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Journal of Children's Orthopaedics

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https://www.readbyqxmd.com/read/29081857/analysis-of-a-paediatric-orthopaedic-network-a-six-year-experience-in-the-south-west-of-the-united-kingdom
#1
D Bruce, C Kocialkowski, F Bintcliffe, F Monsell, J Barnes, R Brown
PURPOSE: We report our experience of a paediatric orthopaedic network, based on a 'hub and spoke' model, covering the South West of the United Kingdom. We identify the areas of most clinical concern, the effect of the network on stream-lining patient management and the benefits of the network to the clinician. METHODS: Prospective data were collected from the minutes of the bi-annual meetings of the South West Paediatric Network (UK) between November 2006 and May 2012...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081856/cast-wedging-a-systematic-review-of-the-present-evidence
#2
REVIEW
S Gaukel, S Leu, L Fink, S R Skovgaard, L E Ramseier, R N Vuille-Dit-Bille
PURPOSE: The objective of this systematic review was to summarise the outcome after cast wedging due to loss of angulation in conservative fracture treatment of children's fractures. METHODS: Electronic searches were performed using MEDLINE, PubMed, OVID, CENTRAL and EMBASE without language restrictions. RESULTS: Three studies comprising 316 patients (210 radius, 52 forearm/both bone forearm fractures and 54 tibia fractures) were included in the present analysis...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081855/the-effects-of-body-mass-index-on-treatment-of-paediatric-femur-fractures-managed-with-flexible-intramedullary-nails
#3
E Nielsen, L M Andras, N Bonsu, R Y Goldstein
PURPOSE: Traditionally, flexible intramedullary nails (FINs) are not to be used to fix femur fractures in patients > 50 kg (110 lbs). However, studies have not examined the efficacy of this technique in overweight and obese patients who may be under this 'weight cutoff'. The purpose of this study was to assess how patient body mass index (BMI) impacts the treatment of paediatric femur fractures managed with FINs. METHODS: Retrospective data was collected on all paediatric patients treated with FINs for diaphyseal femur fractures at a single tertiary care institution over a ten-year period...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081854/toxic-shock-in-children-with-bone-and-joint-infections-a-review-of-seven-years-of-patients-admitted-to-one-intensive-care-unit
#4
D L Kerr, E K Loraas, A C Links, T V Brogan, G A Schmale
PURPOSE: The objective of this study was to compare the frequency of severe systemic, multi-organ involvement and toxic shock syndrome (TSS) in patients with Staphylococcus aureus (SA) and Group A ╬▓-haemolytic Streptococcus pyogenes (GABS) bone and joint infections. METHODS: We retrospectively reviewed patients treated for septic arthritis or osteomyelitis at one children's hospital between 2002 and 2009. The rates of intensive care unit (ICU) admission for methicillin-sensitive SA (MSSA), methicillin-resistant SA (MRSA) and GABS infections were compared, as were the lengths of stay, number of surgeries, operative procedures and cases of TSS...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081853/spinal-canal-dimensions-affect-outcome-of-adolescent-disc-herniation
#5
O Linkoaho, R Kivisaari, M Ahonen
PURPOSE: Small spinal canal dimensions play a role in symptomatic adult disc herniation, but its role in adolescent disc herniation has not been investigated with MRI. The goal of this study was to examine retrospectively if there is a correlation with dimensions of osseous spinal canal and need of discectomy in an adolescent population suffering from disc herniation. METHODS: A retrospective review of child and adolescent patients who were treated in our institution for back or back--related leg pain was conducted...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081852/the-aetiology-of-the-non-ossifying-fibroma-of-the-distal-femur-and-its-relationship-to-the-surrounding-soft-tissues
#6
A Goldin, D A Muzykewicz, J Dwek, S J Mubarak
PURPOSE: We aim to retrospectively evaluate patients with non-ossifying fibroma (NOF) of the distal femur by radiographs, CT and MRI, and to provide a theory describing the reasoning for the distal femur NOF's location and aetiology. METHODS: Charts of patients with NOFs between 2003 and 2014 were retrospectively reviewed. Inclusion criteria encompassed a diagnosis of NOF of the distal femur by imaging, and histologically, if available. Radiographs, CT and MRI were used to characterise the relationship of the NOF lesions with the surrounding soft tissues...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081851/clubfoot-relapse-does-presentation-differ-based-on-age-at-initial-relapse
#7
S T Mahan, S A Spencer, C J May, V I Prete, J R Kasser
PURPOSE: Treatment of idiopathic clubfoot with the Ponseti method is now standard, but predicting relapse can be difficult. Most experts recommend bracing to the age of four years, but this can be challenging for families, and may not be necessary in all patients. The purpose of this study is to compare patterns of bracing and age of relapse to help determine if predictable patterns exist. METHODS: The 70 patients with idiopathic clubfoot treated initially with the Ponseti technique who had relapse of their clubfoot were identified...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081850/obstacles-to-reduction-in-infantile-developmental-dysplasia-of-the-hip
#8
K Studer, N Williams, P Studer, M Baker, A Glynn, B K Foster, P J Cundy
PURPOSE: Identification of anatomical structures that block -reduction in developmental dysplasia of the hip (DDH) is -important for the management of this challenging condition. Obstacles to reduction seen on arthrogram are well-known. However, despite the increasing use of MRI in the assessment of adequacy of reduction in DDH, the interpretation of MRI patho-anatomy is ill-defined with a lack of relevant literature to guide clinicians. METHOD: This is a retrospective analysis of the MRI of patients with DDH treated by closed reduction over a five-year period (between 2009 and 2014)...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081849/physical-function-and-health-related-quality-of-life-in-young-adults-with-unilateral-congenital-lower-limb-deficiencies
#9
T S Kaastad, A T Tveter, H Steen, I Holm
PURPOSE: The primary aim was to examine if there were differences in physical function and health-related quality of life (HRQoL) between young adults (18 to 35 years) with unilateral congenital lower-limb deficiency (CLLD) who had been surgically lengthened (Surg) and those using lengthening prostheses (Pros). Second, we wanted to compare their health status with an age- and gender-matched reference group (Ref) without CLLD. METHODS: Cross-sectional study including a study-specific questionnaire, clinical examination, two field tests evaluating physical function (the six-minute walk test and the Stair test) and HRQoL questionnaires (Short Form (SF)-36 and EuroQol (EQ)-5D-3L)...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081848/developmental-pattern-of-tibiofemoral-angle-in-healthy-north-east-indian-children
#10
R K Baruah, S Kumar, S V Harikrishnan
PURPOSE: Physiological range of tibiofemoral angle (TFA) is poorly defined and may lead to unnecessary therapeutic interventions. Studies on TFA developmental pattern suggest that racial and ethnic differences are present; children in north-east India who have not yet been studied need to be evaluated. PATIENTS AND METHODS: Cross-sectional study of clinical TFA, intermalleolar distance and intercondylar distance in 1020 healthy north-east Indian children aged from 2 to 18 years was done...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081847/an-independent-assessment-of-reliability-of-the-melbourne-cerebral-palsy-hip-classification-system
#11
M W Shrader, A L Koenig, M Falk, M Belthur, C Boan
PURPOSE: Neuromuscular (NM) hip dysplasia is common in patients with cerebral palsy (CP). Traditionally, migration percentage (MP) has been used to measure the severity of NM hip dysplasia; however, the MP has some limitations. The purpose of this study is to determine the intra- and inter-reliability of the Melbourne Cerebral Palsy Hip Classification System in the typical paediatric population of patients with CP. METHODS: A total of 65 anteroposterior pelvis radiographs in patients (age range 12 years to 21 years) with CP spanning all grades (I to VI) of the classification system were identified and collected for analysis in this institutional review board approved study...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081846/avascular-necrosis-in-children-with-cerebral-palsy-after-reconstructive-hip-surgery
#12
L Phillips, K Hesketh, E K Schaeffer, J Andrade, J Farr, K Mulpuri
PURPOSE: Progressive hip displacement is one of the most common orthopaedic pathologies in children with cerebral palsy (CP). Reconstructive hip surgery has become the standard treatment of care. Reported avascular necrosis (AVN) rates for hip reconstructive surgery in these patients vary widely in the literature. The purpose of this study is to identify the frequency and associated risk factors of AVN for reconstructive hip procedures. METHODS: A retrospective analysis was performed of 70 cases of reconstructive hip surgery in 47 children with CP, between 2009 and 2013...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904639/a-comparison-of-functional-outcome-between-amputation-and-extension-prosthesis-in-the-treatment-of-congenital-absence-of-the-fibula-with-severe-limb-deformity
#13
P Calder, S Shaw, A Roberts, S Tennant, I Sedki, R Hanspal, D Eastwood
PURPOSE: Complete fibula absence often presents with significant lower-limb deformity. Parental counselling regarding management is paramount in achieving the optimum functional outcome. Amputation offers a single surgical event with minimal complications. This study compares outcomes with an amputation protocol to those using an extension prosthesis. METHOD: Thirty-two patients were identified. Nine patients (2 males, 7 females; median age at assessment of 23...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904638/functional-outcomes-following-non-operative-versus-operative-treatment-of-clavicle-fractures-in-adolescents
#14
M M Herzog, R C Whitesell, L M Mac, M L Jackson, B A Culotta, J R Axelrod, M T Busch, S C Willimon
PURPOSE: Superiority of non-operative versus operative treatment of clavicle shaft fractures remains unclear. We aimed to assess shoulder function in adolescents following shortened clavicle fracture and compare operative versus non-operative treatment. METHODS: Patients aged 12 to 18 years at the time of fracture and minimum 1.5 years post injury were identified for this institutional review board (IRB)-approved study. For this retrospective cohort study, patients were frequency-matched for age, gender, shortening of the clavicle fracture and activity level...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904637/the-emerging-trend-of-non-operative-treatment-in-paediatric-type-i-open-forearm-fractures
#15
REVIEW
H Zhang, M Fanelli, C Adams, J Graham, M Seeley
PURPOSE: Open fractures are considered an orthopaedic emergency and are generally an indication for operative debridement. Recent studies have questioned this approach for the management of Gustilo-Anderson Type I open fractures in the paediatric population. This meta-analysis studies the non-operative management of Type I open paediatric forearm fractures. METHODS: An Ovid MEDLINE and PubMed database literature search was performed for studies that involved a quantified number of Gustilo-Anderson Type I open forearm fractures in the paediatric population, which were treated without operative intervention...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904636/the-orthopaedic-management-of-lower-limb-deformity-in-hypophosphataemic-rickets
#16
A Horn, J Wright, D Bockenhauer, W Van't Hoff, D M Eastwood
BACKGROUND: Many patients with X-linked hypophosphataemic rickets (X-LHPR) demonstrate significant lower limb deformity despite optimal medical management. This study evaluates the use of guided growth by means of hemi-epiphysiodesis to address coronal plane deformity in the skeletally immature child. METHODS: Since 2005, 24 patients with X-LHPR have been referred to our orthopaedic unit for evaluation. All patients had standardised long leg radiographs that were analysed sequentially before and after surgery if any was performed...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904635/does-orthopaedic-surgery-improve-quality-of-life-and-function-in-patients-with-mucopolysaccharidoses
#17
N Williams, D Challoumas, D M Eastwood
PURPOSE: Mucopolysaccharidoses (MPS) are a group of rare lysosomal storage disorders associated with involvement of multiple organs along with a generalised skeletal dysplasia. Both haematopoetic stem cell transplant and enzyme replacement therapy have improved the outlook for patients while surgery remains high-risk and there is little information on clinical or functional outcome to justify many of the surgical procedures performed. This paper aims to summarise the orthopaedic surgical procedures in MPS patients for which quality of life (QoL) and functional data are available and to describe additional QoL and functional measurement tools of relevance to the assessment of orthopaedic outcomes in MPS...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904634/treatment-of-chronic-stable-slipped-capital-femoral-epiphysis-via-surgical-hip-dislocation-with-combined-osteochondroplasty-and-imhauser-osteotomy
#18
J B Erickson, W P Samora, K E Klingele
PURPOSE: Treatment of slipped capital femoral epiphysis (SCFE), including the modified Dunn procedure, restores anatomy with significant risk for avascular necrosis (AVN), if performed in the setting of moderate to severe, stable SCFE. The Imhauser osteotomy has been shown to be an effective way to correct residual deformity without the risk of AVN. We sought to evaluate the effectiveness and safety of a combined Imhauser osteotomy and osteochondroplasty, performed via a surgical hip dislocation approach for the acute and delayed treatment of stable SCFE...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904633/an-improved-method-for-measuring-hip-abduction-in-spica-after-surgical-reduction-for-developmental-dysplasia-of-the-hip
#19
C J DeFrancesco, T J Blumberg, N A Chauvin, W N Sankar
PURPOSE: Excessive in-spica abduction is a risk factor for oste-onecrosis after surgical reduction for developmental dysplasia of the hip (DDH). The traditional method for radiographically measuring hip abduction using axial imaging does not reflect the true angle, which usually lies in an oblique plane. The purpose of this study was to describe a novel method for measuring true hip position using advanced imaging. METHODS: A trigonometric model was derived to define hip position based upon the femoral axis angular deviation from midline as measured on axial and coronal sequences of MRI studies...
August 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28904632/incidence-of-acetabular-dysplasia-in-breech-infants-following-initially-normal-ultrasound-the-effect-of-variable-diagnostic-criteria
#20
C M Brusalis, C T Price, W N Sankar
PURPOSE: This study aimed to determine the incidence of acetabular dysplasia at six months of age in patients with breech presentation and previously normal hip ultrasounds, reporting primary radiographic measurements to allow for comparison with other patient cohorts. METHODS: A retrospective analysis of breech infants with initially normal clinical examinations and hip ultrasounds was performed to determine the rate of subsequent acetabular dysplasia and to characterise the distribution of acetabular index (AI)...
August 1, 2017: Journal of Children's Orthopaedics
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