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Journal of Pediatric Orthopedics. Part B

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https://read.qxmd.com/read/30932967/scoliosis-and-spinal-muscular-atrophy-in-the-new-world-of-medical-therapy-providing-lumbar-access-for-intrathecal-treatment-in-patients-previously-treated-or-undergoing-spinal-instrumentation-and-fusion
#1
Luca Labianca, Stuart L Weinstein
This study describes a new procedure for a safer and easier access for the intrathecal injection of the recently approved nusinersen therapy in spinal muscular atrophy. This therapy changed the natural history of the disease, but, to date, scoliosis surgery was an excluding criteria for nusinersen therapy. The bone mass, due to the posterior spinal fusion of the scoliosis surgery, prevents the needle for the Nusinersen administration from intervertebral access This is a single-center, single-surgeon case series descriptive study...
March 29, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30925527/c-reactive-protein-what-to-expect-after-bony-hip-surgery-for-nonambulatory-children-and-adolescents-with-cerebral-palsy
#2
Alastair G Dick, Nicholas Magill, Thomas C H White, Michail Kokkinakis, Fabian Norman-Taylor
Bony hip reconstruction surgery in children with severe cerebral palsy is associated with high complication rates, usually postoperative chest and urinary tract infections. C-reactive protein (CRP) level is commonly used as an indication of infection; an understanding of its normal postoperative trends is crucial to allow early identification of abnormal levels and possible infection. Our aim was to describe the trends in CRP following bony hip surgery in children who had an uneventful postoperative course, on the basis that the children for whom CRP does not follow this course are likely to have a bacterial infection...
March 28, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30925526/hamstring-lengthening-in-females-with-cerebral-palsy-have-greater-effect-than-in-males
#3
Hank White, Juanita Wallace, Janet Walker, Sam Augsburger, Vishwas R Talwalkar, Ryan D Muchow, Henry Iwinski
Children with spastic diplegia cerebral palsy often demonstrate crouched gait patterns, and typically undergo hamstring lengthenings. The objective of this retrospective study was to determine if the surgical response to medial and lateral hamstring lengthenings is different between males and females. Preoperative and postoperative kinematic data of 109 (71 males and 38 females) patients with cerebral palsy were evaluated. Females demonstrated larger decreases in popliteal angle, larger decreases in mid-stance knee flexion, and higher incidences of knee hyperextension postoperatively...
March 28, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30921249/complete-remodelling-of-a-displaced-odontoid-synchondrosis-fracture-managed-conservatively-a-case-report
#4
Nima Razii, Abhishek Sharma, Sashin Ahuja
Odontoid synchondrosis fractures are the most common cervical fracture in young children, although their overall incidence is rare. Various strategies have been proposed in the management of injuries with significant displacement or angulation. In this report, we present the long-term functional and radiological outcomes following nonoperative treatment of such a fracture in a 5-year-old female. The patient was referred to our tertiary centre with radiological progression of angulation from 10° to 35° within 5 weeks of the injury, despite wearing a rigid collar...
March 27, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30921248/bilateral-horizontal-salter-osteotomies-with-anterior-symphyseal-closure-using-a-nylon-tape-in-the-treatment-of-exstrophy-of-the-bladder
#5
Ahmad S Aly
The aim of this case series study is to describe the orthopedic management of bladder exstrophy and to report on the intermediate-term outcomes following bilateral horizontal Salter osteotomies with anterior symphyseal closure using a nylon tape. This retrospective study included seven patients (five boys and two girls) who underwent bilateral horizontal osteotomies after reconstruction of the urogenital deformity using the Cantwell-Ransley technique and symphyseal closure by nylon tape number 2-5. the age range was between 7 months and 8 years (median age=17 months)...
March 27, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30882559/the-predictive-value-of-synovial-glucose-level-in-septic-arthritis
#6
Maki Kinugasa, Daisuke Kobayashi, Shinichi Satsuma, Ryosuke Sakata, Yoshiyuki Shinada, Ryosuke Kuroda
The aim of this study was to investigate the ability of the joint fluid glucose level to detect septic arthritis. Thirty joints in 30 patients with suspected septic arthritis were evaluated. When glucose level was less than 40 mg/dl, we performed arthrotomy. Eleven patients had joint fluid glucose levels less than 40 mg/dl. All 11 (100%) had positive joint fluid cultures. Conversely, 19 patients had synovial glucose levels of at least 40 mg/dl. Six (31.6%) of these had positive joint fluid cultures. The remaining 13 were diagnosed with transient synovitis...
March 14, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30882560/upper-extremity-anomalies-in-children-with-femoral-and-fibular-deficiency
#7
Janet L Walker, Hank D White, Cale A Jacobs, Scott A Riley
Defects occurring in the femoral-fibular-ulnar developmental field are believed to cause the cluster of anomalies seen with femoral, fibular and ulnar limb deficiencies. Upper limb function must be considered in the management of lower limb deficiencies. The purpose of this study is to determine the frequency and type of upper extremity anomalies found in children with femoral and/or fibular deficiency. A retrospective review of 327 consecutive patients with the diagnosis of femoral and/or fibular deficiency was performed using existing records and radiographs...
March 13, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30855545/treatment-of-early-onset-scoliosis-with-growing-rods-in-patients-with-neurofibromatosis-1
#8
Marco Carbone, Francesca Vittoria, Alice Del Sal
This study aimed at verifying the efficacy of growing rod treatment in patients affected by neurofibromatosis with early-onset scoliosis. The authors present a retrospective case study of seven children treated between 2001 and 2017. Mean age at initial surgery was 7.2 years. Mean Cobb angle was 82.7°. Lengthening was performed once a year. Mean Cobb angle at last follow-up was 50.1°. Mean spinal growth was 13.6 mm/year, with regular gain during lengthening procedures. Mean follow-up period was 7 years after the first surgery...
March 7, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30855544/the-modified-kostuik-transilial-bar-technique-has-acceptable-results-in-neuromuscular-spinal-deformity-correction
#9
Haci M Ozdemir, Ismail Demirkale, Mahmut Ozdemir, Mehmet A E Aksekili
The aim of this study is to evaluate the results of the modified Kostuik transilial bar technique for neuromuscular scoliosis (NS). We reviewed the records of 21 patients treated for NS with this instrumentation. There were 14 females and seven males, with an average age of 15.6 years (range: 9-21 years). We determined patients' demographics, correction ratio of both curve and pelvic obliquity, loss of correction, screw loosening at first sacral vertebra, and clinical outcomes. Mean follow-up was 56 months (range: 34-96 months)...
March 7, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30855549/is-open-reduction-necessary-for-pediatric-t-condylar-fractures-of-the-humerus
#10
İsmail Eralp Kaçmaz, Can Doruk Basa, Vadym Zhamilov, Ali Reisoğlu, İhsan Akan, Haluk Ağuş
The aim of this study was to investigate the outcomes of closed reduction and percutaneous pinning (Kirschner wire fixation) as a less invasive method for the treatment of pediatric T-condylar fractures of the humerus compared with open reduction and pinning. Among pediatric patients who were diagnosed with T-condylar fractures of the humerus between 2010 and 2017, those who underwent closed reduction and percutaneous pinning were retrospectively evaluated. The surgical technique used was to restore joint alignment through closed reduction and then to insert a pin parallel to the joint surface to stabilize the intercondylar fracture...
March 6, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30855548/a-nationwide-analysis-of-failed-irrigation-and-debridement-for-pediatric-septic-arthritis-of-the-hip
#11
Andrew F Sabour, Ram K Alluri, Nathanael Heckmann, Keemia S Heidari, George F Rick Hatch, Curtis VandenBerg
Irrigation and debridement (I&D) is the gold standard for treatment of pediatric septic arthritis of the hip. If the index surgery fails, subsequent surgery may be required to eradicate the infection, resulting in substantial increases in morbidity, healthcare costs, and psychosocial burden. The purpose of this study was to identify the incidence of failed I&D for pediatric septic arthritis of the hip, defined by the need for at least one subsequent surgical intervention, and potential risk factors for failed initial I&D...
March 6, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30855547/occipitocervical-or-c1-c2-fusion-using-allograft-bone-in-pediatric-patients-with-down-syndrome-8-years-of-age-or-younger
#12
Kei Ando, Kazuyoshi Kobayashi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Naoki Ishiguro, Shiro Imagama
Sufficient internal fixation for occipitocervical (OC) or C1-C2 instability in pediatric patients with Down syndrome is difficult owing to small osseous structures, congenital deformities, and immature ossification. The purpose of this study was to evaluate the clinical outcomes of patients aged 8 years or younger with Down syndrome who underwent OC or C1-C2 fusion using freeze-dried allograft as bone graft substitute. The participants included seven consecutive patients aged 8 years or younger with Down syndrome who were treated for upper cervical disorders with posterior OC or C1-C2 fusion using freeze-dried allografts at our hospital between 2007 and 2016 and had a minimum follow-up of 1 year...
March 6, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30855546/pediatric-navicular-dorsal-osteochondroma-a-rare-case-of-navicular-cuneiform-impingement
#13
Marco Turati, Marco Bigoni, Robert J Omeljaniuk, Jacques Griffet, Giovanni Zatti, Aurélien Courvoisier
Osteochondroma is one of the most common benign bone tumors; however, as it rarely affects any bones in feet, it may easily escape detection without rigorous examination. We present an exceptionally rare case of tarsal navicular dorsal osteochondroma diagnosed in an 11-year-old female child affected by chronic foot pain. Radiographs, MRI, and computed tomography scan revealed bony excrescences extending outward from the navicular bone. After conservative treatment failed, the navicular dorsal exostosis was excised in open surgery with complete resolution of symptoms...
March 6, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30839361/oligohydramnios-should-it-be-considered-a-risk-factor-for-developmental-dysplasia-of-the-hip
#14
Dimitrios Manoukian, Andreas Rehm
Breech, family history, first born and female sex are the main risk factors described for developmental dysplasia of the hip (DDH). Foot abnormalities and oligohydramnios have also been listed. Recent studies have discredited torticollis, multiple gestation pregnancy, mode of delivery and prematurity as risk factors. Definition of oligohydramnios in the literature is inconsistent. Our aim was to investigate the term oligohydramnios and evaluate whether it should be considered a risk factor for DDH. All live births in our institution between 2001 and 2014 were included...
March 4, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30839360/double-hindfoot-arthrodesis-technique-for-the-treatment-of-severe-equino-plano-valgus-foot-deformity-in-cerebral-palsy-long-term-results-and-radiological-evaluation
#15
Pier Francesco Costici, Fabrizio Donati, Rosa Russo, Caroline Verardi, Gaetano Pagnotta
To evaluate the clinical and radiological results of a double arthrodesis technique for the treatment of equino-plano-valgus foot deformity in pediatric patients affected by cerebral palsy. A retrospective evaluation was performed on 175 feet surgically treated with a talonavicular and calcaneocuboid joint fusion technique. The average age at surgery was 14.7 years (range: 12-20 years). Visual analogue scale for pain score, Gross Motor Function Classification System scale, talonavicular angle, Costa-Bertani angle, and Kite's angle on standard weight bearing radiographs were evaluated preoperatively and postoperatively...
March 4, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30830014/oblique-pelvic-osteotomy-in-the-treatment-of-bladder-exstrophy-in-neonates
#16
Marco Giordano, Antonio Di Lazzaro, Vincenzo Guzzanti, Silvia Careri, Pietro Bagolan, Antonio M Zaccara, Renato M Toniolo
Bladder exstrophy is a congenital and rare malformation of the lower abdominal wall with exposure of the bladder mucosa to the external environment, and it is related to pelvis abnormalities. Eighteen patients with bladder exstrophy were treated with bilateral oblique pelvic osteotomy in conjunction with urologic reconstruction after they were stabilized by cast. No failure of midline closure was observed (wound dehiscence or recurrence of bladder exstrophy). Follow-up showed no leg length discrepancy or problems in walking...
March 1, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30807511/effectiveness-of-school-scoliosis-screening-and-the-importance-of-this-method-in-measures-to-reduce-morbidity-in-an-italian-territory
#17
Angelo G Aulisa, Marco Giordano, Vincenzo Guzzanti, Francesco Falciglia, Paolo Pizzetti, Renato M Toniolo
Although several procedures for treating scoliosis have been developed, the most effective treatment is still based on early detection. For early diagnosis of idiopathic scoliosis, many authors have proposed methods of school screening; however, there is still no standardized screening program. The aim of this study was to evaluate a school screening method and the prevalence and distribution of scoliosis in Italian school children, aged 9-14 years, and to determine if the screening method can reduce morbidity in an Italian territory...
February 22, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30807510/spica-mri-predictors-for-epiphyseal-osteonecrosis-after-closed-reduction-treatment-of-dysplasia-of-the-hip
#18
Lee S Haruno, J Herman Kan, Michael J Rivlin, Scott B Rosenfeld, Erica K Schallert, Huirong Zhu, Vinitha R Shenava
Spica MRI with intravenous gadolinium contrast after closed reduction for developmental dysplasia of the hip (DDH) helps to determine successful reduction and attempts to identify patients at risk for epiphyseal osteonecrosis. The objective of our study was to evaluate spica MRI predictors for epiphyseal osteonecrosis after closed reduction. Retrospective study for all patients undergoing closed reduction for DDH followed by gadolinium-enhanced spica MRI between July 2011 and November 2014. Patient demographics and clinical follow-up through 2017, including the development of epiphyseal osteonecrosis and need for reintervention after the initial reduction, were recorded...
February 22, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30807513/management-of-severe-congenital-flexion-deformity-of-the-knee-using-ilizarov-method
#19
Sergey S Leonchuk, Konstantin I Novikov, Koushik N Subramanyam, Natalya G Shikhaleva, Mairbek K Pliev, Abhishek V Mundargi
The aim of this study was to examine the effectiveness of Ilizarov method in severe congenital flexion deformity of the knee. This was a retrospective study of eight consecutive bilateral cases (five girls and three boys, with mean age of 4 years, involving 16 knees) with minimum 2-year follow-up. Four patients had multiple congenital contractures and two patients each had popliteal pterygium syndrome and complete tibial hemimelia. All patients were treated with Ilizarov fixator and gradual correction (additional soft tissue releases in three knees)...
February 21, 2019: Journal of Pediatric Orthopedics. Part B
https://read.qxmd.com/read/30807512/mri-reveals-unrecognized-treatment-failures-after-application-of-fettweis-plaster-in-children-with-unstable-hip-joints
#20
Hannes Kubo, Hakan Pilge, Jan-Philipp Holthoff, Bettina Westhoff, Ruediger Krauspe
We evaluated the success of treatment of unstable hip joints with the Fettweis plaster followed by MRI to detect potential treatment failures. A total of 132 ultrasound-detected unstable hips of type D, III, or IV according to Graf were treated with closed reduction and Fettweis plaster, followed by MRI. We examined 19 type D, 55 type III, and 58 type IV. Mean age at diagnosis was 84.5 days (SD: ±55.4). Treatment period was 63.2 days (SD: ±22.2). In 13 cases, the MRI showed a poor reduction. After repetition of this treatment, all 13 showed a concentric reduction...
February 21, 2019: Journal of Pediatric Orthopedics. Part B
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