摘要:

Assessment of walking ability of patients with spastic cerebral palsy has long been a problem. In an attempt to obtain more precise and objective findings, we used the Polgon goniometry method. The study involved testing the gait of 36 spastic patients. We compared clinical findings and Polgon diagrams of healthy children and spastic patients pre- and postoperatively. The results were classified as very good to good, satisfactory, and poor. The advantages of Polgon are that it is painless, does not irritate the patient, and is a simple, objective method. Its disadvantages arise from a relatively large amount of artifacts and inadequacy when it is used on spastic patients.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Equalization of lower limb length was achieved by epiphysiodesis in 20 children. During the period under review the Phemister procedure was replaced by percutaneous epiphysiodesis, and orthoroentgeno-gram was superseded by computed tomography (CT) scanning. In five children with anisomelia, whose expected discrepancy was 4.5 cm, the results at maturity showed an average discrepancy of 0.7 cm. In 10 girls with limb-length discrepancy (LLD) caused by ischemic necrosis with congenital dislocation of the hip, the average LLD at maturity was 0.6, whereas the expected LLD was 4 cm. In five children with LLD caused by infection, the average discrepancy was 3.8 cm at the time of epiphysiodesis, whereas at maturity it was 0.5 cm. A good result was achieved in 90% of the patients. We recommend the Moseley straight-line graph, CT scanography, and percutaneous epiphysiodesis.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

In a series of 32 patients, the tibia was lengthened nine times and the femur 26 times. The lengthening was 4.1 cm in the tibia and 4.9 cm in the femur. The callotasis principle and atraumatic handling of the periosteum were considered important. The leg inequality was corrected appropriately, except in cases where the leglength inequality was > 12 cm as a result of a progressive congenital deformity. Late femoral fractures occurred in six patients, but no tibial fractures were seen. One hip dislocation was seen after femoral lengthening, one talus deformation developed after the tibial lengthening, and one peroneal nerve entrapment was released operatively. One infection caused delayed bone union. Average follow-up time was 5.0 years.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A progressive bone lengthening procedure according to the Wagner and Ilizarov technique and our own protocol was performed on 24 children (32 bones). Wagner's (transverse midshaft osteotomy, intraoperative lengthening of 1 cm and postoperative distraction of 1 mm/day) led to a marked reduction in osteogenic capacities. Patients operated on according to the Ilizarov technique had osteogenic reactions in the medullary cavity and on the posterior aspect of bone segments. Our own method, which included bone decortication, 5–7 days of neutral fixation without distraction, led to massive bone production in the medullary canal and around the bone segments. Rigid osseous bridging was present as early as 3 months after surgery. Neither the type of external fix-ator nor the location or shape of osteotomy had any specific influence on this massive bone reaction. Osteogenesis in limb lengthening is thus closely related to surgical management.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Thirteen patients with myelomeningocele who required operation for scoliosis were tested for changes in pulmonary function I month before and an average of 13 months after spinal stabilization. The average age at the time of operation was 12 years 11 months. Ten patients had restrictive changes in pulmonary function preoperatively. Owing to the severity of scoliosis, an anterior approach to the spine including resection of ribs and division of the diaphragm was necessary for eight children. Postoperatively, despite these procedures, eight patients had an increase in vital capacity and six patients had an increased forced expiratory volume in 1 s.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The use of autograft versus allograft bone in scoliosis surgery is critically evaluated by a multivariate statistical analysis. Two groups of patients matched for age, angle of curve, and length of fusion, forming a consecutive series of posterior arthrodesis for idiopathic scoliosis, were evaluated. Group A consisted of 83 patients receiving autografts, and group B consisted of 99 patients receiving allografts. There was a significant reduction in operation time in the allograft group, and blood loss also decreased. After 1 year there was no significant difference in correction of the curve. Given the problems of discomfort at the donor site scar, we recommend the use of allograft bone in scoliosis surgery.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Sixty-two patients with histiocytosis X were followed for an average of 5 years. The patients were classified into three groups: general visceral types (14 cases), multiple eosinophilic granulomas (nine cases), and solitary eosinophilic granulomas (39 cases). One hundred bony lesions were noted in 60 of the 62 patients. The bone lesions showed progressive improvement in single and multiple eosinophilic granulomas independent of treatment type. After biopsy, patients received no treatment unless there was a dangerous extension into the soft tissues because of its site. i.e., in the skull. In the general visceral types, chemotherapy was effective in visceral sites and in extensions of the tumor outside the bone but did not alter the natural history of the bony lesion.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A critical review of the surgical treatment of 65 patients with infantile fibrous dysplasia demonstrated that “circumscribed” types of the disease generally do not require surgical treatment, while “extended” types, as well as Albright's syndrome, require early surgical treatment aimed at preventing development of skeletal deformities which are difficult to correct later. Prophylactic intramedullary nailing with nails of suitable caliber is most effective.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Hemangiomas of the bone are rare lesions, accounting for ∼ 1% of all primary bone tumors. Hemangiomas occur fairly frequently in the vertebral bodies and the skull, but are unusual in other bones. We report two cases of unusual and fairly rare aspects of this vascular tumor in children. Both cases involved recurrences. which led to a wide bone resection in case 1 and to several curettages in case 2. In these two cases the histological type of hemangioma was capillary. In reviewing the literature we found no indication of wide resection of the benign forms in children.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A new orthosis designed to deal with unilateral or bilateral idiopathic clubfoot after successful conservative or surgical treatment was used to maintain the correction and to prevent recurrence. Once the neutral position of the heel was achieved, the orthosis was found to be very useful in improving the correction of the hind-foot and/or the forefoot. The first 50 patients treated with the orthosis showed a 92% compliance rate for an average period of 9–12 months.

ISSN:1040-8800    

出版商:OVID    

年代:1991

数据来源: OVID