|
1. |
Practice |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 705-707
Richard Gross,
Preview
|
|
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
2. |
Connective Tissue Structures in Clubfoot: A Morphologic Study |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 708-712
Amir Khan,
Michael Ryan,
Martin Gruber,
Susan Haralabatos,
Marie Badalamente,
Preview
|
|
摘要:
A morphologic study of connective tissue structures in clubfoot, with special emphasis on the presence of myofibroblasts, was undertaken to investigate the theory of retracting fibrosis as an etiologic factor. Nine idiopathic clubfeet from six patients were studied. Specimens from the medial and lateral capsule, medial and lateral fascia, spring and lacinate ligaments, and flexor digitorum longus, flexor hallucis longus, posterior tibialis, and Achilles tendon sheaths were investigated. Fifty specimens were examined using light microscopy and hematoxylin and eosin staining, and 26 were examined by transmission electron microscopy. Light microscopy failed to reveal any myofibroblast-like cells or any qualitative differences between specimens from capsule, fascia, ligaments, and tendon sheath. Using transmission electron microscopy, the authors identified two cell types: fibroblasts and mast cells. Some fibroblasts contained a network of microfilaments but all lacked microbundles, basal lamina, or plasmalemmal attachment plaques seen in typical myofibroblasts. Mast cells were rarely identified in capsular specimens. The absence of myofibroblast-like cells or typical myofibroblasts in clubfoot connective tissue structures does not support the theory of retracting fibrosis as a likely cause of contracture in idiopathic clubfoot.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
3. |
Treatment of Residual Adduction Deformity in Clubfoot: The Double Osteotomy |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 713-718
Alexandre Lourenco,
Luciano Dias,
David Zoellick,
Henrique Sodre,
Preview
|
|
摘要:
Forefoot adduction is the most common residual deformity after clubfoot surgery. Surgical treatment of this deformity is often required for moderate and severe cases. This study reports the results of a closing wedge osteotomy of the cuboid and opening wedge osteotomy of the medial cuneiform in 39 feet. The average follow-up was 4.8 years. Clinical and radiographic improvement was seen in all patients, and no complications were seen. Surgery is advocated in children older than age 4, or when the medial cuneiform ossific nucleus is well developed.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
4. |
Magnetic Resonance Imaging Study of the Congenital Clubfoot Treated With the Ponseti Method |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 719-726
Shafique Pirani,
Laura Zeznik,
David Hodges,
Preview
|
|
摘要:
Little information exists about the degree of efficacy of the several nonoperative treatments, such as manipulation and casting, used in correcting the pathology of the virgin clubfoot deformity. The steps in the correction of the displacements and anomalies of the skeletal components have never been visualized. The method reported to have the best long-term results is that of Ponseti. A magnetic resonance imaging protocol was devised to image the described chondroosseous abnormalities of the virgin clubfoot deformity and to illustrate the changes that occur with the Ponseti method of treatment. Scans were performed at the beginning of, in the middle of, and at the end of treatment. Images obtained with this protocol largely agree with postmortem studies of clubfeet. All of the major chondroosseous pathology could be visualized in vivo. With Ponseti treatment, all the abnormalities seen on the initial scans either improved markedly or corrected completely. Treatment resulted in correction not only of the abnormal relationships of the tarsal bones, but also of the abnormal shapes of the individual tarsal osteochondral anlages, probably because of the changes in growth resulting from the changes in mechanical loading of fast-growing tissues.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
5. |
Ankle and First Metatarsophalangeal Joint Dorsiflexion in Children With Clubfoot |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 727-730
T. Davies,
Gerhard Kiefer,
Ronald Zernicke,
Preview
|
|
摘要:
It has been hypothesised that the stiffness of the plantar aponeurosis after clubfoot surgery affects push-off. Because the first metatarsophalangeal (MTP) joint motion relies on the plantar aponeurosis, it was important to determine whether there was a lack of first MTP joint motion in children with clubfoot that also affected push-off. By examining the motion of the first MTP joint using a motion analysis system and passive motion techniques, then correlating these with gait characteristics, the authors found that the first MTP joint was not affected in children with clubfoot. The authors found that a motion analysis system could be used to determine range of motion accurately.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
6. |
Ankle Joint Complex Mobility of Children 7 to 14 Years Old |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 731-737
Jouko Alanen,
Jarkko Levola,
Hans Helenius,
Martti Kvist,
Preview
|
|
摘要:
The ranges of motions of the ankle have been studied only rarely in children. The authors examined the mobility of the ankle joint complex of 245 healthy children. The mean age was 10.2 years. In healthy children ages 7 to 14 years, the variation of the ankle joint complex range of motion was wide. The largest gender-related difference was recorded for passive plantarflexion, which was greater in girls. Other statistically significant gender differences do exist, but they are small and probably lack clinical meaning. Some of the children had remarkable left–right difference in the range of motions of the ankle joint complex. This means that the “healthy ankle” cannot necessarily be used in clinical practice as a reference when evaluating, for example, treatments of foot and ankle injuries in children.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
7. |
Hematogenous Osteomyelitis of the Calcaneus in Children |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 738-743
Mahomed Rasool,
Preview
|
|
摘要:
Fourteen children (average 9 years) with primary hematogenous osteomyelitis of the calcaneus are reported. Four were seen early and 10 late. Clinical presentation was dramatic, with fever, pain, swelling, and fluctuance around the foot and ankle. The diagnosis was missed initially in 8 cases because the patients were treated for septic arthritis of the ankle, cellulitis, and subcutaneous abscess. The 4 patients seen early healed well, with no complications. The 10 patients seen late had chronic osteomyelitis with growth arrest; shortening of the foot; limb length deficiency; fusion of subtalar, calcaneocuboid, and ankle joints; calcaneus and equinus deformity; avascular necrosis of the talus; and phalangeal loss. Hospital stay was prolonged in 4 patients. Total calcanectomy (3 patients) and talectomy (2 patients) with heel pad preservation were useful salvage procedures avoiding ablation of the limb in chronic cases.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
8. |
Obturator Internus Muscle Abscess in Children |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 744-748
Shari Orlicek,
Jon Abramson,
Charles Woods,
Laurence Givner,
Preview
|
|
摘要:
The authors describe four cases of obturator internus muscle (OIM) abscess in children, including their clinical presentations and treatment. This was a retrospective chart review. Children and adolescents younger than 18 years discharged between July 1, 1985, and September 30, 1998, from Brenner Children's Hospital with the diagnosis of muscle abscess or pelvic abscess were identified. A total of 56 patients were identified with the diagnosis of muscle abscess or pelvic abscess. OIM abscess was defined by radiologic findings of an inflammatory process with fluid collection in the OIM, along with the clinical findings suggestive of an OIM abscess. Four of the patients met the definition of OIM muscle abscess. The common presenting features were fever, limp, and hip pain. Computed tomography or magnetic resonance imaging was diagnostic in all four patients, andStaphylococcus aureuswas the causative agent in each. All the patients recovered, one after surgical drainage and the other three after antimicrobial therapy alone or with needle aspiration. The presentation of OIM pyomyositis is similar to that of psoas muscle pyomyositis and other infectious processes of the pelvis and hip. TheS. aureusis the most common etiologic agent but not the only one reported. Most patients can be managed without open surgical drainage, but needle aspirations may be helpful both therapeutically and diagnostically.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
9. |
Osseous Manifestations of Tuberculosis in Children |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 749-755
Mahomed Rasool,
Preview
|
|
摘要:
Forty-two children with tuberculous osteomyelitis were seen and treated between 1984 and 1999. The age ranged from 1 to 12 years (average 6); there were 31 boys and 11 girls. There were 50 osseous lesions (excluding spinal and synovial). Five children had multifocal bone involvement. There were four basic types of lesions: cystic (n = 26), infiltrative (n = 10), focal erosions (n = 8), and spina ventosa (n = 6). The majority of the lesions were in the metaphyses (n = 25); the remainder were in the diaphysis, epiphysis, short tubular bones, flat bones, and small round bones. The erythrocyte sedimentation rate was normal in seven, and the Mantoux test was negative in four. Bone lesions resembled pyogenic and fungal infections and benign and malignant bone tumors. Histologic confirmation was obtained in all patients. Curettage and antituberculous treatment yielded good results in the majority of patients, with follow-up of 6 months to 9 years. Biopsy is mandatory to confirm the diagnosis.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
10. |
Standards in Anterior Spine Surgery in Pediatric Patients With Neuromuscular Scoliosis |
|
Journal of Pediatric Orthopaedics,
Volume 21,
Issue 6,
2001,
Page 756-760
Vishal Sarwahi,
John Sarwark,
Michael Schafer,
Carl Backer,
Michael Lee,
Erik King,
Afshin Aminian,
John Grayhack,
Preview
|
|
摘要:
The authors reviewed 111 patients with neuromuscular disease who underwent anterior spine surgery for correction of scoliosis. An overall complication rate of 44.1% was found, 21.6% major and 22.5% minor. Pulmonary complications were the most common major complications, urinary tract infections the most common minor complications. The rate of complications was greater in patients with cerebral palsy, thoracoabdominal and transthoracic approaches, staged procedures, operative blood loss >1,000 mL, or previous spine surgery. In addition, statistical analysis confirmed that curve magnitude >100° degrees was a risk factor for complications.
ISSN:0271-6798
出版商:OVID
年代:2001
数据来源: OVID
|
|