摘要:

Summary:The distal femoral epiphysis, physis, and contiguous metaphysis were examined radiographically, morphologically, and histologically in 97 human specimens ranging in age from 9 prenatal weeks to 16 postnatal years. The earliest development of the femoral anlage was characterized by patterns of appositional and interstitial chondrogenesis throughout its entire structure. Once central endochondral ossification began, chondrogenic interstitial and appositional growth became regionally restricted to the femoral epiphyses. Interstitial chondrogenesis became limited to the germinal region of the developing physis, and appositional chondrogenesis was restricted to the region of loosely packed cells of the perichondrial ossification zone of Ranvier. Appositional chondrogenesis within the perichondrium appears to make its greatest contribution to transverse expansion of the distal femoral epiphysis during the first 5 months of gestation. After the sixth month of gestation, the perichondrial appositional growth contribution appears to decline steadily.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:The nonspecific symptoms and radiographic findings associated with osteoid osteoma in the proximal femur mimic inflammatory conditions and delay diagnosis. A review of four cases showed high resolution computerized axial tomography in conjunction with a radioisotope bone scan best demarcated the location and size of the lesion. The combination of careful preoperative localization and intraoperative use of a radiation probe made adequate resection possible while limiting the amount of bone excised. This technique eliminated the need for internal fixation and reduced the duration of the recovery period.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:We carried out a retrospective study of 42 patients with documented Friedreich's ataxia to answer four questions: what is the incidence and natural history of scoliosis in Friedreich's ataxia, and what are the results of operative and nonoperative treatment? We concluded that the incidence of scoliosis in true Friedreich's ataxia is extremely high. The curves tend to progress with the severity of the disease and often tend to progress after skeletal maturity. Bracing and electrospinal instrumentation have no role in treatment. Patients with progressive curves should have early surgical stabilization.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:The relationship between upright static and dynamic equilibrium function and idiopathic scoliosis was investigated using a seven-part postural equilibrium test battery. Twenty-three normal subjects and 31 subjects with differing degrees of idiopathic scoliosis participated in the study. No significant difference was found among any of the subtest scores of the normal and scoliotic groups. Subtest scores were not significantly correlated with curve measurements. Curve measurements and subjects' ages proved to have some effect on subtest scores, but other unknown factors accounted for a greater percentage of score variance. The existence of a clinically measurable deficit in upright static and dynamic equilibrium in idiopathic scoliosis could not be proven. Further investigation is suggested to identify the factors that affect equilibrium scores. If these factors could be identified, the test battery might serve as a tool for the examination of female patients with idiopathic scoliosis.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:In a prospective study 40 of 236 individuals with Down syndrome were found to have atlantoaxial instability. Whereas most of the 40 affected children were asymptomatic, seven patients exhibited various neuropathology. Historical data, neurologic findings, radiologic interpretations, and surgical management of these seven patients are described in detail. In addition, case reports of other individuals with Down syndrome and symptomatic atlantoaxial subluxation from the literature were analyzed. We conclude that early identification of these patients and appropriate surgical management, including reduction of the subluxation and posterior cervical spine fusion, will in most instances result in a favorable outcome; however, patients with long-standing symptoms and marked neuronal damage show no or only little improvement postoperatively.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:Sixty-one cases of brachial plexus birth palsies were documented in 30,451 live births at Kaiser Foundation Hospital, San Francisco, between January 1972 and December 1982, for an incidence of 2.0/1,000 births. Thirty-eight patients were evaluated in follow-up ranging from 1 year to 11 years 6 months. Associated birth traumas include facial palsy, clavicle fracture, arm ecchymosis, and cephalohematoma. The prognosis was excellent, with full recovery in 95.7% of cases. The presence of a palsy did not preclude the development of dominant use of the extremity. Right-handedness was noted in 73% of right-sided palsies. This study showed that the incidence of palsies has not declined in the past 10 years. Risk factors and associated birth injuries were similar to those in other reports. The severity of palsies has lessened, and early recovery is usual.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:The long-term results of nonoperative treatment of myositis ossificans traumatica have been infrequently reported. We reviewed 83 cases of myositis ossificans seen at the Mayo Clinic from 1950 to 1979 in patients up to 21 years of age. The upper extremity was involved in 31 patients. Follow-up averaged 13 years for 23 of the (74%) patients studied. Football injuries had occurred in 20 of these patients, and the diagnosis was made an average of 3.3 weeks from the time of the initial injury. Observation was the only treatment in 18 of the 31 cases. At follow-up two-thirds of the patients with upper extremity involvement had no problems associated with the disorder, and one-third described some difficulties. Nonoperative treatment remains an accepted management approach for this problem.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:T-supracondylar fractures of the humerus occur rarely in children compared with the adult variety. Sixteen such fractures treated at the Children's Hospital of Eastern Ontario between 1975 and 1983 are described. There were nine male and seven female patients, 7–17 years old. All fractures were displaced, two were open, and one patient had an associated radial nerve palsy. All cases were managed by open reduction, internal fixation, and early mobilization. Follow-up revealed no cases of functional disability despite significant loss of motion in two patients. The conservative approach should be abandoned in these intraarticular injuries, and good operative results can be anticipated.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:Twenty-nine patients (42 knees) with severe flexion contracture of the knee (average 69°) were treated by posterior capsulotomy followed by traction and/or casting. Twenty patients (28 knees) had poliomyelitis. After a follow-up of 2½ years, 39 knees were corrected to <15° of flexion. All of the patients except one were able to ambulate using a knee-ankle-foot orthosis, with or without crutches. Complications included skin necrosis in nine patients, recurrence in six, hypertension in three, and peroneal nerve palsy in one. The rate of complication was less in patients with poliomyelitis. This method is recommended for the treatment of severe flexion contracture of the knee, especially in patients with poliomyelitis, but is not recommended in patients with insensitive skin.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Summary:The Verebelyi-Ogston (V-O) procedure, consisting of subchrondral excision of the talus and cuboid, was used for the treatment of 13 resistant clubfeet secondary to myelomeningocele or arthrogryposis. Nine feet were initially satisfactory, but the condition recurred in both feet of one patient after bracing was discontinued 3 years postoperatively. Three feet were graded as satisfactory after a second V-O procedure, and one after a third. The procedure must be monitored by intraoperative fluoroscopy or radiography, and followed by orthotic support. Despite the theoretical long-term disadvantage of incongruent joint surfaces, we consider the V-O procedure to be a good method for the treatment of this subset of rigid neuropathic clubfeet.

ISSN:0271-6798    

出版商:OVID    

年代:1984

数据来源: OVID