ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The anatomical foundations of infant hip sonography techniques are ill-defined. We investigated anatomical specimens of infant hip joints in a water bath, with Graf's and Terjesen's methods. Acetabular position was varied in defined increments, with respect to the ultrasound beam. The alpha angles and the femoral head coverage were measured. Plastic acetabular casts were sawn along the sonographic section planes, and the cut sections compared with the sonographic sections. For images to be obtained, which were analysable by the two methods, the ultrasound beam had to intersect with the acetabular inlet plane at defined angles. The acetabular notch had to be anteriorly rotated from the ultrasound beam plane by at least 20°. Beam entry within a 50° sector posterior to the perpendicular on the inlet plane gave analysable images. The alpha angles and femoral head coverage were much affected by coronal-plane transducer tilt. Caudad tilts were associated with lesser values, a fact that should be borne in mind in clinical ultrasound investigations.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This study evaluates the most widely used sonographic measurements for judging an infant's hip morphology. The&agr;and&bgr;angles of Graf, the bony coverage percentage of Morin and a new combined angle were analysed. This latter angle records the direction of the whole acetabulum (cartilagenous and bony) as one unit. One-hundred sonograms were examined independently by two observers to calculate the interobserver and intraobserver limits of agreement. The new combined angle proved to be the most reproducible measurement. Graf's&agr;angle was the second most reliable measurement followed by the bone coverage percentage. The relationship between the combined angle and&agr;angle was statistically significant with a correlation coefficient of 0.70 (P<0.001).

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The relationship between ultrasonographic findings at birth and risk factors for developmental dysplasia of the hip have not been prospectively evaluated. Since implementing a routine screening programme for all new-born babies in 1989 we have collected 48 000 sets of data, including family history, birth presentation, mode of delivery and birth weight. Of the 92 babies (three per 1000 live births) with persistent ultrasonographic abnormality at 6 weeks only 20% displayed evidence of clinical instability at the original examination. Female babies without the additional risks of breech birth or positive family history were quantitatively the most significant group, accounting for 75% of cases treated. The majority of babies requiring intervention would not have been identified utilizing present criteria for selective ultrasound screening.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Although hip fractures make up less than 1% of all children's fractures, they commonly produce late complications such as avascular necrosis, non-union, coxa vara, and premature physeal closure. A retrospective review of 17 patients with a mean age of 11 years (range, 7–14) and with a mean follow-up of 6 years (range, 2.5–12) who underwent open reduction and internal fixation for hip fractures was performed. There were 10 transcervical and five cervicotrochanteric fractures, one transepiphyseal fracture, and one intertrochanteric fracture. A total of 25 operations were performed. Overall, the complication rate was 59%, with some patients having more than one complication. Seven patients healed without any complications or sequelae. In the remaining 10 patients, the complications were avascular necrosis (nine patients), coxa vara (eight patients), premature physeal closure (seven patients), non-union (four patients), and chondrolysis (one patient). Avascular necrosis, non-union, and chondrolysis were associated with a poor outcome. At final follow-up, the results were assessed using Ratliff's criteria and included seven patients with good, six with fair, and four with poor outcome.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Varus femoral osteotomy is a commonly employed surgical method of effecting containment in the management of Perthes' disease. This can be achieved by performing either an opening lateral wedge or a closing medial wedge osteotomy. The effects of these two techniques on the biomechanical interrelationships about the involved hip were compared using a three-dimensional computer simulation. Both procedures lead to femoral shortening and reduce the moment capacity of the hip abductors. The shortening effect and consequent leg length discrepancy are greater for the closing wedge osteotomy than for the opening wedge procedure. Pelvic obliquity compensation, likely to be greater for a closing wedge osteotomy, provides a beneficial increase in femoral head coverage but at the cost of a further reduction in the hip abductor moment capacity.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The aim of this study was to assess the intra- and interobserver reliability and reproducibility of goniometry and visual estimation of ankle joint range of motion measurements in children with spastic cerebral palsy. Forty-six ankles of 24 spastic cerebral palsy children were measured under a strict protocol. The global mean measurement error was 5°(SD, 5°) for intra- and interobserver measurements and 3° (SD, 3°) for goniometry versus visual estimation. Statistical analysis showed a high reliability for intra- and interobserver measurements (r>0.75), between visual estimation and goniometry (correlation coefficient, r>0.967; concordance coefficient, r>0.957). Both visual estimation and goniometry ankle range-of-motion measurements are reliable and reproducible in spastic cerebral palsy children if a strict but simple protocol is applied.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Although osteoid osteoma is a relatively common lesion, it is rarely found at the elbow. We report three cases of osteoid osteoma of the olecranon fossa in patients under the age of 15 years. Diagnosis was delayed because of nonspecific clinical and radiological features. The three patients suffered from synovitis due to flexion contracture while at the same time prosupination remained normal. Only one patient complained of specific nocturnal pain. All cases had a latency between the onset of symptoms and the appearance of radiological signs. Open surgical excision of the nidus resulted in relief of pain in all cases and motion recovery in two cases. Diagnostic difficulties and treatment options are discussed.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

We report a case of humeral lengthening in an adolescent, 6.5 years after interscapulothoracic resection for an osteosarcoma of the scapula. The lengthening external fixator was augmented by ipsilateral rib fixation in order to prevent cephalad migration of the proximal fragment. At a 3-year follow-up, the patient was satisfied, with an improved cosmesis and function of his limb.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Ten girls and 13 boys with mean age 11 years when sustaining a fracture of the olecranon were examined at a mean of 19 years after the injury. Ten fractures were displaced less than 2 mm, three 2–3 mm, eight more than 3 mm and two were multifragmental. The treatment consisted of mobilization in three cases, plaster treatment in nine and open reduction and internal fixation in 11 cases. At follow-up, 21 children had no subjective complaints while two had occasional mild pain. The upper arm circumference was thinner in the former injured extremities than in the uninjured (P<0.05). No other objective deficits were found. None had developed non-union or elbow osteoarthritis. Olecranon fractures during growth have an excellent long-term outcome.

ISSN:0271-6798    

出版商:OVID    

年代:2002

数据来源: OVID