Beals–Hecht syndrome (congenital contractural arachnodactyly) with additional craniospinal abnormality: a case report
We present a case of a patient with Beals syndrome who presented to the emergency department with pneumonia and was found to have narrowing of the foramen magnum, with partial fusion of C2–C3 vertebral bodies. To our knowledge, this has not been documented in the literature and could be characteristic in relation to Beals syndrome. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Myositis ossificans on the forearm in a 10-year-old girl
Myositis ossificans is a rarely encountered benign lesion characterized by a non-neoplastic heterotopic bone formation in both soft tissue and skeletal muscle. Three subgroups of myositis ossificans are identified: myositis ossificans progressiva, which is hereditary; nontraumatic or pseudomalignant myositis ossificans, which is developed in the absence of any trauma; and myositis ossificans circumscripta, which is related to evident and direct trauma. In this case report, we present a girl with a swelling on the forearm who was finally diagnosed with nontraumatic myositis ossificans. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Dissolution of the capitellum after nondisplaced supracondylar fracture of the humerus in a child: a case report of transient osteochondrosis
We report our experience of transient osteochondrosis of the capitellum in a 5-year-old boy after conservative treatment with cast immobilization for a nondisplaced supracondylar fracture of the distal humerus with 8 years of follow-up. Serial radiography of both the injured and the contralateral elbows were performed, which enabled monitoring of the evolution of the transient osteochondrosis. No specific treatment was provided because there was no evidence of acute complication or of a progressing deformity. The patient had gained full range of motion of the elbow without pain by 6 weeks of follow-up. At 5 years after the...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Posterior shoulder dislocation with ipsilateral proximal humerus type 2 physeal fracture: case report
In pediatric patients, proximal humeral physeal fractures are uncommon injuries compared with distal physeal fractures. Usually, the growth plate is the most vulnerable site of fracture in the proximal humerus. Proximal humeral physeal fractures accompanying posterior shoulder dislocation are very rare. There are few recent reports on the combination of glenohumeral dislocation and proximal humerus fractures. Here, we describe a case of posterior shoulder dislocation with ipsilateral proximal humerus type 2 physeal fracture in a 9-year-old boy. We treated the patient by closed reduction and percutaneous pinning under gener...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Temporary scaphocapitate fixation with or without radial shortening for adolescent Kienböck’s disease
We performed temporary scaphocapitate joint fixation with or without radial shortening osteotomy, depending on the ulnar variance, in adolescent Kienböck’s disease. The aim of the current study was to evaluate the radiological and clinical results and compare our results with those of other previously reported methods. Temporary scaphocapitate fixation alone or fixation accompanied by radial shortening osteotomy has been performed in three patients since 2003. All six patients were males, and their mean age at surgery was 15.5 years. The fixation was performed using two Kirschner-wires in closed methods, and the...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

The shaft fractures of the radius and ulna in children: current concepts
The incidence of forearm shaft fractures in children has increased in recent years. They are challenging to treat and they can result in several long-lasting complications. The treatment of children’s fractures needs to be individualized to their needs. Nonoperative care will be satisfactory for young, preschool children and it is primarily treatment in stable fractures of children at every age. Injury mechanism must be understood to perform appropriate closed reduction. Immobilization using a long-arm cast needs to be focused against the deforming muscle forces – in particular those that rotate – in the ...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Neglected Monteggia fracture dislocations in children: a systematic review
This article aims to study, in a systematic manner, the surgical management and complications of treatment of chronic radial head dislocations. After screening of relevant abstracts, a total of 28 studies were included in the systematic review. A narrative synthesis of various treatment modalities has been discussed. This article concludes that open reduction should be attempted unless dysmorphism of the radial head restricts it. Open reduction with ulnar osteotomy with or without annular ligament reconstruction is the most commonly performed procedure and is expected to result in reduced pain and elbow deformity. (Source:...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

The isolated medial humeral epicondyle fracture treated nonoperatively: does fracture displacement change over time?
This study explores the change in the position of the fragment in isolated, displaced, medial humeral epicondyle fractures in children. In this series, 34 patients (mean age 11.0 years) were treated nonoperatively by cast immobilization with no attempt at closed fracture reduction. A statistically significant association was found between the position of the fracture fragment at the time of initial fracture compared with 3 weeks after fracture (P=0.015). Twenty-six of 34 patients (76.5%) showed spontaneous improvement in fragment position. These findings support the practice of treating significantly displaced medial epico...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Postoperative pain and the use of ultrasound-guided regional analgesia in pediatric supracondylar humerus fractures
A total of 230 children undergoing closed reduction and percutaneous pinning of supracondylar humerus fractures were analyzed retrospectively. Severe pain (score≥7/10) was reported in 10% of general anesthesia-only patients in the postanesthesia care unit and in 28% of the 130 admitted patients. The 36 patients who received ultrasound-guided regional analgesia+general anesthesia had decreased intraoperative opioid consumption and postanesthesia care unit pain scores. After admission, pain scores and opioid consumption did not differ between fracture and anesthesia types. No patient developed compartment syndrome. Severe...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

High recurrence of instability in adolescents playing contact sports after arthroscopic shoulder stabilization
Sixty-one shoulders in 57 adolescents underwent primary arthroscopic shoulder stabilization for labral tears sustained during contact sports (all Stanmore type 1). Mean follow-up was 22 months, mean age 16.8 (13–18) years. Postoperatively, the median subjective improvement was 90%, median VAS pain was 0 and mean Oxford Instability Score was 26.8. Sixty-one per cent returned to preinjury sporting level. A higher than expected proportion reported recurrent dislocation, with 15% followed up for 1 year and 31% for 4 years. Of these 11 requiring further surgery, 90% of redislocations occurred while playing rugby. Sex, typ...
Source: Journal of Pediatric Orthopaedics B - March 31, 2015 Category: Orthopaedics Tags: Upper Extremity Source Type: research

Chronic recurrent multifocal Q fever osteomyelitis in children: a case report and review of the literature: Retraction
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Retraction Source Type: research

Response to ‘Comment on the article ‘Derotational femoral osteotomy technique with locking nail fixation for adolescent femoral antetorsion: surgical technique and preliminary study’ by Pailhé et al.’
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Comment on the article ‘Derotational femoral osteotomy technique with locking nail fixation for adolescent femoral antetorsion: surgical technique and preliminary study’ by Pailhé et al.
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Osteoactivin attenuates skeletal muscle fibrosis after distraction osteogenesis by promoting extracellular matrix degradation/remodeling
The aim of this study was to determine whether osteoactivin attenuated skeletal muscle fibrosis caused by distraction osteogenesis. Tibial osteotomies were performed on wild-type and osteoactivin-transgenic (OA-Tg) mice, and tibiae were distracted for 2 weeks. Ankle plantar flexion torque and the gastrocnemius muscles were analyzed. The amount and area of collagenous tissue and the passive torque were reduced in the OA-Tg group at 8 weeks after osteotomy. Transcript levels of matrix metalloprotease (mmp)-3 and MMP-9 were upregulated, and MMP-3 and MMP-9 proteins were increased in the OA-Tg group. Osteoactivin-mediated incr...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Basic Science & Research Source Type: research

Lymphangioma of the foot mimicking melanoma: an uncommon case of a Chinese boy
We present the case of a Chinese boy with a mass in the foot mimicking melanoma, who was eventually diagnosed with lymphangioma following a thorough diagnostic workup. Complete resection resulted in a curative outcome. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Regular Submissions Source Type: research

Bilateral osteochondrosis of the distal tibial epiphysis: a case report
We report on an 11-year-old female with bilateral osteochondrosis on distal tibial epiphysis. Only one other similar case has been described in the literature to date. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Regular Submissions Source Type: research

Foot centralization for tibial hemimelia
Nineteen foot centralizations were performed in 14 patients with Jones type I and II tibial hemimelia. All feet showed equinovarus deformity and were treated by foot centralization by means of calcaneofibular arthrodesis. The average age of patients at the time of surgery was 1.3 years (range 0.4–3.8 years). The average follow-up postoperative period was 10.2 years (range 2.2–22.9). At the time of the final follow-up, four of the operated feet were plantigrade without secondary surgery. The remaining 15 limbs, however, required secondary surgery to treat postoperative early loss of correction and/or recurrent f...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Regular Submissions Source Type: research

Flexor digitorum accessorius longus muscle in resistant clubfoot patients: introduction of a new sign predicting its presence
Clubfoot, talipes equino varus (TEV), is a common congenital foot anomaly. Some cases are resistant to conservative treatment. Many causes of resistance have been reported, among these, the presence of anomalous muscles; however, the effect of the presence of anomalous muscles on the outcome of conservative management is not well studied. These aberrant muscles are discovered during the extensive surgical release as an abnormal finding. The aim of this work is to study the demographic characteristics of patients with resistant TEV that necessitated extensive soft tissue release at Sudan Clubfoot Clinic and to document the ...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Regular Submissions Source Type: research

Pediatric musculoskeletal injuries associated with recreational motorized vehicle use: do more wheels mean a safer ride?
This study will identify differences in musculoskeletal injury between pediatric riders of four-wheel all-terrain and motorized two-wheel (motorbike) vehicles who were presented to a pediatric trauma center from 2005 to 2011. Musculoskeletal injuries, protective equipment use, and associated injuries were compared. The rate of orthopedic injury in children with all-terrain vehicle-related emergency department visits was 42% (153 injuries/334 patients) versus 72% (123/170) for motorbike-related trauma (P (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

Deformity correction in pediatric skeletal dysplasia: treatment challenges and solutions
We reviewed our experience with limb-deformity correction in 54 children with skeletal dysplasias. Our goal was to outline common treatment strategies developed in our hospital to overcome the challenges associated with the management of these conditions. Utilization of computer-assisted preoperative planning, intraoperative monitoring of peripheral nerve function, individualized bone segment stabilization using a modular circular external fixation system, and a flexible distraction protocol improved the precision of angular deformity correction in our practice, simplified external fixator assembly, diminished postoperativ...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

Evaluation of complications of treatment of severe Blount’s disease by circular external fixation using a novel classification scheme
We present here the outcome of treatment by osteotomy and gradual deformity correction by circular external fixation in 31 patients with either infantile or adolescent Blount’s disease. We used a unique classification scheme to quantify and qualify complications in this patient group: category I, complications not requiring an alteration in the treatment plan, not involving unplanned return to surgery, and not influencing outcome; category II, complications requiring an alteration in the treatment plan, including unplanned returns to surgery, but that did not influence outcome; category IIIA, complications that resul...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

A radiographic scoring system to assess healing in congenital pseudarthrosis of the tibia
The aim of this study was to determine whether an established radiographic union scoring system for tibial fracture healing (RUST) is reliable when used in neurofibromatosis (NF1) patients with congenital pseudarthrosis of the tibia (CPT) treated by intramedullary fixation. Four individuals reviewed 36 sets of radiographs from 12 NF1 patients with CPT (preoperative, and 6 months and 1 year postoperative). Intraobserver reliability (κ-value 0.89) and interobserver reliability (κ-value 0.76) were high. The modified RUST scoring system is a useful tool when faced with the challenge of postoperative radiographic ev...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

Tibial shaft fractures in adolescents: analysis of cast treatment successes and failures
This study retrospectively analyzed cast treatment of 75 adolescent closed tibial diaphyseal fractures. The average age was 13.3 years (range, 10–17.4 years). Of the patients, 21% (16/75) required cast change/wedging in the clinic for loss of reduction, and three patients (4%, 3/75) injured in vehicular collisions had failure of cast treatment, requiring an unplanned surgical intervention. Initial and immediate postreduction radiographic deformities were greater (P (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

A comparison of distal femoral physeal defect and fixation position between two different drilling techniques for transphyseal anterior cruciate ligament reconstruction
The defect of the femoral tunnel at the level of the physeal scar during transtibial and anteromedial portal (AMP) drilling for transphyseal anterior cruciate ligament reconstruction was compared. Five matched pairs of knees (n=10) were drilled, and computed tomography was used to evaluate tunnel position and size at the level of the physeal scar. Significant radiographic changes were observed, including tunnel defect area at the physeal scar: 0.44 cm2 (1.2%) in the transtibial group versus 0.99 cm2 (2.7%) in the AMP group (P=0.008). AMP drilling creates a larger and more lateral tunnel defect at the level of...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

Improved functional outcome with no decrease in hip strength 2 years following Ganz periacetabular osteotomies for adolescent hip dysplasia
To analyze outcomes of adolescents treated with a periacetabular osteotomies (PAO) with a minimum of 2 years of follow-up. Patients undergoing a PAO for adolescent hip dysplasia were analyzed preoperatively, 1 and 2 years postoperatively. In 32 dysplastic hips significant improvement was seen in all radiographic parameters. Gait speed, hip flexion pull-off power, and hip abductor moment impulse were unchanged postoperatively, whereas strength was maintained in 85% (abduction) and 95% (flexion). The Harris Hip Score increased from 67.1 to 77.9 to 81.3 at 1 and 2 years, respectively. Ganz PAO is effective in correcting dyspl...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

The use of ultrasound in the management of septic arthritis of the hip
In the assessment of septic arthritis of the hip in a pediatric population, ultrasound is a safe and easily conducted method to confirm an effusion. The need for MRI to further evaluate the patient for adjacent infection before treatment is debatable. Once an effusion is confirmed on ultrasonography, we have found that septic arthritis of the hip does not need advanced imaging before arthrotomy and debridement. Patients who fail to clinically respond to an initial hip arthrotomy and appropriate antibiotics may benefit from an MRI for the identification of concomitant infections that may require surgical intervention. (Sour...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

Quantitative assessment of synovitis in Legg–Calvé–Perthes disease using gadolinium-enhanced MRI
A quantitative method to assess hip synovitis in Legg–Calvé–Perthes disease (LCPD) is not currently available. To develop this method, the areas of synovial enhancement on gadolinium-enhanced MRI (Gd-MRI) were measured by two independent observers. The volume of synovial enhancement was significantly increased in the initial and the fragmentation stages of LCPD (Waldenström stages I and II), with a persistence of synovitis into the reossification stage (stage III). The Gd-MRI method had high interobserver and intraobserver agreements and may serve as a useful method to monitor the effect of various ...
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

A glimpse into Texas Scottish Rite Hospital’s educational, clinical care, and research development
This article describes four areas of pediatric orthopaedic education, research, and clinical care undertaken at Texas Scottish Rite Hospital (TSRH) over the past 25 years. These areas include the weekly preoperative conferences, the evolution of the limb lengthening and deformity correction program, the development of the TSRH instrumentation system, and the evolution of the clubfoot treatment program. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Invited Papers Source Type: research

Texas Scottish Rite Hospital Special Issue
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 31, 2015 Category: Orthopaedics Tags: Preface Source Type: research

Giant cell tumor of the metacarpal bone in children: free osteoarticular metatarsal transfer: case report
We present a successful total resection of metacarpal bone and nonvascularized joint transfer in a giant cell tumor of the fourth metacarpal bone in a 13-year-old girl. At the 6-year follow-up, a good functional outcome was achieved, with 85° range of motion of the metacarpophalangeal joint and no clinical or radiographic evidence of tumor recurrence and no signs of degeneration of the joint. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Case report: lateral capsular release for acute extension deficit in a child with congenital radioulnar synostosis
We report the case of an 11-year-old girl with congenital radioulnar synostosis who developed acute extension deficit of the right elbow and whose elbow range of motion was restored following lateral capsular release. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Kimura’s disease involving the peripheral nerve of the arm in a child: a case report
A 7-year-old Korean boy was referred for a nontender mass in the left arm. He had a 5-year history of a poorly defined painless mass on the medial side of the left elbow. The ultrasonogram of the left arm indicated an ill-defined, lobulating solid mass involving the deep soft tissue layer. The fat-suppressed T2-weighted magnetic resonance image showed a poorly marginated, homogeneous high-signal intensity mass. On further follow-up of 1 year and 6 months, the mass showed no change in size and nature. At surgery, a poorly demarcated inflammatory mass was dissected from a branch of the superficial radial nerve and excised co...
Source: Journal of Pediatric Orthopaedics B - January 1, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Tibia vara and slipped upper femoral epiphysis: is there an association?
We report a child who was treated for bilateral tibia vara at the age of 3 years and subsequently developed a SUFE at the age of 13 years. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2015 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Walking capacity of children with clubfeet in primary school: something to worry about?
Although the main aim of clubfoot correction is to create a foot without limitations in daily activities and sport, studies on the walking capacity of children with corrected clubfeet are rare. In this cross-sectional study, the outcome of the six-minute walking test in 44 children with clubfeet (16 unilateral and 28 bilateral, mean age 8.57±2.45 years) was compared with the reference values of Geiger, clinical status measured with the Clubfoot Assessment Protocol (CAP), and regression analysis used to calculate which CAP subgroup predicts walking capacity. The mean walking capacity was decreased to 79% (P (Source: ...
Source: Journal of Pediatric Orthopaedics B - January 1, 2015 Category: Orthopaedics Tags: Foot & Ankle Source Type: research

Giant cell tumor of the metacarpal bone in children: free osteoarticular metatarsal transfer: case report
We present a successful total resection of metacarpal bone and nonvascularized joint transfer in a giant cell tumor of the fourth metacarpal bone in a 13-year-old girl. At the 6-year follow-up, a good functional outcome was achieved, with 85° range of motion of the metacarpophalangeal joint and no clinical or radiographic evidence of tumor recurrence and no signs of degeneration of the joint. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Upper Limb Source Type: research

Bilateral Wrisberg discoid menisci mimicking bucket handle tears associated with osteochondritis dissecans: case report
We report the case of a 14-year-old boy who had bilateral unstable lateral discoid menisci with unilateral stage 3 OCD treated with meniscoplasty, meniscal rim stabilization, and fixation of the OCD. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Upper Limb Source Type: research

Case report: lateral capsular release for acute extension deficit in a child with congenital radioulnar synostosis
We report the case of an 11-year-old girl with congenital radioulnar synostosis who developed acute extension deficit of the right elbow and whose elbow range of motion was restored following lateral capsular release. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Upper Limb Source Type: research

Chronic slipping of bilateral distal humeral epiphyses in a gymnastist
We report a case of an 11-year-old male patient who sustained separation of the distal humeral epiphyses bilaterally after 2 years of gymnastics, without a clear mechanism of injury. This patient had been using the vault since he was 9 years old, although children of that age do not normally perform on the vault. When gymnasts place their hands on the vault with their elbows flexed and subsequently extend their elbows to push off, the biomechanical load is placed equally on the right and left arms. Consequently, this type of repeated stress induces injury to the epiphyseal cartilages bilaterally, resulting in chronic progr...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Upper Limb Source Type: research

Kimura’s disease involving the peripheral nerve of the arm in a child: a case report
A 7-year-old Korean boy was referred for a nontender mass in the left arm. He had a 5-year history of a poorly defined painless mass on the medial side of the left elbow. The ultrasonogram of the left arm indicated an ill-defined, lobulating solid mass involving the deep soft tissue layer. The fat-suppressed T2-weighted magnetic resonance image showed a poorly marginated, homogeneous high-signal intensity mass. On further follow-up of 1 year and 6 months, the mass showed no change in size and nature. At surgery, a poorly demarcated inflammatory mass was dissected from a branch of the superficial radial nerve and excised co...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Upper Limb Source Type: research

The preliminary outcome of syndactyly management in children with a new external separation device
To introduce a new external fixation device for the management of syndactyly in children. To evaluate its preliminary clinical result. From January 2011 to June 2012, 12 cases with cutaneous syndactyly of the middle/ring finger were managed with a new external fixator designed by our department. There were eight cases on the right side and four on the left side. The web space and soft tissue were stretched gradually using the new device. A Z-plasty of syndactylies was performed when the web space has reached the width that we required. The results were evaluated according to the clinical appearance and function of the fing...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Upper Limb Source Type: research

Tibial turn-up procedure as an alternative to rotationplasty in a 4-year-old with osteosarcoma of the distal femur
We report a case of osteosarcoma of the distal femur in a 4-year-old boy that was, unusually, treated by amputation and a tibial turn-up procedure; we discuss the rationale for the procedure and report the results at early follow-up. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Tibia vara and slipped upper femoral epiphysis: is there an association?
We report a child who was treated for bilateral tibia vara at the age of 3 years and subsequently developed a SUFE at the age of 13 years. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Epiphysiolysis of the femoral neck due to closed reduction of an adolescent hip dislocation with a 4-year follow-up: a case report and review of the literature
This case study discusses a 13-year-old girl diagnosed with a displaced Salter Harris II fracture of the proximal femoral epiphysis post reduction of a dislocated hip. Radiographs before reduction revealed a small fracture of the inferomedial femoral head. This, however, did not induce concern before reduction. The patient underwent reparative surgery of the epiphysis only to develop a collapsed femoral head, which was remedied through total hip arthroplasty. A decrease in blood flow, the delicacy in reduction, and unknown predispositions might have been contributing factors toward the unique development in this case. (Sou...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Early predictors of acetabular growth after closed reduction in late detected developmental dysplasia of the hip
This study evaluates improvement of the acetabular index (AI) in patients with developmental dysplasia of the hip at 4 years after closed reduction, and determines the association between the final AI and a set of factors. Sixty-two patients (74 hips) treated with closed reduction were categorized into three groups according to age: group A (0–12 months, 18 hips), group B (13–18 months, 24 hips), and group C (>18 months, 32 hips). There was no difference in AI among the three groups before reduction (P=0.293). In groups A and C, the AI decreased significantly over time until 3 years after reduction and no di...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Prognostic radiographic factors in developmental dysplasia of the hip following Salter osteotomy
Radiographic parameters for evaluating hip development are altered by Salter osteotomy, and their prognostic value require further validation. A total of 63 patients who underwent open reduction and Salter osteotomy for unilateral hip dysplasia were evaluated with Severin classification 10.8 years later. The initial first-year postoperative acetabular index, c/b ratio, head–teardrop distance, and head coverage were compared with the final outcome of Severin classification. Greater c/b ratio was significantly associated with later Severin class III hip. Using receiver operating characteristics curve, a c/b ratio great...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Osteochondrosis of the accessory ossification centre of the medial malleolus
We report a case of a painful accessory ossification centre of the medial malleolus in an 11-year-old girl who was not involved in sports activities. The patient was treated conservatively, with complete clinical and radiographic healing of the medial malleolus 6 months after the first presentation. We ruled out the uncommon pathological conditions causing chronic pain in the medial malleolus during skeletal growth, such as traction apophysitis of the medial malleolus, osteochondrosis, osteochondritis or avascular necrosis of the distal tibial epiphysis. We speculate that this painful condition may be classified as an oste...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Foot & Ankle Source Type: research

Clinical outcome of posteromedial versus posteromedial-lateral release for clubfoot
Although the Ponseti serial casting method is the gold standard for the management of clubfoot, surgical correction remains the best option for resistant cases. Therefore, we compared posteromedial and posteromedial-lateral surgical approaches for the correction of resistant clubfoot. Between 2007 and 2013, 68 patients with idiopathic nonsyndromic resistant clubfoot, who were admitted to our referral institute, were enrolled in our study. The patients were divided into two groups. The patients in group 1 (33 cases of clubfoot) underwent posteromedial release with a single incision and those in group 2 (35 cases of clubfoot...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Foot & Ankle Source Type: research

Walking capacity of children with clubfeet in primary school: something to worry about?
Although the main aim of clubfoot correction is to create a foot without limitations in daily activities and sport, studies on the walking capacity of children with corrected clubfeet are rare. In this cross-sectional study, the outcome of the six-minute walking test in 44 children with clubfeet (16 unilateral and 28 bilateral, mean age 8.57±2.45 years) was compared with the reference values of Geiger, clinical status measured with the Clubfoot Assessment Protocol (CAP), and regression analysis used to calculate which CAP subgroup predicts walking capacity. The mean walking capacity was decreased to 79% (P (Source: ...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Foot & Ankle Source Type: research

Conservative treatment of severe clubfoot using a novel functional dynamic splint
This study clearly showed the effectiveness of a functional dynamic splint for the correction of equinus in cases of severe clubfoot. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Foot & Ankle Source Type: research

Does the Ponseti technique affect the vascular development in patients with congenital talipes equinovarus?
In this study, we have evaluated the changes observed in the main arteries of the foot before and after the Ponseti technique. Arterial structures of seven patients were examined using Doppler ultrasound and the parameters studied included the course of the arteries, lumen filling, flow direction, pattern, and velocity. Before the treatment, the side with congenital talipes equinovarus deformity showed decreased blood flow in all arteries, except for the posterior tibial artery. At the second examination, the increase in the flow velocity of both arteries except tibialis anterior arteries was statistically significant. The...
Source: Journal of Pediatric Orthopaedics B - December 4, 2014 Category: Orthopaedics Tags: Foot & Ankle Source Type: research