Nationwide survey of pediatric acute osteomyelitis in the USA
The epidemiology of pediatric acute osteomyelitis in the USA, such as annual hospitalization rates and disparities with respect to age, sex, race/ethnicity, and socioeconomic status, remains unknown. We obtained discharge records of hospitalized patients with acute osteomyelitis younger than 20 years of age from the Kids Inpatient Database for 2006, 2009, and 2012. We weighted the records to estimate the number of hospitalizations in the USA and calculated the annual rates of hospitalization because of acute osteomyelitis. We used a multivariable logistic regression analysis to assess the risk factors associated with the d...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Infections Source Type: research

Treatment of subperiosteal abscesses in children: is drainage of the intramedullary canal required?
Acute osteomyelitis can be successfully treated with antibiotics alone. Surgery is utilized after failure of antibiotic treatment or if an abscess is present. Limited evidence exists with regard to whether intramedullary drainage is required in addition to the drainage of the subperiosteal abscess. We reviewed our 9-year experience of treating subperiosteal abscesses identifying 68 patients. Thirty patients underwent both intramedullary and abscess drainage, whereas 38 patients underwent drainage of the abscess alone at the initial procedure. Our analysis demonstrated a statistical significance (P=0.012) and odds ratio of ...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Infections Source Type: research

Suppurative complications of acute hematogenous osteomyelitis in children
We carried out a case–control study in children with acute hematogenous osteomyelitis (AHO) with and without suppurative complications discharged from our institution over an 11-year period to test the hypothesis that abscess formation was associated with a delayed presentation to care. Of 102 children with AHO, 54 abscesses were documented in 46 patients (25 bone, 29 muscle). A delay in presentation was not associated with abscess formation (6.5 vs. 5.0 days, P=0.26). Overall, 78% of all bone abscesses were visible on initial MRI. Consistent use of MRI at presentation may identify children with suppurative complicat...
Source: Journal of Pediatric Orthopaedics B - September 28, 2017 Category: Orthopaedics Tags: Infections Source Type: research

Progression of stable juvenile osteochondritis dissecans after 10 years of meniscectomy of the discoid lateral meniscus
Ten years after a meniscectomy of discoid lateral meniscus, a 19-year-old man presented a loose body in his right knee with limited range of motion. At the time of meniscectomy, a stable osteochondritis dissecans in the lateral femoral condyle with a T2 high area in MRI was recognized; however, the lesion was left without surgical treatment. We performed fixation of a fragment and osteochondral grafting. Surgical treatment for stable juvenile osteochondritis dissecans still remains controversial; however, drilling will help to increase the healing potential and to prevent lesion progression, especially after meniscectomy t...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Sporadically occurred bilateral osteochondritis dissecans on the trochlea of the femur: case report
We report the case of a 13-year-old boy with bilateral osteochondritis dissecans in the lateral femoral trochlea of the knees. They were classified as grade 4 in the right knee and grade 1 in the left knee on the basis of the Nelson classification within 1 year after first consultation. In the right knee, the fragment was surgically fixed, but the left knee healed with conservative treatment. This case indicates the possibility that osteochondritis dissecans of the lateral femoral trochlea may develop bilaterally at different times and present at different stages. The case shows the importance of early diagnosis and approp...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Delayed treatment of a posterior cruciate ligament tibial insertion avulsion fracture in a child with open physis: a case report with a 4-year follow-up
We present a case of a 13-year-old boy hit by a car, who had a delay in diagnosis and treatment because of severe head trauma. The patient was treated 4 months after the trauma with open reduction and internal fixation of the avulsion fracture. After 4 years of follow-up, he has no complaints and has achieved good functional outcome. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Revision pediatric anterior cruciate ligament reconstruction after failure of iliotibial band technique treated with all-epiphyseal technique in a prepubescent with Ehlers–Danlos syndrome: a case report
The increasing number of pediatric anterior cruciate ligament (ACL) injuries and the failure of nonoperative management of these patients has elicited a concordant response in the surgical community to devise reconstruction techniques that stabilize the knee joint without causing iatrogenic growth disturbances. Likewise, the rise in pediatric ACL reconstructions forecasts a consequent rise in revision ACL reconstructions in patients with open physes. In this case report, we describe a prepubescent with Ehlers–Danlos syndrome and congenital ACL deficiency, who underwent physeal-sparing iliotibial band ACL reconstructi...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

A novel functional correction method for habitual patellar dislocation using autologous hamstring tendon: a case report
Habitual patellar dislocation is an uncommon condition. In this case, a patient demonstrated lateral patellar dislocation in the middle or terminal range of flexion. A functional correction of the patella was devised so that the fixation site of the autologous graft on the femur was able to stabilize the patella selectively during the middle or terminal range of flexion. It is not the anatomical medial patellofemoral ligament attachment of the femur that is essential, but that a relevant fixation point on the femur should be sought in each patient to obtain stabilization of the patella to reverse habitual patellar dislocat...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

The lateral wedge augmentation trochleoplasty in a pediatric population: a 5-year follow-up study
Patellofemoral instability in children requires surgery when recurrent dislocation occurs. The aim of this study is to report the 5-year clinical and radiographic outcomes following lateral wedge augmentation trochleoplasty of the femoral trochlea. This is a review of 23 (mean age: 12.5 years) patients who underwent surgery for recurrent patellar dislocations related to a flat trochlea. In every case, a lateral wedge augmentation trochleoplasty was performed with preservation of the growth plate. This surgery was consistently associated with a soft tissue procedure. All patients were reviewed for a clinical and radiographi...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Comparison of healing intra-articular fracture of distal femur using a Kirschner wire and autologous fibrin glue in an animal model
Considering different surgical techniques for the fixation of osteochondral intra-articular fracture, the present study aimed to compare the efficacy of autologous fibrin glue and Kirschner wire (KW) on an osteochondral fracture in the left lateral condyle of Dutch rabbits with a control group. After 6 weeks, macroscopic and microscopic evaluation showed that autologous fibrin glue is easier and faster with a higher number of bone trabecula (P (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Failure of tension band plating: a case series
This study describes a series of children who developed this complication. Patients who developed TBP failure after operative treatment of lower limb angular deformities were identified from the databases at four institutions over a 5-year period. The medical records were reviewed to record demographics, primary diagnoses, details of the operative procedure, development of physeal arrest, and recurrence of the original deformity. Six patients (five girls) with nine implant failures were identified. The mean age of the children at the time of implant insertion was 7.2 years (range, 4–10 years). The primary diagnoses i...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Paediatric lower limb deformity correction with the Eight Plate: adverse events and correction outcomes of 126 patients from an international multicentre study
No large multicentre studies have yet been published on tension-band-like implants such as the Eight Plate to treat limb-length discrepancies and varus valgus deformities in children. Therefore, we carried out a retrospective international multicentre study including 126 patients to assess outcomes and to reliably quantify the incidence of implant-related and growth-plate related adverse events (AEs). Correction was achieved in 66% of varus valgus deformities and in 59% of limb-length discrepancies and maintained in 85%. Twenty (18%) patients experienced 43 AEs, which were primarily screw-related. The AE rate of the Eight ...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Knee Source Type: research

Malunion of medial condyle fracture of the humerus: a case report
We report a rare case of malunion of medial condyle fracture in a 10-year-old boy who had an injury on the right elbow at age 4. He was referred to our clinic because of severe varus deformity (the carrying angle was 191°, unaffected side 172°) with instability. Extra-articular closing wedge osteotomy was performed. Five years after surgery, the carrying angle was 172° and the patient had no pain and no difficulties with activities of daily living. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Myoclonic movements of the elbow and wrist as a rare complication of supracondylar humerus fracture in a child
In conclusion, myoclonus-like movements are a rare complication of supracondylar humerus fractures, resulting from ulnar nerve injury. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Scapular body fracture and concomitant inferior angle apophyseal separation with intrathoracic displacement: a case report
A 10-year-old patient presented to the emergency room after a motor vehicle accident. The patient was diagnosed with left scapular body fracture and concomitant inferior angle apophyseal separation with intrathoracic displacement causing hemopneumothorax. The displaced scapular body was reduced surgically and separated apophysis of the inferior angle was fixed to the scapular body with absorbable suture. Postoperative 2-year follow-up showed a good result. A literature search found two pediatric cases of intrathoracic displacement of scapular body fracture. There was no previous report of apophyseal separation of the infer...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Cost analysis and performance in distal pediatric forearm fractures: is a short-arm cast superior to a sugar-tong splint?
The aim of this study is to compare splint versus cast immobilization for maintaining alignment following closed reduction of distal 1/3 radius and both-bone forearm fractures. We performed a retrospective review of patient records between 5 and 14 years old with a distal 1/3 radius or radius and ulna fracture requiring reduction. A cost comparison was also performed using facility costs for materials. Reduction was maintained with acceptable alignment in most cases (94%). Although a sugar-tong splint slightly maintained fracture alignment better, this was not significant. Cost analysis favored initial placement of a short...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

It is not just comfort: waterproof casting increases physical functioning in children with minimally angulated distal radius fractures
Waterproof casting has been reported to increase patient comfort and satisfaction, and decrease skin irritation. There are no available data on the influence of waterproof casting materials on physical function in pediatric patients. Our aim was to determine whether the use of waterproof casting would result in faster recovery of physical function while maintaining similar clinical outcomes as those obtained with nonwaterproof materials. Twenty-six children with nonangulated or minimally angulated distal radius fractures were assigned randomly to initially receive a short-arm cast made of one of two optional materials: a h...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Elastic stable intramedullary nailing in paediatric forearm fractures: the rate of open reduction and complications
The aim of this study was to evaluate the rate of open reduction and complications of elastic stable intramedullary nailing (ESIN) in treating unstable diaphyseal forearm fractures in children. We performed a retrospective review of a consecutive series of 102 paediatric patients with a mean age of 9 years (range: 7–14 years) who underwent ESIN of unstable closed forearm fractures at three different centres. Closed reduction of one or both bones was achieved in 68 (67%) patients and open reduction was required in 34 (33%) patients. The rate of open reduction in single-bone fractures (52.2%) was significantly higher t...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Lateral wedge osteotomy for pediatric post-traumatic cubitus varus: Kirschner-wires or locking angular plate?
This study aimed to evaluate and compare two types of internal fixation, locking angular plate (group 1) and Kirschner-wires (group 2), for post-traumatic cubitus varus. The parameters used were Laupattarakasem’s criteria (for range of motion in extension/flexion, correction of carrying angle, and the ‘lazy S’ deformity) and the Barrett’s questionnaire (for patient satisfaction). In group I (plate+screws), we had three excellent results and five good. In group II (Kirschner-wires), we had two good results, three fair, and two poor. Statistical analysis showed a better outcome for group I (plate+scre...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Comparison of daytime and after-hours surgical treatment of supracondylar humeral fractures in children
In this study, we analyze the clinical and radiological outcomes of pediatric supracondylar humeral fractures surgically treated during daytime and night-time hours. In total, 91 patients with Gartland type-3 fractures were included; 47 patients treated between 0800 and 1700 h were defined as the daytime group and 44 patients treated between 1701 and 0759 h were defined as the after-hours group. Age, sex, affected side, fracture type, and day and time of operation were recorded. Any preoperative neurovascular injuries, open fractures, or ipsilateral fractures were noted. The surgical method, use of a medial p...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Are the Appropriate Use Criteria for the management of pediatric supracondylar humerus fractures useful in clinical practice?
The aim of this study was to evaluate our treatment modalities in pediatric supracondylar humerus fractures according to the recently published Appropriate Use Criteria (AUC) by the American Academy of Orthopaedic Surgeons. A total of 991 patients with supracondylar humerus fractures were included. After reviewing medical records, 38 different clinical scenarios described in the AUC were observed. Of the 991 patients, 127 were type I, 423 were type II, and 405 were type III fractures according to the Gartland classification. The AUC was appropriate for 100% of type I, only 25 (5.9%) of type II, and 389 (96.0%) of type III ...
Source: Journal of Pediatric Orthopaedics B - July 27, 2017 Category: Orthopaedics Tags: Trauma - Upper Limb Source Type: research

Is the extensive anterolateral approach for the treatment of developmental dysplasia of the hip more favorable than conventional surgical methods?
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Letter to the Editor Source Type: research

Pediatric isthmic spondylolisthesis showing radiologic evidence of slippage after physis injury
We report such evidence in a 13-year-old boy with low-back pain. Radiography revealed rounding of the S1 surface, a fracture line below the S1 endplate surface, and a bone marrow lesion in addition to slippage. Slippage and the rounding deformity were partially reversed (from 20 to 14% and from 42 to 27%, respectively) with conservative treatment and natural bone remodeling. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Spine Source Type: research

Scoliosis in Down’s syndrome
This study reports the recent experience in the management of scoliosis in Down’s syndrome. Curve patterns, progression in brace, and surgical outcomes were recorded. Cardiac surgery history was compared between children with and without scoliosis. Out of 581 children with Down’s syndrome, 62 children had scoliosis. The mean age of the children was 13.8 years. The mean magnitude was 31°. Bracing was successful in five of seven patients. Ten children had posterior spinal fusion with follow-up of 2.6 years (1–7.3). One deep wound infection was recorded with no revision. No difference was found in cardia...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Spine Source Type: research

The surgical treatment of spinal deformity in children with myelomeningocele: the role of personalized three-dimensional printed models
This study was carried out to evaluate the benefits of personalized three-dimensional printing as an aid to the performance of surgery for the correction of spinal deformity in children with myelomeningocele. We performed a retrospective review to include all such children for whom personalized three-dimensional spine models were used for surgical planning (group A) and compared them through subjective and objective criteria to a similar group that had no models (group B). The seven children in group A were younger and had more complex deformities than the 10 children in group B. The models provided a markedly improved app...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Spine Source Type: research

Reduction and circumferential fusion for low-grade slips and intermediate-grade slips in pediatric spondylolisthesis
Uninstrumented in-situ fusion of pediatric spondylolisthesis harbors a significant risk of suboptimal outcome. We suggest that reduction and instrumented fusion with deliberate protective measures against neurologic insult should be considered for the treatment of low-grade slips to intermediate-grade slips. This retrospective review of the clinical and radiographic data of 13 consecutively treated pediatric patients describes our experience with this approach. Eleven patients were pain free at the most recent follow-up and showed an average sustained correction in percent slip of 39%. This technique provides a safe altern...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Spine Source Type: research

Surgical resection of osteoid osteoma and osteoblastoma of the spine
Intraoperative radiographic guidance has traditionally been utilized in orthopedic surgery through 2-D navigation with the C-arm and recently with 3-D navigation with the O-arm. The aim of this study was to describe the outcome of surgical treatment of spinal osteoblastoma and osteoid osteoma with the utilization of the O-arm and conventional C-arm guidance. This is a retrospective cohort study of patients with spinal osteoid osteoma and or osteoblastoma who were treated at our institution between 2002 and 2011. Seventeen patients were examined in this study including seven with spinal osteoblastoma and 10 with spinal oste...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Spine Source Type: research

Proximal femoral focal deficiency associated with fibular duplication and diplopodia and complete agenesis of the tibia: a case report
A 14-year-old boy reported with congenital deformity of the left lower limb, with gross shortening, hip and knee flexion deformities, ankle with equinus deformity, and polydactyly of the left foot. Radiologic examination showed proximal femoral focal deficiency, double fibula, and duplication of the tarsal bones, and a diagnosis of ‘proximal femoral focal deficiency associated with fibular duplication and diplopodia with complete agenesis of tibia’ was made. Such association of deformities is very rare and poses difficulties in rehabilitation of the case. This patient was managed with elective knee disarticulat...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Bilateral femoral neck fractures associated with complex pelvic ring injuries in a pediatric patient: a case report
Femoral neck and pelvic fractures are rarely encountered in the pediatric population secondary to the resilient nature of the immature skeleton. Both fracture types usually result from high-energy blunt trauma including motor vehicle collisions, motor vehicle-pedestrian accidents, and falls from height. Considerable studies have been published on the natural history, management, and complications of pediatric pelvis and femoral neck fractures. However, few case reports have documented both fracture types in the same patient. Management of concomitant injuries presents unique challenges both for operative stabilization and ...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

The management of residual acetabular dysplasia: updates and controversies
Residual acetabular dysplasia is a frequent cause of secondary osteoarthritis of the hip and its management is still controversial. The aim of this review is to describe residual acetabular dysplasia, to estimate the age limit above which surgical management is needed, and to emphasize the role of assistive imaging in evaluating predictive parameters for future acetabular development. A decision-making algorithm is presented. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Opinion survey of members of British Society of Children’s Orthopaedic Surgery related to specific case scenarios in slipped capital femoral epiphysis
The aim of this study was to assess contemporary management of slipped capital femoral epiphysis (SCFE) by surveying members of the British Society of Children’s Orthopaedic Surgery (BSCOS). A questionnaire with five case vignettes was used. Two questions examined the timing of surgery for an acute unstable SCFE in a child presenting at 6 and 48 h after start of symptoms. Two further questions explored the preferred method of fixation in mild and severe stable SCFE. The final question examined the management of the contralateral normal hip. Responses were entered into an Excel spreadsheet and the data was anal...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Normal radiographic parameters in paediatric pelvic radiographs from a Chinese population
This report describes an attempt to establish normal values of medial joint space, acetabular index and centre edge angle according to specific age groups and sex in a Chinese population. Patients who had undergone a pelvic radiograph as part of their assessment, but were subsequently found to have normal hips were recruited retrospectively. These patients were grouped according to sex and age; medial joint space, acetabular index and centre edge angle were measured in all radiographs. A mean±SD was calculated for each group, and then each age group was tested for statistical significance between the male and the fe...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Proximal femoral osteotomy in Legg-Calvé-Perthes disease using a monolateral external fixator: surgical technique, outcome, and complications
Although external fixation methods have been described for proximal femoral osteotomy for various etiologies, none are dedicated to a single disease entity. Our study introduces a technique of proximal femoral osteotomy and fixation with a monolateral external fixator system in Legg-Calvé-Perthes disease (LCPD). Twenty-three patients (19 males, four females) with LCPD underwent surgery at our institute between 2004 and 2012. Varus osteotomy (group A, 11 hips) and valgus osteotomy (group B, 12 hips) were performed and the monolateral external fixator system was used. The average age of patients at surgery was 13 year...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Percutaneous multiplanar subtrochanteric osteotomy with external fixation for developmental coxa vara (preliminary results)
Developmental coxa vara (DCV) develops during early childhood between the age of independent walking and 6 years. The deformity includes a decrease in the neck–shaft angle and femoral retroversion. Recently, good results have been reported using external fixator systems for the correction of proximal femoral deformities secondary to slipped capital femoral epiphysis, Perthes’ disease in children, and percutaneous proximal femoral osteotomy for coxa vara. This preliminary study was performed to evaluate the results of percutaneous subtrochanteric osteotomy in restoring the normal alignment and orientation (radio...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Coxa vara in postseptic arthritis of the hip in children
The behavior and treatment of coxa vara and pseudarthrosis of the proximal femur secondary to sepsis is not well described. The aim of this study is to describe the pathoanatomy for coxa vara and pseudarthrosis in postseptic hips, evaluate progression of neck shaft angle (NSA), and discuss treatment. This is a retrospective case series of 20 patients (21 hips). There were 11 hips with predominant avascular necrosis of the capital femoral epiphysis without pseudarthrosis (type 1) and 10 with pseudarthrosis (type 2). The interobserver κ value was 0.79. There was a decrease in NSA from 110.3° to 99.3° during an ...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Minimally invasive, iliac crest-sparing approach for pelvic osteotomies in children
In conclusion, the ICSA fulfills all the criteria of minimally invasive surgery. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Intra-articular dysplasia of the femoral head in developmental dysplasia of the hip
Central to the current treatment of dysplasia of the hip (DDH) is the concept of congruent reduction of the hip. If the femoral head is aspherical in DDH, this concept needs reconsideration. MRI scans are used to examine the femoral head in children. Diameters of 14 DDH and 12 normal hips were measured in three planes by eight observers on two occasions. Femoral head sphericity was determined using the mathematical concept of eccentricity. In DDH, the femoral head was less spherical, most marked in the coronal plane, yielding a ‘rugby ball’-shaped femoral head. Accordingly, concentric reduction of the femoral h...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Pavlik harness treatment for pathological developmental dysplasia of the hip: meeting the standard?
This study evaluated the outcomes of Pavlik harness treatment in neonates/infants with ‘pathological hips’ diagnosed by ultrasound imaging in a district general hospital setting. In a 10-year prospective observational longitudinal cohort study, modified Graf type III and IV hips (excluding those presenting with irreducible hip dislocation) were classified as pathological and splinted. A total of 2826 neonates/infants underwent ultrasound assessment in the paediatric orthopaedic ‘screening clinic’. Neonates and infants were referred as ‘at-risk’ or as clinically unstable by the Paediatric...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

MRI assessment of the importance of the acetabular labrum: a comparative radiographic and MRI study in children’s hips
The aim of this study was to investigate the correlation between radiograph [acetabular index (AI)] and MRI measurements of the angles of children’s hips and the percentage of coverage that labrum provides to the acetabulum in healthy hips of children. The healthy hips of 38 children, of a mean age of 7.7 years, were studied using anteroposterior radiographs and coronal plane MRI. We used picture archiving and communication systems software to measure the AI in hip radiographs and the acetabular bone index (ABI) and acetabular labrum index (ALI) in hip MRIs. The Kolmogorov–Smirnov test and t-test were performed...
Source: Journal of Pediatric Orthopaedics B - June 2, 2017 Category: Orthopaedics Tags: Hip Source Type: research

Abstracts of the 8th International Clubfoot Congress, Rome, September 8-10, 2016.
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: ABSTRACTS: PDF Only Source Type: research

A solitary unilobed osteochondroma of the hamate: a case report
We report a solitary, unilobed osteochondroma arising from the hamate that was excised, with no evidence of recurrence at the 3-year follow-up. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: Upper Limb Source Type: research

Septic shoulder presenting as a shoulder dislocation in the pediatric patient: a case report
We present a 5-year-old male who presented to the office with post-traumatic left shoulder pain for about 1 week. Radiographs of the left shoulder indicated inferior subluxation of the humeral head. He was ultimately diagnosed and treated for a septic shoulder. Septic arthritis of the glenohumeral joint accounts for about 3% of all septic arthritis cases. About half of the pediatric patients with a septic arthritis will present with a concomitant osteomyelitis about the joint involved. Widening of the glenohumeral joint and subluxation clinically as well as radiographically have been described in cases of large joint effus...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: Upper Limb Source Type: research

Endoscopic Woodward procedure for Sprengel deformity: case report
Sprengel deformity (SD) results in a limitation of movement of the shoulder girdle and produces an esthetic defect. Our aim is to assess the feasibility and advantages of a minimally invasive endoscopic approach for SD correction. A 4-year-old boy with a Cavendish grade III right SD. The patient underwent an endoscopic Woodward procedure with access through two small incisions at the level of the upper and lower angles of the scapula. Near-symmetrical shoulder elevation was achieved, with an excellent cosmetic result. The endoscopic Woodward procedure is a feasible, effective, and minimally invasive technique in the treatm...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: Upper Limb Source Type: research

Tubercular dactylitis in children
Tubercular dactylitis is a rare manifestation of skeletal tuberculosis in the paediatric population. Its clinical diagnosis is often delayed as local symptoms may easily be missed in children and constitutional features such as loss of weight, loss of appetite, night sweats, evening rise of temperature and history of close contact with a patient of tuberculosis may not always be present. Parents seek treatment only when they notice significant swelling or tenderness of fingers or hand in their children. Radiology and fine-needle aspiration cytology may help in establishing an early diagnosis. Astute multidrug antitubercula...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: Upper Limb Source Type: research

Hand and wrist tuberculosis in paediatric patients – our experience in 44 patients
Skeletal tuberculosis (TB) of the hand and wrist is rare, accounting for less than 1% of all osteoarticular TB. Although rare, TB of the hand and wrist is a cause of major morbidity. A common feature among all available reports on TB of the hand and wrist was a delay in diagnosis, causing residual stiffness and pain after treatment. Minimal initial symptoms, rarity of the lesion and ability of wrist TB to mimic more common pathologies account for the delay. Skeletal TB may behave differently in this age compared with the adult population. Further, the disease may affect the growing bone, causing residual deformities. The p...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: Upper Limb Source Type: research

Operative treatment of congenital pseudarthrosis of the clavicle: a single-centre experience
Congenital pseudarthrosis of the clavicle (CPC) is a very rare condition with a predilection for the right clavicle. Young children are often only symptomatic with activities and as they grow. Operative management in an asymptomatic child is debatable, with various techniques reported in the literature. This is a retrospective, single-centre case series study. All children with CPC treated surgically by resection, bone grafting (nonvascular iliac crest) and plate fixation between 2004 and 2012 at our centre were included. Excluded conditions were traumatic or obstetric fractures of the clavicle, children with musculoskelet...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: Upper Limb Source Type: research

Curve progression risk in a mixed series of braced and nonbraced patients with idiopathic scoliosis related to skeletal maturity assessment on the olecranon
We aimed to determine the curve progression risk of idiopathic scoliosis in patients at the time of peak height velocity by plotting curve magnitudes against olecranon stages of skeletal maturation. Register data of 372 patients with juvenile or adolescent idiopathic scoliosis followed at 6-month intervals from onset of scoliosis to skeletal maturity were reviewed. At the onset of the pubertal growth spurt, curves greater than 30° have a 100% risk of progressing over 45° (P (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: The Montpellier School of Pediatric Orthopedics Special Issue Source Type: research

Safety and efficacy of sublaminar bands and Ponte osteotomies in rigid deformity: preliminary results in a prospective series of 20 neuromuscular scoliosis patients
This prospective cohort study investigated radiographic outcomes and complications over time in patients with rigid neuromuscular scoliosis treated with sublaminar bands and Ponte osteotomies. Twenty consecutive patients with neuromuscular scoliosis were treated with sublaminar bands in addition to Ponte osteotomies at and around the apex of the deformity and prospectively included. All curves were rigid, with less than 30% reduction on preoperative bending films. Cobb angle, pelvic obliquity, and shoulder obliquity were significantly corrected (P (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: The Montpellier School of Pediatric Orthopedics Special Issue Source Type: research

Three-dimensional and volumetric thoracic growth in children with moderate idiopathic scoliosis compared with normal
We aimed to measure thoracic dimensions and volume in relation to growth and verify the influence of scoliosis on thoracic growth. A reference group of 294 healthy volunteers was compared with a group of 557 patients with idiopathic scoliosis ranging in age from 3 to 25 years. The optical ORTEN system for trunk surface data acquisition was used to calculate thoracic volume, perimeter, anterior–posterior and transversal diameters, T1–T12 length, and sternal length. There was no significant difference in thoracic dimensions and volume between scoliosis and reference groups in either girls or boys. Thoracic volume...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: The Montpellier School of Pediatric Orthopedics Special Issue Source Type: research

Risk of infection and secondary displacement in pediatric supracondylar or lateral condyle fractures treated with unburied Kirchener-wires removed before complete bone healing
This study evaluated the risk of infection and of secondary displacement among children with displaced lateral condyle or supracondylar fractures treated by surgery. The study included a consecutive sample of 84 supracondylar fractures and 21 lateral condyle fractures treated with closed reduction and percutaneous pinning. The mean time to Kirchener wire removal was 29 days (range: 25–37 days) postsurgery. Two out of 105 (1.9%) patients developed infectious complications and two of 105 (1.9%) patients had a secondary displacement. Removal of unburied Kirchener wires before complete bone healing in the physician&rsquo...
Source: Journal of Pediatric Orthopaedics B - March 31, 2017 Category: Orthopaedics Tags: The Montpellier School of Pediatric Orthopedics Special Issue Source Type: research