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https://www.readbyqxmd.com/read/29145286/bilateral-discoid-medial-meniscus-associated-with-meniscal-tears-and-hypoplasia-of-the-medial-femoral-condyle-a-case-report
#1
Hong-De Wang, Shi-Jun Gao
RATIONALE: Bilateral discoid medial menisci is an extremely rare abnormality of the knee joint. The presence of a discoid medial meniscus has been associated with magnetic resonance imaging (MRI) and radiographic changes in the tibial region, such as cupping of the medial tibial plateau and tibial physis collapse. While discoid medial meniscal tears with hypoplasia of the femoral medial condyles have not been previously reported. Herein, we report a case of bilateral discoid medial menisci associated with meniscal tears and femoral bone changes...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29113159/treatment-of-osteosarcoma-around-the-knee-in-skeletally-immature-patients
#2
Weitao Yao, Qiqing Cai, Jiaqiang Wang, Songtao Gao
Limb sparing surgery in growing young patients with malignant tumors is difficult as invasion of the physis by the tumor or surgical resection through the metaphysis may cause significant limb discrepancy following surgery. At present, hinged tumor prosthesis or biological reconstructions are the main methods following tumor resection in these patients. The aim of the present study was to assess different procedures for the treatment of osteosarcoma around knee joints in immature patients. A retrospective study of 56 patients (<15 years old, open physis) who had been treated for osteosarcoma around the knee joint between January 2007 and December 2015 was performed...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29083227/variation-in-the-medial-patellofemoral-ligament-origin-in-the-skeletally-immature-knee-an-anatomic-study
#3
Kevin G Shea, W Duncan Martinson, Peter C Cannamela, Connor G Richmond, Peter D Fabricant, Allen F Anderson, John D Polousky, Theodore J Ganley
BACKGROUND: The medial patellofemoral ligament (MPFL) is frequently reconstructed to treat recurrent patellar instability. The femoral origin of the MPFL is well described in adults but not in the skeletally immature knee. PURPOSE: To identify a radiographic landmark for the femoral MPFL attachment in the skeletally immature knee and study its relationship to the distal femoral physis. STUDY DESIGN: Descriptive laboratory study. METHODS: Thirty-six cadaveric specimens between 2 and 11 years old were dissected and examined (29 male and 7 female)...
October 1, 2017: American Journal of Sports Medicine
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
#4
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/29070026/a-biomechanical-comparison-of-kirschner-wire-fixation-on-fracture-stability-in-salter-harris-type-i-fractures-of-the-proximal-humeral-physis-in-a-porcine-cadaveric-model
#5
Jiawen Ma, Tian Wang, Vedran Lovric, Kenneth A Johnson, William R Walsh
BACKGROUND: The physis is the weakest component of immature long bones, and physeal fractures constitute about 30% of fractures in growing dogs. Fractures of the proximal humeral physis typically have a Salter Harris type I or II configuration. These fractures require accurate reduction and adequate stabilization to allow for any potential continued longitudinal bone growth, in conjunction with physeal fracture healing. Conventional internal fixation of these fractures involves insertion of two parallel Kirschner wires, although other methods described include tension band wiring, Rush pinning, and lag screws...
October 25, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29066475/effects-of-long-term-use-of-the-preferential-cox-2-inhibitor-meloxicam-on-growing-pigs
#6
Ben M C Gorissen, Joost J Uilenreef, Wilhelmina Bergmann, Ellen Meijer, Bert van Rietbergen, Franz Josef van der Staay, P René van Weeren, Claudia F Wolschrijn
Meloxicam, a preferential COX-2 inhibitor, is a commonly used NSAID in pigs. Besides having potential side effects on the gastrointestinal tract, this type of drug might potentially affect osteogenesis and chondrogenesis, processes relevant to growing pigs. Therefore, the effects of long-term meloxicam treatment on growing pigs were studied. Twelve piglets (n=6 receiving daily meloxicam 0.4 mg/kg orally from 48 until 110 days of age; n=6 receiving only applesauce (vehicle control)) were subjected to visual and objective gait analysis by pressure plate measurements at several time points...
October 24, 2017: Veterinary Record
https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#7
Shital N Parikh, Charles T Mehlman
Pediatric ankle fractures are common and have unique fracture characteristics because of the presence of distal tibial and fibular physes. When displaced (>3 mm widening of the physis or >2 mm intra-articular gap/step-off), these fractures are typically treated with anatomical reduction and internal fixation. Computed tomography is recommended for preoperative evaluation and surgical planning for intra-articular fractures. These fractures in younger children with substantial growth remaining should be followed closely to monitor for any growth disturbance...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29025614/outcome-of-distal-tibia-physeal-fractures-a-review-of-cases-as-related-to-risk-factors
#8
Fabio D'Angelo, Giuseppe Solarino, Davide Tanas, Alessia Zani, Paolo Cherubino, Biagio Moretti
INTRODUCTION: The physeal fractures represent the 20-30% of all fractures of the child. The distal tibial physis is the third most frequently injured. The most important complication is the premature physeal closure (PPC). Aim of this study is to evaluate risk factors that can influence the outcome like fracture pattern, fracture displacement, mechanism of injury and treatment method. MATERIAL AND METHODS: The records of 46 patients treated for distal tibia physeal fractures between 2003 and 2013 were reviewed...
October 2017: Injury
https://www.readbyqxmd.com/read/29016430/an-anatomic-and-radiographic-study-of-the-distal-tibial-epiphysis
#9
Cynthia V Nguyen, Janelle D Greene, Daniel R Cooperman, Raymond W Liu
BACKGROUND: Although the undulating shape of the distal tibial epiphysis is well recognized, its anatomic features have not been well quantified in the literature. To guide the placement of surgical implants about the distal tibial physis, we investigated the topographical anatomy of the distal tibial epiphysis and explored the ability of standard radiographs to visualize the physis. METHODS: We studied 30 cadaveric distal tibial epiphyses in specimens 3 to 14 years of age...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28983219/reliability-and-reproducibility-of-subject-positioning-with-eos-low-dose-biplanar-x-ray
#10
Christine Goodbody, Paz Kedem, Michaela Thompson, Huong T Do, Douglas N Mintz, Roger F Widmann, Emily R Dodwell
BACKGROUND: EOS low-dose biplanar X-ray used with tantalum bead implantation is an appealing imaging modality to evaluate limb length and physeal growth due its relatively low radiation exposure, excellent inter- and intra-observer reliability, and minimal magnification/shrinkage error. QUESTIONS/PURPOSES: The purpose of this study was to establish the error in total length and inter-bead distances using EOS and tantalum beads due to variable positioning in the EOS gantry, by assessing variation in measurements made on the same subject repeatedly positioning by one positioner (intra-positioner measurement error) and variation in measurements made on the same subject with positioning by multiple positioners (inter-positioner measurement error)...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28983218/percutaneous-epiphysiodesis-using-transphyseal-screws-a-case-series-demonstrating-high-efficacy
#11
Emily R Dodwell, Matthew R Garner, Elise Bixby, Eva M Luderowski, Daniel W Green, John S Blanco, Roger F Widmann
BACKGROUND: Percutaneous epiphysiodesis using transphyseal screws (PETS) has been associated with implant failure, implant prominence, angular deformities, and delayed growth inhibition. QUESTIONS/PURPOSES: The aim of this study was to assess the complication rate and efficacy (defined as actual growth inhibition divided by expected growth inhibition) of PETS and to identify factors associated with improved efficacy. METHODS: Patients who underwent distal femoral and/or proximal tibial PETS between January 2007 and June 2014 were identified...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28976599/biomechanical-investigation-of-two-long-bone-growth-modulation-techniques-by-finite-element-simulations
#12
Manuel Schneider, Jan Buschbaum, Alexander Joeris, Oliver Röhrle, Jonathan Dwyer, James B Hunter, Richard A K Reynolds, Theodor F Slongo, Boyko Gueorguiev, Peter Varga
Implants used to correct pathological varus-valgus deformities (VVD) and leg length discrepancies (LLD) may not be optimized for the specific treatment, as suggested by their off-label use. Detailed analysis of this issue has been limited by the poorly understood mechanical behavior of the growing physis and ignorance of the loads acting on the implants. The aim of this study was to predict and compare the loading conditions of a growth modulation implant in VVD and LLD treatments. Idealized finite element (FE) models of the juvenile distal femur treated with the eight-Plate implant were developed for VVD and LLD...
October 4, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28970983/double-row-suture-anchor-repair-of-posterolateral-corner-avulsion-fractures
#13
Brian B Gilmer
Posterolateral corner avulsion fractures are a rare variant of ligamentous knee injury primarily described in the skeletally immature population. Injury is often related to a direct varus moment placed on the knee during sporting activities. Various treatment strategies have been discussed ranging from nonoperative management, to excision of the bony fragment, to primary repair with screws or suture. The described technique is a means for achieving fixation of the bony avulsion using principles familiar to double-row transosseous equivalent rotator cuff repair...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28945692/the-surgical-management-of-tibial-spine-fractures-in-children-a-survey-of-the-pediatric-orthopaedic-society-of-north-america-posna
#14
Taylor J Jackson, Eileen P Storey, Theodore J Ganley
BACKGROUND: Tibial spine fractures are rare, complex injuries. Management remains varied given a lack of consensus about the optimal approach. Thus, the purpose of this study is to determine prevailing strategies among pediatric orthopaedists and establish areas of agreement and ongoing controversy in the management of tibial spine fractures. METHODS: An electronic survey was distributed to the Pediatric Orthopaedic Society of North America (POSNA) membership. Surgeon demographics, experience, and responses to clinical vignettes were collected...
September 22, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28928921/an-unusual-cause-of-genu-valgum-and-persistent-instability
#15
Edward Holloway, Paul Sutton, Robert Cooper
We present the case of a professional adolescent footballer who attended our clinic with ongoing instability symptoms and valgus knee deformity after conservative management of an medial collateral ligament injury. The patient was found to have sustained a contra-coup Salter Harris Type V injury to his lateral distal femur physis resulting in premature growth arrest and deformity. Salter Harris Type V injuries are rare, and often not diagnosed until growth has arrest has occurred due to lack of identifiable features on initial plain radiographs...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28917547/growth-of-the-new-thumb-metacarpal-after-pollicization-for-thumb-hypoplasia
#16
Michael A Tonkin, Nathan D Trist, Dirk J van der Spuy, Albert Yoon, Harvinder P Singh, Richard D Lawson
PURPOSE: To investigate the radiographic length and width of the new thumb metacarpal in relation to the middle finger proximal phalanx; to assess the incidence of premature physeal closure of the new metacarpal; and to consider whether there is a relationship between growth characteristics and the presence of union or nonunion of the new trapezium to the retained index finger metacarpal base. MATERIALS AND METHODS: Forty pollicizations were assessed with preoperative or immediate postoperative radiographs and follow-up radiographs to establish the growth characteristics of the new thumb metacarpal...
September 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28902001/guided-growth-of-the-proximal-femur-for-the-management-of-hip-dysplasia-in-children-with-cerebral-palsy
#17
Nicola Portinaro, Marco Turati, Matteo Cometto, Marco Bigoni, Jon R Davids, Artemisia Panou
BACKGROUND: Progressive hip displacement is one of the most common and debilitating deformities seen in children with cerebral palsy (CP). The aim of this study was to evaluate the results of temporary medial hemiepiphysiodesis of the proximal femur (TMH-PF) using a transphyseal screw to control hip migration during growth in children with CP. METHODS: This was a retrospective study of children with CP and hip dysplasia, age 4 to 11 years and GMFCS levels III-V...
September 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28884099/medial-patellofemoral-ligament-and-medial-patellotibial-ligament-reconstruction-in-children-preliminary-results
#18
David Sadigursky, Lucas Cortizo Garcia, Maurício Armede, Lucas Rodrigues de Oliveira, Rogério Jamil Fernandes Carneiro, Paulo Oliveira Colavolpe
OBJECTIVE: The aim of this study was to evaluate the reconstruction of the medial patellofemoral ligament associated with the medial patellotibial ligament in skeletally immature patients. METHOD: This is a case series study in patients with patellar instability with open physis. In total, seven patients were evaluated: four males and three females were operated using the proposed technique. Patients with open physis who had more than two episodes of recurring patellar dislocation were included...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28867290/modified-adductor-sling-technique-a-surgical-therapy-for-patellar-instability-in-skeletally-immature-patients
#19
Lena Alm, Matthias Krause, Carolin Mull, Karl-Heinz Frosch, Ralph Akoto
BACKGROUND: Due to open femoral physis the therapy of patellar instability in skeletally immature patients is challenging. We developed a modified surgical technique of the 'Adductor-Sling-Approach' by Sillanpää. The purpose of this study was to evaluate the clinical outcome of the operative technique and to analyse the reasons for failure. METHODS: Thirty 'modified adductor sling' reconstructions in 28 patients were included in the study. From 2010 to 2016 modified adductor sling reconstruction was performed by looping the gracilis or semitendinosus tendon around the adductor magnus tendon and attaching it at the medial facet of the patella...
August 31, 2017: Knee
https://www.readbyqxmd.com/read/28840674/-case-report-comprehensive-treatment-of-forefoot-with-double-brachymetatarsia-in-one-surgical-stage
#20
I Caldiño-Lozada, O Gallegos-de la Torre, R Esperón-Hernández
Brachymetatarsia (shortening of the metatarsal) directly affects the transversal arch of the foot causing severe deformities, such as hallux valgus, divergent toes, overlapping toes, metatarsalgia, all of these alter the biomechanics of the foot and gait. Treatment consists of two main techniques, one-stage lengthening with bone graft or elongation through callotaxis with external fixator; there are variants of both techniques used to minimize the disadvantages of each. The objective of treatment must be to return the structural harmony to the forefoot, improving the biomechanics, resulting in a satisfactory outcome for the patients...
March 2017: Acta Ortopédica Mexicana
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