Editorial comment to accompany ‘Role of Rush rods in proximal femoral osteotomies for cerebral palsy’
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Letters to Editor and Commentary/Response by the Authors Source Type: research

Role of Rush rods in proximal femoral osteotomies for cerebral palsy
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Letters to Editor and Commentary/Response by the Authors Source Type: research

Response to: Citlak A. Surgical and nonsurgical containment methods for patients with Legg–Calvé–Perthes disease of the onset ages between 6.0 and 8.0 years provided similar congruency of the hip joint
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Letters to Editor and Commentary/Response by the Authors Source Type: research

Surgical and nonsurgical containment methods for patients with Legg-Calvé-Perthes disease of the onset ages between 6.0 and 8.0 years provided similar congruency of the hip joint
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Letters to Editor and Commentary/Response by the Authors Source Type: research

Clinical results and complication rates of lower limb lengthening in paediatric patients using the PRECICE 2 intramedullary magnetic nail: a multicentre study
Implantable intramedullary nail lengthening devices (e.g., PRECICE 2 system) have been proposed as alternative method to external fixation for lower limb lengthening surgery. The aim of this study was to analyse our outcomes and complications using the PRECICE 2 (P2) nail system and review them in light of the existing literature. A retrospective multicentre study was conducted on patients (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Limb Reconstruction Source Type: research

Hereditary spherocytosis: a risk factor for thigh pressure myonecrosis in posterior spine surgery
The objective of this study was to make surgeons aware of a potential pressure complication in posterior spine surgery for patients with hereditary spherocytosis (HS) and to present a plausible hypothesis for injury. Posterior spine surgery is common practice for adolescent idiopathic scoliosis (AIS). Common, less severe surgical risks include pressure ulcers; while rare, more severe pressure complications include rhabdomyolysis and compartment syndrome. In patients with HS, a familial hemolytic disorder with altered red cell deformability, it is unknown if their red cell disorder is an additional risk factor for pressure-...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Spine Source Type: research

Early outcomes of transforaminal percutaneous endoscopic lumbar discectomy for high school athletes with herniated nucleus pulposus of the lumbar spine
This study examined the outcomes of transforaminal PELD in high school athletes suffering from HNP. Subjects were 18 patients [14 males and four females; mean age 17 (15–18) years] who underwent PELD at our institutions. The events in which the patients competed were baseball (n = 6), softball (n = 2), rugby (n = 2), basketball (n = 2), table tennis (n = 2), American football (n = 1), wrestling (n = 1), track and field (n = 1), and dance (n = 1). All patients underwent PELD under local anesthesia. Back pain was assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and a visu...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Spine Source Type: research

Pediatric intervertebral disc calcification: case series and systematic review of the literature
Pediatric intervertebral disc calcification (PIDC) is an uncommon disease with an unclear etiology. The clinical picture may suggest a severe spinal disease, thus involving an extensive differential diagnosis. The aim of this study was to find a diagnostic and treatment approach for PIDC on the basis of the literature. The Medline, Embase, Web of Science, and Cochrane Systematic Review databases were searched for relevant studies, whose reference lists were checked manually for additional articles. For each study, year of publication, study design, demographics, onset type, history of trauma, clinical and neurological sign...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Spine Source Type: research

Importance of lowest instrumented vertebra on clinical and radiological outcomes in patients with Lenke type 3C adolescent idiopathic scoliosis: a minimum 4-year follow-up
The purpose of this retrospective study was to determine the most appropriate distal fusion level in terms of clinical results and radiological changes in Lenke 3C adolescent idiopathic scoliosis (AIS). Between June 2010 and May 2014, a total of 90 consecutive patients who underwent surgery for Lenke 3C AIS were divided into three groups as L2, L3, and L4 according to the fusion levels and compared in terms of functional and radiological outcomes. Patients were evaluated with Scoliosis Research Society 22 (SRS 22) and the Oswestry disability index (ODI) at the final follow-up. Preoperative standard posteroanterior and late...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Spine Source Type: research

Posterior vertebral column resection with short-segment fusion for the patients with congenital kyphoscoliosis
The purpose of this study was to assess the surgical outcomes of posterior vertebral column resection (PVCR) with short-segment fusion for pediatric patients with congenital kyphoscoliosis (CKS). The medical records of 12 consecutive pediatric patients with CKS due to hemivertebrae located in thoracolumbar and lumbar area that had undergone PVCR and presented for follow-up at a minimum of 2 years were retrospectively reviewed. The mean follow-up period was 56.2 months, and the mean age at the surgery was 9.2 years. We evaluated radiographic parameters using plain radiographs, and evaluated segmental co...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Spine Source Type: research

Burden of care in families of patients with early onset scoliosis
Early onset scoliosis is a complex manifestation of a heterogenous group of disorders, often necessitating multiple medical and surgical interventions to address the spinal deformity and its accompanying comorbidities. Current literature documents decreases in the health-related quality of life of these patients; however, there is a distinct lack of published data examining the burden on their caregivers. The purpose of this study is to compare burden on caregivers of children with early onset scoliosis and those on caregivers of age-matched healthy peers. A multicenter retrospective cohort study was conducted by querying ...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Spine Source Type: research

Influence of passive smoking on the onset of Legg-Calvè-Perthes disease: a systematic review and meta-analysis
The relationship between passive smoking and the onset of Legg-Calvè-Perthes disease is still controversial. Therefore, we conducted the study to systematically evaluate and analyze the relationship. A comprehensive search was conducted. Meta-analysis was performed with RevMan 5.3 software, with the odds ratio as the effect size. Eight English articles with a total of 1379 Legg-Calvè-Perthes disease patients were eventually included. Passive smoking type of family members smoking in indoor (odds ratio = 2.53), paternal smoking (odds ratio = 2.76), maternal smoking (odds ratio = 2.02), maternal smoking during ...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Hip Source Type: research

Arthrodiastasis in the management of Perthes disease: a systematic review
This systematic review explores the relevant literature to assess the efficacy of the use of arthrodiastasis in the management of Perthes disease. Until this moment, arthrodiastasis is not well established for its use in Perthes disease as opposed to other containment procedures. Furthermore, there are no clear indications for its use in this disease. Twelve articles were matched to the inclusion criteria and all articles were reviewed and radiological and clinical data were collected and compiled. As regards the hip flexion range of motion, the average preoperative flexion range of motion was 55.32°, while the postope...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Hip Source Type: research

Comparison of surgical and nonsurgical containment methods for patients with Legg-Calvé-Perthes disease of the onset ages between 6.0 and 8.0 years: Salter osteotomy versus a non-weight-bearing hip flexion-abduction brace
Since bone healing potential decreases with age, patients with Legg-Calvé-Perthes disease should receive treatment appropriate to their age group. Nonsurgical treatment is commonly applied to patients under 6.0 years of age at the onset and surgical treatment is recommended for those over 8.0 years of age, but it remains unclear which is better for those between 6.0 and 8.0 years. The aim of this retrospective study was to compare outcomes of Salter osteotomy and a non-weight-bearing brace in this age group. Inclusion criteria were unilateral Legg-Calvé-Perthes disease patients who were 6.0–8.0 years of...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Hip Source Type: research

Do seizures compromise correction maintenance after spinal fusion in cerebral palsy scoliosis?
Seizure disorder in cerebral palsy (CP) has been described as a risk factor for postoperative complications after posterior spinal fusion. However, the effect of seizures on the maintenance of curve correction has not been reported. The aim of this study is to investigate associations between seizure history and maintenance of curve correction after posterior spinal fusion in children with CP. We analyzed records of 201 children with CP who underwent posterior spinal fusion with two-year follow-up. Patients were classified as having no seizures (31%); controlled seizures (54%); or poorly controlled seizures (PCS, 15%). Per...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Evaluation of the functional outcome of a percutaneous technique in correction of excessive anteversion in cerebral palsy
In cerebral palsy, patients’ excessive femoral anteversion is one of the most common skeletal abnormalities. The general agreement is concurrent correction of both soft tissue and bony deformities during the same operative setting by combining open femoral derotation osteotomy (FDO) with soft tissue releases. Fifty-one children (75 lower limbs) with cerebral palsy with a mean age of 10.7 years (range 6–16 years) fulfilling the inclusion criteria who underwent percutaneous FDO and when needed customized soft tissue releases. Derotation was maintained by a pin-in-cast technique. The mean follow-up w...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Mid-term clinical result of femoral varus osteotomy combined with Pemberton osteotomy in treating spastic hip subluxation
This study aimed to introduce the indications and methods of femoral varus osteotomy combined with Pemberton osteotomy in treating spastic hip subluxation to evaluate the interim clinical result and outcome and to discuss its corrective mechanism and orthopedic effect. A total of 23 children with spastic hip subluxation, who underwent femoral varus osteotomy combined with Pemberton osteotomy were selected. The clinical effects were evaluated according to the migration percentage, acetabular index, proximal femur neck shaft angle (NSA), and Melbourne Cerebral Palsy Hip Classification System (MCPHCS). The median migration pe...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Developing a province-wide hip surveillance program for children with cerebral palsy: from evidence to consensus to program implementation: a mini-review
Hip displacement is a common orthopedic problem in children with cerebral palsy (CP) that can result in significant morbidity. Hip surveillance has been shown to reduce the incidence of hip dislocations in children with CP and to reduce the need for salvage hip surgeries. Guidelines for hip surveillance have been developed and can be adapted to meet local needs. Implementation of surveillance guidelines for a population of children is complex and highly dependent upon the region, province/state, or country’s system of care for children with CP. Recognizing that implementation of the evidence on hip surveillance was n...
Source: Journal of Pediatric Orthopaedics B - October 3, 2020 Category: Orthopaedics Tags: Cerebral Palsy Source Type: research

Pin placement may be more important than fracture type in predicting failure. Response to: fracture obliquity is a predictor for loss of reduction in supracondylar humerus fractures in older children: an answer to a commentary
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Pin placement may be more important than fracture type in predicting failure. Response to: fracture obliquity is a predictor for loss of reduction in supracondylar humeral fractures in older children
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Use of hamstring autograft to reconstruct the patellar tendon after endoprosthetic replacement of the proximal tibia for bone sarcomas
We describe the surgical technique and, using an illustrative case, compare the outcome of this technique with the outcome following reconstruction without reinforcement. Level of evidence: Level III. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Bone Tumours Source Type: research

Chondrosarcomas in adolescents: are they different?
The objective of this study was to evaluate the characteristics and oncologic outcomes of a single institution series of chondrosarcoma of pelvis and extremities in patients who were 21 years or younger. Between January 2006 and December 2016, we operated on 249 chondrosarcomas of the pelvis and extremities. Eleven (4%) of these were 21 years or younger. The mean age was 18 years (range 14–21 years). There were eight males and three females. Four occurred in the pelvis. The other sites were humerus (three) and one each in the scapula, clavicle, metatarsal and proximal femur. There were five primary chondrosarcomas an...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Bone Tumours Source Type: research

Is the incidence of paediatric stress fractures on the rise? Trends in New York State from 2000 to 2015
The purpose of this study is to analyze trends in the epidemiology of paediatric stress fractures. The New York Statewide Planning and Research Cooperative System database was queried for stress fractures in children between the ages of 6 and 18 years. After checking for monotonicity of the data, Spearman’s correlation coefficient was calculated. Multivariate regressions were used to test for associations between demographic variables and risk of stress fracture. Analysis of 11 475 386 outpatient visits between 2000 and 2015 showed that the annual incidence of paediatric stress fractures increased from 1.37 cases per...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Lower Limb Trauma Source Type: research

Clinical, radiographic and pedobarographic analysis of skeletally immature patients with surgically treated distal metaphyseal fractures of the tibia: is concomitant fixation of the fibula necessary?
This study evaluated the outcomes of distal tibia metaphyseal fractures (DTMFs) managed surgically and compared the outcomes of patients with and without associated fibula fracture fixation. Thirty-two consecutive patients (14 males; mean age at the time of injury: 7.8 years) with closed displaced DTMFs, with (22 patients; group A) or without associated fibula fractures fixation (10 patients; group B), were included. Besides standard radiographic measurements, the following static and dynamic pedobarographic parameters were evaluated: foot total static plantar pressure percentage (PP%tot), static plantar pressure percentag...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Lower Limb Trauma Source Type: research

External fixator-augmented flexible intramedullary nailing of an unstable pediatric femoral shaft fracture model: a biomechanical study
The objective of this study was to test the compressive strength and torsional stiffness provided by the addition of a two-pin external fixator to an unstable pediatric femoral shaft fracture model after being instrumented with flexible intramedullary nailing (FIMN), and to compare this to bridge plating and FIMN alone. A length-unstable oblique diaphyseal fracture was created in 15 pediatric sized small femur models. Fracture stabilization was achieved by three constructs: standard retrograde FIMN with two 3.5-mm titanium (Ti) nails (Group 1), FIMN augmented with a two-pin external fixator (Group 2), and a 4.5-mm bridge p...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Lower Limb Trauma Source Type: research

Enhancing stability by penetrating the apophysis of greater trochanter or the posterior neck cortex during titanium elastic nailing of paediatric subtrochanteric femoral fractures in children aged 5–12 years
We report the clinical/radiological outcomes after at least 5 years of follow-up. We prospectively included 17 children aged 5–12 years diagnosed with subtrochanteric femoral fractures between January 2004 and December 2013. Radiological evaluations of bony union, malunion, and limb-length discrepancies (LLDs) were performed at the final follow-up. Clinical outcomes, as revealed by the Flynn scoring system, and the range of hip motion were also recorded. The mean patient age was 8.4 ± 2.0 years. Twelve patients presented with length-stable fractures and the others with unstable fractures. Bony union was eviden...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Lower Limb Trauma Source Type: research

Flexible intramedullary nailing of femoral shaft fractures: closed versus open reduction
Children's femoral shaft fractures are commonly treated with flexible intramedullary nailing after closed or open reduction, but there is little information concerning indications for open reduction. The purpose of this study was to determine radiographic and clinical features likely to lead to open reduction before flexible intramedullary nailing. Record review identified 158 femoral shaft fractures treated with flexible intramedullary nailing. In addition to patient demographics and mechanism of injury, data obtained included surgeon name, estimated blood loss, type of reduction, type and diameter of nail, type of operat...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Lower Limb Trauma Source Type: research

Focal fibrocartilaginous dysplasia of the distal femur
This study aimed to determine a strategy to successfully manage distal femoral FFCD. Nine case of femoral FFCD treated in our department between 2008 and 2018, together with 22 cases from literature, were retrospectively reviewed. Tibiofemoral anatomical axis angle (TFA) was used to evaluate and follow the deformities. Treatment methods and outcome were analyzed. Five methods were used to manage the disease: osteotomy with tether release in 14 cases with mean TFA of 29°; simple tether release in eight cases with mean TFA of 31°; guide growth without tether release in 3 case with mean TFA of 27°; guide growth wi...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Limited internal fixation combined with a joint-spanning external fixator in the treatment of Midfoot injuries in children
The aim of this study was to explore the clinical features and surgical treatment methods of unstable midfoot injuries in children. Eleven children with severe unstable midfoot injuries admitted to Jishuitan Hospital, Beijing, from June 2009 to October 2016 were enrolled, including seven patients with Lisfranc injuries and four patients with Chopart injuries. All Lisfranc injuries had radiographic data from the healthy sides, and radiographs of the affected sides showed that all injured Lisfranc joints separated more than 3 mm compared with the healthy sides. The treatment methods employed a joint-spanning external fixator...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

The use of a transolecranon pin joystick technique in the treatment of multidirectionally unstable supracondylar humeral fractures in children
Multidirectionally unstable supracondylar humeral fractures cause severe instability in both flexion and extension movements. The traditional closed reduction often fails to overcome this lack of stability. The aim of this study is to use a closed reduction technique with a transolecranon pin to achieve temporary stability. From 35 pediatric multidirectionally unstable supracondylar humeral fractures hospitalized between March 2012 and March 2018 at our hospital, 23 fractures (65.7%) were treated with closed reduction and percutaneous pinning (CRPP) (group 1) and the remaining twelve fractures (34.3%) were treated utilizin...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Use of MRI assisting the diagnosis of pediatric medial condyle fractures of the distal humerus
The aim of this study was to describe the radiographic appearance and to evaluate the elbow function with the Mayo elbow performance score (MEPS) in children with medial condyle fracture of the distal humerus (MCFH) who were treated surgically. During the period of 2011–2017, a total of 10 patients (three boys, seven girls) were retrospectively reviewed after obtaining institutional review board approval. All patients underwent open reduction and percutaneous pinning fixation. The average age at the time of injury was 7.7 years (range: 4.0–12.5 years), and the mean follow up was 43.9 months...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Functional and radiological outcome in patients with acute Monteggia fracture treated surgically: a comparison between closed reduction and external fixation versus closed reduction and elastic stable intramedullary nailing
In conclusion, both elastic stable intramedullary nailing and external fixation can achieve satisfactory clinical and radiographic outcomes in children with acute Monteggia fractures. However, the rate of residual pain and less satisfactory clinical appearance was higher in patients managed by external fixation compared to those treated by elastic stable intramedullary nailing. According to our results, elastic stable intramedullary nailing should be used as primary treatment option in children with acute Monteggia fracture requiring surgical management. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Effect of age on radiographic outcomes of patients aged 6–24 months with developmental dysplasia of the hip treated by closed reduction
This study aimed to investigate the effect of age on the rates of redislocation, avascular necrosis (AVN) of the femoral head, and final radiographic outcomes in patients with developmental dysplasia of the hip (DDH) treated with closed reduction. A total of 308 hips (276 patients) with DDH treated with closed reduction were included and divided into three groups according to age ( (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Comparison between the Pavlik harness and the Tübingen hip flexion splint for the early treatment of developmental dysplasia of the hip
The Pavlik harness and the Tübingen hip flexion splint (Tübingen hip flexion splint) are two effective options for the early management of patients younger than 6 months of age with developmental dysplasia of the hip (DDH). The main objective of this study was to evaluate the clinical and radiological outcomes of patients younger than 6 months of age with type IIb to IV DDH managed by Pavlik harness or Tübingen hip flexion splint. The Pavlik harness and Tübingen hip flexion splint groups were comparable regarding the affected side (P = 0.09), Graf grade (P = 0.635), an...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Clinical and radiological outcomes of combined acetabuloplasty with acetabular redirectional osteotomy and femoral shortening for children older than 9 years of age with developmental dysplasia of the hip: a retrospective case series
This study aimed to investigate the feasibility and the efficacy of Dega osteotomy in combination with pelvic triple osteotomy or periacetabular osteotomy and femoral shortening with derotational osteotomy for the treatment of severe acetabular deformity secondary to DDH in children older than 9 years of age. The clinical data of 22 children treated at our institution were retrospectively collected. Pre- and postoperative hip radiographs were evaluated. Center-edge (CE) angle was measured, and Severin classification and McKay criteria were used to evaluate the final outcome. Twenty-two patients (including 21 female patient...
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Origins and development of pediatric orthopedic surgery in China
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - August 4, 2020 Category: Orthopaedics Tags: Pediatric Orthopedic Surgery in China Special Issue Source Type: research

Letter regarding ‘Risk factors associated with neonatal brachial plexus palsy in the United States’
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Letter to the Editor Source Type: research

Classification of stress fractures of the first rib in adolescent athletes
This study proposed a classification system and a possible mechanism for stress fractures of the first rib using three-dimensional computed tomography (3D-CT). The data of 10 stress fractures of the first rib in adolescent athletes obtained using 3D-CT between 2007 and 2018 were reviewed. Fractures of the first rib were classified according to the location and type of the fracture line. Stress fractures of the first rib were classified into three types: type 1, center-transverse fracture; type 2, center to posterior-oblique fracture; and type 3, posterior-transverse fracture. There were three type 1 fractures, five type 2 ...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Upper Limb Source Type: research

Assessment of hand function using the functional dexterity test after opponensplasty in young children with Blauth type 2 hypoplastic thumb
The functional dexterity test (FDT) is a timed pegboard test based on the manipulation of each peg and suitable for young children as it is both simple and quick to perform. We assessed the postoperative FDT values for children with Blauth type 2 hypoplastic thumbs after opponensplasty. We evaluated hand function using FDT for 12 hands of 11 patients with Blauth type 2 hypoplastic thumbs. Opponensplasty was performed in all hands following by Huber’s procedure. All patients were evaluated from 6 to 12 months after surgery for hand function using three types of FDT scores: time in seconds to complete the test (...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Upper Limb Source Type: research

Upper extremity anomalies in children with femoral and fibular deficiency
Defects occurring in the femoral–fibular–ulnar developmental field are believed to cause the cluster of anomalies seen with femoral, fibular and ulnar limb deficiencies. Upper limb function must be considered in the management of lower limb deficiencies. The purpose of this study is to determine the frequency and type of upper extremity anomalies found in children with femoral and/or fibular deficiency. A retrospective review of 327 consecutive patients with the diagnosis of femoral and/or fibular deficiency was performed using existing records and radiographs. Characteristics of those with and without upper ex...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Upper Limb Source Type: research

Risk factors associated with neonatal brachial plexus palsy in the United States
Neonatal brachial plexus palsy (NBPP) is a birth injury that can cause severe functional loss in the affected limb. The purpose of this study was to determine the temporal changes in the national incidence of this condition and whether associated risk factors have changed over time. Children born via vaginal delivery were identified in the Kids’ Inpatient Database (KID) from 1997 to 2012, and those with NBPP were identified. The trend in incidence and risk factors were assessed through the study period. The nationwide incidence of NBPP decreased during the study period. Infants with shoulder dystocia, fetal macrosomi...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Upper Limb Source Type: research

Naviculectomy for two ambulatory children with intractable congenital vertical talus: redefining the indications of an old technique
We reported favorable results in terms of foot appearance, function and radiology. We believe that a less invasive procedure like naviculectomy/midtarsal resection is an encouraging technique to investigate in children with intractable congenital vertical talus. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Subungual exostosis – treatment results with preservation of the nail bed
We describe the surgical technique used, the characteristics of the patients and lesions, and evaluate the results obtained in terms of function, satisfaction and complications. Thirteen patients were included in this study, seven female (54%) and six male (46%), median age 11 years old. The most common location was the hallux, in eight patients (73%). Patients had good functional results with a median American Orthopedic Foot & Ankle Society score of 100 [80; 100] and a median personal satisfaction score of 9. The median follow-up was 30 [3;68] months. In our patients, subungual excision with nail bed preservation, al...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

A new anchoring technique for tibialis anterior tendon transfer
This study included 26 feet in 18 patients, who underwent tibialis anterior tendon transfer as a part of management of their congenital clubfoot. The mean age was 3.6 years (ranging from 2.5 to 5 years), all patients were followed up for 6 to 30 months (mean = 14 months). The transferred tibialis anterior tendon was anchored in the third cuneiform using transfixing K wires. This novel technique resulted in successful and stable anchoring of the transferred tibialis anterior tendon. The transferred tendon was well palpated in all patients with active dorsiflexion, with no associated tendon rupture, anchoring problems, or wo...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

YouTube as an information source for clubfoot: a quality analysis of video content
Idiopathic clubfoot is the most common congenital anomaly of the lower extremity. YouTube has emerged as an important source of health-related information for patients and families. Parents seek information about clubfoot on YouTube. However, the quality of these videos remains unknown. Therefore, we decided to evaluate the quality of YouTube videos about clubfoot. We searched YouTube for clubfoot videos using appropriate keywords. English language videos with more than 10 000 views were included. Three fellowship trained pediatric orthopedic surgeons independently assessed the videos and classified them into corpor...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Unsuspected tarsal coalitions in equinus and varus foot deformities
Tarsal coalitions have been reported in the setting of equinovarus foot deformities, but only as rare isolated findings. Failure to recognize this diagnosis may inhibit successful equinovarus correction. Here, we review a series of tarsal coalitions seen in congenital and neuropathic equinovarus deformity at two institutions, to report the breakdown of types of coalitions encountered, and to suggest methodology to facilitate earlier diagnosis. The records of all patients treated by two of the authors for bilateral equinovarus deformities and found to have either a unilateral or bilateral tarsal coalition between 2006 and 2...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Stable childhood osteochondral lesions of the talus: short-term radiographic outcomes suggest risk for early osteoarthritis
Recent literature suggests that adults do not necessarily develop osteoarthritis if they have an osteochondral lesion of the talus (OLT). The purpose of this study was to determine if children with OLT are at risk to develop any radiographic evidence of early joint degeneration despite treatment efforts. Fifty-six ankles were identified over 6 years with stable OLT that underwent operative treatment. Preoperatively, each lesion was classified according to Berndt-Hardy for radiographs, Hepple for MRI, and Ferkel and Sgaglione for computed tomography. Radiographs were also evaluated for physeal status, OLT characteristics (l...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

A simple approach for determining tendon limb length in open Achilles lengthening: technical note
Estimating the appropriate tendon length and associated skin incision needed to achieve a plantigrade foot without compromising function are essential steps in open Achilles tendon lengthening. Here we describe a technique using basic surgical instruments referencing anatomic landmarks without the need for radiographs. The center of ankle rotation in the sagittal plane is found referencing the tip of the medial malleolus. This point is translated to the plantar surface of the foot, and a straight instrument in line with the foot is used to make a mark at the posterior calcaneal fat pad. The straight instrument is then rota...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Pediatric acute leg compartment syndrome after peroneus longus rupture: a case series
We present the case of three pediatric patients who presented with non-fracture acute lateral compartment syndrome after ‘minor trauma’. All patients were male and sustained the inciting event during football. Two of the patients were able to resume play after their injury. All patients sustained intramuscular proximal avulsion ruptures of the peroneus longus muscle. At final follow-up, all but one patient had documented full neurologic recovery. A seemingly innocuous event may cause acute compartment syndrome in the adolescent male. Compartment syndrome in the absence of fracture should be promptly recognized ...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

In-toeing gait in children with clubfoot and the effect of tibial rotation osteotomy
In-toeing gait is common after treatment for clubfoot deformity and is often secondary to residual internal tibial torsion. The purpose of the current study was to characterize the gait pattern in children with an intoeing gait pattern associated with talipes equinovarus (TEV) deformity, identify secondary changes at the hip that occur with intoeing, and determine if these secondary effects resolve after correction of tibial torsion. Patients with a diagnosis of TEV deformity, in-toeing gait secondary to residual internal tibial torsion corrected with tibial rotation osteotomy (TRO) and complete preoperative and postoperat...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research