摘要:

Twenty-two patients with cerebral palsy (CP) and progressive lateral migration of the hip who underwent a combined adductor transfer, iliopsoas release, and proximal hamstring release were reviewed retrospectively. The average age at surgery was 4 years 9 months, and clinical and roetgenographic follow-up averaged 21.9 and 19.2 months, respectively. Ninety-five percent of the patients demonstrated an improved range of motion. Roentgenographic analysis showed a statistically significant decrease in the migration percentage and the acetabular angle and an increase in the CE angle. We concluded that this procedure adequately addressed this complex problem, thereby limiting the number of hospitalizations and surgical procedures for this patient group. Longer follow-up will be necessary to determine if these results are maintained with time.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Significant spinal abnormalities were found in eight patients (average age of 6 years, 5 months) with camptomelic dysplasia. The late ossification of the midthoracic pedicles served as a clear diagnostic criterion for the syndrome. Scoliosis averaging 63° was found in all seven nonquadriplegic cases. Thoracic hyperkyphosis averaging 126° was seen in six (75%) of the patients, while cervical kyphosis averaging 66° was noted in three (38%). Vertebral body hypoplasia appeared to be a major cause of deformity. This study clarifies that patients with camptomelic dysplasia are surviving longer than previously expected and therefore should have their spinal deformities treated aggressively.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Thirty-four surgical procedures were performed over a 12-year period on a select population of severely multiply handicapped individuals. Heel cord lengthening, hamstring and adductor releases, as well as selected osteotomies, tenotomies, and arthrodeses (both wrist and foot) were performed. The objectives were improvement in sitting posture, care, and comfort. Independent evaluations of active function, passive function, cosmesis, self-esteem, limb posture, and ease of dressing and hygiene were assessed. Significant improvement was generally noted. No patient was made worse. Selected procedures in the severely multiply handicapped individual have a definite place in patient management.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Two male patients, aged 6 and 9 years, were suspected of having unilateral Perthes disease because of typical symptoms and clinical signs. Roentgenograms, including scintigraphy, were normal. Magnetic resonance imaging (MRI) snowed definite avascular necrosis in the affected hip. Roentgenograms subsequently also became positive for Perthes disease. These two cases document the advantages of MRI in early diagnosis of Perthes disease prior to development of typical radiologic changes.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Three cases in which wrist pain developed in skeletally immature competitive gymnasts are presented. In all three cases there is radiographic evidence of premature growth plate closure, resulting in shortening of the radius and alterations in the normal distal radioulnar articulation. Repetitive compressive loading of the distal growth plate of the radius is proposed as a potential etiology of this condition. Treatment goals, including an example of successful ulnar shortening, are reviewed. The authors suggest activity limitation with the onset of symptoms, in order to avoid the permanent structural changes observed in our patients.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Forty-four patients (45 fractures) with open physes (age range 11–16 years) underwent treatment for femoral shaft fractures. Seven malunions occurred in the 24 fractures in the nonoperative group; none occurred in the 21 fractures treated by intramedullary nailing. Hospital stay was significantly shorter in the operatively treated patients. There was no premature growth arrest in the surgical group.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

To determine whether limping is associated with decreased bone mineralization, the trabecular and integral bone densities (BDs) of 18 Caucasian children exhibiting computed tomographic evidence of tarsal coalition (14 boys, 4 girls, aged 9 years, 5 months to 16 years, 3 months) were compared with those of an age-and sex-matched control group. Patients with tarsal coalition had significantly lower trabecular (p < 0.05) and integral (p < 0.05) BD than controls. Trabecular spinal density was ±17% lower on the average in patients with tarsal coalition. Among the limping patients, neither the duration of symptoms nor bilaterality was associated with decreased BD. The findings suggest that painful tarsal coalition may decrease vertebral bone mass and predispose to spinal osteoporosis.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The radius and tibia of an immature monkey remodeled 5o/year until maturity after osteotomies. The periosteum and the growth plate contributed equally to the correction. Valgus, varus, and flexion deformities corrected to the same degree. Epiphysiodesis of the adjacent growth plates did not prevent correction of the shaft. Remodeling at the osteotomy site was characterized radiographically by bone deposition on the concave side but no significant resorption on the convex side.

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The clinical and radiographic results of posteromedial release performed on 30 patients (44 feet) were assessed. The patients were divided into three groups based on their average age at the time of operation (early, 4.4 months; middle, 9.1 months; and late, 16.1 months). All patients had similar preoperative deformity, surgical management, and postoperative treatment. The outcomes of all three groups were similar with the exception of hindfoot-to-forefoot alignment and hindfoot varus correction. The early group demonstrated better clinical and radiologic foot alignment and had the lowest incidence of radiologic tarsal deformities (7 vs. 28% in the middle group and 35% in the late group).

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Ninety-nine feet in 54 children were both clinically and roentgenographically evaluated following one of three different procedures of soft tissue clubfoot release. A new rating system that weights dynamic functional results more heavily was used to compare results. Roentgenographic complications included both over- and undercorrection at the talonavicular articulation, avascular necrosis of the talus, navicular, and calcaneus, and talar dome flattening. Recommendations concerning technical aspects of operative approach to clubfeet include (a) more physiologic orientation of the bimalleolar axis, (b) anatomic alignment at the talonavicular joint, and (c) use of the hinged ankle cast brace to increase final ankle range of motion (ROM).

ISSN:0271-6798    

出版商:OVID    

年代:1989

数据来源: OVID