A retrospective study was done of eighty-seven patients who had 129 diaphyseal fractures either the radius or ulna, both, and were treated with fixation using an AO dynamic-compression plate. Open internally fixed primarily, both comminuted open routinely bone-grafting. Ninety-eight per cent united, 92 achieved excellent satisfactory functional result. The rate infection 2.3 cent. Refracture occurred after removal a 4.5-millimeter plate in two patients, but there no refractures...

The optimal treatment of severe acetabular dysplasia with subluxation the femoral head or presence a secondary acetabulum remains controversial. purpose this study was to analyze extent surgical correction and early clinical results obtained Bernese periacetabular osteotomy for severely dysplastic hips in adolescent young adult patients.Sixteen thirteen patients an average age 17.6 years (range, 13.0 31.8 years) were classified as having (Group IV V according Severin classification). Eight...

Limited data exist about complications of titanium elastic nails (TNs) for femur fracture management in pediatric patients. Thirty-nine patients with 43 femoral shaft fractures were identified whose average age was 6.0 years. There 21 (1 intraoperative, 20 postoperative) (49%). two major postoperative complications: one septic arthritis after nail removal and hypertrophic nonunion. Minor pain at the 13 extremities, erosion through skin 4, delayed union. an association between prominence TNs...

Background: Differentiation between septic arthritis and transient synovitis of the hip in children can be difficult. Kocher et al. recently developed a clinical prediction algorithm for based on four variables: history fever, non-weight-bearing, an erythrocyte sedimentation rate ≥40 mm/hr, serum white blood-cell count >12,000/mm3 (>12.0 × 109/L). The purpose this study was to apply retrospectively determine its predictive value our patient population. Methods: A retrospective review...

Supracondylar distal humerus fractures are one of the most common skeletal injuries in children. The current treatment choice North America is closed reduction and percutaneous pin fixation. Often surgeons leave pins exposed beneath a cast but outside skin. Great variation exists with respect to preoperative skin preparation, perioperative antibiotic administration. Few data exist regarding rate infection other complications. purpose this study review large series children evaluate...

Between January 1, 1994 and December 31, 1997, we evaluated 138 children with displaced supracondylar distal humerus fractures treated by closed reduction percutaneous pinning. There were 49 type II 89 III fractures. Three principal pin configurations used at the surgeon's discretion: 2 lateral pins (42 fractures), 1 medial (37 (57 fractures). was no statistically significant difference in clinical stability between these groups. One fracture pinned using two showed marked rotational...

A retrospective review of 60 diaphyseal tibia fractures (31 closed and 29 open fractures) treated with flexible intramedullary fixation was conducted. All charts radiographs were reviewed. Children ranged in age from 5.1 to 17 years. Fifty patients 51 followed up until union comprised the study group. The mean follow-up period for these 50 79 weeks. Forty-five achieved bony within 18 weeks (mean, 8 weeks). Five (11%) had delayed healing (3 unions that ultimately healed casting or...

The treatment of femoral shaft fractures in older children and adolescents using rigid intramedullary (IM) nail fixation offers the advantages decreased soft tissue stripping, low incidence malalignment, leg length discrepancy, early ambulation, hospital stay. Recent reports have described development osteonecrosis head after IM nailing through piriformis fossa tip greater trochanter. Others noted secondary proximal valgus neck narrowing antegrade nailing. Using lateral aspect \trochanter as...

There have been very few reports regarding symptomatic snapping of the iliopsoas tendon, and none those dealt exclusively with an adolescent population. We report our experience surgical treatment this entity in a group patients who had average age fifteen years.Nine (eleven hips) underwent fractional lengthening tendon at musculotendinous junction because persistent painful hip. A modified iliofemoral approach to was used. The diagnosis all cases made on basis history physical examination....

Ponseti demonstrated correction of most clubfeet in infants using proper manipulative techniques followed by application well-molded long-leg plaster casts and a percutaneous tendoachilles tenotomy to correct residual equinus contracture. Medical complications occurring as result this technique have not our knowledge been reported. The authors retrospectively reviewed 134 consecutive with 219 idiopathic treated the method. A was performed on 200 (91%) at mean age 16 weeks (range, 6–77 weeks)...

A retrospective study was performed to evaluate the results of intramedullary fixation used in management unstable, diaphyseal both-bone forearm fractures skeletally immature patients. Twenty-five patients with 25 were identified whose fracture included only fixation. Galeazzi, Monteggia, radial head, and distal metaphyseal excluded from this analysis. Mean age at 10 + 8 years. There 15 closed open (eight grade I two II). Smooth Kirschner wires or Rush rods for Average length immobilization...

Ponseti demonstrated correction of most clubfeet in infants using proper manipulative techniques followed by application well-molded long-leg plaster casts and a percutaneous tendoachilles tenotomy to correct residual equinus contracture. Medical complications occurring as result this technique have not our knowledge been reported. The authors retrospectively reviewed 134 consecutive with 219 idiopathic treated the method. A was performed on 200 (91%) at mean age 16 weeks (range, 6-77 weeks)...

Recent reports on the treatment of a dislocation hip due to developmental dysplasia have documented conflicting data importance ossific nucleus in development postreduction ischemic necrosis. Delaying reduction until is present bypasses time-period maximal osseous remodeling hip, thereby possibly increasing need for future operations. We hypothesized that hips with an are more likely subsequent reconstructive procedures.A retrospective review medical records at two tertiary-care children's...

Recurrent clubfoot deformity after successful initial correction with the use of Ponseti method continues to be a common problem and is often caused by noncompliance wear traditional foot abduction brace. The purpose this study was assess results newly designed dynamic orthosis in terms (1) parental compliance (2) effectiveness preventing recurrent deformities. Twenty-eight patients (49 clubfeet) who were treated accordance included study. Of 28 patients, 18 had idiopathic clubfeet (31...

Spica casting is the standard of care for femur fractures in children up to 6 years age. The indications surgery are controversial. We sought compare immediate spica (Spica) and flexible intramedullary nailing [titanium elastic (TEN)] a group ages 2 years. hypothesized that young can be successfully treated with nails, resulting faster return ambulation an equivalent complication rate when compared casting.This was multicenter retrospective review 215 patients, 141 casting, 74 nails. Patient...

A retrospective review was performed of 106 patients to determine the effect knee pain as initial complaint slipped capital femoral epiphysis (SCFE). Sixteen (15%) had a primary distal thigh or both at presentation our institution referring physician. Ninety (85%) described primarily hip, groin, proximal discomfort. Of with SCFE, 65 received no operative treatment before being evaluated and were subject remainder study. these, 15 (23%) their chief (group I), 50 (77%) II). There difference...

A retrospective review was performed of 106 patients to determine the effect knee pain as initial complaint slipped capital femoral epiphysis (SCFE). Sixteen (15%) had a primary distal thigh or both at presentation our institution referring physician. Ninety (85%) described primarily hip, groin, proximal discomfort. Of with SCFE, 65 received no operative treatment before being evaluated and were subject remainder study. these, 15 (23%) their chief (group I), 50 (77%) II). There difference...

Ultrasound scans of the hip were carried out in 132 children with pain during an 18-month period to evaluate for presence effusion. Seventy-three these patients followed up long enough ascertain or absence septic arthritis. The remaining 59 discharged diagnoses other than arthritis but could not be located confirm ultimate accuracy diagnosis. Four initially determined have no effusion subsequently diagnosed (false-negative rate 5%). Two had inadequate initial ultrasound examinations....

The management of unstable slipped capital femoral epiphysis (SCFE) is controversial. A high incidence avascular necrosis (AVN) has been reported after SCFE.Twenty-eight consecutive patients with thirty SCFE underwent urgent reduction and fixation two 6.5-mm cannulated screws. Positional was performed in 25 cases. Arthrotomy percutaneously 16 cases as part an open capsulotomy 5 cases.Slip severity mild 13 patients, moderate 9, severe 8. At mean duration follow-up 5.5 years (range: 2.0 to...

There exist varying reports in the literature regarding incidence of compartment syndrome (CS) after intramedullary (IM) fixation pediatric forearm fractures. A retrospective review experience with this treatment modality at our institution was performed to elucidate rate postoperative CS and identify risk factors for developing complication.In case series, we reviewed charts all patients treated operatively isolated radius ulnar shaft fractures from 2000 2009 identified 113 who underwent IM...

Recent reports have described osteonecrosis of the femoral head after intramedullary nailing femur through piriformis fossa in children. Other raised concerns about development neck narrowing and valgus deformity proximal part tip greater trochanter. We evaluated radiographic changes following lateral trochanteric area at a minimum two years postoperatively twenty-five affected extremities. The mean age patients time index procedure was ten six months.A retrospective review performed to look...