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https://www.readbyqxmd.com/read/28819612/uncommon-floating-knee-in-a-teenager-a-case-report-of-ipsilateral-physeal-fractures-in-distal-femur-and-proximal-tibia
#1
Youssef Othman, Lassaad Hassini, Aymen Fekih, Issam Aloui, Abderrazek Abid
INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in the pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed, and the fracture was seen on the post-operative radiographs...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28799991/treatment-of-infantile-blount-disease-an-update
#2
Samir Sabharwal, Sanjeev Sabharwal
Although the core principles of managing infantile Blount disease generally remain unchanged, treatment modalities have evolved over the years. Consensus has yet to be reached regarding the efficacy of bracing. Children with Blount disease commonly have advanced bone age, which may impact the timing and magnitude of (over) correction of angular deformity. Techniques of growth modulation, based on the tension band principle, continue to gain popularity. Although there are limited reports in the last decade on proximal tibial osteotomy for this developmental disorder, both acute and gradual correction remain viable treatment options in the appropriate setting...
September 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28777278/elastic-intramedullary-nailing-versus-open-reduction-internal-fixation-of-pediatric-tibial-shaft-fractures
#3
Andrew T Pennock, Tracey P Bastrom, Vidyadhar V Upasani
BACKGROUND: The optimal fixation strategy for unstable pediatric tibia fractures is unclear with some favoring elastic intramedullary nails (EIN) and others favoring plate and screws [open reduction internal fixation (ORIF)]. The purpose of this study was to compare outcomes and complications of skeletally immature patients undergoing surgical stabilization of the tibia with either EIN or ORIF. METHODS: A retrospective review was performed on all patients undergoing EIN or ORIF of a diaphyseal fracture at a single pediatric level I trauma center between 2010 and 2016...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28768782/anterior-cruciate-ligament-reconstruction-in-skeletally-immature-patients-a-systematic-review
#4
U G Longo, M Ciuffreda, C Casciaro, N Mannering, V Candela, G Salvatore, V Denaro
AIMS: Different methods of anterior cruciate ligament (ACL) reconstruction have been described for skeletally immature patients before closure of the growth plates. However, the outcome and complications following this treatment remain unclear. The aim of this systematic review was to analyse the outcome and complications of different techniques which may be used for reconstruction of the ACL in these patients. MATERIALS AND METHODS: We performed a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28767613/effect-of-greater-trochanteric-epiphysiodesis-after-femoral-varus-osteotomy-for-lateral-pillar-classification-b-and-b-c-border-legg-calv%C3%A3-perthes-disease-a-retrospective-observational-study
#5
Keun-Sang Kwon, Sung Il Wang, Ju-Hyung Lee, Young Jae Moon, Jung Ryul Kim
This is a retrospective observational study. Greater trochanteric epiphysiodesis (GTE) has been recommended to prevent Trendelenburg gait and limitation of the hip joint motion due to trochanteric overgrowth after femoral varus osteotomy (FVO) in Legg-Calvé-Perthes disease (LCPD). However, capital femoral physeal arrest frequently occurs in patients with severe disease (lateral pillar C), so GTE might not be as effective in these patients. The aim of this study was to compare trochanteric growth inhibition due to GTE after FVO between 2 age groups (<8 or >8 years) in patients with lateral pillar B and B/C border LCPD and evaluate the effectiveness of GTE compared with the normal, unaffected hip...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28704299/slipped-capital-femoral-epiphysis-in-children-younger-than-10-years-old-clinical-characteristics-and-efficacy-of-physeal-sparing-procedures
#6
Mi Hyun Song, Woo Young Jang, Moon Seok Park, Won Joon Yoo, In Ho Choi, Tae-Joon Cho
We aimed to investigate the clinical characteristics of slipped capital femoral epiphysis (SCFE) in patients aged less than 10 years and identify the efficacy of physeal-sparing procedures in this age group. Demographic data of 18 SCFE patients aged less than 10 years were compared with those of 71 older patients to investigate the clinical characteristics. The efficacy of physeal-sparing procedures (n=5) was investigated compared with that of in-situ screw fixation (n=13). Obese children were noticeably more common among SCFE patients aged less than 10 years (P=0...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28688811/angular-deformity-correction-by-guided-growth-in-growing-children-eight-plate-versus-3-5-mm-reconstruction-plate
#7
Kyeong-Hyeon Park, Chang-Wug Oh, Joon-Woo Kim, Il-Hyung Park, Hee-June Kim, Young-Seo Choi
BACKGROUND: Guided growth using the eight-plate (8-plate) is the most commonly used method to correct angular deformities in children; however, implant failure has been reported. Recently, the 3.5-mm reconstruction plate (R-plate) has been used as an alternative option for guided growth; however, hardware prominence has been problematic. This study aimed to compare the coronal angular deformity correction results of guided growth between relatively thin 8-plates with cannulated screws and thick R-plates with solid screws...
July 6, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28687098/physeal-fractures-in-foals
#8
REVIEW
David G Levine, Maia R Aitken
Physeal fractures are common musculoskeletal injuries in foals and should be included as a differential diagnosis for the lame or nonweightbearing foal. Careful evaluation of the patient, including precise radiographic assessment, is paramount in determining the options for treatment. Prognosis mostly depends on the patient's age, weight, and fracture location and configuration.
August 2017: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/28687092/septic-arthritis-physitis-and-osteomyelitis-in-foals
#9
REVIEW
Kati Glass, Ashlee E Watts
Despite differences in etiology and diagnostics, the mainstay of therapy in the foal is similar to the adult: local lavage and/or debridement and local antimicrobial therapy. When musculoskeletal infection is concurrent with neonatal sepsis, the prognosis for survival is fair. When musculoskeletal infection is the primary problem, the prognosis is fair to good for survival of synovial, bony, and physeal infections with appropriate and aggressive local therapy. Recent literature may indicate that prognosis for survival and potential athleticism in foals that are treated expediently with local therapies and are without comorbidities may be more favorable than has been previously indicated...
August 2017: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/28675805/characterization-of-normal-murine-carpal-bone-development-prompts-re-evaluation-of-pathologic-osteolysis-as-the-cause-of-human-carpal-tarsal-osteolysis-disorders
#10
Syndia Lazarus, Hsu-Wen Tseng, Felicity Lawrence, Maria Ann Woodruff, Emma Letitia Duncan, Allison Robyn Pettit
Multicentric carpal-tarsal osteolysis; multicentric osteolysis, nodulosis, and arthropathy; and Winchester syndromes, skeletal dysplasias characterized by carpal/tarsal and epiphyseal abnormalities, are caused by mutations in v-maf musculoaponeurotic fibrosarcoma oncogene ortholog B (MAFB), matrix metalloproteinase 2 (MMP2), and MMP14, respectively; however, the underlying pathophysiology is unclear. Osteoclast-mediated osteolysis has been regarded as the main mechanism, but does not explain the skeletal distribution...
July 1, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28660402/bisphosphonate-induced-zebra-lines-in-fibrous-dysplasia-of-bone-histo-radiographic-correlation-in-a-case-of-mccune-albright-syndrome
#11
Alessandro Corsi, Ernesto Ippolito, Pamela G Robey, Mara Riminucci, Alan Boyde
Bisphosphonates (BPs) are currently used in the treatment of diverse bone diseases including fibrous dysplasia of bone (FD). In pediatric patients, a radiographic consequence of cyclical administration of BPs is the development of apo-, epi-, and meta-physeal sclerotic bands, otherwise known as zebra lines, which result from the temporary inhibition of osteoclastic activity at the time of drug treatment. We report here on a child with McCune-Albright syndrome (FD in addition to hyperfunctioning endocrinopathies and skin hyperpigmentation) treated with cyclical intravenous infusions of pamidronate in which conventional radiography, contact microradiography, histology, and backscattered electron image analysis demonstrated that zebra lines formed only where bone was normal, were arrested at the boundary between FD-unaffected and FD-affected bone where bone is sclerotic, and were absent within the undermineralized FD bone...
June 28, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28652828/prevention-treatment-and-rehabilitation-of-anterior-cruciate-ligament-injuries-in-children
#12
REVIEW
Pamela J Lang, Dai Sugimoto, Lyle J Micheli
As more children and adolescents participate in competitive organized sports, there has been an increase in the reported incidence of anterior cruciate ligament (ACL) injuries in these age groups. ACL injuries in skeletally immature athletes present a challenge, as reconstruction must preserve the physis of the distal femur and of the proximal tibia to avoid growth disturbances. Historically, a skeletally immature athlete with an ACL injury was treated with a brace and activity modification until skeletal maturity, with ACL reconstruction being performed at that time in the "non-copers" who experienced instability...
2017: Open Access Journal of Sports Medicine
https://www.readbyqxmd.com/read/28643552/drug-induced-physeal-abnormalities-in-preclinical-toxicity-studies
#13
Kendall S Frazier
Most toxic physeal changes are characterized microscopically by altered chondrocyte development, proliferation, or maturation in the growth plate and eventually result in disordered appositional bone growth. Many therapeutic drugs directly or indirectly target proteins involved in chondrocytic differentiation and maturation pathways, so toxic physeal injury has become increasingly common in preclinical toxicologic pathology. While physeal dysplasia has been associated with several different drug classes including bisphosphonates, vascular endothelial growth factor receptor inhibitors, fibroblast growth factor receptor inhibitors, transforming growth factor beta receptor inhibitors, and vascular targeting agents, physeal changes often share similar morphologic features including thickening and disorganization of the hypertrophic layer, increased numbers of hypertrophic chondrocytes, altered mineralization of endochondral ossification, and/or increased thickness of subphyseal bone...
January 1, 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28636058/percutaneous-tibial-physeal-fracture-repair-in-small-animals-technique-and-17-cases
#14
Dirsko J F von Pfeil, Mathieu Glassman, Meaghan Ropski
OBJECTIVES: To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures. METHODS: Clinical data of 14 dogs and three cats were included. The "spiking" technique was described. RESULTS: Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures...
June 21, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#15
Jeremy Korsh, Stephen Adolfsen
Salter-Harris type I (SH-I) fractures of the distal fibula are commonly encountered in pediatric orthopedics. We describe 2 unique cases of adolescents with completely displaced SH-I distal fibula fractures that were treated operatively. In the first case, a closed reduction attempt failed and the patient required open reduction and internal fixation of the distal fibula and syndesmosis. The syndesmotic ligaments were avulsed from the distal fibular metaphysis. In the second case, closed reduction of the distal fibula fracture was partially successful, but anatomic reduction could not be achieved without open reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28612581/surgical-options-for-anterior-cruciate-ligament-reconstruction-in-the-young-child
#16
Meghan J Price, Lionel Lazaro, Frank A Cordasco, Daniel W Green
Injury to the anterior cruciate ligament (ACL) is becoming increasingly common in the skeletally immature population. Historically, there was a reluctance to operate on skeletally immature patients due to potential damage to the physis and subsequent growth disturbances; however, more recently, ACL reconstruction techniques specifically developed for this young population have shown good outcomes and low complication rates. In this article, we briefly discuss the modifiable and non-modifiable risk factors for ACL injury in children, options for conservative management for ACL rupture, and outcomes for delayed operative management...
August 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28601180/musculoskeletal-traumatic-injuries-in-children-characteristic-imaging-findings-and-mimickers
#17
REVIEW
Victor M Ho-Fung, Matthew A Zapala, Edward Y Lee
Musculoskeletal traumatic injuries in children demonstrate characteristic imaging findings. The physis is the most susceptible structure to traumatic injury. The periosteum in children plays a key role in rapid bone healing and stability. The main complications of fractures in children are premature physeal closure, potential limb length discrepancy, and angular deformities. Understanding the normal bone growth, healing, and complications of pediatric fractures is crucial for appropriate imaging diagnosis. This article discusses currently available imaging modalities with up-to-date techniques, underlying mechanisms, and characteristic imaging findings of musculoskeletal traumatic injuries and mimickers encountered in daily clinical practice...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28594522/skeletally-immature-anterior-cruciate-ligament-injuries-controversies-and-management
#18
Shital N Parikh, Bradley P Jaquith, Christopher M Brusalis, Lauren H Redler, Theodore J Ganley, Mininder S Kocher
At one time, anterior cruciate ligament (ACL) tears in skeletally immature patients were considered rare. The recommended treatment option for skeletally immature patients with ACL tears was to modify activities until skeletal maturity, at which point definitive ACL reconstruction could be safely performed. The management of ACL tears in skeletally immature patients has evolved as a result of the increased frequency of ACL tears in younger patients and an increased awareness for the potential development or worsening of meniscal tears, chondral lesions, and degenerative changes that occur with the "wait-and-fix-later" approach...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594521/pediatric-distal-radius-fractures
#19
Karan Dua, Joshua M Abzug, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Distal radius fractures are the most common orthopaedic injury that occur in the pediatric population. The annual incidence of distal radius fractures has increased as a result of earlier participation in sporting activities, increased body mass index, and decreased bone mineral density. Most distal radius fractures are sustained after a fall onto an outstretched arm that results in axial compression on the extremity or from direct trauma to the extremity. Physeal fractures of the distal radius are described based on the Salter-Harris classification system...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28590374/return-to-sport-after-pediatric-anterior-cruciate-ligament-reconstruction-and-its-effect-on-subsequent-anterior-cruciate-ligament-injury
#20
Travis J Dekker, Jonathan A Godin, Kevin M Dale, William E Garrett, Dean C Taylor, Jonathan C Riboh
BACKGROUND: Anterior cruciate ligament (ACL) graft failure and contralateral ACL tears are more frequent in children and adolescents than adults. The reasons for higher subsequent injury rates in this population are incompletely understood. METHODS: We analyzed a continuous cohort of patients who were <18 years of age. Subjects underwent isolated, primary ACL reconstruction with autograft between 2006 and January 1, 2014, and had a minimum 2-year follow-up. Return-to-sport characteristics were described, and multivariable Cox regression modeling was used to identify predictors of a second ACL injury...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
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