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K E Dittmer, R E Morley, R L Smith
CASE HISTORY: A group of 545 pregnant rising 2-year-old Coopdale ewes on a Southland sheep farm were grazed over winter on a fodder beet (Beta vulgaris) crop. Subsequently, 45 out of approximately 750 lambs were born with a variety of skeletal deformities, including shortened limbs, varus and valgus angular limb deformities, palmar grade stance and cranial bowing of the carpus. Analysis of the crop showed the fodder beet contained a low percentage of phosphorus. In addition, 60 out of 460 rising 2-year-old ewes that had been grazed on the fodder beet crop as 1-year-olds had incisor abnormalities and malocclusion...
October 2, 2016: New Zealand Veterinary Journal
Omar Adib, Emeline Berthier, Didier Loisel, Christophe Aubé
Injuries of the cervical spine are uncommon in children. The distribution of injuries, when they do occur, differs according to age. Young children aged less than 8 years usually have upper cervical injuries because of the anatomic and biomechanical properties of their immature spine, whereas older children, whose biomechanics more closely resemble those of adults, are prone to lower cervical injuries. In all cases, the pediatric cervical spine has distinct radiographic features, making the emergency radiological analysis of it difficult...
September 20, 2016: Skeletal Radiology
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
Rajeev Chaudhary, Ming-Song Lee, Kuwabo Mubyana, Sarah Duenwald-Kuehl, Lyndsey Johnson, Jarred Kaiser, Ray Vanderby, Kevin W Eliceiri, David T Corr, Matthew S Chin, Wan-Ju Li, Paul J Campagnola, Matthew A Halanski
PURPOSE: The accepted mechanism explaining the accelerated growth following periosteal resection is that the periosteum serves as a mechanical restraint to restrict physeal growth. To test the veracity of this mechanism we first utilized Second Harmonic Generation (SHG) imaging to measure differences of periosteal fiber alignment at various strains. Additionally, we measured changes in periosteal growth factor transcription. Next we utilized SHG imaging to assess the alignment of the periosteal fibers on the bone both before and after periosteal resection...
November 2016: Bone
Jaclyn F Hill, Benton E Heyworth, Anneliese Lierhaus, Mininder S Kocher, Susan T Mahan
In this descriptive analysis of pediatric Lisfranc injuries, records of 56 children treated for bony or ligamentous Lisfranc injuries over a 12-year period were reviewed. Overall, 51% of fractures and 82% of sprains were sports-related (P=0.03). A total of 34% of the cohort underwent open reduction internal fixation, which was more common among patients with closed physes (67%). Full weight bearing was allowed in open reduction internal fixation patients at a mean of 14.5 weeks, compared to 6.5 weeks in the nonoperative group...
September 3, 2016: Journal of Pediatric Orthopedics. Part B
Andrew Pennock, Michael M Murphy, Mark Wu
The management of pediatric patients with an anterior cruciate ligament (ACL) tear can be a challenging endeavor for physicians, athletic trainers, coaches, and parents alike. In particular, the significant longitudinal growth that arises from the physes about the knee creates a unique set of circumstances that must be considered in this patient population. The purpose of this review is to provide a summary of the most recent current literature for the management of skeletally immature patients with an ACL tear...
September 1, 2016: Current Reviews in Musculoskeletal Medicine
S E Hoey, A H Biedrzycki, M J Livesey, R Drees
Juvenile bovine patients who present with clinical signs of lameness are commonly evaluated using radiographic techniques both within a hospital setting and in a farm environment. The radiographic development of the juvenile bovine skeleton is currently poorly documented. In this study, the limbs of four heifer calves were sequentially radiographed to assess development of the juvenile bovine appendicular skeleton in the first 12 months of life. Images were acquired at three weeks, three months, six months, nine months and one year of age...
August 24, 2016: Veterinary Record
Selina Shah
A 13-year-old ballet dancer who had been dancing en pointe (on the tips of the toes) since 10 years presented to the clinic with a shortened right second toe. She had no previous history of pain or trauma. She was diagnosed with premature growth arrest of the second metatarsal head physes resulting in a shortened metatarsal. This is the first reported case of premature growth arrest in a ballet dancer as a result of dancing en pointe.
August 5, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Kevin G Shea, Alexandra C Styhl, John C Jacobs, Theodore J Ganley, Matthew D Milewski, Peter C Cannamela, Allen F Anderson, John D Polousky
BACKGROUND: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis. PURPOSE: To evaluate the relationship of the distal femoral physis and the MPFL. STUDY DESIGN: Descriptive laboratory study...
July 29, 2016: American Journal of Sports Medicine
Sarah Nemanic, Britton K Nixon, Wendy Baltzer
OBJECTIVE: Identify radiographic risk factors for development of elbow dysplasia in giant breed dogs less than one year of age. METHODS: Twenty-five giant breed puppies (Bernese Mountain dogs, English Mastiff, and Newfoundland) were studied. Both elbows of each dog were radiographed monthly from two to six months of age, then every other month until radial and ulnar physeal closure, followed two months later by bilateral elbow computed tomography. Radiographic parameters measured included the presence or absence of a separate centre of ossification of the anconeal process (SCOAP), medial coronoid disease (MCD), ununited anconeal process, humeral osteochondrosis, elbow incongruity, as well as the length of the radius and ulna, radius-to-ulna ratio, and date of closure of the radial and ulnar physes...
September 20, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Mike J Schoonover, Chase T Whitfield, Mark C Rochat, Robert N Streeter, Kate Sippel
OBJECTIVE: To report the successful surgical correction of severe bilateral metacarpophalangeal valgus angular limb deformities in a seven-month-old intact male alpaca cria using curved osteotomies stabilized with type II external skeletal fixation. METHODS: Using a 21 mm crescentic shaped oscillating saw blade, bilateral osteotomies were performed in the distal metaphyses of the fused third and fourth metacarpal bones to correct valgus angular limb deformity of the metacarpophalangeal joints...
September 20, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Carlo Camathias, Katrin Studer, Ata Kiapour, Erich Rutz, Patrick Vavken
BACKGROUND: The essential static patellar stabilizer is a normal-shaped trochlear groove. A dysplastic groove destabilizes the patella. Trochleoplasty approaches this underlying condition and reshapes the trochlea. However, studies have reported on trochleoplasty for revision cases or as accompanied by other interventions. The effect of trochleoplasty alone remains unexplained. PURPOSE: To introduce trochleoplasty as a stand-alone treatment for recurrent patellar dislocation and to compare its pre- to postoperative functional and clinical variables...
July 19, 2016: American Journal of Sports Medicine
Valentina Brioschi, Sorrel J Langley-Hobbs, Sharon Kerwin, Richard Meeson, Heidi Radke
OBJECTIVES: The objective was to describe the complications and long-term outcome associated with Kirschner (K)-wire fixation of combined distal radial and ulnar physeal fractures in six cats. METHODS: Medical records (2002-2014) of six referral institutions were searched for cats with combined distal radial and ulnar physeal fractures. Cases with complete clinical files, radiographs and surgical records were retrospectively reviewed. Long-term outcome was assessed via telephone interviews using an owner questionnaire...
June 27, 2016: Journal of Feline Medicine and Surgery
Ali Maqdes, Camille Steltzlen, Nicolas Pujol
This is a report of a rare case of recurrent traumatic peroneal tendon dislocation in a patient with open physes. Through fibular tendon endoscopy, an intramuscular needle was introduced under direct visualisation and implanted inferiorly to the growth plate while reclining the tendons posteriorly. A fibular groove deepening was performed in order to stabilize the tendons. The patient was able to return to full activity after 3 months. MRI taken 12 months after surgery showed neither signs of recurrence of the lesion nor growth plate disturbance...
June 17, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Kristina L Dunn, Kenneth C Lam, Tamara C Valovich McLeod
UNLABELLED: Reference: Ramski DE, Kanj WW, Franklin CC, Baldwin KD, Ganley TJ. Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med. 2014;42(11):2769-2776. Clinical Questions: In pediatric patients, does early operative treatment of an anterior cruciate ligament (ACL) injury result in decreased knee instability compared with delayed or nonoperative treatment? DATA SOURCES: This review focused on the PubMed/MEDLINE and EMBASE databases...
May 2016: Journal of Athletic Training
Michael J Collins, Thomas A Arns, Timothy Leroux, Austin Black, Randy Mascarenhas, Bernard R Bach, Brian Forsythe
PURPOSE: To identify all reported cases of growth disturbances after anterior cruciate ligament (ACL) reconstruction in patients with open growth plates and analyze trends with respect to different surgical techniques, graft choices, and methods of fixation. METHODS: A systematic literature review was conducted using the MEDLINE, EMBASE, and SCOPUS databases with the following term: "((anterior cruciate ligament OR ACL) AND ((((immature) OR growth plates) OR physes) OR pediatric))...
August 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
James O Smith, Sam K Yasen, Harry C Palmer, Breck R Lord, Edward M Britton, Adrian J Wilson
PURPOSE: Instability following non-operative treatment of anterior cruciate ligament (ACL) rupture in young children frequently results in secondary chondral and/or meniscal injuries. Therefore, many contemporary surgeons advocate ACL reconstruction in these patients, despite the challenges posed by peri-articular physes and the high early failure rate. We report a novel management approach, comprising direct ACL repair reinforced by a temporary internal brace in three children. METHODS: Two patients (aged 5 and 6 years) with complete proximal ACL ruptures and a third (aged seven) with an associated tibial spine avulsion underwent direct surgical repair, supplemented with an internal brace that was removed after 3 months...
June 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
I Anwar, D Amiras, M Khanna, M Walker
Traumatic injuries involving the scapula and clavicle in skeletally immature patients have unique characteristics that distinguish them from similar injuries in the mature skeleton. Fractures involving unossified cartilage and unfused epiphyses are difficult to appreciate on plain radiographs and computed tomography (CT) imaging. Knowledge of the developmental anatomy and normal radiological appearances during different stages of development of these bones is an essential prerequisite for the radiologist tasked with interpreting the imaging of such injuries in order to avoid potential diagnostic pitfalls...
July 2016: Clinical Radiology
Michael W Aversano, Payam Moazzaz, Anthony A Scaduto, Norman Y Otsuka
BACKGROUND: Children who present with idiopathic slipped capital femoral epiphysis (SCFE) have an increased risk of developing bilateral disease. Predicting which patients will develop problems with bilateral hips is important for determining treatment algorithms. This is a retrospective observational study that evaluates the relationship and risk between body mass index (BMI)-for-age and unilateral and bilateral SCFE in patients followed until physeal closure. METHODS: This is a retrospective study of all patients with SCFE presenting to one institution from 1998-2005...
June 2016: Journal of Children's Orthopaedics
Jason C Ho, Marcelo B P Siqueira, Paul Jacob, Ryan C Goodwin, Wael K Barsoum
There are limited reports of total knee arthroplasty (TKA) in the pediatric population. The use of constrained, stemmed components is particularly unusual in the setting of open physes due to concerns with growth arrest and implant survivorship. The current authors describe a 15-year-old boy with open growth plates and an epiphyseal dysplasia-like condition affecting the knees bilaterally. He had no other significant medical or orthopedic conditions and his genetic workup was negative. He had severe knee pain and a bilateral 40° valgus with severe lateral compartment arthritis...
May 1, 2016: Orthopedics
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