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Alternative technique for open reduction and fixation of displaced pediatric medial epicondyle fractures: author response to letter to the editor.

J Child Orthop. 2012 Jul;6(3):257

Authors: Glotzbecker MP, Shore B, Matheney T, Gold M, Hedequist D

PMID: 23814627 [PubMed]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23814627?dopt=Abstract

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Commentary on the article "Alternative technique for open reduction and fixation of displaced pediatric medial epicondyle fractures" by Michael P. Glotzbecker, Benjamin Shore, Travis Matheney, Meryl Gold, Daniel Hedequist. J Child Orthop doi:10.1007/s11832-012-0395-1.

J Child Orthop. 2012 Jul;6(3):255

Authors: Gopinathan NR, Kothari MK

PMID: 23814626 [PubMed]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23814626?dopt=Abstract

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The modulation of spinal growth with nitinol intervertebral stapling in an established swine model.

J Child Orthop. 2012 Jul;6(3):241-53

Authors: Carreau JH, Farnsworth CL, Glaser DA, Doan JD, Bastrom T, Bryan N, Newton PO

Abstract
PURPOSE: Anterior spinal stapling for the treatment of adolescent idiopathic scoliosis has been shown to slow progression in small curves; however, its role in larger curves remains unclear. The purpose of this study was to evaluate the effectiveness of nitinol staples to modulate spinal growth by evaluating the two-dimensional and three-dimensional morphological and histological effects of this method in a well-established porcine model.
METHODS: Three immature Yucatan miniature pigs underwent intervertebral stapling. Two staples spanned each of three consecutive mid-thoracic discs and epiphyses. Monthly radiographs were obtained. Computed tomography (CT) was conducted at harvest after 6 months of growth. Measurements of wedging and height for each disc and vertebral body were conducted. Micro CT was used to compare physeal closure between stapled and non-stapled levels. Histology of the growth plate also compared the hypertrophic zone thickness for control and stapled vertebrae.

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Spondylolysis is frequently missed by MRI in adolescents with back pain.

J Child Orthop. 2012 Jul;6(3):237-40

Authors: Yamaguchi KT, Skaggs DL, Acevedo DC, Myung KS, Choi P, Andras L

Abstract
PURPOSE: Magnetic resonance imaging (MRI) is often used in the evaluation of lower back pain in adolescents. The purpose of our study is to report on the frequency of MRI missing spondylolysis in adolescents with back pain in a pediatric orthopaedic practice.
METHODS: A retrospective review of all patients with a diagnosis of spondylolysis who presented from January 2000 to March 2010 was performed. All patients were evaluated at a single institution by the senior author. Inclusion criteria were patients with spondylolysis confirmed on computed tomography (CT) or plain film that also received an MRI.
RESULTS: Eleven patients with spondylolysis had an MRI performed. The mean age of the study patients was 14.2 years (range 10-17). The diagnosis of spondylolysis was missed in the MRI radiology reading in 7 out of 11 (64 %) studies.
CONCLUSIONS: MRI missed a spondylolysis in over half of the adolescents in this consecutive series. In patients with a history or physical findings suggestive of spondylolysis, such as localized pain of the lumbar spine with back extension, further radiographic evaluation should be considered, even if an MRI is negative.
LEVEL OF EVIDENCE: III, retrospective review.

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Comparison of hamstring lengthening with hamstring lengthening plus transfer for the treatment of flexed knee gait in ambulatory patients with cerebral palsy.

J Child Orthop. 2012 Jul;6(3):229-35

Authors: Feng L, Patrick Do K, Aiona M, Feng J, Pierce R, Sussman M

Abstract
PURPOSE: Children with spastic diplegic and hemiplegic cerebral palsy frequently ambulate with flexed knee gait. There has been concern that hamstring lengthening used to treat this problem may weaken hip extension. This study evaluates the primary outcome of hamstring transfer plus lengthening in comparison with traditional hamstring lengthening in treating flexed knee gait in ambulatory patients with cerebral palsy.
METHODS: A total of 47 children (67 lower limbs) ranging in age from 5 to 17 years old were included in this study. All subjects underwent a variety of additional surgeries at the time of the hamstring surgery as part of a multilevel treatment plan. All patients who met the inclusion criteria were divided into two groups, the hamstring lengthening alone group (HSL) and the hamstring transfer plus lengthening group (HST). Full gait analysis studies were done for all subjects pre-operatively and 1 year post-operatively.

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Pes planovalgus deformity surgical correction in ambulatory children with cerebral palsy.

J Child Orthop. 2012 Jul;6(3):217-27

Authors: Kadhim M, Holmes L, Church C, Henley J, Miller F

Abstract
PURPOSE: Planovalgus foot deformity is common in diplegic and quadriplegic patients. Surgery is the definitive treatment to restore the alignment of the talus, calcaneus, and navicular bones. We aimed, in the current study, to compare the effectiveness of subtalar fusion and calcaneal lengthening, and to assess the recurrence in ambulatory children with cerebral palsy.
METHODS: This is a retrospective study of 78 patients (138 feet diagnosed with planovalgus deformity) who underwent surgical correction using subtalar fusion or calcaneal lengthening. Range of motion, radiographic indices, kinematic, and pedobarographic data were used to examine the deformity and the outcome of surgery. A repeated measures analysis of variance (ANOVA) was used to test the study hypothesis.

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Primary obturator-muscle pyomyositis in immunocompetent children.

J Child Orthop. 2012 Jul;6(3):205-15

Authors: García-Mata S, Hidalgo-Ovejero A, Esparza-Estaun J

Abstract
PURPOSE: Primary pyomyositis in immunocompetent children in non-tropical regions (countries with temperate climates) is very uncommon. It is rarely found in the intrapelvic muscles, and even more rarely in the obturator muscles. We try to draw attention to the potential occurrence in these conditions.
METHODS: Five new cases of primary obturator-muscle pyomyositis in immunocompetent children aged between 6 and 11 years in a temperate climate are presented. They present with symptoms as follows: fever, pain (thigh, abdominal, inguinal, and/or hip pain), and limp. Three of them had no hip movement limitation. All of them had tenderness in the perineum zone.
RESULTS: Laboratory tests may reveal high erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) counts, but depend on the length of diagnostic delay. The evolution time oscillated from 1 to 5 days. Fever and limp disappearance depends on the evolution time previous to the onset of the antibiotics administration. In 4 out of 5 patients, Staphylococcus aureus was present in the blood cultures. In all cases of obturator-muscle pyomyositis, diagnosis was confirmed using computed tomography (CT) scan (one) and/or magnetic resonance imaging (MRI) (four).

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Musculoskeletal manifestations of neonatal nonketotic hyperglycinemia.

J Child Orthop. 2012 Jul;6(3):199-203

Authors: Ramirez N, Flynn JM, Casalduc F, Rodriguez S, Cornier AS, Carlo S

Abstract
PURPOSE: Neonatal nonketotic hyperglycinemia is an autosomal recessive inborn disorder of glycine metabolism in which large quantities of glycine accumulate in all body tissues. It is characterized by a progressive lethargy, hypotonia, myoclonic jerks, and early death secondary to respiratory problems. As a result of early diagnosis and treatment protocols, more patients survive the critical neonatal period with profound mental retardation, delayed developmental milestones, seizures, and spasticity. There are no reports about the orthopaedic manifestations of neonatal nonketotic hyperglycinemia. The purpose of this study is to evaluate the musculoskeletal findings of neonatal nonketotic hyperglycinemia.
METHODS: This is a retrospective IRB-approved study of all patients in our Orthopaedic and Genetics Clinics with the diagnosis of neonatal nonketotic hyperglycinemia during a 10-year period. Demographic, clinical, and imaging data were analyzed.

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Congenital constriction ring in children: sine plasty combined with removal of fibrous groove and fasciotomy.

J Child Orthop. 2012 Jul;6(3):189-97

Authors: Hung NN

Abstract
OBJECTIVE: To evaluate the clinical and functional results of a technical procedure used in the surgical treatment of congenital constriction ring (CCR) in children.
MATERIALS AND METHODS: This was a retrospective study undertaken to evaluate the results of surgical techniques performed from January 1995 to December 2005 on 95 patients with 134 congenital constriction bands. Due to the drop-out of nine patients during follow-up, data on 86 patients (121 congenital constriction rings; average age at surgery 1 year 2 months) were analyzed. The extent of the constrictions was classified by according to the Patterson criteria. All patients were treated by two-stage sine plasty combined with removal of the fibrous groove and fasciotomy, with one-half of the ring removed during the first stage and the other half removed 1 week later during the second state. The surgical outcomes were assess according to the Moses criteria.