Academic literature on the topic 'Ligamentotaxia'

OBJETIVO: avaliar a correção da cifose, da altura do corpo vertebral e da redução dos fragmentos retropulsados nas fraturas toracolombares tipo explosão por ligamentotaxia. MÉTODOS: estudo retrospectivo avaliando um total de 238 pacientes com fraturas toracolombares tipo explosão do grupo A3 pela classificação de Magerl et al., dos quais 63 deles elegíveis para a pesquisa. Todos foram tratados com fixador interno pedicular e tinham imagens radiográficas e tomográficas pré e pós-operatórias. RESULTADOS: No estudo, foi constatada, no pós-operatório imediato, uma correção da cifose vertebral no local da fratura de 87%, com correção de 51% na altura do corpo vertebral e redução de 40% dos fragmentos retropulsados intracanal. CONCLUSÕES: o uso de fixador interno por via posterior permite, ao realizar ligamentotaxia, a restauração da altura do corpo vertebral fraturado, do alinhamento sagital da coluna e descompressão do canal espinhal, minimizando as comorbidades em relação à cirurgia pela via anterior e à laminectomia para descompressão do canal.

A descompressão do canal vertebral, para aliviar as estruturas nervosas, pode ser realizada por meio da ligamentotaxia. O objetivo foi analisar a influência da seqüência de realização da ligamentotaxia sobre a descompressão do canal vertebral. Foram utilizados segmentos de vértebras de suínos (Landrace). Um equipamento especialmente desenvolvido foi utilizado para produção de fratura do tipo explosão. Após a tomografia computadorizada, 10 espécimes que melhores apresentavam fraturas do tipo explosão foram fixados com fixador interno (Synthes). Foram formados dois grupos. No primeiro (n=5) foi realizada a lordose e depois a distração. Posteriormente, foram submetidos à nova compressão por meio de morsa até o retorno da fratura à posição inicial, a seguir foram novamente submetidos à distração e lordose. No segundo grupo (n=5) foi realizada a distração e depois a lordose. Após cada manobra era realizado o exame tomográfico para medir o diâmetro do canal vertebral. Os deslocamentos dos fragmentos dos corpos vertebrais fraturados foram mensurados e comparados utilizando t de Student (p<0,05). Comparando os deslocamentos entre os grupos, não foram observadas diferenças estatísticas (p<0,06). Esse resultado é próximo ao nível de significância adotado, sugerindo uma forte tendência que demonstra a eficácia superior da manobra iniciada pela realização da lordose.

Complex fracture subluxations of the proximal interphalangeal joint are often difficult to treat and their outcome variable. A number of methods for treatment of these injuries have been described. We have used a ligamentotaxis device ( Ligamentotaxor, Arex, Palaiseau Cedex, France) since 2008. We performed 28 operations in 28 patients with complex proximal interphalangeal joint injuries over a 3-year period. Patients followed a standardized postoperative rehabilitation regime, including fixator adjustment as necessary. The mean age was 33 years (range 18–67). The mean time to surgery was 7 days. At final follow-up (mean 22 months, range 6–52) the mean proximal interphalangeal joint range of motion was 85° (range 60°–110°). The mean QuickDASH functional outcome score was 4.8 (range 0–36.4). Our results compare favourably with other devices reported in the literature.

Background. This study was conducted with the aim of evaluating the role of Ligamentotaxis in the management of neglected clubfeet managed by ligamentotaxis using Joshi's External Stabilisation System (JESS).Method & Material. Total 20 subjects (28 feet) were studied, which were corrected by differential ligamentotaxis using JESS. All were evaluated clinically, radiologically, podogrammically, and by Catterall Pirani Scoring System, both before and after the correction.Results. Severity of the deformities and clinical correction was assessed by Pirani score. All patients achieved good clinical results as per Pirani score, which was statistically significant. Radiological evaluation showed that all subjects achieved the normal range of values. The pre- and postcorrection difference in FBA was statistically significant.Conclusion. Differential distraction by fixator for the correction of neglected idiopathic CTEV is an effective and patient-friendly method of management.

<p><strong>Background</strong>: Comminuted fractures of lower end of radius most often bring out unsatisfactory outcome, if treated by conservative means of closed reduction and casting. This study was aimed to compare the results of ligamentotaxis in comminuted fractures of the distal end of radius and with that of closed manipulative reduction and plaster cast immobilization.</p><p><strong>Methods</strong>: Patients with comminuted fracture lower end of radius treated by ligamentotaxis or the conservative methods were included in the prospective study. Patients in group l treated by external fixator and in group 2 treated by conservative line of management. Postoperative check X-rays were taken. All the patients were evaluated on 3rd, 6th, 12th and 18th months after surgery. Functional results were assessed by Gartlands point score system and subjected to statistical analysis.</p><p><strong>Results: </strong>Total fifty patients were included in the study. Twenty five were treated by external fixator and the remaining was treated by conservative line of management. Patients underwent ligamentotaxis had 88% excellent results whereas 52% of patients on conservative care had similar results. When the conservative methods gave poor results for severely comminuted fractures, ligamentotaxis could bring out excellent re-orientation of fragments back to near normal alignment.</p><p><strong>Conclusions</strong>: Ligamentotaxis using a distracter is a better method to treat comminuted fractures of lower end of radius. Even though the initial reductions were excellent in a plaster cast, re-displacement rates are very high in a plaster cast. Fractures without intra articular extension always yielded far better results than intra articular fractures.</p>

<p class="abstract"><strong>Background:</strong> Fractures of the distal radius continue to be the one of the most common skeletal injuries treated by an orthopaedic surgeon. They are the most common fractures of the upper extremity and account for 15-20% of all fractures. All intra articular fractures need good reduction for better functional outcome. There are multiple treatment methods from casting to arthroscopic surgeries. This study has been undertaken to study the functional outcomes of distal radius intra-articular fractures managed by ligamentotaxis. The objective of the present study was to evaluate the functional outcomes of distal radial intra-articular fractures treated by ligamentotaxis.</p><p class="abstract"><strong>Methods:</strong> This cross sectional study was conducted in Orthopaedic department of Kilpauk Medical College between April 2017 to April 2019 on 60 patients with fracture of the distal end of radius, with comminuted fracture, who fulfilled the inclusion and exclusion criteria were included in the study. All fractures were managed by ligamentotaxis and were followed regularly and assessed after four months for their functional outcomes.<strong></strong></p><p class="abstract"><strong>Results:</strong> 80% of the study population were males. Around 67% of the study population had type III or type IV fracture according to Frykman’s classification. 84% of the study population had better prognosis with ligamentotaxis. The difference between mean Mayo wrist score between affected side and normal side was not statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> Ligamentotaxis, external fixation for comminuted intra articular distal radius fractures is safe and effective treatment. It is also cost effective.</p>

Abstract BACKGROUND The spine is the most common site of bony metastases. Associated pathological fractures can result in pain, neurological deficit, biomechanical instability, and deformity. OBJECTIVE To present a minimally invasive technique for indirect decompression by ligamentotaxis in pathological fractures. METHODS A minimally invasive approach was utilized to perform percutaneous pedicle screw fixation in patients who required stabilization for pathological fractures. Preoperative and postoperative computed tomography and magnetic resonance imaging were used to compare spinal canal area and midsagittal canal diameter. RESULTS Two patients with newly diagnosed pathological fractures underwent minimally invasive treatment. Each presented with minimal epidural disease and a chief complaint of intractable back pain without neurological deficit. They underwent minimally invasive pedicle screw fixation with indirect decompression by ligamentotaxis. In each case, postoperative imaging demonstrated an increase in spinal canal area and midsagittal canal diameter by an independent neuroradiologist. There were no perioperative complications, and each patient was neurologically stable without evidence of hardware failure at their 5- and 6-mo follow-up visits. CONCLUSION Minimally invasive percutaneous fixation can be used to stabilize pathological fractures and provide indirect decompression by ligamentotaxis. This procedure is associated with minimal blood loss, low morbidity, and rapid initiation of radiation therapy. Only patients with minimal epidural disease, stenosis caused primarily by bony retropulsion, and mild-to-moderate deformity should be considered candidates for this approach.

<p class="abstract"><strong>Background:</strong> Fractures of distal end of radius are beginning at the proximal end of pronator quadratus and ending at the radio-carpal articulation. The final aim in the management of comminuted intra-articular fractures of distal radius is to restore normal function. Recognition of patterns that are inherently unstable and therefore necessitate additional forms of fixation to secure and maintain reduction and prevent late collapse is the key for successful management of the more complex fractures of distal radius. The aim is to study the functional outcome of surgical management of comminuted intra-articular fractures of distal end radius by comparing 2 different methods of surgical interventions.</p><p class="abstract"><strong>Methods:</strong> In study of 30 cases treated in period from March 2008 to September 2009 at St. Martha’s Hospital by ligamentotaxis and percutaneous pinning, all patients with compound fractures, Frykman's IV, V, VI, VII and VIII, comminuted fractures and in fractures where reduction was lost following closed reduction and POP application were taken into consideration.<strong></strong></p><p class="abstract"><strong>Results:</strong> The average age in males were 41.35 years and female were 35 years. 12 (40%) fractures were type VII, 6 (20%) were type VIII, 9 (30%) were type IV and 3 cases (10%) was type V. functional results in ligamentotaxis group (G1) 7 cases had excellent results (47%), in percutaneous pinning (G2), 3 cases had excellent result (20%). In ligamentotaxis group (G1) 3 had good results (20%), in percutaneous group (G2) 6 had good results (40%). In ligamentotaxis group (G1) 5 had poor results (33%), in percutaneous pinning group (G2) 6 had poor results (40%).</p><p class="Bodytext20" align="left"><strong>Conclusions:</strong> In comparative studies, external fixation with percutaneous pinning consistently achieves better anatomical results as compared to percutaneous pinning alone. In our study, also this technique has shown satisfactory result that lead to high rate of return to pre-injury status, high level of patient satisfaction and low rate of complications.</p>

DE CASTRO, I.J.C. Seqüência das manobras para ligamentotaxia em fraturas de coluna. 2006. 59f. Dissertação (Mestrado) – Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2006. As fraturas da coluna, possivelmente, projetam fragmentos da parede posterior do corpo da vértebra para o interior do canal vertebral. Esses fragmentos ósseos podem comprimir as estruturas nervosas localizadas no interior do canal. A descompressão realizada por meio da ligamentotaxia é um método indireto. A técnica implica a realização de distração e correção da cifose do segmento vertebral fraturado. O objetivo do trabalho foi analisar a influência da ordem de realização dessas manobras (distração + lordose versus lordose + distração), durante a ligamentotaxia, relativa à descompressão do canal vertebral. Foram utilizadas no estudo, vértebras da transição tóracolombar de suínos híbridos, derivados da raça Landrace, com idade de cinco meses e média de peso de 102,05±3,47 kgf. Após a produção da fratura do tipo explosão, por meio de equipamento especialmente desenvolvido para esta finalidade, as vértebras foram submetidas à tomografia computadorizada e foram selecionados 10 espécimes que apresentavam fraturas do tipo explosão. Os segmentos vertebrais foram estabilizados por meio do fixador interno (Synthes), uma vértebra acima e outra, abaixo da vértebra fraturada. Os 10 modelos foram divididos em dois grupos com cinco cada. O primeiro grupo foi denominado (lor+dis), no qual foi realizada a correção da cifose (lordose) e depois a distração. Finalizada a seqüência de manobras desse grupo, os mesmos foram submetidos à nova compressão, por meio de morsa, até o retorno à posição inicial da fratura. Esses modelos reposicionados, denominados (R:dis+lor) foram novamente submetidos à seqüência de manobras, iniciando com a distração e depois correção da cifose. No segundo grupo denominado (dis+lor) foi realizada a distração e depois a lordose. Após cada manobra, era realizado o exame tomográfico, para a mensuração do diâmetro do canal vertebral. O deslocamento do fragmento do corpo vertebral fraturado foi mensurado e os valores obtidos, comparados por meio de estudo estatístico, pelo teste t de Student, com nível de significância de 5%. Os resultados de ligamentotaxia desse trabalho mostraram que o deslocamento dos fragmentos, percentualmente, foi maior na seqüência que inicia com a correção da cifose (lordose). Mas a análise estatística em que se usou um nível de significância de p?5%, mostrou que não houve diferença entre as seqüências. O nível de significância obtido nesta comparação foi de p?0,06. Esse resultado é próximo ao nível adotado. Isto sugere um forte tendência, demonstrando a eficácia superior da seqüência, quando se inicia pela realização da correção da cifose (lordose), seguida de distração. Com os resultados qualitativos e quantitativos encontrados neste trabalho, sugerimos que a ligamentotaxia deva ser iniciada pela correção da cifose, seguida da distração do segmento vertebral fraturado.
CASTRO, I.J.C.: Experimental study of the sequence of ligamentotaxis maneuvers in vertebral canal decompression. 2006. 59f. Thesis (Master) – Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2006. Spinal fractures may project fragments of the posterior wall of the vertebral body into the vertebral canal and these bone fragments may compress the nervous structures located in the canal. Decompression of the vertebral canal can be performed by ligamentotaxis, which is an indirect method of vertebral canal decompression. The ligamentotaxis techniques involves distraction and lordosis of the fractured vertebral segment.The objective of the present study was to analyze the influence of the sequence in which these maneuvers are performed (distraction + lordosis versus lordosis + distraction) during ligamentotaxis on vertebral canal decompression. Thoracolumbar transition vertebrae of hybrid Landrace swine aged 5 months and weighing on average 102.05± 3.47 kg were used in the study.After production of a burst fracture using a device specially developed for this purpose, the vertebrae were submitted to computed tomography and ten specimens presenting fractures of the burst type were selected. The vertebral segments were fixed with an internal fixator (Synthes) to one vertebra above and one vertebra below the fractured one. The 10 models were divided into two groups of 5. The first group was submitted to lordosis followed by distraction and called (lor+dis). At the end of the sequence of maneuvers, the vertebrae of this group were submitted to a new compression with a clamp until they returned to the initial position of the fracture. These moldels with ther repositioned fractures, denoted (R:dis+lor) were again submitted to the dis+lor sequence.The second group was submitted to distraction followed by lordosis and denoted (dis+lor).Tomography was performed after each maneuver to measure the diameter of the vertebral canal. The dislocation of the fractured vertebral fragment was measured and the values obtained were compared by the Student t-test, with the level of significance set at 5%. The results of ligamentotaxis obtained in the present study showed that the percent dislocation of the fragments was higher in the sequence starting with kyphosis correction (lordosis), but statistical analysis with a level of of significance of ? 5% (p?0,05), showed that there was no difference between the sequences with a p level of ? 0,06. This result was close to level of significance adopted, suggesting that the sequence starting with kyphosis correction (lordosis) followed by distraction strongly tended to be more effective.