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Myelomeningocele hip

José Ulisses Manzzini Calegaro, João Batista Monteiro Tajra, Janaína França De Magalhães Souto, Flávia Ribeiro Marciano, Danielle Cicarini De Landa, Sung Boon Bae, Hélio Buzon Filho
The aim of this study was to assess the colonic transit in children and teenagers with chronic constipation. Twenty patients from 1.5 to 16 years old were included (mean age = 6.9 years). Chronic constipation etiologies were as follows: congenital megacolon in 6; surgical treatment in 5 (imperforate anus 2, hip dysplasia 1, sacral teratoma 1, and paraspinal neuroblastoma 1); idiopathic chronic constipation in 5; sacral myelomeningocele in 3; and intestinal duplication in 1. Static images on the anterior projection of the abdomen were performed 1, 6, 24, 48, and 72 h after the radiotracer oral administration...
October 2018: World Journal of Nuclear Medicine
Rachel M Thompson, Joanna Foley, Luciano Dias, Vineeta T Swaroop
BACKGROUND: Nearly 50% of individuals with myelomeningocele will develop a dislocated hip by skeletal maturity. The purpose of this study was to determine the influence of hip status on functional outcomes in a cohort of adult patients with myelomeningocele. METHODS: Patients with a diagnosis of myelomeningocele >18 years were prospectively enrolled over a 12-month period. Neurological level of involvement was obtained from chart review and interview. Clinical examination included hip range of motion and leg-length discrepancy...
March 2019: Journal of Pediatric Orthopedics
Carol L Baym, James B Hedgecock, Mary Jane K Rapport
PURPOSE: To describe the use and effectiveness of a novel intensive progressive resistance exercise (PRE) approach to address the functional goals of a 14-year-old adolescent with a myelomeningocele. SUMMARY OF KEY POINTS: The child had lower extremity weakness, knee and hip flexion contractures, impaired somatosensation, and cardiopulmonary deconditioning, affecting gait mechanics and functional ambulation. An 8-week intensive PRE-based intervention was designed to improve walking in the home by targeting both power-generating and stabilizing lower extremity musculature...
April 2018: Pediatric Physical Therapy
Taghi Baghdadi, Reza Abdi, Ramin Zargar Bashi, Hossein Aslani
BACKGROUND: Children with myelomeningocele (MMC) develop a wide variety of hip deformities such as muscle imbalance, contracture, subluxation, and dislocation. Various methods and indications have been introduced for treatment of muscle imbalances and other hip problems in patients with MMC but there is no study or meta-analysis to compare the results and complications. This review aims to find the most acceptable approach to hip problems in patients with MMC. METHODS: MEDLINE was searched up to April 2015...
June 2016: Archives of Bone and Joint Surgery
Mehmet Bülent Balioğlu, Yunus Emre Akman, Hanifi Ucpunar, Akif Albayrak, Deniz Kargın, Yunus Atıcı, Abdül Fettah Büyük
PURPOSE: Sacral agenesis (SA), or caudal regression syndrome, is a congenital malformation of the spine of varying degree of severity. The aim of our study was to identify associated impairments in structure and function of the orthopedic, neurological, cardiopulmonary, genitourinary, and gastrointestinal systems, and to evaluate their impact on function. METHODS: This was a retrospective case series analysis of 38 patients with SA. Patients were divided into two groups: SA with myelomeningocele (group 1) and without myelomeningocele (group 2)...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Brad E Dicianno, Amol Karmarkar, Amy Houtrow, Theresa M Crytzer, Katelyn M Cushanick, Andrew McCoy, Pamela Wilson, James Chinarian, Jacob Neufeld, Kathryn Smith, Diane M Collins
OBJECTIVE: To provide descriptive data on ambulatory ability and muscle strength in a large cohort of individuals with spina bifida enrolled in a National Spina Bifida Patient Registry and to investigate factors associated with ambulatory status. DESIGN: Cross-sectional analysis of data from a multisite patient registry. RESULTS: Descriptive analysis of mobility variables for 2604 individuals with spina bifida aged 5 and older are presented from 19 sites in the United States...
December 2015: American Journal of Physical Medicine & Rehabilitation
Andrew Mundy, Indranil Kushare, Venkata R Jayanthi, Walter P Samora, Kevin E Klingele
BACKGROUND: Exstrophy of the bladder is a rare congenital defect seen in 2.15 children out of every 100,000 live births, with the most severe variant, cloacal exstrophy (CE), only occurring in 1 in 200,000. Developmental dysplasia of the hip (DDH) describes a spectrum of disease ranging from mild hip instability to frank dislocation. Underlying malformations, such as myelomeningocele and arthrogryposis, are often associated with the most severe variant of hip dysplasia, teratologic hip dislocation...
December 2016: Journal of Pediatric Orthopedics
Timur Yildirim, Sarper Gursu, İlhan Avni Bayhan, Hakan Sofu, Aysegul Bursali
BACKGROUND: Treatment of hip instability in patients with lower lumbar level myelomeningocele is clinically challenging. Muscle transfer procedures, release of contractures, and intertrochanteric varus-rotation osteotomies have been described to restore weak or absent abductor strength as well as relocation of the hip. However, controlled trials evaluating hip instability in lower lumbar myelomeningocele are limited in the current literature. QUESTIONS/PURPOSES: The purposes of this study were to compare the (1) radiographic evidence for joint stability; (2) clinical outcomes (including abductor strength, ambulatory ability, and residual use of orthoses); and (3) complications between patients undergoing combined periarticular contracture releases and bony procedures with and without external oblique abdominal muscle transfers...
October 2015: Clinical Orthopaedics and related Research
Beverly G Coleman, Jill E Langer, Steven C Horii
Myelomeningocele (MMC) is one of the most devastating, nonlethal congenital anomalies worldwide. The live birth prevalence of MMC changed dramatically in the 1980s with the introduction of maternal serum screening and the widespread use of prenatal ultrasound imaging. The high-resolution ultrasound affordable today with state-of-the-art equipment allows us to make a very accurate diagnosis of MMC, including details related to the entire fetal central nervous system. Ultrasound can accurately localize the site of the osseous and soft tissue defects...
2015: Fetal Diagnosis and Therapy
R Hammesfahr, S Topple, K Yoo, T Whitesides, A M Paulin
Hip abductor paralysis leads to gait abnormalities and to hip instability. Correction of abductor paralysis was first done by Mustard in patients with poliomyelitis and later adapted by Sharrard for patients with a myelomeningocele. The Mustard-Sharrard procedure is technically difficult, with strict indications for patient selection. By contrast, the external oblique transfer of Thompson has broad applicability and is a relatively simple operative procedure. This is a preliminary report of 37 external oblique transfers performed on poliomyelitic patients...
March 1, 1983: Orthopedics
Fiona Burns, Robbie Stewart, Dinah Reddihough, Adam Scheinberg, Kathleen Ooi, H Kerr Graham
PURPOSE: The majority of children with orthopaedic conditions in childhood survive to adult life, and there is a need for many of them to transition to adult services. This includes children with disorders such as club foot or developmental dislocation of the hip as well as those with complex syndromic conditions, bone dysplasias or neuromuscular disorders such as cerebral palsy and myelomeningocele. In many tertiary paediatric centres, transition has become a formal process in which clinicians document and communicate the status of patients who have been under their care to ensure a smooth transfer to adult services...
May 2014: Journal of Children's Orthopaedics
Felix Stief, Harald Böhm, Carsten Ebert, Leonhard Döderlein, Andrea Meurer
Ipsilateral trunk lean toward the affected stance limb has been identified as a compensatory mechanism to unload the hip joint. However, this altered gait pattern increases the lever arm around the knee joint by shifting the ground reaction vector more lateral to the knee joint center, which could be sufficient to deform the lateral compartment of the knee. The purpose of the present study was to show the effect of ipsilateral trunk lean on hip and knee joint moments in the frontal plane in 132 young patients with different orthopedic diagnosis...
March 2014: Gait & Posture
A Leland Albright, Humphrey Okechi
OBJECT: The purpose of this study was to evaluate the effect of distal cordectomies on motor function in the lower extremities of infants with lumbosacral myelomeningoceles. METHODS: Medical records were reviewed in 32 infants with lumbosacral myelomeningoceles who were 1 day to 7 months old, who had some lower-extremity function preoperatively, and who were treated by distal cordectomies, dividing the cord between its exit from the intact spinal canal and the neural placode...
February 2014: Journal of Neurosurgery. Pediatrics
Asa Bartonek, Helena Saraste, Aina Danielsson
AIM: The aim was to study health-related quality of life (HRQL) in Swedish children with myelomeningocele (MMC) with respect to ambulatory function. METHODS: A physical examination of the lower limbs was performed, and occurrence of orthopaedic deformities and shunted hydrocephalus was documented. A questionnaire on general health-related quality of life Child Health Questionnaire-50 Parent Form (CHQ-PF50) was answered by the parents of 62 children, mean age 12...
September 2012: Acta Paediatrica
Mokhtar Arazpour, Ahmad Chitsazan, Stephen W Hutchins, Farhad Tabatabai Ghomshe, Mohammad Ebrahim Mousavi, Esmaeil Ebrahimi Takamjani, Gholamreza Aminian, Mehdi Rahgozar, Monireh Ahmadi Bani
BACKGROUND AND AIM: This article describes the development and testing of a new powered gait orthosis to potentially assist spinal cord injury patients to walk by producing synchronized hip and knee joint movements. TECHNIQUE: The first evaluation of the orthosis was performed without users, and was followed by evaluation of the orthosis performance using three healthy subjects to test the structure under weight-bearing conditions. The orthosis was primarily evaluated to ascertain its ability to generate appropriate hip and knee motion during walking...
March 2012: Prosthetics and Orthotics International
Smita Rao, Fred Dietz, H John Yack
BACKGROUND: Knee pain and early arthrosis have emerged as significant problems in young adults with myelomeningocele (MMC). The purpose of our study was to examine kinematics and kinetics during gait in symptomatic and asymptomatic limbs of children with an MMC to better understand the factors that may predispose individuals with an MMC to potentially debilitating knee problems. METHODS: Seven children with L3-L4 level MMC and 8 age-matched typically-developing control children participated in this study...
January 2012: Journal of Pediatric Orthopedics
Michał Latalski, Marek Fatyga, Andrzej Gregosiewicz
AIM OF THE STUDY: Early-onset scoliosis with co-existing thoracic deformity is particularly difficult to treat, with early surgery usually being the only rational solution. Operative correction of the deformed spine and rib cage employs techniques enabling further growth of the structures, an example of which is the Vertical Expandable Prosthetic Titanium Rib (VEPTR), designed to provide dynamic stabilization of the spinal column and the thoracic cage. Our study aimed to present difficulties and complications related to VEPTR-based operative reduction of the spinal and thoracic deformities in the youngest child...
September 2011: Ortopedia, Traumatologia, Rehabilitacja
Ritesh R Shah, Robert L Barrack
The pathophysiology of hip subluxation and advanced arthritic changes in patients with myelomeningocele is usually due to a muscle imbalance between intact hip flexor and adductor muscles and weak gluteal and abductor muscles. Operative options include resection arthroplasty, hip arthrodesis, and total hip arthroplasty (THA). Each option has been reported to be fraught with complications. Previous reports of THA in these patients have largely been unsuccessful with catastrophic failures characterized by instability and early loosening...
May 2012: Journal of Arthroplasty
A Ferrari, C Ferrara, M Balugani, S Sassi
Scoliosis is an important cause of disability in childhood, due to its incidence and limitation on ability. In neurodevelopmental disabilities, scoliosis worsens the already limited functional capacities of the child and can thwart abilities partially recovered through rehabilitation. In celebral palsied children (CP), scoliosis is considered a consequence of damage to the central nervous system or a complication of a peripheral impairment, in particular, through obliquity of pelvis, of the unilateral dislocation of hip...
December 2010: European Journal of Physical and Rehabilitation Medicine
James W Roach, Barbara F Short, Hanna M Saltzman
BACKGROUND: Patients with spina bifida potentially experience social isolation with limited employment opportunities and restriction of independent living, neurologic and intellectual impairment, and orthopaedic and urologic consequences of their condition. However, the degree of disability as these individuals age into adulthood has not been completely delineated. QUESTIONS/PURPOSE: In adults with spina bifida we determined the cause of death for those who had died, IQ, level of education, work history, independent living status, physical disabilities, and urologic status; we then identified surgical procedures that led to better adult function...
May 2011: Clinical Orthopaedics and related Research
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