Benign calcaneal osteomata.
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Adolescent↗
Biomedical subjects
I Torode
Publications and source records attributed to I Torode.
Posterior dislocation of the humeral head in association with obstetric paralysis.
Twelve children with obstetric paralysis were diagnosed as having a posterior dislocation of the humeral head. The diagnosis was suspected on clinical grounds and confirmed by computed tomography (CT) scans in all cases. All 12 patients were treated with open reduction via an anterior approach. The age range at the time of surgery was from 7 months to 7 years (average, 2 years and 3 months). All patients were immobilized in a shoulder spica for 6 weeks and a further 6 weeks in an orthosis. All patients were examined by CT scans in the postoperative period, which confirmed a satisfactory reduction in all cases. With a minimal follow-up of 12 months, there have been no redislocations. This article demonstrates that dislocation of the shoulder in association with obstetric paralysis is not rare, as previously described, and shows that once diagnosed, the dislocation can be satisfactorily treated by a single anterior open reduction of the shoulder.
Child↗
Pelvic fractures in children.
A retrospective study was performed on 141 patients with multiple injuries that included pelvis fractures. The mode of injury, type of fracture of the pelvis, associated injuries, morbidity and mortality, and outcome following healing of the fracture were studied. From this study a classification has been derived which appears to show a correlation among the type of pelvic fracture, the associated injuries, and the expected outcome from that fracture. Of the 141 patients, there were 11 deaths and 130 patients available for clinical review. The greatest morbidity, mortality, and complications from the fractures were in the type IV group, comprising patients with segmental instability of the pelvis. We suggest that computed tomographic scanning be used when segmental instability is suspected and when the posterior elements of the pelvis are difficult to examine by conventional radiographs. When there has been disruption of the acetabulum, then the treatment of choice is open reduction, stable fixation, and early motion. When there is segmental instability of the pelvis that cannot be controlled by conventional methods of pelvic slings or spica casts or when associated injuries preclude the use of these methods, then the treatment of choice should be external fixation.
Adolescent↗
Surgical correction of congenital kyphosis in myelomeningocele.
A progressive kyphosis in myelomeningocele patients may occur when the lesion is in the lower thoracic spine (i.e., a high-level lesion). Previously described techniques for this difficult problem have been fraught with problems of loss of fixation, recurrent deformity, implant failure, and wound breakdown. The technique described involves resection of the apical vertebra and proximal portion of the gibbus followed by fixation with a single U-shaped rod implanted distally into the lumbosacral spine. The rod is fixed to the thoracic spine using the Luque technique. No wires are used distally and the sacroiliac joints are not violated. This paper presents the first four patients who have undergone this form of spinal surgery. To date these patients have maintained a satisfactory result, and there has been no implant failure. Although this is a small series and with a short follow-up, the results support the use of this technique.
Adolescent↗