摘要:

Summary:A classification system for congenital deficiency of the femur is introduced, based on initial radiographic appearance of the hip joint in 60 patients (70 affected limbs). Follow‐up records ranging from 1 to 30 years demonstrated a relatively constant percentage of shortening in each patient with further growth (2.4% average change). Treatment programs have been established for each of the following groups: 1, short femur with good hip joint (19 limbs); II, short femur and coxa vara (17 limbs); III, short femur with proximal deficiency, a welldeveloped hip joint, and broad angulated and sclerosed diaphysis (15 limbs); IV. dysplastic distal femoral segment with no hip joint (16 limbs); and V, total absence of the femur (3 limbs).

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:Nonunions after diaphyseal fractures of long bones in children are rare. Thirty diaphyseal nonunions in 30 children are reported. The sites of nonunion were tibia (15), femur (5), ulna (4), humerus (3), radius (2), and fibula (1). Nonunions in children tend to occur after highenergy trauma, particularly when the fracture is compound, there is soft tissue loss, and infection develops. Open reduction and internal fixation may contribute to nonunion, particularly when the fixation is inadequate or holds the fracture apart. Repeated manipulation of the fracture after open reduction may also contribute to nonunion. Treatment of the nonunion must be individualized, but usually requires excision of the nonunion fibrous tissue, bone grafting, and internal fixation. Electrical stimulation was not used. The average time from fracture to union was 14.7 months, and multiple surgical procedures were required.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:The results of treatment of 20 unstable diaphyseal fractures of the forearm in adolescent patients by closed intramedullary nailing are presented. All fractures healed within 4‐7 weeks. No cross‐union, nonunion, pseudarthrosis, or infection occurred. The advantages of this method are (a) maintenance of accurate reduction, (b) reduction of complication rate, (c) negligible cosmetic defect, and (d) removal of the internal fixation device under local anesthesia.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:Eosinophilic granuloma of bone is a rare skeletal manifestation of one of the spectrum of diseases known as histiocytosis X. These lesions often simulate other pathophysiologic processes (Ewing sarcoma, chronic osteomyelitis, Brodie abscess, and chondroblastoma) and may present significant diagnostic problems. Three additional cases of eosinophilic granuloma in an epiphysis are reviewed in this report. Transphyseal extension was present in all our cases and in five of 10 cases documented in the literature. Diagnosis demands accurate biopsy and histopathologic evaluation. Treatment and prognosis are individualized.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:The combined use of radionuclide scintigraphy and computed tomography is recommended for evaluating children with laboratory and clinical data suggestive of flat bone osteomyelitis despite normal conventional radiographs. In addition, computed tomography may be helpful in the presence of abnormal radiographs in determining the exact location of the focus of osteomyelitis and the most suitable route for appropriate drainage or to obtain culture material.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:Three patients with primary subacute epiphyseal osteomyelitis are reviewed. All had a history of minor trauma and complained of pain and limp; none was systemically ill. Plain radiographs demonstrated a welldefined lytic lesion in the epiphysis. One case occurred in the distal tibial epiphysis from which pneumococci were isolated; this appears not to have been described previously. Patients were treated with flucloxacillin and two without operative intervention; all recovered completely. Follow‐up radiographs at 2‐5 years demonstrated healing of the lesions with no evidence of damage to the epiphysis or the joint. There have been 10 previously reported cases in the literature, all treated by antibiotics and curettage. Based on this experience we believe that administration of appropriate antibiotics and immobilisation of the affected limb are sufficient treatment for some children presenting with this condition.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:Because of recent literature reports of the rare occurrence of osteomyelitis in patients with sickle cell disease, we reviewed 5 years of experience at Dhahran Health Center (Dhahran, Saudi Arabia). Twelve cases of bone and/or joint infection were identified in patients with sickle cell disease; 83% caused bySalmonellaspecies. This relatively high incidence might be related to the common occurrence of infection withSalmonellain this region. Long bone and multiple site involvements were noticed. Differentiation from acute bone infarcts is difficult, and a systemic and aggressive approach to early diagnosis, management, and follow‐up is suggested. Before therapy is started, full history, physical examination, blood cultures, local cultures, stool and urine cultures, and measurement of febrile agglutinin levels should be done. Once diagnosis is confirmed or highly suspected, adequate surgical drainage, prolonged parenteral antibiotic therapy, and transfusion of packed red blood cells should be used. A prolonged follow‐up is recommended.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:Infection of the ischiopubic synchondrosis (IPS) is a diagnostic dilemma. This article reviews four such cases. All patients complained of ipsilateral groin pain, were febrile, and had elevated erythrocyte sedimentation rates. Initial radiographs were interpreted as normal but later showed increasingly lucent zones at the IPS. Radionuclide bone scans demonstrated diffusely increased uptake in the vicinity of the IPS. This contrasts with the discrete pattern seen with a normal IPS. Blood cultures were positive. Satisfactory outcomes were obtained with conservative treatment. Clinical presentation, laboratory results, radiographs, and bone scans must be correlated to distinguish this syndrome from a “normal radiologic variant.”

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:The evaluation by counterimmunoelectrophoresis (CIE) of joint fluid for bacterial antigen from 16 children with suspected septic arthritis is reported. Joint fluid from six children contained capsular antigen ofHaemophilus influenzaetype b (four) orStreptococcus pneumoniae(two). One child was infected withS. pneumoniaebut was positive by CIE for bothH. influenzaetype b andS. pneumoniae.Five of six children who were <2 years of age were infected withH. influenzae.Two children had negative cultures of joint fluids, and a presumptive etiology for their infection was proposed only by demonstration of bacterial antigen. CIE, which has been widely applied to cerebrospinal fluid, urine, and serum, is a helpful adjunct to the evaluation of joint fluid from children with suspected septic arthritis.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Summary:The distinction between congenital short tendo calcaneus and mild cerebral palsy may often be difficult to ascertain by standard physical examination. Dynamic electromyography (EMG) was used to study the muscular activity during walking of four children who had a clinical diagnosis of congenital short tendo calcaneus. Two children displayed EMG evidence of cerebral palsy, while two had studies similar to normal children walking on their toes. Dynamic EMG may be a useful diagnostic tool in the evaluation of children with toe‐walking.

ISSN:0271-6798    

出版商:OVID    

年代:1985

数据来源: OVID