Twenty-seven cases of fractures of the medial condyle of the humerus in children were grouped into one of three types, based on displacement of the medial condyle on initial roentgenograms. Results after an average follow-up of 2.2 years showed that children less than 5 years old tended to have undisplaced fractures giving rise to good results. Older children tended to have more severely displaced fractures. Good results were obtained in patients who were seen early after injury and who had adequate reduction of their fractures. In cases seen late, proper reduction and immobilization are necessary to achieve satisfactory results.

Age Factors↗

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Surgery in residual clubfoot: one-stage medioposterior release "à la carte".

A series of 142 clubfeet in 113 children were treated by a one-stage medioposterior release for deformity persisting after vigorous physical therapy. The talonavicular joint and hindfoot are released to achieve correct alignment. Long-term good results were seen in 73% of the entire series and in 87% of the idiopathic subgroup.

Child↗

PubMedDate not supplied

The Pavlik harness in the treatment of congenital dislocating hip: report on a multicenter study of the European Paediatric Orthopaedic Society.

The results of functional treatment using the Pavlik harness in congenital dislocation and congenital dysplasia of the hip in children aged less than 11 months were examined by an EPOS study group. This study was conducted on 3,611 hips in 2,636 patients for a period of 1-9 years after treatment. The reduction rate was 92% in grade Tonnis 2 and 3; the healing rate was 80%. In children with dysplastic hips, the healing rate was 95.35%. Avascular necrosis of the femoral head was observed in 2.38%. The Pavlik harness is designed for outpatient treatment if the parents are compliant.

Hip Dislocation, Congenital↗

PubMedDate not supplied

Lateral humeral condylar fractures in children: a report of 47 cases.

Forty-seven children with fractures of the lateral condyle were reviewed, 4 of whom were treated after a five month delay. The roentgenographic study revealed 4 different types of fractures according to the degree of displacement. Each type corresponded to precise anatomical lesions. In the treatment of recent fractures, we must distinguish between strictly undisplaced fractures, which can be immobilized in a cast, and other fractures, which require open reduction and internal fixation.

Child↗

PubMedDate not supplied

Subtalar posterior displacement osteotomy of the calcaneus: a preliminary report of seven cases.

A preliminary report of a new posterior displacement osteotomy of the calcaneus is presented. Seven calcaneocavus feet in six patients ranging in age from 10 to 18 years were operated on with a follow-up of 2-4 years. The osteotomy was performed just below the subtalar joint after a complete plantar release. The posterior shift obtained was limited only by skin tension. The cavus deformity was corrected, and gait improvement was evident. The geometric study of postoperative lateral radiographs showed an expected 30-50% increase in tendo-Achilles strength.

Adolescent↗

PubMedDate not supplied

Lower limb bone hemangiomas in children: report of two cases.

Hemangiomas of the bone are rare lesions, accounting for approximately 1% of all primary bone tumors. Hemangiomas occur fairly frequently in the vertebral bodies and the skull, but are unusual in other bones. We report two cases of unusual and fairly rare aspects of this vascular tumor in children. Both cases involved recurrences, which led to a wide bone resection in case 1 and to several curettages in case 2. In these two cases the histological type of hemangioma was capillary. In reviewing the literature we found no indication of wide resection of the benign forms in children.

Adolescent↗

PubMedDate not supplied

Practical applications in idiopathic clubfoot: a retrospective multicentric study in EPOS.

We report a European study of idiopathic clubfoot that was compiled with the aid of a detailed questionnaire. The retrospective study was presented at the seventh meeting of the European Paediatric Orthopaedic Society (EPOS). Most EPOS members treat idiopathic clubfoot at birth with plaster cast, but a few use physiotherapy and splints. The results of this conservative treatment vary. Operation is usually indicated at an age ranging from 4 to 15 months. Some physicians perform extensive procedures, and others limit operation to the medial and posterior parts of the foot. We propose a classification system for idiopathic clubfoot in an attempt to standardize procedures.

Casts, Surgical↗

PubMedDate not supplied

Results of physical therapy for idiopathic clubfoot: a long-term follow-up study.

Physical therapy without anesthesia or plaster casts was used to treat 338 cases of clubfoot (CF). Our technique is based on progressive sequential manipulations at birth. We first reduce the varus and later the equinus component of the CF. The gentle stretches used in this technique are complemented by active physiotherapy stimulating the muscles, and then a simple splint is suited to the foot to fix its degree of realignment. When used alone, this technique achieves 77% good and fair results. In resistant cases, complementary surgery was used. We obtained 96% good and fair results.

Adolescent↗

PubMedDate not supplied

Congenital dislocation of the knee.

Congenital dislocations of the knee (CDK) are rare, occurring 40-80 times more rarely than congenital dislocation of the hip (CDH). In a multicentric study of the European Paediatric Orthopaedic Society, 56 cases of CDK were found in 46 babies. Many other malformations associated with CDK were noticed, and muscular abnormality was always found at the knee. According to the classification of Leveuf, three grades have to be considered: grade 3, or complete dislocation, was the most frequent. At birth, treatment consisted of physiotherapy with rigid splint. Twenty-four patients with CDK have been treated only by the conservative technique. Operations were performed according to the abnormalities of the extensor apparatus: a progressive release and lengthening of the quadricipital tendon was necessary in all cases. In all forms of treatment, the range of the knee flexion was 120 degrees. Only two children had a bad result because of unstable knees. Results were always better with conservative treatment.

Female↗

PubMedDate not supplied

Tibiofibular torsion from the fetal period until birth.

The anatomic findings of Le Damany and Dupuis are still valuable as a reference. However, their measurement of tibial torsion does not correspond to clinical conditions. In fact, the torsion of the tibiofibular functional unit corresponds to the angle between the transverse axis of the proximal tibial epiphyseal plate and the axis through the middle of both malleoli. A comparative morphologic, radiologic, computerized axial tomographic and anatomic study performed on 50 fetuses with this definition has shown different results. Tibiofibular torsion was in the clear lateral position from the beginning of the fetal period, with a positive gradient at birth.

Anthropometry↗

PubMedDate not supplied

[Surgical treatment of severe club foot: cutaneous plasty (author's transl)].

As they are seen late, some club feet get an important contracture of the skin. It can be an impediment to obtain a whole straightening of the foot by the cutaneous tension when the soft-tissues are closed. In order to avoid this risk, a rotational plasty is proposed, to which a "Z" plasty is added. It allows to realize a suture without any tension; it produces a very good and esthetic scar. So as, the physical therapy can be soon begun without any risk.

Child↗

PubMedDate not supplied

[Current status of femoral re-centering osteotomies for paralytic hips].

Explore the source record for details and available documents.

Child↗

PubMedDate not supplied

[Recurrent dislocation of the patella in children].

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Adolescent↗