Journal of Pediatric Orthopaedics-Part B最新文献_第3页

Interobserver reliability of Pirani scoring for idiopathic clubfoot in walking-age children. 学龄儿童特发性内翻足的皮拉尼评分的观察者间信度。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-21 DOI: 10.1097/BPB.0000000000001236

Anil Agarwal, Ashish Upadhyay, Varun Garg, Kishmita Sachdeva, Ankitha Ks, Jainam Salot

{"title":"Interobserver reliability of Pirani scoring for idiopathic clubfoot in walking-age children.","authors":"Anil Agarwal, Ashish Upadhyay, Varun Garg, Kishmita Sachdeva, Ankitha Ks, Jainam Salot","doi":"10.1097/BPB.0000000000001236","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001236","url":null,"abstract":"Pirani scoring system is one of the most commonly used tools to assess the initial deformity, monitor the treatment progression, and identify relapse in clubfoot. The method has been demonstrated to correlate well with the sequential correction of deformity for children under age 1 year. We conducted a study to examine the interobserver reliability of Pirani scores in children of walking-age. The retrospective study focused on children >1 year age with idiopathic clubfoot presenting for primary treatment. The Pirani scores at presentation charted by pediatric orthopedic consultant and orthopedic registrars were compared and the intergroup reliability calculated using Cohen's kappa. Thirty-five feet in 22 clubfoot children (13 bilateral) were analyzed. The mean child's age was 3.9 years. The mean Pirani score for the consultant was 3.2 and for the registrars was 3.6. The overall reliability of Pirani score was 0.3 ('fair'). The highest reliability was calculated for the head of talus (0.55), rigid equinus (0.48), and lateral border (0.44) (moderate). A lower kappa was recorded for medial crease (0.28), posterior crease (0.34), and empty heel (0.4). The registrars graded the clubfoot deformity in the walking-age child as more severe compared to the consultant. The mean Pirani scores for medial and posterior crease subcomponents were low. Contrary to the common perception, empty heel manifested even in this age group. Looking to the statistics of 'fair' reliability of Pirani score for older child, further research is warranted to develop more reliable scores for assessment and treatment of clubfoot.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short-term outcomes of gradual ulnar lengthening in multiple hereditary osteochondromas of the forearm with monolateral external fixator. 单侧外固定架治疗前臂多发性遗传性骨软骨瘤患者尺骨逐渐延长的短期疗效。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-09 DOI: 10.1097/BPB.0000000000001232

Seyed Arman Moein, Javad Dehghani, Reza Fereidooni, Mohammad Hadi Gerami, Asal Seifaei, Seyyed Hamidreza Ayatizadeh

{"title":"Short-term outcomes of gradual ulnar lengthening in multiple hereditary osteochondromas of the forearm with monolateral external fixator.","authors":"Seyed Arman Moein, Javad Dehghani, Reza Fereidooni, Mohammad Hadi Gerami, Asal Seifaei, Seyyed Hamidreza Ayatizadeh","doi":"10.1097/BPB.0000000000001232","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001232","url":null,"abstract":"Hereditary multiple exostoses is an autosomal dominant genetic condition primarily affecting long bones. Forearm deformities, including wrist ulnar deviation, ulnar shortening, radial or ulnar bowing, and radial head dislocation, are common manifestations. Gradual ulnar lengthening is suggested as a viable treatment option for managing these deformities. This retrospective single-center study included 15 forearms treated with gradual ulnar lengthening using a monolateral external fixator by a single surgeon. Clinical and radiological characteristics were recorded preoperatively and during follow-ups. The Wilcoxon signed-rank test compared preoperative and postoperative radiological and clinical parameters, while McNemar's test assessed changes in radial head dislocation or subluxation. Significant radiological improvements were observed post-treatment. Proportional ulnar length increased from a mean of 0.85 ± 0.10 preoperatively to 1.11 ± 0.03 at the last follow-up (P < 0.001). Ulnar variance decreased from a mean of 17.6 ± 5.58 mm preoperatively to 0.13 ± 1.81 mm at the last follow-up (P < 0.001), while radial bowing decreased from a mean of 0.06 ± 0.02 to 0.05 ± 0.01 at the last follow-up (P < 0.001). In addition, the radioarticular angle decreased significantly from a mean of 29.93 ± 7.34 to 20.20 ± 5.71° (P < 0.001). The incidence of radial head dislocation or subluxation decreased significantly, from 11 patients preoperatively to only one at the last follow-up. These findings demonstrate the effectiveness of gradual ulnar lengthening with a monolateral external fixator in correcting forearm deformities and reducing the incidence of radial head dislocation or subluxation.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intramalleolar triplane ankle fractures in adolescents. 青少年踝内三平面踝关节骨折。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-08 DOI: 10.1097/BPB.0000000000001230

Heloisa Z Faggion, Javier Masquijo, Weverley R Valenza, Jamil F Soni, Gabriel J S Lange

{"title":"Intramalleolar triplane ankle fractures in adolescents.","authors":"Heloisa Z Faggion, Javier Masquijo, Weverley R Valenza, Jamil F Soni, Gabriel J S Lange","doi":"10.1097/BPB.0000000000001230","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001230","url":null,"abstract":"This article aims to describe a multicenter cohort of atypical triplane ankle fractures with intramalleolar involvement of the epiphysis, providing insights into the affected population, treatment outcomes, and complications. In addition, we propose a treatment strategy for such fractures based on our findings. A retrospective analysis was conducted on adolescent patients diagnosed with triplane ankle fractures. Data from three participating centers in Brazil and Argentina were collected and analyzed. Treatment strategies, including surgical and nonsurgical approaches, were evaluated. Clinical outcomes such as pain levels, functional scores (AOFAS), and return to normal activities were assessed. Radiographic evaluations were performed to evaluate fracture healing and alignment. Data were collected from seven patients with an average age of 13 years. The sample consisted predominantly of male patients (6/7), with the left side affected (6/7) and Shin type 3 fractures. Two cases were treated conservatively, with consolidation within the expected period without subsequent displacements or negative functional repercussions (AOFAS score, 100). In surgical cases, starting fixation from the metaphysis made it possible to avoid fixation of the epiphyseal fragment in all cases, except one. All surgically treated cases had consolidation within the expected time, without subsequent deviations or complications. This multicenter evaluation offers valuable insights into the presentation of fractures, diverse treatment approaches employed, and their respective clinical and radiographic outcomes. However, further prospective studies with larger sample sizes are necessary to validate these findings and to establish evidence-based treatment guidelines for this specific fracture pattern in the adolescent population.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Was the ultrasound examination for developmental dysplasia of the hip performed correctly? Introduction of a rapid training tool for nonexpert practitioners. 髋关节发育不良的超声检查是否正确？为非专业从业人员引入快速培训工具。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-07 DOI: 10.1097/BPB.0000000000001228

Manuele Lampasi, Giovanni Lucchesi, Camila Bettuzzi, Salvatore Bonforte, Federico Canavese

{"title":"Was the ultrasound examination for developmental dysplasia of the hip performed correctly? Introduction of a rapid training tool for nonexpert practitioners.","authors":"Manuele Lampasi, Giovanni Lucchesi, Camila Bettuzzi, Salvatore Bonforte, Federico Canavese","doi":"10.1097/BPB.0000000000001228","DOIUrl":"https://doi.org/10.1097/BPB.0000000000001228","url":null,"abstract":"Pediatricians and general practitioners are involved in the newborn screening for developmental dysplasia of the hip. They often rely on the quality of the ultrasound (US) examination to make diagnostic and therapeutic decisions. Therefore, the professional must be able to assess its quality. The aim of our work is to present a new system to evaluate the quality of a neonatal hip US and to assess the effectiveness and reproducibility of this tool among professionals involved in the evaluation of the neonatal hip but not experts in the radiological examination of hip US. In a 15-min training session, 135 professionals involved in neonatal hip US screening with limited or no experience in evaluating the quality of hip US were taught to recognize the basic landmarks of hip US using evocative descriptions (Christmas ball) despite the technical terms. Before and after training, participants were given a test of 10 hip US images presented in random order and asked to identify incorrect images. One hundred thirty-five physicians participated in the study. In the first and second evaluation, participants answered 1.46 ± 2.49 and 8.64 ± 1.51 questions correctly on average (P < 0.05); analysis of the individual questions showed a significant improvement (P < 0.05) for all questions. A simple and relatively quick training tool can help professionals with little or no experience in interpreting neonatal hip US to understand when a hip US exam has been performed incorrectly and improve their diagnostic and therapeutic decisions. Level of evidence: III.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical outcomes of gradual reduction of late-detected developmental dysplasia of the hip using ultrasound-guided flexion abduction continuous traction: a midterm follow up study. 利用超声引导下的屈曲外展持续牵引逐步缩小晚期发现的髋关节发育不良的临床效果：中期随访研究。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-01 Epub Date: 2024-08-06 DOI: 10.1097/BPB.0000000000001201

Yaichiro Okuzu, Masako Tsukanaka, Fusako Shimozono, Mitsuru Soen, Akiko Miwa, Yutaka Kuroda, Toshiyuki Kawai, Yugo Morita, Shuichi Matsuda, Tohru Futami

{"title":"Clinical outcomes of gradual reduction of late-detected developmental dysplasia of the hip using ultrasound-guided flexion abduction continuous traction: a midterm follow up study.","authors":"Yaichiro Okuzu, Masako Tsukanaka, Fusako Shimozono, Mitsuru Soen, Akiko Miwa, Yutaka Kuroda, Toshiyuki Kawai, Yugo Morita, Shuichi Matsuda, Tohru Futami","doi":"10.1097/BPB.0000000000001201","DOIUrl":"10.1097/BPB.0000000000001201","url":null,"abstract":"Reducing the avascular necrosis (AVN) rate in infants treated for developmental dysplasia of the hip (DDH) is important. We previously reported the clinical outcomes of gradual reduction via ultrasound-guided flexion abduction continuous traction (FACT-R), which achieved a 99% reduction with an AVN rate of 1.0% in infants <12 months. Here, we investigated the clinical outcomes of late-detected DDH after FACT-R. Infants ≥12 months who were treated with FACT-R for DDH from January 1995 to 2007 and followed up for 6 years were enrolled. Treatment comprised continuous traction, a hip-spica cast, and an abduction brace. The rates of reduction, redislocation, AVN, and secondary osteotomy surgery were evaluated. In the study patients ( n = 26, hips 30), the mean age at the time of traction therapy was 23 months (range: 13-44) and the mean follow-up was 12.5 years (range: 6-16.4). Female gender and the left side were predominant. The rates of reduction, redislocation, and AVN were 100%, 0%, and 0%, respectively. However, 25 hips (83%) required secondary osteotomy surgery, including Salter innominate osteotomy in 21 hips, Salter innominate osteotomy combined with femoral osteotomy in 3 hips, and triple pelvic osteotomy in 1 hip. They had a larger acetabular index after FACT-R ( P = 0.04) and a longer duration of FACT-R ( P = 0.05). All hips were successfully reduced, with no redislocation or AVN. However, most hips required a secondary osteotomy surgery because of residual dysplasia. Careful follow-up and informed consent for secondary osteotomy surgery is thus essential.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"51-56"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bending osteotomy through the distal tibial physis for stable reduction of the ankle joint in fibular hemimelia. Update at skeletal maturity. 通过胫骨远端骨骺进行弯曲截骨术，稳定缩小腓骨半脱位患者的踝关节。骨骼成熟期的最新进展

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-01 Epub Date: 2023-12-29 DOI: 10.1097/BPB.0000000000001144

G Ulrich Exner, Gerardo J Maquieira, Leonhard E Ramseier

{"title":"Bending osteotomy through the distal tibial physis for stable reduction of the ankle joint in fibular hemimelia. Update at skeletal maturity.","authors":"G Ulrich Exner, Gerardo J Maquieira, Leonhard E Ramseier","doi":"10.1097/BPB.0000000000001144","DOIUrl":"10.1097/BPB.0000000000001144","url":null,"abstract":"Fibular hemimelia is a complex longitudinal malformation of the lower extremity with partial or complete deficiency of the fibula resulting in dorso-fibular dislocation of the hindfoot. Typically associated are talocalcaneal coalition, absence of rays of the foot, diaphyseal tibial deformity of valgus-procurvatum type and longitudinal growth deficiency. We have addressed the deformity of the distal tibial epiphysis surgically by a metaphyseal osteotomy to bend through the physis inspired by the Pemberton's acetabular osteotomy in 7 to 21-month-old children. Short-term results of a maximum of 42 months of follow-up have been published. Meanwhile, the first 4 patients thus treated have reached skeletal maturity, and the long-term results are presented. Three patients with unilateral and one patient with bilateral fibular hemimelia were operated on as described before at ages 7, 9, 15, and 18 months. Subsequently, several other procedures have been performed on all patients mainly consisting of lengthening of the tibia combined with axial corrections as well as additional foot alignment if needed. The osteotomy leads to stable axial retainment of the hindfoot in all patients without premature closure of the physis. Most of them need adaptation of footwear. None of the patients at present would favor to have been treated by amputation. The technique has shown good clinical results with preserved growth of the physis of the distal tibia and full axial weight bearing at long-term. In selected cases, this technique should be considered as a valuable alternative to other reconstructions.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"14-19"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality of life in adult patients with developmental dysplasia of the hip who were treated for hip dislocation during childhood. 曾在儿童时期接受过髋关节脱位治疗的髋关节发育不良成年患者的生活质量。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-01 Epub Date: 2024-02-26 DOI: 10.1097/BPB.0000000000001173

Kenta Sawamura, Hiroshi Kitoh, Masaki Matsushita, Kenichi Mishima, Yasunari Kamiya, Shiro Imagama

{"title":"Quality of life in adult patients with developmental dysplasia of the hip who were treated for hip dislocation during childhood.","authors":"Kenta Sawamura, Hiroshi Kitoh, Masaki Matsushita, Kenichi Mishima, Yasunari Kamiya, Shiro Imagama","doi":"10.1097/BPB.0000000000001173","DOIUrl":"10.1097/BPB.0000000000001173","url":null,"abstract":"Developmental dysplasia of the hip (DDH) can lead to premature loss of hip function if not properly treated; however, few studies have focused on the long-term outcomes of DDH. We conducted a survey of health-related quality of life in adult patients with DDH who were treated for hip dislocation during childhood. We sent a questionnaire to 287 adult patients with DDH who were treated for hip dislocation during childhood in our institutions. We examined patient demographics, disease-specific medical history, and health-related quality of life using the short form-36. Physical component summary (PCS), mental component summary (MCS) and role/social component summary (RCS) were compared between the patients and Japanese standard values. Sixty-eight patients were evaluated after exclusion. The overall mean PCS, MCS and RCS scores of the patients were comparable to the standard values. The PCS was maintained until the age of 50, but it was significantly decreased in 10 patients over 50 years old. In addition, PCS was significantly lower in patients who underwent open reduction than in those who were conservatively reduced. The MCS and RCS of the patients did not differ from the standard values in each age and treatment group. Additionally, the PCS, MCS and RCS did not differ according to bilaterality, age at diagnosis, or requirement for additional surgeries. Physical quality of life was maintained until the age of 50 but rapidly declined thereafter in patients with DDH, especially in those who required open reduction during childhood.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"38-43"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting prolonged hospital stay following hip dysplasia surgery in the pediatric population. 儿童髋关节发育不良手术后住院时间延长的预测。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-01 Epub Date: 2024-07-08 DOI: 10.1097/BPB.0000000000001198

Sarah Dance, Theodore Quan, Philip M Parel, Rachel Ranson, Sean A Tabaie

{"title":"Predicting prolonged hospital stay following hip dysplasia surgery in the pediatric population.","authors":"Sarah Dance, Theodore Quan, Philip M Parel, Rachel Ranson, Sean A Tabaie","doi":"10.1097/BPB.0000000000001198","DOIUrl":"10.1097/BPB.0000000000001198","url":null,"abstract":"Previous studies have shown that minimizing the length of hospital stay (LOS) following surgical procedures reduces costs and can improve the patients' quality of life and satisfaction. However, this relationship has not been defined following operative treatment for developmental dysplasia of the hip (DDH). Therefore, the purpose of this study was to determine the most important nonmodifiable and modifiable factors that can predispose patients to require a prolonged LOS following hip dysplasia surgery. From 2012 to 2019, a national pediatric database was used to identify pediatric patients who underwent surgery for hip dysplasia. Demographic, clinical, and comorbidity variables were analyzed in a patient cohort who had a normal LOS versus one with an extended LOS using chi-square tests and analysis of variance. Statistically significant variables ( P value <0.05) were inputted into an artificial neural network model to determine the level of importance. Out of 10,816 patients, 594 (5.5%) had a prolonged LOS following DDH surgery. The five most important variables to predict extended LOS following hip dysplasia surgery were increased operative time (importance = 0.223), decreased BMI (importance = 0.158), older age (importance = 0.101), increased preoperative international normalized ratio (importance = 0.096), and presence of cardiac comorbidities (importance = 0.077). Operative time, BMI, age, preoperative international normalized ratio, and cardiac comorbidities had the greatest effect on predicting prolonged LOS postoperatively. Evaluating factors that impact patients' LOS can help optimize costs and patient outcomes.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"44-50"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low osteotomy cut of Dega procedure for older children with developmental dysplasia of the hip. 为髋关节发育不良的大龄儿童实施 Dega 手术的低截骨术。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-01 Epub Date: 2024-02-27 DOI: 10.1097/BPB.0000000000001163

Ming-Hua Du, Rui-Jiang Xu, Wen-Chao Li, Hai-Yan Zhu

{"title":"Low osteotomy cut of Dega procedure for older children with developmental dysplasia of the hip.","authors":"Ming-Hua Du, Rui-Jiang Xu, Wen-Chao Li, Hai-Yan Zhu","doi":"10.1097/BPB.0000000000001163","DOIUrl":"10.1097/BPB.0000000000001163","url":null,"abstract":"The effect on acetabular management in developmental dysplasia of the hip (DDH) patients aged 7 or older with modified low Dega osteotomy procedure was evaluated. Patients between 7 and 14 years old were managed with modified low Dega osteotomy and open reduction and concomitant procedures to evaluate whether low level osteotomy improved the clinical and radiologic outcomes after treatment. Clinical status was assessed using the modified McKay's criteria; radiologic evaluations were assessed for the modified Severin classification, the mean acetabular index (AI), Sharp angle and center-edge (CE) angle. And occurrence of triradiate cartilage injury and complications was recorded. Forty-two DDH patients (57 hips) between 7 and 14 years old were managed with modified low Dega osteotomy. The results demonstrated the latest follow-up 43 hips (75.4%) were rated excellent and 10 hips (17.5%) rated good according to the modified McKay criteria and 41 hips (71.9%) were rated excellent and 11 hips (19.3%) rated good according to Modified Severin classification, respectively. The mean Hip Score improved from 69.53 ± 7.14 before the operation to 93.17 ± 8.43 at the final follow-up. The mean AI changed from 31.9° to 20.2°, mean Sharp angle decreased from 59.3° to 38.8° and mean CE angle increased from -10.9° to 35.2°, preoperatively and at latest follow-up, respectively. The modified low Dega osteotomy combined with open reduction and concomitant procedures were found to be adequate in improving instant and sustained clinical and radiographic outcomes for the late detected pediatric walking DDH patients.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"57-63"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11594551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does open or closed reduction with internal fixation reduces the incidence of complications in neck of femur fractures in pediatrics: a meta-analysis and systematic review. 开放或闭合复位加内固定能否降低儿科股骨颈骨折并发症的发生率：一项荟萃分析和系统综述。

IF 0.9 4区医学

Journal of Pediatric Orthopaedics-Part B Pub Date : 2025-01-01 Epub Date: 2024-05-03 DOI: 10.1097/BPB.0000000000001186

Ahmed T Hafez, Mohammed Aly, Islam Omar, George Richardson, Kyle James

{"title":"Does open or closed reduction with internal fixation reduces the incidence of complications in neck of femur fractures in pediatrics: a meta-analysis and systematic review.","authors":"Ahmed T Hafez, Mohammed Aly, Islam Omar, George Richardson, Kyle James","doi":"10.1097/BPB.0000000000001186","DOIUrl":"10.1097/BPB.0000000000001186","url":null,"abstract":"The neck of femur fracture (FNF) in children is a rare injury with a high incidence of complications such as avascular necrosis (AVN), coxa-vara and nonunion. The aim of this review is to compare the incidence of complications between open reduction with internal fixation (ORIF) and closed reduction with internal fixation (CRIF) of FNF in children. Two independent reviewers searched EMBASE, MEDLINE, COCHRANE and PUBMED databases from inception until April 2022 according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies included comparison of complications between open and closed approaches with fixation of FNF in patients less than 18 years old. Publication bias was assessed using Egger's test while the Newcastle-Ottawa tool was used to assess the methodological quality of the studies. A total of 724 hip fractures from 15 included studies received either ORIF or CRIF. Overall, the rate of AVN was approximately 21.7% without statistical significance between both reduction methods [relative risk (RR) = 0.909, using fixed effect model at 95% confidence interval (CI, 0.678-1.217)]. No significant heterogeneity among AVN studies ( I2 = 3.79%, P = 0.409). Similarly, neither coxa-vara nor nonunion rates were statistically significant in both treatment groups (RR = 0.693 and RR = 0.506, respectively). Coxa-vara studies showed mild heterogeneity ( I2 = 27.8%, P = 0.218), while significant publication bias was encountered in nonunion studies ( P = 0.048). No significant difference in the incidence of AVN, coxa-vara and nonunion between ORIF or CRIF of FNF in children. High-quality studies as Randomised Controlled Trials can resolve the inconsistency and heterogeneity of other risk factors including age, initial displacement, fracture type, reduction quality and time to fixation.","PeriodicalId":50092,"journal":{"name":"Journal of Pediatric Orthopaedics-Part B","volume":" ","pages":"64-73"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0