Abstract：
BACKGROUND:With cerebral palsy (CP), an equinus deformity may lead to genu recurvatum. Botulinum toxin A (BtA) injection into the calf muscles is a well-accepted treatment for dynamic equinus deformity. QUESTIONS/PURPOSES:The purpose of this study was to determine whether BtA injections into the calf muscles to decrease equinus would decrease coexisting genu recurvatum in children with diplegic CP. METHODS:In a retrospective study, 13 children (mean age, 5 years) with spastic diplegic CP showing equinus and coexisting primary genu recurvatum, who were treated with BtA injections into the calf muscles, were included. Evaluations were done before and 6 and 18 weeks after intervention using three-dimensional gait analysis and clinical examinations according to a standardized protocol. Basic statistical analyses (power analysis, ANOVA) were performed to compare genu recurvatum before treatment and at 6 and 18 weeks after injection with BtA. RESULTS:During stance phase, maximum ankle dorsiflexion was increased substantially from -3.0° ± 14.3° before to 6.2° ± 14.2° 6 weeks after the injections. Despite this, with the numbers available, the amount of recurvatum in stance did not improve with treatment at either 6 or 18 weeks. There was significant improvement of knee hyperextension during stance phase of 6.2° between baseline and 18 weeks after BtA injection, but a genu recurvatum was still present in most patients. CONCLUSIONS:Despite improvement of ankle dorsiflexion after injection with BtA, genu recurvatum did not show relevant improvement at 6 or 18 weeks after injection with the numbers available. Because knee hyperextension remained in most patients, other factors leading to genu recurvatum should be taken into consideration. In addition, a botulinum toxin-induced weakness of the gastrocnemius may explain why recurvatum gait was not significantly reduced. LEVEL OF EVIDENCE:Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Klotz MC,Wolf SI,Heitzmann D,Gantz S,Braatz F,Dreher Tdoi
10.1007/s11999-013-2897-7subject
Has Abstractpub_date
2013-07-01 00:00:00pages
2327-32issue
7eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract：:A series of patients with single major scoliosis curvatures attributable to spina bifida treated by anterior only spinal fusion was studied for 2 years to determine whether the infection rate could be decreased, adequate correction and pelvic balance could be provided, and posterior surgery could be avoided in these p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199907000-00016
更新日期：1999-07-01 00:00:00
abstract：:This biographical sketch on John R. Moore corresponds to the historic text, The Classic: Cartilaginous-cup Arthroplasty in Ununited Fractures of the Neck of the Femur (1948), available at DOI 10.1007/s11999-011-1974-z. ...
journal_title：Clinical orthopaedics and related research
pub_type： 传,评论,杂志文章
doi：10.1007/s11999-011-1976-x
更新日期：2011-10-01 00:00:00
abstract：BACKGROUND:Femoroacetabular impingement has been proposed as a cause of early osteoarthritis, but it is not known how this develops over time or whether the shape of the proximal femur influences this risk. QUESTIONS/PURPOSES:(1) Which areas of the acetabulum are worn more frequently by individuals with a cam deformit...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2720-x
更新日期：2013-02-01 00:00:00
abstract：:Insertion of distal interlocking screws in femoral nails can be technically demanding and may entail substantial exposure. A method of insertion of femoral interlocking screws that uses a laser guiding system in addition to the standard image intensifier was used in an attempt to improve the accuracy of distal screw p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：BACKGROUND:The use of traction during hip arthroscopy is commonly used to provide safe joint access and to improve visualization. However, traction during hip arthroscopy has been associated with complications ranging from transient neuropraxias to devastating soft-tissue necrosis. Trendelenburg positioning may be help...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1097/CORR.0000000000000804
更新日期：2019-08-01 00:00:00
abstract：:The mainstay of local control of primary bone malignancies in the skeletally immature has been amputation or, in selected cases, rotationplasty. The development of expandable endoprostheses has permitted an alternative approach for local control in the growing child. Between January 1985 and December 1987, 12 skeletal...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：BACKGROUND:Distal radius reconstruction after en bloc tumor resection remains a surgical challenge. Although several surgical techniques, either reconstructing the wrist or achieving a stable arthrodesis, have been described, it is unclear to what degree these restore function. DESCRIPTION OF TECHNIQUE:We describe an ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2555-5
更新日期：2013-03-01 00:00:00
abstract：:This report describes a laboratory model designed to illustrate a newer concept for the control of plasma calcium concentrations. This postulate suggests that plasma calcium levels are the result of a balance or imbalance in opposing calcium ion fluxes between plasma and bone fluid compartments existing around osteocy...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：BACKGROUND:The os peroneum is a sesamoid bone in the peroneus longus tendon. Fractures of the os peroneum are rare. Some authors recommend surgery for active patients. CASE DESCRIPTION:A 41-year-old male professional tennis coach sustained a minimally displaced fracture of the os peroneum. He was treated with restrict...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-011-1812-3
更新日期：2011-05-01 00:00:00
abstract：UNLABELLED:Resurfacing arthroplasty has become an attractive option for young patients who want to maintain a high activity level. One recent study reported modestly increased activity levels for patients with resurfacing compared to standard total hip arthroplasty (THA). We conducted a prospective randomized clinical ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11999-009-1029-x
更新日期：2010-02-01 00:00:00
abstract：:Comminuted fractures of the femoral shaft, especially when combined with fractures of the hip, may be difficult to treat. A four-sided titanium alloy locking nail with transfixing screws was designed in 1967 and allows compression of the fracture site. If necessary, the nail may be inserted without intraoperative roen...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-11-01 00:00:00
abstract：BACKGROUND:Septic arthritis is frequently associated with adjacent infections including osteomyelitis and subperiosteal and intramuscular abscesses. While often clinically indiscernible from isolated septic arthritis, the diagnosis of adjacent infections is important in determining the need for additional surgical inte...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000019
更新日期：2018-01-01 00:00:00
abstract：:Failure of bone grafting in scaphoid nonunion presents the hand surgeon a perplexing set of problems. Controversy remains as to the best course of treatment in this difficult situation. The authors have retrospectively reviewed during a 5-year period the patients treated at the Mayo Clinic who have gone on to a second...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199606000-00015
更新日期：1996-06-01 00:00:00
abstract：UNLABELLED:We review evidence-based treatments for patients seeking care for lower-back pain and patients who have been diagnosed with nonspecific lower-back pain. The review is based on selected systematic reviews and national and international guidelines for the treatment of lower-back pain. Additional randomized con...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000198721.75976.d9
更新日期：2006-02-01 00:00:00
abstract：:Giant sacral schwannomas (GSS) are extremely rare. Complete resection of benign but neurologically devastating tumors has been recommended. A 48-year-old man with GSS had a tumor so large that a total sacrectomy was necessary. A special method of lumbar iliac fixation was devised. Two years and nine months after surge...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：:The optimal method of fixation during periacetabular osteotomy is unknown. Periacetabular osteotomies were created on both sides of six whole pelves from fresh cadavers and were fixed randomly either with three long 4.5-mm cortical screws from the iliac crest to the osteotomized fragment (iliac fixation) or with two s...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200210000-00032
更新日期：2002-10-01 00:00:00
abstract：:Osteogenic proteins, also referred to as BMPs, are a family of bone matrix polypeptides isolated from a variety of mammalian species. These proteins are members of the transforming growth factor-beta superfamily of molecules that contain a highly conserved 7 cysteine transforming growth factor-beta domain in their C-t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1996-03-01 00:00:00
abstract：:Functional treatment of fractures is a nonoperative technique used in intraarticular knee fractures and multifragment and multilevel fractures of the shaft of femurs since 1974. The basic principle of this technique is placement of the fractured extremity in the specially designed rehabilitation splint, with skeletal ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-11-01 00:00:00
abstract：BACKGROUND:Patellofemoral osteoarthritis (OA) and anterior knee pain sometimes are considered contraindications for unicompartmental knee arthroplasty (UKA). However, several studies have demonstrated excellent patient-reported outcome scores in patients with patellofemoral OA treated with medial mobile-bearing UKA. Be...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000738
更新日期：2019-09-01 00:00:00
abstract：:The results of medial column stabilization, lateral column lengthening, and combined medial and lateral procedures were reviewed in the treatment of adult acquired flatfoot secondary to posterior tibialis tendon insufficiency. All bony procedures were accompanied by transfer of the flexor digitorum longus tendon to th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199908000-00011
更新日期：1999-08-01 00:00:00
abstract：:The radiographs of 57 patients who had undergone 58 callus distractions and 13 epiphyseal distractions were evaluated. During the course of treatment, the density of the distraction areas on radiographs was measured in total and along the medial, lateral, ventral, and dorsal margins using a digital radiograph processi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199602000-00036
更新日期：1996-02-01 00:00:00
abstract：UNLABELLED:The iliopsoas and adductor tendons are often soft tissue barriers obstructing relocation of the femoral head into the acetabulum and are frequently released to obtain reduction. We assessed whether posteromedial soft tissue release including sectioning of the adductor longus and iliopsoas tendons would lead ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0146-2
更新日期：2008-04-01 00:00:00
abstract：BACKGROUND:Patients with symptomatic residual Perthes-like deformities may present with a combination of structural abnormalities including a large aspheric femoral head, short and wide femoral neck, high greater trochanter, and acetabular dysplasia. Sometimes, the hip is further compromised by concurrent symptomatic f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-4115-7
更新日期：2015-04-01 00:00:00
abstract：:In order to clearly understand the synovial metabolic pathway of 5-HT, which is interesting as an inflammatory mediator and a pain producing substance, in patients with RA and with OA, determinations were made of 5-HIAA levels and of the activities of MAO-A and MAO-B, in the synovial fluid and the blood. With respect ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:Radiation therapy in the treatment of osteosarcoma has been considered with respect of the subclinical metastatic disease in the lung and the primary lesion. Emphasis is given to the necessity of coordinating the management plan of the primary lesion with an adjuvant program. Evaluation of the efficacy of a conservati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-197509000-00009
更新日期：1975-09-01 00:00:00
abstract：:A cement-free bioceramic aluminum oxide double cup endoprosthesis is under investigation as an alternative to the cemented stem endoprosthesis. Nine patients with 11 operated hips are without complaints after an average of 20.8 months (range 8--28 months). Early loosening of 2 femoral components occurred because of te...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：:Although the Chiari osteotomy is usually effective in reducing pain, many patients are left with a long-term limp. The postoperative limp can at times be caused by hip abductors that have strength insufficient to counteract the torque from body weight during single-leg stance. To study how the surgical technique affec...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-05-01 00:00:00
abstract：:In a series of 70 consecutive patients with nonpathologic intertrochanteric or subtrochanteric hip fractures, the first 35 were treated by a single semi-flexible condylocephalic nail. The second 35 patients were treated by a sliding compression screw and side-plate. The groups were comparable regarding age and intercu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:This preliminary report outlines the rationale for a new approach to deep-vein thrombosis (DVT) prophylaxis in total knee arthroplasty (TKA) patients and describes preliminary hematologic and venographic findings. A protocol was employed to (1) document a series of hematologic events surrounding cemented TKA and the a...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1989-11-01 00:00:00
abstract：:Eighteen hips in 15 children showed persistent roentgenographic evidence of congenital acetabular residual dysplasia at four- to eight-year follow-up evaluations. The mean follow-up period was 5.8 years. These hips were subsequently evaluated by magnetic resonance (MR) imaging. MR imaging studies revealed thick unossi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-04-01 00:00:00
