ABSTRACT
The clubfoot deformity associated with Weber type I tibial hemimelia, a rare congenital disorder, is rigid and difficult to correct. Surgeons have utilized a variety of treatment methods. Since the 1960s, some adopted the Syme amputation to produce a weightbearing lower limb. Others began to explore alternatives such as the Ilizarov technique, ankle reconstruction, and casting, which salvage the foot but have produced mixed results. The current investigators suggest that the Ponseti method, a minimally invasive technique, can produce a functional weightbearing foot. Two cases were treated with the Ponseti method, including a percutaneous Achilles tenotomy and post-cast bracing. After a minimum of 2-years follow-up, both are ambulatory.
Subject(s)
Clubfoot/surgery , Orthopedic Procedures , Bone Diseases, Developmental/diagnostic imaging , Bone Diseases, Developmental/genetics , Bone Diseases, Developmental/physiopathology , Bone Diseases, Developmental/surgery , Braces , Casts, Surgical , Clubfoot/diagnostic imaging , Clubfoot/genetics , Clubfoot/physiopathology , Ectromelia , Humans , Infant , Infant, Newborn , Male , Minimally Invasive Surgical Procedures , Orthopedic Procedures/instrumentation , Radiography , Recovery of Function , Tibia/abnormalities , Tibia/diagnostic imaging , Tibia/physiopathology , Tibia/surgery , Time Factors , Treatment Outcome , Walking , Weight-BearingABSTRACT
Routine removal of nonspinal, orthopedic implants from pediatric patients is a debated practice. The purpose of this study was to compare preremoval and postremoval outcome measures in children. Twenty-five patients, mean age 11.6 years, completed a pain scale and the Pediatric Outcomes Data Collection Instrument (PODCI). Many patients scored in the normal range of the PODCI before and after removal. Higher postoperative PODCI scores were found in patients without preoperative pain, and in patients with upper extremity versus lower extremity implants. In summary, routine removal of implants in children was carried out without complications and with some functional benefits.
Subject(s)
Device Removal/adverse effects , Outcome Assessment, Health Care , Postoperative Complications , Prostheses and Implants , Adolescent , Bones of Lower Extremity/surgery , Bones of Upper Extremity/surgery , Child , Child, Preschool , Disability Evaluation , Female , Humans , Male , Pain Measurement , Pain, Postoperative/etiology , Treatment OutcomeABSTRACT
Patients with slipped capital femoral epiphysis(SCFE)are often instructed to use crutches and restrict their activities after surgery. In the retrospective study reported here, we determined actual duration of crutch use and activity restriction in patients with SCFE treated with in situ pinning. Forty-three patients (mean age, 14.1 years) responded to a questionnaire. Four patients (9%) never used crutches, and 29 patients (67%) used crutches for 4 weeks or less. Three patients (7%) never restricted their activity, and 29 patients (67%) had resumed full activities, including sports, by 6 months. None of the patients had any postoperative complications. Although these results suggest that early resumption of activities, which would be beneficial to these typically obese patients, is possible without detrimental effects, further investigation is needed before an algorithm for postoperative rehabilitation can be presented.
Subject(s)
Epiphyses, Slipped/rehabilitation , Motor Activity , Adolescent , Adult , Bone Nails , Child , Crutches , Epiphyses, Slipped/surgery , Female , Humans , Male , Postoperative Period , Recovery of Function , Retrospective Studies , Weight-BearingABSTRACT
We present a case of a type I Monteggia equivalent lesion in a 7-year-old child consisting of anterior dislocation of the radial head, radial neck fracture, and a fracture of the olecranon without an associated fracture of the ulnar diaphysis or metaphysis. After a review of the literature, we report this fracture pattern as a rare type I Monteggia equivalent fracture-dislocation variant. This report describes delayed surgical treatment and outcome after close follow-up of a rare type I Monteggia equivalent lesion. Diagnostic challenges with and treatment options for pediatric Monteggia equivalent fracture-dislocations are discussed.
