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Energy Expenditure during Walking by Children Who Have Proximal Femoral Focal Deficiency*
EILEEN FOWLER, PH.D, P.T.†; RONALD ZERNICKE, PH.D‡; YOSHIO SETOGUCHI, M.D.§; WILLIAM OPPENHEIM, M.D.†, LOS ANGELES, CALIFORNIA
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Investigation performed at the Functional Assessment Laboratory and the Pulmonary Function Laboratory, University of California at Los Angeles Medical Center, Los Angeles
J Bone Joint Surg Am, 1996 Dec 01;78(12):1857-62
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Abstract

The energy expended during walking by sixteen children who had proximal femoral focal deficiency was measured to compare the outcomes after Syme amputation (seven subjects) with those after Van Nes rotational osteotomy (nine subjects). Multivariate regression analysis revealed that the subjects who had had a Van Nes procedure had a mean oxygen cost (energy per unit of body mass expended per distance walked) that was 0.12 milliliter per kilogram of body mass per meter lower than that of the subjects who had had a Syme amputation (p = 0.001). The subjects who had had a Van Nes procedure tended to walk faster (p = 0.07). A significant decrease in the oxygen cost as a function of increasing age was observed for both groups (p < 0.0001, r2 = 0.79). We believe that the reduced energy expenditure associated with the Van Nes rotational osteotomy is one of several factors to consider when deciding which operation should be done for children who have proximal femoral focal deficiency.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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