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Journal of Children's Orthopaedics

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https://www.readbyqxmd.com/read/27914027/the-role-of-guided-growth-as-it-relates-to-limb-lengthening
#1
REVIEW
Peter M Stevens
For decades, the classic indication for limb lengthening has been reserved for anisomelia that was expected to reach or exceed 5 cm at maturity. Epiphysiodesis was reserved for discrepancies in the 2-5 cm range. With the increasing sophistication of fixators, including rail, hexapod, and hybrid, complex deformities may be corrected simultaneously while moderate to extreme lengthening is achieved. More recently, iterations of telescoping intramedullary rods have further strengthened our armamentarium. Meanwhile, permanent epiphysiodesis techniques, both open and percutaneous, have yielded to more versatile and reversible tethering of one (angle) or both (length) sides of a physis...
December 2, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#2
REVIEW
Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909860/tibial-hemimelia-new-classification-and-reconstructive-options
#3
REVIEW
Dror Paley
Tibial hemimelia is a rare congenital lower limb deficiency presenting with a wide spectrum of associated congenital anomalies, deficiencies and duplications. Reconstructive options have been limited, and the gold standard for treatment has remained amputation with prosthetic fitting. There is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia. Armed with this knowledge, I present here a new classification to guide treatment and prognosis and then discuss new treatment strategies and techniques for limb reconstruction based on this new classification scheme...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27900541/tendon-transfer-to-unossified-bone-in-a-porcine-model-potential-implications-for-early-tibialis-anterior-tendon-transfers-in-children-with-clubfeet
#4
Matthew A Halanski, Sam Abrams, Rachel Lenhart, Ellen Leiferman, Teresa Kaiser, Emily Pierce, Rachel Rebekah Franklin, Dayton Opel, Kenneth J Noonan, Thomas D Crenshaw
PURPOSE: Tibialis anterior tendon transfers (TATT) are commonly performed in young children following Ponseti casting for clubfeet. The classic TATT involves advancing the tendon through a hole drilled in the ossified cuneiform. The aim of this study was to determine if tendons transferred through unossified bones have untoward effects on subsequent bone development. METHOD: Twenty-five piglets underwent one of five surgical procedures. An 18-gauge needle was then used to place a tunnel through the bony or cartilaginous portion of the calcaneus (through direct visualization) and isolated slips of the flexor digitorum superficialis (FDS) were placed through the tunnels, as determined by surgical procedure...
November 30, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27878660/residual-bone-growth-after-lengthening-procedures
#5
Pierre Journeau, Pierre Lascombes, Dominique Barbier, Dmitry Popkov
The prognosis of limb length discrepancy is a major subject in paediatric orthopaedic surgery. The strategy depends on the prognosis and must be adapted to each patient. The residual growth of the lengthened segment often remains unknown, but is dependent on age, the percentage of lengthening and other factors. Using a large cohort of 150 children who had undergone bone lengthening procedures, we describe five patterns of post-intervention growth and identify factors that are favourable for normal residual growth...
November 23, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27866316/epidemiology-of-developmental-dysplasia-of-the-hip-within-the-uk-refining-the-risk-factors
#6
Timothy Woodacre, Thomas Ball, Peter Cox
PURPOSE: The epidemiology and risk factors for developmental dysplasia of the hip (DDH) are still being refined. We investigated the local epidemiology of DDH in order to define incidence, identify risk factors, and refine our policy on selective ultrasound screening. METHODS: With a cohort study design, data were prospectively recorded on all live births in our region from January 1998 to December 2008. We compared data on babies treated for DDH with data for all other children...
November 19, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27854003/health-related-quality-of-life-and-function-in-middle-aged-individuals-with-thalidomide-embryopathy
#7
Shadi A Ghassemi Jahani, Jon Karlsson, Helena Brisby, Aina J Danielsson
OBJECTIVES: The aim of this study was to evaluate the effect of limb malformations on health-related quality of life (HRQL) and function of the extremities in middle-aged individuals with thalidomide embryopathy (TE). Between 1959 and 1962, approximately 150 children with multiple malformations were born in Sweden following the maternal intake of thalidomide during pregnancy, of whom 100 survived. METHODS: Thirty-one individuals with TE underwent evaluations of musculoskeletal manifestations by clinical examination...
November 16, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27848194/intramedullary-lengthening-nails-can-we-also-correct-deformities
#8
REVIEW
U Lenze, A H Krieg
Unlike external fixators, the use of solid intramedullary lengthening nails is restricted to defined anatomical preconditions, such as an adequate bone length. Furthermore, all deformity corrections except the lengthening procedure have to be implemented intraoperatively and cannot be adjusted postoperatively. Conversely, even complex deformity corrections can be performed using intramedullary devices after a thorough preoperative planning. For preparation of the intramedullary cavity as well as positioning of the lengthening nail according to the preoperative planning, reaming the medullary canal with rigid reamers which don't follow the line of least resistance is inevitable...
November 15, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27848193/from-prevention-of-pin-tract-infection-to-treatment-of-osteomyelitis-during-paediatric-external-fixation
#9
REVIEW
Dimitri Ceroni, Catherine Grumetz, Odile Desvachez, Sophie Pusateri, Pierre Dunand, Eleftheria Samara
Pin-tract infection (PTI) is the most commonly expected problem, or even an almost inevitable complication, when using external fixation. Left unteated, PTI will progress unavoidably, lead to mechanical pin loosening, and ultimately cause instability of the external fixator pin-bone construct. Thus, PTI remains a clinical challenge, specifically in cases of limb lengthening or deformity correction. Standardised pin site protocols which encompass an understanding of external fixator biomechanics and meticulous surgical technique during pin and wire insertion, postoperative pin site care and pin removal could limit the incidence of major infections and treatment failures...
November 15, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27838825/the-biology-of-bone-lengthening
#10
REVIEW
Ivan Hvid, Joachim Horn, Stefan Huhnstock, Harald Steen
Distraction osteogenesis biologically resembles fracture healing with distinctive characteristics notably in the distraction phase of osteogenesis. In the latency phase of bone lengthening, like in the inflammatory phase of fracture repair, interleukines are released and act with growth factors released from platelets in the local haematoma, leading to attraction, proliferation and differentiation of mesenchymal stem cells into osteoblasts and other differentiated mesenchymal cells. These in turn produce matrix, collagen fibers and growth factors...
November 12, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27837313/cosmetic-lengthening-what-are-the-limits
#11
F Guerreschi, H Tsibidakis
OBJECTIVES: In the last decades, limb lengthening has not been limited to the treatment of patients with dwarfism and deformities resulting from congenital anomalies, trauma, tumor and infections, but, has also been used for aesthetic reasons. Cosmetic lengthening by the Ilizarov method with circular external fixation has been applied to individuals with constitutional short stature who wish to be taller. MATERIALS AND METHODS: From January 1985 to December 2010, the medical records of 63 patients with constitutional short stature (36 M, 27F; 126 legs) who underwent cosmetic bilateral leg lengthening using a hybrid advanced fixator according to the Ilizarov method, were reviewed, retrospectively...
November 11, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826910/humeral-lengthening-and-deformity-correction
#12
REVIEW
Gamal Ahmed Hosny
INTRODUCTION: Ilizarov principles and hybrid fixation have improved the results of humeral lengthening. We reviewed the literature on humeral lengthening using different fixators with regard to indications, operative technique, results and complications. We also retrospectively reviewed 56 segments in 46 patients treated with humeral lengthening and deformity correction using Ilizarov external fixation. The etiology was achondroplasia (10 patients), epiphyseal injury (8 cases), infection (11 cases) and Erb's palsy (17 cases)...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826909/updates-on-preoperative-planning-limb-deformity-analysis-and-surgical-correction-for-the-growing-children-epos-meeting-marseille-2015-proceedings
#13
Eitan Segev
Successful deformity correction depends on establishing the aetiology of the deformity. Clinical examination, additional laboratory tests and consultation with other experts may be needed to complete the workup. Imaging studies should include full-length standing X-rays in all relevant planes, and additional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) may add information on bone morphology and growth plates' anatomy. Based on the data, analysis of the deformity and length differences is performed, followed by prediction of deformities at skeletal maturity...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826908/guided-growth-mechanism-and-reversibility-of-modulation
#14
REVIEW
Martin Gottliebsen, Juan Manuel Shiguetomi-Medina, Ole Rahbek, Bjarne Møller-Madsen
In paediatric orthopaedics, deformities and discrepancies in length of bones are key problems that commonly need to be addressed in daily practice. An understanding of the physiology behind developing bones is crucial for planning treatment. Modulation of the growing bone can be performed in a number of ways. Here, we discuss the principles and mechanisms behind the techniques. Historically, the first procedures were destructive in their mechanism but reversible techniques were later developed with stapling of the growth plate being the gold standard treatment for decades...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826907/the-unstable-knee-in-congenital-limb-deficiency
#15
REVIEW
Gabriel T Mindler, Christof Radler, Rudolf Ganger
PURPOSE: Instability of the knee is a common finding in patients with congenital limb deficiency. The instability can be attributed to soft tissue abnormalities, frontal, sagittal or rotational deformity of the lower limb and bony dysplasia of the patella or of the femoral condyles. In most of the cases, these pathomorphologic changes stay asymptomatic in daily activity. However, instability can appear during deformity correction and bone-lengthening procedures, leading to flexion contracture or subluxation of the knee...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826906/amputation-and-rotationplasty-in-children-with-limb-deficiencies-current-concepts
#16
REVIEW
Ralph Sakkers, Iris van Wijk
PURPOSE: Amputations and fitting surgery have a long history in children with limb deficiencies. With the current developments in limb reconstruction and new techniques in prosthetics, the indications for amputation and fitting surgery might have shifted, but still have a very important role in creating high functional performance, optimal participation and quality of life. The purpose of this current concepts article is to give an overview of the indications, dilemmas and technical considerations in the decision-making for amputation and fitting surgery...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826905/current-approaches-to-flexible-intramedullary-nailing-for-bone-lengthening-in-children
#17
REVIEW
Dmitry Popkov, Pierre Lascombes, Pierre Journeau, Arnold Popkov
Limb-length discrepancies and extremity deformities are among the most common non-traumatic orthopaedic conditions for which children are hospitalised. There is a need to develop new treatment options for lower-limb length discrepancy in order to ameliorate treatment outcomes, avoid or reduce rates of complication and provide early rehabilitation. The authors report on the basic principles, experimental and clinical data, advantages, problems and complications of a combined technique associating the Ilizarov method and flexible intramedullary nailing (FIN) in limb lengthening and deformity correction in children...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826904/forearm-lengthening-management-of-elbow-and-wrist
#18
REVIEW
Franck Launay, Sébastien Pesenti
The risk and consequences of an elbow or a wrist contracture are lower during a forearm lengthening than during a lower limb lengthening. This kind of complication can mostly be avoided by an active and intensive regimen of physiotherapy. However, there are some challenges to deal with in treating the disorder multiple exostoses and the radial club hand, including the lack of consensus on the best treatment for multiple exostoses. However, it is important to realize that the evolution of multiple exostoses can lead to a radial head dislocation which will damage the pronation and the supination range of motion...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826903/bone-lengthening-bridging-joints-soft-tissue-releases-physiotherapy
#19
REVIEW
Franck Launay, Sébastien Pesenti
When we lengthen a bone in a child, the parents and the family circle are often obsessed by the amount a lengthening obtained. However, for the surgeon, lengthen a bone is quite pretty easy, but dealing with the joints above and below the lengthening area can be very challenging. Indeed, during the lengthening process, muscles and tendons will be progressively stretched, leading to potential joint contracture or even dislocation. The objective of the surgeon will be to avoid this situation. The first mean at disposal is the physiotherapy in order to help the joints to be more supple and to maintain their range of motion...
November 8, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27826902/acknowledgement-to-reviewers-2016
#20
(no author information available yet)
No abstract text is available yet for this article.
November 8, 2016: Journal of Children's Orthopaedics
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