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Journal of Children's Orthopaedics

N Tuomilehto, A Sommarhem, P Salminen, A Y Nietosvaara
Purpose: To assess if postponing surgery of paediatric supracondylar humerus fractures (SCHF) without compromised blood circulation to office hours can improve the quality of reduction and pin fixation and decrease complications. Methods: In 2004, night-time (0am to 7am) surgery was allowed only for children with compromised blood circulation. Number of open reductions, surgeons experience, operation time, quality of reduction (Baumann angle, anterior humeral line crossing point with capitellum) and pin fixation as well as the number of complications were compared in 100 children before (A) and 100 after (B) the new protocol...
June 1, 2018: Journal of Children's Orthopaedics
L Corominas, A Fernandez-Ansorena, P Martinez-Cepas, J Sanpera, A Obieta
Purpose: The frequency of injuries sustained while playing on inflatable toys such as bouncy castles have rapidly increased. These supposedly safe structures are likely unsafe. The objective of this review was to investigate the risk that these attractions represent and the necessary measures to minimize risk of accidents. Methods: We conducted a prospective study of 114 patients over a period of one year (2015 to 2016). Demographic data collected included: age, gender, anatomical location and side of involvement as well as supervision of the child whilst on the bouncy castle...
June 1, 2018: Journal of Children's Orthopaedics
L R Perotti, O Abousamra, K J Rogers, F Miller, J P Sees
Purpose: Data on the benefits of perioperative prophylactic antibiotics in the paediatric population are lacking. In this study, we aimed to assess the rate of infection after isolated soft-tissue procedures in patients with cerebral palsy with and without preoperative prophylactic antibiotics between 2009 and 2015. Methods: We reviewed the records of all children with cerebral palsy who underwent isolated soft-tissue procedures (on the upper and lower limb) at our hospital between 2009 and 2015...
June 1, 2018: Journal of Children's Orthopaedics
B Hedrick, F K Gettys, S Richards, R D Muchow, C-H Jo, M D Abbott
Purpose: The Ponseti method of treatment is the standard of care for idiopathic clubfoot. Following serial casting, percutaneous tendo-Achilles tenotomy (TAT) is performed to correct residual equinus. This procedure can be performed in either the outpatient clinic or the operating room. The purpose of this study was to evaluate the expense of this procedure by examining hospital charges in both settings. Methods: We retrospectively reviewed charts of 382 idiopathic clubfoot patients with a mean age of 2...
June 1, 2018: Journal of Children's Orthopaedics
A Johansson, Y Aurell, B Romanus
Purpose: To establish reproducible posterior ultrasonographic projections for evaluation of the movement in the talocrural joint in clubfeet and normal feet from the perinatal period up to the age of four years. Methods: The feet in 105 healthy children and 46 patients (71 clubfeet and 21 normal feet) were examined. In all, 14 feet in seven patients were examined twice by two examiners independently to evaluate the repeatability of the ultrasonography scans. A posterior sagittal projection was used...
June 1, 2018: Journal of Children's Orthopaedics
C Buckle, A M Wainwright
Purpose: To systematically review the available literature regarding outcomes for the treatment of anterior cruciate ligament (ACL) injuries in the skeletally immature at skeletal maturity or more than five years after surgery. Methods: A systematic search was performed of seven online databases for literature reporting patient reported outcomes for the treatment of ACL injuries in the skeletally immature. A systematic review of this literature was performed examining the outcomes and their association with skeletal immaturity and treatment techniques...
June 1, 2018: Journal of Children's Orthopaedics
C R Øye, O A Foss, K J Holen
Purpose: The aetiology of femoral trochlear dysplasia is unknown. The aim of this prospective cohort study was to describe trochlear development in a newborn population during the first six years of life. Methods: In an earlier study, the femoral trochlea was examined by ultrasound in 174 newborns. A dysplastic trochlea was defined with a sulcus angle (SA) above 159°. Two groups were defined, one group of 15 knees with SA > 159° (dysplastic group), and one group of 101 knees with SA < 159° (non-dysplastic group)...
June 1, 2018: Journal of Children's Orthopaedics
C Alves, W H Truong, M V Thompson, J R Suryavanshi, C L Penny, H T Do, E R Dodwell
Purpose: The aim of this study was to elucidate developmental dysplasia of the hip (DDH) diagnosis and treatment preferences among members of the Pediatric Orthopaedic Society of North America (POSNA) and European Paediatric Orthopaedic Society (EPOS). Methods: A 54-question survey on DDH diagnosis and treatment preferences was distributed to POSNA and EPOS members. Descriptive statistics were performed. Results: A total of 459 responses were analyzed...
June 1, 2018: Journal of Children's Orthopaedics
G T Fedorak, D C DeRosa, A K Brough, R H Miyamoto
Purpose: Previous work has examined the impact of delay of diagnosis in slipped capital femoral epiphysis (SCFE) but not the impact of delay in treatment after radiographic diagnosis. Due to requirements for long distance transportation from less developed regions for many of our patients, our hospital was able to study variation in time between diagnosis and surgery for SCFE, as related to slip severity. Methods: This is a retrospective review of patients treated for SCFE between 2005 and 2014 at a tertiary care paediatric hospital...
June 1, 2018: Journal of Children's Orthopaedics
Ahmad S Aly, Mohamed A Al-Kersh
Purpose: The purpose of this case series study is to report on the intermediate-term outcomes following a femoral varus derotational osteotomy (FVDO) performed in conjunction with a Dega osteotomy (DO) in management of hip -instability in Down syndrome (DS) patients. Methods: Ten hips in seven children with DS suffering from hip dislocation were included. All patients included in this study had hip dislocation in the habitual phase and painless mobile hip to full abduction...
June 1, 2018: Journal of Children's Orthopaedics
L R Perotti, O Abousamra, M Del Pilar Duque Orozco, K J Rogers, J P Sees, F Miller
Purpose: Foot and ankle deformities are common orthopaedic disorders in children with Down syndrome. However, radiographic measurements of the foot and ankle have not been previously reported. The aim of this study is to describe the foot and ankle deformity in children with Down syndrome. Methods: Children who had foot and ankle radiographs in the standing weight-bearing position were selected. Three groups of patients were identified. The relationship of radiographic measurements with age, body mass index and pain is discussed...
June 1, 2018: Journal of Children's Orthopaedics
M E Womack, J C Ryan, V Shillingford-Cole, S Speicher, G D Hogue
Purpose: Paediatric trigger finger (PTF) is a rare condition as seen by the lack of studies published about paediatric populations. Due to this general lack of information, the steps to employ to correct this disorder, whether surgically or non-surgically, have not yet reached consensus status. The objective of this study is to review the published literature regarding treatment options for PTF in order to develop a proposed step-wise treatment algorithm for children presenting with trigger finger...
June 1, 2018: Journal of Children's Orthopaedics
S Hashavya, I Gross, A Michael-Gayego, N Simanovsky, R Lamdan
Background: Musculoskeletal infections are among the most common bacterial infections in children leading to hospitalization, invasive procedures and prolonged antibiotic administration. Blood, synovial and sometimes tissue cultures are essential for the diagnosis and treatment of musculoskeletal infections; 16S ribosomal DNA (rDNA) sequencing is a novel diagnostic tool for the detection of bacteria.While the yield of 16S rDNA sequencing in synovial fluid was previously assessed, data regarding the efficacy of this method from blood samples or partially treated children with suspected musculoskeletal infections is lacking...
April 1, 2018: Journal of Children's Orthopaedics
N Lennon, C Church, F Miller
Purpose: To describe self-reported life satisfaction and motor function of young adults with cerebral palsy (CP). Methods: A total of 57 young adults with spastic CP classified as levels I (seven), II (25), III (16), IV (nine) by the Gross Motor Function Classification System, followed from childhood by our CP clinic, returned at a mean age of 27 years two months (SD 3 years 4 months). Self-reported life satisfaction and mobility status were measured by the Pediatric Outcomes Data Collection Instrument (PODCI), Patient-Reported Outcomes Measurement Information System (PROMIS), Functional Mobility Scale (FMS) and a project questionnaire...
April 1, 2018: Journal of Children's Orthopaedics
J Wright, R A Hill, D M Eastwood, A Hashemi-Nejad, P Calder, S Tennant
Purpose: To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. Patients and Methods: In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures...
April 1, 2018: Journal of Children's Orthopaedics
S I Shiran, L Shabtai, L Ben-Sira, D Ovadia, S Wientroub
Purpose: Distinct normal physiological patterns of fat conversion in vertebrae were described both for children and adults. Our aim was to evaluate the T1-weighted bone marrow pattern of the vertebral bodies in various sites along the scoliotic spine of children with adolescent idiopathic scoliosis (AIS). Methods: We retrospectively evaluated spine MRI studies of children with AIS. Scoliosis radiographs were assessed for type of curvature according to the Lenke classification...
April 1, 2018: Journal of Children's Orthopaedics
I Swarup, J Gruskay, M Price, J Yang, J Blanco, S Perlman, R Widmann
Purpose: Surgical site infection (SSI) caused by Propionibacterium acnes is an infrequent but devastating complication after spinal fusion. The purpose of this study was to identify risk factors for SSI with Propionibacterium acnes after spinal fusion for juvenile and adolescent idiopathic scoliosis (JIS and AIS). Methods: A case-control study was performed. Each case was matched 2:1 for age, gender and diagnosis. Retrospective chart review was performed to obtain relevant demographic, surgical and clinical data for all cases and controls...
April 1, 2018: Journal of Children's Orthopaedics
B G Beutel, S J Girdler, J A Collins, N Y Otsuka, A Chu
Purpose: The morphology of the proximal femur has been extensively studied in the adult population. However, no literature providing a comprehensive evaluation of the anatomy in paediatric patients exists. The current study aims to characterize such anatomy in skeletally-immature patients, examine potential differences between genders, and analyze how these anatomical parameters change with age. Methods: Cadaveric femurs from the Hamann-Todd Osteological Collection were examined...
April 1, 2018: Journal of Children's Orthopaedics
A Lam, S A Boenerjous, Y Lo, J M Abzug, J Kurian, M C Liszewski, D E Sanderson, J M Scholnick, B H Taragin, J A Gomez, N Y Otsuka, R Hanstein
Purpose: To evaluate sensitivity, specificity and accuracy of a radiographic slipped capital femoral epiphysis (SCFE)-diagnosis among medical specialists. Methods: Three paediatricians, three paediatric radiologists and three paediatric orthopaedic surgeons completed two rounds of a survey of anteroposterior and frog-leg lateral radiographs of patients with a diagnosis of SCFE (25), femoroacetabular impingement (four), Legg-Calvé-Perthes (11) or no hip pathology (ten)...
April 1, 2018: Journal of Children's Orthopaedics
E N Novais, K-P Kienle, P E Miller, G Bowen, Y-J Kim, S D Bixby
Purpose: To determine age-and gender-dependent variation of epiphyseal tilt and epiphyseal angle using CT in adolescents without hip pathology. Methods: Pelvic CT scans were obtained in 132 adolescents for evaluation of abdominal pain. Radially oriented planes around the femoral neck were reformatted and the epiphyseal tilt and angle were measured in the anterior, anterosuperior and superior planes. Variations in the tilt angle and epiphyseal angle were assessed by age group from 12 to 18 years and gender by using a linear mixed model analysis...
April 1, 2018: Journal of Children's Orthopaedics
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