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Pediatric deformity

Nicolas Palaskas, Kara Thompson, Gregory Gladish, Ali M Agha, Saamir Hassan, Cezar Iliescu, Peter Kim, Jean B Durand, Juan C Lopez-Mattei
PURPOSE OF REVIEW: Our purpose is to discuss the importance of multimodality imaging in the assessment of cardiac tumors and management. We have compiled a recent review of the scientific literature and embedded our clinical pathways and recommendations based on data and clinical experience. RECENT FINDINGS: The use of contrast echocardiography in the assessment of cardiac masses has been shown to be helpful in distinguishing tumor from thrombus. Deformation imaging of cardiac tumors has been shown to differentiate better rhabdomyomas from fibromas in pediatric patients...
March 20, 2018: Current Treatment Options in Cardiovascular Medicine
Matthew R Schmitz, Todd J Blumberg, Susan E Nelson, Julieanne P Sees, Wudbhav N Sankar
BACKGROUND: Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis...
March 17, 2018: Journal of Pediatric Orthopedics
Yun-Sik Dho, Hyoungmin Kim, Kyu-Chang Wang, Seung-Ki Kim, Ji Yeoun Lee, Hee Young Shin, Kyung Duk Park, Hyoung Jin Kang, Il Han Kim, Sung-Hye Park, Ji Hoon Phi
PURPOSE: s: Spinal epidural lymphoma with compressive myelopathy is a rarely found condition. The aims of this study are to describe the clinical features and to analyze its treatment outcome and prognostic factors. MATERIALS & METHODS: We searched for all pediatric patients with newly diagnosed spinal epidural lymphoma from 1999 to 2014 in our institution. We evaluated the clinical features, including neurological status, time interval to treatment, treatment modality, and outcomes...
March 14, 2018: World Neurosurgery
Quan Wang, Shulei Fan, Chun Wu, Xianqing Jin, Zhengxia Pan, Daqing Hong
BACKGROUND: Pectus excavatum, the most common congenital chest wall deformity in pediatric patients, leads to pulmonary dysfunction. There is no consensus regarding the effectiveness of the Nuss procedure for recovering pulmonary function. In this meta- analysis, we focused on the changes that occur in pulmonary function after the Nuss procedure. METHODS: We performed a literature search in the MEDLINE, Embase, Cochrane library and PubMed databases. The included studies were required to contain pulmonary function tests with results adjusted to predicted values both before and after the Nuss procedure...
February 21, 2018: Journal of Pediatric Surgery
Francesca Uccheddu, Marco Ghionzoli, Yary Volpe, Michaela Servi, Rocco Furferi, Lapo Governi, Flavio Facchini, Roberto Lo Piccolo, Kathleen S McGreevy, Alessandra Martin, Monica Carfagni, Antonio Messineo
BACKGROUND: Current approaches to quantifying the severity of pectus excavatum (PE) require internal measurements based on cross-sectional imaging. The aim of this study is to exploit a novel index evaluated on the external surface of the chest with a 3D optical scanner. METHODS: 51 children (41 males, 10 females), between 2 and 17 years old, were evaluated with a 3D optical scanner. PE severity was calculated by using an ad hoc instant 3D scanner and defining an automatic procedure to generate an optical 3D index (CI-3D)...
March 13, 2018: Annals of Thoracic Surgery
Carolyn J Baglole, Feng Liang, Hussein Traboulsi, Angela Rico de Souza, Christian Giordano, Josephine T Tauer, Frank Rauch, Basil J Petrof
BACKGROUND: Osteogenesis imperfecta (OI) is most often caused by mutations in type I collagen genes. Respiratory complications have been largely attributed to spine and ribcage deformities. We hypothesized that direct involvement of the pulmonary parenchyma and/or diaphragm by the disease may occur. METHODS: In Col1a1Jrt/+ mice, a model of severe dominant OI, mean linear intercept length (Lm) was used to assess distal airspace size. Cross-sectional area (CSA) and myosin heavy chain (MyHC) phenotype of diaphragm muscle fibers, as well as contractile properties, were determined...
March 14, 2018: Pediatric Research
Jaime L Bernstein, Benjamin P Cohen, Alexandra Lin, Alice Harper, Lawrence J Bonassar, Jason A Spector
PURPOSE: The significant shortcomings associated with current autologous reconstructive options for auricular deformities have inspired great interest in a tissue engineering solution. A major obstacle in the engineering of human auricular cartilage is the availability of sufficient autologous human chondrocytes. A clinically obtainable amount of auricular cartilage tissue (ie, 1 g) only yields approximately 10 million cells, where 25 times this amount is needed for the fabrication of a full-scale pediatric ear...
March 13, 2018: Annals of Plastic Surgery
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Joel B Huleatt, Carl W Nissen, Matthew D Milewski
The treatment of sports injuries in the skeletally immature has a unique set of complications. Growth deformity may occur after anterior cruciate ligament reconstruction; therefore, skeletal age is used to help guide the choice between physeal sparing and transphyseal techniques. Arthrofibrosis after tibial spine fracture fixation can be reduced by initiating immediate range of motion, and should be treated early and cautiously to avoid iatrogenic fracture. Nonunions of medial epicondyle elbow fractures are more common with nonoperative treatment, but seldom lead to clinical problems outside of certain athletes...
April 2018: Clinics in Sports Medicine
Max S Riley, Lawrence G Lenke, Todd M Chapman, Brenda A Sides, Kathy M Blanke, Michael P Kelly
BACKGROUND: Short-term studies have shown improved outcomes and alignment after posterior vertebral column resection for severe spinal deformity. Our goal was to report long-term changes in radiographic and health-related quality-of-life measures in a consecutive series of pediatric and adult patients undergoing posterior vertebral column resection with a minimum follow-up of 5 years. METHODS: We reviewed all patients undergoing posterior vertebral column resection by a single surgeon prior to January 1, 2010, at a single institution...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
Muhammad Younus Khan Durrani, Amir Humza Sohail, Inamullah Khan, Pervaiz Hashmi
Various shoulder bone deformities have been identified in the pediatric age group, with the most common being undescended scapula. Sprengel's deformity is dysplasia and malposition of the scapula, especially in the supraspinatus portion, mainly due to abnormal descent in the embryonic period. The clavicle is shorter and has a different contour. In some patients cervical spine deformities are also noted. This is a case of 3 years old girl presented to the clinic with difficulty in abducting right shoulder and sleeping with an internal rotation of the right arm...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Tyler Safran, Alex Viezel-Mathieu, Benjamin Beland, Alain J Azzi, Rafael Galli, Mirko Gilardino
INTRODUCTION: Craniosynostosis, the premature fusion of ≥1 cranial sutures, is the leading cause of pediatric skull deformities, affecting 1 of every 2000 to 2500 live births worldwide. Technologies used for the management of craniofacial conditions, specifically in craniosynostosis, have been advancing dramatically. This article highlights the most recent technological advances in craniosynostosis surgery through a systematic review of the literature. METHODS: A systematic electronic search was performed using the PubMed database...
March 1, 2018: Journal of Craniofacial Surgery
Robert G Willson, Regina O Kostyun, Matthew D Milewski, Carl W Nissen
Background: Reconstruction of the anterior cruciate ligament (ACL) in the skeletally immature patient is frequently performed in hopes of preventing new or additional chondral damage and meniscal injuries. Patients within a few years of skeletal maturity are more at risk for ACL injuries than prepubescent patients, about whom several physeal-sparing techniques have been described. Reconstruction techniques in the former higher risk group need to be better understood. Purpose: To review a series of adolescent patients with ACL injuries surgically treated with the hybrid physeal-sparing technique...
February 2018: Orthopaedic Journal of Sports Medicine
Mohammed H El Fahar
Oral chemical burn injuries induce more damage to the underlying tissues with extensive scarring. It is very well known that alkali causes severe liquefaction necrosis and injury to the deeper tissues. Pediatric facial burns must be managed thoroughly and always require complex reconstruction, which is a challenging process. So, any reconstructive surgeon must be aware of all the deformities that may have significant functional and aesthetic impact on the burn survivors especially children. Few medical studies addressed pediatric microsurgical reconstruction for oral burn injuries induced by chemical materials...
February 27, 2018: Annals of Plastic Surgery
Min-Jeong Cho, Rami R Hallac, Jananie Ramesh, James R Seaward, Nuno V Hermann, Tron A Darvann, Angelo Lipira, Alex A Kane
BACKGROUND: Restoring craniofacial symmetry is an important objective in the treatment of many craniofacial conditions. Normal form has been measured using anthropometry, cephalometry, and photography, yet all of these modalities have drawbacks. In this study, the authors define normal pediatric craniofacial form and craniofacial asymmetry using stereophotogrammetric images, which capture a densely sampled set of points on the form. METHODS: After institutional review board approval, normal, healthy children (n = 533) with no known craniofacial abnormalities were recruited at well-child visits to undergo full head stereophotogrammetric imaging...
March 2018: Plastic and Reconstructive Surgery
Victor S Alvarez, Svein Kleiven
Finite element (FE) models are a powerful tool that can be used to understand injury mechanisms and develop better safety systems. This study aims to extend the understanding of pediatric spine biomechanics, where there is a paucity of studies available. A newly developed and continuously scalable FE model was validated and scaled to 1.5-, 3-, 6-, 10-, 14- and 18-year-old using a non-linear scaling technique, accounting for local topological changes. The oldest and youngest ages were also scaled using homogeneous geometric scaling...
February 8, 2018: Journal of Biomechanics
Andrew J Kobets, Daniel Komlos, John K Houten
BACKGROUND: Ehler-Danlos syndome (EDS) refers to a group of heritable connective tissue disorders; rare manifestations of which are cervical kyphosis and clinical myelopathy. Surgical treatment is described for the deformity in the thoracolumbar spine in adolescents but not for infantile cervical spine. Internal fixation for deformity correction in the infantile cervical spine is challenging due to the diminutive size of the bony anatomy and the lack of spinal instrumentation specifically designed for young children...
February 15, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Michael Seungcheol Kang, Il-Yeong Hwang, Soo-Sung Park
BACKGROUND: Selective soft tissue release (SSTR), which includes a combination of abductor hallucis, tibialis posterior, and Achilles lengthening, has been used in patients with recurrent clubfoot deformity after Ponseti treatment. The aim of this study was to investigate the prognostic factors for recurrence of clubfoot deformity after SSTR. METHODS: Consecutive patients with idiopathic clubfoot and residual or recurrent deformity after Ponseti treatment underwent SSTR between 2005 and 2013...
February 1, 2018: Foot & Ankle International
J-C Bernard, E Berthonnaud, J Deceuninck, L Journoud-Rozand, G Notin, E Chaleat-Valayer
Background: Scoliosis is a 3D deformity that can be reconstructed through 2D antero-posterior and lateral radiographs, which provide an upper view of the deformed spine as well as regional planes matching all vertebrae of elective plane for each curve. The objective of this study is to explore whether all idiopathic scoliosis classified Lenke 1A have the same 3D representation made with regional planes. Methods: All patients treated for idiopathic thoracic scoliosis during the growth period and classified Lenke 1A were included in this study conducted in the pediatric spinal orthopedic department of Centre des Massues...
2018: Scoliosis and Spinal Disorders
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