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Markus Siedhoff, Karsten Ridderbusch, Sandra Breyer, Ralf Stücker, Martin Rupprecht
BACKGROUND AND PURPOSE: For the treatment of leg-length discrepancies (LLDs) of between 2 and 5 cm in adolescent patients, several epiphyseodesis options exist and various complications have been reported. We reviewed the 8- to 15-year outcome after temporary epiphyseodesis in patients with LLD. PATIENTS AND METHODS: 34 children with LLD of up to 5 cm were included in the study. Mean age at epiphyseodesis was 12.8 (10-16) years. Temporary epiphyseodesis was performed with Blount staples or 8-plates...
December 2014: Acta Orthopaedica
David E Westberry, Jon R Davids, Linda I Pugh
BACKGROUND: The level of amputation in the pediatric population requires appropriate planning to provide an optimal residual limb for prosthetic fitting and must include long-term strategies to accommodate future growth of the extremity. METHODS: A retrospective review over a 15-year period was performed of all Boyd procedures (calcaneotibial fusion) in the pediatric limb deficiency population at a single institution. A chart review and radiographic analysis was performed to identify the indications, surgical outcomes, complications, need for additional surgical intervention, and nature of the postoperative prosthetic management...
January 2014: Journal of Pediatric Orthopedics
Hiroshi Kitoh, Hiroshi Kaneko, Kenichi Mishima, Masaki Matsushita, Naoki Ishiguro
Trochanteric overgrowth is one of the major residual deformities after the treatment of Legg-Calvé-Perthes disease. The present study was designed to determine the predictive factors for trochanteric overgrowth at skeletal maturity in patients with the disease. Medical records and radiographs of 45 Legg-Calvé-Perthes disease patients who were treated with containment therapy at our institution were reviewed retrospectively. Univariate analysis was carried out to determine the predictors for trochanteric overgrowth using the Mann-Whitney U-test for continuous variables and the Pearson test for categorical variables...
September 2013: Journal of Pediatric Orthopedics. Part B
S McGillion, N M P Clarke
PURPOSE: Lateral growth arrest is recognised as the most common form of avascular necrosis (AVN) seen in the management of developmental dysplasia of the hip (DDH). The purpose of this report is to present a new technique that is of benefit in the early identification and subsequent radiological monitoring of lateral growth arrest and which may permit appropriate timely surgical intervention. METHODS: We performed a retrospective review of the medical records and serial radiographs of 11 patients (three males and eight females) with lateral growth disturbance in the proximal femoral physis...
June 2011: Journal of Children's Orthopaedics
Marc Tompkins, Craig Eberson, Michael Ehrlich
If left uncorrected, valgus ankle deformity in multiple hereditary exostoses can cause significant disability in skeletally immature children and in adults. Various management methods have been described, including hemiepiphyseal stapling, transphyseal screw placement, fibular-Achilles tenodesis, distal tibial osteotomy, and ablative epiphyseodesis. In this article, we report the cases of 3 skeletally immature children who had undergone hemiepiphyseal stapling of the medial distal tibial epiphysis for correction of valgus ankle deformity in multiple hereditary exostoses...
February 2012: American Journal of Orthopedics
Saadallah George Haidar, David J Culliford, Edward David Gent, Nicholas M P Clarke
BACKGROUND: Interventions to treat unicameral bone cysts vary. Nonetheless, regardless of the intervention modality, the outcome is not certain. The purpose of this study was to determine if the distance between the growth plate and the cyst can be used to predict the outcome of the treatment. METHODS AND MATERIALS: Retrospectively, we assessed the outcome of 39 interventions in nineteen children that were performed between 1994 and 2003. Seventeen different modalities of treatment were employed...
April 2011: Journal of Children's Orthopaedics
Eva Maria Jelinek, Bernd Bittersohl, Friederike Martiny, Axel Scharfstädt, Rüdiger Krauspe, Bettina Westhoff
PURPOSE: In skeletally immature patients, treatment of malalignment about the knee is possible by performing temporary hemi-epiphyseodesis. Following the well-established procedure of physeal stapling, the 8-plate was introduced as a new device. The purpose of this study was to compare physeal stapling with 8-plate hemi-epiphyseodesis. We focused on evaluating deformity correction, complication rate and duration of the procedures. METHODS: We retrospectively analysed 35 patients (61 extremities, age 2...
March 2012: International Orthopaedics
Martin Rupprecht, Alexander S Spiro, Johannes M Rueger, Ralf Stücker
BACKGROUND: Ankle valgus in multiple hereditary exostoses (HME) is frequently seen and may result in activity related pain, deformity, or even early degenerative arthritis. Standard treatment protocols do not exist. The effect of medial screw hemiepiphysedesis of the distal tibia to correct ankle valgus is evaluated in this patient population. METHODS: A retrospective review of 9 patients with HME and ankle valgus deformity (15 affected extremities) who were treated by a screw hemiepiphyseodesis of the medial physis of the distal tibia is presented...
January 2011: Journal of Pediatric Orthopedics
P Havránek, V Mrzena
Treatment of the sequelae of the osseous connection between the metaphysis after damage of a part of the growth plate (bone bridge, partial arrest of growth) is still difficult. In addition to many symptomatic operations (repeated osteotomies, prolongation of the bones, epiphyseal distraction, epiphyseodesis etc.) also causal provisions can be made. Because transplantations of the physis are not yet very successful in clinical work, the only procedure which has an impact on the cause of restricted growth is resection of the bone bridge and interposition of inert material prevents a relapse of ossification at the site of the impaired physis...
1995: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
M Niethard, M Deja, M Rogalski
AIM: Angular deformities of the lower extremity are considered as prearthrotic factors. Osteotomy is regarded as a way of corrective treatment. But this intervention is considered as complex and requires a special after-treatment. During childhood and with remaining growth, guided growth offers an elegant solution for this problem. Resulting in a temporary hemiepiphyseodesis, the eight-Plate offers an alternative technique besides the Blount staples and the definitive epiphyseodesis. We evaluated the effect of this device on the correction of angular deformities in children with different diagnoses and at different ages...
March 2010: Zeitschrift Für Orthopädie und Unfallchirurgie
Hitesh Shah, Nandi D Siddesh, Benjamin Joseph, Sreekumaran N Nair
To evaluate the effect of prophylactic epiphyseodesis of the greater trochanter in Perthes' disease, 62 children with unilateral Perthes' disease who underwent trochanteric epiphyseodesis combined with varus osteotomy of the femur during the active stage of the disease (mean age at surgery: 8.4 y) and 20 controls were followed up until skeletal maturity. On radiographs taken at skeletal maturity, the articulo-trochanteric distance, the center-trochanteric distance, the length of the abductor lever arm, the neck-shaft angle, the radius of the femoral head, and the Reimer's migration index of normal and affected hips were measured...
December 2009: Journal of Pediatric Orthopedics
Lee S Segal, Robin C Crandall
BACKGROUND: Progressive varus deformity of the tibia in pediatric patients after transtibial and Syme amputations has not been reported in a series. A distal tibia to fibula synostosis, created surgically to minimize the risk of terminal overgrowth or occurring spontaneously, was noted in most patients. The goals of this study are to address the causes of the deformity, the implications for prosthetic wear, and potential treatment options. METHODS: Twelve patients identified from the juvenile amputee database at 2 centers developed progressive varus deformity of the residual limb...
March 2009: Journal of Pediatric Orthopedics
James O Sanders, Joseph G Khoury, Shyam Kishan
No abstract text is available yet for this article.
September 2007: Journal of Children's Orthopaedics
James O Sanders, Joseph G Khoury, Shyam Kishan
PURPOSE: Limb length inequality and epiphyseodesis timing calculations are common in pediatric orthopedics. The multiplier method developed by Paley et al. has significantly simplified the calculation of ultimate limb length. The calculation of limb length inequality has also become very simple for congenital limb length inequalities. However, the equations for limb length inequality from acquired differences and epiphyseodesis timing are not simple, and are prone to arithmetic errors...
July 2007: Journal of Children's Orthopaedics
Joshua Gary, B Stephens Richards
Infantile tibia vara (infantile Blount's disease) is a condition in which progressive varus of the knee develops due to diminished physeal growth of the medial aspect of the proximal tibia. A 6-year-old boy with severe bilateral infantile tibia vara (Langenskiold stage V) underwent operative correction of his deformities. Surgery consisted of epiphyseolyses of the medial proximal tibiae and valgus-producing corrective tibial osteotomies. Nearly 5 years after symmetric growth, he again developed progressive varus involving his left knee...
May 2008: Orthopedics
Hitesh Shah, N D Siddesh, Benjamin Joseph
Radiographs of 75 children with unilateral disease were studied to quantify the extent of remodeling of the proximal femur and the acetabulum between healing and skeletal maturity in children with Perthes disease. The mean ages at disease onset, healing, and skeletal maturity were 8.3, 11.9, and 15.5 years, respectively. Fifty-seven children were treated surgically by subtrochanteric varus osteotomy with trochanteric epiphyseodesis; the remaining 18 children were treated nonoperatively. Assessment of the Mose's index and Stulberg grading and measurements of the proximal femur and the acetabulum were made at healing and at skeletal maturity...
October 2008: Journal of Pediatric Orthopedics
Christoph Bertram, Dietmar A Kumm, Joern W-P Michael, Jürgen Rütt, Matthias H Hackenbroch, Peer Eysel
OBJECTIVE: In situ fixation of the proximal femoral epiphysis to prevent further dislocation while maintaining the potential for longitudinal growth by insertion of a central gliding screw. Prevention of secondary coxarthrosis. INDICATIONS: Incipient and imminent slipped capital femoral epiphysis in children with a displacement angle of < 30 degrees in the axial view (ET' < 30 degrees ) and prophylactic treatment of the contralateral side. CONTRAINDICATIONS: Allergies to implant materials...
October 2007: Operative Orthopädie und Traumatologie
Alexander Van Tongel, Guy Fabry
Patients with Legg-Calvé-Perthes disease (LCP) often exhibit relative overgrowth of the greater trochanter and shortening of the femoral neck. Biomechanically, this corresponds to a shorter lever arm and a decreased muscle tension which may result in a Trendelenburg gait and pelvic instability. This is a retrospective study of 31 patients (32 hips) with LCP disease and relative overgrowth of the greater trochanter who were treated with an epiphyseodesis. The average age at operation was 10 years and 6 months...
June 2006: Acta Orthopaedica Belgica
T Kucera, A Krajina, P Sponer, A Kohout
PURPOSE OF THE STUDY: This study on vascular malformations of the musculoskeletal system in children is concerned with the disease diagnosis and evaluation of treatment results in a group of pediatric patients. MATERIAL: Eighteen children with musculoskeletal vascular malformations, treated at the Department of Orthopedics in Hradec Králové, were assessed. The relevant data were obtained from their medical notes and the children were examined at the outpatient department...
April 2006: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
E Skyttä, A Savolainen, H Kautiainen, E A Belt
OBJECTIVE: Leg length discrepancy and excessive knee valgus are potential complications of juvenile chronic arthritis of the knee. The aim of the present study was to evaluate retrospectively the safety and efficacy of temporary stapling of the knee epiphyses in management of valgus deformities of the knee in children with JCA. METHODS: Medical data of the patients with temporary epiphyseodesis due to knee valgus deformity (KVD) were studied. 177 knees in 112 patients were found with sufficient data for evaluation...
March 2005: Clinical and Experimental Rheumatology
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