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Journal of Pediatric Orthopedics. Part B

Amin Abdel Razek Youssef Ahmed
Bony exostoses are benign osteocartilaginous growths that start close to growth plates. Approximately 30-60% of patients have forearm deformities. The commonly encountered forearm deformities in these patients are bowing of the radius, with or without ulnar drift of the carpus, radial head dislocation, shortening of the ulna, and radial head dislocation. The current study reported on the results of management of radial head dislocation for type IIb Masada and Oho classification of forearm deformities by Ilizarov ulnar lengthening and without tumor excision...
July 10, 2018: Journal of Pediatric Orthopedics. Part B
Arnold T Besselaar, Maud C Kamp, Max Reijman, Marieke van der Steen
The incidence of clubfoot patients is an important factor for centralization of care. Medical records of 21 accredited clubfoot centers were selected using the diagnosis treatment codes and checked to confirm diagnosis. All idiopathic clubfoot cases born during 2013-2014 were analyzed with respect to sex, affected foot, regional distribution, and seasonal variation. Among the 346 522 live births, 377 idiopathic clubfoot cases were registered. The incidence of the congenital idiopathic clubfoot in the Netherlands during 2013 and 2014 was 1...
June 29, 2018: Journal of Pediatric Orthopedics. Part B
William Zelenty, Richard S Yoon, Lior Shabtai, Paul Choi, Benjamin Martin, David Horn, David S Feldman, Norman Y Otsuka, David H Godfried
The goal of this study was to compare open reduction versus percutaneous fixation of adolescent ankle fractures with regards to the incidence of growth disturbance. We performed a retrospective cohort analysis of adolescent patients with triplane or Tillaux fractures. There was an even distribution of triplane fractures and mean initial displacement between cohorts. Analysis of follow-up radiographs revealed no instances of growth disturbance in the percutaneous fixation group and six in the open reduction group (P=0...
June 27, 2018: Journal of Pediatric Orthopedics. Part B
Masakazu Ishikawa, Atsuo Nakamae, Tomoyuki Nakasa, Yasunari Ikuta, Seiju Hayashi, Mitsuo Ochi, Masataka Deie, Nobuo Adachi
Current treatment algorithms for stable juvenile osteochondritis dissecans (JOCD) of the knee have not been established. For arthroscopically stable lesion, in-situ arthroscopic fixation with bioabsorbable pins was introduced as a more desirable approach because of less surgical morbidity and faster recovery. However, there is a paucity of literature that concludes on its efficacy. The aim of this study is to determine the efficacy and limitation of in-situ arthroscopic fixation on stable JOCD lesion in the knee...
June 25, 2018: Journal of Pediatric Orthopedics. Part B
Pedro Gutiérrez Carbonell
Our purpose is to analyze results, following the use of arthrodiastasis for the treatment of inveterate congenital hip dislocations. The study included eight patients. The mean age was 6 years. Three (37.5%) were male patients, and five (62.5%) were female patients. The patients were followed-up for 46 months. Teratologic, neurologic, rheumatic, and syndrome-associated dislocations were excluded. The following scores were used: Harris Hip Score, displacement of femoral head with respect to Hilgenreiner's line, Acetabular index, Wiberg angle, Reimer's extrusion index, and leg length discrepancy...
June 11, 2018: Journal of Pediatric Orthopedics. Part B
Rolf D Burghardt, John E Herzenberg, Andre Strahl, Peter Bernius, Murteza A Kazim
This systematic review sums up the state of knowledge about complications and reasons for failure when children with Blount disease are treated with temporary hemiepiphysiodesis. Twelve studies meet the inclusion criteria. The main reported obstacles were under correction and the poor predictability of the amount of correction that was obtainable. Obese patients with severe deformity are the most challenging groups of patients in the treatment of angular deformities. Patients with Blount disease require a careful evaluation regarding the deformity, age, body weight, and social background to reach the optimal treatment strategy...
June 8, 2018: Journal of Pediatric Orthopedics. Part B
Nithin Kesireddy, Rowida K Kheireldin, Alex Lu, Jonathan Cooper, Jiayong Liu, Nabil A Ebraheim
To compare the current treatments for congenital pseudarthrosis of tibia, a total of 33 studies were reviewed. Vascularized fibular graft with external fixation or combined fixation had the fastest time till initial union (P<0.05). Bone morphogenetic protein had no advantage in terms of initial union, time till union, and refracture rates. This meta-analysis supports that fixation methods with corticocancellous bone autograft utilizing the combined technique of Ilizarov external fixation and intramedullary rod stabilization ensure a statistically significant reduction in the number of refractures compared with standalone fixation methods and would be the preferred method for preventing long-term complications in patients with congenital pseudarthrosis of tibia...
June 6, 2018: Journal of Pediatric Orthopedics. Part B
Izumi Kadono, Hiroshi Kitoh, Kenichi Mishima, Masaki Matsushita, Koji Sato, Masato Kako, Naoki Ishiguro
Increase in the magnitude of lengthening during the limb lengthening procedure involves a high risk of decreased range of motion (ROM) in adjacent joints. Even though patients with achondroplasia can tolerate a relatively larger amount of lengthening owing to its inherent soft-tissue laxity, they often exhibit significant joint contractures during extensive lengthening. In the present study, we evaluated temporal changes in the ROM of the hip, knee, and ankle joints throughout the treatment period in 12 limbs of six patients with achondroplasia who had undergone extensive tibial lengthening...
June 6, 2018: Journal of Pediatric Orthopedics. Part B
Jennifer J Beck, Daniel V Boguszewski, Nirav B Joshi, Edward C Cheung, Richard E Bowen, William L Oppenheim
OBJECTIVES: Defining normal pediatric patellar height is complicated. Current methods use ratios calculated from lateral radiographs, but often provide inconsistent results and are time-consuming. It has been observed that the angle formed by Blumensaat's line and the distal femoral physis, when extended, form an area of patellar containment throughout a range of knee flexion. Deemed the Blumensaat-Epiphyseal Containment of the Knee (BECK) Angle, the objective of this study was to investigate this as a simple alternative to identify normal pediatric patellar height...
June 6, 2018: Journal of Pediatric Orthopedics. Part B
Shih-Hui Peng, Wei-Chun Lee, Hsuan-Kai Kao, Wen-E Yang, Chia-Hsieh Chang
This study reported guided growth for caput valgum deformity and subsequent hip development. Ten children with unilateral hip dysplasia had guided growth by one eccentric transphyseal screw at age 9.1 years with minimum 2 years of follow-up. The first change was decreasing articulotrochanteric distance and then increasing physis tilt angle and head-shaft angle by 1.5 years. The center edge angle that was significantly less than the normal side (18.3 vs. 24.8°) preoperatively became comparable between both the hips 2 years later...
June 6, 2018: Journal of Pediatric Orthopedics. Part B
Junting Zang, Katsufumi Uchiyama, Mitsutoshi Moriya, Zhengwei Li, Kensuke Fukushima, Takeaki Yamamoto, Jianguo Liu, Wei Feng, Naonobu Takahira, Masashi Takaso
Intracapsular cuneiform osteotomy was initially introduced to restore the morphology of the proximal femur after slipped capital femoral epiphysis (SCFE). However, whether this procedure results in a higher risk of avascular necrosis (AVN) or lower incidence of cam deformity than in-situ pinning is unclear. The aim of this study was to compare the outcomes of intracapsular cuneiform osteotomy and in-situ pinning to treat SCFE in children. Twenty-three children who suffered from SCFE underwent either intracapsular cuneiform osteotomy (eight patients, eight hips) or in-situ pinning (15 patients, 18 hips) between 2006 and 2014...
June 1, 2018: Journal of Pediatric Orthopedics. Part B
Bart Kowalczyk, Anna Kuźnik-Buziewicz
This study presents outcomes of rotation-plasty for unilateral proximal femoral focal deficiency in the adolescent population. The function, timing of knee fusion, and complications were presented as well as patients' assessment of their function and appearance. Eight patients, aged 8.37 years (range: 3-16 years) during surgery, were evaluated. The mean follow-up duration was 9.25 years (range: 6-12 years). At follow-up, all the patients were pain free and able to ambulate outdoors. Complications included derotation of the foot in five patients, necessitating a re-rotation osteotomy in two...
May 30, 2018: Journal of Pediatric Orthopedics. Part B
Antonio Andreacchio, Flavia Alberghina, Matteo Paonessa, Mattia Cravino, Vincenzo De Rosa, Federico Canavese
The aim of this work was to evaluate the outcome and efficacy of treatment in a homogeneous group of skeletally immature patients with chronic osteomyelitis of the long bones managed by a combination of radical debridement and insertion of tobramycin-impregnated calcium sulfate pellets to fill the bone defect in a single-stage procedure. Between 2011 and 2016, 12 skeletally immature patients were treated surgically by the reported technique. Single-stage surgery using tobramycin-impregnated calcium sulfate pellets in association with systemic antibiotic therapy yields satisfactory outcomes in skeletally immature children presenting chronic osteomyelitis by reducing the risk of occurrence of comorbidities, hospital stays, and healthcare costs...
May 30, 2018: Journal of Pediatric Orthopedics. Part B
Choon Sung Lee, Chang Ju Hwang, Dong-Ho Lee, Jae Hwan Cho
Proximal fusion level selection in adolescent idiopathic scoliosis (AIS) with a double thoracic curve (Lenke-2) remains debatable. The aim of this study was to compare the radiological outcomes of corrective surgery for Lenke-2 AIS according to the upper instrumented vertebra (UIV). This study included 74 patients who underwent corrective surgery for Lenke-2 AIS with the right main thoracic and left proximal thoracic (PT) curve at a single center. Various radiological parameters were measured using whole-spine standing radiographs preoperatively and postoperatively...
May 30, 2018: Journal of Pediatric Orthopedics. Part B
Jennifer K Hurry, Saad Rehan, Alan J Spurway, Elise K Laende, Janie L Astephen Wilson, Karl J Logan, Michael J Dunbar, Ron El-Hawary
Physeal closure after slipped capital femoral epiphysis fixation can be difficult to assess on two-dimensional conventional radiographs. Radiostereometric analysis offers improved motion detection over conventional radiography, whereas the EOS biplanar imager provides a means for low radiation weight-bearing images. This phantom study assessed the reliability of measuring motion using radiostereometric analysis in the EOS using a slipped capital femoral epiphysis model. The accuracy and precision were better than 0...
May 14, 2018: Journal of Pediatric Orthopedics. Part B
Andrew G Georgiadis, Vivek Dutt, Walter H Truong, Susan A Novotny, Tom F Novacheck
All patients with hypertonic cerebral palsy undergoing Bernese periacetabular osteotomy (PAO) between 2005 and 2014 were reviewed. Clinical and radiographic parameters, including the cerebral palsy hip classification and anterior and posterior wall indices were collected to assess acetabular reorientation. Twenty (83%) of 24 procedures involved the correction of posterolateral acetabular insufficiency and were 'anteverting PAOs'. All 20 experienced improvements in radiographic indices. Eleven (58%) of 19 PAOs in ambulatory patients were performed in the setting of other multilevel orthopedic surgery...
April 27, 2018: Journal of Pediatric Orthopedics. Part B
Atilla Arik, Cemalettin Aksoy, Ayla Aysev, Melda Akçakin
The aim of this study was to establish the torsional and toe-walking profiles of children with autism spectrum disorder (ASD), and to analyze the correlations between torsion, toe-walking, autism severity score, and age. In total, 79 consecutive children with autism were examined to determine their hip rotations, thigh-foot angle, degree of toe-walking, and autism severity. Femoral and tibial torsion values, of the preschool patients, were compared statistically with age-matched controls. The hip rotation profile of the patients was similar to the normal group...
April 24, 2018: Journal of Pediatric Orthopedics. Part B
Hassan Ghandhari, Ebrahim Ameri, Mir Bahram Safari, Habib Kheirabadi, Hadi S Asl, Manijeh Zarghampour, Razieh Behzadmehr, Daniel F Fouladi
The relationship between curve correction and spinal length gain in adolescent idiopathic scoliosis was examined. A total of 102 patients who underwent posterior spinal correction and fusion alone or in combination with anterior spinal correction and fusion (ASF) were studied. The Cobb angle correction, increase in the main thoracic length, T1-L5 spinal length gain, and T1-L5 spinal length gain/Cobb angle correction were reported. The length gain/Cobb angle correction value was not significantly associated with sex, fusion approach, and the number of fused levels...
April 24, 2018: Journal of Pediatric Orthopedics. Part B
Blaž Mavčič, Vinay Saraph, Magdalena M Gilg, Marko Bergovec, Janez Brecelj, Andreas Leithner
Treatment of unicameral bone cysts (UBC) in the humerus with drainage screws is scarcely reported in the literature. The aim of this retrospective study was to compare drainage screws and alternative treatment methods with respect to the number of required surgical procedures to achieve sufficient UBC healing, postoperative fractures/recurrences/complications, and radiological outcome. Medical archives of two tertiary orthopedic referral centers were screened for all patients who were treated surgically for humeral UBC in the period 1991-2015 with a histologically/cytologically confirmed diagnosis...
April 23, 2018: Journal of Pediatric Orthopedics. Part B
Pietro Persiani, Lorena Martini, Filippo Maria Ranaldi, Anna Zambrano, Mauro Celli, Ciro Villani, Patrizia D'Eufemia
No abstract text is available yet for this article.
July 2018: Journal of Pediatric Orthopedics. Part B
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