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Journal of Pediatric Orthopedics. Part B

Yu-Cheng Lai, Huey-Shyan Lin, Hui-Fen Pan, Wei-Ning Chang, Chien-Jen Hsu, Jenn-Huei Renn, Tsu-Jen Kuo
The aim of this study was to clarify the effects of general anesthesia (GA) on joint range of motion (ROM) in children with spastic cerebral palsy (SCP). Eighty-four SCP cases (mean age 8.4 years) admitted for first corrective surgery were retrospectively reviewed. Lower limb ROM were measured 1 day before operation and immediately after GA. Contracture of hip, knee, and ankle joints decreased significantly after GA, with +11.1° (39.5%) for the hip abduction angle, -3.7° (18.0%) for the Thomas test, -15.0° (19...
November 1, 2018: Journal of Pediatric Orthopedics. Part B
Rajan R Murgai, Nina Lightdale-Miric
Pediatric trigger thumb is a common reason for toddlers to present to a pediatric orthopaedic surgeon. There is controversy over the precise etiology and optimal treatment method. Current accepted diagnostic and treatment algorithms in children have not varied based on etiology. This report describes the clinical presentation and care of a 3-year-old child with pediatric trigger thumb and surgical findings of a large flexor tendon sheath ganglion at the level of the annular pulley with no apparent nodule within the FPL...
November 1, 2018: Journal of Pediatric Orthopedics. Part B
Yasmin D Hailer, Eva Penno
It is unclear how patient-reported outcome in patients with Legg-Calvé-Perthes disease (LCPD) is correlated with radiographic outcome. It was therefore the aim of our long-term follow-up to evaluate the agreement of patient-reported outcome measures (PROM) with radiographic outcome in patients with a history of unilateral LCPD and a femoral head involvement of more than 50%. We further investigated to what extent the functional outcome (range of motion and Trendelenburg sign) correlates with PROM and radiographic outcome...
October 16, 2018: Journal of Pediatric Orthopedics. Part B
Priscella Chan, Angela Hsu, Jenna Godfrey, Selina S Silva, Rachel Y Goldstein, Deirdre Ryan, Paul D Choi, Robert M Kay
This study compared the outcomes of four salvage procedures in treating painful dislocated hips in patients with cerebral palsy: Schanz osteotomy, Girdlestone, Castle, and McHale procedures. A retrospective review of cerebral palsy patients treated between 1990 and 2014 with minimum 6-month follow-up was carried out. Of 69 hips (62 patients), there were 36 McHales, 24 Castles, four Girdlestones, and five Schanz procedures at a mean age of 13.9 years. All four procedures provided pain relief. Proximal femoral migration was similar following the procedures, but heterotopic ossification was more common after the Castle procedure...
October 15, 2018: Journal of Pediatric Orthopedics. Part B
Avi Shah, Rujuta Mehta, Alaric Aroojis
The Ponseti method is well-established for the treatment of clubfoot in younger babies; however, its effectiveness in older children is still unclear. The aim of our study was to report our results of the 'traditional' Ponseti method in the management of clubfoot in children of walking age. A total of 56 (81 clubfeet) children with a mean age of 3.16±2.35 years (1-10 years) were divided into two groups: group I consisted of 12 (18 clubfeet) patients with a mean age of 3.36±2.7 years (range: 1-8.4 years) who presented with an untreated clubfoot whereas group II consisted of 44 (63 clubfeet) patients with a mean age of 3...
October 11, 2018: Journal of Pediatric Orthopedics. Part B
Manaf H Younis, Karim Mahmoud, Alaa Kawas, Talal Ibrahim
The purpose of our study was to evaluate the effectiveness of treating paediatric femoral shaft fractures by early (<48 h) versus late (>48 h) hip spica casting. A retrospective review of 44 patients with 44 femoral shaft fractures treated by either early or late hip spica application with at least 9-month follow-up was undertaken. Both groups were treated on an inpatient basis. The late hip spica group had skin traction applied before the application of a hip spica. The outcome measures involved both clinical [Pediatric Outcomes Questionnaire (POQ) and Activities Scale for Kids] and radiological outcomes...
October 11, 2018: Journal of Pediatric Orthopedics. Part B
Alba Mohedano, Ana Castillo, Julio de Pablos, Carlos Barrios
This study aimed to assess the scientific production of bone lengthening research by identifying the most-cited papers. All articles including the term 'bone lengthening' published between 2001 and 2017 were retrieved through the Web of Science database. The 100 most-cited articles on bone lengthening included a total of 4244 citations, with 414 (9.7%) citations in 2017. There was an average of 249.6 citations per year. The articles predominantly addressed biomechanics and bone formation (38). Different surgical techniques, including intramedullary nail (14), Ilizarov (nine), intramedullary skeletal kinetic distractor (ISKD) (six), Taylor spatial frame (6), the PRECICE device (three), and lengthening and submuscular locking plate (three), were the second most-studied topic...
October 11, 2018: Journal of Pediatric Orthopedics. Part B
Yong Huang, Ganjun Feng, Limin Liu, Xi Yang, Yueming Song, Chunguang Zhou, Lei Wang, Zhongjie Zhou
The treatment of congenital hemivertebrae in the upper thoracic region is challenging. The objective of this study was to investigate the outcomes of posterior hemivertebral resection for the upper thoracic region. Twenty-one patients diagnosed with upper thoracic congenital scoliosis were included. All of them received hemivertebral resection surgery via the posterior-only approach with at least 2 years of follow-up. The radiographic parameters and Scoliosis Research Society-22 score were analyzed. All the intraoperative and postoperative complications were recorded retrospectively...
October 10, 2018: Journal of Pediatric Orthopedics. Part B
Vidyasagar Chandankere, Praharsha Mulpur, Venkateshwar Reddy Maryada, Sudhakar R Pendyala, Guravareddy V Annapareddy
We present a rare case of a previously healthy 16-year-old boy who sustained simultaneous bilateral femoral neck fractures after a single first-time seizure episode. He was diagnosed to have severe vitamin D deficiency and secondary hyperparathyroidism. Symptomatic hypocalcemia was the cause of seizures. Both fractures were treated surgically and united at 3 months. Bilateral femoral neck fractures after seizures are very rare, especially in children. Severe vitamin D deficiency may cause seizures and also weakening of bone, predisposing to fractures without significant trauma...
October 10, 2018: Journal of Pediatric Orthopedics. Part B
Robert F Murphy, Mark A Pacult, William R Barfield, Richard H Gross, James F Mooney
Limited reports exist with regard to clinical and radiographic details of patients with early-onset spinal deformity (EOSD) undergoing definitive instrumented final fusion (FF) following implantation of a growing construct. Charts and radiographs were queried for all patients who underwent FF after management of EOSD with a distraction-based posterior construct at a single institution from 2006 to 2017. Patients managed during the growth modulation period with either proximal rib or spinal fixation were included...
October 8, 2018: Journal of Pediatric Orthopedics. Part B
Hamzah Najid, Abdul Halim Abdul Rashid, Sharaf Ibrahim
Traumatic elbow dislocation in a child is rare, and it is usually associated with fractures. Simultaneous proximal radioulnar joint (PRUJ) translocation with ulnar nerve palsy is even rarer. We report an unusual case of a missed PRUJ translocation with ulnar nerve entrapment in a 10-year-old child. The key to diagnosing the translocation is the position of the proximal radius, which lies medial to the ulna. This was treated by open reduction and release of the entrapped nerve. The ulnar nerve palsy recovered fully at the 1-year follow-up...
October 3, 2018: Journal of Pediatric Orthopedics. Part B
Juanita J Wallace, Hank D White, Samuel F Augsburger, Vishwas R Talwalkar, Ryan D Muchow, Henry J Iwinski, Janet L Walker
Using age and height matched cohorts with unilateral idiopathic clubfeet (n=40 each), we retrospectively reviewed pedobarographic studies to determine the impact of treatment, Ponseti versus comprehensive surgical releases (CSR), on the foot length, width, and contact area. The foot pressures were determined by self-selected walking across a force plate. Ponseti treatment results in more symmetrical foot lengths, widths, and total contact areas with an improvement of 1.3 shoe sizes difference compared with treatment with CSR...
September 26, 2018: Journal of Pediatric Orthopedics. Part B
Matthew R Boylan, Aldo M Riesgo, Alice Chu, Carl B Paulino, David S Feldman
Accelerated discharge protocols for scoliosis surgery have recently been described in the literature. There are limited data describing the association of length of stay (LOS) during the index admission with postoperative outcomes. We sought to define the economic and clinical implications of an additional 1 day in the hospital for scoliosis surgery. The Statewide Planning and Research Cooperative System database was used to identify patients with adolescent idiopathic scoliosis who underwent spinal fusion from 1 October 2007 to 30 September 2012 at high-volume institutions (>20 cases/year) in the state of New York...
September 25, 2018: Journal of Pediatric Orthopedics. Part B
Veerappa N Radhakrishna, Vrisha Madhuri, Thomas Palocaren
We describe a technique for optimal use of fibula in reconstruction of type II tibial hemimelia. Six affected children with mean age of 1.4 years and treated over a 5-year period were reviewed. All underwent staged reconstruction by lowering the fibula to below knee level using Ilizarov soft tissue distraction, transfer of distal fibula under proximal tibia, and foot centralization. Mean follow-up period was 3.6 years (range: 1.6-6.05 years). Mean age at follow-up was 4.4 years, and increase in length was 4...
September 25, 2018: Journal of Pediatric Orthopedics. Part B
Cathleen J O'Neill, Stephen A Brennan, Cian Quinn, Dermot Brabazon, Patrick J Kiely
The aim of this study was to develop a new type of preoperative flexibility test for adolescent idiopathic scoliosis. The objective was to develop a test that was standardized and allow for the measurement of in-vivo forces required for curve correction. It was undertaken to compare the results of this new test with side-bending radiographs. Various preoperative radiographic techniques have been used to assess flexibility in patients awaiting scoliosis correction surgery. The major limitation of these investigations is a lack of standardization...
September 24, 2018: Journal of Pediatric Orthopedics. Part B
Neil R Rajdev, Shital N Parikh
Trochlear dysplasia is a major risk factor for patellar instability. It has been sparsely reported that the trochlea can remodel when patellar stabilization is performed in skeletally immature patients before the age of 10 years. It is not known whether trochlea can remodel significantly after the age of 10 years. The purpose of the study was to evaluate trochlear remodeling in skeletally immature patients after patellar stabilization surgery, with a focus on children older than 10 years of age. In a retrospective study, knee MRI of 21 patients who had undergone patellar stabilization surgery, were evaluated...
September 24, 2018: Journal of Pediatric Orthopedics. Part B
Cosimo Gigante, Luisella Pedrotti, Davide Guido
A total of 70 clubfeet were treated by a posterior above-knee cast (pressure points on the talus and on the first metatarsal) according to Ponseti method. At diagnosis, average Pirani score was 4.44, and mean time of treatment was 50.32 days. Overall, 27 (38.6%) clubfeet had only conservative treatment (5.29 casts) and 43 (61.4%) also had Achilles tenotomy (6.38 casts). At the end 61/70 feet (87,14%) had Pirani score 0; 10/70 feet (5,71%) had Pirani score 0,5 . The Pirani score gain/cast was β=-0.432 (P<0...
September 24, 2018: Journal of Pediatric Orthopedics. Part B
Stanley Jones, John Shepherd, Karen Robinson, Sumukh A Khandekar
To determine the rate of surgical site infection (SSI) and the factors that predispose to it in children undergoing nonspinal orthopaedic surgery. Over a 6-month period, 326 children who underwent 334 nonspinal elective orthopaedic surgical procedures were prospectively reviewed for the development of surgical site infections. A total of 14 sites became infected, with an overall infection rate of 4.19%. All the infections were superficial, and the only causative organism detected was Staphylococcus aureus. Operating times longer than 1 h and surgical wounds greater than 10 cm in length were positively associated with SSIs...
September 24, 2018: Journal of Pediatric Orthopedics. Part B
Bryce A Basques, Molly C Meadows, Jonathan N Grauer, Monica Kogan
The risk factors for increased perioperative morbidity following pediatric pelvic osteotomies are poorly understood. The purpose of this study was to characterize differences in adverse events, operative time, length of stay, and readmission following pelvic osteotomy for obese and nonobese patients. A retrospective cohort study was carried out using the National Surgical Quality Improvement Program Pediatric database to identify patients that underwent pelvic osteotomy with or without femoral osteotomy. Obesity was found to be an independent risk factor for blood transfusion (relative risk: 1...
September 18, 2018: Journal of Pediatric Orthopedics. Part B
Ali Bicimoglu, Emrah Caliskan
The objectives of this retrospective study were to evaluate long-term functional and radiological outcomes of 102 dislocated hips of 79 patients treated with the modified medial approach and to compare them with respect to both of our short-term and mid-term outcomes and also with the current literature. The mean age at operation was 11.3±4.3 months (range: 3-18 months), with a minimum follow-up of 15 years (range: 15-23 years). It was determined that 94.1% of mean hip scores were either good or excellent...
September 18, 2018: Journal of Pediatric Orthopedics. Part B
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