摘要:

The first section of three on the new concept and approach to treatment of clubfoot gives a detailed description of morbid anatomy. The author believes that internal rotation and failure of correction are due to unrecognized rotation in subtalor complex. A detailed explanation of the horizontal subtalor rotation is given. The calcaneus rotates through the subtalor joint pivoting on the interosseus ligaments, causing the calcaneus to move toward the fibula posterior to the ankle joint, and with the same motion tilts the calcaneus in varus.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The Pavlik harness has made an important contribution to the treatment of congenital dislocation of the hip before walking age. Our experience of 74 cases confirms the good results already reported by several authors; however, four instance of moderate avascular necrosis of the femoral head occurred. The precise indications for the harness and the rules governing its use must be clearly understood. It may be used from the neonatal period up to 6 to 8 months of age for dislocation or subluxation with limitation of hip abduction. Selection of suitable candidates is made more accurate by taking into account the child's general tone and that of the adductor muscles, as well as the data from X-ray films taken in the harness position.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

At Rancho Los Amigos Hospital on the Children's Orthopedic Service, 43 patients underwent anterior transfer of the posterior tibial tendon through the interosseous membrane between 1969 and 1979. This included 74 procedures for the following diagnoses: Duchenne muscular dystrophy, clubfoot, cerebrospastic disease (cerebral palsy and head injury). Charcot-Marie-Tooth disease, scapuloperoneal dystrophy, and peroneal palsy. The purpose of this paper is to present the 54 of these transfers that have a minimum 2 year follow-up, were performed with a uniform surgical technique, and had uniform postoperative management. This series is analyzed and compared with a review of the literature in order to set down guidelines for the use of the procedure. The analysis reveals that the patient with Duchenne muscular dystrophy who has decreasing gait function or brace fitting problems is the ideal candidate for the procedure with 26 of 28 satisfactory result. Gait electromyography was critical to the selection of the cerebrospastic patient for the transfer with those patients demonstrating swing-phase function of the posterior tibialis muscle yielding the best results. Finally, posterior tibial tendon transfer is generally not indicated in congenital clubfoot with six unsatisfactory results in 10 procedures, and the procedure should only be done in Charcot-Marie-Tooth disease as part of staged treatment that includes a possible future hindfoot stabilization.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A revised classification of injuries to the epiphyseal, physeal, metaphyseal, and diaphyseal growth mechanisms is proposed. While based on preexistent schemes, it adds subclassifications that relate specific injury patterns to the risk of growth disturbance, as well as other growth mechanism injury patterns not included in the previous systems. It is hoped that this new, more detailed scheme will further our understanding of growth mechanism injuries, will aid in roentgenographic recognition and treatment, and will allow better estimation of prognosis for normal or abnormal growth.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The variability in measurement of the angle of curvature in scoliotic spines was estimated by having 50 anteroposterior roentgenograms read in random order twice by five orthopedic surgeons. The average error was ±9 (±2 SD) on duplicate readings, with a range of ±5° to ±15.1° for individual orthopedists. Difficulty in reproducibly choosing the end vertebrae prior to making the angle measurment appeared to be the major source of measurement error.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Singh index determinations in normal children, children with mild scoliosis, and Scheuermann's kyphosis indicate that the femoral trabecular index is applicable to children as well as adults and that children with mild, untreated scoliosis and untreated Scheuermann's kyphosis have relative osteoporosis when compared to normal children. The relationship of osteoporosis and acquired back deformities is discussed.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The incidence of tibio-fibular shaft and anakle fractures in children aged 0 to 18 years was calculated in the area primarily served by the University Hospital in Lund. Of 919 fractures treated from 1971 to 1979. 746 fractures occurred in the chosen population. The accumulated incidence of tibio-fibular shaft fractures in children 0 to 18 years of age was 190 and 110 per 10,000 boys and girls, respectively, whereas the accumulated incidence of ankle fractures was slightly less (172) in boys, but higher (141) in girls. The accumulated incidence of physeal fractures of distal tibia and/or fibula was 118 in boys and 90 in girls including tibio-fibular shaft fractures associated with ankle fractures. The accumulated incidence of ankle fractures without growth plate fracture in children with open growth plates was 13 in boys and 19 in girls. Longitudinal tibio-fibular shaft fractures occurred at the same age in boys and girls, whereas transverse fractres occurred at an older age in boys mainly due to traffic accidents and sports. Ankle fractures occurred at an older age than tibio-fibular shaft fractures. Injuries classified as supination-eversion and supination-adduction were found to be the most common types, but supination-eversion injuries occurred at an older age than supination-adduction injuries. The traumatological classification by Gerner-Smidt was compared with the anatomical classification by Salter and Harris. The traumatological classification failed to classify 14 cases (5%), whereas 48 (17%) of the physeal fractures could not be classified according to Salter and Harris. Of these, 33 showed combinations of physeal fractures, 9 showed a zig-zag pattern, and 6 were undeterminable. The results of the study suggest that ratational trauma to the lower leg reslts in a longitudinal fracture of the tibio-fibular shaft in the younger child and in an ankle fracture in the older child. No corresponding relation between transverse tibio-fiblar shaft fractures and ankle fractures due to bending could be found.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The nature of acetabular deficiency in both congenital and paralytic hip instability was investigated by computed tomography (CT). Sixty-six hips in 35 children with paralytic or congenital hip instability underwent transpelvic CT. Two angles were defined: angle 1 is a function of anterior and angle 2 a function of posterior coverage. The sum of the two angles represented acetabular depth. Results showed anterior deficiency in cerebral palsy and congenital hip instability. An absolute acetablar deficiency as opposed to a torsional disorder was present.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The radiographic appearance of the metaphysis was studied in 125 cases of Perthes disease (134 affected hips). Abnormalities were found in 90% and were classified into those with and those without “cysts.” Using a simple definition of a bad result, all such cases had cysts present in the metaphysis, and 76% had extension of the cystic process to involve the lateral metaphyseal cortex. It is suggested that the presence of cysts within the metaphysis, especially if they involve the lateral metaphyseal cortex, is of prognostic significance.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Sixteen adolescents presented with symptoms referable to the posterior lateral compartment of the knee, specifically the region of the fabella. The salient features of the syndrome include intermittent pain in the posterolateral region, accentuated by knee extension and localized tenderness when the fabella is compressed against the femoral condyle. The condition appears to be unique to late adolescence (15–17 years of age). Five patients responded to conservative measures. Eleven patients reqired surgery, all of whom obtained immediate relief of symptoms with removal of the ossified fabella, cartilaginous fabella, or thickened gastrocnemius fibers.

ISSN:0271-6798    

出版商:OVID    

年代:1982

数据来源: OVID