Browsing by Subject "Osteotomy"

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    Characterization of a reproducible model of fracture healing in mice using an open femoral osteotomy
    (Elsevier, 2020-02-05) Collier, C.D.; Hausman, B.S.; Zulqadar, S.H.; Din, E.S.; Anderson, J.M.; Akkus, O.; Greenfield, E.M.; Orthopaedic Surgery, School of Medicine
    Purpose: The classic fracture model, described by Bonnarens and Einhorn in 1984, enlists a blunt guillotine to generate a closed fracture in a pre-stabilized rodent femur. However, in less experienced hands, this technique yields considerable variability in fracture pattern and requires highly-specialized equipment. This study describes a reproducible and low-cost model of mouse fracture healing using an open femoral osteotomy. Methods: Femur fractures were produced in skeletally mature male and female mice using an open femoral osteotomy after intramedullary stabilization. Mice were recovered for up to 28 days prior to analysis with microradiographs, histomorphometry, a novel μCT methodology, and biomechanical torsion testing at weekly intervals. Results: Eight mice were excluded due to complications (8/193, 4.1%), including unacceptable fracture pattern (2/193, 1.0%). Microradiographs showed progression of the fracture site to mineralized callus by 14 days and remodelling 28 days after surgery. Histomorphometry from 14 to 28 days revealed decreased cartilage area and maintained bone area. μCT analysis demonstrated a reduction in mineral surface from 14 to 28 days, stable mineral volume, decreased strut number, and increased strut thickness. Torsion testing at 21 days showed that fractured femurs had 61% of the ultimate torque, 63% of the stiffness, and similar twist to failure when compared to unfractured contralateral femurs. Conclusions: The fracture model described herein, an open femoral osteotomy, demonstrated healing comparable to that reported using closed techniques. This simple model could be used in future research with improved reliability and reduced costs compared to the current options.
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    A Comparison Study of Temporomandibular Joint Symptoms in Patients Following Mandibular Advancement by Bilateral Sagittal Split Osteotomies: Rigid Fixation Versus Nonrigid Fixation
    (1989) Flynn, Brent Cameron; Roberts, W. Eugene; Brown, David T.; Nelson, Charles L.; Shanks, James C.; Hennon, David K.
    Primary consideration must be given to the temporomandibular joint when planning and performing orthognathic surgical procedures. It has long been understood that the status of the temporomandibular joint can easily and unintentionally be altered during orthognathic surgery, regardless of the method of fixation used. With the advent of modern fixation techniques, many clinicians and investigators have questioned the effects of rigid fixation on the temporomandibular joint. To investigate this, a clinical study of 40 patients treated with mandibular advancement for retrognathism was performed. Twenty patients were treated with rigid fixation while another 20 patients had inferior border wires placed with anterior skeletal fixation. All patients were asked questions regarding the history of their temporomandibular joints. In addition, all patients received a clinical postoperative temporomandibular joints. In addition, all patients received a clinical postoperative temporomandibular joint evaluation. The results were statistically analyzed with the Chi-square analysis and Standard T test. It was determined that the Null Hypothesis could not be rejected for any of the symptoms evaluated in this study. The results support the belief that rigid fixation is no different when compared to wire osteosynthesis in terms of prevalence of temporomandibular joint symptoms.
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    Two-stage corrective operation for the treatment of pes cavovarus in patients with spina bifida
    (Baishideng, 2024-07-18) Padgett, Anthony Mack; Kothari, Ezan; Conklin, Michael J.; Orthopaedic Surgery, School of Medicine
    Background: Pes cavovarus has an estimated incidence of 8%-17% in patients with spina bifida (SB). The majority of the current literature on surgical treatment of cavovarus feet in children and adolescents includes a variety of diagnoses. There are currently no case series describing a treatment algorithm for deformity correction in this specific patient population. The authors of this study present the results of a retrospective case series performed to assess the radiographic outcomes of two-stage corrective surgery in patients with SB. Aim: To assess the radiographic outcomes of a staged operation consisting of radical plantar release followed by osteotomy for pes cavovarus in patients with SB. Methods: Retrospective chart review was performed on patients with SB with a diagnosis of pes cavovarus at a freestanding children's hospital who underwent surgical correction of the deformity. Patients were excluded for lack of two-stage corrective operation, nonambulatory status, lack of at least six months follow-up, and age > 18 years at the time of surgery. This resulted in a cohort of 19 patients. Radiographic analysis was performed on 11 feet that had a complete series of preoperative and postoperative weightbearing X-rays. Preoperative and postoperative radiographic outcome measurements were compared using a two-sample t-test. Results: Significant changes between the preoperative and postoperative measurements were seen in Meary's angle, the anteroposterior talo-first metatarsal (AP TMT1) angle, and the talonavicular coverage. Mean values of Meary's angle were 17.9 ± 13.1 preoperatively and 4.7 ± 10.3 postoperatively (P = 0.016). Mean AP TMT1 angle was 20.6 ± 15.1 preoperatively and 9.3 ± 5.5 postoperatively (P = 0.011). Mean talonavicular coverage values were -10.3 ± 9.6 preoperatively and -3.8 ± 10.1 postoperatively (P = 0.025). Conclusion: The two-stage corrective procedure demonstrated efficacy in correcting cavovarus deformity in patients with SB. Providers should strongly consider employing the staged surgical algorithm presented in this manuscript for management of these patients.