ABSTRACT
We report a retrospective review of 50 consecutive patients (75 feet) with chronically symptomatic accessory tarsal naviculars that failed to improve with conservative treatment. Surgical treatment consisted of excision of the accessory tarsal navicular or medial protuberance of a prominent cornuate-shaped navicular combined with simple replication of the tibialis posterior tendon without altering its course. Good and excellent results were obtained in 45 (70 feet) of the 50 patients (90%). The procedure has a low rate of minor complications, is easy to perform, and is extremely well accepted by the patients.
Subject(s)
Foot Deformities, Congenital/surgery , Osteotomy/standards , Tarsal Bones/abnormalities , Adolescent , Biomechanical Phenomena , Child , Consumer Behavior , Female , Foot Deformities, Congenital/diagnostic imaging , Foot Deformities, Congenital/physiopathology , Humans , Male , Osteotomy/methods , Osteotomy/psychology , Pronation , Radiography , Retrospective Studies , Surveys and Questionnaires , Tendon Transfer/methods , Tendon Transfer/standardsABSTRACT
The treatment of unstable forearm fractures in children remains a challenging and controversial subject. There are times when more rigid fixation is needed to obtain and maintain fracture reduction. Open reduction/internal fixation or intramedullary nailing can be avoided by the use of the technique of pins and plaster. This study reviewed 20 forearm fractures treated between 1978 and 1984. All fractures healed uneventfully in satisfactory alignment. No complications were encountered. We conclude that the method of pins and plaster is a safe and reliable method to treat unstable pediatric forearm fractures.
Subject(s)
Bone Nails , Casts, Surgical , Fracture Fixation, Internal/methods , Radius Fractures/surgery , Ulna Fractures/surgery , Adolescent , Child , Child, Preschool , Female , Humans , Male , Radiography , Radius Fractures/diagnostic imaging , Radius Fractures/pathology , Retrospective Studies , Ulna Fractures/diagnostic imaging , Ulna Fractures/pathologyABSTRACT
Reangulation and displacement after closed reduction of pediatric forearm fractures were reviewed in 90 patients treated with 1978-1984. All fractures were remanipulated and followed to union. No complications occurred and all had a functionally satisfactory result. Both intrinsic and extrinsic factors were identified as contributing to the complication of reangulation/displacement. Nonepiphyseal fractures were safely remanipulated up to 24 days postfracture, with the majority at 1-2 weeks. We conclude that 7% of pediatric forearm fractures treated by closed reduction are subject to reangulation and/or displacement following routine acceptable primary treatment, and that remanipulation provides a safe, effective means to obtain and maintain reduction.
Subject(s)
Fractures, Ununited/diagnostic imaging , Manipulation, Orthopedic , Radius Fractures/therapy , Ulna Fractures/therapy , Adolescent , Biomechanical Phenomena , Child , Child, Preschool , Female , Fracture Fixation , Fractures, Ununited/etiology , Fractures, Ununited/therapy , Humans , Infant , Male , Radiography , Radius Fractures/complications , Radius Fractures/diagnostic imaging , Retrospective Studies , Ulna Fractures/complications , Ulna Fractures/diagnostic imagingABSTRACT
Several maturation factors relative to growth and epiphyseal development were reviewed retrospectively in 191 patients with slipped capital femoral epiphysis, including bone age, height and weight, thyroid functions, sex hormone levels, and growth hormone levels. Seventy-one percent of 138 patients had weights above the 80th percentile. Active thyroid (T3) was significantly low in 25% of 80 patients studied. Testosterone levels were markedly depressed in 76% of 64 patients tested. In this same group, 87% had low growth hormone levels. The consistently low testosterone and growth hormone levels, along with a tendency toward hypothyroidism, lend support to the biochemical theory of a delicate hormonal imbalance in slipped capital femoral epiphysis.
