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Journal of Pediatric Orthopedics. Part B

Sherif Galal
: Developmental coxa vara (DCV) develops during early childhood between the age of independent walking and 6 years. The deformity includes a decrease in the neck-shaft angle and femoral retroversion. Recently, good results have been reported using external fixator systems for the correction of proximal femoral deformities secondary to slipped capital femoral epiphysis, Perthes' disease in children, and percutaneous proximal femoral osteotomy for coxa vara. This preliminary study was performed to evaluate the results of percutaneous subtrochanteric osteotomy in restoring the normal alignment and orientation (radiographic outcome), thereby restoring the normal mechanics of the hip joint, overcoming shortening of the limb, and re-establishing the length-tension relationship of the abductor muscles (functional outcome)...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
Yann Philippe Charles, Amélie Marcoul, Mickaël Schaeffer, Federico Canavese, Alain Diméglio
We aimed to measure thoracic dimensions and volume in relation to growth and verify the influence of scoliosis on thoracic growth. A reference group of 294 healthy volunteers was compared with a group of 557 patients with idiopathic scoliosis ranging in age from 3 to 25 years. The optical ORTEN system for trunk surface data acquisition was used to calculate thoracic volume, perimeter, anterior-posterior and transversal diameters, T1-T12 length, and sternal length. There was no significant difference in thoracic dimensions and volume between scoliosis and reference groups in either girls or boys...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
Hamlet A Peterson, William J Shaughnessy, Anthony A Stans
Premature partial physeal arrest without the formation of an osseous bar - physeal bar equivalent (PBE) - is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity...
September 29, 2016: Journal of Pediatric Orthopedics. Part B
Juha-Jaakko Sinikumpu, Niina Salokorpi, Heikki Rantala, Willy Serlo
Supracondylar humerus fractures are associated with neurological complications. This report describes a child who suffered from persistent myoclonus-like movements of the elbow and wrist as a consequence of a previous displaced fracture. Symptoms were progressive. Seven years later, sensation was decreased in the ulnar nerve distribution. Palpation of the ulnar nerve exacerbated the myoclonic jerks. As symptoms progressed, electoneuromyography became abnormal. Cubital tunnel release and anterior transposition of the ulnar nerve were required to reach full recovery...
September 20, 2016: Journal of Pediatric Orthopedics. Part B
Hao Yin, Zhang Huang, Zhengjun Pan
An anterior-superior iliac spine avulsion fracture is an uncommon injury in adolescent athletes and simultaneous bilateral avulsion fracture is fairly rare. The authors report cases of traumatic avulsion fractures of anterior-superior iliac spine after sports activity in teenagers. Open reduction and cannulate screws fixation resulted in an excellent functional outcome for this relatively uncommon fracture. The authors also stress the importance of careful clinical examination and recommend open reduction and internal fixation for patients requiring rapid rehabilitation...
September 17, 2016: Journal of Pediatric Orthopedics. Part B
Erika Marquez, Verity Pacey, Alison Chivers, Paul Gibbons, Kelly Gray
This study quantifies the change in passive ankle range of motion following modified Ponseti casting in children with relapsed idiopathic clubfoot. Fifty-three cases (feet) were retrospectively reviewed, with 6-month follow-up data available for 72% of participants. The median improvement in dorsiflexion was 15° (95% confidence interval: 12.5°-17.5°, P≤0.05), with 85% achieving dorsiflexion≥10°. At the 6-month follow-up, dorsiflexion remained significantly improved and 12 feet (32%) presented with subsequent relapse...
September 17, 2016: Journal of Pediatric Orthopedics. Part B
Matthew B Dobbs, Steven L Frick, Vincent S Mosca, Ellen Raney, Harold J VanBosse, Joel A Lerman, Vishwas R Talwalkar, Karen Steger-May, Christina A Gurnett
The aim of this study was to describe the design and baseline characteristics of participants enrolled in the prospective randomized-controlled Clubfoot Foot Abduction Brace Length of Treatment Study (FAB24). Foot abduction bracing is currently the standard of care for preventing clubfoot relapse. Current recommendations include full-time bracing for the first 3 months and then 8-12 h a day for 4 years; however, the optimal length of bracing is not known. The FAB24 trial is a clinical randomized study to determine the effectiveness of 2- versus 4-year foot abduction bracing...
September 14, 2016: Journal of Pediatric Orthopedics. Part B
Artur Oberc, Jerzy Sułko
The aim of the paper is to present the case of a 3-year-old boy with an unaligned fracture of the sacroiliac joint region to propose a minimally invasive method of fracture fixation without using metal implants and to review the literature addressing this injury, which is uncommon in children. The patient was hit by a car; he suffered a fracture of the iliac ala with a complete traumatic damage to the L4-L5 nerve roots. The fracture was fixated by osteosuture and normal bone fusion was achieved. The follow-up period was 4 years...
September 8, 2016: Journal of Pediatric Orthopedics. Part B
Hideki Ueyama, Toshio Kitano, Keisuke Nakagawa, Masanari Aono
Focal periphyseal edema (FOPE) zones were first described in 2011. The aim of this report was to investigate the clinical course of patients with FOPE zones. Three adolescent patients with a FOPE zone in the knee were treated and observed for a maximum of 2 years. No symptoms or leg-length discrepancy developed at the final follow-up after conservative therapies. This is the first report on the follow-up of FOPE zones with a maximum of 2 years. The results suggest that observation of FOPE zones may be sufficient without invasive examinations and treatment...
September 7, 2016: Journal of Pediatric Orthopedics. Part B
Albane B Maggio, Xavier E Martin, Dimitri Ceroni
: Physical inactivity, which may result from immobilization, is recognized as a risk factor for the development of obesity. We aimed to quantify the decrease in activity-related energy expenditure (AEE) because of lower limb cast immobilization. We carried out a longitudinal matched case-control study: 34 adolescents with a first episode of lower limb fracture and 34 healthy cases. Physical activity was assessed during cast immobilization by an accelerometer from which we calculated the decrease in AEE...
September 7, 2016: Journal of Pediatric Orthopedics. Part B
Kathleen J Maguire, Norman Y Otsuka
: Shoulder dislocation is relatively uncommon in the younger pediatric population. Because of the relative strength of the surrounding soft tissue structures of the shoulder compared with the proximal humeral physis, subluxation or dislocation resulting from a traumatic event or application of force is rare and instead a proximal humeral physeal injury occurs. Case presentation - We present a 5-year-old male who presented to the office with post-traumatic left shoulder pain for about 1 week...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Joshua S Acree, John Schlechter, Scott Buzin
The aim of this study is to compare splint versus cast immobilization for maintaining alignment following closed reduction of distal 1/3 radius and both-bone forearm fractures. We performed a retrospective review of patient records between 5 and 14 years old with a distal 1/3 radius or radius and ulna fracture requiring reduction. A cost comparison was also performed using facility costs for materials. Reduction was maintained with acceptable alignment in most cases (94%). Although a sugar-tong splint slightly maintained fracture alignment better, this was not significant...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Ze-Qing Huang, Xiao-Hui Zheng, Xiang Yu, Chong-Zhi Ou-Yang
: The radiocapitellar line (RCL) has long been used for the radiographic evaluation of elbow injuries in children. However, the utility of the RCL remains limited because the RCL does not always intersect the ossified capitellum centrically. To explore the eccentric rule of the RCL in young children, this study sought to evaluate how the RCL eccentric distance (ED) relative to the center point of the ossific capitellum changes with age. In 1022 children with normal elbows, aged between 1 and 10 years, the RCLs were drawn along the radial neck on the elbow anteroposterior (AP) and lateral radiographs by two orthopedic surgeons blinded to the study...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Jaclyn F Hill, Benton E Heyworth, Anneliese Lierhaus, Mininder S Kocher, Susan T Mahan
In this descriptive analysis of pediatric Lisfranc injuries, records of 56 children treated for bony or ligamentous Lisfranc injuries over a 12-year period were reviewed. Overall, 51% of fractures and 82% of sprains were sports-related (P=0.03). A total of 34% of the cohort underwent open reduction internal fixation, which was more common among patients with closed physes (67%). Full weight bearing was allowed in open reduction internal fixation patients at a mean of 14.5 weeks, compared to 6.5 weeks in the nonoperative group...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Rikuo Shinomiya, Toru Sunagawa, Yuko Nakashima, Akihiro Nakabayashi, Manami Makitsubo, Nobuo Adachi
Popliteal artery injury is most commonly associated with high-energy trauma, which is easily diagnosed upon initial physical examination. However, in some situations, the diagnosis of arterial injury is delayed because of slow progression of arterial insufficiency, which may lead to limb amputation. We report a rare case of popliteal arterial occlusion with the presence of arterial pulses during initial assessment, resulting from a neglected proximal tibial physis fracture. This case shows that even in the presence of foot pulses, the surgeon must consider the possibility of a popliteal artery damage whenever trauma is seen near the knee joint...
August 19, 2016: Journal of Pediatric Orthopedics. Part B
Oussama Abousamra, Maria Del Pilar Duque Orozco, Mehmet S Er, Kenneth J Rogers, Julieanne P Sees, Freeman Miller
: This study reports the recent experience in the management of scoliosis in Down's syndrome. Curve patterns, progression in brace, and surgical outcomes were recorded. Cardiac surgery history was compared between children with and without scoliosis. Out of 581 children with Down's syndrome, 62 children had scoliosis. The mean age of the children was 13.8 years. The mean magnitude was 31°. Bracing was successful in five of seven patients. Ten children had posterior spinal fusion with follow-up of 2...
August 19, 2016: Journal of Pediatric Orthopedics. Part B
Roger D M Walton, Neal M Ormsby, Steven D Brookes-Fazakerley, Shambavi Manohar, Trupesh Patel, David M Wright, Alf A Bass, Colin E Bruce
Paediatric Monteggia-type injuries are complicated by treatment failure and posterior interosseous nerve palsy, without reliable predictive indicators. Outcome is considered to be good, with little patient-reported evidence. We propose novel radiographic parameters. A total of 33 Monteggia-type injuries were analysed. Posterior interosseous nerve palsy was strongly predicted by the Radial Head Displacement Index. The presence of two or more of three novel instability markers was associated strongly with treatment failure...
August 10, 2016: Journal of Pediatric Orthopedics. Part B
Bart Kowalczyk, Krzysztof Miklaszewski, Jarosław Feluś
Intercalary biologic reconstructions using allogenic bone grafts remain a useful option in orthopedic oncology; however, these reconstructions are prone to fractures, and treatment is usually required involving surgical interventions. Biologic activity of the implanted allografts remains minimal, but in some cases, spontaneous healing of the graft may occur. We present a report and discussion on two fractures and corrective osteotomy within the implanted allograft that healed with abundant callus without the need for additional surgery...
August 8, 2016: Journal of Pediatric Orthopedics. Part B
Laura Pino-Almero, Maria Fe Mínguez-Rey, Daniel Rodríguez-Martínez, Rosa M Cibrián-Ortiz de Anda, Maria Rosario Salvador-Palmer, Salvador Sentamans-Segarra
We present the results of the clinical validity in the screening of idiopathic scoliosis with a nonharming method of back surface topography by means of structured light projection. A total of 155 patients were evaluated (mean age 13.3 years). They were divided into two groups: pathologic patients (scoliosis) and nonpathologic patients (control and asymmetries). An analytical case-control study was carried out. Our topographic method obtained 92% sensitivity and 74% specificity as a screening test in identifying patients with scoliosis (P=0...
August 8, 2016: Journal of Pediatric Orthopedics. Part B
Yen-Chun Chen, Hsin-Chiao Wen, Yen-Chun Chen, Ta-Sen Wei, Kuan-Lin Chen
Bacille Calmette-Guérin (BCG) osteomyelitis is a rare complication after vaccination. This article reports on a 1-year-old immunocompetent boy with recurrent BCG osteomyelitis involving the distal tibia who presented with a limping gait from the beginning of toddling. The lesion was located in the metaphysis and crossed the growth plate to the epiphysis, causing concern for ambulation. After surgery, he was initiated on an individualized, intense rehabilitation program and achieved a good functional recovery...
August 8, 2016: Journal of Pediatric Orthopedics. Part B
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