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Biomedical subjects

H De Boeck

Publications and source records attributed to H De Boeck.

At least 19 recordsLinked to original sources
PubMed2001

Fractures and nonunions of the carpal scaphoid in children.

Fractures of the carpal scaphoid in children show some quite remarkable differences with respect to fractures of the carpal scaphoid in adults. A review of the literature shows that fractures in children are more often located in the distal third, are more often incomplete and are usually not displaced. Our experience with 23 fresh fractures of the carpal scaphoid in children confirms these findings of the literature. Nonunion of the carpal scaphoid is exceedingly rare in children. When reviewing the literature we could find only 29 published cases of nonunion of the carpal scaphoid in children. In most articles describing carpal scaphoid nonunion in children, bone grafting is recommended as the treatment of choice. We report two children with a nonunion of the carpal scaphoid treated successfully by cast immobilization. Therefore, we propose that a child with a nonunion of the carpal scaphoid bone that has never been immobilized previously should be treated by cast immobilization. Surgery should be considered only if there is no indication of healing after 3 months of immobilization.

Adolescent↗
PubMed2000

Fractures of the capitellum humeri in adolescents.

Six children between 11 and 15 years old with a displaced fracture of the capitellum were treated by open reduction and fixation with one small screw. In all cases union occurred. There were no complications and all the children regained normal elbow function. There were no cases of avascular necrosis.

Adolescent↗
PubMed2000

Treatment of chronic isolated radial head dislocation in children.

Four children had an operative reduction without annular ligament reconstruction for chronic acquired isolated dislocation of the radial head: one girl and three boys with an average age of 7.1 years (range, 4-8.5 years). History indicated that all children had sustained an injury. Results, with an average followup of 50.7 months, were assessed clinically and radiographically. All patients had excellent postoperative functional and radiographic outcomes. Measurements of range of motion of the elbow revealed improved motion in all patients. Reconstruction of the annular ligament seems unnecessary and, therefore, it is suggested that an unreduced radial head dislocation can be treated by simple open reduction and fixation for 6 weeks with a transarticular pin.

Bone Nails↗
PubMed1999

Split coronal fractures of the lumbar spine. Treatment by posterior internal fixation and transpedicular bone grafting.

The clinical and radiological results of 12 patients with a split coronal vertebral fracture were analysed with minimum follow-up of 24 months. All patients were treated operatively with an AO internal spinal fixator and transpedicular bone grafting. The operation was supplemented with posterior bone grafts in 4 patients. All fractures healed without marked deformity. There were no vertebral body pseudarthroses. There were no neurological or vascular injuries due to the placement of pedicle screws or to transpedicular bone grafting. 10 patients, had excellent or good results.

Adult↗
PubMed1999

Subperiosteal ganglion cyst of the tibia. A communication with the knee demonstrated by delayed arthrography.

We report a patient with a subperiosteal ganglion cyst of the tibia which was imaged by radiography, arthrography, CT and MRI. The images were correlated with the arthroscopic surgical and histological findings. Spiculated formation of periosteal new bone on plain radiographs led to the initial suspicion of a malignant tumour. Demonstration of the cystic nature of the tumour using cross-sectional imaging was important for the precise diagnosis. Communication between the ganglion cyst and the knee was shown by a delayed arthrographic technique, and the presence of this communication was confirmed at arthroscopy and surgically.

Arthrography↗
PubMed1999

Bone scintigraphy in children with persistent pain in an extremity, suggesting algoneurodystrophy.

In this retrospective study, the data of bone scintigraphy performed in 21 children suspected of reflex sympathetic dystrophy (RSD) were analyzed. All of them had persistent pain in an extremity or a clinical suspicion of RSD. All children with strong suspicion of RSD showed diffuse hypoactivity at the level of the involved area on bone scintigraphy. This hypoactivity was clearly related to a decreased vascular supply. The specificity of this scintigraphic pattern is questionable, however, since two children without suggestive clinical signs for RSD had the same scintigraphic pattern.

Arm↗
PubMed1998

Bilateral stress fractures of the femoral neck complicated by unilateral displacement in a child.

Stress fractures of the femoral neck with an open capital femoral epiphysis in children are very rare. Up to the time of this writing, 12 cases have been described in children between the ages of 5 and 16 years (2, 4, 10-12, 14). The differential diagnosis from other hip diseases causing pain, a limp, and limited movement can be difficult when standard radiographs are normal. In this situation, tomography, isotope bone scanning, and magnetic resonance imaging (MRI) have proved to be very useful in both adults and children (2, 3, 5-8, 10-12). Complications such as nonunion or severe displacement are uncommon in children and have occurred only after they have resumed or continued the causal activity (12). As far as we are aware, bilateral development of a fatigue fracture of the femoral neck in a child has never been reported. We describe the case of an 8-year-old girl who sustained first a right then later a left femoral neck stress fracture. Displacement of the left fracture occurred after a minor but significant injury and required surgical treatment.

Casts, Surgical↗
PubMed1998

Unusual evolution of a benign-looking cortical defect of the proximal humerus. A case of intracortical osteosarcoma?

A case of an osteosarcoma following a pathological fracture through a small benign-looking cortical lesion of the proximal humerus is described. The unusual evolution from a small cortical lesion to a malignant lesion raises the question whether this is a case of an intracortical osteosarcoma that has some distinct features from those of previously reported cases.

Bone Cysts↗
PubMed1997

Radial neck osteolysis after annular ligament reconstruction. A case report.

The treatment of the dislocated radial head in a late Monteggia lesion remains a matter of controversy. Annular ligament reconstruction using a strip of triceps tendon is a commonly used technique. Although most published series report good and excellent results, the overall complication rate of this procedure is not known. This study reports a 9-year-old boy who had avascular necrosis and bone resorption of the radial neck after a late annular ligament reconstruction using a sling of triceps tendon for a radial head dislocation that was not detected previously.

Child↗
PubMed1997

Valgus deformity following supracondylar elbow fractures in children.

We reviewed the cases of 10 patients with cubitus valgus deformity who had a supracondylar elbow fracture during childhood, in order to identify the causes of valgus deformity. Cubitus valgus deformity occurred in 3 cases because of failure to recognize the deformity at the initial treatment. In 7 patients the deformity was recognized but was insufficiently treated. In this series there was no evidence of progressive valgus deformity after healing of the fracture. Incomplete correction is the main cause of valgus deformity. It is suggested that, in order to reduce the incidence of valgus deformity following supracondylar elbow fracture, careful analysis of the fracture pattern is necessary and the initial angulation should be reduced anatomically and fixed in a correct manner.

Bone Nails↗
PubMed1996

Treatment of isolated distal ulnar shaft fractures with below-elbow plaster cast. A prospective study.

In a prospective study 52 patients with an isolated fracture of the distal ulna were treated with a below-elbow plaster cast. The histories of 46 patients were reviewed after a mean follow-up of 3.5 years (ranging from 10 months to 7 years). Forty-three fractures united. There were two non-unions. One fracture displaced while in the plaster, so that there was no longer any bone contact between the fragments. The fracture was consequently treated by open reduction and internal fixation. The type of fracture, the initial displacement (all fractures had bone contact) or the initial angulation (maximum 10 deg) was not found to influence the final clinical results. Below-elbow plaster cast appeared to produce satisfactory results in 89% of the patients.

Adult↗
PubMed1996

Proximal femoral replacement prosthesis for salvage of failed hip arthroplasty: complications in a 2-11 year follow-up study in 19 elderly patients.

We reviewed 19 elderly patients who underwent revision total hip arthroplasty with a proximal femoral replacement prosthesis for aseptic loosening and severe proximal femoral bone loss. The mean interval from initial hip replacement to revision arthroplasty was 8 (2-20) years. The mean age of the patients was 78 (63-87) years. 2 patients died within 2 years postoperatively and 1 patient was lost for follow-up evaluation. The remaining 16 patients were assessed clinically and radiographically after a mean follow-up period of 5 (2-11) years. All patients had local pain relief, but they all needed a crutch or another walking aid. According to the Merle d'Aubigne hip-rating scale there were no excellent results, 1 very good, 8 good, 5 fair, 2 poor and no bad results. 4 patients had an intraoperative fracture, 7 had a dislocation, 2 had a deep infection, and 3 patients had progressive loosening of the screws fixing the greater trochanter to the femoral component. Our series demonstrates that revision of a failed hip prosthesis, using a proximal femoral replacement prosthesis, presents complex problems.

Aged↗
PubMed1996

Myositis ossificans in an infant.

We report a 15-month-old girl with myositis ossificans at the shoulder. Because of the unusual presentation at this age the differential diagnosis with osteomyelitis or a tumoral process had to be considered. It had a benign evolution without specific treatment.

Clavicle↗
PubMed1996

Radiology of the elbow in children.

Elbow injuries are common in children. Correct management depends on a correct diagnosis. Most elbow injuries can be diagnosed by standard radiographs, but the variability of the developing secondary ossification centers which appear at different ages renders the diagnosis difficult. The normal development of the pediatric elbow should be learned by everyone who treats children's elbow injuries.

Aging↗