Journal of Childrens Orthopaedics最新文献

{"title":"A salvage procedure: Radial head excision in children and adolescents-short-to-midterm outcomes and overview of the literature.","authors":"Christiane Kruppa,&nbsp;Alexis Brinkemper,&nbsp;Jana Cibura,&nbsp;Matthias Königshausen,&nbsp;Charlotte Cibura,&nbsp;Thomas A Schildhauer,&nbsp;Marcel Dudda","doi":"10.1177/18632521231167395","DOIUrl":"https://doi.org/10.1177/18632521231167395","url":null,"abstract":"<p><strong>Purpose: </strong>Purpose of the study was to report the outcomes after radial head excision in children and adolescents in addition with a review of the current literature.</p><p><strong>Methods: </strong>We report a series of five children and adolescents, who had undergone a post-traumatic radial head excision. Clinical outcomes were evaluated in terms of elbow/wrist range of motion, stability, deformity and discomforts or restrictions at two follow-up points. Radiographic changes were evaluated.</p><p><strong>Results: </strong>Patient's age at time of the radial head excision averaged 14.6 (13-16) years. Mean time from the injury to the radial head excision was 3.6 (0-9) years. Follow-up I averaged 4.4 (1-8) years and follow-up II 8.5 (7-10) years. At follow-up I, patients showed an average elbow range of motion of 0-10-120° Ext/Flex and 90-0-80° Pro/Sup. Two patients reported discomfort or pain at the elbow. Four (80%) patients had a symptomatic wrist with pain or crepitation at the distal radio ulnar joint. In three (60%) of them, an ulna plus at the wrist was present. Two patients required ulna shortening and autograft stabilization of the interosseous membrane. At final follow-up, all patients reported full functioning with daily activities. Restrictions were present with sport activities.</p><p><strong>Conclusion: </strong>Functional results at the elbow joint might be improved and pain syndromes lessen due to the radial head excision. Problems at the wrist are likely secondary to the procedure. A critical analysis of other options should be performed ahead of the procedure and a careless application should be avoided by all means.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"239-248"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/54/10.1177_18632521231167395.PMC10242372.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599253","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}

{"title":"Readability assessment of patient educational materials for pediatric spinal conditions from top academic orthopedic institutions.","authors":"Christopher Michel,&nbsp;Christopher Dijanic,&nbsp;George Abdelmalek,&nbsp;Suleiman Sudah,&nbsp;Daniel Kerrigan,&nbsp;George Gorgy,&nbsp;Praveen Yalamanchili","doi":"10.1177/18632521231156435","DOIUrl":"https://doi.org/10.1177/18632521231156435","url":null,"abstract":"<p><strong>Background: </strong>The Internet has become a popular source of health information for patients and their families. Healthcare experts recommend that the readability of online education materials be at or below a sixth grade reading level. This translates to a standardized Flesch Reading Ease Score between 81 and 90, which is equivalent to conversational English. However, previous studies have demonstrated that the readability of online education materials of various orthopedic topics is too advanced for the average patient. To date, the readability of online education materials for pediatric spinal conditions has not been analyzed. The objective of this study was to assess the readability of online educational materials of top pediatric orthopedic hospital websites for pediatric spinal conditions.</p><p><strong>Methods: </strong>Online patient education materials from the top 25 pediatric orthopedic institutions, as ranked by the U.S. News and World Report hospitals for pediatric orthopedics, were assessed utilizing multiple readability assessment metrics including Flesch-Kincaid, Flesch Reading Ease, Gunning Fog Index, and others. Correlations between academic institutional ranking, geographic location, and the use of concomitant multimedia modalities with Flesch-Kincaid scores were evaluated using a Spearman regression.</p><p><strong>Results: </strong>Only 32% (8 of 25) of top pediatric orthopedic hospitals provided online health information at or below a sixth grade reading level. The mean Flesch-Kincaid score was 9.3 ± 2.5, Flesch Reading Ease 48.3 ± 16.2, Gunning Fog Score 10.7 ± 3.0, Coleman-Liau Index 12.1 ± 2.8, Simple Measure of the Gobbledygook Index 11.7 ± 2.1, Automated Readability Index 9.0 ± 2.7, FORCAST 11.3 ± 1.2, and Dale-Chall Readability Index 6.7 ± 1.4. There was no significant correlation between institutional ranking, geographic location, or use of video material with Flesch-Kincaid scores (p = 0.1042, p = 0.7776, p = 0.3275, respectively).</p><p><strong>Conclusion: </strong>Online educational material for pediatric spinal conditions from top pediatric orthopedic institutional websites is associated with excessively complex language which may limit comprehension for the majority of the US population.</p><p><strong>Type of study/level of evidence: </strong>Economic and Decision Analysis/level III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"284-290"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/1a/10.1177_18632521231156435.PMC10242376.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972158","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}

{"title":"Outcomes of percutaneous femoral derotational osteotomy in pediatric patients.","authors":"Adam D Geffner,&nbsp;Bridget K Ellsworth,&nbsp;Michael Greenstein,&nbsp;Austin T Fragomen,&nbsp;S Robert Rozbruch","doi":"10.1177/18632521231159426","DOIUrl":"https://doi.org/10.1177/18632521231159426","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous femoral derotational osteotomies are performed in both adult and pediatric patients. There is little published on the outcomes after femoral derotational osteotomy in pediatric patients.</p><p><strong>Methods: </strong>A retrospective cohort study of pediatric patients treated with percutaneous femoral derotational osteotomy by one of two surgeons between 2016 and 2022 was performed. Data collected included patient demographics; surgical indications; femoral version; tibial torsion; magnitude of rotational correction; complications; time to hardware removal; pre-operative and post-operative patient-reported outcome scores, including Limb Deformity-Scoliosis Research Society and Patient-Reported Outcomes Measurement Information System; and time to consolidation. Descriptive statistics were used to summarize the data and t tests used to compare means.</p><p><strong>Results: </strong>Thirty-one femoral derotational osteotomies in 19 patients were included with an average age of 14.7 (9-17) years. The average rotational correction was 21.5° ± 6.4° (10°-40°). The average length of follow-up was 17.9 ± 6.7 months. There were no instances of nonunion, joint stiffness, or nerve injury. No patients returned to the operating room for additional surgeries other than routine hardware removal. There were no cases of avascular necrosis of the femoral head. Of the 19 patients, 8 completed both a pre-operative and post-operative survey set. There were significant improvements in the Limb Deformity-Scoliosis Research Society Self-Image/Appearance sub-category and the Patient-Reported Outcomes Measurement Information System Physical Function sub-category.</p><p><strong>Conclusion: </strong>Femoral derotational osteotomy using a percutaneous drill hole technique with antegrade trochanteric entry femoral nail is safe in the pediatric population and improves self-image in patients with symptomatic femoral version abnormalities.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"276-283"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/5c/10.1177_18632521231159426.PMC10242370.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972156","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}

{"title":"A four-year clinical and sonographic longitudinal follow-up of clubfeet treated according to Ponseti with normal references.","authors":"G Arne Johansson,&nbsp;Ylva B Aurell,&nbsp;Bertil H Romanus","doi":"10.1177/18632521231172548","DOIUrl":"https://doi.org/10.1177/18632521231172548","url":null,"abstract":"<p><strong>Purpose: </strong>To follow children with a clubfoot by ultrasonography during the entire treatment period up to 4 years and compare with controls.</p><p><strong>Method: </strong>Thirty clubfeet in 20 children treated using the Ponseti method and 29 controls were followed by repeated ultrasonography investigations from neonates to the age of 4 years. The previously established coronal medial and lateral, sagittal dorsal and posterior projections were used. Changes over time, correlations to the Diméglio score, and the course of treatment were studied.</p><p><strong>Results: </strong>The medial malleolus-navicular distance was shorter, while the talar tangent-navicular distance and the talo-navicular angle were larger in clubfeet than in controls even after the initial correction. The healthy feet in unilateral cases did not differ significantly from the controls. The range of motion in the talo-navicular joint was approximately 20° less in clubfeet than in controls during the first four years of life. The medial malleolus-navicular distance (<i>r</i> = -0.58) and the talo-navicular angle (<i>r</i> = 0.66) at the first ultrasonography showed the highest correlation to the number of casts needed to correct the deformities.</p><p><strong>Conclusion: </strong>Ultrasonography can be used to evaluate the initial degree of deformities in clubfeet and to follow the progress of the treatment and growth. Ultrasonography showed a clear difference between clubfeet and controls during the first four years of life. Although it was not possible to define specific limit values as benchmarks in the treatment, dynamic ultrasonography can provide valuable support in the decision-making process when complementary treatment may be needed.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"212-223"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10646366","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}

{"title":"Traumatic hip dislocations in a pediatric cohort: The importance of advanced imaging.","authors":"Daniel Yang,&nbsp;Julianna Lee,&nbsp;Kevin Orellana,&nbsp;Morgan Batley,&nbsp;Akbar Nawaz Syed,&nbsp;Wudbhav Sankar","doi":"10.1177/18632521231164990","DOIUrl":"https://doi.org/10.1177/18632521231164990","url":null,"abstract":"<p><strong>Purpose: </strong>Given that pediatric traumatic hip dislocations are relatively rare, the purpose of the current study is twofold: first, to contribute a significant cohort to the existing corpus, and second, to provide evidence toward the role that computed tomography and magnetic resonance imaging could play in identification and management of this type of injury.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients with traumatic hip dislocation who presented from 2012 to 2022 at a tertiary-level pediatric trauma center. Data regarding demographics, mechanism of injury, imaging, and treatment were tabulated. Outcomes of interest included immobilization length, concomitant injuries, imaging performed and findings, and rates of avascular necrosis, pain, and stiffness. Concomitant injuries were identified using imaging, clinical, and operative notes. Differences between categorical variables were compared using chi-square analysis or Fischer-exact testing, while continuous variables were compared using Student t tests or Wilcoxon rank sum tests when appropriate.</p><p><strong>Results: </strong>Thirty-four patients were identified. Postreduction, 28 patients had a cumulative 17 magnetic resonance imaging, 19 computed tomographies, and 1 intraoperative arthrogram. Of these, 16 patients had 19 injuries identified on advanced imaging that were missed on initial radiographs. Eleven of these patients went on to operative treatment. In eight of these, postreduction advanced imaging helped guide the decision for surgery. In four patients, magnetic resonance imaging was necessary to fully characterize injury to the posterior acetabular rim after initial identification on computed tomography. Magnetic resonance imaging was also used to rule out one computed tomography-diagnosed acetabular fracture.</p><p><strong>Conclusion: </strong>Magnetic resonance imaging is valuable to fully define associated rim and intra-articular injuries following initial treatment of pediatric traumatic hip dislocations.</p><p><strong>Level of evidence: </strong>Level IV diagnostic study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"259-267"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/e2/10.1177_18632521231164990.PMC10242371.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972160","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}

{"title":"Clinical and radiological outcomes of surgically treated osteochondral lesions of the talus in children and adolescents.","authors":"Dae-Yoo Kim,&nbsp;JiSu Park,&nbsp;Ho Won Kang,&nbsp;Chang Ho Shin,&nbsp;Dong Yeon Lee,&nbsp;Tae-Joon Cho,&nbsp;Won Joon Yoo","doi":"10.1177/18632521231152277","DOIUrl":"https://doi.org/10.1177/18632521231152277","url":null,"abstract":"<p><strong>Background: </strong>Osteochondral lesions of the talus are uncommon in children and adolescents. Surgical procedures differ from those used for adults to avoid iatrogenic physeal injuries. This study aimed to evaluate the clinical and radiological outcomes of surgical treatment in pediatric patients with osteochondral lesions, specifically investigating the patient age and the status of distal tibial physis as factors associated with surgical success.</p><p><strong>Methods: </strong>We retrospectively reviewed 28 patients who had symptomatic osteochondral lesions of the talus that were treated surgically between 2003 and 2016. If the lesion was stable and articular cartilage was intact, retrograde drilling was performed under fluoroscopic guidance. Lesions with detached overlying cartilages were treated by debridement of the cartilage combined with microfracture and drilling. Radiographic outcomes, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and skeletal maturity were evaluated.</p><p><strong>Results: </strong>Radiological improvement was observed in 24 (24/28, 86%) patients and complete and incomplete healing in 8 and 16 patients, respectively. Changes in pain grades, American Orthopaedic Foot & Ankle Society scores, and radiological healing after surgery were significant (pain grade, p < 0.001; American Orthopaedic Foot & Ankle Society, p = 0.018; radiological healing, p < 0.001). In addition, patients in the younger age group (≤13 years) showed greater improvements in pain grades than older patients (p = 0.02). Improvement in pain grade after surgery was better in the skeletally immature group than in the skeletally mature group (p = 0.048).</p><p><strong>Conclusion: </strong>Clinical and radiological improvements were observed after surgical treatment. The younger age group and open physis group showed more pain improvement.</p><p><strong>Level of evidence: </strong>Therapeutic level IV.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"224-231"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/be/10.1177_18632521231152277.PMC10242369.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350948","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}

{"title":"Bony hip reconstruction for displaced hips in patients with cerebral palsy: Is postoperative immobilization indicated?","authors":"John Amen,&nbsp;Oliver Perkins,&nbsp;Konstantinos Kafchitsas,&nbsp;Daniel Reed,&nbsp;Fabian Norman-Taylor,&nbsp;Michail Kokkinakis","doi":"10.1177/18632521231164983","DOIUrl":"https://doi.org/10.1177/18632521231164983","url":null,"abstract":"<p><strong>Purpose: </strong>Decisions for postoperative immobilization after bony hip reconstructive surgery in cerebral palsy are controversial in current practice. The aim of this study was to check if choosing not to use any kind of postoperative immobilization is a safe practice.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in a pediatric orthopedic tertiary referral center. The study included 148 patients (228 hips) with cerebral palsy, who had bony hip surgery. Medical records were reviewed for incidence of complications, methods of pain control, and length of hospital stay. Three radiographic measures (neck-shaft angle, Reimers migration index, and acetabular index) were performed on preoperative and postoperative X-rays. X-rays were also checked for mechanical failure of implant, recurrent dislocation/subluxation, and fractures in the first 6 months postoperatively.</p><p><strong>Results: </strong>In total, 94 (64%) were male and 54 (36%) were female. Seventy-seven (52%) were Gross Motor Function Classification System V, mean age at surgery was 8.6 years (2.5-18.4 years). Length of hospital stay was 6.25 days (SD 4.64 days). Medical complications that may have prolonged hospital stay occurred in 41 patients (27.7%). Radiological measurements showed significant improvement postoperatively (<i>p</i> = 0.001). Seven patients (4.7%) had another surgery in first 6 months (three for recurrent dislocation/subluxation, three for implant failure, and one for ipsilateral femur fracture).</p><p><strong>Conclusion: </strong>Avoiding postoperative immobilization following bony hip surgery in cerebral palsy is a safe practice and associated with reduced rate of medical and mechanical problems compared to the current literature. This approach should be utilized with optimal pain and tone management.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 3","pages":"268-275"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/81/5b/10.1177_18632521231164983.PMC10242375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599254","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}

{"title":"Comment on: Risk factors for hip displacement in cerebral palsy: A population-based study of 121 nonambulatory children.","authors":"Philippe Wagner,&nbsp;Gunnar Hägglund","doi":"10.1177/18632521231156548","DOIUrl":"https://doi.org/10.1177/18632521231156548","url":null,"abstract":"(https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). https://doi.org/10.1177/18632521231156548 Journal of Children’s Orthopaedics 2023, Vol. 17(2) 191 –192 © The Author(s) 2023 DOI: 10.1 77/186325 1231 565 journals.sagepub.com/home/cho JOURNAL OF CHILDREN’S ORTHOPAEDICS Letter to the Editor","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 2","pages":"191-192"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9272303","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}

{"title":"Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation.","authors":"Till D Lerch,&nbsp;Tilman Kaim,&nbsp;Markus S Hanke,&nbsp;Florian Schmaranzer,&nbsp;Simon D Steppacher,&nbsp;Jasmin D Busch,&nbsp;Eduardo N Novais,&nbsp;Kai Ziebarth","doi":"10.1177/18632521221149044","DOIUrl":"https://doi.org/10.1177/18632521221149044","url":null,"abstract":"<p><strong>Purpose: </strong>Slipped capital femoral epiphysis is a common pediatric hip disease and was associated with femoral retroversion, but femoral version was rarely measured. Therefore, mean femoral version, mean femoral neck version, and prevalence of femoral retroversion were analyzed for slipped capital femoral epiphysis patients.</p><p><strong>Methods: </strong>A retrospective observational study evaluating preoperative hip magnetic resonance imaging of 27 patients (49 hips) was performed. Twenty-seven untreated slipped capital femoral epiphysis patients (28 slipped capital femoral epiphysis hips and 21 contralateral hips, age 10-16 years) were evaluated (79% stable slipped capital femoral epiphysis, 22 patients; 43% severe slipped capital femoral epiphysis, 12 patients). Femoral version was measured using Murphy method on magnetic resonance imaging (January 2014-December 2021, rapid bilateral 3-dimensional T1 water-only Dixon-based images of pelvis and knee). All slipped capital femoral epiphysis patients underwent surgery after magnetic resonance imaging.</p><p><strong>Results: </strong>Mean femoral version of slipped capital femoral epiphysis patients (-1° ± 15°) was significantly (p < 0.001) lower compared to contralateral side (15° ± 14°). Femoral version of slipped capital femoral epiphysis patients had significantly (p < 0.001) wider range from -42° to 35° (range 77°) compared to contralateral side (-5° to 44°, range 49°). Mean femoral neck version of slipped capital femoral epiphysis patients (6° ± 15°) was lower compared to contralateral side (11° ± 12°). Fifteen slipped capital femoral epiphysis patients (54%) had absolute femoral retroversion (femoral version < 0°). Six of the 12 hips (50%) with severe slips and 4 of the 8 hips (50%) with mild slips had absolute femoral retroversion (femoral version < 0°). Ten slipped capital femoral epiphysis patients (40%) had absolute femoral neck retroversion (femoral neck version < 0°).</p><p><strong>Conclusion: </strong>Although slipped capital femoral epiphysis patients showed asymmetrically lower femoral version compared to contralateral side, there was a wide range of femoral version, underlining the importance of patient-specific femoral version analysis on preoperative magnetic resonance imaging. Absolute femoral retroversion was prevalent in half of slipped capital femoral epiphysis patients, in half of severe slipped capital femoral epiphysis patients, and in half of mild slipped capital femoral epiphysis patients. This has implications for anterior hip impingement and for surgical treatment with in situ pinning or femoral osteotomy (e.g. proximal femoral derotation osteotomy) or other hip preservation surgery.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 2","pages":"116-125"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/98/10.1177_18632521221149044.PMC10080244.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9288614","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}

{"title":"Femoral morphology in Ortolani's anatomical collection of developmental dysplasia of the hip: Anteversion is unrelated to severity of infantile dysplasia.","authors":"Victor Huayamave,&nbsp;Tamara Chambers,&nbsp;Ilaria Fantoni,&nbsp;Carla Stecco,&nbsp;Raffaele De Caro,&nbsp;Charles T Price","doi":"10.1177/18632521231152282","DOIUrl":"https://doi.org/10.1177/18632521231152282","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated and quantified femoral anteversion and femoral head sphericity in healthy and dysplastic hips of post-mortem infant specimens from Ortolani's collection.</p><p><strong>Methods: </strong>Healthy hips and hips with cases of dysplasia, with a large variety of severity, were preserved. Morphological measurements were taken on 14 specimens (28 hips), with a mean age of 4.68 months. The degree of dysplasia was classified as mild (A) to severe (D); 11 hips were Grade A, 6 hips were Grade B, 7 hips were Grade C, and 4 hips were Grade D. The femoral anteversion angle, the minimum femoral head diameter, and the maximum femoral head diameter were measured. The minimum and maximum femoral head diameters were used to estimate femoral head sphericity.</p><p><strong>Results: </strong>The mean femoral anteversion angle was 30.81 degrees ± 11.07 degrees in cases and 29.69 degrees ± 12.69 degrees in controls. There were no significant differences between the normal-to-mild group and moderate-to-severe group when comparing the femoral anteversion angle (p = 0.836). The mean estimated sphericity was 1.08 mm ± 0.50 mm in cases and 0.81 mm ± 0.65 mm in controls, with no statistically significant difference between the groups (p = 0.269).</p><p><strong>Conclusion: </strong>Ortolani's collection showed no significant differences between healthy and dysplastic hips in specimens under 1 year of age. While the femoral head appeared slightly more flattened in dysplastic hips, it was not statistically significant. The findings in the unique collection add to the knowledge of the pathoanatomy of infantile hip dysplasia.</p><p><strong>Clinical relevance: </strong>Femoral anteversion may not play a role in the etiology and pathogenesis of DDH.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 2","pages":"97-104"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/e2/10.1177_18632521231152282.PMC10080246.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283660","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}