Introduction: The natural history of idiopathic scoliosis is not well understood. Previous reports focused on characteristics of curve progression pre-defined at 5–6 degrees. However, the absolute curve magnitude at
Side shift exercise was originally described by Mehta. Since 1986, we adopted it for the treatment of idiopathic scoliosis. Outcome of the side shift exercise for the patients with idiopathic scoliosis after
The purpose of this study was to compare 2 different strategies of management for ACL rupture in skeletally immature patient. In group 1, patients were treated in a children hospital by ACL reconstruction with open physis. In group 2, patients were treated in an adult hospital by delayed reconstruction at
Purpose: We reviewed our pre-puberty patients whose scoliosis or kyphoscoliosis involved a hemivertebra. The purpose of our work was to evaluate the surgical technique used and evaluate spinal static as well as functional outcome at
Introduction. This is a report of the outcome of management of congenital pseudoarthrosis of the tibia (CPT) at
Background: Deformity of the femoral head after open reduction for developmental dislocation of the hip (DDH) influences the outcome of pelvic osteotomy as a final correction for residual dysplasia to prevent secondary osteoarthritis. The purpose of this study was to review long-term outcomes after open reduction using a medial approach for DDH. The correlation between age at the time of operation and femoral head deformity at
It is generally accepted that children treated for congenital pseudarthrosis of the tibia (CPT) should be followed-up until
The atlas of Greulich and Pyle for
Assessment of skeletal age is important in children’s
orthopaedics. We compared two simplified methods used in the assessment
of skeletal age. Both methods have been described previously with
one based on the appearance of the epiphysis at the olecranon and
the other on the digital epiphyses. We also investigated the influence
of assessor experience on applying these two methods. Our investigation was based on the anteroposterior left hand
and lateral elbow radiographs of 44 boys (mean: 14.4; 12.4 to 16.1
) and 78 girls (mean: 13.0; 11.1 to14.9) obtained during the pubertal
growth spurt. A total of nine observers examined the radiographs
with the observers assigned to three groups based on their experience (experienced,
intermediate and novice). These raters were required to determined
skeletal ages twice at six-week intervals. The correlation between
the two methods was determined per assessment and per observer groups. Interclass
correlation coefficients (ICC) evaluated the reproducibility of
the two methods. The overall correlation between the two methods was r = 0.83
for boys and r = 0.84 for girls. The correlation was equal between
first and second assessment, and between the observer groups (r ≥ 0.82).
There was an equally strong ICC for the assessment effect (ICC ≤ 0.4%)
and observer effect (ICC ≤ 3%) for each method. There was no significant
(p <
0.05) difference between the levels of experience. The two methods are equally reliable in assessing
Aim. To determine the rate of recurrence of coronal plane deformity in children treated with ‘guided growth’ using 8-plates, from the time of implant removal to
Introduction and Aims: We studied the outcome of single event multilevel surgery (SEMLS) for the correction of severe crouch gait in spastic diplegia, over a five-year period. It was unknown if gait correction post-SEMLS could be sustained at
We reviewed prospectively, after
We retrospectively reviewed 223 cases of supracondylar fractures of elbow treated in our hospital between the years 1996 and 2000. In 30 patients we found some degree of under-reduction of the extension element of the fracture. Twenty-two of them were evaluated close to
We reviewed and radiographed 30 skeletally-mature patients after isolated closed femoral shaft fractures in childhood which had been treated conservatively. When the fracture had occurred between the ages of 7 and 13 years, the limb overgrew about 1 cm regardless of sex, upper limb dominance, age, fracture site or configuration. Excessive fracture overlap at the time of injury, but not at union, increased limb overgrowth. Angulation of the fracture remodelled in children injured under 10 years of age, but in older patients this sometimes added to limb shortening. Rotational deformities were minor and gave no symptoms. Treatment of the 7- to 13-year-old patient should aim at 1 cm overlap at union, with correction of angular deformity being more important in children over 10 years of age. This management of fractures will give a maximum leg length discrepancy of 1 cm at
Natural history of AIS >30° in skeletally mature patients is poorly defined. Studies reporting rates and risk factors for progression are predominantly of large curves in immature patients. Our aim was to determine the rate of curve progression in AIS following
Introduction: The management of severe slipped upper femoral epiphysis (SUFE) is controversial. Many types of operation have been advocated. The cuneiform osteotomy offers the potential to restore normal anatomy and hence reduce the development of osteoarthritis, but it is not without its risks. This aim of this study was to quantify the long-term clinical &
radiological results of Fish’s cuneiform osteotomy at
We assessed the Japanese specific bone age standard with Tanner-Whitehouse 2 (TW2) method for the evaluation of
Using 90% of final height as a benchmark, we sought to develop
a quick, quantitative and reproducible method of estimating skeletal
maturity based on topographical changes in the distal femoral physis. Serial radiographs of the distal femoral physis three years prior
to, during, and two years following the chronological age associated
with 90% of final height were analyzed in 81 healthy children. The
distance from the tip of the central peak of the distal femoral
physis to a line drawn across the physis was normalized to the physeal width.Aims
Patients and Methods
Introduction. The main challenge in management of adolescent idiopathic scoliosis (AIS) is to predict which curve will progress so that appropriate treatment can be given. We previously reported that low bone mineral density (BMD) was one of the adverse prognostic factors for AIS. With advancement in imaging technology, quantitative ultrasound (QUS) becomes a useful method to assess bone density and bone quality. The objective of this study was to assess the role of QUS as a radiation-free method to predict curve progression in AIS. Methods. 294 girls with AIS were recruited at ages 11–16 years and followed up until
We report the arthroscopic drilling of classical lesions of osteochondritis dissecans in 11 knees in 10 children with at least six months history and no sign of clinical or radiological improvement. There were eight boys and two girls and the average age at operation was 12 years 11 months. Relief of pain was noticed within days of operation; radiological healing occurred within 12 months in nine of the 11 knees.