Journal of Children's Orthopaedics最新文献

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Impact of Pavlik Harness treatment on motor skills acquisition: A case–control study 帕夫利克束带治疗对运动技能学习的影响:病例对照研究
Journal of Children's Orthopaedics Pub Date : 2024-03-27 DOI: 10.1177/18632521241240367
Ana Rita Jesus, Catarina Pinto Silva, Inês Romão Luz, José Eduardo Mendes, I. Balacó, Cristina Alves
{"title":"Impact of Pavlik Harness treatment on motor skills acquisition: A case–control study","authors":"Ana Rita Jesus, Catarina Pinto Silva, Inês Romão Luz, José Eduardo Mendes, I. Balacó, Cristina Alves","doi":"10.1177/18632521241240367","DOIUrl":"https://doi.org/10.1177/18632521241240367","url":null,"abstract":"Our purpose was to analyze the impact of Pavlik Harness treatment on children motor skills development, comparing to a control group. A total of 121 children were included: 55 cases (children with Developmental Dysplasia of the Hip) and 66 healthy controls. Cases were recruited from 2017 to 2021 and followed up to 2022. Controls (healthy children without orthopedic pathology) were recruited from 2020 to 2022. The primary endpoint was the time of achievement of three gross motor milestones (sitting without support, hands-and-knees crawling, and walking independently). The groups had no differences regarding sex distribution, gestational age, birth weight, and rate of twin pregnancy. The prevalence of positive family history of Development Dysplasia of the Hip (20.0% vs 3.0%, p < 0.003), breech presentation (38.2% vs 1.5%, p < 0.001), and C-section delivery (60.0% vs 19.7%, p < 0.001) was significantly higher in Development Dysplasia of the Hip group. Children with Development Dysplasia of the Hip achieved the three gross milestones evaluated 1 month later than healthy controls, although this was not statistically significant (p = 0.133 for sitting, p = 0.670 for crawling, and p = 0.499 for walking). Children with Development Dysplasia of the Hip, treated by Pavlik harness, do not have significant delays in motor skills acquisition.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"93 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term outcomes of reconstructive treatment for painful dislocations in patients with cerebral palsy 脑瘫患者疼痛性脱位整形治疗的长期效果
Journal of Children's Orthopaedics Pub Date : 2024-03-24 DOI: 10.1177/18632521241233165
Aleksander Koch, Maciej Kasprzyk, B. Musielak, M. Jóźwiak
{"title":"Long-term outcomes of reconstructive treatment for painful dislocations in patients with cerebral palsy","authors":"Aleksander Koch, Maciej Kasprzyk, B. Musielak, M. Jóźwiak","doi":"10.1177/18632521241233165","DOIUrl":"https://doi.org/10.1177/18632521241233165","url":null,"abstract":"This report presents the long-term results of the hip joint reconstruction in patients with spastic hip disease through open reduction, proximal femur varus derotation osteotomy, and Dega transiliac osteotomy. We analyzed retrospectively patients diagnosed with a spastic form of bilateral cerebral palsy with painful hip subluxation or dislocation. All patients underwent the same surgical procedure. The minimum follow-up time was 15 years. The study group comprised 15 patients (22 hips), classified with the Gross Motor Function Classification System as levels IV and V. The hip joint range of motion and anteroposterior X-ray examination at the final follow-up visit were compared with pre-operative data. The pain level was evaluated using the Visual Analogue Scale (VAS), and the femoral head shape was assessed using the Rutz classification. The patients’ caregivers answered questions regarding pain during sitting, personal hygiene activities, and at rest. The caregivers’ satisfaction with the treatment was also assessed with the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire. We observed a significant reduction of the hip joint pain and improvement in both radiological hip stability parameters and range of motion at the final follow-up visit. Based on the Rutz classification, one hip remained type B, while the other joints became type A. Reduced pain was reported in all three positions, with the most pronounced improvement during sitting and personal hygiene activities. Interestingly, patients with unilateral hip reconstruction were more prone to pain after reconstruction than those operated bilaterally. Primary reconstruction of the painful hip joint neurogenic dislocation results in a stable joint reduction, pain decrease, and improved quality of life in patients with cerebral palsy. IV case series.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140385509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of treatment of patella fractures in children and adolescents 儿童和青少年髌骨骨折的治疗效果
Journal of Children's Orthopaedics Pub Date : 2024-03-20 DOI: 10.1177/18632521241232301
Evan W. Beatty, Mathilde Hupin, Dennis E. Kramer, Benjamin J. Shore, B. Heyworth
{"title":"Outcomes of treatment of patella fractures in children and adolescents","authors":"Evan W. Beatty, Mathilde Hupin, Dennis E. Kramer, Benjamin J. Shore, B. Heyworth","doi":"10.1177/18632521241232301","DOIUrl":"https://doi.org/10.1177/18632521241232301","url":null,"abstract":"The purpose of this study is to assess clinical and functional outcomes in separate cohorts of operatively and nonoperatively managed pediatric patella fractures. A retrospective review was completed for patients aged 5–19 years treated for a unilateral patella fracture at a single pediatric level-1 trauma center. Patients were excluded for osteochondral fracture associated with patellar dislocation, polytrauma presentation with additional fractures, or <3 months of clinical follow-up. Functional outcomes were assessed via the Pediatric International Knee Documentation Committee form and the Marx Knee Activity Scale. A total of 53 patients met inclusion criteria; 30 patients were treated operatively and 23 patients were treated nonoperatively. Patients with patellar sleeve/pole fractures were significantly younger by 5.2 years (p < 0.01) and presented with greater variability in mechanism of injury (p < 0.01). The nonoperative cohort achieved bony healing and returned to sports at a median (interquartile range) of 1.7 (1.2–2.3) months and 2.8 (2.3–3.3) months, respectively, post-injury. The operative group achieved bony healing and returned to sports at 2.8 (2.1–3.5) months and 5.9 (4.0–7.1) months, respectively, following surgery. Median (interquartile range) Pediatric International Knee Documentation Committee and Marx scores were 98 (89–100) and 14 (10–16), respectively, for the nonoperative group, and 92 (84–99) and 13 (12–16), respectively, for the operative group. No significant differences in patient-reported outcomes were observed between fracture patterns or treatment cohorts. Pediatric and adolescent patients sustaining patella fractures reported long-term functional outcomes comparable to normative values, across multiple fracture patterns and with appropriate operative and nonoperative treatment. Fractures requiring surgery were expectedly associated with slower healing and return to sport timelines. Therapeutic Level III.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"73 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140224370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Maternal risk factors for congenital vertebral formation and mixed defects: A population-based case–control study 先天性脊椎形成和混合缺陷的母亲风险因素:基于人群的病例对照研究
Journal of Children's Orthopaedics Pub Date : 2024-03-20 DOI: 10.1177/18632521241235027
Susanna Heiskanen, I. Helenius, J. Syvänen, T. Kemppainen, E. Löyttyniemi, M. Ahonen, M. Gissler, Arimatias Raitio
{"title":"Maternal risk factors for congenital vertebral formation and mixed defects: A population-based case–control study","authors":"Susanna Heiskanen, I. Helenius, J. Syvänen, T. Kemppainen, E. Löyttyniemi, M. Ahonen, M. Gissler, Arimatias Raitio","doi":"10.1177/18632521241235027","DOIUrl":"https://doi.org/10.1177/18632521241235027","url":null,"abstract":"The etiology and risk factors of congenital vertebral anomalies are mainly unclear in isolated cases. Also, there are no reports on the risk factors for different subgroups of vertebral anomalies. Therefore, we assessed and identified potential maternal risk factors for these anomalies and hypothesized that diabetes, other chronic diseases, smoking, obesity, and medication in early pregnancy would increase the risk of congenital vertebral anomalies. All cases with congenital vertebral anomalies were identified in the Finnish Register of Congenital Malformations from 1997 to 2016 for this nationwide register-based case–control study. Five matched controls without vertebral malformations were randomly selected. Analyzed maternal risk factors included maternal age, body mass index, parity, smoking, history of miscarriages, chronic diseases, and prescription drug purchases in early pregnancy. The register search identified 256 cases with congenital vertebral malformations. After excluding 66 syndromic cases, 190 non-syndromic malformations (74 formation defects, 4 segmentation defects, and 112 mixed anomalies) were included in the study. Maternal smoking was a significant risk factor for formation defects (adjusted odds ratio 2.33, 95% confidence interval 1.21–4.47). Also, pregestational diabetes (adjusted odds ratio 8.53, 95% confidence interval 2.33–31.20) and rheumatoid arthritis (adjusted odds ratio 13.19, 95% confidence interval 1.31–132.95) were associated with mixed vertebral anomalies. Maternal pregestational diabetes and rheumatoid arthritis were associated with an increased risk of mixed vertebral anomalies. Maternal smoking increases the risk of formation defects and represents an avoidable risk factor for congenital scoliosis. III","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140226571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single versus double retrograde intramedullary nail technique for treatment of displaced proximal humeral fractures in children: A retrospective cohort study 治疗儿童移位性肱骨近端骨折的单逆行髓内钉技术与双逆行髓内钉技术:回顾性队列研究
Journal of Children's Orthopaedics Pub Date : 2024-03-18 DOI: 10.1177/18632521241238149
E. Samara, Isabella Locatelli, B. Tschopp, Nicolas Lutz, Pierre-Yves Zambelli
{"title":"Single versus double retrograde intramedullary nail technique for treatment of displaced proximal humeral fractures in children: A retrospective cohort study","authors":"E. Samara, Isabella Locatelli, B. Tschopp, Nicolas Lutz, Pierre-Yves Zambelli","doi":"10.1177/18632521241238149","DOIUrl":"https://doi.org/10.1177/18632521241238149","url":null,"abstract":"Highly displaced proximal humeral fractures in children with low remodeling potential need to be reduced and fixed. The use of two flexible retrograde nails became the most popular fixation technique due to the excellent functional outcome, the low complication rates, and the possibility of early mobilization. A modified single retrograde technique has been suggested by the authors to address the main disadvantage of this technique, the long operative duration. The aim of this study was to compare these techniques in terms of efficacy, and clinical and radiological outcomes. We performed a retrospective, monocentric study. Two groups of patients were defined: One was treated with the standard flexible retrograde double nail technique and the other with the modified single nail technique. The demographic and fracture characteristics were similar in both groups and the postoperative immobilization with a simple sling for 2 weeks. We compared the surgical duration for the initial fixation and hardware removal procedures. The Quick Disabilities of the Arm, Shoulder, and Hand score, the secondary displacement at 1-week follow-up, the radiological union at 6-week follow-up, and the perioperative and short-term complications were also assessed for both groups. The surgical duration of the initial fixation procedure was significantly shorter in single nail technique group ( p = 0.005). The percentage of excellent Quick Disabilities of the Arm, Shoulder, and Hand score (0) was similar in the two groups ( p = 0.98). No secondary displacement was reported for the double nail technique group. In only one patient from the single nail technique group, we detected a secondary displacement at the first week control which did not need reoperation. In both groups, fractures were healed on the 6-week radiologic control. No cases of infection, superficial skin irritation, neurological damage, or complications related to implant removal were reported in both groups. The single nail technique of fixation proximal humeral fractures in children addresses the disadvantage of long surgical times, described until today, with the double nail technique without compromising the excellent functional and radiological short-term outcomes. level III","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"35 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140234524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical treatment for congenital vertebral anomalies with bilateral bifid intrathoracic rib in association: A series of five cases 先天性脊椎畸形伴双侧胸内肋骨双折的手术治疗:五例系列病例
Journal of Children's Orthopaedics Pub Date : 2024-03-18 DOI: 10.1177/18632521241232304
Han-Mei Zhang, Lining Zhu, Jiahao Jiao, D. Guo, Xuejun Zhang, Z. Yao
{"title":"Surgical treatment for congenital vertebral anomalies with bilateral bifid intrathoracic rib in association: A series of five cases","authors":"Han-Mei Zhang, Lining Zhu, Jiahao Jiao, D. Guo, Xuejun Zhang, Z. Yao","doi":"10.1177/18632521241232304","DOIUrl":"https://doi.org/10.1177/18632521241232304","url":null,"abstract":"Congenital scoliosis is often associated with costal deformities, of which a bilateral bifid intrathoracic rib is very rare. The aim of this study was to retrospectively summarize the clinical manifestations, imaging characteristics, treatment strategies, and postoperative outcomes of five patients with bilateral bifid intrathoracic rib. We retrospectively reviewed the imaging findings and medical records of five pediatric patients (two girls, three boys) with bilateral bifid intrathoracic rib who were surgically treated for congenital kyphoscoliosis (mean age = 8 years). The clinical manifestations, imaging characteristics, treatment strategies, and postoperative outcome were summarized. Four of five patients showed abnormalities from birth. All five patients presented with kyphoscoliosis and a fused vertebral body or lamina. The bilateral bifid intrathoracic rib was located at T2–3 in three patients, T7 in one patient, and T10 in one patient. Various congenital spinal deformities and multiple system malformations were present in all five patients. Three patients had preoperative neurological deficits. For corrective surgery, one patient received a traditional growing rod implantation, one patient underwent resection of a bony septum, and three patients underwent spinal osteotomy. One patient suffered complete paralysis of the lower limbs after surgery. Bilateral bifid intrathoracic rib is a rare anomaly that typically occurs in patients with serious kyphoscoliosis. Bilateral bifid intrathoracic rib patients show similar clinical and radiological characteristics and are likely to exhibit neurological deficits before or following corrective surgery. Spinal surgeons should be aware of the high risk of permanent neurological complications related to surgery in these patients. level IV.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"90 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A comparison of screw and suture button fixation in the management of adolescent ankle syndesmotic injuries 在治疗青少年踝关节巩膜损伤时比较螺钉固定和缝合扣固定的效果
Journal of Children's Orthopaedics Pub Date : 2024-03-16 DOI: 10.1177/18632521241238889
Luke Verlinsky, David M. Heath, David A. Momtaz, Boris Christopher, Aaron Singh, Steven D Gibbons
{"title":"A comparison of screw and suture button fixation in the management of adolescent ankle syndesmotic injuries","authors":"Luke Verlinsky, David M. Heath, David A. Momtaz, Boris Christopher, Aaron Singh, Steven D Gibbons","doi":"10.1177/18632521241238889","DOIUrl":"https://doi.org/10.1177/18632521241238889","url":null,"abstract":"Ankle injuries involving the tibiofibular syndesmosis often necessitate operative fixation to restore stability to the ankle. Recent literature in the adult population has suggested that suture button fixation may be superior to screw fixation. There is little evidence as to which construct is preferable in the pediatric and adolescent population. This study investigates outcomes of suture button and screw fixation in adolescent ankle syndesmotic injuries. A retrospective matched cohort study over 10 years of pediatric patients who underwent ankle syndesmotic fixation at a large Level 1 Trauma Center was conducted. Both isolated syndesmotic injuries and ankle fractures with syndesmotic disruption were included. Preoperative variables collected include basic patient demographics, body mass index, and fracture type. Suture button and screw cohorts were matched based on age, race, sex, and open fracture utilizing propensity scores. Outcomes assessed include reoperation and implant failure. A total of 44 cases of operative fixation of the ankle syndesmosis were identified with a mean age of 16 years. After matching cohorts based on age, sex, race, and open fracture status, there were 17 patients in the suture button and screw cohorts, respectively. Patients undergoing screw fixation had a six times greater risk of reoperation (p = 0.043) and 13 times greater risk of implant failure (p < 0.001). Out of six cases of reoperation in the screw cohort, five were unplanned. Our findings favor suture button fixation in operative management of adolescent tibiofibular syndesmotic injuries. Compared with screws, suture buttons are associated with lower risk of both reoperation and implant failure. level III therapeutic.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"132 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140235797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associated injuries and complications in pediatric pelvic fractures requiring hospitalization: A series of 315 cases 需要住院治疗的小儿骨盆骨折的相关损伤和并发症:315 例系列病例
Journal of Children's Orthopaedics Pub Date : 2024-03-14 DOI: 10.1177/18632521241237933
Baojian Song, Qiang Wang, Wei Feng, Danjiang Zhu, Z. Yao, Xuejun Zhang
{"title":"Associated injuries and complications in pediatric pelvic fractures requiring hospitalization: A series of 315 cases","authors":"Baojian Song, Qiang Wang, Wei Feng, Danjiang Zhu, Z. Yao, Xuejun Zhang","doi":"10.1177/18632521241237933","DOIUrl":"https://doi.org/10.1177/18632521241237933","url":null,"abstract":"Pediatric pelvic fractures are uncommon. This study aimed to investigate the clinical characteristics of pediatric pelvic fractures requiring hospitalization and analyze their correlation with associated injuries and complications. Data from 315 pediatric pelvic fracture patients admitted to our hospital from January 2006 to December 2021 were retrospectively analyzed. Sex, age, modified Torode–Zieg classification, abbreviated injury scale score, injury severity score, mortality, and concomitant injuries were analyzed. Of the 285 (90.5%) cases of combined injuries, most injuries occurred in the abdomen (64.8%) and lower extremities (47.6%), followed by the chest (45.4%) and head (34.6%). A total of 78 patients (24.8%) were transferred to the intensive care unit. In total, 94 patients (29.8%) had complications during hospitalization. There were differences based on injury mechanism ( p = 0.001), with the highest complication rate in the fall injury group (32 cases (46.4%)). Approximately 51.4% of patients received surgical treatment for problems that were not related to pelvic fractures. Among these, 30.2% necessitated surgical intervention on the lower limbs. Abdominal surgery was necessary in 19.0% of patients. Children who have pelvic fractures frequently require hospitalization due to the presence of severe injuries in other areas of their bodies. IIIB pelvic fractures frequently occur in conjunction with more severe abdominal injuries; therefore, the prompt management of cavity and organ injuries is of particular importance. Blood transfusion and injury severity score were associated risk factors for intensive care unit admission.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"22 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MR-based Bony 3D models enable radiation-free preoperative patient-specific analysis and 3D printing for SCFE patients 基于磁共振的骨骼三维模型可为 SCFE 患者提供无辐射的术前患者特异性分析和三维打印技术
Journal of Children's Orthopaedics Pub Date : 2024-02-29 DOI: 10.1177/18632521241229618
Till D Lerch, Tilman Kaim, Valentin Grob, M. Hanke, Florian Schmaranzer, S. D. Steppacher, Jasmin D. Busch, Kai Ziebarth
{"title":"MR-based Bony 3D models enable radiation-free preoperative patient-specific analysis and 3D printing for SCFE patients","authors":"Till D Lerch, Tilman Kaim, Valentin Grob, M. Hanke, Florian Schmaranzer, S. D. Steppacher, Jasmin D. Busch, Kai Ziebarth","doi":"10.1177/18632521241229618","DOIUrl":"https://doi.org/10.1177/18632521241229618","url":null,"abstract":"Objectives: Slipped capital femoral epiphyses (SCFE) is a common pediatric hip disease with the risk of osteoarthritis and impingement deformities, and 3D models could be useful for patient-specific analysis. Therefore, magnetic resonance imaging (MRI) bone segmentation and feasibility of 3D printing and of 3D ROM simulation using MRI-based 3D models were investigated. Methods: A retrospective study involving 22 symptomatic patients (22 hips) with SCFE was performed. All patients underwent preoperative hip MR with pelvic coronal high-resolution images (T1 images). Slice thickness was 0.8–1.2 mm. Mean age was 12 ± 2 years (59% male patients). All patients underwent surgical treatment. Semi-automatic MRI-based bone segmentation with manual corrections and 3D printing of plastic 3D models was performed. Virtual 3D models were tested for computer-assisted 3D ROM simulation of patients with knee images and were compared to asymptomatic contralateral hips with unilateral SCFE (15 hips, control group). Results: MRI-based bone segmentation was feasible (all patients, 100%, in 4.5 h, mean 272 ± 52 min). Three-dimensional printing of plastic 3D models was feasible (all patients, 100%) and was considered helpful for deformity analysis by the treating surgeons for severe and moderate SCFE. Three-dimensional ROM simulation showed significantly (p < 0.001) decreased flexion (48 ± 40°) and IR in 90° of flexion (–14 ± 21°, IRF-90°) for severe SCFE patients with MRI compared to control group (122 ± 9° and 36 ± 11°). Slip angle improved significantly (p < 0.001) from preoperative 54 ± 15° to postoperative 4 ± 2°. Conclusion: MRI-based 3D models were feasible for SCFE patients. Three-dimensional models could be useful for severe SCFE patients for preoperative 3D printing and deformity analysis and for ROM simulation. This could aid for patient-specific diagnosis, treatment decisions, and preoperative planning. MRI-based 3D models are radiation-free and could be used instead of CT-based 3D models in the future.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"4 5","pages":"162 - 170"},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140409785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of elastic stable intramedullary nailing versus Kirschner wires in treatment of pediatric radial neck fractures 在治疗小儿桡骨颈骨折时比较弹性稳定髓内钉和 Kirschner 钢丝
Journal of Children's Orthopaedics Pub Date : 2024-02-23 DOI: 10.1177/18632521241233444
Kaixuan Tian, Jin-chao Cao, Xinjian Pei, Yuchang Liu, Tianyou Li, Yazhou Li
{"title":"Comparison of elastic stable intramedullary nailing versus Kirschner wires in treatment of pediatric radial neck fractures","authors":"Kaixuan Tian, Jin-chao Cao, Xinjian Pei, Yuchang Liu, Tianyou Li, Yazhou Li","doi":"10.1177/18632521241233444","DOIUrl":"https://doi.org/10.1177/18632521241233444","url":null,"abstract":"The aim of the study was to compare the different internal fixations between elastic stable intramedullary nailing and Kirschner wires in treatment of angulated radial neck fractures. We retrospectively reviewed the patients with radial neck fracture without associated injuries who underwent surgery approach in our department during April 2011–March 2020. There were 62 patients meeting all the criteria with complete clinical data, with median age of 7.5 (IQR 5.8–9.5) years, 34 males and 28 females. The preoperative fracture pattern was assessed according to the Judet classification system. Depending on the materials implanted and fixation strategy, the patients could be divided into a Kirschner wire group and an elastic stable intramedullary nailing group. Final functional outcomes of patients were assessed by the Mayo Elbow Performance Score and Tibone–Stoltz functional evaluation classification. The Kirschner wire group included 37 patients, with 4.8 years median follow-up. The elastic stable intramedullary nailing group included 25 patients with 5.9 years median follow-up. There were no significant differences in gender, age, Judet classification, average operative time, Mayo Elbow Performance Score, Tibone–Stoltz classification, or length of hospital stay between groups. However, the time to union in the Kirschner wire group was significantly shorter than that in the elastic stable intramedullary nailing group (p < 0.05). Both groups achieved satisfactory functional and cosmetic results. In the management of pediatric radial neck fractures, both elastic stable intramedullary nailing and Kirschner wire internal fixation have shown equivalent therapeutic results, leading to satisfactory functional outcomes. The selection of the internal fixation approach can be influenced by the patient’s fracture characteristics and the surgeon’s preferences. Level III; Retrospective Comparison; Treatment Study.","PeriodicalId":138259,"journal":{"name":"Journal of Children's Orthopaedics","volume":"3 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140436191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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