Aim: To review our experience with hemi-epiphysiodesis using different methods for the correction of
The purpose of this paper was to evaluate the early results of a new technique for correction of
Salter-Harris II fractures of the distal tibia affect children frequently, and when they are displaced present a treatment dilemma. Treatment primarily aims to restore alignment and prevent premature physeal closure, as this can lead to
Study Design. Retrospective review. Objective. To report the technique and results of vertebral column decancellation (VCD) for the management of sharp
Angular proximal femoral deformities increase the technical complexity of primary total hip arthroplasties (THAs). The goals were to determine the long-term implant survivorship, risk factors, complications, and clinical outcomes of contemporary primary THAs in this difficult cohort. Our institutional total joint registry was used to identify 119 primary THAs performed in 109 patients with an angular proximal femoral deformity between 1997 and 2017. The deformity was related to previous femoral osteotomy in 85%, and developmental or metabolic disorders in 15%. 53% had a predominantly varus
Introduction.
The concept of guided growth was proposed by Andry in 1741. In the last decades the concept has been widely used as implants has been introduced that can modulate the growth of the bone and pediatric longitudinal and
The aim of this scoping review is to understand the extent and type of evidence in relation to the use of guided growth for correcting rotational deformities of long bones. Guided growth is routinely used to correct
Introduction. Coronal malalignment and leg length discrepancies (LLD) are frequently associated. Temporary hemiepiphysiodesis (tHED) is commonly employed for the correction of limb malalignment in skeletally immature patients. For treatment of LLD greater than 2 cm, lengthening with intramedullary legnthening nails is a safe and reliable technique. However, the combined application of these approaches in skeletally immature patients has not yet been investigated. Materials & Methods. Retrospective radiological and clinical analysis of 25 patients (14 females, 11 males) who underwent intramedullary femoral lengthening with an antegrade PRECICE® lengthening nail as well as tHED of the distal femur and / or proximal tibia between 2014 and 2019. tHED was conducted by implantation of flexible staples (FlexTack™) either prior (n = 11), simultaneously (n = 10), or subsequently (n = 4) to femoral lengthening. The mean follow-up period was 3.7 years (±1.4). Results. The median initial LLD was 39.0 mm (35.0–45.0). 21 patients (84%) presented valgus and 4 (16%) showed varus malalignment. Leg length equalization was achieved in 13 patients at skeletal maturity (62%). The median LLD of patients with a residual LLD > 10 mm was 15.5 mm (12.8–21.8). Limb realignment was obtained in nine of seventeen skeletally mature patients (53%) in the valgus group, and in one of four patients (25%) in the varus group. Conclusions. The combination of antegrade femoral lengthening and tHED can efficiently correct LLD and coronal limb malalignment in skeletally immature patients. Nevertheless, achieving limb length equalization and realignment may render difficult in cases of severe LLD and
Abstract. Objectives. Epiphysiodesis is a commonly used treatment for lower limb
Introduction.
Background. Temporary hemiepiphysiodesis using 8 plate guided growth has gained widespread acceptance for the treatment of paediatric
Renal failure in children is associated with a wide range of musculoskeletal disorders such as osteonecrosis, stress fractures, brown tumours, epiphysiolysis, joint infections and
Summary Statement. The implantation of scaffold-free CTE from suspension culture into growth-plate defects resulted in a significant reduction in growth arrest of the rabbit tibia. Introduction. In childhood and adolescence, the growth plate injury can cause partial premature arrest of growth plate, which can make problems such as leg length discrepancy and
The aim was to assess the long-term impact of humeral and forearm rodding on functional ability, grip strength, joint range of motion and
Introduction and Aims: To determine the optimum management of growth arrests secondary to meningococcal septicaemia. Method: A retrospective study of 28 children treated in children’s hospitals in the UK for long bone deformities caused by growth plate arrests secondary to meningococcal septicaemia. Results: 28 children (age range four to eight years) with growth arrests of the long bones following meningococcal septicaemia were treated for their bony deformities (a limb length discrepancy or a progressive
Introduction: Meningococcal septicemia is a devastating illness that primarily affects children. Late orthopaedic sequelae, though rare, are being seen more frequently as acute medical management has reduced the initial mortality rate. Aims: To review the case histories and discuss the management of these children. Methods: A retrospective review of medical notes and radiographs was undertaken at the participating hospitals. Outcomes assessed included clinical &
radiologic outcome, limb length equalization and correction of the mechanical axis. Results: Between 1990 and 2000, twenty patients aged 2 to7 years presented to the orthopaedic departments of the participating hospitals with late sequelae. On average presentation wasf 4 years (2 – 6) after the acute phase of the disease. The reasons for referral included
Purpose.
Modern methods of deformity correction such as the Taylor Spatial Frame (TSF) allow correction of deformities to within tolerances of 1° and 0.5mm. Plain X-radiography using orthogonal views is the current standard for the assessment for the evaluation of
Introduction. The purpose of our study was to retrospectively analyze our patients who were treated for FH and PFFD by means of guided growth temporary Hemiepiphysiodesis. We sought to determine the effectiveness of the procedure, as well as its success rates, complications, and rebound phenomena. Materials and Methods. We retrospectively reviewed the medical records and all routine preoperative and post operative long standing radiograph of all the FH and PFFD patients that were operated in our institute using guided growth hemiepiphysiodesis technique of distal femur or proximal tibia between 2007 to 2017. Results. 42 patients (28/FH, 14/PFFD) with 55 involved physis were included in the study. The mean duration of follow-up was 51.11 ± 27.56 months after the first operation. The average age at first plate insertion was 11.7 years and 50% of patients reached puberty by the time of data collection. 32 physes (21 FH, 11 PFFD) were operated due to pathological mLDFA with a mean angle correction of 6.24° for the FH group and 6° for the PFFD group and time-to-correction of 14.07 months and 11.56 months, respectively. 23 physes (14 FH, 9 PFFD) were operated due to pathological mMPTA with a mean angle correction of 4.43° for the FH group and 6.22° for the PFFD group with time-to-correction of 17.95 months and 20.35 months respectively. 40% (12/30) of patients, whose metalwork was removed, had a recurrence of the deformity, 7/21 [33.3%] in the FH group and 5/9 [55%] in the PFFD group. All required a second hemiepiphysiodesis operation. 2. nd. rebound was recorded in 3/21 (14%) FH patients and 2/9 (22%) PFFD patients. Conclusions. Temporary hemiepiphysiodesis is an effective treatment of