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Congenital Muscular Torticollis: A study

Volume 6 | Issue 1 | Jan-April 2020 | Page: 11-15 | Md. Ashraful Islam, Datta N K, Arefin K M N, Faisal A, Mahmud C I, Murad S A, Rahman M M, Alam M M U, Begum I A Authors : Md. Ashraful Islam [1], Datta N K [1], Arefin K M N [1], […]

Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

Volume 6 | Issue 1 | Jan – April 2020 | Page: 16-19 | Ramprasath Ramlal Dhurvas, Vetrivel Chezian Sengodan, Surendar Vellaiyan Authors : Ramprasath Ramlal Dhurvas [1], Vetrivel Chezian Sengodan [1], Surendar Vellaiyan [1] [1] Institute of Orthopaedics and Traumatology, Coimbatore Medical College Hospital (The TN Dr.MGR Medical University) Coimbatore, Tamil Nadu, India. Address […]

Congenital Muscular Torticollis: A study

Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

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Congenital Muscular Torticollis: A study

Volume 6 | Issue 1 | Jan-April 2020 | Page: 11-15 | Md. Ashraful Islam, Datta N K, Arefin K M N, Faisal A, Mahmud C I, Murad S A, Rahman M M, Alam M M U, Begum I A

Authors : Md. Ashraful Islam [1], Datta N K [1], Arefin K M N [1], Faisal A [1], Mahmud C I [1], Murad S A [1], Rahman M M [1], Alam M M U [1], Begum I A [2]

[1] Department of Orthopaedics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
[2] Department of Biochemistry, Popular Medical College, Dhaka, Bangladesh.

Address of Correspondence
Dr. Md. Ashraful Islam
Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Email: dr_ashraf007@yahoo.com

Abstract

Congenital muscular torticollis is not an uncommon problem. We evaluated 14 patients who were operated by bipolar releases and Z-lengthening. Post operatively Halter traction was used for 20 hours for 6 weeks and only at night for another 6 weeks. Out of 14 patients 5 were male, 9 were female with mean age of 9.06 years (2-17yrs) and mean follow up period was 3yrs and 4 months (3 months to 7 years), with involvement of the right side in all the patients. Mean lateral flexion deficit improved 16o and mean rotational deficit improved 12o. According to modified Lee scoring system 3 patients had excellent, 7 well, 3 fair and 1 poor result. Cosmetic improvement was significant and patients and parents were happy. There were no post-operative complications. Scar was not an issue and one patient had residual band due to poor post-operative rehabilitation as the age of the child was 2 years. Bipolar release with Z- lengthening gives well to excellent results in most patients.

Key words: Congenital, Torticollis, Post operatively

References

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How to Cite this Article: Islam M A, Datta N K, Arefin K M N, Faisal A, Mahmud C I, Murad S A, Rahman M M, Alam M M U, Begum I A | Congenital Muscular Torticollis: A study | International Journal of Paediatric Orthopaedics | Jan-April 2020; 6(1): 11-15.

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Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

Volume 6 | Issue 1 | Jan – April 2020 | Page: 16-19 | Ramprasath Ramlal Dhurvas, Vetrivel Chezian Sengodan, Surendar Vellaiyan

Authors : Ramprasath Ramlal Dhurvas [1], Vetrivel Chezian Sengodan [1], Surendar Vellaiyan [1]

[1] Institute of Orthopaedics and Traumatology, Coimbatore Medical College Hospital (The TN Dr.MGR Medical University) Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. Ramprasath Ramlal Dhurvas,
12/23, Murugappa street, Purasaiwakkam, Chennai, Tamil Nadu, India
E-mail: dhurvasramprasath@gmail.com

Abstract

Background: Deformities in femur in children usually involves more than one axis with angular as well as displacement components. Moreover, the remaining growth in the opposite limb necessitates adequate lengthening of the ipsilateral limb.
Case Details: A 9 year old female child presented with genu varum deformity and shortening of 8 cm. X ray revealed the deformity to be localized to distal femur. CT (computed tomography) showed physeal bar in the medial half of distal femoral physis. We performed corrective osteotomy just proximal to the CORA (center of rotation of angulation) and corrected the deformity using Ilizarov apparatus, following which lengthening was done using same apparatus.
Results: A lengthening of 10 cm (over lengthening) was achieved with a lengthening index of 1.4 cm/month. Varus deformity was slightly over corrected to 5 degree of valgus. The range of motion of knee two months after fixator removal was 20 degree. One major complication in the form of regenerate fracture was encountered when the fixator was insitu. This was managed by reapplication of the pins. We achieved correction of varus, internal rotation, and shortening in the right femur.
Conclusion: Multiplanar deformities in children need prolonged treatment after corrective osteotomy. Ilizarov fixator provides the required mechanical stability as well as versatility to achieve this goal. Prolonged physiotherapy is necessary to restore the range of motion after fixator removal.
Key words: Multiplanar deformity, Ilizarov, osteotomy, lengthening, Paediatric femur
MeSH terms: Femur, rotation, Osteotomy, Genu varum, Bone lengthening

References

1. Achterman,c., and kalamachi,A.: congenital deficiency of fibula. J bone and joint surg., 61-B (2): 133-137, 1979
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3. Maffuli N , Nele U, Matarazzo L. Changes in knee range of motion following femoral and tibial lengthening using Ilizarov apparatus : a chorot study .J Orthop Sci 2001;6(4) :333-38.
4. Dahl MT,Gulli B, Berg T. complications of limb lengthening A learning curve .Clin Orthop 1994; 301:10-18
5. Marc B. Danziger, M D., Anant Kumar, ; Fracture after femoral lengthening using the Ilizarov fixator method . Journal of pediatric orthopaedics 15:220-223
6. Daniel E. Prince, John E. Herzenberg; lengthening with external fixator is effective in congenital femoral deficiency. Clinical orthopaedics and related research July 2015
7. Hiroyuki Tsuchiya; kenji Uehara; Deformity correction followed by lengthening with Ilizarov method. Clinical orthopaedics and related research 402, PP. 176-183
8. Goodship AE, Watkins PE, Rigby HS et al (1993) The role of rigid frame stiffness in the control of fracture healing. An experimental study. J biomech 26: 1027-1035
9. Kenwright J, Richardson JB, Cunningham JL et al (1991) Axial movement and tibial fractures. A controlled randomised trial of treatment J Bone Joint surg Br73:654-659
10. Paley D, fleming B, Catagni M et al (1990) Mechanical evaluation of external fixators used in limb lengthening. Clin OrthopRelat Res 250; 50-57.
11. Gasser B, Boman B, Wyder D et al(1990) stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixatoors. J Biomech Eng 112:15-21.
12. Podolsky A, Chao EY (1993) Mechanical performance of Ilizarov circular external fixators in comparison with other external fixators. Clin Orthop Relat Res 293:61-70.
13. Drorpaley; Problems, Obstacles, and complications of limb lengthening by Ilizarov technique.Clinical orthopaedics and related research 250; jan, 1990
14. R.J.Velazquez, D.F. Bfil; Complications of use of Ilizarov technique in the correction of limb deformities in children. Journal of bone and joint surgery vol 75-A, no.8. August 1993 1148-1156.

How to Cite this Article: Dhurvas R R, Sengodan V C, Vellaiyan S.| Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report.| International Journal of Paediatric Orthopaedics | Jan-April 2020; 6(1): 20-23.

Half Sized Blog Element (Single Author Style)

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Congenital Muscular Torticollis: A study

Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

Congenital Muscular Torticollis: A study

Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

Full Sized Blog Element (Big Preview Pic)

Congenital Muscular Torticollis: A study

Authors : Md. Ashraful Islam [1], Datta N K [1], Arefin K M N [1], Faisal A [1], Mahmud C I [1], Murad S A [1], Rahman M M [1], Alam M M U [1], Begum I A [2]

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

Authors : Ramprasath Ramlal Dhurvas [1], Vetrivel Chezian Sengodan [1], Surendar Vellaiyan [1]

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

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