Guiding Femoral Rotational Growth in an Animal Model

Arami, Amir; Bar‐On, Elhanan; Herman, Amir; Velkes, Steven; Heller, Snir

doi:10.2106/jbjs.l.00819

Cited by 30 publications

(42 citation statements)

References 19 publications

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“…Arami et al. ( 2013 ) reported that the additional deformity was one of the limitations of their study. Thus, insertion of these plates with the greatest possible angle to the long axis will lead to both greater rotation and safe controlled growth.…”

Section: Discussionmentioning

confidence: 89%

“…There has been one previous study on the rotationally guided growth of the femur (Arami et al. 2013 ). These authors used the distal femur in rabbits, and in order to create an external rotation, they placed the plates in appropriate positions.…”

Section: Discussionmentioning

confidence: 99%

“…Arami et al. ( 2013 ) reported that an average of 18° of external rotation occurred in the femurs. In our study, only 7 of 15 rabbits could be evaluated for rotation.…”

Section: Discussionmentioning

confidence: 99%

“…Arami et al. ( 2013 ) created a formula: 1° of change in the angle between the plates led to 0.4° of rotation. We did not use a formula.…”

Section: Discussionmentioning

confidence: 99%

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Rotational deformities of the long bones can be corrected with rotationally guided growth during the growth phase

Cobanoglu¹,

Çullu²,

Kilimci

et al. 2016

Acta Orthopaedica

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Background and purposeCoronal and sagittal plane long bone deformities can be corrected with guided growth, whereas transverse plane rotational deformities require osteotomy and internal or external fixation. We investigated whether rotational changes can be introduced with the plating technique.Methods45 rabbits (6 weeks old) were divided into 3 groups. The unoperated right tibia was used as control. In groups 1 and 3, two plates were placed obliquely to the long axis and in different directions. In group 2, a sham operation was performed with screws. Animals in groups 1 and 2 were followed for 4 weeks. In group 3 the implants were removed 4 weeks after the operation to observe rebound effect, and the animals were followed for another 4 weeks. The tibial torsion was assessed on computed tomography (CT). External rotation was accepted as a negative value.ResultsIn group 1, mean torsion was −20° (SD 7.9) in the right tibia and −2.9° (SD 7.2) in the left tibia (p < 0.001). In group 2, mean torsion was −23° (SD 4.9) in the right tibia and −26° (SD 6.5) in the left tibia (p = 0.2). In group 3, mean torsion was −21° (SD 6.3) in the right tibia and −9.5° (SD 5.3) in the left tibia (p < 0.001). Intergroup evaluation for left torsion showed a significant difference between group 2 and the other groups (p < 0.001). When the rebound effect was evaluated, there was no statistically significant difference between groups 1 and 3 (p = 0.08).InterpretationA rotational change was attained with this technique. Although a rebound effect was seen after implant removal, it did not reach statistical significance. The final rotational change remained constant.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

“…Arami et al. ( 2013 ) reported that an average of 18° of external rotation occurred in the femurs. In our study, only 7 of 15 rabbits could be evaluated for rotation.…”

Section: Discussionmentioning

confidence: 99%

“…Arami et al. ( 2013 ) created a formula: 1° of change in the angle between the plates led to 0.4° of rotation. We did not use a formula.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Rotational deformities of the long bones can be corrected with rotationally guided growth during the growth phase

Cobanoglu¹,

Çullu²,

Kilimci

et al. 2016

Acta Orthopaedica

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“…In der Wachstumslenkung gibt es Hinweise dafür, dass auch Rotationsdeformitäten korrigiert werden können. Arami und Mitarbeiter bewiesen in einem Hasenmodell, dass 2 schräg angebrachte Platten medial und lateral das axiale Rotationswachstum am distalen Femur beeinflussen [70].…”

Section: Perspektivenunclassified

Achskorrektur am wachsenden Skelett – therapeutisches Vorgehen

Willegger¹,

Kolb²,

Chiari³

2017

Z Orthop Unfall

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Controlled rotation of long bones by guided growth: A proof of concept study of a novel plate in cadavers

Abood

Hellfritzsch

Möller‐Madsen

et al. 2021

Journal Orthopaedic Research

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Our novel plate design has been developed for controlled rotation of long bones by guided growth. The objective of this proof‐of‐concept study was to evaluate the precision of the rotation in the femur. Twelve cadaverous femora of six adults (right = 6, left = 6) underwent an osteotomy at the level of the physeal scar. The plates were inserted on each side of the distal femur. Growth was simulated by axial distraction of the bone segments. The femur was stabilized using a unilateral external fixator. Femoral torsion was assessed with computed tomography (CT) and with an electric goniometer before and after distraction. The obtained rotation was compared to the predicted rotation based on the dimension of the plate and the bone. All femora were rotated as intended. The mean obtained rotation was 26.3° (95% confidence interval [CI]: 23.5–29.0) and the mean predicted rotation was 28.2° (95% CI: 26.9–29.5) (p > 0.82). The mean axial distraction was 19.5 mm (95% CI: 17.7–21.3). The predicted rotation of the femora was similar to the obtained values on CT and by goniometer. The obtained rotation occurred as a result of an axial distraction of approximately 2 cm. This suggests a potential for controlled rotation of the femur based on the circumference of the bone and plate dimensions that occurs simultaneously with axial distraction. Clinical significance: These findings suggest a possible clinical application in the treatment of maltorsion in children by guided growth, where theplate design guides the bone into torsional axial growth correcting the deformity.

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Guiding Femoral Rotational Growth in an Animal Model

Abstract: Guided growth using plates may be effective for correction of rotational and multiplanar deformities.

Cited by 30 publications

References 19 publications

Rotational deformities of the long bones can be corrected with rotationally guided growth during the growth phase

Rotational deformities of the long bones can be corrected with rotationally guided growth during the growth phase

Achskorrektur am wachsenden Skelett – therapeutisches Vorgehen

Controlled rotation of long bones by guided growth: A proof of concept study of a novel plate in cadavers

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