Salter–Harris type-IV displaced distal radius fracture in a 5-year-old
We describe a 5-year-old boy who sustained a displaced left distal radial Salter–Harris type-IV fracture. The patient had normal wrist function and physeal growth at the 3-year postoperative follow-up. Our patient is by far the youngest reported child with a displaced Salter–Harris type-IV fracture of the distal radius. Prompt anatomic reduction and fixation of a displaced distal radial Salter–Harris type-IV fracture can result in excellent short-term wrist motion with maintenance of physeal function. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Trauma Upper Limb Source Type: research

Primary nonunion of the distal radius fractures in healthy children
There are no published case series of nonunion of distal radius fractures in healthy children because of the rarity of its occurrence. We searched for all reported cases of this condition in Pubmed, Google scholar, and SCOPUS. We found three series, which included one previously reported by our group. The aim of the present study was to define the predisposing factors leading to nonunion after treatment of distal radius fractures in healthy children. We also aimed to emphasize that nonunion should be included in the list of complications of distal radius fractures in children and be mentioned in the textbook of pediatric t...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Trauma Upper Limb Source Type: research

The necessity of fixation in Gartland type 2 supracondylar fracture of the distal humerus in children (modified Gartland type 2A and 2B)
This study was conducted to evaluate the results of pinning versus conservative treatment in these two groups of patients. Patients with Gartland type 2 supracondylar fractures were categorized into two groups: the first group (type 2A) consisted of patients with Baumann angle (BA) differing from the uninjured side by less than 5°; the second group (type 2B) consisted of patients with BA difference greater than or equal to 5°. Statistical analysis was performed between the two groups. In type 2A, we also analyzed the data on loss alignment in patients who had undergone closed reduction without fixation to clarify t...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Trauma Upper Limb Source Type: research

Posterolateral approach for humeral lateral condyle fractures in children
We proposed a simple posterolateral approach to the articular surface of the trochlea for fresh and late fractures of the humeral lateral condyle. Twenty consecutive cases, 16 fresh and four old fractures, were approached between triceps and anconeus before the age of 15 years. All fractures achieved union in 3 months. Nineteen cases were classified as excellent or good by the Hardacre score after 31.3 months of follow-up. One late fracture with elbow subluxation showed radiographic fragmentation of the capitellum and a fair clinical result. This simple optional approach offers good exposure of intra-articular fracture at ...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Trauma Upper Limb Source Type: research

Screw versus pin fixation with open reduction of pediatric lateral condyle fractures
Good results have been described for lateral condyle fractures treated by open reduction and fixation using Kirschner wires or screws. We, in our level III retrospective comparison clinical research study, retrospectively reviewed 84 patients (43 K-wire, 41 screw fixation; average age 5.6 years, average follow-up 6.8 months). With K-wires there were three nonunions (average time to union 9.6 weeks). With screws, all fractures healed (average of 7.8 weeks). Screw fixation patients spent fewer days in a cast and had a greater range of motion at the last follow-up. Screw fixation is associated with fewer nonunions and faster ...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Trauma Upper Limb Source Type: research

Two cases of macrodactyly of the foot: relevance in pediatric orthopedics
Congenital enlargement of one or several digits of the foot, known as macrodactyly, is a rare malformation. Macrodactyly impedes foot development and affects function and gait. Here, we describe a surgical technique used to correct macrodactyly in two pediatric patients. We performed amputation of the enlarged phalanx and debulking of the soft tissues to construct a normal-sized digit. This precise technique involves a simple surgical plan that preserves the metatarsus and cuneiform and does not result in a wide plantapedis. Both patients subsequently showed improved gait and were able to wear normal shoes. (Source: Journa...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Bilateral navicular-medial cuneiform synostosis manifesting as medial foot pain: a case report and review of the literature
We present a case of an 11-year-old with bilateral isolated osseous navicular-medial cuneiform tarsal coalition. The patient was treated with bilateral coalition excision and soft tissue interposition, with excellent results at 2 years of follow-up. The current case is unusual in being an osseous coalition rather than the more commonly seen cartilaginous or fibrous condition. In addition, this case is uncommon as being in a patient of European rather than Asian descent. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

The ‘trampoline ankle’: severe medial malleolar physeal injuries in children and adolescents secondary to multioccupant use of trampolines
The purpose of this study was to describe a series of patients presenting with medial malleolus Salter–Harris types III and IV fractures (MacFarland fractures) related to trampoline use. In total, 11 patients were reviewed retrospectively (mean age: 11.8 years; four boys and seven girls). Salter–Harris type III fractures were more commonly seen (n=7). Undisplaced fractures were more prevalent (n=6). Six children underwent surgical treatment. Average follow-up time was 17.8 months. A medial physeal bar with subsequent growth arrest and ankle deformity was observed in two patients. More than one user was present ...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

The proportion of distal fibula Salter–Harris type I epiphyseal fracture in the paediatric population with acute ankle injury: a prospective MRI study
Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter–Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All paediatric patients with ankle injury, seen at the emergency room from September 2012 to May 2013 at a single institution, underwent a standardized clinical examination, and their radiographs were obtained if found necessary. All images and data were recorded prospectively and patients suspected of having SH1FDF were referred fo...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Modified Grice–Green subtalar arthrodesis performed using a partial fibular graft yields satisfactory results in patients with cerebral palsy
The aim of this study was to report the experience with the use of a modified Grice–Green technique, which was performed using a partial subperiosteal fibular bone graft because of valgus unstable foot in children with cerebral palsy. Fifteen feet of 11 patients were evaluated on the basis of the appearance of the feet, clinical symptoms, and radiographic measurements. After an average follow-up duration of 24 (9–39) months, all feet showed satisfactory clinical and radiological results. Solid fusion and sustained correction took place in all feet. The gap at the donor site was bridged with new bone in all case...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Stepwise surgical approach to equinocavovarus in patients with cerebral palsy
This study investigated the radiologic results of a stepwise surgical approach to equinocavovarus in 24 patients with cerebral palsy and determined the extent to which each procedure affected radiographic parameters using a linear mixed model. The anteroposterior talus–first metatarsal and anteroposterior talonavicular coverage angles were improved. The calcaneal pitch angle, tibiocalcaneal angle, lateral talus–first metatarsal angle, and naviculocuboid overlap were also improved. The Dwyer sliding osteotomy affected the tibiocalcaneal angle, whereas first metatarsal dorsal wedge osteotomy improved the calcanea...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Congenital talipes equinovarus associated with hereditary congenital common peroneal nerve neuropathy: a literature review
We present a unique case of a congenital hereditary common peroneal nerve neuropathy with congenital idiopathic congenital talipes equinovarus that had been treated with the Ponseti method with satisfactory outcome at 5-year follow-up, along with a literature review. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Early management of neurologic clubfoot using Ponseti casting with minor posterior release in myelomeningocele: a preliminary report
This study aimed to examine the results of manipulation and serial casting, followed by open Achilles lengthening combined, when necessary, with posterior release in the management of neurologic clubfoot in infants with myelomeningocele. This study was carried out prospectively with a minimum follow-up of 2 years on 24 consecutive infants (48 feet) with neurologic insensate feet. Manipulation and serial casting were performed, followed by open tendo Achilles lengthening with/without posterior capsulotomy of the ankle and subtalar joints. The Diméglio scoring system was used to assess the degree of deformity correcti...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Modified Ponseti method of treatment for correction of neglected clubfoot in older children and adolescents – a preliminary report
Congenital talipes equinovarus may be the most common congenital orthopedic condition requiring treatment. Nonoperative treatment including different methods is generally accepted as the first step in the deformity correction. Ignacio Ponseti introduced his nonsurgical approach to the treatment of clubfoot in the early 1940s. The method is reportedly successful in treating clubfoot in patients up to 9 years of age. However, whether age at the beginning of treatment affects the rate of effective correction and relapse is unknown. We have applied the Ponseti method successfully with some modifications for 11 patients with a ...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Residual forefoot deformity predicts the need for future surgery in clubfeet treated by Ponseti casting
Tibialis anterior tendon transfer (TATT) is performed for treatment of recurrent clubfeet. We investigated the predictability of residual adductus on the future need for TATT. A retrospective review of 143 patients with clubfoot was performed. The patients were divided into two groups: group 1 with a history of TATT and group 2 with no TATT. Heel-forefoot angle (HFA) was measured. HFA was compared between the groups. HFA was significantly different between groups 1 and 2. Residual adductus deformity in clubfeet treated by Ponseti casting is a risk factor for future need for surgical treatment. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot Source Type: research

Pedobarographic changes in Ponseti-treated clubfeet with and without anterior tibialis tendon transfer: changes due to growth and surgical intervention
The aim of this study was to identify significant changes in pedobarographic parameters attributed to growth versus growth and surgical intervention for uninvolved feet, clubfeet (CF) subjected to anterior tibialis tendon transfer surgery, and unilateral nonsurgical CF. Participants underwent foot-pressure analysis preoperatively and 3 years postoperatively. Six parameters related to the lateral midfoot showed increases for uninvolved and nonsurgical CF, whereas CF subjected to surgery decreased. Transferring the anterior tibialis tendon resulted in improvements beyond typical growth and in a more balanced foot postoperati...
Source: Journal of Pediatric Orthopaedics B - January 27, 2016 Category: Orthopaedics Tags: Ankle & Foot 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 25, 2015 Category: Orthopaedics Tags: Thanks to Referees Source Type: research

Arginiemia is not a contraindication for botulinum toxin injection
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Comment on ‘Closed reduction of slipped capital femoral epiphysis: high-risk factor for avascular necrosis’
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Back pain in Duchenne muscular dystrophy: steroids are not always the culprit
We report on a child with Duchenne muscular dystrophy on prolonged corticosteroid treatment who presented with back pain and was subsequently found to have a monostotic fibrous dysplasia lesion of the spine. It is the intent of this case report to emphasize the need to maintain a high index of suspicion for other potential causes of back pain in Duchenne muscular dystrophy besides vertebral compression fractures. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Miscellaneous Source Type: research

Post-traumatic nonunion of the clavicle in a 4-year-old boy and the importance of vitamin D level testing
We report the youngest case to our knowledge in a 4-year-old vitamin D-deficient male with a 6-month-old right midshaft clavicle fracture nonunion that was treated successfully with vitamin D supplementation, followed by open reduction and internal fixation with autologus iliac crest bone grafting. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Post-traumatic nonunion of a clavicle fracture in a 9-year-old child
Clavicular fractures account for around 15% of fractures in children. Although nonunion is a recognized complication in adults, post-traumatic nonunion of the clavicle in children is extremely rare. To the best of our knowledge, post-traumatic nonunion of the clavicle in a child following repeated clavicular fracture has not yet been published in the English literature. Here, we report a case of a 9-year-old boy who presented with post-traumatic nonunion of his right clavicle following his third fracture after radiologically documented healing of the first two fractures. He underwent open reduction and internal fixation, s...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Buried versus unburied Kirschner wires in the management of paediatric lateral condyle elbow fractures: a comparative study from a tertiary centre
There is little consensus on whether Kirschner wire (K-wire) burial is preferable in the management of paediatric lateral humeral condyle fractures. We identified 124 patients from May 2008 to August 2014. Sixty received buried K-wires and 64 received unburied wires. We found no significant difference in the infection rates between groups, but a high rate of skin erosion (23%) in the buried group, with a subsequent high rate of infection in this subgroup (40%). We found a strong association of wire erosion following early surgery. There is a considerable cost saving associated with using unburied wires. We therefore recomm...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Dome osteotomy using the paratricipital (triceps-sparing) approach for cubitus varus deformity in children: a surgical technique to avoid lateral condylar prominence
Twenty patients (11 males and nine females) with cubitus varus deformity were treated with corrective dome osteotomy through the paratricipital approach. Patients presented after an average 3 years of appearance of the deformity. The average age of the patients was 8.5 years (range 6–14 years). All patients had a previous history of supracondylar fracture. Preoperatively, carrying angle, lateral condylar prominent index, and range of motion were recorded. There were no intraoperative complications. Postoperatively, three patients developed a superficial skin infection. No patient had unsightly scarring or a prominent...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Use of glenoid inclination angle for the assessment of unilateral congenital high scapula
Little has been reported on the motion of the scapula in Sprengel’s deformity. Fourteen patients with unilateral congenital high scapula underwent the Woodward procedure from 1986 to 2004. The median age of the patients at the time of surgery was 4.4 years and the median follow-up duration was 8.8 years. The range of motion of the shoulder and the glenoid inclination angle (GIA) were measured preoperatively and at the final visit. The range of motion of the shoulder and GIA improved at the final visit. There was a positive correlation between the maximum abduction angle of the upper limb and GIA at the final visit. (...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Gorham’s disease of the proximal tibia successfully treated with local administration of OK-432, followed by reconstruction with distraction osteogenesis: a case report
Gorham’s disease (GD) is a rare and intractable disease characterized by marked progression of osteolysis associated with lymphangioma and/or hemangioma. Here, we describe a case of GD of the proximal tibia occurring in a 10-year-old boy. Although we could not correctly diagnose it at first, we finally diagnosed him as having GD. Progression of osteolysis of the tibia stopped 3 months after the local administration of OK-432. Thereafter, the huge bone defect with varus and extension deformity was reconstructed successfully by distraction osteogenesis using the Ilizarov method. The present case suggests that local adm...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Chondral fracture of the lateral femoral condyle in children with different treatment methods
We report three cases of traumatic cartilage fractures of the lateral femoral condyle in adolescents who were treated with three different methods. We also present their follow-up outcomes. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Knee & Leg Source Type: research

A modified Puddu technique for the treatment of adolescent mild to moderate tibia vara
The aim of this work was to evaluate the results of a modified ‘subphyseal’ Puddu technique for the treatment of selected cases of the adolescent tibia vara. Twenty-five legs in 18 patients with adolescent tibia vara between January 2008 and February 2012 were included. The mean value of angular correction was 22.24° (range, 18°–25°, SD 2.0°). All of the osteotomies in this series healed by 8 weeks. There were no postoperative neurologic or vascular complications. At the end of follow-up, no iatrogenic disturbance to the proximal tibial physis was observed, but recurrence was reported in t...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Arthroscopic fixation with intra-articular button for tibial intercondylar eminence fractures in skeletally immature patients
The aim of this study was to describe our experiences with arthroscopy-guided intra-articular button fixation in the treatment of displaced tibial eminence fractures in skeletally immature children. Eleven adolescent patients with an average age of 12.2 years were treated arthroscopically between January 2005 and February 2007. At follow-up evaluation at 69 months, we did not find any instability. Only minimal differences were found in the functional outcomes (Lysholm and International Knee Documentation Committee scores: 95.7 and 94.3, respectively). None of the patients had a leg-length discrepancy defined at the time of...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Endoscopic-assisted epiphysiodesis: technique and 20-year experience
The aim of the study was to describe the endoscopic-assisted epiphysiodesis technique and review our 20-year experience with it. A retrospective review of 44 patients who underwent proximal tibia and/or distal femur endoscopic-assisted epiphysiodesis was carried out. Only patients who had preoperative and postoperative scanograms with clinical follow-up of at least 6 months were included. The mean length of follow-up was 36.8 months. All patients had radiographic evidence of physeal fusion within 6–12 months from the index procedure. No patient required revision surgery. Endoscopic-assisted epiphysiodesis is safe, ef...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Knee & Leg Source Type: research

Vascular evaluation after cervical hip fractures in children: a case series of eight children examined by scintigraphy after surgery for cervical hip fracture and evaluated for development of secondary radiological changes
Femoral neck fractures in children and young adults are rare, but have a high risk of avascular necrosis (AVN) and subsequent gradual collapse of the femoral head. In 2006, we initiated the use of scintigraphy for the diagnosis of vascular impairment after a cervical fracture in children. In the present retrospective case study, we evaluated the effect of the remaining postoperative circulation in the femoral head after fracture in terms of the development of AVN and secondary degenerative changes of the hip joint. Eight children, four girls and four boys [mean age 11.5 years (7–16)], had been operated for a cervical...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Fixator-augmented flexible intramedullary nailing for osteopenic femoral shaft fractures in children
We describe the surgical technique, pitfalls, and outcomes in a series of four patients with underlying osteopenia treated with external fixator-augmented flexible nailing for femoral shaft fractures. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Overgrowth after femoral shaft fractures in infants treated with a Pavlik harness
This study was performed to determine whether overgrowth occurs when treating infantile femoral shaft fractures with a Pavlik harness. Twenty-three patients, aged less than 1 year, treated with a Pavlik harness for a femoral shaft fracture were included. Shortening at the time of injury was recorded on radiographs and compared with those obtained at the follow-up visit 18 months or later. Average overgrowth was 5 mm (1–18 mm). Overgrowth occurs in infants following treatment of femoral fractures with a Pavlik harness. Initial shortening of up to 18 mm was acceptable and resulted in a leg-length d...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Comparison of open reduction alone and open reduction plus Dega osteotomy in developmental dysplasia of the hip
In this study, we compared open reduction (OR) alone with OR plus Dega osteotomy for acetabular index (AI) development. Twenty patients, 10 in each group, who underwent either OR alone or OR plus Dega osteotomy were studied retrospectively. All patients were diagnosed with developmental dysplasia of the hip and none of them received treatment previously. Preoperative, early postoperative, and follow-up radiographs were gathered, radiological grading was performed according to Tönnis, and AI angles were measured. The OR group had a mean age of 24.5 months, whereas the Dega group had a mean age of 24.8 months. The mean ...
Source: Journal of Pediatric Orthopaedics B - November 25, 2015 Category: Orthopaedics Tags: Hip & Femur Source Type: research

Comment on the article ‘Dysplasia epiphysealis hemimelica of the knee: an unusual presentation with intra-articular loose bodies and literature review’ by Wheeldon and Altiok: Erratum
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Erratum Source Type: research

Abstracts of the 7th International Clubfoot Congress, Rio de Janeiro, November 19-22, 2014.
No abstract available (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: ABSTRACTS: PDF Only Source Type: research

Delayed presentation of a heteropagus (parasitic) twin: a case report of a 17-year-old patient
We present an unusual case of an ischiopagus patient presenting at 17 years of age, which appears to be the oldest recorded presentation for surgery of a heteropagus twin in the English literature. The patient had two additional developed lower extremities along with two additional rudimentary upper extremities. The challenges and lessons learned from this rare and complex surgery are discussed. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Miscellaneous Source Type: research

Single forearm radius and ulna asymmetric lengthening in multiple cartilaginous exostoses: a case report and a long-term follow-up
We describe one case of forearm deformity in a patient affected by multiple cartilaginous exostoses – also known as the forearm ‘candy stick deformity’. Surgical treatment usually focuses on the correction of the wrist deformity without correcting the forearm shortening, the latter not being given the same consideration as lower limb shortening. In the presented case, radius and ulna corticotomies were performed and distal forearm deformity and shortening were corrected by two independent monoaxial external fixators, with full pronosupination. It is our belief that simultaneous treatment of forearm shorte...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Fracture dislocation of the pisiform bone in children: a case report and review of the literature
Simultaneous fracture and dislocation of the pisiform is a rare condition, and only two cases have been reported in children. We retrospectively collected and reviewed clinical and radiographic data of a child with a type II Salter–Harris fracture of the distal radius, associated with fracture dislocation of the pisiform. In addition, we performed a systematic review of the literature available to date. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Acute forearm compartment syndrome in a newborn caused by reperfusion after spontaneous axillary artery thrombosis
Acute compartment syndrome of the forearm in newborns is often misdiagnosed and can be disastrous if left untreated. Here, we report a full-term infant of a diabetic mother with underlying heterozygosity for MTHFR C677T and A1298C alleles. A spontaneous thrombosis occurred in the left axillary artery immediately after birth. The patient responded well to anticoagulant (heparin) and thrombolytic (tissue plasminogen activator) agents. After reperfusion of the extremity, acute compartment syndrome developed. Emergent fasciotomy was performed. In this case, effective collaboration between pediatricians and orthopedic surgeons ...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

The distal radius and ulna classification in assessing skeletal maturity: a simplified scheme and reliability analysis
This study concludes that the simplified distal radius and ulna classification is a reliable tool for assessment of skeletal maturity. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Obesity in children with brachial plexus birth palsy
Fetal macrosomia is associated with a 14-fold increased risk of brachial plexus birth palsy (BPBP), and is a predictor of childhood obesity. The purpose of this study was to identify the relationships between BPBP, fetal macrosomia, and childhood obesity. We retrospectively reviewed 214 children with BPBP. The average age was 8 years and 53% had a Narakas 1 grade BPBP. Overall, 49% of children were normal weight, 22% overweight, and 29% obese. Of the children with a history of fetal macrosomia, 41% were obese; a statistically significant difference. Overall quality of life scores, however, were not correlated with obesity....
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Upper Limb Source Type: research

Scarf–Akin osteotomy for hallux valgus in juvenile and adolescent patients
We report the clinical, functional and radiological outcomes of the Scarf–Akin procedure in the treatment of juvenile and adolescent HV. A review of single surgeon series was carried out of all children who underwent Scarf and Akin osteotomies as a combined procedure for HV between February 2001 and 2010. The preoperative and postoperative intermetatarsal angle (IMA1–2), hallux valgus angle, distal metatarsal articular angle and ratio of the length of first metatarsal to that of the second metatarsal were determined. The American Orthopaedic Foot and Ankle Score was used for functional assessment. Twenty-nine p...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Foot Source Type: research

Symmetric limb overgrowth following anterior cruciate ligament reconstruction in a skeletally immature patient
This report describes a case of symmetric femoral and tibial overgrowth of 2.8 cm in a 13-year-old patient after undergoing reconstruction surgery for his torn right anterior cruciate ligament. A literature review of previous cases is also provided. Following a pediatric anterior cruciate ligament tear, delaying surgery until the patient approaches skeletal maturity may avoid long-term growth disturbances, however, delaying this procedure may increase the probability of further joint damage. This growth disturbance was managed with a percutaneous epiphysiodesis that corrected the limb length deformity. (Source: Jour...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Knee Source Type: research

A severe systemic presentation of pigmented villonodular synovitis in a child with underlying Chediak–Higashi syndrome
This report describes a complex paediatric patient who underwent bone marrow transplantation to control the accelerated phase of the Chediak–Higashi syndrome. Diffuse PVNS developed in one knee 2.75 years later. Progression of PVNS was accompanied by the development of severe systemic symptoms, which resolved rapidly following subtotal surgical debridement. The patient remains well with minimal elevation of inflammatory marker levels 10.5 years later. As PVNS and Chediak–Higashi syndrome are both very rare diseases we propose a potential unifying hypothesis for this combination. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Knee Source Type: research

Osteochondritis dissecans of the lateral femoral condyle in a patient affected by osteogenesis imperfecta: a case report
Osteochondritis dissecans is a very uncommon phenomenon in osteogenesis imperfecta (OI). A 14-year-old boy, affected by OI and followed in our Center for Congenital Osteodystrophies, had a knee trauma and MRI indicated a hollowed area of 2.5×1.5 cm in the lateral femoral condyle, which was classified as grade III. The patient underwent surgery, performed as a one-step surgical treatment: the osteochondral fragment was removed, curettage of lesion’s bottom was performed, and a biphasic scaffold was used to fill the defect, implanted with a press-fit technique. MRI at 12 and 24 months after surgery showed ...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Knee Source Type: research

Are patient demographics different for early-onset and late-onset Blount disease? Results based on meta-analysis
Early-onset and late-onset Blount disease has been described with some clinical overlap between the two forms. Using PRISMA guidelines, we searched for articles that included demographics of patients with both types of Blount disease. On the basis of 24 articles that met our inclusion criteria, patients with early-onset Blount disease were more likely to have bilateral involvement [odds ratio (OR) 4.30, 95% confidence interval (CI) 2.27–8.17] and less likely to be Black (OR 0.20, 95% CI 0.08–0.53) or male (OR 0.32, 95% CI 0.13–0.78). Our results confirm that differences based on laterality, race, and sex ...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Knee Source Type: research

Acute, unstable slipped capital femoral epiphysis with associated congenital coxa vara
We present a case of a 5-year-old girl with an acute, unstable, severe slipped capital femoral epiphysis associated with congenital coxa vara and its surgical management. This association has not been described in previous literature. Surgical treatment is proposed and described. (Source: Journal of Pediatric Orthopaedics B)
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Hip Source Type: research

Effect of increase in birth weight in a newborn on hip ultrasonography
Exposure to the pressure experienced by higher birth weight babies during the intrauterine period might cause hip dysplasia. The aim of this study is to determine the effect of birth weight in newborns on hip ultrasonography when the paternal and maternal risk factors are excluded. A total of 701 babies born at 38–42 gestational weeks were included in the study. Hip ultrasonography was performed within 7 days following birth using the Graf technique in the babies without risk factors for developmental dysplasia of the hip. Images obtained were controlled with respect to conformity to the Graf method and angular measu...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Hip Source Type: research

Assessment of lateral subluxation in Legg–Calvé–Perthes disease: a time-sequential study of magnetic resonance imaging and plain radiography
Lateral subluxation of the femoral head is one of the poor prognostic factors of Legg–Calvé–Perthes disease. The aim of this study was to investigate the cause of lateral subluxation of the femoral head on the basis of the changes over time on MRI. Twenty-four patients with unilateral Legg–Calvé–Perthes disease were analyzed retrospectively. Lateral subluxation was measured as the tear drop distance on radiographs. We focused on joint fluid, medial articular cartilage thickening, and abnormal lesion on MRI. Lateral subluxation continued significantly in patients with poor results. Amon...
Source: Journal of Pediatric Orthopaedics B - September 25, 2015 Category: Orthopaedics Tags: Hip Source Type: research