摘要:

Patients with cerebral palsy and fixed hip extension are often unable to sit and therefore lose social and educational opportunities. At Texas Scottish Rite Hospital (Dallas, TX, U.S.A.), 29 patients had hip extension-abduction contractures. Eleven patients with mild involvement were managed with physical therapy. Six patients had moderate involvement and required wheelchair modification to maintain sitting. Twelve patients demonstrated severe contractures that required major soft tissue releases and often femoral shortening osteotomies to regain flexion. Patients with athetosis or rigidity were identified as those most likely to develop extension-abduction contractures either spontaneously or following adductor releases.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A technique of intraarticular hip arthrodesis using a cancellous screw to provide compression across the joint is introduced. We present four patients in whom this method was successful, resulting in solid fusion and pain relief at follow-up.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

A 30-year retrospective review of 497 cases of transient synovitis of the hip involving 475 children allowed full characterization of the syndrome. Femoral head measurements of 118 patients at follow-up of 6 months showed no significant dimensional changes. Three cases of Legg-Calvé-Perthes disease (2.5%) were found in follow-up, as well as a case of osteoid osteoma of the femoral neck and two cases of juvenile rheumatoid arthritis. Recurrent synovitis with a benign prognosis occurred in 19 patients. In spite of a generally anticipated good prognosis in the vast majority of cases, radiographic assessment at 6 months after the initial episode is recommended.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We have performed a transtrochanteric anterior rotational osteotomy on five patients with severe chronic slipped capital femoral epiphysis. Four patients were free from clinical symptoms, whereas one patient continued to feel a dull pain in the hip. Radiographic evaluation indicated that the osteotomy was able to correct even a severe slip without any deformity around the trochanteric region. There were complications in two cases: a posteromedial tilt at the osteotomy site and a focal avascular necrosis in the anterolateral epiphysis.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Skewfoot, a malalignment of tarsal and meta-tarsal bones, is recognized clinically by forefoot adduction and heel valgus. Synonyms include S-shaped foot, serpentine foot, and Z-foot deformity. Skewfoot must be differentiated from metatarsus adductus, metatarsus varus, and metatarsus adductovarus. Only 50 cases have been reported, and only two primary articles have been published in the English literature. Four patients who were treated at the Mayo Clinic are described. The ages of the patients at the time of presentation ranged from 6 months to 3 years. Three patients underwent operation. Because the natural history of skewfoot is unknown and pain is infrequent, treatment alternatives must be carefully considered. If operation is undertaken, realignment of the tarsal bones should be supplemented with hindfoot bone stabilization.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Eighteen idiopathic toe walkers were evaluated by gait electromyography to define muscle timing abnormalities. This group was compared with a matched group of normal children walking on their toes and to a group of patients with cerebral palsy and equinus deformities. Although timing in all three groups differed from normal timing, the two patient groups showed some statistically significant differences in phasic timing from the control group. However, no significant differences existed between toe walking and spastic children. Historical data (family history, male predominance, and learning disabilities) suggest that idiopathic toe walking is a true entity, although the gait electromyograms were not diagnostic.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Three patients with birth fractures and Werdnig-Hoffmann disease are presented. Two of the three were erroneously diagnosed as having osteogenesis imperfecta. The etiology of these fractures appears to be in utero osteoporosis secondary to decreased movement, leading to pathologic fracture during birth. Immobilization led to uneventful healing in all cases; no recurrent fractures were seen.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Fracture of the carpal scaphoid before skeletal maturity represents 0.34% of all fractures in children and 0.45% of children's upper limb fractures. Seventy-seven children, with a mean age of 11 years (range 8–14 years), suffered a scaphoid fracture in Nottingham, England, between 1977 and 1984 inclusive. Sixty-four of them have been personally reviewed. The mechanism of injury was usually a fall onto the outstretched hand and in the majority was an undisplaced fracture of the distal third of the bone. Immobilization in a scaphoid type of forearm-hand cast led to union in virtually all instances. Nonunion is very rare in treated cases of fresh fracture of the carpal scaphoid.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Stress fracture of the pars interarticularis is an increasing cause of disability in highly competitive adolescent athletes. We have documented this lesion in 14 adolescent athletes engaged in repetitive training and competition exercises involving flexion/extension of the lumbar spine. An in vivo spinal muscle torque study in 11 normal adolescent girls also revealed mean torque values of 22.6 Nm for left lateral flexion and 27.4 Nm for hyperextension. The most common sports resulting in this lesion were gymnastics and hockey. In four patients the lesion was bilateral, and in 10 it was unilateral. Five of the unilateral lesions went on to heal with immobilization in a thoracolumbar spinal orthoses; however, none of the four bilateral lesions or the remaining five unilateral lesions healed in spite of 3 months of immobilization.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

We report the incidence of fractures by sex and age based on 851 femoral shaft fractures from specific types of trauma. The maximum incidence occurred between 2 and 3 years of age, and the total incidence was 2.6 times higher in boys than in girls. In 438 cases the fractures were caused by falls and in 413 cases by traffic accidents. Fractures reported to be caused by falls were most common in children 2 and 3 years of age. Because child abuse has been shown to be involved in the majority of such fractures in early infancy, the data demonstrate the possible magnitude of this problem. Traffic accidents were most common in the oldest age groups, reaching 3.7 cases/10,000 population/year in boys 16 and 17 years of age. Although all fractures were more common during the periods of the fastest skeletal growth, the difference in incidence between different causes indicated that environmental factors are more important than endogenous factors for the risk of fracture.

ISSN:0271-6798    

出版商:OVID    

年代:1986

数据来源: OVID