This paper reports the development and validation of a disease-specific measure health status well-being children with severe cerebral palsy (CP). The Caregiver Priorities Child Health Index Life Disabilities (CPCHILD) was constructed from recommendations caregivers, healthcare providers, review other measures. Items spanning six domains are rated on an ordinal scale. Standardized scores (0-100) reported for each domain in total. Primary caregivers (n = 77) 45 males 32 females between 5 18...

Flexible intramedullary nailing has become a popular method of fixation pediatric femoral fractures. The authors analyzed their first 5-year experience with titanium elastic stable intra-medullary nailing, specifically to report the complications associated this technique and provide recommendations avoid these complications. Seventy-eight children 79 fractures were treated by method. Complications included pain/irritation at insertion site (41), radiographic malunion (8), refracture (2),...

Flexible intramedullary nailing has become a popular method of fixation pediatric femoral fractures. The authors analyzed their first 5-year experience with titanium elastic stable intra-medullary nailing, specifically to report the complications associated this technique and provide recommendations avoid these complications. Seventy-eight children 79 fractures were treated by method. Complications included pain/irritation at insertion site (41), radiographic malunion (8), refracture (2),...

Background: Existing radiographic classification schemes (eg, Tönnis criteria) for DDH quantify the severity of disease based on position ossific nucleus relative to Hilgenreiner's and Perkin's lines. By definition, this method requires presence an ossification centre, which can be delayed in appearance eccentric location within femoral head. A new system has been developed by International Hip Dysplasia Institute (IHDI), uses mid-point proximal metaphysis as a reference landmark, therefore...

Primary care medical homes may improve health outcomes for children with special healthcare needs (CSHCN), by improving coordination. However, community-based primary practices be challenged to deliver comprehensive coordination complex subsets of CSHCN such as complexity (CMC). Linking a tertiary center the community achieve cost effective and high quality CMC. The objective this study was evaluate clinics integrated center. A before- after-intervention design mixed...

Background: Children with lower-limb-length discrepancy require repeated radiographic assessment for monitoring and as a guide management. The need accurate of length alignment is balanced by the to minimize radiation exposure. We compared accuracy, reliability, dose EOS, novel low-dose upright biplanar imaging system, at two different settings, that conventional radiographs (teleoroentgenograms) computed tomography (CT) scanograms, limb length. Methods: A phantom in standardized position...

Clubfeet are associated with many neuromuscular and congenital conditions. Nonidiopathic clubfeet typically thought to be resistant nonoperative management. The Ponseti method has revolutionized the treatment of patients idiopathic clubfeet. purpose this study was describe use in whose a diagnosis or syndrome.All who were treated at Hospital for Sick Children, Toronto, from 2001 2005 reviewed. Patients included only if condition syndrome could identified primary our institution. Twenty-three...

Background: The true benefits of scoliosis surgery in cerebral palsy (CP) remain uncertain. Our aims were to determine the spinal fusion according health-related quality life (HRQoL) improvement at long-term follow-up and explore effect surgery-related complications on clinical outcomes. Methods: cases consecutive patients who had Gross Motor Function Classification System (GMFCS) level-IV or V with 5-year from a prospective, longitudinal, multicenter database analyzed. Caregivers completed...

To explore whether health-related quality of life (HRQOL) can be predicted by pain, age, Gross Motor Function Classification System (GMFCS) level, and sex in children with cerebral palsy (CP) different pain etiologies have varying effects on HRQOL.Children CP aged 3 to 19 years their caregivers were consecutively recruited. Caregivers reported child's (Health Utilities Index [HUI3] subset) HRQOL (DISABKIDS questionnaires). Physicians identified etiologies. A multiple linear regression model...

Background Guided growth by tension band plating is commonly used to correct coronal plane deformity. The purpose of this study was measure the effect and further define parameters that influence results in deformity around knee. Methods retrospective multicentre included data on 967 physes 537 patients, with an average follow-up 16 months after plate insertion. Alignment analysis compared preoperatively at least two measurements postoperatively, as well rate amount correction. Results...

We investigated the validity of Gait Outcomes Assessment List (GOAL), as an assessment gait function in children with cerebral palsy (CP).We studied a prospective cohort 105 CP (Gross Motor Function Classification System [GMFCS] levels I-III; 65 males, 40 females; mean [SD] age 11y 11mo [3y 5mo], range 6-20y), who attended over 10-month period. Parents completed GOAL, Functional Mobility Scale (FMS), and Questionnaire (FAQ) during their child's evaluation. Ninety instrumented analysis (IGA)....

The Gross Motor Function Classification System (GMFCS) of cerebral palsy categorizes patients by mobility. Patients at GMFCS level 5 are considered the most disabled and high risk hip spine problems, yet they represent a wide spectrum function. Our aim was to subclassify who underwent spinal arthrodesis on basis central neuromotor impairments assess whether subclassification predicted postoperative complications changes in health-related quality life.Using prospective registry, we identified...

IMPORTANCE Lateral ankle injuries without radiographic evidence of a fracture are common pediatric injury.These children often presumed to have Salter-Harris type I the distal fibula (SH1DF) and managed with immobilization orthopedic follow-up.However, previous small studies suggest that these may represent sprains rather than growth plate fractures.OBJECTIVES To determine frequency SH1DF using magnetic resonance imaging (MRI) compare functional recovery fractures identified by MRI vs those...

Isolated distal fibular ankle fractures in children are very common and at low risk for future complications. Nevertheless, standard therapy these still consists of casting, a practice that carries risks, inconveniences, use subspecialty health care resources. Therefore, the main objective this study was to determine whether who have low-risk treated with removable brace least as effective recovery physical function those cast.This noninferiority, randomized, single-blind trial which were 5...

This paper reports the development and validation of a disease‐specific measure health status well‐being children with severe cerebral palsy (CP). The Caregiver Priorities Child Health Index Life Disabilities (CPCHILD) was constructed from recommendations caregivers, healthcare providers, review other measures. Items spanning six domains are rated on an ordinal scale. Standardized scores (0–100) reported for each domain in total. Primary caregivers ( n =77) 45 males 32 females between 5 18...

Background: The optimal management of femoral fractures in adolescents is controversial. This study was performed to compare the results and complications four methods fixation determine factors related those complications. Methods: We conducted a retrospective cohort 194 diaphyseal 189 children treated with elastic stable intramedullary nail fixation, external rigid or plate fixation. After adjustment for age, weight, energy injury, polytrauma, fracture level pattern, extent comminution,...

The Ponseti method of clubfoot management requires a period bracing in order to maintain correction. This study compared the effectiveness ankle foot orthoses and Denis Browne boots bar prevention recurrence following successful initial management. Between 2001 2003, 45 children (69 feet) with idiopathic clubfeet achieved full correction casting or without tenotomy, whom 17 (30 clubfeet) were braced an orthosis while 28 (39 prescribed bar. groups similar age, gender, number casts tenotomy...

Background: Increasingly, the Ponseti method has been adopted worldwide as preferred of managing idiopathic clubfoot deformity. Following successful implementation by orthopaedic surgeons in our institution, a clinic was established 2003. This is directed physiotherapist who, using protocol, performs serial cast treatment and supervises brace management all children with The purpose this study to compare outcomes physiotherapist-directed surgeon-directed clubfeet. Methods: We performed...

The treatment of unstable slipped capital femoral epiphysis (SCFE) remains controversial. Surgical dislocation and open reduction has the potential to significantly reduce rate avascular necrosis (AVN) by allowing direct preservation head blood supply. purpose this study was determine if SCFE means surgical hip reduced risk AVN compared with closed percutaneous pinning.We reviewed medical records radiographs patients treated at our institution between years 2000 2008. Sex, age, side slip,...

Objective: To evaluate the association of hip lateralisation with health-related quality life (HRQL) in children cerebral palsy (CP) using Caregiver Priorities and Child Health Index Life Disabilities (CPCHILD®) questionnaire. Methods: We assessed n = 34 patients (mean age: 10.2 years, SD: 4.7 years; female: 16) bilateral CP Gross Motor Function Classification System (GMFCS) Level III–V CPCHILD® Hip was measured by Reimer`s migration percentage (MP). Results: There an between both, MP GMFCS...