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Journal of Pediatric Orthopedics. Part B

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https://www.readbyqxmd.com/read/28383327/surgical-approach-for-elastic-stable-intramedullary-nail-in-pediatric-radius-shaft-fracture-a-systematic-review
#1
Sandra L Nørgaard, Sara S Riber, Frederik B Danielsson, Niels W Pedersen, Bjarke Viberg
When using elastic stable intramedullary nailing in children's distal radius shaft fractures, the surgical approach can either be lateral or dorsal. The aim of this article was to carry out a systematic review of the literature comparing the two types of approaches in terms of complications. An electronic search of databases was performed. Titles of articles were screened, and abstracts and full text were read. Data were extracted in terms of demographics and complications. The dorsal approach had a 2.6% rate of extensor pollicis longus tendon rupture, whereas the lateral approach had a 2...
April 5, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28379910/the-effect-of-persistent-toe-walking-on-the-skeletal-development-of-the-pediatric-foot-and-ankle
#2
Mark R Sinclair, Allison A Lind, Joshua Q Knowlton
The aim of this study was to determine whether persistent idiopathic toe walking leads to compensatory skeletal changes in the pediatric foot and ankle. Foot radiographs of children diagnosed with idiopathic toe walking and sex-matched and age-matched controls were retrospectively reviewed. Five blinded providers assessed the foot radiographs for skeletal changes to the ankle. The relationship between each measure and toe-walking status was examined. Providers observed radiographic evidence of skeletal changes of the talus in idiopathic toe walkers compared with controls, suggesting that persistent toe walking impacts the skeletal development of the talus...
April 4, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28379909/the-effect-of-continuous-intrathecal-baclofen-therapy-on-ambulatory-children-with-cerebral-palsy
#3
Blazej Pruszczynski, Julieanne Sees, Robert Hulbert, Chris Church, John Henley, Tim Niiler, Freeman Miller
The effect of a continuous intrathecal infusion of baclofen (CITB) was retrospectively studied in 19 ambulatory children with cerebral palsy (aged 12.4±4.9 years at CITB initiation). The mean clinical follow-up was 5.1±2.4 years and the mean follow-up gait analysis was 2.8±1.9 years. Spastic cerebral palsy diagnosis [14 (74%)] was most frequent. Most patients [11 (58%)] were Gross Motor Function Classification System level III. CITB significantly improved muscle tone and knee flexion at initial contact (P<0...
April 4, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28379908/effects-of-long-term-high-load-exercise-on-the-anatomy-of-the-hip-joints-a-preliminary-report
#4
Yawei Song, Xiyuan Zhang, Ke Rong
The aim of this study was to assess the impact of different sports on hip joint anatomic parameters in athletes. This was a cross-sectional study of eight male trampolinists, eight male weightlifters, and eight male volunteers enrolled in July 2014. Hip joint anatomic parameters were measured from plain radiographs taken at the level of the lesser trochanter center. Data were compared between groups using the χ-test or one-way analysis of variance with the Bonferroni post-hoc test. There were no significant differences among groups in age, height, or weight...
April 4, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28368931/vitamin-d-and-tibiofemoral-joint-orientation-angles-in-children
#5
Nedal Alkhatib, Fadi Bouri, Abdelsalam Hegazy, Talal Ibrahim
Vitamin D is an important component in musculoskeletal development and function in children. The aim of our study was to investigate vitamin D levels and tibiofemoral joint orientation angles in children. We performed a retrospective review on a consecutive series of children presenting with lower limb complaints. The children underwent an assessment of serum vitamin D level and full-length standing lower limb anteroposterior radiographs, and were divided into normal and deficient vitamin D groups. Tibiofemoral angles (TFAs) [lateral distal femoral angle (LDFA); medial proximal tibial angle (MPTA)] were measured by three independent observers and compared between the groups...
March 31, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28368930/managing-large-bone-defects-in-children-a-systematic-review-of-the-induced-membrane-technique
#6
Ilaria Morelli, Lorenzo Drago, David A George, Delia Romanò, Carlo L Romanò
Thirty years after its description by Masquelet in 1986, this is the first systematic review aiming to critically evaluate the 'induced membrane technique' effectiveness in achieving bone union in children. Only six papers fulfilled our inclusion criteria (54 patients). The relatively small number of reported cases did not allow a formal meta-analysis. The tibia was the most involved bone. Most frequent aetiologies were congenital pseudoarthrosis and tumour resections. Although effective in achieving bone healing in ∼91% of the patients (bone defects ≤24 cm long), the induced membrane technique was associated with a high rate of complications (54% of patients)...
March 31, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28368929/outcomes-after-arthroscopic-fixation-of-tibial-eminence-fractures-with-bioabsorbable-nails-in-skeletally-immature-patients
#7
Amit M Momaya, Connor Read, Megan Steirer, Reed Estes
The aim of this paper is to report the outcomes and any complications with arthroscopic bioabsorbable nail fixation of tibial eminence fractures in skeletally immature patients. We retrospectively reviewed all surgically treated tibial eminence fractures treated by a single surgeon and seven patients were identified with a minimum 2-year follow-up. Mean deficits of flexion and extension were minimal. Satisfactory Tegner levels, Lysholm knee scores, and International Knee Documentation Committee subjective scores were reported...
March 31, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28368928/bilateral-avascular-necrosis-of-the-femoral-head-following-asynchronous-postictal-femoral-neck-fractures-a-case-report-and-review-of-the-literature
#8
K Venkatadass, M Avinash, S Rajasekaran
Bilateral avascular necrosis (AVN) following postictal bilateral fracture neck of the femur is a rare occurrence. Here, we report a case of bilateral AVN of the femoral head following an asynchronous bilateral postictal fracture neck of the femur. A 16-year-old autistic boy presented with left hip pain following an episode of seizures and radiographs showed Delbet type II fracture neck of the left femur. This was treated by closed reduction and cancellous screw fixation and skeletal traction for 6 weeks. At 3 months, follow-up radiograph showed union of the fracture, but he had developed segmental AVN with collapse of the head...
March 31, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28362677/medial-approach-open-reduction-with-ligamentum-teres-partial-excision-and-plication-for-the-management-of-congenital-hip-dislocation
#9
Ahmed O Youssef
Because of the known tendency for early redislocation following open reduction, we developed surgical methods for shortening the ligamentum teres to improve immediate postoperative stability when performing medial approach open reduction (MAOR) for the management of developmental dysplasia of the hip. Between 2004 and 2014, 32 patients with dysplasia of the hip were managed by MAOR with partial excision and plication of ligamentum teres. The patients were followed up for an average of 6.9 years. At the final follow-up, clinical outcomes achieved were categorized as excellent and good in 39 (39/40; 97...
March 30, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28328741/sagittal-plane-parameters-in-growing-rod-patients-following-final-fusion
#10
Robert F Murphy, John B Emans, Michael Troy, Patricia E Miller, Michael T Hresko, Lawrence I Karlin, Daniel J Hedequist, Michael P Glotzbecker
Almost half of growing rod (GR) patients that undergo final fusion (FF) have an extension of instrumented levels. The purpose of this study was to review sagittal plane radiographic parameters of patients with distal extension of instrumented levels at FF to those whose levels remained the same. Radiographs were assessed preoperatively, after GR insertion/first lengthening, following GR treatment before FFs, and after FF. Measurements included sagittal balance, lumbar lordosis, thoracic kyphosis, and distal junction angle (DJA)...
March 23, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28328742/treatment-of-proximal-humerus-fractures-in-children-with-a-modified-palm-tree-technique
#11
Ayman M Ali, Sallam I Fawzy, Medhat Moaty, Mohamed Abelaziz
Although most pediatric proximal humeral fractures can be successfully treated conservatively with satisfactory results, many operative techniques have been described for the treatment of displaced proximal humeral fractures. The aim of this study is to evaluate the efficacy of percutaneous fixation using a modified palm tree technique for proximal humerus fractures in children. Between March 2011 and May 2013, the modified palm tree technique was used for the management of 30 children (20 boys and 10 girls) with displaced proximal humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28328740/comparison-of-the-lateral-and-posterior-approaches-in-the-treatment-of-pediatric-supracondylar-humeral-fractures
#12
Gökçer Uzer, Fatih Yildiz, Mehmet Elmadağ, Kerem Bilsel, Tunay Erden, Anil Pulatkan, Derya Çelik, Volkan Gürkan
This study explored the radiological, functional, and cosmetic results of treatment of supracondylar humeral fractures with open reduction and percutaneous pinning, comparing posterior triceps V-splitting (group I, n=22) and lateral (group II, n=25) approaches. The time to union, the functional and cosmetic results, and the flexor and extensor muscle strengths were measured and compared with the contralateral extremities. There were no statistical differences between the groups. The V-splitting posterior approach is as safe and effective as the lateral approach in the surgical treatment of pediatric supracondylar humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28306622/treatment-of-forearm-deformity-with-radial-head-dislocation-because-of-multiple-osteochondromas-a-series-of-three-cases-treated-by-simple-axis-correction-and-distraction-osteogenesis-of-the-ulna
#13
Kousuke Iba, Megumi Hanaka, Yasuhiro Ozasa, Nobuyuki Takahashi, Kohei Kanaya, Toshihiko Yamashita
Radial head dislocation in multiple osteochondroma leads to functional impairment and cosmetic problems, and surgical intervention has not been successful to date, with high rates of redislocation. Simple correction of the longitudinal axis and distraction oste8ogenesis of the ulna without corrective osteotomy of the radius were performed within 1 year of radial head dislocation. The mean age of the patients was 7.2 years and the postoperative follow-up duration was 63.6 months. In all cases, the dislocated radial head was repositioned without surgical invention involving the radius...
March 16, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28296659/modified-ponseti-technique-for-management-of-neglected-clubfeet
#14
Anil Mehtani, Jatin Prakash, Vipul Vijay, Nishikant Kumar, Abhinav Sinha
Achieving adequate dorsiflexion in neglected clubfoot cases remains challenging. On a close observation of the Ponseti method, we have now made certain modifications from the standard Ponseti protocol. This has helped us improve functional results, as well as reduce the number of casts in this walking-age group. From March 2011 onward, we managed 62 neglected clubfeet in 41 patients with the modified protocol. All these patients were treated with serial weekly above-knee casts. The feet were assessed by Dimeglio and Pirani scorings, which were done every week...
March 14, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28291024/pavlik-harness-treatment-for-pathological-developmental-dysplasia-of-the-hip-meeting-the-standard
#15
Qaisar Choudry, Robin W Paton
In the UK, the Pavlik harness is generally the accepted treatment technique for the treatment of neonatal and infant pathological developmental dysplasia of the hip. In 2013, the success rate of the Pavlik harness became an outcome measure from the British Society of Children's Orthopaedic Surgery for appraisal and revalidation with the GMC for paediatric orthopaedic surgery. The standard set requires an 80% success rate, with less than 20% requiring surgery. This study evaluated the outcomes of Pavlik harness treatment in neonates/infants with 'pathological hips' diagnosed by ultrasound imaging in a district general hospital setting...
March 13, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28277417/comparison-of-healing-intra-articular-fracture-of-distal-femur-using-a-kirschner-wire-and-autologous-fibrin-glue-in-an-animal-model
#16
Mohammad R Azarpira, Kasra Vazani, Maryam Ayatollahi, Negar Azarpira, Maryam Kaviani
Considering different surgical techniques for the fixation of osteochondral intra-articular fracture, the present study aimed to compare the efficacy of autologous fibrin glue and Kirschner wire (KW) on an osteochondral fracture in the left lateral condyle of Dutch rabbits with a control group. After 6 weeks, macroscopic and microscopic evaluation showed that autologous fibrin glue is easier and faster with a higher number of bone trabecula (P<0.05), whereas the healing rate and cellularity of the healing site were not different between the two groups (KW and glue)...
March 8, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28277416/incidence-and-risk-factors-of-hardware-related-complications-after-proximal-femoral-osteotomy-in-children-and-adolescents
#17
Myung Ki Chung, Soon-Sun Kwon, Byung Chae Cho, Gye Wang Lee, Jaeyoung Kim, Seung Jun Moon, Jae Woo Lee, Chin Youb Chung, Ki Hyuk Sung, Kyoung Min Lee, Moon Seok Park
Proximal femoral osteotomy has been used in cerebral palsy, Perthes disease, hip dysplasia, idiopathic femoral anteversion, and various hip diseases in children and adolescents. Conventionally, a blade plate (BP) has been used. However, the pediatric locking compression plate (LCP) has recently been applied widely. We compared the hardware-related complications of the BP and the LCP as well as the factors influencing these complications in patients who have undergone a proximal femoral osteotomy in children and adolescents...
March 8, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28263247/return-to-sport-activities-after-subtalar-arthroereisis-for-correction-of-pediatric-flexible-flatfoot
#18
Nicolò Martinelli, Alberto Bianchi, Polina Martinkevich, Elena Sartorelli, Giovanni Romeo, Carlo Bonifacini, Francesco Malerba
The aim of this study was to establish whether children treated with subtalar arthroereisis for flexible flatfoot were able to return to sport activities. We reviewed 49 patients with a mean age at the time of surgery of 10.7 years. The type of sport activities, the number of sessions per week, the time dedicated to each session, and the level achieved were assessed preoperatively and at the last follow-up. Overall, 45 patients returned to sports after surgery. Surgery did not alter the duration, frequency, and type of sporting activities, but the participation in physical activities as well as the emotional status and footwear issues improved...
March 3, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28252480/delayed-treatment-of-a-neonatal-type-i-monteggia-fracture-dislocation-a-case-report
#19
William R Smith, Scott H Kozin, Dan A Zlotolow
Delayed diagnosis of a Monteggia fracture-dislocation changes a straightforward, treatable injury into a complex problem. Acute neonatal injuries may be missed because of the inability to visualize the unossified skeleton on radiography, interpreted later as 'congenital' dislocations. We report the case of a 14-month-old with a neonatal Monteggia type-I fracture-dislocation secondary to birth trauma, with anterior radial head dislocation and plastic deformation of the ulna. Uniplanar external fixation was used to restore ulnar length and correct angulation, with subsequent radiocapitellar joint closed reduction...
March 1, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28244886/solitary-osteochondroma-of-the-sinus-tarsi
#20
Antonio Andreacchio, Lorenza Marengo, Federico Canavese
Tumors are a rare cause of ankle-region pain. Osteochondroma is one of the most common benign bone tumors, but is rarely localized to the foot bones. Here, we describe a case of a solitary osteochondroma of the sinus tarsi presenting in an 8-year-old boy with a history of recurrent ankle sprains and limited range-of-motion of the subtalar joint. Treatment was surgical excision of the tumor, and the patient is now symptom free. Clinical presentation, treatment, pathoanatomy, localization, and complication of this benign form of tumor are discussed and all previously reported cases are reviewed to provide a more comprehensive picture of osteochondroma of talus...
February 27, 2017: Journal of Pediatric Orthopedics. Part B
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