Conservative versus surgical treatment in management of salter-harris type II distal tibial physeal fractures

Twenty-one patients with Salter-Harris type II physeal fractures of the ankle were treated, either conservatively or operatively, according to the indication for the different types of mechanism of injury. All patients were evaluated and followed clinically and radiologically for an average of 15 months. There were 15 males and 6 females. The average age at injury was 9 years and 6 months, whereas the average age at follow-up was11 years. Thirteen patients were treated conservatively by closed reduction, while eight were treated operatively by open reduction and internal fixation. There were no nonunion or arthritis. There was one case of clinically insignificant premature physeal closure. The overall results were good or excellent in 100% of cases and excellent in 86% of cases. There was significant relation between mechanism of injury type and line of treatment. We think that closed reduction should be attempted in every case of Salter-Harris type II physeal fractures of distal tibia with good results, and operative treatment with open reduction and internal fixation could be reserved to cases of irreducible or incompletely reduced fractures, and we found that most of the cases of distal tibial physeal fractures of pronation-eversion external rotation, injury type, needs surgical management

Postural control: static and dynamic balance in juvenile rheumatoid arthritis patients

The aim of the present study was to assess and identify the effect of a specific balance program on the improvement of postural control for children with rheumatoid arthritis [RA]. Children with balance problems often have difficulty controlling posture in static and dynamic situations. Children with rheumatoid arthritis have reported fear of falling and thus reducing their physical activity level. The present study was conducted on 30 Juvenile rheumatoid arthritis [JRA] children of both sex, their ages ranged between 7 to 12 years [X9.5 +/- 2.5]. They were divided randomly into 2 groups of equal number [A] and [B]. The static and dynamic balance were tested at the start of the study and after 10 weeks. Both groups received the traditional treatment program for JRA 5 times/week. In addition, group [B] underwent a specific intervention program for balance. At the end of the study the results revealed a significant unproven tent in the static and dynamic balance [P<0.05] for group [A] and a highly significant improvement for group [B] in the same parameters measured [P<0.001]. It could be concluded that static and dynamic balance would be involved in physical therapy for JRA patients

Prolonged stretching: its effect on crouch gait of diplegic cerebral palsied children

The purpose of this study was to evaluate the effect of prolonged stretching for both calf muscles simultaneously, using wooden stretcher, on improving diplegic gait of cerebral palsied children. This study included fifteen diplegic cerebral palsied children from both sexes with age ranged from 6 to 8 [X6.2]. They were selected from out patient clinic of Faculty of Physical Therapy, Cairo university, on a basic criteria. Hoffman reflex/myogenic response [H/M] ratio and gait pattern were assessed before and after treatment. The treatment program included prolonged stretching using wooden stretcher in addition to traditional physical therapy modalities. It was conducted for 4 months, 4 times/week. At the end of study the results revealed significant reduction in H/M ratio which in turn resulted in functional improvement of diplegic walking pattern. This improvement could be attributed to the cumulative effect of stretching protocol and traditional physical therapy modalities

Postural control via electrical stimulation and its effect on ventilatory functions in cerebral palsied children

Thirty subjects from both sexes participated in this study, their ages ranged from 5 to 11 years with mean 7 years. They were randomly classified into two groups [study group 20 patients and control group 10 patients]. Measuring pulmonary functions and chest expansion were done for both groups before and after application of treatment program. Both groups received program of treatment 5 times/week for 16 weeks. The program of treatment for the study group included 30 minutes electrical stimulation for the back muscles followed by neurodevelopmental technique [NDT], while control group received only NDT. The results of the study group revealed significant improvement in all pulmonary function parameters except the small air ways measurements showed insignificant increase post-treatment. Also, the chest expansion values showed highly significant improvement in all evaluated parameters