摘要:

Outpatient percutaneous tendo Achillis lengthening is a quick, complication-free, inexpensive approach to a common pediatric orthopedic problem. The procedure is a known alternative to conventional open procedures, but it is not widely used. This study outlines the advantage of the percutaneous procedure performed in outpatient surgery with the patient under a general anesthetic. Fifty-five patients were operated on between December 1980 and March 1984. Overall results were excellent, with 97% improvement in gait. There were no infections. Percutaneous heel cord lengthening in children is a safe and simple operation, yielding results equal to those of open procedures. The advantage of outpatient surgery adds a further positive dimension to this procedure.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The proper use of outpatient surgery is still being defined. In similar groups of cerebral palsied children, the results of Achilles tendon lengthening were compared in those having inpatient versus outpatient surgery. No significant anesthesia or surgical complication occurred in either group, and independent ambulation in casts was achieved at similar times. Pain medication requirements (based on an analgesic potency scale) averaged 9.5 ± 6.0 for the children having outpatient surgery compared with 25.8 ± 22.8 for those having inpatient surgery (p < 0.02). Outpatient Achilles tendon lengthening provides psychological and economic advantages without compromise of surgical results.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A 9-year-old boy had pain in the medial side of the right knee with limited range of motion and limping. Roentgenography showed a small sclerotic shadow (8 × 8 mm2) in the medial femoral condyle, where bone scintigraphy revealed a high uptake area and angiography showed a nidus. Five months after initial presentation, en bloc excision was done through the posteromedial approach. Histological examination showed a network of osteoid trabeculae, differentiated osteoblasts, and multinucleated giant cells in this nidus, which were compatible with those of osteoid osteoma. Complete relief of pain was obtained at follow-up 1 year after the operation.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Thirty-six cerebral palsied patients who underwent a unilateral operative procedure for spastic hip subluxation or dislocation were reviewed for assessment of the effect on the nonoperated hip. Unilateral soft tissue procedures on patients < 9 years of age had a definite untoward effect on the contralateral, nonoperated hip (progressive subluxation and development of a windswept pelvis deformity). The effect of unilateral bony procedures on the nonoperated hip was not statistically significant. Following unilateral surgery, nonambulators are at increased risk of demonstrating deterioration of the nonoperated hip in comparison to ambulators.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We evaluated 38 noninstitutionalized patients with spastic quadriplegic cerebral palsy with 51 dislocated hips. Nine hips had been reduced. The mean follow-up was 18 years, with an average age of 26 years. At follow-up, four were ambulatory with aids. Patients who could walk had normal intelligence and a level pelvis. In patients with 18 unreduced unilateral hip dislocations, pelvic obliquity and scoliosis were present in 12. In seven patients with reduced unilateral hip dislocations, similar findings were present in only two patients. Half of the dislocated hips were painful. Based on these findings, we recommend reduction of unilateral dislocations. Bilateral dislocations may benefit from reduction if treatment is undertaken before significant adaptive deformity of the femoral head occurs.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

A screening programme for congenital dislocation of the hip in which physiotherapists examine all neonates is described, together with the results over a 7-year period. All easily reducible dislocated and dislocatable hips are splinted within 2–5 days of birth. Subluxable or “slidey” hips are identified and followed up but not splinted. Risk groups are also identified and followed up. There was a progressive decrease in the number of late diagnosed cases, a result suggesting that even late-presenting acetabular dysplasia can be eliminated by neonatal screening.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We conducted a retrospective study of 97 cases of slipped capital femoral epiphysis occurring in 77 children. Gradual epiphyseal slip frequently occurred, and complications were more frequent with greater degrees of slips. Diagnostic delay should, therefore, be avoided, and a high index of suspicion is necessary when adolescents with leg pain or limp are examined. Minor epiphyseal slip should be carefully fixed in situ, and we suggest that the remainder undergo a gentle manipulation. Only those hips with a persisting deformity need undergo femoral osteotomy.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Divergent opinions about the pathophysiology and the optimal time and methods for the treatment of Legg-Calvé-Perthes (LCP) disease exist. Synovitis causing restriction of hip motions may be hazardous to the circulation to the femoral head. We studied 23 children (24 hips) in the initial phase of LCP disease. Seven to 14 days of Russell traction decreased the intraosseous pressure significantly (p < 0.001) and increased the hip motion a mean of 33.6°. As assessed by osteovenography, the venous congestion decreased in almost every hip during Russell traction.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We have used magnetic resonance imaging (MRI) to evaluate 22 patients with various clinical and/or radiographic findings potentially associated with intraspinal pathology whose evaluation would have necessitated myelography or computed tomography scanning in the past. Ten of these 22 children were diagnosed by MRI to have significant intraspinal lesions: diastematomyelia in four, syringomyelia in four, tethered spinal cord in three, intraspinal lipoma in two, and spinal cord tumor in one. MRI is noninvasive, requires no exposure to ionizing radiation, and provides multiplanar images and three-dimensional reconstruction potential, all with superior soft tissue imaging. In our patient population, it has proven to be a useful diagnostic adjunct.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Eighteen patients with scoliosis were treated with lateral electric surface stimulation (LESS). Four (23%) discontinued the program because of discomfort, five did not carry through an adequate treatment program, and nine (50%) coped with a proper program. In spite of a good initial correction, five patients in the latter group progressed during treatment. Muscle biopsy specimens before and after a treatment period of 18 months revealed a tendency for the stimulation output to spill over to the concave side of the curve. In this study, LESS has not been an effective treatment for scoliosis.

ISSN:0271-6798    

出版商:OVID    

年代:1987

数据来源: OVID