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Knee Osteoarthritis Progression after distal femur Closing Wedge Osteotomy

Open Journal of Orthopedics 2024年第4期14卷 187-199页

作者： Ferdinand Nyankoué Mebouinz Khalifa Fall Kennedy Muluem Justine Raphaela Nyekel Moustapha Niane Alioune Badara Gueye Daniel Handy Eone Charles Valerie Kinkpé Department of Surgery and Specialties The Faculty of Medicine and Biomedical Sciences The University of Yaound&#233 I Yaound&#233 Cameroon Department of Orthopedic and Trauma Surgery Cheikh Anta Diop University of Dakar Dakar Senegal Department of Surgery and Specialties The Faculty of Medicine and Pharmaceuticals Sciences The University of Douala Douala Cameroon

Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.

关键词： Knee Osteoarthritis Progression Osteotomy distal femur

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Surgical Management of Recent Traumatic Epiphyseal Fractures-Detachments of the distal femur at Gabriel TouréUniversity Hospital

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Surgical Science 2023年第2期14卷 61-71页

作者： Mahamadou Diallo Abdoul Kadri Moussa Layes Toure Kalifa Coulibaly Mamadou Bassirou Traoré Cheick Oumar Sanogo Terna Traoré Mamadou Diallo Amadou Maiga Adégné Togo Service d’Orthopédie-Traumatologie CHU Gabriel Touré Bamako Mali Service d’Orthopédie-Traumatologie Etablissement Hospitalier Publique Sikasso Sikasso Mali Service d’orthopédie traumatologie CHU de Kati Kati Mali Service de Neurochirurgie CHU Gabriel Touré Bamako Mali Service de chirurgie générale CHU Gabriel Touré Bamako Mali

Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity is linked to disabling sequelae such as limb length inequality or most often axial deviation. In this report, surgical treatment aims to reconstruct the anatomy of the distal femur, to avoid secondary displacements and to allow early mobilization of the knee. Surgery carried out mainly by the technique of plugging in or screwing, opened or better still closed, can be a source of complications including migration of pins, infections, knee stiffness, and growth disorders. The aim of this work was to describe their epidemiological, anatomo-clinical, therapeutic and evolutionary aspects in the Department of Orthopedics-Traumatology at the CHU Gabriel TOURE. It was a retrospective study over 30 months from July 2019 to December 2021. In fact, it concerned 42 patients with traumatic epiphyseal detachment of the distal femur occurring within 21 days or less, on a healthy knee with cartilage fertile treated surgically and followed in the department. However, the diagnosis of traumatic epiphyseal detachment of the distal femur was retained thanks to the clinical examination and supplemented by radiographic images of the knee from the front and from the side. The treatment was surgical. The functional results were evaluated according to the functional criteria of the Eastern Orthopedic Traumatology Society (SOTEST). Forty-two patients included 32 boys and 10 girls of average age of 12 years with extremes of 8 years and 16 years. The lesions were classified according to the Salter Harris classification. We noted 24% type I (n = 10), type II 71% (n = 30), type III 2% (n = 1), type IV 2% (n = 1). Union was achieved in all patients within an average of 6 weeks with extremes of 4 and 12 weeks. The functional result was considered good in 20% of cases and very good in 80%. Traumatic epiphyseal detachment fractures of the distal end of the femur are a rare lesion whose severity

关键词： Epiphyseal Detachment distal femur Treatment Surgical

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Multiple 2D approaches to human sexual dimorphism of the distal end of femur

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Zoological Systematics 2017年第1期42卷 108-122页

作者： Sitha Piyaselakul Bumpenporn Sanannam Jean-Pierre Dujardin Department of Anatomy Faculty of Medicine Siriraj Hospital Mahidol University Bangkoknoi Bangkok 10700 Thailand IRD UMR IRD-CIRAD INTERTRYP Campus international de Baillarguet Montpellier France

Various studies on the difference of distal femoral condyles between genders have been reported recently in order to provide anatomic information for knee prosthesis design and surgical planning in total knee arthroplasty. They also had the objective to be used as a sex recognition character, as may be needed in forensic medicine. Except for a recent 3D approach on the distal femur, most of the studies used dimensional information or aspect ratio but not shape. Our 2D study aimed to determine the size and shape variation of femoral condyles in Thais, considering age, sex and sides. One hundred and twenty-four cadaveric femurs （male 84 legs and female 40 legs） were dissected. The specimens were photographed by digital camera and images were analyzed using three geometric techniques：（i） the landmark-based method （5 landmarks）, （ii） with or without addition of 23 sliding semilandmark and （iii） the outline-based methods. From the resulting geometric coordinates, size and shape were extracted for comparisons between genders and sides. Between sides, directional asymmetry could be detected only for shape variation, and only when introducing curves in the analyses （either through the semilandmarks technique or through the outline-based one）. Non-directional asymmetry, probably fluctuating asymmetry, was detected for size, as well as for shape, in both genders. Sex discrimination was performed for each geometric technique using two classification methods： the Mahalanobis distance classification and the Maximum likelihood classification. The latter provided much more satisfactory gender validated reclassification （87%） than shape （72%）.

关键词： distal femur landmarks outlines Mahalanobis Maximum likelihood.

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First application of 3D design custom-made uncemented prosthetic stem for distal femoral cemented megaprosthesis revision

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Precision Clinical Medicine 2018年第2期1卷 88-96页

作者： Li Min Kai Yao Minxun Lu Yong Zhou Jie Wang Fan Tang Wenli Zhang Yi Luo Hong Duan Chongqi Tu Department of Orthopedics West China HospitalSichuan UniversityGuoxue Xiang#37ChengduSichuan 610041People’s Republic of China

Objectives:3D design,which is widely used in orthopedics,can be applied for precise distal femoral megaprosthetic *** research aimed to present and evaluate the design,perioperative management,and midterm clinical outcomes of a 3D design custom-made uncemented prosthetic ***:Between January 2014 and January 2016,seven patients received 3D design custom-made uncemented prosthetic stem revision at our *** records and radiographs were evaluated ***:There were no hardware-related complications during the follow-up(average 24.3 months;range 24–48 months).The average Musculoskeletal Tumor Society(MSTS)score at the last follow-up after revision(27.7 points,range 25–28 points)was significantly higher than that before(16.0 points,range 13–18 points).In addition,the range of motion(ROM)of the affected knee,and the scores of pain,function,emotional acceptance,support,walking and gait all improved *** antecurvature radian of the revision stem averaged at 3.6°.Of the seven patients,three received femoral stem revision and four received revision of the femoral stem and the femoral component;three of them used longer prostheses than the *** were no significant differences in function between these two groups at the last follow-up after ***:The 3D design custom-made prosthesis is a typical precision medicine technology in oncologic *** by its individually and precisely designed uncemented stem,it offers an alternative option for distal femoral cemented prosthesis *** the 3D design itself,the perioperative management,especially the techniques for stem implantation,and long-term follow-up are also crucial.

关键词： distal femur bone tumor 3D design prosthetic stem revision precision medicine

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The flexibility and convenience of using a standard orthopaedic table in periarticular knee fractures:Allowing ligamentotaxis and improving imaging accessibility

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Chinese Journal of Traumatology 2022年第6期25卷 375-378页

作者： Zaid AL-Ani Shaival SDalal Amit Chandratreya Khalid Sharif Sarvpreet Singh Tauma&Orthopaedics North West Anglia TrustHinchingbrooke HospitalHuntingdonUnited Kingdom Trauma and Orthopaedics Princess of Wales HospitalBridgendUnited Kingdom Trauma&Orthopaedic Diana Princess of Wales Hospital GrimsbyNorth LincolnshireUnited Kingdom

Tibial plateau and distal femoral fractures are common injuries presenting a significant operative *** of the fracture often needs multi-planar surgical access.A combined two-staged procedure is frequently suggested both in supine and prone position to address this ***,this will significantly increase the operative time and eventually impact the outcome,in addition to the complications associated with prone *** this study we used a standard orthopaedic table to position these patients in order to grant access to the postro-medial and a postro-lateral structures while the patient stays in supine setup,at the same time,giving the flexibility to change the alignment from valgus to varus and vice *** facilitates fracture reduction while addressing the anatomical structure of the knee.A further advantage is the unobstructed imaging access throughout the surgical *** facilitates the reduction in operative time hence leading to a better outcome in these difficult *** tested this positioning technique in more than 40 patients over a 4-year period at two different centres in the United *** found that this approach is safe,reproducible and relatively easy to set up in the two centres.

关键词： Fracture table Ligamentotaxis Tibial plateau distal femur

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Expanding the horizons of clinical applications of proximal humerus locking plates in the lower extremities:A technical note

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Chinese Journal of Traumatology 2020年第6期23卷 331-335页

作者： Robinson E.Pires Richard S.Yoon Frank A.Liporace Daniel Balbachevsky Rogerio CBitar Vincenzo Giordano Andre Wajnsztejn Mauricio Kfuri Departamento do Aparelho Locomotor-Universidade Federal de Minas Gerais Belo HorizonteMGBrazil Division of Orthopedic Trauma&Adult Reconstruction Department of Orthopedic SurgeryJersey City Medical Center-RWJ Barnabas Health Jersey CityNJUnited States Departamento de Ortopedia e Traumatologia Universidade Federal de São PauloSão PauloSPBrazil Departamento de Ortopedia e Anestesiologia Universidade de São PauloRibeirão PretoSPBrazil Serviço de Ortopedia e Traumatologia Prof.Nova Monteiro Hospital Municipal Miguel CoutoRio de JaneiroRJBrazil Serviço de Ortopedia e Traumatologia Hospital Israelita Albert Einstein HospitalSão PauloSPBrazil Missouri Orthopaedic Institute University of MissouriColumbiaUnited States

Pre-contoured anatomical locking plates were designed to address the clinical need of fixing small epiphyseal segments with a larger number of *** plates match the contour and shape of a variety of bones allowing for optimal buttress *** aim of this manuscript is to highlight the benefits of applying proximal humerus locking plates in the fixation of lower extremity *** designed for the proximal humerus,the low-profile plate shape and anatomic contour also provides versatile use in certain areas of the lower *** technical narrative highlights the versatile and reliable use of this plate for other anatomical areas than the one to which it has been originally conceived.

关键词： Proximal humerus Locking plate distal femur Proximal tibia distal tibia

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Primary Malignant Giant Cell Tumor of Bone:A Case Report

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Proceedings of Anticancer Research 2021年第4期5卷 23-26页

作者： Guojun Zhou Sen Li Zhibin Li Qingpeng Deng Peng Wang Xiaowen Sang The First Clinical Medical College of Shaanxi University of Traditional Chinese Medicine Xianyang 712046Shaanxi ProvinceChina Joint Ward Orthopedics HospitalAffiliated Hospital of Shaanxi University of Traditional Chinese MedicineXianyang 712000Shaanxi ProvinceChina

Primary malignant giant cell tumor of bone is clinically rare,lack of specificity,and often ***,related literature about this tumor remains *** case of primary malignant giant cell tumor of bone was diagnosed and treated in our hospital,and the treatment effect was *** was no recurrence or metastasis in 2 years of *** report is as follows.

关键词： Giant cell tumor of bone Primary Malignant distal femur Tumor resection Hinge knee replacement

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