Venous thromboembolism among pediatric orthopedic trauma patients: a database analysis
Using the 2012 Kids Inpatient Database, we assessed records of pediatric patients ( (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - February 2, 2018 Category: Orthopaedics Tags: Trauma Source Type: research

Solitary osteochondroma of the sinus tarsi
Tumors are a rare cause of ankle-region pain. Osteochondroma is one of the most common benign bone tumors, but is rarely localized to the foot bones. Here, we describe a case of a solitary osteochondroma of the sinus tarsi presenting in an 8-year-old boy with a history of recurrent ankle sprains and limited range-of-motion of the subtalar joint. Treatment was surgical excision of the tumor, and the patient is now symptom free. Clinical presentation, treatment, pathoanatomy, localization, and complication of this benign form of tumor are discussed and all previously reported cases are reviewed to provide a more comprehensiv...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Return to sport activities after subtalar arthroereisis for correction of pediatric flexible flatfoot
The aim of this study was to establish whether children treated with subtalar arthroereisis for flexible flatfoot were able to return to sport activities. We reviewed 49 patients with a mean age at the time of surgery of 10.7 years. The type of sport activities, the number of sessions per week, the time dedicated to each session, and the level achieved were assessed preoperatively and at the last follow-up. Overall, 45 patients returned to sports after surgery. Surgery did not alter the duration, frequency, and type of sporting activities, but the participation in physical activities as well as the emotional status and foo...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

The effect of persistent toe walking on the skeletal development of the pediatric foot and ankle
The aim of this study was to determine whether persistent idiopathic toe walking leads to compensatory skeletal changes in the pediatric foot and ankle. Foot radiographs of children diagnosed with idiopathic toe walking and sex-matched and age-matched controls were retrospectively reviewed. Five blinded providers assessed the foot radiographs for skeletal changes to the ankle. The relationship between each measure and toe-walking status was examined. Providers observed radiographic evidence of skeletal changes of the talus in idiopathic toe walkers compared with controls, suggesting that persistent toe walking impacts the ...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Intra-articular findings during the modified Brostrom procedure for lateral instability of the pediatric ankle
The purpose of this study was to identify the rates of chondral injury, soft tissue impingement, and bony impingement in pediatric patients undergoing the modified Brostrom procedure with ankle arthroscopy for lateral ankle instability. A retrospective review of all patients undergoing a modified Brostrom procedure with ankle arthroscopy performed by two surgeons at a tertiary care children’s hospital between October 2002 and April 2014 was performed. Data were collected regarding demographics, history and initial presentation, nonoperative management, surgical procedure and arthroscopic findings, and clinical follow...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Arterial tree anomalies in patients with clubfoot: an investigation carried out at Soba University Hospital
In conclusion, the anterior tibial artery and dorsalis pedis artery are deficient in CTEV patients; to avoid postoperative skin sloughing, arterial supply must be protected using a judicious incision. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Modified Ponseti technique for management of neglected clubfeet
Achieving adequate dorsiflexion in neglected clubfoot cases remains challenging. On a close observation of the Ponseti method, we have now made certain modifications from the standard Ponseti protocol. This has helped us improve functional results, as well as reduce the number of casts in this walking-age group. From March 2011 onward, we managed 62 neglected clubfeet in 41 patients with the modified protocol. All these patients were treated with serial weekly above-knee casts. The feet were assessed by Dimeglio and Pirani scorings, which were done every week. These children were closely monitored and followed up at regula...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Treatment of syndrome-associated congenital talipes equinovarus using the Ponseti method: 4–12 years of follow-up
to evaluate the effectiveness of the Ponseti method in treating syndrome-associated (nonidiopathic) congenital talipes equinovarus. This was a retrospective consecutive review over a 12-year period in a tertiary centre of all patients with syndrome-associated talipes equinovarus treated with the Ponseti method. The primary outcome measure at the final follow-up was the functional correction of the deformity. There were 16 (28 feet) children, with an average follow-up of 7 years (range: 4–12). The average age at presentation was 6.1 (range: 2–17) weeks. Deformities were severe, with an average Pirani score of 5....
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Pain and overcorrection in clubfeet treated by Ponseti method
Long-term outcomes of Ponseti casting have consistently shown improvement over soft-tissue release. The incidence of foot pain and overcorrection in clubfeet treated by Ponseti method has not been reported. We studied the rate of overcorrection and its association with pain in clubfeet treated with Ponseti casting. A retrospective review of clubfoot patients treated with Ponseti method with at least 8 years of follow-up was carried out. Patient charts were reviewed for demographic data, recurrence, type and number of procedures, and patient-reported complaints of foot pain. Pedobarographs were used to document overcorrecti...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: ANKLE & FOOT Source Type: research

Pan-tibial avascular necrosis in a 12-year-old boy: a case report
We report a unique case of post-traumatic avascular necrosis of tibia in a 12-year-old boy following a Salter–Harris type II physeal injury of the proximal tibia. The diagnosis was made on the basis of classical radiological findings. The only clinical symptom was diffuse shin pain. The patient was managed conservatively. At our 2-year follow-up, there was clinical and radiological evidence of spontaneous resolution of avascular necrosis, but with sequelae. The child developed a limb-length discrepancy and genu valgum. The parents of the child refused further treatment. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Simultaneous bilateral tibial tubercle avulsion fracture in a male teenager: case report and literature review
We report the case of a male teenager with simultaneous bilateral tibial tubercle fractures, describe the evolution and treatment of this injury and review the literature on this subject. Level of evidence: Case report. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Slow progressive popliteal artery insufficiency after neglected proximal tibial physeal fracture: a case report
We report a rare case of popliteal arterial occlusion with the presence of arterial pulses during initial assessment, resulting from a neglected proximal ibial physis fracture. This case shows that even in the presence of foot pulses, the surgeon must consider the possibility of a popliteal artery damage whenever trauma is seen near the knee joint. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Chronic lateral epiphyseal separation of the proximal tibia causes late-onset tibia vara
An adolescent obese boy showed late-onset unilateral tibia vara associated with physeal separation (slipped epiphysis) of the lateral proximal tibia and physeal widening of the lateral distal femur. These affected physes showed normal signal intensities by MRI. He was treated with lateral hemiepiphysiodesis of the left proximal tibia and the distal femur using two parallel eight-Plates, and varus deformity rapidly improved postoperatively without recurrence. This is the first case of late-onset tibia vara caused by lateral physeal separation of the proximal tibia. Normal growth of the medial physes around the knee would co...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Clinical experiences of focal periphyseal edema zones in adolescent knees: case reports
Focal periphyseal edema (FOPE) zones were first described in 2011. The aim of this report was to investigate the clinical course of patients with FOPE zones. Three adolescent patients with a FOPE zone in the knee were treated and observed for a maximum of 2 years. No symptoms or leg-length discrepancy developed at the final follow-up after conservative therapies. This is the first report on the follow-up of FOPE zones with a maximum of 2 years. The results suggest that observation of FOPE zones may be sufficient without invasive examinations and treatment. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Congenital pseudarthrosis of the tibia in children: should we defer surgery until 3 years old?
This study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years of age. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Management of pediatric open tibia fractures with supracutaneous locked plates
We evaluated the novel application of supracutaneous locked plates in pediatric open tibia fractures. Pediatric open tibia fractures stabilized with a locked supracutaneous plate from January 2011 to December 2014 were reviewed. Twenty-eight children, mean age 8.9 years, with 29 open tibia fractures were included. Nine of these children who had metaphyseal or metadiaphyseal fractures did not require joint spanning. The mean follow-up duration was 13.5 months. The mean time to uneventful union was 11.46 weeks, with no unacceptable malunion. Supracutaneous locked plates showed early union and no refractures. They could favor...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Outcomes after arthroscopic fixation of tibial eminence fractures with bioabsorbable nails in skeletally immature patients
The aim of this paper is to report the outcomes and any complications with arthroscopic bioabsorbable nail fixation of tibial eminence fractures in skeletally immature patients. We retrospectively reviewed all surgically treated tibial eminence fractures treated by a single surgeon and seven patients were identified with a minimum 2-year follow-up. Mean deficits of flexion and extension were minimal. Satisfactory Tegner levels, Lysholm knee scores, and International Knee Documentation Committee subjective scores were reported. Arthroscopic fixation of tibial eminence fractures with bioabsorbable nails yields satisfactory o...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Guided growth for angular correction in children: a comparison of two tension band plate designs
This retrospective cohort study examined 20 patients (48 physes), 11 boys and nine girls, who were treated with hinge-plate or eight-plate. The mean age of the patients at surgery was 11.9±2.6 years. The mean follow-up duration was 13±2.7 months. The radiographic measurement of both distal femoral and proximal tibial deformity showed significant correction, with no difference between the hinge-plate and the eight-plate. Both screw divergence angle and the hinge angle showed significant changes at the last follow-up. The deformity correction of the distal femoral physis was quicker than the proximal tibial phy...
Source: Journal of Pediatric Orthopaedics B - January 1, 2018 Category: Orthopaedics Tags: KNEE & LEG Source Type: research

Solitary osteochondroma of the sinus tarsi
Tumors are a rare cause of ankle-region pain. Osteochondroma is one of the most common benign bone tumors, but is rarely localized to the foot bones. Here, we describe a case of a solitary osteochondroma of the sinus tarsi presenting in an 8-year-old boy with a history of recurrent ankle sprains and limited range-of-motion of the subtalar joint. Treatment was surgical excision of the tumor, and the patient is now symptom free. Clinical presentation, treatment, pathoanatomy, localization, and complication of this benign form of tumor are discussed and all previously reported cases are reviewed to provide a more comprehensiv...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Return to sport activities after subtalar arthroereisis for correction of pediatric flexible flatfoot
The aim of this study was to establish whether children treated with subtalar arthroereisis for flexible flatfoot were able to return to sport activities. We reviewed 49 patients with a mean age at the time of surgery of 10.7 years. The type of sport activities, the number of sessions per week, the time dedicated to each session, and the level achieved were assessed preoperatively and at the last follow-up. Overall, 45 patients returned to sports after surgery. Surgery did not alter the duration, frequency, and type of sporting activities, but the participation in physical activities as well as the emotional status and foo...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

The effect of persistent toe walking on the skeletal development of the pediatric foot and ankle
The aim of this study was to determine whether persistent idiopathic toe walking leads to compensatory skeletal changes in the pediatric foot and ankle. Foot radiographs of children diagnosed with idiopathic toe walking and sex-matched and age-matched controls were retrospectively reviewed. Five blinded providers assessed the foot radiographs for skeletal changes to the ankle. The relationship between each measure and toe-walking status was examined. Providers observed radiographic evidence of skeletal changes of the talus in idiopathic toe walkers compared with controls, suggesting that persistent toe walking impacts the ...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Intra-articular findings during the modified Brostrom procedure for lateral instability of the pediatric ankle
The purpose of this study was to identify the rates of chondral injury, soft tissue impingement, and bony impingement in pediatric patients undergoing the modified Brostrom procedure with ankle arthroscopy for lateral ankle instability. A retrospective review of all patients undergoing a modified Brostrom procedure with ankle arthroscopy performed by two surgeons at a tertiary care children’s hospital between October 2002 and April 2014 was performed. Data were collected regarding demographics, history and initial presentation, nonoperative management, surgical procedure and arthroscopic findings, and clinical follow...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Arterial tree anomalies in patients with clubfoot: an investigation carried out at Soba University Hospital
In conclusion, the anterior tibial artery and dorsalis pedis artery are deficient in CTEV patients; to avoid postoperative skin sloughing, arterial supply must be protected using a judicious incision. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Modified Ponseti technique for management of neglected clubfeet
Achieving adequate dorsiflexion in neglected clubfoot cases remains challenging. On a close observation of the Ponseti method, we have now made certain modifications from the standard Ponseti protocol. This has helped us improve functional results, as well as reduce the number of casts in this walking-age group. From March 2011 onward, we managed 62 neglected clubfeet in 41 patients with the modified protocol. All these patients were treated with serial weekly above-knee casts. The feet were assessed by Dimeglio and Pirani scorings, which were done every week. These children were closely monitored and followed up at regula...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Treatment of syndrome-associated congenital talipes equinovarus using the Ponseti method: 4–12 years of follow-up
to evaluate the effectiveness of the Ponseti method in treating syndrome-associated (nonidiopathic) congenital talipes equinovarus. This was a retrospective consecutive review over a 12-year period in a tertiary centre of all patients with syndrome-associated talipes equinovarus treated with the Ponseti method. The primary outcome measure at the final follow-up was the functional correction of the deformity. There were 16 (28 feet) children, with an average follow-up of 7 years (range: 4–12). The average age at presentation was 6.1 (range: 2–17) weeks. Deformities were severe, with an average Pirani score of 5....
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Pain and overcorrection in clubfeet treated by Ponseti method
Long-term outcomes of Ponseti casting have consistently shown improvement over soft-tissue release. The incidence of foot pain and overcorrection in clubfeet treated by Ponseti method has not been reported. We studied the rate of overcorrection and its association with pain in clubfeet treated with Ponseti casting. A retrospective review of clubfoot patients treated with Ponseti method with at least 8 years of follow-up was carried out. Patient charts were reviewed for demographic data, recurrence, type and number of procedures, and patient-reported complaints of foot pain. Pedobarographs were used to document overcorrecti...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Pan-tibial avascular necrosis in a 12-year-old boy: a case report
We report a unique case of post-traumatic avascular necrosis of tibia in a 12-year-old boy following a Salter–Harris type II physeal injury of the proximal tibia. The diagnosis was made on the basis of classical radiological findings. The only clinical symptom was diffuse shin pain. The patient was managed conservatively. At our 2-year follow-up, there was clinical and radiological evidence of spontaneous resolution of avascular necrosis, but with sequelae. The child developed a limb-length discrepancy and genu valgum. The parents of the child refused further treatment. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Simultaneous bilateral tibial tubercle avulsion fracture in a male teenager: case report and literature review
We report the case of a male teenager with simultaneous bilateral tibial tubercle fractures, describe the evolution and treatment of this injury and review the literature on this subject. Level of evidence: Case report. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Slow progressive popliteal artery insufficiency after neglected proximal tibial physeal fracture: a case report
We report a rare case of popliteal arterial occlusion with the presence of arterial pulses during initial assessment, resulting from a neglected proximal ibial physis fracture. This case shows that even in the presence of foot pulses, the surgeon must consider the possibility of a popliteal artery damage whenever trauma is seen near the knee joint. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Chronic lateral epiphyseal separation of the proximal tibia causes late-onset tibia vara
An adolescent obese boy showed late-onset unilateral tibia vara associated with physeal separation (slipped epiphysis) of the lateral proximal tibia and physeal widening of the lateral distal femur. These affected physes showed normal signal intensities by MRI. He was treated with lateral hemiepiphysiodesis of the left proximal tibia and the distal femur using two parallel eight-Plates, and varus deformity rapidly improved postoperatively without recurrence. This is the first case of late-onset tibia vara caused by lateral physeal separation of the proximal tibia. Normal growth of the medial physes around the knee would co...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Clinical experiences of focal periphyseal edema zones in adolescent knees: case reports
Focal periphyseal edema (FOPE) zones were first described in 2011. The aim of this report was to investigate the clinical course of patients with FOPE zones. Three adolescent patients with a FOPE zone in the knee were treated and observed for a maximum of 2 years. No symptoms or leg-length discrepancy developed at the final follow-up after conservative therapies. This is the first report on the follow-up of FOPE zones with a maximum of 2 years. The results suggest that observation of FOPE zones may be sufficient without invasive examinations and treatment. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Congenital pseudarthrosis of the tibia in children: should we defer surgery until 3 years old?
This study suggests that there is no need to defer surgery for pseudarthrosis of the tibia until the child is older than 3 years of age. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Management of pediatric open tibia fractures with supracutaneous locked plates
We evaluated the novel application of supracutaneous locked plates in pediatric open tibia fractures. Pediatric open tibia fractures stabilized with a locked supracutaneous plate from January 2011 to December 2014 were reviewed. Twenty-eight children, mean age 8.9 years, with 29 open tibia fractures were included. Nine of these children who had metaphyseal or metadiaphyseal fractures did not require joint spanning. The mean follow-up duration was 13.5 months. The mean time to uneventful union was 11.46 weeks, with no unacceptable malunion. Supracutaneous locked plates showed early union and no refractures. They could favor...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Outcomes after arthroscopic fixation of tibial eminence fractures with bioabsorbable nails in skeletally immature patients
The aim of this paper is to report the outcomes and any complications with arthroscopic bioabsorbable nail fixation of tibial eminence fractures in skeletally immature patients. We retrospectively reviewed all surgically treated tibial eminence fractures treated by a single surgeon and seven patients were identified with a minimum 2-year follow-up. Mean deficits of flexion and extension were minimal. Satisfactory Tegner levels, Lysholm knee scores, and International Knee Documentation Committee subjective scores were reported. Arthroscopic fixation of tibial eminence fractures with bioabsorbable nails yields satisfactory o...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Guided growth for angular correction in children: a comparison of two tension band plate designs
This retrospective cohort study examined 20 patients (48 physes), 11 boys and nine girls, who were treated with hinge-plate or eight-plate. The mean age of the patients at surgery was 11.9±2.6 years. The mean follow-up duration was 13±2.7 months. The radiographic measurement of both distal femoral and proximal tibial deformity showed significant correction, with no difference between the hinge-plate and the eight-plate. Both screw divergence angle and the hinge angle showed significant changes at the last follow-up. The deformity correction of the distal femoral physis was quicker than the proximal tibial phy...
Source: Journal of Pediatric Orthopaedics B - November 30, 2017 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Viktor Bialik (1942–2017)
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Obituary Source Type: research

Regarding a limb with PFFD, fibular dimelia and mirror foot deformity
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Letter to the Editor Source Type: research

Bilateral congenital torticollis: a case report with 25 years of follow-up
We describe a surgical treatment of such deformation that ended with a satisfactory result confirmed through a 25-year follow-up. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Miscellaneous Source Type: research

Surgical management of congenital torticollis in children older than 7 years with an average 10-year follow-up
The aim of the present study is to present the results of the surgical management of late presenting cases of congenital muscular torticollis. Between 1990 and 2010, 31 cases of late presenting congenital muscular torticollis were managed surgically in our department. Postoperatively, head halter traction was applied for 10 days; a cervical brace was applied for 5 weeks, followed by a soft one collar for 3 months. The final result was assessed on the basis of the criteria of Cheng and Tang. In total, 84% of patients achieved an excellent final result and 16% of the patients achieved a good result. Our results indicated tha...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Miscellaneous Source Type: research

Is there a role for a child life specialist during orthopedic cast room procedures? A prospective-randomized assessment
Pediatric anxiety during cast room procedures is common and various methods to manage distress may be used. Certified Child Life Specialists (CCLS) are formally trained professionals with proficiency in helping children during taxing events. The utilization of a CCLS has not been well documented in a pediatric orthopedic cast room. The aim of this study was to assess the impact of a CCLS in this setting through a prospective randomized trial. 86 children, age range 2–10 years, who underwent cast room procedures were randomized: group I (42 children) had a CCLS present during their procedure. Group II (44 children) di...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Miscellaneous Source Type: research

Spontaneous healing of fractures and osteotomy within intercalary allograft reconstruction after distal femur osteosarcoma resection in a child
We present a report and discussion on two fractures and corrective osteotomy within the implanted allograft that healed with abundant callus without the need for additional surgery. In selected patients, allograft incorporation can be completed to a degree allowing for its biologic activity and spontaneous healing of fractures or osteotomy. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Bone Tumors Source Type: research

Osteoid osteoma of the acetabulum: diagnosis and medical treatment
We describe the medical management of an acetabular osteoid osteoma in an 11-year-old girl. There was a 2-year delay until proper diagnosis of the patient’s pathology was made. Accurate localization of the nidus in the subchondral bone, involving the cartilage, is difficult on the basis of plain radiographs. All imaging methods, including computed tomography, MRI, and bone scintigraphy, were used to confirm the diagnosis. We proposed medical treatment to avoid possible severe complications from surgical intervention. At the patient’s latest follow-up visit, after 2 years of medical treatment with NSAIDs, there ...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Bone Tumors Source Type: research

Calcifying aponeurotic fibroma in children: our experience and a literature review
We report our experience treating four children with calcifying aponeurotic fibroma who underwent surgical excision of the tumour. Two of them developed a local recurrence: one required a surgical revision, whereas the other currently continues to be under observation. The incidence found over a 5-year period (2010–2015) may lead us to consider that this condition is not as rare as reported and may often be misdiagnosed. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Bone Tumors Source Type: research

Minimal invasive intralesional excision of extremity-located osteoid osteomas in children
In this retrospective study, we evaluated the efficiency of minimal invasive intralesional extended curettage in the treatment of osteoid osteomas of the extremities in children. Forty-seven children (29 males, 18 females; mean age 10.5 years; range 4–19 years) with osteoid osteoma of the extremities underwent minimal invasive intralesional extended curettage. The exact localization of the nidus was determined preoperatively by thin-section (1–1.5 mm) computed tomography scans, and complete excision of the nidus was performed using a modified burr-down technique. None of the procedures required bone graf...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Bone Tumors Source Type: research

Atelosteogenesis type III: orthopedic management
We report the case and orthopedic management of a 6-year-old female patient with atelosteogenesis type III after 3 years of follow-up. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Skeletal Dysplasias Source Type: research

Trevor’s disease: up-to-date review of the literature with case series
Trevor’s disease, also known as dysplasia epiphysealis hemimelica, is a rare nonhereditary skeletal development disorder that affects epiphyses. This type of dysplastic lesion was first reported by Mouchet and Berlot in 1926 under the name ‘tarsomegaly’. The main aim of this study is to raise awareness of Trevor’s disease among orthopedic surgeons and underline some important aspects of treatment by a detailed presentation of four different possible manifestations of the disease. Four different treatment methods were used on four different patients (three localized in hindfoot ankle region and one c...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Skeletal Dysplasias Source Type: research

The fate of hips that are conservatively treated in multiple epiphyseal dysplasia
We reviewed the radiologic and clinical outcomes of hip joints affected by multiple epiphyseal dysplasia in 40 patients. The average patient age was 9.6 years. All patients were followed up for an average of 7.2 years. No patient underwent surgical treatment. The variances of the center-edge angle and femoral head coverage had the greatest tendency to increase with conservative treatment and follow-up (P=0.011 and 0.015, respectively). The acetabular angle and the acetabular depth index at the first visit and the latest follow-up were statistically significantly different (P=0.046 and 0.027, respectively). According to the...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Skeletal Dysplasias Source Type: research

The prevalence of the complications and their associated factors in humeral lengthening for achondroplasia: retrospective study of 54 cases
The aim of this study is to evaluate the complications of humeral lengthening and their associated factors. Fifty-four achondroplastic patients were treated by bilateral humeral lengthening. Our original shoulder sling was sufficient to prevent shoulder dislocation. Pre-existing radial head dislocation was observed in 18 patients. Lengthening was accomplished in all cases without a decrease in the elbow function. Seven humeri fractured after the fixator removal. The risk factors for postoperative fracture were a waiting period of less than 5 days, a healing index less than 25, and the concave shape of the callus. There was...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Skeletal Dysplasias Source Type: research

Osteomyelitis of the accessory and body of the navicular bone: a case report
A 16-year-old boy developed left foot pain of unknown cause that was unresponsive to conservative treatment, associated with fever and difficulty walking. He was admitted to our hospital with osteomyelitis of the accessory and body of the navicular bone. Surgery could not be performed because the patient had been diagnosed with Wiskott–Aldrich syndrome. After antibiotic therapy, laboratory abnormalities and pain had resolved. One year after treatment, the patient had returned to his original level of sports activity. Both an accessory navicular and the body of the navicular bone may develop osteomyelitis in immunocom...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Infections Source Type: research

Physeal bar equivalent
Premature partial physeal arrest without the formation of an osseous bar – physeal bar equivalent (PBE) – is uncommon. Four children with a PBE had an infection near the distal femoral physis before the age of 11 months. Some growth was achieved after resection of the PBE in each case. Of two cases diagnosed and treated early, one required only contralateral physeal arrests to achieve limb-length equality at maturity. The other, currently 8 years and 4 months old, has a 1.1-cm limb-length discrepancy 6 years after PBE resection and will require observation until maturity. Of two cases diagnosed and treated late...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Infections Source Type: research