Zhiqiang Zhao, Qinglin Jin, Xianbiao Xie, Yongqian Wang, Tiao Lin, Junqiang Yin, Gang Huang, Changye Zou, Jingnan Shen
BACKGROUND: At present, amputation was widely adopted for young patients when limb salvage was deemed risky with several surgical strategy such as rotationplasty. However, leg length discrepancies and unfavorable cosmetic results were indispensable complication of this strategy. The purpose of this study was to propose a novel reconstruction strategy and evaluate the early clinical and functional outcomes of the strategy. METHODS: Plastic lengthening amputation (PLA) has been developed by lengthening the stump to preserve one additional distal joint for fixing the artificial limb well...
September 15, 2020: World Journal of Surgical Oncology
Xi Yang, Qiang Zou, Yueming Song, Limin Liu, Chunguang Zhou
BACKGROUND: The windswept lower limb deformity describes valgus deformity in one leg with varus deformity in the other. It is mostly seen in young children with metabolic bone diseases (such as rickets) and may lead to leg length discrepancy (LLD) and Degenerative scoliosis (DS) in older age. To the best of our knowledge, there was no report of the spinal surgery in patient with severe DS associated with windswept deformity. The objective of this study is to report the unique case of a 60-year-old woman with severe degenerative scoliosis (DS) associated with windswept deformity caused by rickets who underwent a posterior correction and fusion surgery in spine...
September 3, 2020: BMC Surgery
Giovanni Luigi Di Gennaro, Giovanni Gallone, Edgar Alejandro Martinez Vazquez, Leonardo Marchesini Reggiani, Costantina Racano, Eleonora Olivotto, Stefano Stilli, Giovanni Trisolino
BACKGROUND: congenital posteromedial bowing of tibia (CPMBT) is a very rare birth defect, characterized by shortened bowed leg and ankle deformity. We described a single institution experience in the management of CPMBT. METHODS: we identified 44 CPMBT in 44 children. The age at presentation was 5.5 ± 5.6 years and the mean age at the final review was 10.1 ± 4.8 years. Radiographic evaluation included the antero-posterior and lateral inter-physeal angle (AP-IPA and L-IPA), the limb length discrepancy (LLD), the morphology of the distal tibia and the lateral distal tibial angle (LDTA)...
July 3, 2020: BMC Musculoskeletal Disorders
Xavier Cubiró, Eduardo Rozas-Muñoz, Pau Castel, Esther Roé Crespo, Cristina Garcia-Melendo, Lluis Puig, Eulalia Baselga
BACKGROUND: Diffuse capillary malformation with overgrowth (DCMO) has been well described. However, capillary malformation with undergrowth (CMU) has been less reported in the literature. OBJECTIVES: We sought to describe the clinical features and determine associated somatic mutations in patients with CMU. METHODS: We searched our multidisciplinary vascular anomalies clinic database for patients with CMU. Girth and length limb measurements were performed...
July 1, 2020: Pediatric Dermatology
Jin Li, Xikai Guo, Hai Qiang Wang, Changjie Yue, Kailei Chen, Jiewen Ma, Jing Wang, Xin Tang
BACKGROUND: Displaced supracondylar femoral fractures (SFF) are difficult injuries to treat in children. Several techniques have been widely used but few studies have compared the merits and drawbacks of each surgical intervention in order to analyze clinical values. The aim of this study was to (1) evaluate postoperative and functional conditions after treatments with locking plate (LP) or external fixation (EF), (2) observe adverse events associated with these two techniques, and (3) evaluate the clinical value of these two techniques...
June 23, 2020: Journal of Orthopaedic Surgery and Research
Antti Stenroos, Jani Puhakka, Jenni Jalkanen, Topi Laaksonen, Reetta Kivisaari, Jussi Kosola, Yrjänä Nietosvaara
The reported incidence of premature physeal closure (PPC) in fractures of the distal tibia has varied between 5 and 36%, but there is no consensus on the cause. We wanted to determine incidence and predictors of PPC in distal tibia physeal fractures in a population-based patient cohort. Two hundred forty-one patients (195 Peterson type I-V fractures and 46 transitional fractures) treated for a physeal fracture of the distal tibia during a 5-year period in two tertiary-level teaching hospitals. Odds ratios (OR) for developing PPC for different parameters (Peterson fracture type, associated fibula fracture, primary and postreduction displacement, number of reductions and the method of treatment) were calculated by binary logistic regression analysis...
June 15, 2020: Journal of Pediatric Orthopedics. Part B
Adrien Frommer, Maike Niemann, Georg Gosheger, Gregor Toporowski, Andrea Laufer, Maria Eveslage, Jan Niklas Bröking, Robert Rödl, Bjoern Vogt
Background and purpose - To date there is a lack of studies defining the anatomical position of the proximal fibula. This is especially relevant when planning surgical interventions affecting the knee joint such as permanent or temporary epiphysiodesis to correct leg length discrepancies or angular deformities in growing patients. The goal of this study is to establish a standardized measurement technique and radiological reference values for the position of the proximal fibula in children.Patients and methods - 500 measurements were performed in calibrated long standing anteroposterior radiographs of 256 skeletally immature patients (8-16 years; 233 female, 267 male legs)...
May 26, 2020: Acta Orthopaedica
Kazuyoshi Kobayashi, Kei Ando, Hiroaki Nakashima, Masaaki Machino, Masayoshi Morozumi, Shunsuke Kanbara, Sadayuki Ito, Taro Inoue, Hidetoshi Yamaguchi, Kenichi Mishima, Naoki Ishiguro, Shiro Imagama
Study Design: Single-center retrospective study in pediatric patients. Purpose: The purpose of the study was to investigate the effects of the presence and severity of leg-length discrepancy (LLD) on scoliosis in children. Overview of Literature: LLD is a common orthopedic problem that can result in standing imbalance, low back pain, and stress fractures. It may cause structural changes in the spine over time, but the exact effect of LLD on scoliosis is unknown...
May 21, 2020: Asian Spine Journal
Joseph B Kahan, Don T Li, Christopher A Schneble, Rachel Esparza, Jonathan Cui, Daniel R Cooperman
BACKGROUND: The creation of accurate markers for skeletal maturity has been of significant interest to orthopaedic surgeons. They guide the management of diverse disorders such as adolescent idiopathic scoliosis, leg length discrepancy, cruciate ligament injuries, and slipped capital femoral epiphysis. Multiple systems have been described to predict growth using radiographic skeletal markers; however, no such system has yet been developed for the proximal tibia. The purpose of this study was to establish quantitative radiographic parameters within the proximal tibia that can be used to assess degree of skeletal maturity...
May 12, 2020: Journal of Pediatric Orthopedics
Qiang Zheng, Sphoorti Shellikeri, Hao Huang, Misun Hwang, Raymond W Sze
Background Radiographic measurement of leg length discrepancy (LLD) is time consuming yet cognitively simple for pediatric radiologists. Purpose To compare deep learning (DL) measurements of LLD in pediatric patients to measurements performed by radiologists. Materials and Methods For this HIPAA-compliant retrospective study, radiographs obtained to evaluate LLD in children between January and August 2018 were identified. LLD was automatically measured by means of image segmentation followed by leg length calculation...
April 21, 2020: Radiology
Mary C Kamienski
Trauma is the leading cause of death and disability in children. Orthopaedic trauma has led to more than 84,000 hospital admissions annually and costs nearly a billion dollars. Femoral diaphyseal fractures account for nearly 2% of all bony injuries in children and are the most common orthopaedic injury requiring hospitalization. These injuries occur at an annual rate of 19 per 100,000, with an associated cost of millions of dollars. Emergency department (ED) visits for musculoskeletal injuries account for 10%-15% of the 100 million annual visits to U...
March 2020: Orthopaedic Nursing
Koushik Ghosh, Lucy J Salmon, Emma Heath, Leo A Pinczewski, Justin P Roe
PURPOSE: To determine outcomes of transphyseal ACL reconstruction using a living parental hamstring tendon allograft in a consecutive series of 100 children. METHODS: One hundred consecutive juveniles undergoing ACL reconstruction with a living parental hamstring allograft were recruited prospectively and reviewed 2 years after ACL reconstruction with IKDC Knee Ligament Evaluation, and KT1000 instrumented laxity testing. Skeletally immature participants obtained annual radiographs until skeletal maturity, and long leg alignment radiographs at 2 years...
January 30, 2020: Knee Surgery, Sports Traumatology, Arthroscopy
Panagiotis V Samelis, Eftychios Papagrigorakis, Theodore Troupis, Panagiotis Koulouvaris
Limb length discrepancy (LLD) is a frequent complication after elastic stable intramedullary nailing (ESIN) of femoral shaft fractures in children. It is the result of either shortening or lengthening of the affected limb. A shorter limb is usually observed when there is no strict adherence to the main indication of the technique, which is a transverse or short oblique fracture of the diaphysis. A longer limb may be the result of either improper reduction and significant dissociation of fracture fragments, or stimulation of growth of the fractured bone of the child, known as overgrowth...
December 11, 2019: Curēus
Emmanouil G Maragkoudakis, Ioannis Gelalis, Theodoros Grivas, Geofrey R Burwell, Christina Mazioti, Gerasimos Tsilimidos
Background The purpose of this study is to evaluate the effects of the forward bending (FB) test versus the standing erect (SE) position on back trunk asymmetry (TA). The Scoliometer in the FB position and the 4D Formetric (4DF; Diers International, Schlangenbad, Germany) readings in the SE position were assessed. Method The angle of trunk inclination (ATI) was measured at the midthoracic, thoracolumbar, and lumbar levels using the Scoliometer in the FB position and the 4DF in the SE position. A total of 134 subjects attending the scoliosis clinic (86 girls and 48 boys), age ranging from seven to 18 years, were assessed...
December 10, 2019: Curēus
Anil Agarwal, Rahul Yogendra Raj, Mukesh Shanker
We aimed to study clinical and radiological outcomes following a 'single-stage protocol' in postosteomyelitic-infected nonunion of the femur in children. The report is based on a retrospective chart review (2010-2018) of 10 children below 12 years of age presenting with nonunion following a pathological fracture after osteomyelitis of hematogenous origin treated with above-mentioned operative modality. All patients were grade A (normal host) on the basis of the physiological classification. Patients with posttraumatic or surgical osteomyelitis were excluded...
December 9, 2019: Journal of Pediatric Orthopedics. Part B
Teresa Nu Phuong Trinh Bui, Ayse Corap, Anette Bygum
BACKGROUND: Cutis marmorata telangiectatica congenita (CMTC) is a rare capillary malformation characterised by persistent reticulated marbled erythema. It tends to be associated with cutaneous atrophy, ulcerations and body asymmetry. CMTC is usually reported to be a benign condition; however, associated anomalies are not rare. Here, we have compiled information on published CMTC patients with the aim to evaluate the proposed diagnostic criteria by Kienast et al. and address the clinical manifestations, associated anomalies, differential diagnoses, management and prognosis...
December 4, 2019: Orphanet Journal of Rare Diseases
Moon-Jib Yoo, Jun-Il Yoo, Joon-Yeul Lee, Young-Jin Park, Kang-Heo
PURPOSE: To evaluate the results of trampoline fracture of the proximal tibia treated with either external fixator or conservative management at a minimum 1-year follow-up. METHODS: A retrospective review was performed on 22 children who between January 2005 and November 2013 presented with proximal metaphyseal fracture due to trampoline injury. Proximal metaphyseal fractures in 22 pediatric patients were clinically and radiologically evaluated. Of 22 subjects, 9 were male, 13 were female, and mean age was 4...
November 16, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Kyeong-Hyeon Park, Byoung Kyu Park, Chang-Wug Oh, Dae-Wook Kim, Hoon Park, Kun-Bo Park
OBJECTIVES: To evaluate overgrowth after internal fixation for pediatric femur fracture and to identify any factors related with overgrowth in terms of fracture type and fixation method. DESIGN: Retrospective comparative study. SETTING: Multicenter, children's hospital and general hospital. PATIENTS/PARTICIPANTS: Eighty-seven children between 4 and 10 years of age were included. Length-stable fracture was noted in 49 children, and length-unstable fracture was found in 38 children...
March 2020: Journal of Orthopaedic Trauma
Mahmoud Abdel-Monem El-Rosasy
Congenital pseudarthrosis of the tibia is defined as a non-union of a tibial fracture that develops in a dysplastic bone segment of the tibial diaphysis. Pathologically, a fibrous hamartoma surrounds the bone at the congenital pseudarthrosis of the tibia site. The cases of 25 children, who have congenital pseudarthrosis of the tibia, were included in this study. Their ages ranged from 15 months to 15 years at the time of treatment. Neurofibromatosis-1 was present in 24 children. They were managed according to our classification system and treatment protocol...
September 9, 2019: Journal of Pediatric Orthopedics. Part B
Tao Ji, Yi Yang, Da-Sen Li, Xiao-Dong Tang, Wei Guo
OBJECTIVE: Limb salvage in pediatric patients remains a challenge. We describe a staged strategy. The procedure includes: (i) tumor removal and non-hinged static endoprosthesis reconstruction; (ii) leg length discrepancy (LLD) correction by shoe lift or distraction osteogenesis; and (iii) maturity reconstruction by regular endoprosthesis. The aim of the study was to investigate the results of non-hinged static megaprosthesis reconstruction and staged LLD correction in the treatment of malignant tumors in the distal femur in children...
September 5, 2019: Orthopaedic Surgery
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