Clinical efficacy of kinesiology taping in reducing edema of the lower limbs in patients treated with the ilizarov method--preliminary report.

INTRODUCTION: Postoperative edema of predominantly lymphatic origin is a significant hindrance to physiotherapy in patients subjected to limb lengthening by the Ilizarov method. New treatment methods are being sought, and Kinesiology Taping is one of them. MATERIAL AND METHODS: The study involved 24 patients of both sexes subjected to lower limb lengthening using the Ilizarov method who had developed edema of the thigh or crus of the lengthened extremity. The mean age of the patients was 21 years. The patients were randomized into two groups of twelve, which were then subjected to 10 days of standard physiotherapy. The study group was additionally treated with Kinesiology Taping (lymphatic application), while the control group received standard lymphatic drainage. Treatment results were assessed by comparing the linear circumferences of the lower limbs before and after the treatment. RESULTS: The application of Kinesiology Taping in the study group produced a decrease in the circumference of the thigh and crus statistically more significant than that following lymphatic drainage. CONCLUSIONS: 1. Both standard edema-reducing treatment in the form of lymphatic massage and Kinesiology Taping significantly reduced lower limb edema in patients treated by the Ilizarov method. 2. The application of Kinesiology Taping in the study group produced a significantly faster reduction of the edema compared to standard lymphatic massage.

Chronic psoas syndrome caused by the inappropriate use of a heel lift.

Heel lifts are commonly recommended for patients to manage the pain and discomfort of leg length discrepancies. However, used inappropriately, orthotics can create additional pain instead of alleviating it. In the case described, a 79-year-old male physician used a recommended heel lift for a perceived leg length discrepancy after right hip arthroplasty. Six months postsurgery, chronic, intractable pain developed in his hip and groin. He underwent a battery of tests to locate the pain, but its source remained elusive. Osteopathic evaluation and radiographic examination revealed an absence of leg length discrepancy and the presence of chronic psoas syndrome. Osteopathic manipulative treatment was prescribed and heel lift therapy discontinued, and the patient reported complete remission from pain.

[Reduction of the period of treatment for leg lengthening. Technique and advantages]. / Réduction de la durée du traitement dans les allongements osseux progressifs. Technique et advantage.

PURPOSE OF THE STUDY: We assessed an adaptation of the Ilizarov method aimed at a considerable reduction in the period of treatment for leg lengthening in order to limit complications related to the duration of the external fixation. This technique associates multiple segment lengthening, automatic high-frequency lengthening, and stimulation of bone regeneration by extemporaneous compression at the end of traction. MATERIAL AND METHODS: We analyzed 78 cases of automatic fémur lengthening in 40 patients and simultaneous fémur and tibia lengthening in 38 patients. There were 51 men and 27 women, mean age 13.2 years (6 - 43 years). Mean length deficiency was 4.3 cm for the fémur and 3.5 cm for the tibia. Femoral and/or tibial deformations were observed in 32 patients. Minimal follow-up was 1.5 years. The automatic traction device was composed of the conventional Ilizarov fixator and complementary elements. Different assemblies were used depending on the associated deformations allowing their progressive correction. For 17 patients, radioimmunoassay of thyrocalcitonin and parathormone was performed to compare the time courses. RESULTS: Mean femoral lengthening achieved was 49 mm (8.5 to 20%). Mean tibial lengthening was 42 mm (7.2 to 18.8%). The consolidation index was 18.1 to 21.3 days/cm for single-segment lengthenings and 11.5 days/cm (mean) for two-segment lengthenings (taking into account both the femoral and tibial gain in length). The ideal moment of compression was 5.6 N/cm(2). Acceleration of the bone repairing process was evidenced by activation of the osteotrop hormone system. According to the SOFCOT classification of complications (1990), 60 patients (76.9%) were in category I, 15 (19.3%) in category II, and 3 (3.8%) in category III. DISCUSSION: Improvement of lengthening procedures with external fixators remains an important issue. Treatment periods are often long with consolidation indices for the femur ranging from 39.6 d/cm to 45 d/cm, which can lead to many types of complications. Use of a high-frequency progressive lengthening procedure based on the Ilizarov method considerably reduces the rate of complications compared with progressive lengthening methods and has allowed achieving more satisfactory results in a shorter treatment period. CONCLUSION: Multiple-segment lengthening using an automatic lengthening procedure set at 1 mm per day in four times provides an important reduction in the treatment delays since distraction is performed more rapidly and fewer steps are needed. Automatic high-frequency lengthening with the Ilizarov method provides optimal conditions for tissue regeneration: Treatment periods are shorter and anatomic and functional outcome is very satisfactory. Stimulation by extemporaneous compression of the regeneration zone allows a significant reduction in the duration of consolidation. Shorter delays to consolidation help avoid device-related complications.

Hereditary multiple exostosis: another etiology of short leg and scoliosis.

A case study is presented demonstrating a patient with a scoliosis as a result of a short leg. The etiology of the short leg was a large sessile osteochondrom in a patient with Hereditary Multiple Exostoses (HME). A review of the condition is presented.

Electrical stimulation of the callus formation by means of bipolar rectangular pulse sequences.

The clinical application of the electrical stimulation, lasting several weeks, for the callus formation is reported in 11 patients. Bipolar rectangular pulse sequences were used for the stimulation at a frequency of 1 Hz and a current intensity of +/-20mu amp. The electrical stimulation was successfully employed after distraction osteotomies with a KDA-apparatus in shortening of the leg provoked by different causes or in the treatment of pseudarthroses. The realignment of the newly formed callus and the osseous consolidation are stimulated and speeded up by the bipolar rectangular pulse sequences as it is also shown in the light of the roentgenograms of a case.