatening injuries or may result in considerable physical disability if not treated with care and caution. Nonoperative treatment of these fractures continues to be popular among the patient population in the Indian subcontinent, which in majority of cases, leads to healing in malalignment, shortening of the limb, chondromalacia patellae, and loss of knee motion. Although the majority of these fractures are being treated by operative methods today, success of the treatment depends largely on the surgeon's familiarity with the procedure or the type of fracture pattern (comminuted or segmental) particularly in a polytraumatized patient. Delayed union and nonunion of femoral-diaphyseal fractures and implant failures usually result after these procedures or the type of injury. The purpose of this study is to discuss various types of neglected femoral diaphyseal fractures and to review the literature on their treatment.- - - - - - - - - - ranking = 0.33333333333333keywords = malalignment (Clic here for more details about this article) |
4/5. Transfibular osteotomy in the correction of ankle joint incongruity.The mechanics involved in Danis-Weber-types B and C ankle fractures may allow the fibula to seek a shortened and externally rotated position following injury. Residual talar instability secondary to fibular malalignment may ensue if proper anatomic restoration is not achieved at the time of reduction. Evaluation of ankle incongruity may take the form of clinical, radiographic, and diagnostic techniques. Three case studies are presented in which fibular osteotomies were utilized to restore proper anatomic alignment and function to the ankle mortise.- - - - - - - - - - ranking = 0.33333333333333keywords = malalignment (Clic here for more details about this article) |
5/5. Corrective osteotomy for scaphoid malunion: technique and long-term follow-up evaluation.Five patients with dorsal intercalated segment instability underwent corrective osteotomy for symptomatic scaphoid malunion. Follow-up examination at an average of nearly 9 years after the procedure (range, 1.5-19 years) revealed that all had improvement in range of motion (ROM). Total active ROM improved from a mean of 127 degrees (range, 95 degrees-165 degrees) to a mean of 156 degrees (range, 95 degrees-214 degrees). Grip strength increased from a mean of 16 kg (range, 14-35 kg) to a mean of 32 kg (range, 24-48 kg). The wrist score improved from an average of 19 to 75. The preoperative intrascaphoid and carpal malalignments were reduced, as demonstrated by trispiral tomography. Symptomatically, all patients reported improvement. All osteotomies healed within 5.5 months of the procedure. No case of avascular necrosis was noted. Mild radioscaphoid arthrosis is apparent in four patients and a preexisting midcarpal arthrosis persists in one patient. Corrective osteotomy for scaphoid malunion may have a role in the prevention or slowing of the onset of premature arthritis in young patients with high functional demands. A technique is described.- - - - - - - - - - ranking = 0.33333333333333keywords = malalignment (Clic here for more details about this article) |