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https://www.readbyqxmd.com/read/29343450/paediatric-physeal-sparing-posterior-cruciate-ligament-pcl-reconstruction-with-parental-donation-allograft-rationale-and-operative-approach
#1
R S Khakha, S K Yasen, A J Wilson
BACKGROUND: Paediatric PCL injuries are rare but constitute a significant management challenge. We describe a novel approach to the surgical management of an 11-year-old boy who presented with persisting symptomatic instability following 18months of failed conservative therapy. METHODS: PCL reconstruction was performed using a physeal sparing, all-inside technique under fluoroscopic control. This avoids the potential for iatrogenic growth injury. A parentally donated hamstrings allograft was used to ensure adequate graft size, and reinforced using a non-elastic two millimetre braided suture...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29315109/update-on-treatment-of-adolescent-blount-disease
#2
Julio de Pablos, Lucas Arbeloa-Gutierrez, Antonio Arenas-Miquelez
PURPOSE OF REVIEW: Treatments available to correct adolescent Blount disease deformities differ in terms of features, advantages, and disadvantages. Each is indicated, therefore, for different scenarios of severity, physeal condition, and maturity. The purpose of this review is to update basic concepts, surgical treatments, and controversies concerning this disorder. RECENT FINDINGS: The cause of Blount disease is unknown although etiologic factors as morbid obesity and hypovitaminosis D are thought to be associated with it...
February 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29291284/little-league-shoulder-in-a-15-year-old-male-baseball-pitcher
#3
Mark C Zipser, Jonathan C Sum, Alison G Wilcox
A 15-year-old baseball pitcher presented to physical therapy with a 1-week history of acute right shoulder pain experienced during the acceleration phase of throwing. The week after physical therapy evaluation, the patient returned with radiographs and magnetic resonance imaging results that revealed lateral physeal widening with adjacent edema. Additionally, a nondisplaced labral tear was noted. In this case, imaging was necessary for an accurate diagnosis of lateral physeal widening, commonly referred to as "Little League shoulder...
January 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29279562/midterm-result-of-arthroscopic-bicruciate-ligament-sutures-for-multiligament-knee-injury-in-an-adolescent-patient
#4
Yasushi Oshima, Norishige Iizawa, Shinro Takai
BACKGROUND: Treatment of multiligament knee injuries, especially in adolescent patients, is challenging for orthopedic surgeons. Repair of collateral ligaments and reconstruction of cruciate ligaments are usually performed, however, ligament reconstruction with transphyseal or physeal-sparing techniques may lead to physeal damage and growth disturbances in skeletally immature patients. We present a case report on performing bicruciate ligament sutures arthroscopically in an adolescent patient...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29239869/challenges-in-the-management-of-anterior-cruciate-ligament-ruptures-in-skeletally-immature-patients
#5
Christopher J DeFrancesco, Eileen P Storey, Kevin G Shea, Mininder S Kocher, Theodore J Ganley
Although initially considered rare, anterior cruciate ligament (ACL) ruptures in pediatric patients recently have increased substantially as a result of greater awareness of the injury and increased participation in youth sports. Although pediatric patients with an ACL injury and a clinically stable joint may handle the injury well and return to sports activity without requiring surgical reconstruction, young, active patients with an ACL rupture and an unstable joint may be good candidates for ACL reconstruction to prevent ongoing instability and additional joint damage...
December 8, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29226166/a-radiographic-healing-classification-for-osteochondritis-dissecans-of-the-knee-provides-good-interobserver-reliability
#6
David E Ramski, Theodore J Ganley, James L Carey
Background: Recent studies have examined radiographic factors associated with healing of osteochondritis dissecans (OCD) lesions of the knee. However, there is still no gold standard in determining the healing status of an OCD lesion. Purpose: We examined temporally associated patterns of healing to (1) evaluate the practicality of a classification system and (2) elucidate any associations between healing pattern and patient age, sex, lesion location, treatment type, and physeal patency...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29223628/five-and-10-year-follow-up-of-nonvascularized-toe-phalanx-transfers
#7
Hidehiko Kawabata, Daisuke Tamura
PURPOSE: The purpose of this study was to evaluate long-term outcomes of nonvascularized toe phalanx transfer. METHODS: We retrospectively reviewed 54 nonvascularized toe phalanx transfers in 29 children with symbrachydactyly. Forty-seven transfers in 24 children were evaluated at 5-year follow-up and 27 transfers in 14 children were evaluated at 10-year follow-up. We recorded the incidence of the early physeal closure and the length of the transferred toe phalanx on plain radiographs at 5- and 10-year follow-up...
December 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29218364/ultrasound-evaluation-of-stress-injuries-and-physiological-adaptations-in-the-fingers-of-adolescent-competitive-rock-climbers
#8
Kathryn Garcia, Diego Jaramillo, Erika Rubesova
BACKGROUND: The impact of high-intensity, repetitive training on the fingers of adolescent climbers is relatively unknown. OBJECTIVE: To evaluate this effect by ultrasound (US) and to confirm some findings by magnetic resonance imaging (MRI). MATERIALS AND METHODS: The US study was performed in 20 adolescent rock climbers (ages 10-17 years) and 6 non-climbing controls (ages 11-15 years). US was used to examine the third digit of the right hand for differences in thickness of soft tissue, flexor and extensor tendon, volar plate and bony and growth plate adaptations...
December 7, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29203221/distal-femoral-physeal-crush-injury-with-metaphyseal-comminution-a-report-of-two-cases-and-a-new-perspective-to-physeal-injury
#9
Prateek Behera, Nirmal Raj Gopinathan, Avinash Kumar, Balaji Saibaba, Pebam Sudesh, Rakesh John
The physis of a long bone may get 'sandwiched' and crushed between the metaphysis and the epiphysis if it is traumatically loaded along its long axis. Such a physeal injury may lead to complications like angular deformities and growth restrictions and hence, management of such injuries requires adequate planning and attentive execution. Two patients with distal femoral physeal crush injury were treated using a ring fixator such that one ring had the wires passing through the epiphysis and the other through the femoral shaft...
September 28, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29201291/long-term-results-of-modified-salter-innominate-osteotomy-for-legg-calv%C3%A3-perthes-disease
#10
Kyung Soon Park, Kyu Jin Cho, Hong Yeol Yang, Kamolhuja Eshnazarovich Eshnazarov, Taek Rim Yoon
Background: In a previous study, we reported clinical and radiographic results of our modified Salter innominate osteotomy technique in 16 hips affected by Legg-Calvé-Perthes disease (LCPD) with an average follow-up of 31.8 months. In this study, we present the long-term results of the osteotomy in LCPD patients followed until physeal closure. Methods: Thirty hips of 29 patients were followed until skeletal maturation after modified Salter innominate osteotomy...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29189533/experimental-induction-of-physeal-injuries-by-fracture-drill-and-ablation-techniques-analyses-of-immunohistochemical-findings
#11
Helen E Gruber, Nomaan Ashraf, Michael D Cox, Jane A Ingram, Megan Templin, John Michael Wattenbarger
BACKGROUND: Although physeal fractures and physeal bars can result in significant clinical consequences to growth and development of the injured physis, little orthopaedic research has focused upon this topic. Our objective was to extend a previously developed rat model to examine the immunohistochemical features following surgical application of techniques disrupting the physis. METHODS: Physes were surgically disrupted using fracture (control), epiphyseal scrape (ES), or epiphyseal drill (ED)...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189529/trends-in-management-and-complications-of-anterior-cruciate-ligament-injuries-in-pediatric-patients-a-survey-of-the-prism-society
#12
Charles A Popkin, Margaret L Wright, Andrew T Pennock, Laura A Vogel, Ajay Padaki, Lauren H Redler, Christopher S Ahmad
BACKGROUND: Anterior cruciate ligament (ACL) injuries have been recognized and treated with increasing frequency in children and adolescents. ACL reconstruction (ACLR) in skeletally immature patients has unique considerations and there is a large practice variation in the management of these injuries. The purpose of this study was to survey the members of the Pediatric Research in Sports Medicine (PRiSM) Society regarding their experience with the management and complications of pediatric ACL injuries...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29182123/angular-deformity-development-after-the-distal-tibial-physeal-fractures
#13
B Özkul, M S Saygılı, E Çetinkaya, F Arslanoğlu, I A Bayhan, B Demir, A C Tekin
Several clinical and radiological factors can be prognostic in the development of angular deformity following physeal injuries of the distal tibia. One of the radiological parameters, premature physeal closure (PPC), can be detected during postoperative follow-ups. Aim of our study was to identify the prognostic factors in development of angular deformity and its relationship with PPC. One hundred and four patients treated due to physeal injuries of the distal tibia were included in our study. Patients were divided into three groups based on Salter-Harris (SH) classification...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29182121/primary-epiphyseal-and-metaepiphyseal-tubercular-osteomyelitis-in-children-a-series-of-8-case
#14
A Agarwal, N Gupta, M Mishra, N Agrawal, D Kumar
Clinical series of primary epiphyseal and metaepiphyseal tubercular osteomyelitis are few. The purpose of our study was to retrospectively review the presentation, healing response and functional results of 8 such cases in children. MATERIAL AND METHODS: The patients were evaluated for pain, deformity, range of motion, limb length discrepancy (if any) and recurrence. Serial radiographs of the region were studied to see remineralization, obliteration of radiological lesions, status of physis and remodeling of the growth plate...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29167606/results-of-operative-4-in-1-patella-realignment-in-children-with-recurrent-patella-instability
#15
Francesc Malagelada, Ole Rahbek, Cyrus Sahirad, Manoj Ramachandran
Purpose: Recurrent patellar instability is a cause of knee dysfunction, limitation and pain for children. If nonoperative treatment fails to stabilise the patella, operative realignment and stabilisation have been advocated. Operative techniques in the paediatric population must preserve physeal growth while ensuring stability. We aimed to determine the outcome of children and adolescents who underwent a 4-in-1 patellar realignment (lateral release, medial reefing, Insall tube realignment and Roux-Goldthwaite patella ligament transfer)...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29157992/complications-associated-with-the-techniques-for-anterior-cruciate-ligament-reconstruction-in-patients-under-18-years-old-a-systematic-review
#16
W Tovar-Cuellar, F Galván-Villamarín, J Ortiz-Morales
OBJECTIVE: Determine the complications related to the different techniques for anterior cruciate ligament reconstruction in patients under 18 years old. METHODOLOGY: Systematic review using the databases Medline, Cochrane Database of Systematic Reviews and Embase (until July 2016), additional studies were included conducting a search of the references of previous studies. The terms included in the search were: «cruciate», «ligament», «anterior», «immature», «complications», «outcome», «acl reconstruction»,« cruciate ligament anterior reconstruction», «children», «child», «infants», «adolescent», «open physis», «growth plate» and «skeletally immature»...
November 17, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29110047/hip-shape-is-symmetric-non-dependent-on-limb-dominance-and-gender-specific-implications-for-femoroacetabular-impingement-a-3d-ct-analysis-in-asymptomatic-subjects
#17
Vasco V Mascarenhas, Paulo Rego, Pedro Dantas, Miguel Castro, Lennart Jans, Rui M Marques, Nélia Gouveia, Francisco Soldado, Olufemi R Ayeni, José G Consciência
OBJECTIVE: To determine the reference intervals (RefInt) of the quantitative morphometric parameters of femoroacetabular impingement (FAI) in asymptomatic hips with computed tomography (CT) and determine their dependence on age, side, limb dominance and sex. METHODS: We prospectively included 590 patients and evaluated 1111 hips with semi-automated CT analysis. We calculated overall, side- and sex-specific parameters for imaging signs of cam [omega and alpha angle (α°)] and pincer-type morphology [acetabular version (ACvers), lateral centre-edge angle (LCEA) and cranio-caudal coverage]...
November 6, 2017: European Radiology
https://www.readbyqxmd.com/read/29107133/physeal-fractures-of-the-lower-leg-in-children-and-adolescents-therapeutic-results-pitfalls-and-suggested-management-protocol-based-on-the-experience-of-the-authors-and-contemporary-literature
#18
Marcin Karlikowski, Jerzy Sułko
INTRODUCTION: Physeal fractures in children frequently give rise to concerns about the condition of the growth plate. Our observations have proven that the dysfunction of the growth plate is less frequent complication in those cases than misdiagnosed interposition of the periosteum. The aim of this paper is to familiarize the readers with the issue of treatment of physeal fractures of the distal tibia and fibula in the growing skeleton. MATERIALS AND METHODS: We analyzed the group of 75 patients - children and adolescents - with surgically treated physeal fractures of the lower leg...
October 26, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/29104071/hybrid-fixation-in-adult-osteochondritis-dissecans-of-the-knee
#19
L Chadli, C Steltzlen, C Toanen, P Boisrenoult, P Beaufils, N Pujol
Osteochondritis dissecans progresses to osteoarthritis if integration of the fragment is not obtained. The prognosis of osteochondritis dissecans is more severe in adults, as spontaneous integration due to physeal closure does not occur. Hybrid fixation consists in combining screw fixation of the fragment with mosaicplasty through the fragment to promote integration into the native condyle. We describe this technique with reference to 17 patients.
November 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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
#20
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
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