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Leg length discrepancy in children

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https://www.readbyqxmd.com/read/28448898/kinematic-gait-pattern-in-children-with-cerebral-palsy-and-leg-length-discrepancy-effects-of-an-extra-sole
#1
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...
April 17, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28428035/evaluation-of-the-external-fixator-truelok-hexapod-system-for-tibial-deformity-correction-in-children
#2
Sébastien Pesenti, Christopher A Iobst, Franck Launay
BACKGROUND: Tibial deformities are common in paediatric orthopaedic practice. Correcting multiplanar tibial deformities associated with lower limb length discrepancycan 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(TM)(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
#3
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...
March 14, 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
#4
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
#5
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
#6
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
#7
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...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28031512/z-plasty-for-severe-gluteal-muscle-contracture-in-children
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27909134/what-is-the-morbidity-of-a-non-invasive-growing-prosthesis
#11
M M Gilg, C L Gaston, M C Parry, L Jeys, A Abudu, R M Tillman, S R Carter, R J Grimer
AIMS: Extendible endoprostheses have been available for more than 30 years and have become more sophisticated with time. The latest generation is 'non-invasive' and can be lengthened with an external magnetic force. Early results have shown a worryingly high rate of complications such as infection. This study investigates the incidence of complications and the need for further surgery in a cohort of patients with a non-invasive growing endoprosthesis. PATIENTS AND METHODS: Between 2003 and June 2014, 50 children (51 prostheses) had a non-invasive growing prosthesis implanted for a primary bone sarcoma...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27845969/closing-the-growth-plate-a-review-of-indications-and-surgical-options
#12
Joseph J Ruzbarsky, Christine Goodbody, Emily Dodwell
PURPOSE OF REVIEW: The purpose is to review the indications for epiphysiodesis in the treatment of pediatric limb length discrepancies; provide an update on current diagnostic, planning, and surgical techniques; and to introduce possible future alternatives. RECENT FINDINGS: Retrospective comparative studies have failed to demonstrate superiority of one epiphysiodesis technique over the others. EOS low-dose biplanar X-ray and smartphone growth prediction applications are improving our ability to diagnose and plan treatment for leg length discrepancy...
November 14, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27815015/arthroscopic-anterior-cruciate-ligament-repair-for-proximal-anterior-cruciate-ligament-tears-in-skeletally-immature-patients-surgical-technique-and-preliminary-results
#13
Marco Bigoni, Diego Gaddi, Massimo Gorla, Daniele Munegato, Marco Pungitore, Massimiliano Piatti, Marco Turati
BACKGROUND: Anterior cruciate ligament (ACL) tears in children are increasingly common and present difficult treatment decisions due to the risk of growth disturbance. Although open primary ACL repair was abandoned in the historical literature, recent studies have suggested that there is a role for arthroscopic primary repair in patients with proximal tears. METHODS: This is a retrospective review of five consecutive patients aged 9.2years (range 8 to 10) who underwent suture anchor ACL reinsertion...
November 2, 2016: Knee
https://www.readbyqxmd.com/read/27684849/elastic-stable-intramedullary-nailing-for-severely-displaced-distal-tibial-fractures-in-children
#14
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27648453/the-risk-of-transphyseal-drilling-in-skeletally-immature-patients-with-anterior-cruciate-ligament-injury
#15
Peter Faunø, Lone Rømer, Torsten Nielsen, Martin Lind
BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) in skeletally immature patients can result in growth plate injury, which can cause growth disturbances. PURPOSE: To evaluate radiological tibial and femoral length and axis growth disturbances as well as clinical outcomes in skeletally immature ACLR patients treated with a transphyseal drilling technique. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 39 pediatric patients with ACL injury and open physes at time of surgery, as diagnosed clinically and with magnetic resonance imaging (MRI), were treated using transphyseal ACLR using hamstring graft...
September 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27548584/complications-associated-with-epiphysiodesis-for-management-of-leg-length-discrepancy
#16
Marina R Makarov, Samuel H Dunn, Dustin E Singer, Karl E Rathjen, Brandon A Ramo, Chukwudi K Chukwunyerenwa, John G Birch
BACKGROUND: Epiphysiodesis is well-established surgical treatment for the management of leg length discrepancy (LLD) in children; however, a variety of complications may occur. This study evaluates the nature, rate, and potential risk factors of complications associated with epiphysiodesis in a large patient population treated in 1 institution. METHODS: We evaluated the medical and radiographic records of 863 children who had lower extremity epiphysiodesis to manage LLD between 1980 and 2011...
August 19, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27451290/pediatric-pelvic-ring-injuries-how-benign-are-they
#17
Christiane G Kruppa, Justin D Khoriaty, Debra L Sietsema, Marcel Dudda, Thomas A Schildhauer, Clifford B Jones
INTRODUCTION: With an incidence of less than 0.2% of all pediatric fractures, pelvic ring injuries are rare. Historically they were conservatively treated, but because malunion and long-term morbidity are associated with unstable injuries, a trend towards operative treatment can be observed. The purpose was to determine clinical and radiographic outcomes following these complex pediatric pelvic ring injuries. PATIENTS AND METHODS: This Level IV retrospective analysis was completed at a private orthopaedic practice in association with a Level One teaching trauma center...
October 2016: Injury
https://www.readbyqxmd.com/read/27384736/limb-salvage-by-distraction-osteogenesis-for-distal-tibial-osteosarcoma-in-a-young-child-a-case-report
#18
Xin He, Hui-Lin Zhang, Yong-Cheng Hu
Under the effective chemotherapy protocol, physeal distraction could be used as an effective limb salvage in the growing children with lower-limb malignant metaphyseal bone tumours and could actively prevent leg length discrepancy or malalignment that profoundly affects function. In this paper, we report a 7-year-old boy with right distal tibial osteosarcoma but not yet invaded the epiphysis, which underwent surgical treatment after effective chemotherapy. The surgical procedure included two phases: epiphysiolysis (physeal distraction) and en-bloc resection of tumor and distraction osteogenesis...
May 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27264403/development-of-gait-performance-and-dynamic-hip-and-knee-joint-loading-after-containment-improving-surgery-in-patients-with-legg-calv%C3%A3-perthes-disease
#19
Felix Stief, André Schmidt, Stefanie Adolf, Laura Kremer, Moamer Brkic, Andrea Meurer
Current surgery outcome evaluations in patients with Legg-Calvé-Perthes disease (LCPD) are usually based on static radiological changes. The aim of the present study was to assess the development of characteristic gait parameters and passive hip range of motion (ROM) measurements during the postoperative period up to healed stage of the femoral head represented by Stulberg classification. Twelve children (10 male, 2 female) with unilateral diagnosis of LCPD and 19 healthy control subjects at the same age participated in this prospective longitudinal study...
June 2016: Gait & Posture
https://www.readbyqxmd.com/read/27243804/ilizarov-bone-transport-versus-fibular-graft-for-reconstruction-of-tibial-bone-defects-in-children
#20
Mostafa Abdelkhalek, Barakat El-Alfy, Ayman M Ali
The aim of this study was to compare the results of treatment of segmental tibial defects in the pediatric age group using an Ilizarov external fixator versus a nonvascularized fibular bone graft. This study included 24 patients (age range from 5.5 to 15 years) with tibial bone defects: 13 patients were treated with bone transport (BT) and 11 patients were treated with a nonvascularized fibular graft (FG). The outcome parameters were bone results (union, deformity, infection, leg-length discrepancy) and functional results: external fixation index and external fixation time...
November 2016: Journal of Pediatric Orthopedics. Part B
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