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https://www.readbyqxmd.com/read/28403653/congenital-pseudoarthrosis-of-the-distal-radius-treated-with-physeal-sparing-double-barrel-vascularized-free-fibula-transfer-a-case-report
#1
David Y Ding, Joey LaMartina, Chau Tai, Nirav K Pandya
BACKGROUND: Neurofibromatosis type 1 is a hereditary disease that can lead to pseudoarthrosis of various long bones. Rarely, pseudoarthrosis affects the forearm, and to the best of our knowledge, this is the first reported case of pseudarthrosis of the distal radius treated by this unique method. METHODS: We present a case of a 7-year-old male who underwent multiple operations to treat pseudoarthrosis of the distal radius. RESULTS: After failed conservative and operative fixation augmented with autologous iliac crest bone grafting, the patient underwent a successful double-barrel vascularized free fibula graft while preserving the physis of the distal radius...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#2
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28382187/ultrasonographic-diagnosis-of-slipped-capital-femoral-epiphysis
#3
Manikandan Palaniappan, Venkatraman Indiran, Prabakaran Maduraimuthu
BACKGROUND: Slipped capital femoral epiphysis (SCFE), a fracture through the physis with resultant slip of the epiphysis, is the most common hip abnormality in adolescents and is a major cause of early osteoarthritis. Plain radiograph is the initial modality used to evaluate patients with painful hip joints. Ultrasonography and magnetic resonance imaging (MRI), which do not involve radiation exposure, have also been used. This case report supports the view that ultrasound can be used as an initial, cost-effective and radiation-free modality for the evaluation of suspected SCFE...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28379125/-tillaux-fractures-functional-results-after-surgical-treatment
#4
Andres Aguilar Ezquerra, María Eugenia Monge Vazquez, Lorena Gracia Torralba, Marina Angulo Tabernero
INTRODUCTION: Tillaux Fractures are an infrequent type of fracture that occurs in teenagers. The mechanism is an external rotation that causes stress on the anterior tibiofibular ligament, which displace the distal tibial physis fragment. METHODS: 6 patients (5 girls and one boy), with an age between 12-14 years, who had Tillaux fractures with a displacement more than 2 mm; were treated by orthopedic reduction and fixation with a screw. RESULTS: After surgery patients underwent cast immovilization for 4 to 6 weeks; starting then progressive partial bear-weight...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28376474/magnetic-resonance-imaging-features-as-surrogate-markers-of-x-linked-hypophosphatemic-rickets-activity
#5
Marta Lempicki, Anya Rothenbuhler, Valérie Merzoug, Stéphanie Franchi-Abella, Catherine Chaussain, Catherine Adamsbaum, Agnès Linglart
OBJECTIVE: X-linked hypophosphatemic rickets (XLH) is the most common form of inheritable rickets. Rickets treatment is monitored by assessing alkaline phosphatase (ALP) levels, clinical features, and radiographs. Our objectives were to describe the magnetic resonance imaging (MRI) features of XLH and to assess correlations with disease activity. STUDY DESIGN: Twenty-seven XLH patients (median age 9.2 years) were included in this prospective single-center observational study...
April 3, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/28361185/assessment-of-pharmacokinetics-for-microvessel-proliferation-by-dce-mri-for-early-detection-of-physeal-bone-bridge-formation-in-an-animal-model
#6
Bernhard Neumayer, Eva Amerstorfer, Clemens Diwoky, Richard A Lindtner, Elisabeth Wadl, Eva Scheurer, Annelie-Martina Weinberg, Rudolf Stollberger
OBJECTIVES: Bone bridge formation occurs after physeal lesions and can lead to growth arrest if not reversed. Previous investigations on the underlying mechanisms of this formation used histological methods. Therefore, this study aimed to apply a minimally invasive method using dynamic contrast-enhanced MRI (DCE-MRI). MATERIALS AND METHODS: Changes in functional parameters related to the microvessel system were assessed in a longitudinal study of a cohort of an animal model applying a reference region model...
March 30, 2017: Magma
https://www.readbyqxmd.com/read/28334547/origin-of-cam-morphology-in-femoroacetabular-impingement
#7
William Z Morris, Ryan T Li, Raymond W Liu, Michael J Salata, James T Voos
Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28332046/ramp-lesions-in-acl-deficient-knees-in-children-and-adolescent-population-a-high-prevalence-confirmed-in-intercondylar-and-posteromedial-exploration
#8
Matthieu Malatray, Sebastien Raux, Adrien Peltier, Clemence Pfirrmann, Romain Seil, Franck Chotel
PURPOSE: Ramp lesions are common in ACL deficient knees. Their diagnosis is difficult and, therefore, they may be underestimated. So far, no study analyzed their prevalence in a pediatric population. The diagnosis of these Ramp lesions is of major clinical relevance because of a frequent misestimating and technic difficulties. Ramp lesions might be associated with residual knee pain and instability after ACL reconstruction. The aim of this study was to evaluate the prevalence of ramp lesions explored through a systematic intercondylar and posteromedial arthroscopic approach during an ACL reconstruction in a pediatric and adolescent population...
March 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28328566/physeal-and-subphyseal-distraction-osteogenesis-in-atrophic-type-congenital-pseudarthrosis-of-the-tibia-efficacy-and-safety
#9
Woo Young Jang, Yoon Hyo Choi, Moon Seok Park, Won Joon Yoo, Tae-Joon Cho, In Ho Choi
PURPOSE: To examine the efficacy, safety, and clinical outcomes of distraction osteogenesis through the physis (PDO) or through subphyseal osteotomy (SPDO) in patients with atrophic-type congenital pseudarthrosis of tibia with proximal tibial dysplasia. METHODS: To validate the efficacy and safety of PDO and SPDO, radiographic and clinical parameters were compared between 5 patients who underwent proximal tibial metaphyseal or metadiaphyseal lengthening as a control (group 1) and 7 patients who underwent PDO or SPDO (group 2)...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28302429/does-bony-regrowth-occur-after-arthroscopic-femoroplasty-in-a-group-of-young-adolescents-femoroplasty-regrowth-in-adolescents
#10
Itay Perets, Asheesh Gupta, Edwin O Chaharbakhshi, Lyall Ashberg, David E Hartigan, Mary R Close, Benjamin G Domb
PURPOSE: To evaluate femoral head-neck bone regrowth and PROs in skeletally immature patients that underwent arthroscopic femoroplasties over a minimum 2-year period. METHODS: Eleven skeletally immature hips (10 patients) with open femoral head physes underwent femoroplasty between October 2008 and November 2013. Inclusion criteria were minimum 2-year follow-up with patient-reported outcomes (PROs) and radiographs preoperatively, at 2 weeks, and at a minimum of 2 years postoperatively...
March 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28295122/epiphysiodesis-screw-bending
#11
Brett M Normandin, David J Tennent, Todd H Baldini, Alesia M Blanchard, Jason T Rhodes
Percutaneous epiphysiodesis using transphyseal screws is a common method for treatment of limb length discrepancy and angular deformity. The authors report 3 cases of a previously unreported complication following treatment with percutaneous epiphysiodesis using transphyseal screws: bending of the transphyseal screw. In each case, this rare complication was associated with difficult removal of the screw. This retrospective case report accessed the medical records of 3 children, 2 boys and 1 girl, 9 to 14 years old...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28293503/near-complete-humerus-reconstruction-in-the-pediatric-patient-with-vascularized-free-fibula-transfer
#12
John Shuck, Benjamin C Wood, Christopher Zarella, Albert K Oh, Robert M Henshaw, Gary F Rogers
Vascularized free fibula transfer remains the gold standard for reconstruction of large segmental diaphyseal defects of the upper extremity. In the pediatric patient, before skeletal maturity, free fibula transfer with the fibular head provides an active physis for growth and an articular interface for glenohumeral joint reconstruction. Clinical and cadaveric studies have demonstrated that the vascular supply to the fibular head originates, in most cases, from the anterior tibial system. However, anatomical variation exists, and we report a case in which a vascularized fibula autograft including the physis was transferred on the peroneal artery in a 5-year-old patient with Ewing's sarcoma...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28291184/lateral-radiographic-landmarks-for-acl-and-lcl-footprint-origins-during-all-epiphyseal-femoral-drilling-in-skeletally-immature-knees
#13
Kevin G Shea, Peter C Cannamela, Peter D Fabricant, E Bailey Terhune, John D Polousky, Matthew D Milewski, Theodore J Ganley, Allen F Anderson
BACKGROUND: This study was conducted to evaluate the spatial relationship of the anterior cruciate ligament (ACL) and lateral collateral ligament (LCL) femoral footprint origins in knee specimens from skeletally immature donors as viewed on lateral radiographs. METHODS: Fourteen cadaver specimens of skeletally immature knees from children between 7 and 11 years old at the time of death were examined through gross dissection. Metallic pins were placed at the center of the ACL and LCL femoral footprints, and computed tomography (CT) scans were performed...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28266297/surgical-treatment-of-a-rare-reverse-madelung-deformity-in-11-years-female-patient
#14
Alexandru Ulici, Daniel Catalin Florea, Iulia Tevanov, Dan Zaharie, Madalina Carp
Madelung deformity is an abnormality of the distal part of the forearm due to a growth arrest in the distal radial physis creating an increase of the radial tilt angle associated with a dorsal subluxation of the distal ulna in most cases. It is a rare condition which represents only 1.7% of hand deformities being characterized by the presence of an abnormal structure, Vickers ligament, that tethers the distal radius to the lunate bone. Although it is believed to be a congenital disorder, the symptoms are absent till late childhood...
January 2017: Chirurgia
https://www.readbyqxmd.com/read/28244924/humerus-lengthening-with-the-precice-internal-lengthening-nail
#15
Anton M Kurtz, S Robert Rozbruch
BACKGROUND: Deformity and growth arrest of the humerus in children may result as sequelae of proximal humerus fractures and unicameral bone cysts, or as complications of their treatment. As approximately 80% of the growth of the humerus arises from the proximal physis, the resultant upper limb-length discrepancy can be substantial. Benefits to lengthening the shortened arm have been previously demonstrated with the use of external fixation devices. To our knowledge, no reports have been published on the use of intramedullary implants for this purpose...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#16
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28159425/magnetic-resonance-imaging-evaluation-of-physeal-violation-in-adolescents-after-transphyseal-anterior-cruciate-ligament-reconstruction
#17
Joon-Ho Wang, Kang-Min Son, Dae-Hee Lee
PURPOSE: To quantify and compare the amount and location of physis violation of the distal femur and proximal tibia after transphyseal anterior cruciate ligament (ACL) reconstruction in skeletally immature patients. METHODS: This study included 19 patients with open physes of the distal femur and proximal tibia who underwent ACL reconstruction with tibialis anterior allografts. Physeal tunnel volume and location on the growth plate, as well as obliquity to the growth plate, were measured by 3-dimensional postoperative magnetic resonance imaging of the distal femur and proximal tibia...
January 31, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28156202/diffusion-tensor-imaging-of-the-physes-a-possible-biomarker-for-skeletal-growth-experience-with-151-children
#18
Maria A Bedoya, Jorge Delgado, Jeffrey I Berman, Nancy A Chauvin, David Zurakowski, Raul Ramirez-Grueso, Aikaterini Ntoulia, Diego Jaramillo
Purpose To determine the changes of diffusion-tensor imaging (DTI) and tractography in the distal femur and proximal tibia related to age, sex, and height. Materials and Methods Following institutional review board approval, with waiver of consent and with HIPAA compliance, the authors retrospectively analyzed DTI images of the knee in 151 children, 73 girls (median age, 14.1 years; range, 6.5-17.8 years) and 78 boys (median age, 16.6 years; range, 6.9-17.9 years), studied from January 2013 to October 2014...
February 2, 2017: Radiology
https://www.readbyqxmd.com/read/28155066/pediatric-musculoskeletal-injuries-role-of-ultrasound-and-magnetic-resonance-imaging
#19
REVIEW
C L Piccolo, M Galluzzo, S Ianniello, M Trinci, A Russo, E Rossi, M Zeccolini, A Laporta, G Guglielmi, V Miele
Pediatric musculoskeletal system is particularly prone to traumatic and sports-related injuries, both acute and chronic, i.e., overuse injuries, because of inherent conditions of weakness, such as the open physis, representing the weakest aspect within the bone, the ligamentous supports and changing biomechanics. Being aware that a quick diagnosis is essential to preserve the good functionality of the limb involved, it is mandatory for the radiologist to recognize the most common patterns of these injuries, identifying those requiring a prompt surgery, as well as be confident with the technique performed, and be supported by an important background experience and knowledge skills...
March 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28148656/adolescent-patellar-instability-current-concepts-review
#20
REVIEW
D Clark, A Metcalfe, C Wogan, V Mandalia, J Eldridge
Patellar instability most frequently presents during adolescence. Congenital and infantile dislocation of the patella is a distinct entity from adolescent instability and measurable abnormalities may be present at birth. In the normal patellofemoral joint an increase in quadriceps angle and patellar height are matched by an increase in trochlear depth as the joint matures. Adolescent instability may herald a lifelong condition leading to chronic disability and arthritis. Restoring normal anatomy by trochleoplasty, tibial tubercle transfer or medial patellofemoral ligament (MPFL) reconstruction in the young adult prevents further instability...
February 2017: Bone & Joint Journal
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