Is Proximal Fibula Epiphysiodesis Necessary When Performing a Proximal Tibial Epiphysiodesis?

Background: Controversy exists regarding the need for proximal fibular epiphysiodesis in conjunction with proximal tibial epiphysiodesis to prevent relative overgrowth of the fibula. The purpose of this study was to determine the incidence of relative fibular overgrowth in patients who had undergone proximal tibial epiphysiodesis with or without proximal fibular epiphysiodesis to manage leg-length discrepancy. Methods: We identified patients who had undergone proximal tibial epiphysiodesis, with or without concomitant fibular epiphysiodesis, followed to skeletal maturity, and with adequate scanograms to measure tibial and fibular lengths. We assessed tibial and fibular lengths, ratios, and distances between the tibia and fibula proximally and distally preoperatively and at skeletal maturity, and obvious radiographic proximal migration of the fibular head. Results: A total of 234 patients met inclusion criteria, including 112 girls and 122 boys. In total, 179 patients had undergone concomitant fibular epiphysiodesis, and 55 had not. The fibular epiphysiodesis group was significantly younger preoperatively than the nonfibular epiphysiodesis group (average: 12.3 vs. 13.6 y), which accounted for most of the preoperative differences noted between the groups. Within the subset of younger patients (≥2 y of growth remaining at the time of epiphysiodesis), there were statistically significant differences between those with or without fibular epiphysiodesis at ...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Leg Length Discrepancy Source Type: research

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Conclusions: This study demonstrates that there is minimal error due to image acquisition and measurement when using a biplanar slot scanner. Biplanar slot scanning technology tended to underestimate the size of the marker; however, the least accurate measurements only erred by 1.5% from the true length. This indicates that unlike traditional radiographs the sources of error in biplanar slot scanning images are not due to parallax and are likely due to patient-specific factors and rather than the technology itself.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Scioliosis/Kyphosis Source Type: research
AbstractObjectivesTo compare diagnosis performance and effective dose of ultra-low-dose CT (ULD CT) versus radiographs in suspected spinal or pelvic ring or hip fracture for minor trauma.MethodsULD CT, in addition to radiography, was prospectively performed in consecutive patients admitted to the emergency department for minor traumas, during working hours over 2 months. Presence of a recent fracture was assessed by two blind radiologists independently. Sensitivities and specificities were estimated using the best valuable comparator (BVC) as a reference and using a latent class model in Bayesian inference (BLCM). Dosimetr...
Source: European Radiology - Category: Radiology Source Type: research
ConclusionAcute traumatic cerebrovascular injury is a prevalent complication in civilian PBI, frequently involving both the arterial and venous sinus systems. Although some radiographic features might be associated with presence of vascular injury, assessment of the intracranial vasculature in the acute phase of all PBI is essential for early diagnosis. Treatment of vascular injury remains variable depending on local practice.
Source: Neurocritical Care - Category: Neurology Source Type: research
Conclusion: This study concluded that dental specialists were well aware of the concept of AI, that AI programs could be used as an adjunctive tool by dentists to increasing their diagnostic precision when interpreting radiographs, and that AI has a promising role in radiological diagnosis. PMID: 33005576 [PubMed]
Source: Imaging Science in Dentistry - Category: Dentistry Tags: Imaging Sci Dent Source Type: research
This study aimed to verify the relationship between the number of fusion level and the risk of screw loosening by using cortical bone trajectory (CBT) screws in patients with lumbar degenerative disease. We retrospectively reviewed the serial plain radiograph images of lumbar degenerative disease patients who had undergone posterior fixation and fusion surgery with CBT from 2014. All included patients should have been followed-up with computed tomography scan or plain radiograph for at least 6 months after operation. We individually evaluated the prevalence of screw loosening according to each vertebral level. We also det...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Despite scaphoid fractures being relatively uncommon pro-active treatment of suspected fractures has been seen as a risk management strategy. The poor positive predictive value of X-rays has led to published guidelines advocating MRI as a first-line or early imaging tool. It is unclear whether UK hospitals have been able to introduce early scanning and this national survey sought to establish the current management strategies for patients with a suspected scaphoid fracture.
Source: Radiography - Category: Radiology Authors: Source Type: research
How accurate is chest imaging for diagnosing COVID-19?Why is this question important?People with suspected COVID-19 need to know quickly whether they are infected, so that they can self-isolate, receive treatment, and inform close contacts. Currently, formal diagnosis of COVID-19 infection requires laboratory analysis of blood or nose and throat samples. The laboratory test, called RT-PCR, requires specialist equipment and takes at least 24 hours to produce a result. Further, RT-PCR is not completely accurate and a second RT-PCR or a different test may be required to confirm the diagnosis.COVID-19 is a respiratory infectio...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
Study Design. Two-year clinical and radiographic follow-up of a double-blind, multicenter, randomized, intra-patient controlled, non-inferiority trial comparing a bone graft substitute (AttraX® Putty) with autograft in instrumented posterolateral fusion (PLF) surgery. Objectives. The aim of this study was to compare PLF rates between 1 and 2 years of follow-up and between graft types, and to explore the role of bone grafting based on the location of the PLF mass. Summary of Background Data. There are indications that bony fusion proceeds over time, but it is unknown to what extent this can be related to bone gr...
Source: Spine - Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research
Conclusion: Awareness of this uncommon manifestation would help differential diagnosis of periostitis and could help decrease the patient's anxiety. It should also be noted that periosteal reactions by benign entities could cause aggressive-looking periosteal reactions in post-operative regions.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Summary: Mortality after gluteal augmentation with fat transfer techniques is extremely high. Placement of fat subcutaneously versus in the gluteal musculature, or both, is considerably debated. The purpose of this study was to radiographically show the anatomical difference in live subjects in different procedural positions: the flexed or “jackknife” versus prone position. A total of 10 women underwent computed tomographic scanning of the pelvis with venous phase run-off in both the jackknife and prone positions. A computed tomography–specialized radiologist then reviewed images and measured distances ...
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Cosmetic: Ideas and Innovations Source Type: research
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