Satisfaction and pain levels after proximal femoral valgus osteotomy according to Schanz in patients with cerebral palsy and hip dislocation.

Outcome after Schanz osteotomy in the treatment of chronic hip dislocation in children with cerebral palsy was evaluated. Medical charts and questionnaires were used to assess pain, functional outcome and satisfaction. A total of 24 children, with a mean age of 13.8 years (± 8.9), were included in the study, out of which 11 were classified with Gross Motor Function Classification System (GMFCS) level IV and 13 with GMFCS level V. Current pain was comparable to patients without chronic hip dislocation, and satisfaction was intermediate. Functional outcome improved in several domains. Longer postoperative time was associated with improved pain and satisfaction. The Schanz osteotomy allowed improvement in pain levels; however, it did not completely meet caregiver's expectation and has high reoperation rates.

Prevalence of vertebral pars defects (spondylolysis) in a population with osteogenesis imperfecta.

STUDY DESIGN: We performed a retrospective study of spinal roentgenograms of a large cohort of patients suffering from osteogenesis imperfecta. OBJECTIVE: To determine the prevalence of vertebral pars defects (spondylolysis) in patients with osteogenesis imperfecta. SUMMARY OF BACKGROUND DATA: Patients suffering from osteogenesis imperfecta are known to be prone to pathologic fractures. Pathologic fractures due to microtraumas, repetitive activities, and posture acting together on a congenitally weakened pars interarticularis may lead to vertebral pars defects. The prevalence of vertebral pars defects in patients with osteogenesis imperfecta has never been studied before to our knowledge. METHODS: We performed a retrospective study of posterior-anterior and lateral, standing, roentgenograms of the spine of patients with osteogenesis imperfecta for the occurrence of vertebral pars interarticularis defects. RESULTS: The patients (5.3%) in our series showed vertebral pars defects, this is not significantly different from the prevalence of vertebral pars defects in the general population. CONCLUSION: 5.3% of the patients with osteogenesis imperfecta showed vertebral pars defects, this does not differ significantly from the occurrence in the general population.

Physical training in children with osteogenesis imperfecta.

OBJECTIVE: To study the effects of a physical training program on exercise capacity, muscle force, and subjective fatigue levels in patients with mild to moderate forms of osteogenesis imperfecta (OI). STUDY DESIGN: Thirty-four children with OI type I or IV were randomly assigned to either a 12-week graded exercise program or care as usual for 3 months. Exercise capacity and muscle force were studied; subjective fatigue, perceived competence, and health-related quality of life were secondary outcomes. All outcomes were measured at baseline (T = 0), after intervention (T = 1), and after 6 and 9 months (T = 2 and T = 3, respectively). RESULTS: After intervention (T = 1), peak oxygen consumption (VO2peak), relative VO2peak (VO2peak/kg), maximal working capacity (Wmax), and muscle force were significantly improved (17%, 18%, 10%, and 12%, respectively) compared with control values. Subjective fatigue decreased borderline statistically significantly. Follow-up at T = 2 showed a significant decrease of the improvements measured at T = 1 of VO2peak, but VO2peak/kg, Wmax, and subjective fatigue showed no significant difference. At T = 3, we found a further decrease of the gained improvements. CONCLUSION: A supervised training program can improve aerobic capacity and muscle force and reduces levels of subjective fatigue in children with OI type I and IV in a safe and effective manner.