Long-term psychosocial functioning after Ilizarov limb lengthening during childhood

Moraal, Judith M; Elzinga-Plomp, A.; Jongmans, Marian J.; Roermund, P.M. van; Flikweert, Petra E.; Castelein, René M.; Sinnema, Gerben

doi:10.3109/17453670903473024

Cited by 37 publications

(36 citation statements)

References 18 publications

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“…Along with the accumulation of experience in the use of the external fixation apparatus, a number of problems were identified such as risks of developing joint contractures, vascular and neurological complications; "ischemic" regenerates; penetration of infectious agents along the structural elements of the external fixation apparatus that pass into the bone [11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of clinical efficacy and safety of the Ilizarov apparatus for external fixation (literature review)

Soldatov¹,

Stogov²,

Овчинников³

et al. 2019

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Purpose A retrospective analysis of clinical efficacy and safety of using the external fixation apparatus of G.A. Ilizarov's design. Materials and methods Analysis and evaluation of clinical data was performed using 107 literary sources. 4.200 clinical cases were studied to evaluate effectiveness, and 6.274 cases to assess safety. Results The analysis revealed a high clinical efficacy of using the Ilizarov apparatus for external fixation (various assemblies) in solving a wide range of practical problems in the field of traumatology and orthopedics. According to the results of the study, its high clinical treatment effectiveness was confirmed both on the use of the method in general (about 95 % of positive outcomes), and in specific nosological groups of patients (not lower than 90 % of positive outcomes). After having assessed the available data on the safety in the application of the Ilizarov apparatus for external fixation (various assemblies), we can conclude that the rates of adverse events, recorded in the literature analyzed, can be considered acceptable. Among all those events, the events classified as adverse effects of the product amounted to 17.03 % (5 ÷ 95 % CI: 16.11 ÷ 17.97 %).

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Section: Introductionmentioning

confidence: 99%

Evaluation of clinical efficacy and safety of the Ilizarov apparatus for external fixation (literature review)

Soldatov¹,

Stogov²,

Овчинников³

et al. 2019

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“…The psycho-social functioning of young patients undergoing LL has been frequently studied but studies on mental health and somatic function on a long term basis are sparse [11]. Our study was both prospective with a pre op assessment, a 1-year follow-up and a longterm study with a 10-year follow-up of a cohort of LLI patients.…”

Section: Discussionmentioning

confidence: 99%

“…All of the patients n=28 had meaningful social activities such as schooling (17) or work (11). 10 lived with their parents and 18 had their own apartments.…”

Section: Socio-economic Situationmentioning

confidence: 99%

“…Moraal et al concluded that the patients still have physical limitations but that they appear to have normal psychosocial functioning and self-esteem. Residual leg length inequality (LLI) of more than 2 cm remains important even after long-term follow-up, as these patients report lower quality of life [11]. Several of the patients have complex deformities of limb and foot and/or neurological deficits that could not always be corrected by the LL.…”

Section: Introductionmentioning

confidence: 99%

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Mended But Not Healed - Somatic and Mental Health 10 Years after Leg Lengthening with Ilizarov

Niemela¹

2014

J Depress Anxiety

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Objective: To study the somatic and mental health in patients who had leg lengthening (LL) in a 10-year follow-up and to compare it with the 1 year-follow-up. Earlier studies have demonstrated severe maladaptive reactions in children and adolescents on a short term basis but also that they tolerate it without sustained psychological impact. Cohort sequential longitudinal studies, in which individuals from different age groups are followed over time, are needed to tease apart aging and cohort effects. Methods: This was a prospective study with 28 patients, mean age of 20, who had undergone leg lengthening (LL) between 1997-2005 at the Department of Pediatric Orthopedics, Uppsala University Hospital. The somatic health was studied by a structured medical assessment of the reconstructed leg and an interview focused on the patient's experiences of surgery, outcome and function. The mental health was studied by Beck depression-and the State-Trait Anxiety Inventories and a specially designed questionnaire for patient with LLI. Results: When the patients rated their mental health, 20 were within a normal level and 7 had symptoms of depression. Patients' self-esteem was on a median level. Those who had scored highly on the depression inventory also had high levels on both State-and Trait anxiety scale. Conclusion: One fourth of the patients reported themselves to be depressed at the 10-year follow-up, while 7% of the patients were depressed one year after LL. Self-esteem results for the cohort were on a median level, both one and ten years after LL. Interview data demonstrated that the majority of patients were preoccupied with their LLI and more psychological support during the lengthening period would have been desirable. From available data we cannot conclude that the leg lengthening per se caused the depressive symptoms in the patients.

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“…В клинической практике при применении аппаратов внешней фиксации и при имплантации погружных изделий в целях протезирования дополнительным основанием для стимуляции остеогенеза является минимизация у пациентов ятрогенных рисков (инфицирование имплантатов, контрактуры, атрофия мышц и др. ), а также снижение бытового и психологического дискомфорта пациента, связанного с длительным нахождением в аппарате [6][7][8]. Исходя из этих соображений, стимуляция остеогенеза выглядит вполне разумным и необходимым элементом при лечении пациентов, у которых используют технологии с применением внешних фиксаторов, в целях обеспечения сокращения сроков лечения, что не только снижает ятрогенные риски, но и может иметь медико-экономическую целесообразность.…”

Section: Introductionunclassified

Stimulation of Osteogenesis by Direct Electric Current (Review)

Овчинников

Stogov

2019

Traumatology and Orthopedics of Russia

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Background. Stimulation of osteogenesis in the treatment of certain orthopedic and trauma pathologies is a necessary element to ensure the best clinical outcome. The purpose of the present analytical review is to analyze the literature data in respect of evaluating the approaches and possibilities to stimulate osteogenesis using direct current. Methods. The search for literature data was performed in the open electronic databases of scientific literature PubMed and eLIBRARY under the following keywords and their combinations: “osteogenesis”, “reparative osteogenesis”, “direct electric current”, “orthopaedics”, “traumatology”, “electric current” (in Russian as well as in English language ). Results. According to some fundamental research, the stimulating effect of direct current lies is both in stimulating differentiation and proliferation of osteoblasts, and in stimulating differentiation of stem cells, mainly mesenchymal stem cells of bone marrow and adipose tissue, in the process of osteogenesis. The following stimulating technologies were developed and clinically tested to date: 1 — direct exposure of bone to the direct current; 2 — capacitive coupled stimulation; and 3 — inductive coupled (electromagnetic) stimulation. Analysis of clinical practice demonstrated that the first technology is most effective in terms of osteoreparation, but less safe than technology 2 and 3. It should be noted that there are no clear indications and modes of application for the abovementioned methods. Based on the data collected in the present analysis, technology 1 is considered by authors as the most promising. Safety of technology 1 can be enhanced by application of metal implants as electrodes in case those are planned to be used for medical reasons: wires, rods, staples, fixators, etc. Conclusion. Use of electric current to stimulate bone formation is a promising method which requires clarification in respect of indications and application modes.

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Long-term psychosocial functioning after Ilizarov limb lengthening during childhood

Cited by 37 publications

References 18 publications

Evaluation of clinical efficacy and safety of the Ilizarov apparatus for external fixation (literature review)

Evaluation of clinical efficacy and safety of the Ilizarov apparatus for external fixation (literature review)

Mended But Not Healed - Somatic and Mental Health 10 Years after Leg Lengthening with Ilizarov

Stimulation of Osteogenesis by Direct Electric Current (Review)

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