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Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Volume 8 | Issue 2 | May-August 2022 | Page: 06-10 | Sandeep Patwardhan, Arkesh Madegowda, Sujith Omkaram, Pavan Patil, Ashok Shyam, Parag Sancheti DOI- https://doi.org/10.13107/ijpo.2022.v08i02.137 Authors: Sandeep Patwardhan MS Ortho [1], Arkesh Madegowda MS Ortho [1], Sujith Omkaram MS Ortho [1], Pavan Patil MS Ortho [1], Ashok Shyam MS Ortho [1], Parag Sancheti MS Ortho […]

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Volume 8 | Issue 2 | May-August 2022 | Page: 02-05 | Tushar Nayak, Amrut Raje, Ashish Ragase, Love Kapoor , Venkatesan Sampath Kumar, Shah Alam Khan DOI- https://doi.org/10.13107/ijpo.2022.v08i02.136 Authors: Tushar Nayak MS Ortho [1], Amrut Raje MS Ortho [2], Ashish Ragase MS Ortho [2], Love Kapoor MS Ortho [3], Venkatesan Sampath Kumar MS Ortho [1], […]

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

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Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Volume 8 | Issue 2 | May-August 2022 | Page: 06-10 | Sandeep Patwardhan, Arkesh Madegowda, Sujith Omkaram, Pavan Patil, Ashok Shyam, Parag Sancheti

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.137

Authors: Sandeep Patwardhan MS Ortho [1], Arkesh Madegowda MS Ortho [1], Sujith Omkaram MS Ortho [1], Pavan Patil MS Ortho [1], Ashok Shyam MS Ortho [1], Parag Sancheti MS Ortho [1]

[1] Department of Paediatric Orthopaedics Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.

Address of Correspondence
Dr. Arkesh Madegowda,
Clinical Fellow, Department of Paediatric Orthopaedics Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
E-mail: dr.arkesh@gmail.com

Abstract

Objectives: To report the incidence of overcorrection as complication following eight-plate application for genu varum/valgum deformities and its management.
Methods: This was a retrospective review of children who underwent growth modulation for genu varum/valgum between 2012-2019. Data of patients who had presented with overcorrection of their primary deformity, the reasons for such complication and its management were collected and analysed.
Results: 110 children had undergone growth modulation during the study period. 75 children (68%) had achieved deformity correction in mean time of 14.4 months and had their implant removed on time when intercondylar (ICD)/intermalleolar (IMD) distance was ≤ 5 centimeters (cms) and/or Hip Knee Ankle (HKA) angle was < ±6⁰. 29 children (26%) were lost to follow up. 6 children (5.4%) had presented with overcorrection of moderate to severe grade with mean ICD/IMD of 13.3 cms (range 11-18) and mean HKA angle of 14.3⁰ (range 11-21⁰). Mean age of initial surgery was 6.1 years (range 5-8). Mean time gap of presentation with overcorrection was 33.6 months (range 24-45). Lack of awareness, long distance of hospital, medical expenses were some of the notable reasons for irregular follow-up. All 6 had an open physes with growth remaining when they presented with overcorrection. These children managed with repeat growth modulation. Final correction was achieved at mean time of 15.3 months and underwent implant removal. At the latest follow up of 4.4 years, limb alignment within physiologic limits was maintained.
Conclusion: Children undergoing growth modulation should be carefully monitored with regular follow-up to avoid complication of overcorrection. Overcorrection beyond physiologic limits can be managed with repeat growth modulation in younger children with open physes.
Keywords: Growth modulation, Genu valgum, Genu varum, Irregular follow up, Complication, Overcorrection.

References

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How to Cite this Article: Patwardhan S, Madegowda A, Omkaram S, Patil P, Shyam A, Sancheti P | Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 06-10.
https://doi.org/10.13107/ijpo.2022.v08i02.137

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Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Volume 8 | Issue 2 | May-August 2022 | Page: 02-05 | Tushar Nayak, Amrut Raje, Ashish Ragase, Love Kapoor , Venkatesan Sampath Kumar, Shah Alam Khan

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.136

Authors: Tushar Nayak MS Ortho [1], Amrut Raje MS Ortho [2], Ashish Ragase MS Ortho [2], Love Kapoor MS Ortho [3], Venkatesan Sampath Kumar MS Ortho [1], Shah Alam Khan MS Ortho [1]

[1] Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
[2][ Department of Musculoskeletal Oncology, All India Institute of Medical Sciences, New Delhi, India.
[3] Department of Orthopaedics, N.C.I.; A.I.I.M.S, Jhajjar, Haryana, India.

Address of Correspondence
Dr. Tushar Nayak,
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
E-mail: orthodrtushar@gmail.com

Abstract

Introduction: With a less than ideal health infrastructure and a vast underprivileged population in our country, many cases of Sprengel’s deformity are initially missed and are subsequently untreated. Although for best surgical results, the patient must be under the age of five, many patients present late at out tertiary care center. Thus, we evaluated the clinical results of the modified Woodward’s Procedure in such neglected cases.
Methods: A retrospective study, of 16 patients aged 8-yr or above, with Sprengel’s deformity who underwent the modified Woodward’s procedure between 2006 and 2011. Clavicular osteotomy/morselization was avoided. The Cavendish scoring system was used to grade cosmesis and shoulder abduction was used to assess the functional outcome. The patients were prospectively followed up at two-years and after skeletal maturity.
Results: There were ten females and six males and the average age was 9.4 years. The mean follow up was 4.2 yr. Omo- vertebral bar excision was done in 13 (81.25%) patients. The mean increase in postoperative shoulder abduction and Cavendish grades at a 2-yr follow-up were, 19.1° and 1.32 grades, respectively. None of our patients needed Clavicular osteotomy/morselisation and none developed neurological abnormalities. The was no change in the values at skeletal maturity.
Conclusion: Satisfactory outcomes can be acquired by the Modified Woodward’s procedure in neglected Sprengel’s deformities. Besides a definitive cosmetic correction, the procedure also results in improvement of shoulder abduction. Clavicular Ostetomy/Morselization is not always required in cases presenting after the age of 8 years.
Keywords: Woodward’s procedure; Sprengel’s shoulder, Cavendish grading, modified Woodward’s procedure; neglected Sprengel deformity.

References

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How to Cite this Article: Nayak T, Raje A, Ragase A, Kapoor L, Kumar VS, Khan SA | Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 02-05. https://doi.org/10.13107/ijpo.2022.v08i02.136

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Full Sized Blog Element (Big Preview Pic)

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Authors: Sandeep Patwardhan MS Ortho [1], Arkesh Madegowda MS Ortho [1], Sujith Omkaram MS Ortho [1], Pavan Patil MS Ortho [1], Ashok Shyam MS Ortho [1], Parag Sancheti MS Ortho [1]

Abstract

(Article Text HTML) (Full Text PDF)

Modified Woodward’s Procedure in the Management of Neglected Sprengel’s Shoulder

Authors: Tushar Nayak MS Ortho [1], Amrut Raje MS Ortho [2], Ashish Ragase MS Ortho [2], Love Kapoor MS Ortho [3], Venkatesan Sampath Kumar MS Ortho [1], Shah Alam Khan MS Ortho [1]

Abstract

(Article Text HTML) (Full Text PDF)

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