摘要:

Which way are the bones rotated in a club-foot? This question has long been debated by clubfoot surgeons. Opinions have been based on observations from surgery, radiographs, and autopsies. These methods all have pitfalls and are subject to misinterpretation. We used three-dimensional computer modeling to analyze histologic sections of a newborn clubfoot and a newborn normal foot. Relative to the bimalleolar axis in the axial plane, the normal talus demonstrated 5° of internal rotation of its body and 25° internal rotation of its neck. The clubfoot talus showed 14° of external rotation of its body and 45° of internal rotation of its neck. The calcaneus was externally rotated 5° in the normal foot and internally rotated 22° in the clubfoot.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The continuing development of gait in 60 children aged 7–16 years was studied with plantar surface-attached transducers to describe the time pressure profiles of foot segments during stance. Decreased pronation/supination of the subtalar and midtarsal joints was shown by simultaneous onset and simultaneous peak on medial and lateral heel sensors. The resultant midstance showed a rapid lateral-to-medial loading of the forefoot. The foot-flat position with decreased rotation about the longitudinal axis of the foot persists even after the temporal parameters of gait attain mature values.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We measured the physeal angle (slope) of the proximal femoral physis on the standard anteroposterior (AP) radiographs. Controls consisted of 307 hips in children aged 1–18 years. Similar measurements were made on the affected (slip) and unaffected (nonslip) sides of 107 children with manifest unilateral slipped capital femoral epiphysis. An age-related increase of 14° occurs in the slope of the proximal femoral physis between ages 1 and 18 years, with maximal increase between ages 9 and 12 years. Increasing obliquity of the proximal femoral physis may be yet another factor contributing to slipped capital femoral epiphysis.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Twelve cerebrospastic patients underwent 13 Chiari osteotomies for the treatment of subluxed or dislocated hips. Twelve of these 13 hips were reexamined 24–80 months later. Ten patients had painless located hips. The two failures had pelvic obliquity that resulted in redislocation.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This study presents our results with a single graft modification of slotted acetabular augmentation in severely neuromuscularly compromised children from 1983 to 1986. Included in the study were 26 hips of 24 patients (13 males and 11 females) with an average age of 8 years 3 months at the time of surgery. Most of the patients had spastic cerebral palsy. The average follow-up was 29 months. We believe that our current results show that slotted acetabular augmentation in patients with neuromuscular conditions is a relatively simple and safe procedure with a high probability for a successful outcome.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The Louisville Behavioral Checklist was administered to 23 white boys between the ages of 7 and 12 years who completed treatment for Perthes disease by bracing or surgery at the Florida Elks Children's Hospital. The groups were comparable, with 11 children in the surgery group and 12 in the bracing group. Results indicated statistically significant differences (p = 0.05) between the groups in three areas. Patients in the bracing group were more likely to demonstrate deficits in social, academic, and sexual behavior as compared with patients in the surgery group.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The operative findings and results in our first 40 consecutive open reductions of the congenitally dislocated hip by the medial approach are presented. These were all performed by one surgeon before walking age and, with one exception, all patients were aged <11 months at operation. Follow-up was from 2 to 7 years (mean 4.6 years). Avascular necrosis did not occur, but coxa magna and significant acetabular dysplasia were each present in one case. We have not performed any secondary operations.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The clinical records and radiographic files of 79 patients who underwent bilateral distal femoral derotation osteotomies for severe persistent medial femoral torsion at the Alfred I. duPont Institute from 1967 to 1983 were reviewed. We excluded patients with neuromuscular disorders and those with <2 years of postoperative follow-up, including satisfactory radiographs at our institution. Fourteen patients were included in the study. Following the osteotomy, two of these patients developed progressive valgus deformity that was the result of medial femoral overgrowth. Both patients required a second surgical procedure to correct this deformity. To our knowledge, this progressive angular deformity has not been reported previously.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Four cases of complex dislocation of the index metacarpophalangeal joint prior to skeletal maturity were reviewed. Despite the generalized laxity present in these children, none of the dislocations could be anatomically reduced by closed methods. Two patients had a concomitant osteochondral fracture from the ulnar side of the metacarpal epiphysis; one subsequently developed a lesion similar to an epiphyseal osteochondroma. One patient developed ischemic necrosis leading to premature growth arrest, a shortened metacarpal, and a deformed metacarpal head. The possibility of vascular damage must be considered in the skeletally immature patient, since the epiphyseal and physeal circulation may be compromised by either the dislocation or exposure for the reduction.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

One hundred seventeen children with tibial shaft fractures were treated by above knee cast with or without traction depending on stability. All fractures united in an average period of 37 days. Reevaluation after 3–10 years showed that initial shortening, fracture type, fracture location, and age of the patient affected growth acceleration, whereas the initial angular magnitude, direction, and planes, as well as the type of the fracture, the age of the patient, and length of follow-up period, affected correction of angulation. We concluded that: shortening can be compensated by growth acceleration; varus deformities can undergo spontaneous correlation whereas valgus deformity and posterior angulation partially persist and rotational deformities persist.

ISSN:0271-6798    

出版商:OVID    

年代:1988

数据来源: OVID