In cases of unilateral clubfoot, the leg and foot is visually smaller than the opposite, uninvolved side. Parents want to know how much smaller the leg and foot will be. The purpose of this study was to answer this question and compare the results of children treated with a posterior medial release (PMR) with those treated with the Ponseti method (PM). This is a prospective, longitudinal study of calf circumference and foot length. We measured the calf circumference with a tape measure at the visually maximum girth of the uninvolved side and at the symmetrical position of the involved side. We measured each foot length from the tip of the hallux to the end of the heel. We recorded the measurements at each follow-up visit in a database and analysed the data using linear regression analysis.Introduction
Methods
Deciding how to allocate scarce surgical resources is a worldwide issue. These decisions are difficult when considering procedures aimed primarily at improving functional quality of life, such as lower extremity joint replacement (LEJR) surgery, and procedures perceived as life preserving which also have impacts on physical function, such as coronary artery bypass graft (CABG) surgery. Comparing functional outcomes of these two procedures may provide further evidence to guide resource allocation decisions. We compared patient-reported functional outcomes following CABG and LEJR surgery using standardised, validated outcome metrics. A retrospective review of prospectively collected pre- and post-operative health related quality of life (SF-36) measures were conducted from 105 patients undergoing elective CABG and 105 elective LEJR surgery patients. Patients were matched based on gender and age.Background
Methods
Total disc replacement (TDR) provides an alternative to fusion that is designed to preserve motion at the treated level and restore disc height. The effects of TDR on spine biomechanics at the treated and adjacent levels are not fully understood. Thus, the present study investigated facet changes in contact pressure, peak contact pressure, force, peak force, and contact area at the facet joints after TDR. Seven fresh-frozen human cadaveric lumbar spines were potted at T12 and L5 and installed in a 6-DOF displacement-controlled testing system. Displacements of 15° flexion/extension, 10° right/left bending, and 10° right/left axial rotation were applied. Contact pressure, peak contact pressure, force, peak force and contact area for each facet joint were recorded at L2-L3 and L3-L4 before and after TDR at L3-L4 (ProDisc-L, Synthes Spine). The data were analysed with ANOVAs/t-tests.Introduction
Methods
Malignant hyperthermia (MH) is a pharmacogenetic disorder, potentially lethal, due to the exposure to anesthetic drugs that triggers, a high increase of corporal temperature, progressive muscular stiffness, severe rabdomiolisis and death due to cardiac dysfunction. Many research works relate Malignant Hyperthermia to muscular illnesses or to the King Syndrome. Through this study we present the incidence of MH in patients with congenital vertebrae malformations. (CVM) The objective is to establish the incidence of the MH in patients who were operated on CVM and to alert about this association. 1029 patients with CVM were treated between 1972 and 2000. 390 with congenital vertebrae malformation were operated on. 3 patients (0.76%) (1 girl and 2 boys) developed MH while they underwent surgical treatment for the CVM. 1 patient presented an isolated congenital vertebrae malformation. 1 patient presented King Syndrome and the other presented Robert Syndrome. Only 1 elevated amount of preoperative CPK was found (the are no reports on the others). No muscular biopsy was done to test sensitivity. Two of them were biopsied for a post episode study. At the surgical moment, any patients reported personal or familiar antecedents of MH. No deaths were reported, although it is considered as a potentially lethal disorder. We found no reports in the literature in this subject. Most of the bibliographic data belonged to anesthesiologists or geneticists. Our approach as spine surgeons leaded us to the detailed analysis of this studies and the 0.76% (3 out of 390) incidence suggested us to have an alert attitude when facing patients with surgical MVC and take the necessary precautions.
