{"title":"Common foot deformities in children","authors":"Alexander Beer","doi":"10.1016/j.mporth.2024.10.001","DOIUrl":"10.1016/j.mporth.2024.10.001","url":null,"abstract":"<div><div>Paediatric foot deformities are common and can have a significant impact on function and quality of life. They represent a diverse group of clinical presentations from benign normal variants to complex deformity. It is crucial to have a good understanding of this subject matter, as they present commonly and early diagnosis can often improve outcomes. There has been an evolution in the management foot deformities, with surgeons moving from large open procedures to less invasive and non-surgical procedures, such as serial casting. However, there remains a role for open surgery, particularly in complex, rigid and severe cases. Common deformities that affect the paediatric foot are discussed in terms of their aetiology, clinical presentation, diagnosis and management.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 343-348"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698503","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}
{"title":"Understanding gait assessment and analysis","authors":"Tarlochan Singh Bhambra, Abdal Qadir Zafar, Adelle Fishlock","doi":"10.1016/j.mporth.2024.10.003","DOIUrl":"10.1016/j.mporth.2024.10.003","url":null,"abstract":"<div><div>The gait cycle involves a repeated sequence of tasks that result in walking. The cycle is divided into two phases: the stance and swing phase. Both phases have further sub-phases. The stance phase may be considered from the perspective of the three functional foot-ankle fulcrums or ‘rockers’. Gait analysis is defined as the assessment of gait and identification of abnormalities. The different classes of gait data include temporal-spatial parameters, kinematics, and kinetics. Instrumented gait analysis uses motion capture systems and instrumented walkways to record gait data in these various classes. Evolving technologies for gait analysis include two–dimensional camera systems and wearable devices. Inertial measuring units are small electronic wearable devices containing sensors, which record temporal-spatial gait parameters. There is potential to use inertial measuring units in conjunction with machine learning to estimate more detailed gait data. The identification of abnormal gait patterns in patients with certain neurological disorders helps guide clinical decision-making. Pattern recognition and kinematic data have been used to develop a classification system for sagittal plane gait deviations in the spastic diplegic variant of cerebral palsy. Five common patterns are recognized. These are equinus, jump, apparent equinus, crouch and asymmetric gait patterns. Orthotics are important non-operative management devices. Surgery may be used to address specific primary or secondary pathology.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 371-377"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698507","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}
Marjan Raad, Kyle James, Christopher James, Jai Relwani
{"title":"Surgical approaches for septic arthritis","authors":"Marjan Raad, Kyle James, Christopher James, Jai Relwani","doi":"10.1016/j.mporth.2024.09.005","DOIUrl":"10.1016/j.mporth.2024.09.005","url":null,"abstract":"<div><div>Bone and joint infection is an extremely common emergency procedure in paediatric orthopaedics. An arthrotomy is a surgical exploration of a joint and is commonly needed to be performed for septic arthritis on an emergency basis. Although there is an increasing trend towards arthroscopic irrigation and washout, open arthrotomy is still an important tool for orthopaedic surgeons. It also has other therapeutic purposes, and these include: debridement/removal of loose bodies, ligament reconstruction, fracture fixation, disarticulation, joint replacement and tumour excision. We describe the most commonly used approaches to perform arthrotomy in the hip, knee, ankle, shoulder, elbow, wrist, hand and fingers. Orthopaedic surgeons must be aware of common pitfalls and neurovascular structures present when performing an arthrotomy of common joints. This article provides an illustrative overview to approach each joint and will be a quick-reference guide especially for junior orthopaedic surgeons.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 378-385"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698508","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}
Tom Barrow, Kyle James, Naidu Maripuri, Thomas Crompton
{"title":"Normal variants and disorders of growth: apophysitis","authors":"Tom Barrow, Kyle James, Naidu Maripuri, Thomas Crompton","doi":"10.1016/j.mporth.2024.09.001","DOIUrl":"10.1016/j.mporth.2024.09.001","url":null,"abstract":"<div><div>Musculoskeletal conditions in children frequently lead to referrals to paediatric orthopaedic clinics, driven by anxiety among parents and primary care providers. Normal variants, which represent a substantial proportion of these referrals, require thorough understanding to distinguish them from pathologic conditions and provide appropriate reassurance. This review outlines common normal variants and disorders of growth, categorized by presenting complaints, anatomical location, and age group. Effective management often involves parental reassurance, observation, and conservative measures such as physiotherapy and activity modification. Surgical interventions are rarely required. Emphasizing the importance of collaboration between paediatric orthopaedic surgeons and primary care providers, this review highlights the importance of musculoskeletal education to reduce unnecessary referrals and optimize patient care.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 336-342"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698513","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}
{"title":"CME questions on Children's Orthopaedics","authors":"","doi":"10.1016/j.mporth.2024.10.006","DOIUrl":"10.1016/j.mporth.2024.10.006","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 405-406"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698511","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}
{"title":"Answers to the CME questions on Spinal Trauma","authors":"","doi":"10.1016/j.mporth.2024.10.005","DOIUrl":"10.1016/j.mporth.2024.10.005","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Page 407"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698502","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}
{"title":"Trauma to the lower cervical spine (sub-axial or C3–C7) in adults","authors":"Himanshu Shekhar, Andreas K. Demetriades","doi":"10.1016/j.mporth.2024.07.005","DOIUrl":"10.1016/j.mporth.2024.07.005","url":null,"abstract":"<div><div>In comparison to upper cervical and thoraco-lumbar regions, injury to the lower cervical spine (subaxial, C3–C7) is more likely to be associated with spinal cord injury. This makes this a region of special interest in the context of trauma. A sound understanding of the different injury patterns, morphology, mechanisms, neurological deficit and patient-specific factors is essential in individualizing management strategies. In this article we review the anatomy, clinical patterns of injury, and the options in their clinical management.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 289-295"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314161","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}
{"title":"Cauda equina syndrome","authors":"Gabriel Metcalf-Cuenca, Sadaquate Khan","doi":"10.1016/j.mporth.2024.07.003","DOIUrl":"10.1016/j.mporth.2024.07.003","url":null,"abstract":"<div><div>Cauda equina syndrome is a rare presentation of lumbar spine disease that can result in significant lower limb neurological deficits and permanent bladder, bowel and sexual dysfunction. Delays in diagnosis and treatment can result in irreversible worsening of the condition. Therefore, this is a major cause of litigation against spinal surgeons in the NHS. Urgent MRI scanning is the diagnostic gold-standard and should be available at all hours in all hospitals where patients with potential cauda equina syndrome present. Imaging should be performed within 4 hours of requesting and if the scan is positive for cauda equina compression then treatment should be undertaken as a matter of urgency. Surgery to decompress the cauda equina can prevent further deterioration in symptoms but compared to elective lumbar surgery carries a much higher rate of complications owing to the nature of the disease. Despite rapid treatment, patients can suffer from significant long-term sequelae and require prolonged periods of rehabilitation.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 273-278"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316228","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}
George Mataliotakis, Saeed Mohammad, Athanasios I Tsirikos
{"title":"Injuries of the thoracic spine and the thoracolumbar junction","authors":"George Mataliotakis, Saeed Mohammad, Athanasios I Tsirikos","doi":"10.1016/j.mporth.2024.07.006","DOIUrl":"10.1016/j.mporth.2024.07.006","url":null,"abstract":"<div><div>Fractures of the thoracic and thoracolumbar spine are common both in low- and high-energy injuries. Most of the fractures can be treated conservatively; however surgical intervention may be required in unstable injuries and those with spinal cord involvement. This article describes the biomechanics of the thoracic and thoracolumbar regions of the spine, explains the classification of the fracture and injury patterns and provides guidance on the decision-making for surgical management. Special considerations with regards to the approaches and length of fixation in each fracture pattern are mentioned. Categories such as fractures on the background of osteoporosis or ankylosing spondylitis are also covered.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 296-303"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316229","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}
{"title":"Spinal fractures associated with metabolic and metastatic conditions: principles of diagnosis and management","authors":"M.Zaki B. Choudhury, Athanasios I. Tsirikos","doi":"10.1016/j.mporth.2024.07.008","DOIUrl":"10.1016/j.mporth.2024.07.008","url":null,"abstract":"<div><div>Spinal fractures without significant trauma are commonly observed in daily practice. There are various descriptive terms, such as pathological fracture, vertebral compression fracture (VCF) and insufficiency fracture. Fundamentally speaking the problem arises from the inability of the bone, due to various causes to support physiological load. It is important to be able to rapidly identify the underlying causes of fractures and thus appropriately treat them. We provide an overview of the two key categories to differentiate between and a scheme to determine likely causes. Background biomechanical principles are discussed and treatment pathways reviewed.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 5","pages":"Pages 311-319"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316231","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}
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