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Fulltext Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint

Kwan MK, Penafort R, Saw A

Med J Malaysia, 2004 Dec;59 Suppl F:39-41.
PMID: 15941159

Joint stiffness is one of the complications of limb procedure. It developes as a result of failure of knee flexors to lengthen in tandem with the bone, especially when there is inadequate physical therapy to provide active and passive mobilization of the affected joint. We are reporting four patients who developed fixed flexion contracture of their knees during bone lengthening procedure for the tibia with Ilizarov external fixator. Three of them were treated for congenital pseudoarthrosis and one was for fibular hemimelia. None of them were able to visit the physiotherapist even on a weekly basis. A splint was constructed from components of Ilizarov external fixator and applied on to the existing frame to passively extend the affected knee. Patients and their family members were taught to perform this exercise regularly and eventually near complete correction were achieved. With this result, we would like to recommend the use of this "Passive Knee Extension Splint" to avoid knee flexion Contracture during limb lengthening procedures with Ilizarov external fixators.

Matched MeSH terms: Range of Motion, Articular/physiology
Comparison of two methods of percutaneous pin fixation in displaced supracondylar fractures of the humerus in children

Foead A, Penafort R, Saw A, Sengupta S

J Orthop Surg (Hong Kong), 2004 Jun;12(1):76-82.
PMID: 15237126

To conduct a prospective randomised controlled study to compare the stability and risk of nerve injury between fractures treated by medial-lateral pin fixation and those treated by 2-lateral pin fixation.

Matched MeSH terms: Range of Motion, Articular/physiology
Long-term results of tibialis posterior tendon transfer for drop-foot

Yeap JS, Birch R, Singh D

Int Orthop, 2001;25(2):114-8.
PMID: 11409449

Twelve patients with drop-foot secondary to sciatic or common peroneal nerve palsy treated with transfer of the tibialis posterior tendon were followed-up for a mean of 90 (24-300) months. In 10 patients the results were 'excellent' or 'good'. In 11 patients grade 4 or 5 power of dorsiflexion was achieved, although the torque, as measured with a Cybex II dynamometer, and generated by the transferred tendon, was only about 30% of the normal side. Seven patients were able to dorsiflex their foot to the neutral position and beyond. The results appeared to be better in men under 30 years of age with common peroneal palsies. A painful flatfoot acquired in adulthood does not appear to be a significant long-term complication despite the loss of a functioning tibialis posterior tendon.

Matched MeSH terms: Range of Motion, Articular/physiology
Number of pegs influence focal stress distributions and micromotion in glenoid implants: a finite element study

Wahab AH, Kadir MR, Harun MN, Kamarul T, Syahrom A

Med Biol Eng Comput, 2017 Mar;55(3):439-447.
PMID: 27255451 DOI: 10.1007/s11517-016-1525-6

The present study was conducted to compare the stability of four commercially available implants by investigating the focal stress distributions and relative micromotion using finite element analysis. Variations in the numbers of pegs between the implant designs were tested. A load of 750 N was applied at three different glenoid positions (SA: superior-anterior; SP: superior-posterior; C: central) to mimic off-center and central loadings during activities of daily living. Focal stress distributions and relative micromotion were measured using Marc Mentat software. The results demonstrated that by increasing the number of pegs from two to five, the total focal stress volumes exceeding 5 MPa, reflecting the stress critical volume (SCV) as the threshold for occurrence of cement microfractures, decreased from 8.41 to 5.21 % in the SA position and from 9.59 to 6.69 % in the SP position. However, in the C position, this change in peg number increased the SCV from 1.37 to 5.86 %. Meanwhile, micromotion appeared to remain within 19-25 µm irrespective of the number of pegs used. In conclusion, four-peg glenoid implants provide the best configuration because they had lower SCV values compared with lesser-peg implants, preserved more bone stock, and reduced PMMA cement usage compared with five-peg implants.

Matched MeSH terms: Range of Motion, Articular/physiology*
Biomechanical investigation on the influence of the regional material degeneration of an intervertebral disc in a lower lumbar spinal unit: A finite element study

Masni-Azian, Tanaka M

Comput Biol Med, 2018 07 01;98:26-38.
PMID: 29758454 DOI: 10.1016/j.compbiomed.2018.05.010

Intervertebral disc degeneration involves changes in its material properties that affect the mechanical functions of the spinal system. However, the alteration of the biomechanics of a spinal segment through specific material degradation in a specific region is poorly understood. In this study, the influence of the constitutive material degeneration of disc tissues on the mechanics of a lower lumbar spinal unit was examined using a three-dimensional nonlinear finite element model of the L4-L5 functional spinal unit. Different grades of disc degeneration were simulated by introducing a degeneration factor to the corresponding material properties to represent fibrous nucleus, increased fibre and ground substance laxity, increased fibre stiffness and total annular fracture along posterior and posterolateral regions. The model was loaded with an axial compression of 500 N and pure moments of up to 10 Nm to simulate extension, flexion, lateral bending and axial rotation. To validate the model, the spinal motion and intradiscal pressure of healthy and degenerated discs with existing in vitro data were compared. The disc with a fibrous nucleus and the presence of intradiscal pressure increase the spinal instability during flexion and axial rotation, and the absence of intradiscal pressure increases the spinal instability in all directions. Bulging displacement and shear strains in the disc with total fracture and ground substance laxity are high in all of the loading cases. Our study could provide useful information to enhance our understanding of the influence of each constitutive component of the intervertebral disc on the mechanics of the spinal segment.

Matched MeSH terms: Range of Motion, Articular/physiology
Statistical factorial analysis approach for parameter calibration on material nonlinearity of intervertebral disc finite element model

Masni-Azian, Tanaka M

Comput Methods Biomech Biomed Engin, 2017 Aug;20(10):1066-1076.
PMID: 28532164 DOI: 10.1080/10255842.2017.1331345

In the biomechanics field, material parameters calibration is significant for finite element (FE) model to ensure a legit estimation of biomechanical response. Determining an appropriate combination of calibration factors is challenging as each constitutive component responds differently. This study proposes a statistical factorial analysis approach using L16(4(5)) orthogonal array to evaluate material nonlinearity and applicable calibration factor of the intervertebral disc FE model in pure moment. The calibrated model exhibits improved agreement to the experimental findings for all directions. Appropriate combination of calibration parameter reduces the estimation gap to the experimental findings, ensuring agreeable biomechanical responses.

Matched MeSH terms: Range of Motion, Articular/physiology
Kinematic comparison of the wrist movements that are possible with a biomechatronics wrist prosthesis and a body-powered prosthesis: a preliminary study

Abd Razak NA, Abu Osman NA, Wan Abas WA

Disabil Rehabil Assist Technol, 2013 May;8(3):255-60.
PMID: 22830946 DOI: 10.3109/17483107.2012.704654

This study examined the kinematic differences between a body-powered prosthesis and a biomechatronics prosthesis as a transradial amputee performed activities that involve flexion/extension and supination/pronation of the wrist.

Matched MeSH terms: Range of Motion, Articular/physiology*
Outcome of expandable endoprosthesis: A single centre retrospective review

Ajit Singh V, Earnest Kunasingh D, Haseeb A, Yasin NF

J Orthop Surg (Hong Kong), 2019 5 30;27(2):2309499019850313.
PMID: 31138060 DOI: 10.1177/2309499019850313

PURPOSE: Expandable endoprosthesis allows limb salvage in children with an option to leading a better life. However, the revision rate and implant-related complications impose as a limitation in the skeletal immature. This study investigates the functional outcomes and complications related to expandable endoprosthesis in our centre.
MATERIALS AND METHODS: Twenty surviving patients with expandable endoprosthesis from 2006 till 2015 were scored using Musculoskeletal Tumour Society (MSTS) outcomes instrument and reviewed retrospectively for range of motion of respected joints, limb length discrepancy, number of surgeries performed, complications and oncological outcomes. Patients with less than 2 years of follow-up were excluded from this study.
RESULTS: Forty-five percentage patients reached skeletal maturity with initial growing endoprosthesis and 25% of patients were revised to adult modular prosthesis. One hundred fifty-seven surgeries were performed over the 9-year period. The average MSTS score was 90.83%. The mortality rate was 10% within 5 years due to advanced disease. Infection and implant failure rate was 15% each. The event-free survival was 50% and overall survival rate was 90%.
CONCLUSION: There is no single best option for reconstruction in skeletally immature. This study demonstrates a favourable functional and survival outcome of paediatric patients with expandable endoprosthesis. The excellent MSTS functional scores reflect that patients were satisfied and adjusted well to activities of daily living following surgery despite the complications.

Matched MeSH terms: Range of Motion, Articular/physiology*
Anthropometric and physiological profiles of sepak takraw players

Jawis MN, Singh R, Singh HJ, Yassin MN

Br J Sports Med, 2005 Nov;39(11):825-9; discussion 825-9.
PMID: 16244191

OBJECTIVES: Anthropometric and physiological profiles of national sepak takraw players were determined.
METHODS: Thirty nine players, specialising in the three playing positions (tekong/server, feeder, and killer/spiker) were divided into three age categories of under 15 (U15), under 18 (U18), and under 23 (U23) years of age. Height, weight, percent body fat (%bf), maximum oxygen consumption (Vo(2max)), range of motion (ROM), back and leg strength, and heart rate, for the estimation of oxygen consumption during matches, were recorded. Statistical analysis was performed using one way ANOVA for independent measurements and data are presented as mean+/-standard deviation.
RESULTS: The U23 players were significantly taller and heavier with significantly better ROM of the neck, trunk, and ankle joints and back and leg strength than the U15 players. No significant difference was found in %bf between the three age categories. Mean maximum heart rate during exercise was significantly higher in the U15 group when compared to the U18 and U23 groups (p<0.05). Mean Vo2max was similar between the three groups. Estimated oxygen consumption during matches was 69.1%, 68.5%, and 56.4% of Vo2max in the killer, tekong, and the feeder groups, respectively.
CONCLUSIONS: The mean height, body weight, and cardiopulmonary capacities of the players were within the Malaysian population norms, but were somewhat lower than those of players of other court games from other countries. %bf was also lower in these players. This study provides the much needed anthropometric and physiological data of sepak takraw players for further development of this sport.

Matched MeSH terms: Range of Motion, Articular/physiology
Acute effect of static and dynamic stretching on hip dynamic range of motion during instep kicking in professional soccer players

Amiri-Khorasani M, Abu Osman NA, Yusof A

J Strength Cond Res, 2011 Jun;25(6):1647-52.
PMID: 21358428 DOI: 10.1519/JSC.0b013e3181db9f41

The purpose of this study was to examine the effects of static and dynamic stretching within a pre-exercise warm-up on hip dynamic range of motion (DROM) during instep kicking in professional soccer players. The kicking motions of dominant legs were captured from 18 professional adult male soccer players (height: 180.38 ± 7.34 cm; mass: 69.77 ± 9.73 kg; age: 19.22 ± 1.83 years) using 4 3-dimensional digital video cameras at 50 Hz. Hip DROM at backward, forward, and follow-through phases (instep kick phases) after different warm-up protocols consisting of static, dynamic, and no-stretching on 3 nonconsecutive test days were captured for analysis. During the backswing phase, there was no difference in DROM after the dynamic stretching compared with the static stretching relative to the no-stretching method. There was a significant difference in DROM after the dynamic stretching compared with the static stretching relative to the no-stretching method during (a) the forward phase with p < 0.03, (b) the follow-through phase with p < 0.01, and (c) all phases with p < 0.01. We concluded that professional soccer players can perform a higher DROM of the hip joint during the instep kick after dynamic stretching incorporated in warm-ups, hence increasing the chances of scoring and injury prevention during soccer games.

Matched MeSH terms: Range of Motion, Articular/physiology*
Aesthetic refinements in second toe-to-thumb transfer surgery

Zhao J, Tien HY, Abdullah S, Zhang Z

Plast Reconstr Surg, 2010 Dec;126(6):2052-2059.
PMID: 21124145 DOI: 10.1097/PRS.0b013e3181f44994

BACKGROUND: Second toe-to-thumb transfer is a good alternative to using the great toe for reconstruction of the thumb. It achieves excellent function and reduces morbidity to the donor foot. However, cosmesis is often poor. The second toe has three unattractive features, a narrow "neck," a bulbous tip, and a short nail.
METHODS: The authors describe a modified second toe transfer that addresses cosmesis in six patients. These include (1) harvesting a flap from the adjacent side of the great toe and insetting it into the volar aspect of the second toe to give more bulk, (2) making skin excisions on each side of the tip to reduce the bulbous appearance, and (3) excising the eponychium to produce apparent lengthening of the nail.
RESULTS: The mean follow-up period was 18 months (range, 6 to 36 months). The procedure resulted in good function and improved cosmesis in all six cases. Part of the great toe flap was lost in one case. The mean two-point discrimination in the transferred toes was 10.1 mm, with protective sensation present in the flaps. The range of motion of the transferred toe was 14 to 38 degrees at the metatarsophalangeal joint, 16 to 55 degrees at the proximal interphalangeal joints, and 20 to 36 degrees in the distal interphalangeal joints. All patients except one were happy with the appearance of the transferred toe.
CONCLUSION: This novel approach will allow patients to take advantage of the lower morbidity to the donor site afforded by second toe-to-thumb transfer and provide the patients with a more aesthetic appearance of the new thumb.

Matched MeSH terms: Range of Motion, Articular/physiology