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

Congenital pseudarthrosis of the tibia: the outcome of a pathology-oriented classification system and treatment protocol
Congenital pseudarthrosis of the tibia is defined as a non-union of a tibial fracture that develops in a dysplastic bone segment of the tibial diaphysis. Pathologically, a fibrous hamartoma surrounds the bone at the congenital pseudarthrosis of the tibia site. The cases of 25 children, who have congenital pseudarthrosis of the tibia, were included in this study. Their ages ranged from 15 months to 15 years at the time of treatment. Neurofibromatosis-1 was present in 24 children. They were managed according to our classification system and treatment protocol. The treatment for mobile pseudarthrosis (types 1 and 2) included ...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Insight into the possible aetiologies of Blount’s disease: a systematic review of the literature
The objective of this study is to provide an overview of the available hypotheses on the aetiology of Blount’s disease since its first description and assessment of the available level of evidence, the quality of evidence and the occurrence of bias supporting these individual hypotheses. A systematic search according to the PRISMA statement was conducted using PubMed, MEDLINE, EMBASE and the Cochrane Library using a broad combination of terminology to ascertain a complete selection. Proper MESH search criteria were formulated and the bibliographic search was limited to English and Dutch language articles. Articles wi...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

The femoral deformity in Blount’s disease: a comparative study of infantile, juvenile and adolescent Blount’s disease
This study found distal femoral varus deformity to be present in all groups of children with Blount’s disease. In this study population, it was most significant in the infantile and adolescent groups when compared to a control group from the same population. Although further studies are required, the surgeon must always assess the distal femoral component in treating children with Blount’s disease. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Assessment of the reliability and reproducibility of the Langenskiöld classification in Blount’s disease
The Langenskiöld classification is the most commonly utilized classification system for the radiological features of Blount’s disease. Although there is only a single study found on the interobserver variability and none found on the intraobserver variability, it is commonly used for prognostication and guiding management decisions. The aim of this study was to determine the reliability and reproducibility of the Langenskiöld classification. A retrospective review of radiographs was done of patients treated for infantile and juvenile Blount’s disease at Chris Hani Baragwanath Academic Hospital from 20...
Source: Journal of Pediatric Orthopaedics B - June 2, 2020 Category: Orthopaedics Tags: Leg & Foot Source Type: research

Is it necessary to perform hip arthrography before incision in developmental dysplasia of the hip? Response to: Arthrography of the hip should be performed before incision in developmental dysplasia of the hip. J Pediatr Orthop B 2019; 28: 415
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Letter to the Editor Source Type: research

Simplified arthroscopic lavage of pediatric septic hip: case series
In this report, we describe a simplified arthroscopic technique that may be performed using a single portal based on fluoroscopy and surface landmarks and without regular use of traction. We present results of a series of patients who underwent the simplified arthroscopic method for the management of pediatric septic hip. Data were obtained by a retrospective chart review of 13 consecutive patients (14 hips) with pediatric septic hip treated with arthroscopic lavage from 2010 to 2015. Age at the time of surgery ranged from 3 months to 8 years with three patients less than 1 year old. Ten hips (71%) returned f...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Infections Source Type: research

Differential MRI findings of transient synovitis of the hip in children when septic arthritis is suspected according to symptom duration
We investigated the differential MRI findings in children with transient synovitis of the hip in whom septic arthritis was suspected. Under the hypothesis that disease progression can alter representative MRI findings, we stratified these findings in accordance with symptom duration as this can correlate with disease progression. We analyzed 65 children who underwent MRI for acute hip pain and who were suspected of having a septic condition (i.e. presented with fever or increased inflammatory markers) when the imaging was performed. Symptom duration was defined as the interval from the first presentation of hip pain to the...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Infections Source Type: research

The predictive value of synovial glucose level in septic arthritis
The aim of this study was to investigate the ability of the joint fluid glucose level to detect septic arthritis. Thirty joints in 30 patients with suspected septic arthritis were evaluated. When glucose level was less than 40 mg/dl, we performed arthrotomy. Eleven patients had joint fluid glucose levels less than 40 mg/dl. All 11 (100%) had positive joint fluid cultures. Conversely, 19 patients had synovial glucose levels of at least 40 mg/dl. Six (31.6%) of these had positive joint fluid cultures. The remaining 13 were diagnosed with transient synovitis. Patients with joint fluid glucose levels less ...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Infections Source Type: research

Intertrochanteric Imhäuser osteotomy combined with osteochondroplasty in treatment of moderate-severe stable slipped capital femoral epiphysis: a case series study
The aim of the study is to assess the safety and efficacy of Imhäuser osteotomy combined with osteochondroplasty in the treatment of moderate-severe stable slipped capital femoral epiphysis (SCFE) on short-term basis. Nineteen patients (20 hips) with moderate-severe stable SCFE were surgically treated by Imhäuser osteotomy combined with osteochondroplasty and followed up for 3–4 years. The cases aged between 12 and 18 years at the time of surgery and complained of a variety of symptoms and signs that included pain, limping, limited range of motion (ROM), and/or abductor weakness. The outcomes were assessed ...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Contralateral slip after unilateral slipped capital femoral epiphysis is associated with acetabular retroversion but not increased acetabular depth and overcoverage
Overcoverage of the femoral head by the acetabulum, increased acetabular depth and retroversion have been associated with the etiology of slipped capital femoral epiphysis (SCFE). However, limited evidence exists about the impact of the acetabular morphology on the development of a contralateral slip following an initial presentation of unilateral SCFE. We aimed to investigate whether acetabular overcoverage as assessed by an increased lateral center-edge angle (LCEA) and low Tönnis angle, increased acetabular depth assessed by the acetabular depth-width ratio (ADR) and the presence of coxa profunda; and acetabular re...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Effect of seasonal variation on the peak presentation of slipped capital femoral epiphysis. A comparison of children in Johannesburg, South Africa and London, UK
This study found significant differences in the two countries, including a more skeletally mature population in the UK. Both cohorts showed seasonal variation in peak incidence, but there was more seasonal variation in peak incidence in the UK – in the summer for onset of symptoms and autumn months for time of presentation. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Radiological results of Shelf acetabuloplasty in adolescent hip dysplasia with aspherical femoral head: how to get an ideal placement of the Shelf graft
Shelf acetabuloplasty continues to be effective in the prevention or delay of osteoarthritis in adolescent dysplastic hips. We aimed to evaluate the efficacy and to determine the correct level of the bone graft objectively. We retrospectively analyzed 16 hips underwent Shelf acetabuloplasty originated by Spitzy. The mean age at surgery was 15.3 years old with the mean caput index at 39.7%. The average follow-up was 11 years. The radiological evaluation was based on acetabular-head index (AHI) at preoperative and latest radiographs, acetabular-Shelf distance (ASD) and Shelf-head ratio at immediate postoperative and latest r...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Comparison of total cost and outcomes between single-stage open reduction and Pemberton periacetabular osteotomy operation and two separate consecutive operations in treatment of bilateral developmental hip dysplasia in children at walking age
In this study, we aimed to compare the outcomes, length of hospitalization and total cost between the patients whom had single-stage open reduction and PPO or two consecutive operations due to bilateral DDH in the walking age children. One hundred thirty patients with bilateral DDH had undergone open reduction and PPO for both hips. Seventy-five patients had one-stage open reduction and PPO for both of the hips, whereas 55 patients have two separate consecutive operations. Total time of exposure to anesthetics, blood loss and duration of operation were noted. Hospitalization period and total treatment costs were also noted...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Simultaneous bilateral single-stage combined open reduction and pelvic osteotomy for the treatment of developmental dysplasia of the hip
Children older than 18 months with developmental dysplasia of the hip (DDH) for the first time or who do not respond to closed treatment require open reduction with/without acetabuloplasty. We determined whether open reduction and pelvic acetabuloplasty using the Pemberton or Dega technique for both hips simultaneously was well tolerated and offered better outcomes. A total of 140 hips of 70 patients with bilateral DDH were identified. All patients were diagnosed after they started walking. Patients were treated with bilateral single-stage open reduction with acetabuloplasty using the Pemberton or Dega procedure. Al...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Citation analysis of the highest-cited articles on developmental dysplasia of the hip
The purpose of this study is to determine the highest-cited articles on developmental dysplasia of the hip (DDH) and analyze their bibliometric characteristics. We searched the Web of Science (WoS) for articles with the highest number of citations on DDH and recorded their number of citations in WoS, Scopus, and Google Scholar (GS). We ranked and selected the top 100 cited articles. The average number of citations in WoS was 148 (range 66–638). The most-cited article in all databases was Crowe’s total hip replacement cohort on DDH. The Journal of Bone and Joint Surgery American Volume (n = 35) had the most arti...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Discrepancy between ultrasonographic and radiographic findings in patients treated for developmental dysplasia of the hip; hip maturation on ultrasonography may not be consistent with radiographic hip maturation
This study included 88 infants (98hips) treated for DDH. Radiography was simultaneously used for treatment and follow-up evaluation in addition to ultrasonography after six months of age. A retrospective evaluation was made of the ultrasonographs and radiographs of these infants. Of the total 98 hips, 28 were normal both ultrasonographically and radiographically, and a pathologic hip was demonstrated in 32 hips both sonographically and radiographically. Hip ultrasonography showed abnormal development in 32 hips, while radiography showed abnormal development in 70 hips. In 38 hips, the findings were normal according to ultr...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Neonatal hip ultrasound: tangent to lateral roof angle correlates better with stability than alpha angle according to Graf or percentage femoral head coverage
The aim of this study was to determine the relationship of tangent to the lateral roof angle (TLRA), Graf’s alpha angle and percentage femoral head cover (PHC) and to observed stability, and to establish intraobserver and interobserver errors for measurement of alpha angle and TLRA. In total, 2235 babies referred to the hip review clinic over a period of 8  years. Intraobserver and interobserver errors were calculated from readings of 383 hip images by an experienced paediatric radiologist and a trainee. Taking TLRA (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Interpreting neonatal hip sonography: intraobserver and interobserver variability
The purpose of this study is to state the reliability of neonatal hip ultrasound interpretation, defining the intra and interoperator variability in the evaluation of the scans. We considered a sample of 2071 scans (coming from 798 patients who attended the screening programme for hip dysplasia), which were interpreted by the operator who obtained and read the images at the screening time and then by a different operator who saw the images for the first time. Both the intra and interoperator variability of α and β angles’ values resulted statistically not significative (intraclass correlation coefficient&g...
Source: Journal of Pediatric Orthopaedics B - March 28, 2020 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research