Effectiveness of the Ponseti method for treating clubfoot associated with myelomeningocele: 3–9 years follow-up
We present our experience using the Ponseti method to treat clubfoot associated with myelomeningocele. This was a retrospective, consecutive review over a 10-year period in our tertiary centre. On initial presentation, patients were assessed using the Pirani scoring system and the standard Ponseti method was initiated. Our outcome measures were successful functional correction of deformity defined as achieving a plantigrade pain-free foot. Secondary outcome measures included relapse and the need for surgical procedures. A total of 11 children with 18 myelomeningocele-associated clubfeet were included, with an average follo...
Source: Journal of Pediatric Orthopaedics B - January 28, 2017 Category: Orthopaedics Tags: Leg, Foot & Ankle Source Type: research

Development of congenital clubfoot during growth: a long-term study on the basis of pedobarography, biomechanics, and magnetic resonance imaging measurements of muscle volumes
The aim of this study was to clarify the degree to which the operated congenital asymptomatic clubfoot still shows malpositions or whether it approaches a physiological development with increasing age. Clubfeet of 12 children were examined repeatedly over up to 10 years using pedobarography. The muscle volumes of the lower legs were investigated with MRI and compared with those of a healthy control group. Although some characteristics of clubfoot remained in the plantar pressure distribution, a gradual decrease in the heel and metatarsus load accompanied by an increase in the forefoot load could be registered as is typical...
Source: Journal of Pediatric Orthopaedics B - January 28, 2017 Category: Orthopaedics Tags: Leg, Foot & Ankle Source Type: research

The Ponseti technique and improved ankle dorsiflexion in children with relapsed clubfoot: a retrospective data analysis
This study quantifies the change in passive ankle range of motion following modified Ponseti casting in children with relapsed idiopathic clubfoot. Fifty-three cases (feet) were retrospectively reviewed, with 6-month follow-up data available for 72% of participants. The median improvement in dorsiflexion was 15° (95% confidence interval: 12.5°–17.5°, P≤0.05), with 85% achieving dorsiflexion≥10°. At the 6-month follow-up, dorsiflexion remained significantly improved and 12 feet (32%) presented with subsequent relapse. Nine were referred for further casting and three were recommended for extra-art...
Source: Journal of Pediatric Orthopaedics B - January 28, 2017 Category: Orthopaedics Tags: Leg, Foot & Ankle Source Type: research

Effect of a modified dynamic accordion hinge Denis Browne brace on the success rate of the Ponseti method in idiopathic clubfoot: a preliminary study
After the success of Dr Ponseti’s method for the treatment of idiopathic clubfoot deformity, the number of patients who need soft tissue release has decreased, but the use of foot abduction orthosis is crucial for maintaining correction after this method. The lack of adherence to the orthosis regimen is reported to be a major factor for recurrence. Noncompliance with brace may be because of skin ulceration and blistering or irritability of children because of restrictiveness of the leg motion in the brace. The aim of this article is to introduce a new design of Denis Browne brace (accordion Hinge DB brace) and evalua...
Source: Journal of Pediatric Orthopaedics B - January 28, 2017 Category: Orthopaedics Tags: Leg, Foot & Ankle Source Type: research

Early application of the Ponseti casting technique for clubfoot correction in sick infants at the neonatal intensive care unit
The treatment of congenital clubfoot has been changing rapidly since the mid-1990s with the worldwide use of the Ponseti method for serial casting and limited operative interventions. This method was first applied for isolated clubfeet and later on for other types of clubfoot (teratologic, residual, and neurogenic). Premature babies sustaining clubfoot commonly suffer from additional congenital and acquired medical problems. These may postpone clubfoot management until urgent issues are resolved. The current study describes early initiation of treatment of clubfoot in premature babies at the neonatal intensive care unit (N...
Source: Journal of Pediatric Orthopaedics B - January 28, 2017 Category: Orthopaedics Tags: Leg, Foot & Ankle Source Type: research

Design and descriptive data of the randomized Clubfoot Foot Abduction Brace Length of Treatment Study (FAB24)
The aim of this study was to describe the design and baseline characteristics of participants enrolled in the prospective randomized-controlled Clubfoot Foot Abduction Brace Length of Treatment Study (FAB24). Foot abduction bracing is currently the standard of care for preventing clubfoot relapse. Current recommendations include full-time bracing for the first 3 months and then 8–12 h a day for 4 years; however, the optimal length of bracing is not known. The FAB24 trial is a clinical randomized study to determine the effectiveness of 2- versus 4-year foot abduction bracing. Participant enrollment for FAB24 wa...
Source: Journal of Pediatric Orthopaedics B - January 28, 2017 Category: Orthopaedics Tags: Leg, Foot & Ankle Source Type: research

A note of thanks to referees
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Thanks to Referees Source Type: research

Spontaneous improvement of cervical kyphosis in eosinophilic granuloma: a case report
We describe the case of a spontaneous improvement of the cervical kyphosis in eosinophilic granuloma with long-term follow-up. A collapse of the C5 vertebral body was confirmed by cervical spine radiography and computed tomography. The patient wore a sterno-occipitalmandibular immobilizer brace for 6 months, and remodeling of the vertebral body was confirmed 18 months after onset. Seven years have passed since the onset of symptoms, and the patient’s cervical spine has maintained normal alignment. Management of eosinophilic granuloma of the pediatric cervical spine is still controversial. Conservative treatment suffi...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Eight-year follow-up findings of surgical treatment for severe dystrophic changes in the cervical spine associated with neurofibromatosis type I: a case report
Long-term follow-up findings for dystrophic changes in the cervical spine caused by neurofibromatosis type 1 have been rarely reported. A 13-year-old boy with severe dural ectasia in the cervical spine underwent cervical posterior fusion from C1 to C5 for prevention of cervical spine fracture and spinal injury. We followed him up for 8 years after surgery. We measured the progression of the destruction on yearly MRI. The dural ectasia gradually progressed until 3 years postoperatively. Subsequently, no further enlargement of the dural sac occurred. At the 8-year follow-up examination, the patient had no limitations in the ...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Screw fixation for atlantoaxial dislocation related to Down syndrome in children younger than 5 years
The aim of this study was to present cases of upper cervical fixation in Down syndrome patients younger than 5 years. In two cases, C1 lateral mass screws were installed. However, owing to the irreducible atlantoaxial dislocation, the screw backed out and fractured. Therefore, O–C2 fusion was performed. Furthermore, C2 bilateral lamina screws were added to the C2 pedicle screw for reinforcement. C1–C2 fusion is an option for Down syndrome patients younger than 5 years with atlantoaxial dislocation, when the dislocation is reducible. If the dislocation is irreducible, or the implant cannot be firmly secured, the...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Craniocervical spinal instability after type 1 Arnold Chiari decompression: a case report
We present a craniocervical instability secondary to surgical decompression; clinical and radiological symptoms, and definitive treatment were described. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Conservative treatment of pediatric thoracic and lumbar spinal fractures: outcomes in the sagittal plane
To assess sagittal plane spinopelvic balance and functional outcomes in a pediatric cohort of patients with a thoracic and/or a lumbar fracture treated conservatively. A multicentric study retrospectively reviewed radiological and functional outcomes (mean follow-up 49 months) of 48 patients (mean age 12 years) with thoracic and/or lumbar spinal fractures that occurred between 1996 and 2014. Demographic data and radiological spinopelvic parameters were analyzed. Functional outcome was evaluated by a telephone interview. First, a comparison between the initial and the last follow-up full-spine radiographs was performed for ...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Clinical application of back surface topography by means of structured light in the screening of idiopathic scoliosis
We present the results of the clinical validity in the screening of idiopathic scoliosis with a nonharming method of back surface topography by means of structured light projection. A total of 155 patients were evaluated (mean age 13.3 years). They were divided into two groups: pathologic patients (scoliosis) and nonpathologic patients (control and asymmetries). An analytical case–control study was carried out. Our topographic method obtained 92% sensitivity and 74% specificity as a screening test in identifying patients with scoliosis (P=0.05). We could quantify the vertebral deformity of scoliosis in the three spat...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Psychometric evaluation of the Scoliosis Research Society-22 Revised questionnaire among adolescents with idiopathic scoliosis
This cross-sectional descriptive study was carried out to develop and evaluate the reliability and validity of the Korean version of the Scoliosis Research Society-22 Revised (SRS-22r) questionnaire among adolescents with idiopathic scoliosis. Of the initial 122 adolescents surveyed, 87 adolescents returned the second questionnaire, which assessed test–retest reliability between SRS-22r and the pediatric quality of life inventory questionnaire (PedsQL 4.0). The results were found to be reliable and valid, with acceptable internal consistency, intraclass correlation, and moderate correlation with a similar questionnai...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Does adolescent obesity affect surgical presentation and radiographic outcome for patients with adolescent idiopathic scoliosis?
The purpose of this study was to test a hypothesis that overweight patients with adolescent idiopathic scoliosis present with larger curves and achieve less surgical correction than do healthy weight counterparts. A total of 251 individuals were grouped by BMI into overweight (BMI% ≥85) and healthy weight (BMI% (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Vitamin-D measurement in patients with adolescent idiopathic scoliosis
Our retrospective study compared vitamin-D levels in 229 patients with adolescent idiopathic scoliosis (AIS) and 389 age-matched controls, and evaluated the correlation between vitamin-D levels and sex, Cobb’s angle, and serum levels of calcium (Ca), phosphorus, and alkaline phosphatase in the AIS group. Vitamin-D levels were lower in the AIS group, with no sex-specific effects, indicative of a possible vitamin-D resistance in AIS. Vitamin-D levels correlated positively with Ca levels and negatively with Cobb’s angle, indicative of a possible role of vitamin D in the etiopathogenesis of AIS. Patients with AIS s...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Spine Source Type: research

Focal fibrocartilaginous dysplasia in the ulna with the radial head dislocation: a case report and literature review
We present an additional case of FFCD in the distal ulna that showed progressive bowing of the right forearm and the radial head dislocation. Resection of the abnormal tissue, osteotomy of the radius and ulna, and gradual lengthening of the ulna were performed. On the basis of the previously published data of 14 cases and our data, we have summarized the etiology, clinical features, natural history, and treatment of FFCD in the ulna. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Complex Monteggia fracture in a 5 year old
We describe a case of a Bado type I Monteggia fracture with a posteriorly dislocated radial head and neck fracture that has not been described before in the literature. The patient required advanced imaging because of ossification delays and led to an operative intervention to reduce the radial head and neck. This case exemplifies how irreducible Monteggia fractures may necessitate advanced imaging to determine blocks to a successful reduction. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Surgical treatment of upper extremity contractures in Emery–Dreifuss muscular dystrophy
Emery–Dreifuss muscular dystrophy is a rare form of muscular dystrophy. In the present study we present two patients with Emery–Dreifuss muscular dystrophy and severe upper extremity contractures treated successfully with contracture release and musculotendinous lengthenings. For each of these patients a chart review was carried out and surgical technique reviewed. Patient 1 demonstrated elbow flexion contractures of 65° (right) and 60° (left) preoperatively and ∼45° (right) and 20° (left) postoperatively. Patient 2 demonstrated flexion contractures of 75° bilaterally preoperatively and ...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Stability-based assessment of Monteggia-type injuries predicts failure of treatment
Paediatric Monteggia-type injuries are complicated by treatment failure and posterior interosseous nerve palsy, without reliable predictive indicators. Outcome is considered to be good, with little patient-reported evidence. We propose novel radiographic parameters. A total of 33 Monteggia-type injuries were analysed. Posterior interosseous nerve palsy was strongly predicted by the Radial Head Displacement Index. The presence of two or more of three novel instability markers was associated strongly with treatment failure. Patient-reported outcome measures were almost uniformly excellent. We advocate the use of a new, inclu...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Eccentric rule of the radiocapitellar line from radiographs of normal elbows in young children
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Correction of elbow flexion contracture by means of olecranon resection and anterior arthrolysis in obstetrical brachial plexus palsy sequelae
The authors have developed a particular surgical technique (olecranon bone resection together with anterior elbow arthrolysis) to increase the elbow’s range of motion in adolescents and young adults suffering from elbow flexion contracture in obstetrical palsy sequelae. The surgical procedure was carried out in a preliminary group of 11 patients. The original procedure included a double incision: first of all by means of a posterior approach to resect the tip of the olecranon and then another incision carried out through the anteromedial aspect of the elbow, with a view to performing the anterior capsulotomy. Preoper...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

A comparative study for the treatment of simple bone cysts of the humerus: open curettage and bone grafting either without instrumentation or with intramedullary nailing
Functional and radiographic outcomes, in addition to complication and reoperation rates of open curettage and grafting without instrumentation or with intramedullary nailing, in the treatment of simple bone cysts (SBCs) of the humerus were compared. Thirty-seven children [25 males, 12 females; median age=9.5 years (range, 3–17 years)] with humeral SBC were treated with curettage and grafting without instrumentation (group 1, 21 patients) or with intramedullary nailing (group 2, 16 patients). The pathological fracture rate was 85.7% in group 1 and 87.5 in group 2. The follow-up duration ranged from 26 to 85 months. Th...
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Three point fixation of pediatric proximal humerus fractures by prebent wave-shaped wires: technical notes
We describe a three-point fixation method of applying two Kirschner wires, prebent into a wave shape, and inserted into the proximal humerus through a single cortical hole. In this minimally invasive approach, we treated four boys, obtaining accurate reduction and stable fixation, with all patients starting pendulous exercises the day after surgery. At follow-up, all patients had regained full shoulder range of motion, with no residual pain and no complications recorded. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 30, 2016 Category: Orthopaedics Tags: Upper Limb - Shoulder & Elbow Source Type: research

Development of genu valgum after removal of osteochondromas from the proximal tibia
Genu valgum is a well-documented deformity secondary to hereditary multiple exostoses about the knee. Post-traumatic tibia valgus is also a well-described phenomenon that occurs in children who sustain an incomplete fracture of the proximal tibia. The finding is considered to be secondary to asymmetric blood flow to the proximal tibial physis. The existing literature only describes genu valgum as a sequela of the hereditary multiple exostoses disorder itself and does not address genu valgum occurring as a postoperative consequence of mass excision. In this paper, we report on three pediatric patients who developed unilater...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Fibrous tether of the distal femur produced unilateral genu valgus with subsequent patellar dislocation: case report and review of the literature
We report the case of a 2-year-old boy presenting with unilateral genu valgus. The patient had a subsequent lateral patellar dislocation, 1 year after surgical correction. A second surgery was performed to correct this patellar dislocation. Intraoperative finding indicated contracted lateral patellar retinaculum. To the best of our knowledge, this is the first report of such a finding. The natural history is still not understood. At the 6-month-follow-up visit, the patient still has good results without recurrent patellar dislocation or angular deformity. We also review the literature in terms of proper treatment an...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Bucket-handle meniscal tear in a 9-year-old girl: a case report and review of the literature
Bucket-handle meniscal tears used to be rare in children younger than 10 years of age. However, nowadays, we encounter more cases because of increased sport and recreational activities. In this paper, we report on a 9-year-old girl who presented with an isolated medial meniscal bucket-handle tear of the right knee and review the literature for similar cases. Bucket-handle meniscal tears are rare in young children. However, it should be ruled out in patients with knee pain and mechanical symptoms following knee injury. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Pigmented villonodular synovitis of the knee joint in a 5-year-old girl treated with combined open and arthroscopic surgery: a case report
We report the case of a 5-year-old girl with left knee pain and swelling who was diagnosed with diffuse pigmented villonodular synovitis of the left knee based on MRI findings. Combined open and arthroscopic surgery was performed to completely remove the tumor. Postoperative histopathological examination confirmed the diagnosis of diffuse pigmented villonodular synovitis. The postoperative course was uneventful, with a gradual improvement in symptoms. There were no signs of recurrence on postoperative MRI performed at the 8-month follow-up, with neither knee pain nor limitation of range of motion. The favorable outcome in ...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Partial double-layered patella in a nondysplasic adolescent
Double-layered patella (DLP) is a rare patella-formation abnormality reported in association with multiple epiphyseal dysplasia. DLP is one of the five types of bipartite patella, caused by a coronal septum that divides the patella into anterior and posterior segments. Although the double layer of bone has been reported as complete, it may also manifest as partial, as in our case. A 13-year-old male patient attended A&E after accidentally falling and sustaining a direct injury to his left knee, with pain in the anterior surface of the right patella. He was diagnosed with an incomplete vertical fracture of the left pate...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Ilizarov bone transport versus fibular graft for reconstruction of tibial bone defects in children
This study included 24 patients (age range from 5.5 to 15 years) with tibial bone defects: 13 patients were treated with bone transport (BT) and 11 patients were treated with a nonvascularized fibular graft (FG). The outcome parameters were bone results (union, deformity, infection, leg-length discrepancy) and functional results: external fixation index and external fixation time. In group A (BT), one patient developed refracture at the regenerate site, whereas, in group B (FG), after removal of the external fixator, one of the FGs developed a stress fracture. The external fixator time in group A was 10.7 months (range 8&n...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Cozen’s phenomenon revisited
In conclusion, treatment with a long leg cast with the knee in extension and a varus mold minimized the valgus deformity compared with previous reports in the literature. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

The effectiveness of posterior knee capsulotomies and knee extension osteotomies in crouched gait in children with cerebral palsy
This study evaluated the effectiveness of single-event multilevel surgery including posterior knee capsulotomy or distal femoral extension osteotomy to correct knee flexion contracture in children with CP. Gait analyses were carried out to evaluate gait preoperatively and postoperatively. Significant improvements were found in physical examination and kinematic measures, which showed that children with CP and crouched gait who develop knee flexion contractures can be treated effectively using single-event multilevel surgery including a posterior knee capsulotomy or distal femoral extension osteotomy. (Source: Journal of Pe...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Popliteal cysts in children: another look
This retrospective review of 46 popliteal cysts seen in 44 patients at a pediatric orthopedic referral center clarifies the presenting symptomatology, associated conditions, and likely duration of a popliteal cyst, and the need for intervention. The patients were followed up for more than 1 year. Thirty-six of the 46 cysts with duration data showed no resolution of the popliteal cyst during the period of observation (average, 32.1 months). The 10 cysts that showed clinical resolution were present for an average of 16.9 months. The benign course of action for virtually all patients obviated the need for intervention and sup...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Knee & Leg Source Type: research

An unusual case of chondrolysis of the hip: a possible etiology for a rare condition – a case report
We present a rare case of a 10-year-old boy where imaging tests and physical examination were consistent with conventional idiopathic hip chondrolysis. Following hip joint biopsy and culture, we observed the presence of bacteria originating from the mouth, which could have been responsible for the pathogenesis of ICH. This is the first report of ICH in which common bacteria of the mouth were found upon joint biopsy. In addition, with respect to the pathogenesis of hip chondrolysis, this case emphasizes that numerous factors are involved, many of which remain unknown. Level of Evidence: V. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Physeal separation and complete resorption of femoral head associated with chronic osteomyelitis of femoral diaphysis in a young child: rare case report
We report the case of a two and a half-year-old girl who presented with injury to the right thigh along with a discharging sinus in the midthigh region following a nonorthopaedic surgical procedure. Radiographs of the thigh indicated osteomyelitis of the femoral diaphysis with pathological fracture. During follow-up examination, shortening was observed in the affected limb, along with complete separation of the femoral epiphysis with partial resorption of the femoral head. A few cases of physeal separation of the femoral head following osteomyelitis of the femoral diaphysis have been reported in the published literature, b...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Iliac wing osteotomy for the closure of pelvis in the treatment of bladder exstrophy in the neonate
We describe a novel technique of bilateral iliac wing osteotomies to achieve the same function that has not been described previously in the literature. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Pediatric pelvic pyomyositis: initial MRI can be misleading
Pelvic pyomyositis is an infection of the skeletal muscles around the hip joint. Fever, hip pain, limp, and leukocytosis are common; however, the clinical picture is often vague. MRI is the current gold-standard imaging for pyomyositis. No studies in the current literature have reported an unremarkable initial MRI in a patient with symptomatic pyomyositis. An adolescent female presented with symptomatic pelvic pyomyositis, but admission MRI was normal. A follow-up MRI indicated development of pelvic pyomyositis. The patient was successfully managed nonoperatively. The initial MRI in pyomyositis can be misleading. Patients ...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Percutaneous aspiration and irrigation technique for the treatment of pediatric septic hip: effectiveness and predictive parameters
Septic arthritis of the hip has been treated traditionally by surgical drainage. Recent reports have described repeated aspirations as an adequate and safe treatment. The aim of the present study was to assess the success of treatment of septic arthritis of the hip by repeated aspirations and to identify predictive factors for failure. Medical records were retrospectively reviewed for all patients treated by ultrasound-guided aspiration and intravenous antibiotics between 2002 and 2010. The demographic, clinical, laboratory, and outcome data were recorded. Findings were compared between patients who responded to this treat...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Short-term results of early (before 6 months) open reduction of dislocated hips in arthrogryposis multiplex congenita
The aim of this study was to report the results of early open reduction of hip dislocations in infants with arthrogryposis multiplex congenita. Seven patients who were under 6 months of age at the time of hip reduction, with a mean follow-up period of 47.5±11.3 months after surgery, were included in this study. Four of seven patients (six of 13 hips) required additional hip surgeries during their follow-up. The short-term results of early open reduction of hips were not promising as most of the patients required additional hip surgeries. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Single-stage medial open reduction and Pemberton acetabuloplasty in developmental dysplasia of the hip
In this study, we aimed to evaluate the long-term clinical and radiological results of single-stage open reduction through a medial approach and Pemberton acetabuloplasty in developmental dysplasia of the hip. We treated 32 hips (22 patients) with developmental dysplasia by a single-stage open reduction through Ferguson’s medial approach and Pemberton acetabuloplasty. The procedure was performed bilaterally in 10 patients. The mean age of the patients at the time of the operation was 19.8 months (16–24 months). The mean follow-up period was 10.9 years (7–19 years). Group I avascular necrosis according to ...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Radiological results of treatment using an extensive anterolateral approach for developmental dysplasia of the hip: minimum 5-year follow-up
To investigate the radiological results using the extensive anterolateral approach in patients with developmental dysplasia of the hip. A total of 16 hips with developmental dysplasia of the hip treated by the extensive anterolateral approach were retrospectively reviewed after a minimum follow-up of 5 years. For evaluation, we considered the Severin classification and postoperative complications. At the final follow-up (mean 75.6 months), 14 hips (87.5%) were satisfactory in the Severin classification. Reoperation was performed in only one hip (6.3%) because of redislocation. No femoral head necrosis was observed. Our res...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Comparison of Salter osteotomy and Tonnis lateral acetabuloplasty with simultaneous open reduction for the treatment of developmental dysplasia of the hip: midterm results
The aim of this study was to compare the midterm clinical and radiological outcomes of the Salter osteotomy (SO) and Tonnis lateral acetabuloplasty (TLA) with concomitant open reduction for the treatment of developmental dysplasia of the hip. Twenty-five hips of 20 patients who underwent SO with open reduction and 26 hips of 23 patients who underwent TLA with open reduction were evaluated retrospectively. The average age of the patients at the time of the operation was 35.6 months in the SO and 36.6 months in the TLA group, without a statistically significant difference (P=0.836). The average follow-up times in the SO and ...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

MRI versus computed tomography as an imaging modality for postreduction assessment of irreducible hips in developmental dysplasia of the hip: an interobserver and intraobserver reliability study
Following surgical reduction of an irreducible hip in developmental dysplasia of the hip, imaging is required to ascertain successful reduction. Recent studies have compared MRI versus computed tomography (CT) in terms of cost, time, sensitivity and specificity. This is the first study to compare intraobserver and interobserver reliability for both modalities. Nineteen CT scans of 38 hips in 10 patients and nine MRI scans of 18 hips in six patients were reviewed on two separate occasions by three clinicians. Image clarity, confidence of diagnosis, time taken to perform the scan as well as radiation dose for CT were recorde...
Source: Journal of Pediatric Orthopaedics B - September 30, 2016 Category: Orthopaedics Tags: Pelvis & Hip Source Type: research

Ipsilateral obturator type of hip dislocation with fracture shaft femur in a child: a case report and literature review
The incidence of traumatic hip dislocations in children is rising in this fast developing world along with increasing numbers of high-velocity road traffic accidents. Anterior dislocation of the hip has a lower incidence compared with posterior dislocation of the hip. We encountered a rare case of the obturator type of anteriorly dislocated hip associated with ipsilateral fracture of the shaft femur in an 11-year-old child. This is a highly unusual injury combination and the mechanism of injury is obscure. Only two similar cases have been reported in the English literature to date. Closed reduction of the hip using a hithe...
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Lower Limb - Hip & Femur Source Type: research

Comminuted long bone fractures in children. Could combined fixation improve the results?
Comminuted diaphyseal fractures in the pediatric age group represent a major orthopedic problem. It is associated with a high incidence of complications and poor outcomes because of the instability and difficulty in treatment. The aim of this study was to evaluate the efficacy of combined external skeletal fixation and flexible intramedullary nails in reconstruction of comminuted diaphyseal fracture in skeletally immature patients. Combined external fixator and elastic stable intramedullary nails were used in the management of 27 pediatric patients (15 males and 12 females) with unstable comminuted diaphyseal fractures of ...
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Lower Limb - Hip & Femur Source Type: research

Comparison between external fixation and elastic stable intramedullary nailing for the treatment of femoral shaft fractures in children younger than 8 years of age
In conclusion, EF and ESIN can be considered as safe and effective methods for femoral shaft fracture treatment in children younger than 8 years of age. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Lower Limb - Hip & Femur Source Type: research

A meta-analysis of flexible intramedullary nailing versus external fixation for pediatric femoral shaft fractures
To compare the difference in efficacy following flexible intramedullary nailing (FIN) and external fixation (EF) for pediatric femoral shaft fractures. A systematic search was performed on PubMed, Embase, Medline, and Cochrane library for relevant studies. We included controlled trials comparing complications between FIN and EF for pediatric femoral shaft fractures published before 25 November 2014. Modified Jadad scores were utilized to assess the methodological quality of the studies included. The meta-analysis was carried out using Stata 12.0 software. Six studies involving 237 patients were included. On comparison of E...
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Lower Limb - Hip & Femur Source Type: research

Delayed treatment of femoral neck fractures in 58 children: open reduction internal fixation versus closed reduction internal fixation
This study compares the outcomes of closed and open reduction performed 24 h after the injury was sustained. We retrospectively reviewed 58 cases (40 males, 18 females) of femoral neck fractures reset after more than a 24-h delay at our hospital (May 2005 to May 2014). According to Delbet’s classification, there were 30 type II fractures (51.7%), 21 type III fractures (36.2%), and seven type IV fractures (12.1%). A total of 21 patients underwent closed reduction and internal fixation; the remaining patients underwent open reduction and internal fixation. The follow-up period was 17–61 months (average, 35...
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Lower Limb - Hip & Femur Source Type: research

Outcome of the unaffected contralateral hip in unilateral slipped capital femoral epiphysis: a report comparing prophylactic fixation with observation
This was a retrospective review of 80 patients with unilateral slipped capital femoral epiphysis treated with either prophylactic fixation or observation. The unaffected hip of 44 patients (mean age 12.6 years) were subjected to simultaneous prophylactic fixation and 36 patients (mean age 13.4 years) were managed by observation. Fisher’s exact test showed a significantly high incidence of sequential slip of unaffected hips in the observation group in comparison with prophylactic fixation (P=0.002). No cases had avascular necrosis or chondrolysis. Prophylactic fixation significantly reduces the incidence of sequential...
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Lower Limb - Hip & Femur Source Type: research

Tardy ulnar nerve palsy caused by chronic radial head dislocation after Monteggia fracture: a report of two cases
We report two rare cases of tardy ulnar nerve palsy associated with anterior radial head dislocation combined with anterior bowing of the ulna. They had cubitus valgus deformity, valgus instability, and osteoarthritis of the elbow, and had elbow injury more than 40 years back. They were diagnosed with chronic radial head dislocation long after a Bado type 1 Monteggia fracture. Anterior subcutaneous ulnar nerve transposition yielded favorable results. It is important to recognize the possibility of tardy ulnar nerve palsy caused by an improperly treated Monteggia fracture. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - July 30, 2016 Category: Orthopaedics Tags: Trauma Upper Limb Source Type: research