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Leg length discrepancy in children

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https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#1
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29214458/the-effects-of-uninvolved-side-epiphysiodesis-for-limb-length-equalization-in-children-with-unilateral-cerebral-palsy-clinical-evaluation-with-the-edinburgh-visual-gait-score
#2
Marco Corradin, Roberto Schiavon, Andrea Borgo, Jacques Deslandes, Antonella Cersosimo, Federico Canavese
PURPOSE: Hemiplegic cerebral palsy patient may present a shorten leg on the hemiplegic side that afflicts negatively the kinematic of the uninvolved limb. Thus, the aim of this study was to investigate the modification of gait kinematic after epiphysiodesis for limb equalization and secondary to verify the prediction of correction. METHODS: Skeletally immature hemiplegic patients with a minimum limb leg discrepancy (LLD) of 2.5 cm were treated with epiphysiodesis of the unaffected knee and clinically evaluated with Edinburgh visual gait score (EVGS)...
December 6, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29053501/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-tibia-fracture-pearls-and-pitfalls
#3
Steven A Lovejoy, Charles T Mehlman
Tibial fractures in children present a wide array of challenges to the managing orthopaedic surgeon. Injuries cover a spectrum from subtle tibial spine fractures to comminuted high-energy shaft fractures requiring free flap coverage. Significant risks range from malunion and leg length discrepancy to infected nonunions and Volkmann ischemic contracture. This article offers evidence and experience-based advice that is aimed at helping the community orthopaedic surgeon taking call.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29052010/open-versus-closed-treatment-of-distal-tibia-physeal-fractures-a-systematic-review-and-meta-analysis
#4
Waleed A Asad, Manaf H S Younis, Abdulaziz F Ahmed, Talal Ibrahim
AIMS: Distal tibia physeal fractures can lead to growth complications such as premature physeal closure (PPC), angular deformity and leg length discrepancy. The aim of our study was to systematically review the literature to assess whether open reduction and internal fixation (ORIF) is associated with lower rates of PPC compared to closed treatment. MATERIALS AND METHODS: We searched several databases from 1966 to 2016 for studies that evaluated ORIF versus closed treatment of distal tibia physeal fractures...
October 19, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29040235/acetabular-fractures-in-children-and-adolescents-comparison-of-isolated-acetabular-fractures-and-acetabular-fractures-associated-with-pelvic-ring-injuries
#5
Christiane G Kruppa, Debra L Sietsema, Justin D Khoriaty, Marcel Dudda, Thomas A Schildhauer, Clifford B Jones
OBJECTIVES: To compare mechanism of injury, fracture pattern, displacement, clinical and radiographic outcome of isolated acetabular fractures (Group 1) versus acetabular fractures associated with a pelvic ring injury (Group 2). DESIGN: Retrospective cohort comparative analysis. SETTING: Private orthopaedic practice associated with a level one teaching trauma center. MAIN OUTCOME MEASUREMENTS: Mechanism of injury, fracture pattern, displacement and treatment, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), leg length discrepancy (LLD) and hip dysplasia...
October 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29027184/low-rate-of-clinically-important-avascular-necrosis-of-the-femoral-head-after-ludloff-s-procedure
#6
Jesper Holbeck-Brendel, Bjarne Møller-Madsen, Ivan Hvid, Michel B Hellfritzsch, Line K Pedersen, Peter Dalsgaard, Ole Rahbek
INTRODUCTION: Ludloff's procedure for open reduction of congenital dislocation of the hip (CDH) is recommended for its minimal tissue damage, but is criticised for the risk of late avascular necrosis (AVN) of the femoral head. The aim of present study was primarily to assess the risk of late AVN of the femoral head and secondly the range of motion (ROM) of the hip and the quality of life in children following Ludloff's procedure. METHODS AND MATERIALS: 13 hips in 11 children after Ludloff's procedure due to CDH were included retrospectively from 1997 to 2005 at Aarhus University Hospital...
October 12, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28963775/clinical-and-hemodynamic-risk-factors-associated-with-discrepancies-in-lower-limb-length-with-capillary-malformations-data-from-the-national-paediatric-french-cohort-conape
#7
M Samimi, M Durieux-Verde, A Caille, J Mazereeuw-Hautier, O Boccara, L Martin, C Chiaverini, C Eschard, N Beneton, P Vabres, X Balguerie, P Plantin, D Bessis, S Barbarot, A Dadban, C Droitcourt, S Leducq, G Lorette, B Morel, A Maruani
BACKGROUND: Genetics discoveries have allowed for better understanding capillary malformations (CMs) with overgrowth syndrome. However, molecular analyses are still not easy to perform or interpret. Other analytical methods are needed. OBJECTIVE: We aimed to identify clinical and hemodynamic factors associated with leg length discrepancy (LLD) in children with CM of lower limbs. METHODS: Data were obtained from the multicentre French national cohort CONAPE (COhorte Nationale d'enfants atteints d'Angiome Plan de membrE inférieur), including children from 2 to 12 years old with CM of lower limbs...
September 30, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28943899/surgical-management-of-pelvic-ewing-s-sarcoma-in-children-and-adolescents
#8
Hongbin Fan, Zheng Guo, Jun Fu, Xiangdong Li, Jing Li, Zhen Wang
The present study describes a novel surgical strategy used to treat immature pelvic Ewing's sarcoma (ES), one made possible owing to the intrinsic structure of the skeletally immature pelvis. A total of 12 children and adolescents with open triradiate cartilage received limb-salvage surgeries following a diagnosis of pelvic ES. In total, 3 patients with iliac lesions (2 lesions with extension into the sacrum) received surgical tumor excisions and allograft reconstructions. Another 8 patients with periacetabular lesions received trans-acetabular osteotomies and allograft reconstructions...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28840156/clinical-outcome-reporting-in-youth-acl-literature-is-widely-variable
#9
REVIEW
Christopher M Brusalis, Nikita Lakomkin, Joash R Suryavanshi, Aristides I Cruz, Daniel W Green, Kristofer J Jones, Peter D Fabricant
BACKGROUND: Advances in anterior cruciate ligament (ACL) reconstruction procedures in pediatric and adolescent patients have resulted in an increase in recent clinical studies on this topic. However, the consistency with which outcome measures are reported in this demographic is unknown. PURPOSE: To document outcome reporting patterns of youth ACL reconstruction studies in high-impact journals. STUDY DESIGN: Systematic review; Level of evidence, 4...
August 2017: Orthopaedic Journal of Sports Medicine
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
#10
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/28448898/kinematic-gait-pattern-in-children-with-cerebral-palsy-and-leg-length-discrepancy-effects-of-an-extra-sole
#11
Meta N Eek, Roland Zügner, Ingibjörg Stefansdottir, Roy Tranberg
The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP...
June 2017: Gait & Posture
https://www.readbyqxmd.com/read/28428035/evaluation-of-the-external-fixator-truelok-hexapod-system-for-tibial-deformity-correction-in-children
#12
S Pesenti, C A Iobst, F Launay
BACKGROUND: Tibial deformities are common in paediatric orthopaedic practice. Correcting multiplanar tibial deformities associated with lower limb length discrepancy can be challenging. Hexapod external fixation with gradual correction has been proven effective in this situation. OBJECTIVE: To assess clinical and radiological outcomes of gradual tibial deformity correction using the external fixator TL-HEX™ (Orthofix) in children. HYPOTHESIS: TL-HEX™ is effective in correcting tibial deformities in children...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28295122/epiphysiodesis-screw-bending
#13
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...
July 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28249982/staged-lengthening-and-reconstruction-for-children-with-a-leg-length-discrepancy-after-excision-of-an-osteosarcoma-around-the-knee
#14
S Kang, J S Lee, J Park, S-S Park
AIMS: Children treated for osteosarcoma around the knee often have a substantial leg-length discrepancy at skeletal maturity. The aim of this study was to investigate the results of staged skeletal reconstruction after a leg lengthening procedure using an external fixator in these patients. PATIENTS AND METHODS: We reviewed 11 patients who underwent staged reconstruction with either an arthroplasty (n = 6) or an arthrodesis (n = 5). A control group of 11 patients who had undergone wide excision and concurrent reconstruction with an arthroplasty were matched for gender, location, and size of tumour...
March 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28188335/posterior-cruciate-ligament-reconstruction-in-skeletal-immature-children
#15
Ole Gade Sørensen, Peter Faunø, Svend Erik Christiansen, Martin Lind
PURPOSE: Rupture of the posterior cruciate ligament (PCL) is a rare knee injury in children with open growth plates. The follow-up results of six patients with open physes treated with PCL reconstruction are presented. The objective is to evaluate the clinical outcomes of PCL reconstruction for six skeletally immature patients. METHODS: Between 2006 and 2010, six skeletally immature patients were treated with PCL reconstruction. At the time of surgery, the median age was 9 years (range 6-14)...
February 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28116449/-treatment-of-femoral-shaft-fractures-in-children-and-adolescents-%C3%A2-50%C3%A2-kg-a%C3%A2-retrospective-multicenter-trial
#16
M Rapp, R Kraus, P Illing, D W Sommerfeldt, M M Kaiser
BACKGROUND: Operative treatment of diaphyseal fractures of the femur in older children and adolescents remains controversial due to multiple surgical options and higher complication rates in single-center studies compared to younger children. This retrospective multicenter study aimed to register early and late complications in day-by-day treatment. MATERIAL AND METHODS: Sixteen hospitals with particular expertise in pediatric orthopedic trauma participated in this study...
January 23, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28068825/microdose-acquisition-in-adolescent-leg-length-discrepancy-using-a-low-dose-biplane-imaging-system
#17
Janni Jensen, Bo R Mussmann, John Hjarbæk, Zaid Al-Aubaidi, Niels W Pedersen, Oke Gerke, Trine Torfing
Background Children with leg length discrepancy often undergo repeat imaging. Therefore, every effort to reduce radiation dose is important. Using low dose preview images and noise reduction software rather than diagnostic images for length measurements might contribute to reducing dose. Purpose To compare leg length measurements performed on diagnostic images and low dose preview images both acquired using a low-dose bi-planar imaging system. Material and Methods Preview and diagnostic images from 22 patients were retrospectively collected (14 girls, 8 boys; mean age, 12...
September 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28031512/z-plasty-for-severe-gluteal-muscle-contracture-in-children
#18
Kun Zha, GuoHui Liu, Shuhua Yang, Faqi Cao
PURPOSE: To review the records of 363 patients with severe gluteal muscle contracture to determine its mechanism, underlying pathology, and treatment outcome. METHODS: Records of 136 males and 227 females aged 5 to 18 (mean, 12.2) years who underwent Z-plasty for bilateral (n=347) or unilateral (n=16) severe gluteal muscle contracture were reviewed. Severe gluteal muscle contracture was classified as typical (n=52) or special (n=311). The typical type is associated with symptoms of positive out-toe gait, Ober sign, back-extending test, cross-leg test, squatting with knee side-by-side test, and hip dysfunction...
2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28028968/the-use-of-3d-printing-technology-in-the-ilizarov-method-treatment-pilot-study
#19
Karolina Burzyńska, Piotr Morasiewicz, Jarosław Filipiak
BACKGROUND: Significant developments in additive manufacturing technology have occurred in recent years. 3D printing techniques can also be helpful in the Ilizarov method treatment. OBJECTIVES: The aim of this study was to evaluate the usefulness of 3D printing technology in the Ilizarov method treatment. MATERIAL AND METHODS: Physical models of bones used to plan the spatial design of Ilizarov external fixator were manufactured by FDM (Fused Deposition Modeling) spatial printing technology...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28009802/benign-osteolytic-lesions-in-children-with-previously-normal-radiographs
#20
Emily Tan, Charles T Mehlman, Michael Baker
BACKGROUND: Benign bone tumors are common in children and are usually diagnosed incidentally or after pathologic fractures. However, case reports of children with lytic lesions with previously normal radiographs are rare. This series presents several such cases. METHODS: This was a retrospective case series of 8 benign osteolytic lesions in 8 pediatric patients (5 female and 3 males). All have previous radiographs of the effected extremity showing no pathology. All participants were at a single institution...
June 2017: Journal of Pediatric Orthopedics
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