Aims

The primary aim of this study was to determine the morbidity of a tibial strut autograft and characterize the rate of bony union following its use.

1. A description of the planning for the application of a powered prosthesis to a child with bilateral upper limb deficiency is given. 2. Details of twenty such children are recorded

In children cubitus varus is common after malunion of a supracondylar fracture of the humerus. Later problems such as tardy ulnar nerve palsy, snapping of the lateral triceps tendon or ulnar nerve and posterolateral rotatory instability are well documented. We present a case of anteromedial dislocation of the entire triceps tendon with loss of extensor power and describe the method of treatment

1. Experience with the McLaurin swivel walker for children with bilateral phocomelia of the lower limbs is described. 2. Modifications to the prosthesis and the method of fitting in stages are recorded

Our aim in this retrospective study of 52 children with spastic hemiplegia was to determine the factors which affected the amount of residual pelvic rotation after single-event multilevel surgery. The patients were divided into two groups, those who had undergone femoral derotation osteotomy and those who had not. Pelvic rotation improved significantly after surgery in the femoral osteotomy group (p < 0.001) but not in the non-femoral osteotomy group. Multiple regressions identified the following three independent variables, which significantly affected residual pelvic rotation: the performance of femoral derotation osteotomy (p = 0.049), the pre-operative pelvic rotation (p = 0.003) and the post-operative internal rotation of the hip (p = 0.001). We concluded that there is a decrease in the amount of pelvic rotation after single-event multilevel surgery with femoral derotation osteotomy. However, some residual rotation may persist when patients have severe rotation before surgery

A careful study of children with transient synovitis of the hip has failed to establish any connection with infection by staphylococci or streptococci, with allergy, with viral infection and with trauma

1. Three children with metatarsus adductus varus have been found to have ball and socket ankle joints. 2. The effect of this finding on treatment is discussed

Fractures of the clavicle in the neonate are usually diagnosed by clinical examination and confirmed by plain radiography. Exposure of newborn infants to irradiation should be avoided if possible. Following the clinical examination of 2978 neonates, 15 had suspected fractures of the clavicle. All were confirmed by ultrasound. In combination with clinical examination, ultrasound is a satisfactory alternative to radiological assessment for the diagnosis of fractures of the clavicle in newborn children

Aims

The glenohumeral joint is the most frequently dislocated articulation, but possibly due to the lower prevalence of posterior shoulder dislocations, approximately 50% to 79% of posterior glenohumeral dislocations are missed at initial presentation. The aim of this study was to systematically evaluate the most recent evidence involving the aetiology of posterior glenohumeral dislocations, as well as the diagnosis and treatment.

Synovial chondromatosis is a rare metaplastic condition affecting major synovial joints. It is extremely rare in childhood. The two children reported here are believed to be the youngest patients with this condition affecting the knee to have been described in the literature

The hand-foot syndrome is a benign self-limiting condition seen in young children with sickle-cell haemoglobinopathy, usually at the time of a crisis. The authors have observed 36 cases among 4920 patients. The features and management of the condition are discussed and the published literature is reviewed

Tuberculosis (TB) remains endemic in many parts of the developing world and is increasingly seen in the developed world due to migration. A total of 1.3 million people die annually from the disease. Spinal TB is the most common musculoskeletal manifestation, affecting about 1 to 2% of all cases of TB. The coexistence of HIV, which is endemic in some regions, adds to the burden and the complexity of management.

This review discusses the epidemiology, clinical presentation, diagnosis, impact of HIV and both the medical and surgical options in the management of spinal TB.

Cite this article: Bone Joint J 2018;100-B:425–31.

Avulsion of the distal pole of the patella in spastic children with a flexed knee gait may upset the equilibrium of the knee and cause deterioration in walking. We emphasise the clinical features, discuss the mechanism and outline the principles of treatment

A case of rotatory dislocation of both atlanto-axial joints is presented. A review of the literature reveals two other cases, both in children. This would appear to be the first report in an adult, who survived and made a full recovery

Two children and one infant with a "human tail" are presented. The patho-embryology of this medical curiosity is briefly discussed. Treatment is usually unnecessary but resection of part of the coccyx together with the "tail" may become indicated by coccygodynia or for aesthetic reasons

1. An account is given of twenty patients who had sustained accidental division of one or more foot tendons (other than tendo calcaneus). 2. Severe deformities occur when these injuries are neglected in children

Aims

It is well established that there is a strong association between Perthes’ disease and worsening socioeconomic deprivation. It has been suggested that the primary determinant driving this association is exposure to tobacco smoke. This study aimed to examine this hypothesis.

1. Seven cases of localised lumbar spine defects in children associated with low back pain are described. 2. The importance is emphasised of the recognition and differentiation of the condition from tuberculosis, which it may resemble both clinically and radiographically

Paralytic clawing of the hallux may occur in children with congenital disorders of the neuraxis. Tenodesis of flexor hallucis longus allows correction of this deformity in early childhood. Seventeen of these procedures have been reviewed and good results were obtained in fifteen