K Burger, S Farr, J Hahne, C Radler, R Ganger
Purpose: The aim of the study was to evaluate the accuracy and radiographic outcomes of Canale's method in patients with idiopathic leg-length discrepancy (LLD) following percutaneous epiphysiodesis. The accuracy of two common growth prediction methods was assessed. Methods: A total of 18 patients with 26 affected bones (eight distal femur, two proximal tibia, five combined) were clinically and radiologically analyzed after reaching skeletal maturity. We compared the final effect of epiphysiodesis at maturity with the expected effect of epiphysiodesis before surgery; these measures were calculated using the Green-Anderson and multiplier methods, respectively...
August 1, 2019: Journal of Children's Orthopaedics
Kenta Momii, Satoshi Hamai, Goro Motomura, Kensuke Kubota, Masato Kiyohara, Takuaki Yamamoto, Yasuharu Nakashima
INTRODUCTION: Avascular necrosis of the femoral capital epiphysis is the most serious complication after traumatic dislocation of the hip in children. This case report discusses the localization and revascularization of the necrotic femoral head following rarely experienced traumatic open anterior hip dislocation in children. CASE PRESENTATION: Our patient was an 11-year-old Japanese boy who had open anterior hip dislocation sustained in a traffic accident. Reduction of the hip joint was performed in an emergency operation, and he was evaluated using serial gadolinium-enhanced magnetic resonance imaging...
August 16, 2019: Journal of Medical Case Reports
D Adam, A Hamel, P Perrot, F Duteille
OBJECTIVE: Bony resection in children presents a unique reconstructive challenge because of future growth potential. To achieve limb salvage and provide the patient with a functional extremity, vascularized free fibula transfer has become the workhorse for bony reconstruction. The authors present their reconstructive experience using vascularized fibula flaps in a group of pediatric patients. PATIENTS AND METHOD: This is a monocentric, retrospective study of 25 pediatric patients who underwent reconstruction of bony defects with a vascularized fibula flap from 2004 to 2017...
July 26, 2019: Annales de Chirurgie Plastique et Esthétique
Olga D Savvidou, Angelos Kaspiris, Leonidas Dimopoulos, George Georgopoulos, Stavros D Goumenos, Vasilios Papadakis, Panayiotis J Papagelopoulos
Treatment of bone sarcomas in children is associated with wide tumor re-section and segmental reconstruction. The optimal surgical approach is still under debate in the literature. During the past decade, the application of expandable prostheses has gained remarkable attention because it improves patients' appearance and allows limb growth preventing leg length discrepancy. A systematic review of the literature was performed to identify studies focusing on the functional and surgical outcomes of the application of expandable endoprostheses...
July 1, 2019: Orthopedics
John G Birch, Marina A Makarov, Taylor J Jackson, Chan-Hee Jo
BACKGROUND: Epiphysiodesis of the distal femoral and/or proximal tibial physes is commonly performed in children and adolescents to treat lower-limb length discrepancy. It is important to determine the amount of growth remaining in the physes of these patients. Two main methods are used to make this determination: the White-Menelaus arithmetic method, which assumes a consistent amount of growth per year until skeletal maturity, and the Anderson-Green growth-remaining charts, which diagram average growth per year ± 2 standard deviations...
June 5, 2019: Journal of Bone and Joint Surgery. American Volume
Silvia Caino, Rosario Ramos Mejia, Rodolfo Goyeneche, Darío Filippo, Victoria Allende, Claudia Casalis, Laura Collado, Martín D'Elía, Guillermo Fernández, Mónica Galeano, Juan C Hernández, Leopoldo Lonegro, Juliana Lostra, Javier Masquijo, Horacio Miscione, Alberto Navarro Fretes, Dalia Sepúlveda Arriagada, Eduardo Stéfano, Graciela Infesta, Virginia Fano
INTRODUCTION: Leg length discrepancy is when the length of one leg is different from the other, and is a common reason for consultation at the pediatrician's and pediatric orthopedist's office. The objective of this study was to develop recommendations for the follow-up, pre-surgical planning, and treatment of children with leg length discrepancy based on expert consensus. MATERIAL AND METHODS: The Delphi method was used. A coordinating group selected a panel of experts, designed and analyzed each of the rounds of consultations...
April 1, 2019: Archivos Argentinos de Pediatría
Tyler J Uppstrom, Meghan Price, Sheena Black, Elizabeth Gausden, Jonathan Haskel, Daniel W Green
PURPOSE: The purpose of this study was to assess the physeal safety associated with the use of an epiphyseal femoral socket for paediatric medial patellofemoral ligament (MPFL) reconstruction. METHODS: Fifty-four knees in 49 skeletally immature patients underwent physeal-sparing MPFL reconstruction performed by 1 surgeon at a tertiary care academic medical centre from 2007 to 2016. A femoral socket distal to the femoral physis was used for graft fixation in all the patients...
November 2019: Knee Surgery, Sports Traumatology, Arthroscopy
W-C Lee, H-K Kao, W-E Yang, C-H Chang
Purpose: Little data is available on the efficiency of different implants for epiphysiodesis. The purpose of this study is to compare the efficacy between plates and staples in decreasing leg-length discrepancy. Methods: A retrospective review of 19 children who underwent temporary epiphysiodesis of the legs was conducted, with a minimum of two years of follow-up. The bone length and length ratio to the short side were measured at six months, one year and two years postoperatively...
December 1, 2018: Journal of Children's Orthopaedics
Ching-Ying Huang, Nan-Chang Chiu, Hsin Chi, Fu-Yuan Huang, Pin-Hsuan Chang
OBJECTIVE: To evaluate the clinical manifestations, management, and outcomes of Mycobacterium bovis Bacillus Calmette-Guérin (BCG) osteitis/osteomyelitis. STUDY DESIGN: We reviewed 71 cases of BCG osteitis/osteomyelitis registered in Taiwan's vaccine injury compensation program (VICP) in 1998-2014. Demographic, clinical, laboratory, treatment, and outcome data were compared according to site(s) of infection. RESULTS: Involvement of a long bone of the lower extremity was present in 36...
April 2019: Journal of Pediatrics
Domenico Fenga, Michele A Rosa
Management of bone tumors of the limbs is still a field to be explored. The problems to be faced are diff erent, especially when the lower limbs are the point of interest, due to the diff erent leg length residual. A possible solution, provided by new technologies, is the use of electromagnetic expandable prosthesis. This device is successfully used in the management of paediatric malignant bone tumors. The strength of this prosthesis is the possibility to assist the musculoskeletal growth in children. To our acknowledge review of literature points out only few cases in which this mechanism is used in adult population...
September 1, 2018: Folia Medica
Haridimos Tsibidakis, Artemisia Panou, Antonios Angoules, Vassilios I Sakellariou, Nicola Marcello Portinaro, Julian Krumov, Anastasios D Kanellopoulos
BACKGROUND: Alteration of the posteromedial part of the proximal tibia is the main characteristic of Blount's disease and if left untreated, leg alignment and normal development of the lower limbs may be compromised. AIM: To report treatment outcomes in children with Blount's disease using the Taylor Spatial Frame (TSF). MATERIALS AND METHODS: From January 2007 to December 2014, 16 young children (24 tibia) with a mean age of 7.5 years (range of 3-14 yrs) and severe Blount's disease were treated using TSF...
June 1, 2018: Folia Medica
M Troy, B Shore, P Miller, S Mahan, D Hedequist, B Heyworth, J Kasser, S Spencer, M Glotzbecker
Purpose: To compare two common surgical techniques of epiphysiodesis: drill/curettage epiphysiodesis (PDED) versus cross screw epiphysiodesis (PETS). The hypothesis is that the two techniques have similar efficacy but demonstrate differences in length of hospital stay (LOS), time to return to activity and complication rates. Methods: A retrospective review of growing children and adolescents less than 18 years old who required an epiphysiodesis with leg-length discrepancy (LLD) of 2 cm to 6 cm with minimum two years of follow-up was conducted...
October 1, 2018: Journal of Children's Orthopaedics
Siyi Liu, Shengxiang Tao, Jinhai Tan, Xiang Hu, Huiyi Liu, Zonghuan Li
The use of fibular graft for the reconstruction of bone defects has been demonstrated to be a reliable method. The aim of this study was to assess the clinical outcome of graft union, functional outcome (hypertrophy of the graft bones) and complications of both non-vascularized and vascularized grafts.From 1981 to 2015, 10 patients were treated using non-vascularized fibular graft or free vascularized fibular graft. The outcomes were bony union time, graft hypertrophy and complications based on radiograph and functional outcomes according to the Musculoskeletal Tumor Society (MSTS) score...
October 2018: Medicine (Baltimore)
Masafumi Kashii, Sadaaki Kanayama, Taichi Kitaoka, Takahiro Makino, Takashi Kaito, Motoki Iwasaki, Takuo Kubota, Takehisa Yamamoto, Keiichi Ozono, Hideki Yoshikawa
The purpose of this study was to clarify the prevalence of scoliosis and determine risk factors for the development of scoliosis in young children with osteogenesis imperfecta (OI) who underwent intravenous pamidronate (PAM) therapy. Thirty-four young children with OI who had no scoliosis at the first PAM administration underwent cyclic PAM therapy alone. The medical records and radiographs of these patients were retrospectively reviewed. We examined the relationship between scoliosis (Cobb angle ≥ 10) and type of OI (Sillence classification: types I, III, and IV), physical mobility, Z-scores of bone mineral density in L2-4 of the lumbar spine (L2-4 BMD Z-scores), age of patients at first treatment with PAM, pelvic frontal tilt and leg-length discrepancy...
September 5, 2018: Journal of Bone and Mineral Metabolism
Jacob Archer, Andrew Jea
Tethered cord syndrome is a constellation of signs and symptoms involving sensory and motor dysfunction of the lower extremities, bladder, and bowel. The pathophysiology may be from a mechanical stretch of the distal spinal cord causing deleterious changes in blood supply and metabolism. The standard of care for tethered cord syndrome has been tethered cord release. However, drawbacks of traditional tethered cord release include neurological injury, cerebrospinal fluid leak, and intradural scarring and retethering of the spinal cord (secondary tethering)...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Akihiko Takeuchi, Norio Yamamoto, Katsuhiro Hayashi, Hidenori Matsubara, Hiroaki Kimura, Shinji Miwa, Takashi Higuchi, Kensaku Abe, Yuta Taniguchi, Hiroyuki Tsuchiya
BACKGROUND: Epiphyseal-preservation surgery for osteosarcoma is an alternative method which has been indicated carefully to selected patients. The tumor-devitalised autograft treated with liquid nitrogen procedure is one of the biological reconstruction method to reconstruct the defect after tumor excision. The limb length discrepancy is usually appeared in children with their growth after limb-sparing surgery. This study was aimed to investigated the growth of residual epiphysis following epiphyseal-preservation surgery for childhood osteosarcoma around the knee joint...
June 6, 2018: BMC Musculoskeletal Disorders
Rattanachai Rermruay, Supattra Rungmaitree, Sunsanee Chatpornvorarux, Chantapat Brukesawan, Orasri Wittawatmongkol, Keswadee Lapphra, Wanatpreeya Phongsamart, Nantaka Kongstan, Benjawan Khumcha, Kulkanya Chokephaibulkit
BACKGROUND: Bacille Calmette-Guérin (BCG) vaccination at birth may cause mild and benign local adverse effects (AE). More serious AE are rarely reported. OBJECTIVE: To describe clinical features and outcomes of BCG (Tokyo-172 strain)-induce diseases (BCG-ID) that required medical attention at a tertiary care center in Bangkok, Thailand. METHOD: We retrospectively reviewed medical records from January 2007 to December 2016 that were selected by ICD-10 codes...
June 27, 2018: Vaccine
M J Anderton, G R Hastie, R W Paton
Aims: The aim of this study was to identify the association between asymmetrical skin creases of the thigh, buttock or inguinal region and pathological developmental dysplasia of the hip (DDH). Patients and Methods: Between 1 January 1996 and 31 December 2016, all patients referred to our unit from primary or secondary care with risk factors for DDH were assessed in a "one stop" clinic. All had clinical and sonographic assessment by the senior author (RWP) with the results being recorded prospectively...
May 1, 2018: Bone & Joint Journal
M M Gilg, C L Gaston, L Jeys, A Abudu, R M Tillman, J D Stevenson, R J Grimer, M C Parry
Aims: The use of a noninvasive growing endoprosthesis in the management of primary bone tumours in children is well established. However, the efficacy of such a prosthesis in those requiring a revision procedure has yet to be established. The aim of this series was to present our results using extendable prostheses for the revision of previous endoprostheses. Patients and Methods: All patients who had a noninvasive growing endoprosthesis inserted at the time of a revision procedure were identified from our database...
March 1, 2018: Bone & Joint Journal
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
August 2018: Strategies in Trauma and Limb Reconstruction
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