摘要:

We propose a femoral desrotational osteotomy to antevert the femoral head associated with plication of the anterior and superior capsule for treatment in the early stages of hip dislocation in Down syndrome. Eight patients (10 hips) with Down syndrome and hip dislocation were reviewed. Five children (seven hips) were operated. We used the proposed surgical technique in three patients (four hips). The average follow-up was 11 years (range, 5-16 years). No infections or complications were observed. In our short experience, this is the recommended procedure in the early stages of hip dislocation in Down syndrome.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was to assess the variations in the measurement of hip ultrasonography using the Graf method in developmental hip dysplasia. Twenty-two observers independently analyzed 20 hip ultrasonograms on two occasions. Intraobserver and interobserver agreement ratios on the exact Graf classification were 65% and 51%, respectively. Intraobserver and interobserver agreement ratios on the treatment method according to the hip type were 76% and 64%, respectively. Average intraobserver and interobserver differences were 4.0° and 5.1° for the alpha angle, and 5.9° and 10.1° for the beta angle, respectively. It was concluded that having a basic knowledge of the Graf method was the key point, and the observer's previous number of examinations had no effect on the results.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

We report a case of slipped capital femoral epiphysis that developed associated with a peripheral osteoarticular tuberculosis lesion located at the proximal metaphysis of the femur in contact with the growth plate in a 12-year-old boy. Multiple factors have been involved in slipped capital femoral epiphysis pathogenesis, but we believe an osteoarticular tuberculosis lesion is not a common finding as a possible etiological factor causing weakness of the growth plate and, therefore, the femoral head displacement.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Subacute osteomyelitis has a very anodyne symptomatology and is, therefore, difficult to diagnose. We studied 21 cases treated between 1984 and 1998 with subacute osteomyelitis of variable location and a mean diagnostic delay of 158.5 days. Of these, 10 cases could not be placed in the current classification. Diagnosis was radiologic in all cases, although in a few patients confirmation by isotopic bone scan and magnetic resonance imaging was required. Treatment was surgical in the first 11 cases to become, currently, predominantly conservative. The causal microorganism was only isolated in nine cases. Complete healing without sequelae was achieved in all but one case, which was of very tardy diagnosis and developed coxarthrosis.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

We report the case of a 12-year-old girl with thoracic spondylitis, who initially presented with a painless scoliotic deformity and was therefore misdiagnosed as having idiopathic scoliosis. Six weeks after initiation of brace therapy, increasing back pain neccessitated admission. X-Ray, bone scintigraphy and magnetic resonance imaging then revealed a pathologic process in D8. To rule out a tumorous lesion, open biopsy was performed and led to the diagnosis of acute spondylitis. Treatment with oral antibiotics and bed rest led to a complete resolution of the scoliotic deformity, which clearly demonstrated that it was secondary to spondylitis. After 2 years, the girl is persistently well and free of pain. This unusual presentation of spondylitis delayed correct diagnosis and therefore specific treatment in the case of this 12-year-old girl.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

To study the clinical usefulness of granulocyte scintigraphy, eight children with clinical, laboratory and/or radiologic findings strongly suggestive of osteomyelitis were prospectively evaluated. Comparison was made with bone scintigraphy and magnetic resonance imaging. In adults, granulocyte scintigraphy is highly infection specific, although nonspecific findings (i.e. photopenic lesions) may also occur. Granulocyte scintigraphy was positive in one patient, false-negative in two and demonstrated nonspecific photopenic lesions in five children (62%). In conclusion, there appears to be little place for granulocyte scintigraphy in routine investigation of suspected ostoemyelitis in children.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Osteomyelitis of the pelvis or proximal femur may still be diagnosed late because the infection is deeply placed and investigations may concentrate solely upon the possibility of septic arthritis. Periacetabular infection was diagnosed in 16 children between 1994 and 1998. A high index of suspicion and the use of appropriate imaging will ensure that the condition is not allowed to progress, although in this series one child underwent an unnecessary appendicectomy, and a subsequent sepsis of the hip joint was drained in another case. Radiographs of the pelvis were rarely abnormal within 7 days of the onset of symptoms and an ultrasound scan focused on the hip joint may miss the periarticular changes.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

A 5-year-old girl sought treatment for pyrexia of unknown origin. Despite prompt surgical drainage of a streptococcal septic arthritis of the ankle joint, her condition deteriorated. Multifocal pyomyositis was subsequently diagnosed. This was complicated by acute compartment syndrome in three extremities. With aggressive surgical and medical management, the child made a complete recovery. Orthopaedic clinicians in nontropical areas must familiarize themselves with this rare, potentially life-threatening, but eminently curable disease.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Growth disturbances after fractures of the lateral condyle of the distal humerus in children present mostly as transient stimulation of the lateral physis. Clinically lateral condylar overgrowth leads to a radial bony prominence and varisation of the elbow. From 1974 to 1994, 66 fractures were prospectively diagnosed with standard roentgenograms and treated by open reduction and internal fixation with a metaphyseal lag screw in case of displacement. Fifty-four patients (82%) were reviewed with an average length of follow-up of 10 years (range, 2-22 years) to assess all sequelae of growth disturbances. Screw osteoynthesis led to anatomical union, symmetric carrying angles and full range of motion in all 27 operated cases, and proved to prevent stimulating growth disturbances contrary to the common but relatively unstable fixation with Kirschner wires.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This was a randomized controlled trial of 28 children 1 year to 12 years of age with closed totally displaced supracondylar humeral fracture. The purpose of the study was to compare closed reduction and pinning (group A) and open reduction and pinning (group B). Each group consisted of 14 children. The general characteristics of both groups (age, sex side, displacement, nerve injury preoperatively) were statistically the same (P> 0.05). All cases healed with good alignment without cubitus varus, without infection and with a good range of motion except for one. The mean ± standard deviation of the Baumann's angle difference between the injured and uninjured side were 2.32 ± 1.6° in group A (range, 0-6.5°) and 2.45 ± 1.8° in group B (range, 0-6.5°). This difference was statistically not significant (P= 0.8). By Flynn criteria, group A had good to excellent results in 100%, and group B had good to excellent results in 93% and fair in 7%. This difference was not statistically significant (P= 1). The satisfaction score (0-10) was significantly higher in group A for both parents' and evaluator's (blinded to treatment) perspective (P= 0.017 and 0.019, respectively). The author concludes that both treatments gave good results. Closed reduction should be performed first and, if it fails, then open reduction can be performed. This will produce good results in the hands of an experienced surgeon.

ISSN:0271-6798    

出版商:OVID    

年代:2001

数据来源: OVID