ABSTRACT
Se realiza un estudio retrospectivo de los resultados clínicos y radiológicos de 6 pacientes afectos de escápula elevada congénita (deformidad de Sprengel) tras el tratamiento quirúrgico de los mismos empleando la técnica de Woodward. El nivel medio de elevación prequirúrgica del borde inferior de la escápula respecto a la contralateral fue de 3,3 cm, mientras que el déficit medio de abducción fue de 45°. Con un seguimiento medio de 6 años la elevación del borde inferior escapular había pasado a 1,4 cm y la ganancia media de abducción había mejorado 30° respecto a los valores prequirúrgicos. En 2 casos se realizó una osteotomía clavicular para evitar una posible lesión del plexo braquial al descender la escápula. Debido a la hipoplasia escapular asociada, con una disminución en la longitud vertical, no se debe intentar durante la cirugía llevar el ángulo inferior escapular al mismo nivel del contralateral (AU)
Subject(s)
Female , Child, Preschool , Male , Child , Humans , Scapula/surgery , Limb Deformities, Congenital/surgery , Bone Diseases/surgery , Osteotomy/methods , Retrospective Studies , Treatment Outcome , Follow-Up StudiesABSTRACT
We present a review of six cases of children with congenital pseudarthrosis of the clavicle, treated and followed up at the "La Fe" Hospital for Children. One of them had bilateral involvement. Five of them, including the bilateral case, were surgically treated at ages ranging from 18 months to 4 years. Bone graft and internal fixation with a Kirschner wire were used. Healing of the pseudarthrosis was obtained in all patients in 6-8 weeks. We discuss the suitability of early surgical treatment that, in our opinion, produces very satisfactory results.
Subject(s)
Clavicle/injuries , Fracture Fixation, Internal , Pseudarthrosis/congenital , Pseudarthrosis/surgery , Bone Wires , Child, Preschool , Fracture Healing , Humans , Infant , Male , Pseudarthrosis/diagnostic imaging , Radiography , Retrospective StudiesABSTRACT
We report here three fully documented cases of periosteal chondroma diagnosed and treated in our hospital. There have been few references since Lichtenstein first described this condition as a separate tumour, and none of them concerned children under 10 years old. deSantos accurately describes the radiological features of the tumour. All of our patients were under 10 years old at the moment of the appearance of the lesion, which was always detected in the long bones of the upper limbs. The study included a previous histological examination in two cases and a follow-up in all of them. From this study we learned that invasive diagnosis procedures are unnecessary as we could follow the behaviour and evolution of this cartilaginous benign tumour for a long period of time.
Subject(s)
Bone Neoplasms , Chondroma , Humerus , Metacarpus , Age Factors , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Bone Neoplasms/surgery , Child , Chondroma/diagnosis , Chondroma/pathology , Chondroma/surgery , Female , Follow-Up Studies , Humans , Humerus/diagnostic imaging , Humerus/pathology , Humerus/surgery , Magnetic Resonance Imaging , Male , Metacarpus/diagnostic imaging , Metacarpus/pathology , Metacarpus/surgery , Radiography, Thoracic , Time Factors , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: The epidemiological and clinical characteristics, treatment and evolution of osteoarthritis by Haemophilus influenzae type b (HIB) are reviewed since there has been little published on this subject in our country. PATIENTS AND METHODS: The clinical histories of the 7 children with osteoarthritis due to Hib infection are reviewed. The diagnostic criteria included classical signs and symptoms of septic arthritis, radiological alterations compatible with joint infection and isolation of microorganisms in joint effusion and/or in the blood. RESULTS: During a 24-year period (1973-1996), 248 cases of invasive infection by Hib were documented. Seven cases (2.82%) had osteoarticular infections. The ages were between 5 and 7 years and there were more males than females (71.4% vs. 28.6%). Four children/58%) had previous upper respiratory infections (URI). The microorganism was isolated in the joint effusion in 5 children and in the blood sample of the other 2. C-reactive protein was high and radiology showed alterations in 100% of the cases. Surgical treatment with articular drainage was necessary in 5 children/71.4%). In 6 cases (85.7%) initial medical treatment was i.v. beta-lactam antibiotics for 2-3 weeks followed by oral antibiotic treatment for a minimum of 6 weeks. Three children (42.8%) had sequelae. CONCLUSIONS: Early diagnosis of bacterial osteoarthritis by Hib is difficult. Final therapeutical success depends on an early clinical diagnosis and aggressive multidisciplinary treatment. Drainage of the hip joint is mandatory for successful outcome. Currently, arthritis by Hib can be avoided and its sequelae prevented by vaccination.
