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Leg length discrepancy in children

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https://www.readbyqxmd.com/read/29589498/the-use-of-a-non-invasive-extendable-prosthesis-at-the-time-of-revision-arthroplasty
#1
M M Gilg, C L Gaston, L Jeys, A Abudu, R M Tillman, J D Stevenson, R J Grimer, M C Parry
Aims The use of a noninvasive growing endoprosthesis in the management of primary bone tumours in children is well established. However, the efficacy of such a prosthesis in those requiring a revision procedure has yet to be established. The aim of this series was to present our results using extendable prostheses for the revision of previous endoprostheses. Patients and Methods All patients who had a noninvasive growing endoprosthesis inserted at the time of a revision procedure were identified from our database...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29549568/cozen-s-deformity-resolved-by-guided-growth
#2
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
https://www.readbyqxmd.com/read/29456750/paediatric-tibial-shaft-fractures-treated-by-open-reduction-and-stabilization-with-monolateral-external-fixation
#3
A-L Simon, N Apostolou, C Vidal, E Ferrero, K Mazda, B Ilharreborde
Purpose: Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods: All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed...
February 1, 2018: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29387916/incidence-of-knee-height-asymmetry-in-a-paediatric-population-of-corrected-leg-length-discrepancy-a-retrospective-chart-review-study
#4
Louis-Nicolas Veilleux, Mohammed AlOtaibi, Noémi Dahan-Oliel, Reggie C Hamdy
PURPOSE: The purpose of the study is to provide a methodology to quantify knee height asymmetry (KHA) and to establish the incidence of knee height asymmetry in a patient population visiting the limb length discrepancy clinic in a paediatric-orthopaedic hospital centre. METHOD: A retrospective chart review was performed on all patients who attended the limb length discrepancy clinic and underwent corrective surgery at the Shriners Hospital for Children-Canada from December 2009 to December 2015...
February 1, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29377054/mechanical-testing-of-epiphysiodesis-screws
#5
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
https://www.readbyqxmd.com/read/29329145/orthopaedic-management-of-leg-length-discrepancy-in-proteus-syndrome-a-case-series
#6
Molly M Crenshaw, Cara G Goerlich, Lauren E Ivey, Julie C Sapp, Kim M Keppler-Noreuil, Allison C Scott, Leslie G Biesecker, Laura L Tosi
INTRODUCTION: Proteus syndrome (PS) is a rare mosaic disorder comprising asymmetric bony and soft tissue overgrowth leading to significant morbidity. Placement of growth inhibition hardware with subsequent epiphyseal arrest improves leg-length and angular deformities in pediatric patients without PS. The purpose of this study was to review the surgical approach and present outcomes, complications, and recommendations in 8 patients with PS and leg-length discrepancy (LLD). METHODS: We conducted a retrospective chart review of 8 patients with PS whose primary reason for surgery was LLD...
March 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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-haemodynamic-risk-factors-associated-with-discrepancies-in-lower-limb-length-with-capillary-malformations-data-from-the-national-paediatric-french-cohort-conape
#13
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 a better understanding of capillary malformations (CMs) associated with overgrowth syndrome. However, molecular analyses are still not easy to perform or interpret. Other analytical methods are needed. OBJECTIVES: To identify clinical and haemodynamic factors associated with leg length discrepancy (LLD) in children with CMs of the lower limbs. METHODS: Data were obtained from the multicentre French national cohort CONAPE (COhorte Nationale d'enfants atteints d'Angiome Plan de membrE inférieur), from children aged 2-12 years old with CMs of the lower limbs...
February 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/28943899/surgical-management-of-pelvic-ewing-s-sarcoma-in-children-and-adolescents
#14
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
#15
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
#16
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
#17
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
#18
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...
September 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28295122/epiphysiodesis-screw-bending
#19
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
#20
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
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