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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
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
March 16, 2018: Strategies in Trauma and Limb Reconstruction
Luis A Aponte-Tinao, Jose I Albergo, Miguel A Ayerza, D Luis Muscolo, Federico Milano Ing, German L Farfalli
BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...
March 2018: Clinical Orthopaedics and related Research
Ena Nielsen, Lindsay M Andras, David L Skaggs
BACKGROUND: In adults, a relative "safe zone" for lateral approaches to the elbow has been well described in efforts to reduce iatrogenic injury, typically a minimum of 6 cm proximal to the lateral epicondyle. To avoid iatrogenic injury to the radial nerve intraoperatively, we investigated the distance of the nerve from the distal humeral physis in children. METHODS: All patients who had axial and coronal T1-weighted magnetic resonance imagings of the humerus and elbow between 2005 and 2015 were eligible...
March 8, 2018: Journal of Pediatric Orthopedics
Aakash Chauhan, Alan Slipak, Mark C Miller, Daniel T Altman, Gregory T Altman
INTRODUCTION: The use of a postoperative brace may be beneficial after open reduction and internal fixation of tibial plateau fractures. However, bracing has potential drawbacks related to cost, fitting, wound complications, and compliance. We hypothesized that no difference will be found between patients with and without bracing after open reduction and internal fixation of tibial plateau fractures. METHODS: In this prospective, comparative trial, patients were randomized to 6 weeks of bracing or no bracing after open reduction and internal fixation of tibial plateau fractures...
March 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
Andrew T Pennock, Jerry Dwek, Emily Levy, Philip Stearns, John Manning, M Morgan Dennis, Amanda Davis-Juarez, Tracey Bastrom, Kenneth S Taylor
Background: Youth baseball is extremely popular in the United States, but it has been associated with shoulder pain and injury. The incidence of shoulder abnormalities in this athletic population has yet to be defined. Purpose: To examine abnormalities noted on magnetic resonance imaging (MRI) in the shoulders of asymptomatic Little League baseball players and to correlate these findings with the players' throwing history and physical examinations. Study Design: Case-control study; Level of evidence, 3...
February 2018: Orthopaedic Journal of Sports Medicine
Xiaofan Ji, Ren-Tsung Wu, Lingliang Long, Chenxing Guo, Niveen M Khashab, Feihe Huang, Jonathan L Sessler
Reported here is a hydrogel-forming polymer network that contains a water-soluble tetracationic macrocycle. Upon immersion of this polymer network in aqueous solutions containing various inorganic and organic salts, changes in the physical properties are observed that are consistent with absorption of the constituent anions into the polymer network. This absorption is ascribed to host-guest interactions involving the tetracationic macrocyclic receptor. Removal of the anions may then be achieved by lifting the resulting hydrogels out of the aqueous phase...
February 19, 2018: Journal of the American Chemical Society
James M Brian, David H Choi, Michael M Moore
The primary physis is responsible for long bone growth in children and adolescents. Injury and physiologic or metabolic stress to the primary physis present unique radiologic findings that are important for radiologists to recognize and diagnose. Appreciation of the anatomy and histology of the primary physis forms the basis for understanding the imaging findings associated with pathologic conditions affecting the primary physis. Salter-Harris injuries, physeal bars, growth arrest lines, rickets, and focal periphyseal edema zones are common conditions with recognizable radiologic presentations...
February 2018: Seminars in Musculoskeletal Radiology
Helen Anwander, Martin Beck, Lorenz Büchler
Anatomy and biomechanics of the human hip joint are a consequence of the evolution of permanent bipedal gait. Habitat and behaviour have an impact on hip morphology and significant differences are present even within the same biological family. The forces acting upon the hip joint are mainly a function of gravitation and strength of the muscles. Acetabular and femoral anatomy ensure an inherently stable hip with a wide range of motion. The femoral head in first human ancestors with upright gait was spherical (coxa rotunda)...
February 5, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Enrique Marqués, Pedro J Mancha
PURPOSE: The purpose of this study was to evaluate ethylene-vinyl acetate (EVA) foam as a new lung substitute in radiotherapy and to study its physical and dosimetric characteristics METHODS: We calculated the ideal vinyl acetate (VA) content of EVA foam sheets to mimic the physical and dosimetric characteristics of the ICRU lung tissue. We also computed the water-to- medium mass collision stopping power ratios, mass attenuation coeffcients, CT numbers, effective atomic numbers and electron densities for: ICRU lung tissue, the RANDO commercial phantom, scaled WATER and EVA foam sheets with varying VA contents in a range between the minimum and maximum values supplied by the manufacturer...
February 5, 2018: Medical Physics
Andrew T Chen, Keegan T Conry, Allison Gilmore, Jochen P Son-Hing, Raymond W Liu
Background: Many surgeons advocate for surgical intervention of adult mallet fractures that involve either subluxation of the distal interphalangeal (DIP) joint or those that involve more than one-third of the articular surface. However, the efficacy of operative treatment and complication rates are unclear regarding the adolescent population. Questions/Purposes: The goal of this study is to evaluate the clinical outcomes following operative fixation of bony mallet fractures in the adolescent population...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Kevin G Shea, Peter C Cannamela, Peter D Fabricant, Elizabeth B Terhune, John D Polousky, Matthew D Milewski, Allen F Anderson, Theodore J Ganley
PURPOSE: To investigate the relation of the at-risk structures (distal femoral physis, lateral collateral ligament, anterolateral ligament, popliteus, and articular cartilage) during all-epiphyseal femoral tunnel drilling. A second purpose was 2-fold: (1) to develop recommendations for tunnel placement and orientation that anatomically reconstruct the anterior cruciate ligament (ACL) while minimizing the risk of injury to these at-risk structures, and (2) to allow for maximal tunnel length to increase the amount of graft in the socket to facilitate healing...
January 25, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Brett M Normandin, David J Tennent, Todd H Baldini, Alesia M Blanchard, Jason T Rhodes
Epiphysiodesis is performed to treat leg-length discrepancies and angular deformities in children. However, when placed across a physis to modulate growth, screws can bend or break postoperatively. This study evaluated the mechanical properties of 3 different screw designs commonly used when performing an epiphysiodesis. Six 4.0-mm cannulated, fully threaded; six 4.0-mm cannulated, partially threaded; and six 4.0-mm noncannulated, partially threaded cancellous screws underwent cantilever bending and tension testing in a simulated physis...
January 25, 2018: Orthopedics
Vinícius Alexandre de Souza Almeida, Carlos Henrique Fernandes, João Baptista Gomes Dos Santos, Francisco Alberto Schwarz-Fernandes, Flavio Faloppa, Walter Manna Albertoni
Objective: To measure the reliability of Albertoni's classification for mallet finger. Methods: Agreement study. Forty-three radiographs of patients with mallet finger were assessed by 19 responders (12 hand surgeons and seven residents). Injuries were classified by Albertoni's classification. For agreement comparison, lesions were grouped as: (A) tendon avulsion; (B) avulsion fracture; (C) fracture of the dorsal lip; and (D) physis injury-and subgroups (each group divided into two subgroups)...
January 2018: Revista Brasileira de Ortopedia
Ravi Mittal, Avtar Singh Balawat, Vikrant Manhas, Amit Roy, Navin Kumar Singh
Background: Habitual patellar dislocation is a rare condition affecting children. The growth plates are open in children and any surgical intervention should take that in to consideration. We are describing a modified four in one technique for habitual patellar dislocation, which is a soft tissue procedure without the use of any implant. Method: In this study we included 6 children (4 females and 2 males) with open growth plates, which were diagnosed with habitual patellar dislocation...
November 2017: Journal of Clinical Orthopaedics and Trauma
Alexander Zimmerer, Christian Sobau, Peter Balcarek
Recent years have been characterized by an ongoing increase in knowledge about the different conditions associated with lateral patellar instability. This increase in knowledge provides differentiated approaches to the various pathologies of the patellofemoral joint. Though current guidelines consider medial patellofemoral ligament (MPFL) reconstruction the basic treatment for the unstable patella, medial soft tissue-stabilizing procedures should not be interpreted as stand-alone procedures in every case. The influence of different anatomical factors leading to patellar instability, as well as their impact on clinical outcome measures, is becoming increasingly apparent and deserves further attention...
January 10, 2018: Journal of Experimental Orthopaedics
Ryo Hotta, Hyuma Makizako, Takehiko Doi, Kota Tsutsumimoto, Sho Nakakubo, Keitaro Makino, Takao Suzuki, Hiroyuki Shimada
OBJECTIVES: In this paper and prospective study, we examine the number of healthy behaviors and the incidence of disability in community-dwelling older adults aged 65 years and older. METHODS: Participants (N = 4483) were residents of Obu, Japan who were asked about regular exercise, smoking status, and sleep duration. Demographic variables, history of disease, physi- cal function, and cognitive function were measured as confounders. Information about disabil- ity was obtained from the Obu City Office...
January 1, 2018: American Journal of Health Behavior
Adalheidur Ran Thrastardottir, Frida Run Thordardottir, Johanna Torfadottir
INTRODUCTION: The aim of the study was to explore prevalence of food allergies and intolerances among children in preschools in Reykjavik, Iceland. Also, to investigate how well preschools maintain a safe environment for children with food allergies. MATERIALS AND METHODS: In 2014, a questionnaire designed specifically for this study, was sent to 65 preschools. Forty-nine participated (75%) representing a total of 4225 children. Prevalence of food allergy and intolerance was determined based on medical certificates from physi-cians delivered to the preschools...
January 2018: Læknablađiđ
Sebastien Pesenti, Matthieu Ollivier, Jean-Charles Escudier, Mathieu Cermolacce, Alexandre Baud, Franck Launay, Jean-Luc Jouve, Elie Choufani
PURPOSE: Management of post-traumatic patellar instability in children with osseous abnormalities is challenging because of the presence of an open physis. The aim of our study was to compare the rate of recurrence after isolated reconstruction of the medial patellofemoral ligament (MPFL) in children with or without osseous abnormalities. METHODS: The medical records of 25 children (27 knees) with recurrent patellar dislocation were reviewed. Each child underwent an isolated reconstruction of the MPFL using a hamstring graft...
January 4, 2018: International Orthopaedics
Dennis E Kramer, Patricia E Miller, Iman K Berrahou, Yi-Meng Yen, Benton E Heyworth
BACKGROUND: The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports. METHODS: Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period...
December 8, 2017: Journal of Pediatric Orthopedics
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