Journal of Childrens Orthopaedics最新文献

{"title":"Health-related quality of life after Dega pelvic osteotomy and varus derotation osteotomy due to spastic hip disease in children with cerebral palsy.","authors":"Maciej Kasprzyk, Aleksander Koch, Marek Jóźwiak","doi":"10.1177/18632521241300880","DOIUrl":"10.1177/18632521241300880","url":null,"abstract":"<p><strong>Purpose: </strong>Our study aimed to present health-related quality of life (HRQL) after combined bone reconstruction in nonambulatory patients with cerebral palsy (CP) after at least a 2-year follow-up and to assess its impact on HRQL using the Caregiver Priorities and Child Health Index of Life with Disabilities questionnaire (CPCHILD) as the primary outcome measure.</p><p><strong>Methods: </strong>In this prospective study, we analyzed 31 nonambulatory patients with spastic or mixed CP (GMFCS levels IV-V) who underwent hip reconstructive surgery between 2015 and 2021. The surgical procedures included one-sided varus derotation osteotomy of the femur with Dega transiliac osteotomy and, on the opposite side, varus derotation osteotomy (VDRO) of the femur with shortening and, as needed, Dega pelvic osteotomy.</p><p><strong>Results: </strong>The study demonstrated significant improvement in the hip joint motion range, as assessed by the Thomas test, in hip abduction and rotational movements of the hip, as well as reduction of spasticity. The procedures also resulted in significant radiographic improvement of the femoral head coverage. The assessment of symptoms and problems associated with the hip revealed a positive influence of the surgery on pain, contractures, toileting/perineal hygiene, dressing, seating, transferring, and position changes. The mean improvement at a follow-up visit was significant in all domains of the CPCHILD, except for communication and social interaction.</p><p><strong>Conclusion: </strong>Hip reconstruction with VDRO and Dega pelvic osteotomy can enhance the HRQL of children with CP. These surgical interventions can help to achieve the correct hip position and to reduce pain, which positively affects the patient QL, although proactive treatment results in less invasive procedures.</p><p><strong>Level of evidence: </strong>IV case series.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"83-91"},"PeriodicalIF":1.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973449","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":"Diagnosis and management of septic arthritis: A current concepts review.","authors":"Ignacio Sanpera, Marta Salom, Cristina Alves, Deborah Eastwood","doi":"10.1177/18632521241311302","DOIUrl":"10.1177/18632521241311302","url":null,"abstract":"<p><p>Correct diagnosis and treatment of septic arthritis (SA) are essential to achieve satisfactory results and avoid lifelong consequences. Diagnosing septic arthritis is not always easy, which is why new biomarkers have been sought. Another difficulty in diagnosis is the increase in septic arthritis due to Kingella Kingae, which does not show the same signs and symptoms as classic <i>Staphylococcus aureus</i> infections. Increasingly, magnetic resonance imaging plays a more fundamental role in diagnosing septic arthritis, and many studies are focused on this line, especially for the study of associated pathologies. Numerous studies have been published on less invasive treatments for septic arthritis, although the evidence suggests that the results should be taken cautiously. Although most of the published studies focus on the hip and knee, there have also been recent publications on SA in the upper limb, foot, and ankle. Finally, the literature also pays attention to SA in young children due to its different etiology and the greater difficulties in its diagnosis.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"14-19"},"PeriodicalIF":1.3,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933742","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":"Treatment of symptomatic bipartite patella in patients <21 years of age: A systematic review and treatment algorithm.","authors":"Kristen E Hines, David S Liu, Amy E Steele, Daniel Gabriel, Anjali Prabhat, Yi-Meng Yen, Grant Douglas Hogue","doi":"10.1177/18632521241308410","DOIUrl":"10.1177/18632521241308410","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to develop an evidence-based algorithm for the management of symptomatic bipartite patella in the pediatric and adolescent population based on a systemic review of the published literature.</p><p><strong>Methods: </strong>A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines on PubMed and Embase, selecting for studies discussing the management of symptomatic bipartite patella.</p><p><strong>Results: </strong>Five studies met criteria, involving 315 knees (314 patients, average age 15.8 years). All patients presented with symptomatic bipartite patella and underwent an initial trial of conservative management. Seventy-six percent (239 knees) achieved full resolution of symptoms after conservative management at a median of 1.9 months. The remaining 76 knees (24.12%) had persistent symptoms requiring operative intervention. Surgical techniques included surgical excision, screw fixation, synchondrosis drilling, lateral release, and both arthroscopic and open interventions (92.1%). Most patients (90.79%) who underwent surgical intervention had partial or complete resolution of their symptoms. Seven of 76 knees (9.21%) needed management postoperatively for pain due to trauma, residual symptomatic ossicles, and hardware complications. Of these, four patients required reoperations (average 2 years). The remaining three patients had satisfactory outcomes with an additional course of conservative management and oral analgesics.</p><p><strong>Conclusion: </strong>Management of symptomatic bipartite patella should begin with a trial of conservative management. With refractory symptoms lasting greater than 3 months, surgical intervention may be considered with positive outcomes of partial or complete resolution of symptoms. The proposed algorithm is provided to guide physician management of symptomatic BPP in pediatric or adolescent patients.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"75-82"},"PeriodicalIF":1.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900879","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":"Ankle and foot deformities and malformations in proximal femoral focal deficiency.","authors":"Jiri Chomiak, Monika Frydrychova, Martin Ošťádal, Pavel Dungl","doi":"10.1177/18632521241301942","DOIUrl":"10.1177/18632521241301942","url":null,"abstract":"<p><strong>Purpose: </strong>To describe foot abnormalities in proximal femoral focal deficiency and their correlation to the severity.</p><p><strong>Methods: </strong>Eighty-nine extremities in 87 patients were evaluated between 1996 and 2020 clinically and radiologically. Fibula length, ankle shape, tarsal coalitions, and the number of foot rays were recorded. Extremities with proximal femoral focal deficiency were classified according to Pappas and divided into severe (classes II and V), medium severe (classes III and IV), and mild groups (classes VII, VIII, and IX).</p><p><strong>Results: </strong>The fibula was short in 89% and absent in 11% of cases. An absent fibula occurred mostly in severe class III and only in 4% of mild grades (statistically significant, <i>p</i> = 0.004). The valgus ankle joint prevailed in 82% of cases. Spherical ankle joints (18% of cases) were associated in all cases with a tarsal coalition. Tarsal coalitions occurred in 14.6% and were present in all classes except class IV. Five ray feet were found in 83% of cases, four ray feet were found in 16%, and three ray feet in one extremity. Reduction in the number of foot rays occurred more commonly in association with fibular aplasia (30%).</p><p><strong>Conclusions: </strong>Abnormalities of the fibula and ankle joint represent a constant part of proximal femoral focal deficiency, whereas tarsal coalition and a reduction of foot rays do not. The severity of foot abnormalities does not correlate to the severity of proximal femoral focal deficiency but does with fibular aplasia.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"56-63"},"PeriodicalIF":1.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11656460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877982","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":"What's new in the pediatric spine?","authors":"Brice Ilharreborde, Ilkka Helenius, Daniel Studer, Carol Hasler, Moyo Kruyt, Jorge Mineiro, Dror Ovadia, David Farrington, Sebastien Pesenti, Muharrem Yazici","doi":"10.1177/18632521241309531","DOIUrl":"10.1177/18632521241309531","url":null,"abstract":"<p><strong>Introduction: </strong>The field of pediatric spine surgery has encountered major changes and evolutions lately, with new treatment options available and the development of enabling technologies. This article aims to summarize the most relevant recent literature.</p><p><strong>Materials and methods: </strong>The five most relevant topics were selected and assigned to one or two authors who performed a comprehensive Pubmed database search for articles published in the last 4 years (2021-2024). Only studies with a high level of evidence or clinical relevance were reported.</p><p><strong>Results: </strong>Thirty-nine articles were selected and analyzed, covering the following subjects: treatment options in tweeners, the impact of new medical treatments in pediatric spine practice, the emergence of new surgical techniques, the development of enabling technologies in scoliosis surgery, and recent relevant randomized controlled trials.</p><p><strong>Discussion: </strong>Many new surgical concepts and techniques have been developed lately, but their results need to be further assessed on specific subgroups of patients. Numerous significant medical improvements have been reported in the last 5 years, affecting positively the management of syndromic and neuromuscular patients.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"3-13"},"PeriodicalIF":1.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877983","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":"Exploring the impact of developmental dysplasia of the hip on refugees with temporary protected status in Türkiye.","authors":"Izzet Bingöl, Murat Taşcı, Niyazi Erdem Yaşar, Naim Ata, M Mahir Ülgü, Şuayip Birinci, Yavuz Sağlam, Mehmet Salih Söylemez","doi":"10.1177/18632521241299318","DOIUrl":"10.1177/18632521241299318","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we examined whether there was a change in the number of children who had been screened by hip ultrasound, the age of first diagnosis, and the number of invasive and conservative treatments applied due to developmental dysplasia of the hip between 2016 and 2022 among refugees who were in \"Temporary Protection Status\" in Türkiye?</p><p><strong>Methods: </strong>The records were collected via the e-health database of the Turkish Ministry of Health. Over 1 month old were included in the study.</p><p><strong>Results: </strong>The number of ultrasonography (USG) that was performed for developmental dysplasia of the hip survey had significantly increased over time. The incidence for 5 years was 6 cases per 100 babies. However, the incidence of developmental dysplasia of the hip needing intervention was 0.4 cases per 1000 babies. In 2016, the most used diagnosis method was X-ray. By contrast, the use of USG has increased from 2016 to 2022. The mean age at the time of diagnosis was significantly high in 2016, 2017, and 2020. The number of invasive treatment modalities including closed reduction under anesthesia, open reduction alone, or open reduction with pelvic and/or femoral osteotomies had significantly decreased from 2016 to 2022. However, the number of abduction orthosis used for treatment also increased significantly.</p><p><strong>Conclusions: </strong>Free access to health services is effective in promoting families' compliance with screening programs for developmental dysplasia of the hip. But is not enough for initial periods of mass migrations. To increase sensitivity to screening programs for possible diseases, further efforts are needed to prevent low compliance in early cases of mass migrations.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"99-105"},"PeriodicalIF":1.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830484","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":"Management of the supposed elbow dislocation in newborns.","authors":"Florian Kruse, Frederique Dizin, Brice Ilharreborde, Pascal Jehanno, Anne-Laure Simon, Virginie Mas","doi":"10.1177/18632521241278166","DOIUrl":"10.1177/18632521241278166","url":null,"abstract":"<p><strong>Background: </strong>The newborn transphyseal fracture of the distal humerus is frequently misdiagnosed with an elbow dislocation due to the absence of the lateral condyle ossification node. No consensus has been reported either for the diagnosis or the management of these rare fractures. This study aimed to analyze a series of newborns with transphyseal distal humerus fractures.</p><p><strong>Methods: </strong>All consecutive infants treated between 2005 and 2020 for a transphyseal fracture of the distal humerus before the age of 6 months were retrospectively included. All radiological examinations were analyzed (X-ray, ultrasound, and magnetic resonance imaging (MRI)) as well as the therapeutic management (orthopedic or surgical treatment). The patients were seen at outpatient clinic visits with a minimum of 2-year follow-up.</p><p><strong>Results: </strong>Nine newborns were treated. The main cause was an obstetrical traumatism (<i>n</i> = 8). The diagnosis was made on physical examination and addressed by obstetric departments with standard biplanar radiographs in four cases. The fracture was suspected on physical examination in the remaining five cases and confirmed by complementary imaging (ultrasound (2), MRI (1), and both (3)). A total of six patients were treated conservatively and three surgically with an open reduction. At a mean follow-up of 79 months, two complications occurred: one axillary abscess due to the cast and one cubitus varus deformity. All children had a full functional recovery.</p><p><strong>Conclusions: </strong>The transphyseal fracture of the distal humerus in newborns is a rare entity that should be managed conservatively. Additional imaging examinations are recommended to clarify the diagnosis.</p><p><strong>Level of evidence: </strong>Level IV, cohort study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"48-55"},"PeriodicalIF":1.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820373","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":"Acknowledgement to Reviewers 2024.","authors":"","doi":"10.1177/18632521241302361","DOIUrl":"https://doi.org/10.1177/18632521241302361","url":null,"abstract":"","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"18 6","pages":"654-655"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775106","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":"Conservative treatment for traumatic atlantoaxial joint infra-anterior dislocation complicating odontoid fracture in young children: A case series.","authors":"Chunxing Wu, Yiming Zheng, Chuang Qian, Peng Huang, Bo Ning, Dahui Wang","doi":"10.1177/18632521241267107","DOIUrl":"https://doi.org/10.1177/18632521241267107","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to retrospectively analyze children treated conservatively in our hospital to explore the clinical characteristics of children with traumatic atlantoaxial joint infra-anterior dislocation complicating odontoid fracture and the therapeutic effects of treatment.</p><p><strong>Methods: </strong>Patients with atlantoaxial joint infra-anterior dislocation complicating odontoid fracture received conservative treatment, which comprised three steps: cervical traction (2 weeks), plaster fixation (2 months), and brace fixation (3 months).</p><p><strong>Results: </strong>We treated three patients (boy:girl = 0:3, mean age = 2.5 years old) from 2017 to 2020, the diagnoses were all traumatic C1-2 infra-anterior dislocations associated with odontoid fracture (Anderson and D'Alonzo classification type II: three cases, Hosalkar type IB: two case and IC: one case), with or without cervical spinal cord injury. The C1-2 infra-anterior dislocations were all successfully reduced by gentle traction with the halo method (case 1) or occipital-jaw (cases 2 and 3) for a mean of 18.3 days (19, 15, 21 days), after which the Calot plaster vests (head-neck-chest plaster vests) were fitted and maintained for 2 months, without operation. Braces were maintained for 3 months after the Calot plaster vests were removed. All patients achieved fracture healing and recovered from the spinal injury.</p><p><strong>Conclusion: </strong>In young children, atlantoaxial joint infra-anterior dislocation complicating odontoid fracture usually occurred at the odontoid synchondrosis and belonged to Anderson and D'Alonzo classification type II or Hosalkar type I. Conservative treatment achieved good results (dislocation reduction, bone healing, recovery of neurological symptoms).</p><p><strong>Level of evidence: </strong>Level IV case series.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"18 6","pages":"622-631"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775113","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":"Treatment of scoliosis in children after resection of neuroblastoma-A report of five cases.","authors":"Jianglong Xu, Yan Zou, Hanwen Zhang, Jinchen Chen, Haonan Liu, Dong Guo, Ziming Yao","doi":"10.1177/18632521241287031","DOIUrl":"https://doi.org/10.1177/18632521241287031","url":null,"abstract":"<p><strong>Purpose: </strong>Neuroblastoma (NB) is a common extracranial solid tumor in children, often requiring surgical resection. Post-resection NB near the spine can lead to spinal deformities, but treatment strategies are not well-documented.</p><p><strong>Methods: </strong>We retrospectively reviewed our patients who developed spinal deformities after NB resection at our hospital from 2013 to 2021. Treatment included the traditional growing rod (TGR) technique for patients with growth potential, posterior spinal fusion (PSF) for skeletally mature patients, and intermittent cast therapy for infants.</p><p><strong>Results: </strong>Five female patients underwent chemotherapy and surgical resection for NB, with no recurrence during follow-up. Single curves were seen in Cases 1, 2, 4, and 5, and Case 3 had double curves. NB tumors were on the convex side in Cases 1, 3, and 5, and on the concave side in Cases 2 and 4. TGR was used for Cases 1 and 2 due to growth potential and inadequate height. PSF was chosen for Cases 3 and 4, achieving satisfactory scoliosis and kyphosis correction. Case 5, diagnosed with scoliosis at 16 months, underwent intermittent cast therapy for 2 years, significantly correcting scoliosis and avoiding surgery. The average time from NB resection to scoliosis onset was 65.2 ± 49.3 months, with scoliosis treatment starting at 82.6 ± 58.1 months. The mean follow-up was 38.2 ± 12.1 months. All patients showed significant improvement in spinal deformities, with no significant correction loss at the last follow-up.</p><p><strong>Conclusions: </strong>After NB resection, spinal deformities should be closely monitored, with intervention preferably within 6 months of discovery. TGR, PSF, and casting are effective interventions, with the treatment modality based on the patient's skeletal maturity and height.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"18 6","pages":"632-641"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775135","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}