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Dive into the research topics where Elke Viehweger is active.

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Featured researches published by Elke Viehweger.


Journal of Pediatric Orthopaedics | 2004

Comprehensive treatment of ambulatory children with cerebral palsy: an outcome assessment.

Michael H. Schwartz; Elke Viehweger; Jean L. Stout; Tom F. Novacheck; James R. Gage

A retrospective study was used to evaluate the outcome of treatment of 135 ambulatory children with cerebral palsy. Diplegic subjects were selected from the existing database at the Gillette Childrens Specialty Healthcare Motion Analysis Laboratory. All subjects had undergone gait analysis before and after intervention, which included orthopaedic surgery, selective dorsal rhizotomy, or both treatments. Outcome was based on gait pathology, gait efficiency, functional walking ability, and higher-level functional skills. Gait pathology was assessed using 16 clinically relevant kinematic parameters. Gait efficiency was assessed with steady-state oxygen consumption. Walking ability and higher-level functional skills were based on patient report surveys. Improvements were seen in all outcome measures. A significant majority of subjects (79%) improved on a predominance of outcome measures; only 7% of subjects worsened. Within the restrictions of this study design, the results indicate that surgical intervention, guided by preoperative gait analysis, is effective and safe for children with cerebral palsy.


Journal of Pediatric Orthopaedics | 2002

Nontuberculous spondylodiscitis in children

Emmanuel Garron; Elke Viehweger; Frank Launay; Jean Marc Guillaume; J.-L. Jouve; Gérard Bollini

Forty-two children with nontuberculous spondylodiscitis treated between 1966 and 1997 were reviewed, and the clinical, paraclinical, and therapeutic results are presented. The study shows the difficulties of diagnosis and understanding the pathophysiology of the disease. Additional information is provided by new imaging techniques, disc aspiration, and biopsy. The mean age at treatment was 4 years 6 months. The initial clinical presentation was often misleading and the diagnosis was often delayed (42 days average). Standard radiographs and technetium bone scans were important for diagnosis and patient follow-up. Magnetic resonance imaging and needle aspiration of the disc gave an additional reliable aid in differential diagnosis and helped to guide treatment. Bacteria were isolated in 22 of the 35 samples taken (55%Staphylococcus aureus, 27%Kingella kingae;Coxiella burnetii in one sample). The functional outcome is good if treatment is properly carried out. Disc fibrosis and occasional vertebral fusion develop inevitably in the long term. According to these results, nontuberculous spondylodiscitis is truly osteomyelitis of the spine.


Spine | 2006

Thoracolumbar hemivertebrae resection by double approach in a single procedure - Long-term follow-up

Gérard Bollini; Pierre-Louis Docquier; Elke Viehweger; Franck Launay; Jean-Luc Jouve

Study Design. Retrospective review of patients records with clinical and radiographic assessment. Objective. To evaluate the long-term result of thoracolumbar hemivertebrae resection using a double approach in a single procedure. Summary of Background Data. Thoracolumbar hemivertebrae resection by a combined posterior and anterior approach has been previously described, but this is the largest series of hemivertebrae reported. Methods. From 1987 to 2003, a consecutive series of 34 congenital scoliosis or kyphoscoliosis due to thoracolumbar hemivertebrae were managed by hemivertebra resection using a combined posterior and anterior approach and short anterior and posterior convex fusion in the same day/same anesthesia. Results. The mean age at surgery was 3.5 years. The mean follow-up period was 6.0 years. There was a mean improvement of 69.3% in the segmental curve from a mean angle of 34.8° before surgery to 10.7° at the latest follow-up assessment. The global scoliosis curve improved of 33.4% from 40.4° to 26.9°, respectively. Trunk shift was significantly improved. The mean final kyphosis was within normal values. Conclusions. This procedure is safe and offers a persistent correction with a short segment fusion. Surgery should be performed as early as possible to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.


Journal of Bone and Joint Surgery, American Volume | 2006

Lumbar Hemivertebra Resection

Gérard Bollini; Pierre-Louis Docquier; Elke Viehweger; Franck Launay; Jean-Luc Jouve

BACKGROUND A single lumbar hemivertebra can be expected to cause progressive scoliosis. The aim of this study was to evaluate the results of a lumbar hemivertebra resection and short-segment fusion through a combined posterior and anterior approach. METHODS From 1987 to 2002, a consecutive series of twenty-one patients with congenital scoliosis or kyphoscoliosis due to a lumbar hemivertebra were managed by resection of the hemivertebra through a combined posterior and anterior approach and with the use of a short anterior and posterior convex-side fusion. RESULTS The mean age at the time of surgery was 3.3 years (range, twelve months to 10.2 years). The mean followup period was 8.6 years. There was a mean improvement of 71.4% in the segmental scoliosis curve from a mean angle of 32.9 degrees before surgery to 9.4 degrees at the time of the latest follow-up assessment, and a mean improvement of 63.9% in the global scoliosis curve from 34.1 degrees to 12.3 degrees. The mean final lordosis was within normal values. CONCLUSIONS Excision of a lumbar hemivertebra is safe and provides stable correction when combined with a short-segment fusion. Surgery should be performed as early as possible to avert the development of severe local deformities and prevent secondary structural deformities that would require a more extensive fusion later.


Clinical Orthopaedics and Related Research | 2014

No Benefit of Patient-specific Instrumentation in TKA on Functional and Gait Outcomes: A Randomized Clinical Trial

Matthew P. Abdel; S. Parratte; Guillaume Blanc; Matthieu Ollivier; Vincent Pomero; Elke Viehweger; Jean-Noël Argenson

BackgroundAlthough some clinical reports suggest patient-specific instrumentation in TKA may improve alignment, reduce surgical time, and lower hospital costs, it is unknown whether it improves pain- and function-related outcomes and gait.Questions/purposesWe hypothesized that TKA performed with patient-specific instrumentation would improve patient-reported outcomes measured by validated scoring tools and level gait as ascertained with three-dimensional (3-D) analysis compared with conventional instrumentation 3 months after surgery.MethodsWe randomized 40 patients into two groups using either patient-specific instrumentation or conventional instrumentation. Patients were evaluated preoperatively and 3 months after surgery. Assessment tools included subjective functional outcome and quality-of-life (QOL) scores using validated questionnaires (New Knee Society Score© [KSS], Knee Injury and Osteoarthritis Outcome Score [KOOS], and SF-12). In addition, gait analysis was evaluated with a 3-D system during level walking. The study was powered a priori at 90% to detect a difference in walking speed of 0.1 m/second, which was considered a clinically important difference, and in a post hoc analysis at 80% to detect a difference of 10 points in KSS.ResultsThere were improvements from preoperatively to 3 months postoperatively in functional scores, QOL, and knee kinematic and kinetic gait parameters during level walking. However, there was no difference between the patient-specific instrumentation and conventional instrumentation groups in KSS, KOOS, SF-12, or 3-D gait parameters.ConclusionsOur observations suggest that patient-specific instrumentation does not confer a substantial advantage in early functional or gait outcomes after TKA. It is possible that differences may emerge, and this study does not allow one to predict any additional variances in the intermediate followup period from 6 months to 1 year postoperatively. However, the goals of the study were to investigate the recovery period as early pain and functional outcomes are becoming increasingly important to patients and surgeons.Level of EvidenceLevel I, therapeutic study. See the Instructions to Authors for a complete description of levels of evidence.


Spine | 2006

Lumbosacral hemivertebrae resection by combined approach - Medium- and long-term follow-up

Gérard Bollini; Pierre-Louis Docquier; Elke Viehweger; Franck Launay; Jean-Luc Jouve

Study Design. Retrospective review of patients records with clinical and radiographic assessment. Objectives. To evaluate the long-term result of lumbosacral hemivertebrae resection using a combined approach. Summary of Background Data. Lumbosacral hemivertebrae resection by a combined posterior and anterior approach have been previously described, but only one study is concerning such a large series of hemivertebrae. Methods. From 1980 to 2001, a consecutive series of 17 congenital scolioses due to lumbosacral hemivertebrae were managed by hemivertebrae resection using a combined approach and short anterior and posterior convex fusion. Results. The mean age at surgery was 4.9 years. The mean follow-up period was 7.6 years. One postoperative complication was encountered: a patient had motor deficit and recovery was incomplete. The mean segmental scoliosis curve was 27.5° before surgery, 10.7° after surgery, and 8.9° at the latest follow-up assessment. This represents a mean improvement of 61.1% after surgery and of 67.6% at the latest follow-up. The total main scoliosis curve improved from 28.4° to 12.7° and 11.4°, respectively. It represents a mean improvement of 55.3% and 59.9%, respectively. The mean final lordosis was within normal values. Conclusions. This procedure offers a persistent correction with a short-segment fusion. The early surgery is able to avert severe local deformities and prevent secondary structural deformities in order to avoid extensive fusions.


Journal of Pediatric Orthopaedics B | 2006

Lipoblastoma and lipoblastomatosis.

Sophie Bourelle; Elke Viehweger; Franck Launay; Benoit Quilichini; Corinne Bouvier; Anne Hagemeijer; Jean-Luc Jouve; Gérard Bollini

We report two cases of lipoblastoma of the buttock in a 10-month-old boy and a 20-month-old girl, the first with rearrangement of chromosome 8 and the second without cytogenetic abnormality, and one case of lipoblastomatosis of a leg in a 6-month-old boy with a normal karyotype but with a rearrangement of the PLAG1 gene. Lipoblastoma and lipoblastomatosis are two different presentation of the same rare benign soft tissue mesenchymal tumour arising from fetal white fat and occurring almost exclusively in young children under 3 years. These neoplasms have no malignant potential but may recur in cases of incomplete resection. Histological diagnosis sometimes used to be difficult because of the close resemblance of the lesion with myxoïd liposarcoma. Nowadays, cytogenetic analysis may contribute to the diagnosis by showing abnormalities of the long arm of chromosome 8, leading to rearrangement of the PLAG1 gene. Actual advances in cytogenetic molecular analysis may aid in accurate diagnosis.


Journal of Pediatric Orthopaedics B | 1998

Bone growth after lengthening of the lower limb in children.

Elke Viehweger; Pouliquen Jc; Bashar Kassis; Christophe Glorion; Jean Langlais

Femoral and tibial growth was studied in 6 children undergoing a femoral lengthening and 28 children a tibial lengthening. Growth of both femurs and tibiae was evaluated for 3 years both before and after the procedure. No significant growth disturbance was noted in femoral lengthenings of 14%. However, growth variations were constant after tibial lengthening of 18% on the average and could be correlated to the amount of lengthening. The consequences of these changes are limited in terms of final limb length because overgrowth of the femur often compensates for growth retardation of the tibia when tibial lengthening is less than 18%. Experimental and clinical studies assert that lengthenings of more than 30% can result in significant and definite growth retardation of the lengthened bone.


Journal of Pediatric Orthopaedics B | 2010

Congenital abnormalities associated with hemivertebrae in relation to hemivertebrae location.

Gérard Bollini; Franck Launay; Pierre-Louis Docquier; Elke Viehweger; Jean-Luc Jouve

Numerous congenital abnormalities have been reported in association with hemivertebrae (HV). No data exist about their incidence depending on the location of the HV. From 1980 to 2003, 75 patients with 80 HV responsible for evolutive congenital scoliosis were managed by HV resection using a double approach and short anterior and posterior convex fusion. The associated abnormalities were evaluated with MRI, echocardiography and renal ultrasound. Associated genitourinary abnormalities were found in 24% of patients, cardiac abnormalities in 8% and intrathecal abnormalities in 15%. Medullar abnormalities were more frequent in case of vertebral malformations at lumbosacral level.


Journal of Pediatric Orthopaedics | 2005

Hip Flexion Contracture and Lumbar Spine Lordosis in Myelomeningocele

Yann Glard; Franck Launay; Elke Viehweger; Jean-Marc Guillaume; Jean-Luc Jouve; Gérard Bollini

The objective of this study was to assess the correlation between hip flexion contracture (HFC) and the sagittal alignment of the lumbar spine in ambulatory children with myelomeningocele. Ambulatory patients with myelomeningocele are generally free of scoliosis or kyphosis. Among them, some develop increased lumbar lordosis. It is postulated that HFC and increased lumbar lordosis may be correlated. Thirty-eight patients, with a mean age of 12.7 years, were evaluated. Standing lateral spine films were obtained and the lumbar lordosis was measured using the Cobb method. HFC was measured using the Thomas test. A statistically significant correlation was found between the lumbar curve and HFC. High values of lumbar Cobb angle (hyperlordosis) were correlated with high values of HFC. These results show a correlation between HFC and increased lumbar lordosis in ambulatory myelomeningocele patients.

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Franck Launay

Aix-Marseille University

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Jean-Luc Jouve

Boston Children's Hospital

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J.-L. Jouve

Aix-Marseille University

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Vincent Pomero

Arts et Métiers ParisTech

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Yann Glard

Centre national de la recherche scientifique

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J.-L. Jouve

Aix-Marseille University

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