ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

In a retrospective study of results of treatment in 160 children (265 feet) who had metatarsus adductus prospectively defined by severity and flexibility, we found that in 147 patients treated with plaster casts or casts followed by derotation splints the only significant predictor of a good outcome was the age of the patient. Results were statistically significantly better when treatment was begun from ages 1 day to 8 months. No significant correlations with poor results were found using the severity and flexibility grading systems. Given the public attitude toward deformity, it seems wiser to treat in infancy those feet graded “moderate” or “severe.” If treatment is not commenced until the child is old enough to preclude conservative treatment, extensive surgery will be necessary to correct a “severe” deformity.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The second section of three on the new concept of and approach to treatment of clubfoot presents a radically new method of correction of the abnormal subtalar rotation presented in Section I. The nonoperative and operative approach is based on applying pressure in the opposite direction. Thus, the calcaneus and cuboid are pushed laterally anterior to the ankle joint and the calcaneus is pushed medially toward the medial malleolus posterior to the ankle joint. A detailed description of the surgical technique, including a method of maintaining flexor tendon function and protection of ankle joint from fibrosis, and postoperative treatment, including a new method of obtaining early joint motion, is given. Indication for flexor hallux longus transfer to improve peroneal longus function, particularly with previously failed surgical correction, is also described.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The thickness of the acetabular floor and the horizontal diameter of the femoral head often appear enlarged on X-ray films of congenitally dislocated hips, particularly in the later stages. These distances were, therefore, measured and compared with the normal side in 49 strictly unilateral cases. Increased floor thickness was an early change and usually persisted, often in spite of a satisfactory reduction. Increased head diameter was detectable later and these two features together increased the distance between the centre of the femoral head and the midline of the body. This lateral displacement, even when the head is well covered, increases abductor effort and force transmitted to the femoral head on weight bearing and may have an adverse effect on the joint's long term future.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Three out of 480 hips with Legg-Calve-Perthes disease have been found to have intraarticular osteochondroma-like lesions of the femoral neck. In all three cases, the osteochondroma unexpectedly diminished in size during the last phase of reossification and. therefore, did not require surgical excision. The occurrence of osteochondroma of the femoral neck with Perthes disease is rare, and resolution has not been previously reported.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Intraoperative monitoring of spinal cord Function has been carried out in 59 patients during spinal instrumentation for scoliosis. Posterior tibial nerve stimulation in the popliteal space was performed and spinal evoked potentials from electrodes in the spinous processes observed. A rod artifact problem causing partial obliteration of the wave form can be minimized or eliminated by careful selection of the insertion of the fixation device. A drop in amplitude of the signal occurred in many of the tracings from control to distraction observations but did not result in neurologic deficit. One patient had a loss of the signal after maximum distraction with a Harrington rod and a return with release of distraction. This patient awoke with paralytic urinary bladder retention which resolved spontaneously but no other neurologic deficit. This method has been used for monitoring of spinal cord function during Harrington rod instrumentation, using both compression and distraction systems as well as Luque rod instrumentation. This method is safe, simple, and provides consistent and predictable wave forms: it appears to be reliable in indicating continuation of spinal cord function during the procedure.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Function is the most important consideration in the evaluation of patients with congenital ulnar deficiency. The upper extremity function of 8 patients with ulnar deficiency was evaluated. None of these patients had been treated with surgical procedures directed to the elbow, forearm, or wrist. The functional criteria included: (a) active ranges of elbow, forearm, and wrist motion, (b) power grip, (c) prehension, (d) dexterity, and (e) a patient's activities questionnaire. The averaged total active range of joint motion was 229 or 46% of predicted normal active motion. Power grip averaged 27% of the contralateral extremity, and prehension tests were generally well performed. Timed tests were completed an average of 11.6 s slower than the contralateral control hand. Our patients did not report any deficiencies in bimanual activities. Patients performed most poorly when their congenital anomaly included radiohumeral synostosis or congenital absence, deformity, or contracture of the ipsilateral digits. The radiographic appearances or classification of the ulnar deficiency, in the absence of radiohumeral synostosis. did not correlate well with patient function.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Results of an experiment to test the validity of measurements attained in the torsional profile physical examination are reported. Design of the experiment, its statistical analysis, and results are presented. The significance of these variations in clinical practice is discussed.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Congenital abnormalities of the femur vary from a deficiency of the entire femur with abnormal development of the pelvis to a hypoplastic femur of normal configuration. Previous classification systems that have focused on either congenital coxa vara, hypoplastic femur, or proximal femoral focal deficiency provide a limited definition of congenital abnormalities and are included within the combined classification system outlined in this text. This system, based on embryological, teratological, biological, and anatomical considerations of 125 patients with 139 affected femora, classifies deficiencies of the proximal end, middle, and distal end of the femur and associated lower extremity abnormalities. Unlike previous classification systems, congenital femoral abnormalities principally involving the middle and distal end of the femur are recognized in distinct classes when appropriate. Associated abnormalities range from severe growth retardation of the tibia and an absent fibula accompanied by a deficiency of ischiopubic structures with an absent acetabulum to a mild tibial and fibular growth retardation. Treatment objectives include pelvic-femoral stability, prosthetic management, extremity length equality, knee stability, ankle and foot stability, and anatomical alignment.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Nine of 212 cases of traumatic anterior shoulder dislocations occurred in children with clearly open epiphyses (4.7% incidence). All cases associated with psychological or physical abnormalities were excluded. A high recurrence rate of 80% (8 of 10) was noted requiring operative intervention. Two of the three remaining unoperated cases had a history of “subluxation” after their initial dislocation.

ISSN:0271-6798    

出版商:OVID    

年代:1983

数据来源: OVID