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Outcome Measures of Microsurgical Toe Transfers for Reconstruction of Congenital and Traumatic Hand Anomalies.

J Pediatr Orthop. 2013 Aug 29;

Authors: Kaplan JD, Jones NF

Abstract
BACKGROUND:: Outcomes data for children undergoing surgical reconstruction of their congenital hand anomalies has been used infrequently or not at all. Some surgeons even contend that children with total absence of digits or hands function perfectly well. Therefore, the purpose of this study was to evaluate and compare the functional outcomes of children who have undergone microsurgical toe-to-hand transfers for reconstruction of congenital and traumatic hand anomalies with the normal pediatric population.
METHODS:: A total of 10 adolescents and 15 parents of pediatric and adolescent patients who underwent microsurgical toe-to-hand transfers were assessed using the Pediatric Outcomes Data Collection Instrument (PODCI) survey. Surveys were distributed during routine clinic visits or by mail. Indication and diagnosis were analyzed in relation to the functional outcomes obtained from the survey. Scores of the toe transfer patients group were compared with the scores of the normal pediatric population as well as the effect of patient and parent reporting.

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Direct Beam Radiation Exposure to Surgeons During Pinning of Supracondylar Humerus Fractures: Does C-Arm Position and the Attending Surgeon Matter?

J Pediatr Orthop. 2013 Aug 29;

Authors: Eismann EA, Wall EJ, Thomas EC, Little MA

Abstract
BACKGROUND:: Direct beam radiation exposure to the surgeon, especially to their hands, is extremely common during supracondylar humerus fracture pinnings and results in exposure to significantly greater doses of ionizing radiation when compared with scatter radiation. The purpose of this study was to determine how often surgeons are exposed to direct beam radiation during this surgery and whether the C-arm position and the surgeon's experience influence radiation exposure.
METHODS:: In this double blind study, we collected 3842 fluoroscopic still images from 78 closed reduction and percutaneous pinning surgeries for supracondylar humerus fractures performed or supervised by 6 attending surgeons. The percentage of images containing a surgeon's body was calculated as an indicator of direct beam radiation exposure. Total fluoroscopy time, C-arm position (standard or inverted), and whether the primary surgeon was an attending, resident, or both were recorded. Nonparametric statistical analyses were performed.
RESULTS:: Fluoroscopy lasted for a median of 34 seconds, and the surgeon was exposed to direct beam radiation in a median of 13% of fluoroscopy films, with exposure ranging

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Progressive early-onset scoliosis in Conradi disease: a 34-year follow-up of surgical management.

J Pediatr Orthop. 2013 Mar;33(2):e4-9

Authors: Kabirian N, Hunt LA, Ganjavian MS, Akbarnia BA

Abstract
BACKGROUND: Conradi-Hunermann syndrome (CHS) is a rare metabolic syndrome with several orthopaedic problems. Early-onset scoliosis is of great importance because of often rapidly progressive nature and high risk of postoperative complications.
OBJECTIVES: To report the 34-year follow-up and outcome of a patient with CHS treated with combined anterior and posterior fusion without instrumentation.
METHODS: All available clinical and radiographs of a female patient with CHS retrospectively reviewed. Overall health status, sagittal and coronal deformity, pulmonary function test, and outcome questionnaires were evaluated.

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Reliability and necessity of computed tomography in distal tibial physeal injuries.

J Pediatr Orthop. 2013 Mar;33(2):e18

Authors: Strohm PC, Hauschild O

PMID: 23389581 [PubMed - indexed for MEDLINE]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23389581?dopt=Abstract

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Recurrence of infantile cortical hyperostosis: a case report and review of the literature.

J Pediatr Orthop. 2013 Mar;33(2):e10-7

Authors: Navarre P, Pehlivanov I, Morin B

Abstract
OBJECTIVE: Also named Caffey disease, infantile cortical hyperostosis is a rare disease that usually affects children of a few weeks of age. The clinical picture is that of irritability, soft tissue swelling at various sites (mandible, clavicle, limbs) with local warmth, and pain on palpation. Radiographs demonstrate an important cortical thickening of the affected bony structures. There is generally spontaneous resolution of the inflammatory signs within the first few months or years of life, without future recurrence. We report the case of a recurrence in the adolescent period and conducted a thorough review of the literature to confirm this rare possibility.

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Correlation between the Child Health Questionnaire and the International Knee Documentation Committee score in pediatric and adolescent patients with an anterior cruciate ligament tear.

J Pediatr Orthop. 2013 Mar;33(2):216-20

Authors: Boykin RE, McFeely ED, Shearer D, Frank JS, Harrod CC, Nasreddine AY, Kocher MS

Abstract
BACKGROUND: The modified International Knee Documentation Committee (Pedi-IKDC) Subjective Knee Evaluation Form has recently been shown to be valid, reliable, and responsive in a pediatric and adolescent population. The correlations between the Pedi-IKDC and quality-of-life-related health measures have not been studied in depth to determine how a knee injury affects patients in this age group. The purpose of this study was to examine the association between the Pedi-IKDC score and the Child Health Questionnaire (CHQ) in a group of pediatric patients with an anterior cruciate ligament (ACL) injury.
METHODS: A prospectively collected registry of patients with ACL injuries was searched to indentify all patients who had completed both the Pedi-IKDC and CHQ (CHQ-CF87) questionnaires. These were analyzed to determine significant correlations between domains of the CHQ and the Pedi-IKDC.
RESULTS: A total of 135 patients were included (80 male, 55 female) with a median age of 15.3 years (range, 13.1 to 17.2 y).

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Variations in AP and frog-leg pelvic radiographs in a pediatric population.

J Pediatr Orthop. 2013 Mar;33(2):212-5

Authors: Hudak KE, Faulkner ND, Guite K, Muchow R, Narotam V, Nemeth B, Halanski M, Noonan K

Abstract
INTRODUCTION: It is common for pediatric patients with a history of hip dysplasia to undergo anteroposterior (AP) and frog-leg (FL) lateral radiographs to monitor development of the hip. Because of sensitivity of pediatric tissues to ionizing radiation, we sought to document the relationship between AP and FL radiographs and to determine which image was better to assess acetabular dysplasia.
METHODS: An Institutional Review Board-approved, retrospective review was conducted on 33 patients screened for hip dysplasia at a single institution. We sought to determine whether either film was more likely to be qualitatively better in position and whether there were differences in acetabular measures between the 2 radiographs. Standard measurements on AP and FL radiographs were made by 5 observers on 2 different occasions to assess interobserver and intraobserver variability.
RESULTS: The mean age was 23+1 months, and 80% were female; none of the children had hip dysplasia. There was no statistical significance in the quotient of pelvic rotation (AP 1.2 + 0.1 degrees and FL 1.1 + 0.1 degrees; P = 0.84). There was a

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Correction in malrotation of the scapula and muscle transfer for the management of severe Sprengel deformity: static and dynamic evaluation using 3-dimensional computed tomography.

J Pediatr Orthop. 2013 Mar;33(2):205-11

Authors: Yamada K, Suenaga N, Iwasaki N, Oizumi N, Minami A, Funakoshi T

Abstract
BACKGROUND: The clinical results of surgical procedures for severe Sprengel deformity have been uncertain. To obtain improved elevation, we consider that it is necessary to realign the lateral border of the scapula for upward rotation. The purposes of the current study were to evaluate the clinical results and range of motion of the scapula after such realignment.

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Comparative study of 2 commissural dorsal flap techniques for the treatment of congenital syndactyly.

J Pediatr Orthop. 2013 Mar;33(2):197-204

Authors: Mallet C, Ilharreborde B, Jehanno P, Litzelmann E, Valenti P, Mazda K, Penneçot GF, Fitoussi F

Abstract
BACKGROUND: Many commissural reconstruction techniques have been described for the treatment of syndactyly. This study is the first to compare long-term results of 2 commissural dorsal flap procedures (T-flap and omega-flap).
METHODS: Fifty-nine web-spaces in 39 patients, operated on between 1991 and 2008, were retrospectively analyzed. Thirty-six T-flap and 23 omega-flap procedures were performed using full-thickness skin graft in every case for digital resurfacing. Factors that could affect the long-term outcome were collected, including development of web-creep, clinodactyly, and flexion contracture. Patients were reviewed with a mean follow-up of 5 years and 8 months.