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At least 361 records · Page 20Linked to original sources

Lambdoid synostosis.

Recent increases in presentation of occipital deformities have presented the craniofacial team with new challenges in diagnosis and treatment. As presented in this article, they appear to have a functional abnormality of the suture that results in a localized growth deformity. The growth inhibition in severe cases can result in changes in the local bone and brain, along with the entire skull and cranial base. Histologic analysis supports the theory that this is true lambdoid synostosis. Surgical correction is indicated in moderate to severe cases, and the authors have presented their technique and new data on outcomes.

Cranial Sutures↗

Sagittal synostosis: quantitative assessment of presenting deformity and surgical results based on CT scans.

We reviewed our experience with nine consecutive patients with untreated isolated nonsyndromic sagittal synostosis. Using a method of 14 clinically relevant measurements taken from preoperative and postoperative CT scan images of these patients, we documented their presenting skeletal dysmorphology and the results of surgical correction at least 1 year after operation. Significant preoperative findings included an elongated cranial vault length that averaged 103 percent of normal and a narrowed cranial vault width both anteriorly at 92 percent and posteriorly at 86 percent of normal. Results of surgical correction, as documented by CT scan measurements, included normalization of the cranial length to 100 percent and of the anterior width to 101 percent of normal and improvement (but undercorrection) of the posterior width to 94 percent of normal. Quantitative measurement of CT scan images confirmed clinically observed findings in these patients before suture release and reconstruction and proved useful in assessing the surgical results achieved.

Child, Preschool↗

[Progressive paraparesis, complication of acquired pagetic synostosis of the cervical vertebrae. 2 cases].

Two cases of pagetic cervical intervertebral synostosis with spinal cord compression are reported. Computed tomography and magnetic resonance imaging enabled detailed analysis of pagetic bone structure and relationships between the fused spinal segment and spinal cord. Few similar cases have been reported and most authors have advocated conservative therapy with calcitonin and/or diphosphonates, with surgery only in cases unresponsive to pharmacotherapy.

Aged↗

Proximal tibiofibular bifurcation synostosis for the management of longitudinal deficiency of the tibia.

Three adults with severe longitudinal deficiency of the tibia (LDT), in which an unossified proximal tibial anlage was present, who had been treated with proximal tibiofibular bifurcation synostosis (PTFBS) in early childhood, were evaluated between 20 and 31 years after the index procedure. All three were found to be functioning well as below-the-knee (BK) amputees. Mediolateral stability and anteroposterior instability of the knee were present in all cases. Instrumented motion analysis revealed diminished loading characteristics of the prosthetic limb, similar to that described for BK amputees in general. The most significant gait deviations at the knee unique to this study group were a quadriceps-avoidance gait pattern and an increased dynamic varus alignment. Instrumented muscle testing suggested that these deviations were a consequence of ligamentous instability. This study supports the concept that the presence of a proximal tibial anlage in severe LDT is indication for a surgical strategy that preserves the biological knee joint. The PTFBS maintains the integrity of the knee-extensor mechanism, the fibular collateral ligament, the tibiofemoral joint capsule, and the medial collateral ligament, enhancing the long-term stability and function of the knee joint.

Adult↗

The Antley-Bixler syndrome. A new case without radiohumeral synostosis.

The author report a new case of the syndrome described by Antley and Bixler. It concerns a female new-born who presents a craniosynostosis with brachycephaly, midface hypoplasia, unilateral choanal atresia, multiple joint contractures and arachnodactyly. There was no bowing of the femora and only the radius and the ulna were bowed. The absence of radiohumeral synostosis reported in all observations of the literature represents the main particularity of this observation.

Abnormalities, Multiple↗