Dissolution of the capitellum after nondisplaced supracondylar fracture of the humerus in a child: a case report of transient osteochondrosis.

Supracondylar fractures of the humerus are the most common type of elbow fractures in children. Nonunion of the lateral condyle, cubitus varus, cubitus valgus, fishtail deformity, or growth disorders, including premature physeal arrest or even avascular necrosis, are uncommon but important complications. However, transient osteochondrosis of the capitellum after a supracondylar fracture has been reported in only two cases in the literature. We report our experience of transient osteochondrosis of the capitellum in a 5-year-old boy after conservative treatment with cast immobilization for a nondisplaced supracondylar fracture of the distal humerus with 8 years of follow-up. Serial radiography of both the injured and the contralateral elbows were performed, which enabled monitoring of the evolution of the transient osteochondrosis. No specific treatment was provided because there was no evidence of acute complication or of a progressing deformity. The patient had gained full range of motion of the elbow without pain by 6 weeks of follow-up. At 5 years after the fracture, the ossification center of the capitellum was restored to its normal size and shape. There was no evidence of growth disturbances in this case. This case report is an uncommon case of transient osteochondrosis of the capitellum in the distal humerus after conservative treatment for nondisplaced supracondylar fractures in children. The evolution of this entity is good and it is managed by conservative treatment.

Inestabilidad occipitocervical en la enfermedad de Morquio. Presentación de 2 casos y revisión de la literatura / Occipital-cervical instability in Morquio disease: a presentation of 2 cases and a review of the literature

Introducción. El síndrome de Morquio se produce por un déficit enzimático de herencia autosómica recesiva. Presenta numerosas manifestaciones musculoesqueléticas, entre las que destaca por su riesgo vital la inestabilidad atloaxoidea. En estos casos está indicada la cirugía de artrodesis (y descompresión) occipitocervical Objetivo. Se presentan 2 pacientes con síndrome de Morquio que precisaron de este tipo de cirugía, así como una revisión de la literatura. Pacientes y métodos. Dos pacientes: un niño y una niña, con síndrome de Morquio e inestabilidad cervical alta, con signos y síntomas neurológicos, que fueron intervenidos quirúrgicamente mediante descompresión y artrodesiso occipitocervical instrumentada; con un seguimiento de 6 y un año respectivamente. Resultados. Ambos pacientes mejoraron de sus problemas neurológicos, realizando en al actualidad una vida normal para su edad. Conclusión. La artrodesis occipitocervical con descompresión proporciona un entorno biomecánico seguro que previene de la afectación neurológica. Estaría indicada ante la aparición de sintomatología o de inestabilidad mecánica (AU)

Introduction. Morquio syndrome is caused by an inherited autosomal recessive enzyme deficiency. It presents with numerous musculoskeletal anomalies, among which atlantoaxial instability is highlighted, due it being life-threatening. Occipital-cervical arthrodesis surgery (and decompression) is indicated in these cases. Objective. The cases of 2 patients with Morquio syndrome that required this type of surgery are presented, along with a review of the literature. Patients and methods. Two patients: one boy and one girl, with Morquio syndrome and high cervical instability, with neurological signs and symptoms, who were subjected to surgery using decompression and instrumented occipital-cervical arthrodesis and followed up for 6 months and one year, respectively. Results. The neurological problems of both patients improved, and are currently having a normal life for their age. Conclusion. Occipital-cervical arthrodesis with decompression provides a safe biomechanical environment that prevents neurological involvement. It should be indicated before the appearance of symptoms or mechanical instability (AU)

[Occipital-cervical instability in Morquio disease: a presentation of 2 cases and a review of the literature]. / Inestabilidad occipitocervical en la enfermedad de Morquio. Presentación de 2 casos y revisión de la literatura.

INTRODUCTION: Morquio syndrome is caused by an inherited autosomal recessive enzyme deficiency. It presents with numerous musculoskeletal anomalies, among which atlantoaxial instability is highlighted, due it being life-threatening. Occipital-cervical arthrodesis surgery (and decompression) is indicated in these cases. OBJECTIVE: The cases of 2 patients with Morquio syndrome that required this type of surgery are presented, along with a review of the literature. PATIENTS AND METHODS: Two patients: one boy and one girl, with Morquio syndrome and high cervical instability, with neurological signs and symptoms, who were subjected to surgery using decompression and instrumented occipital-cervical arthrodesis and followed up for 6 months and one year, respectively. RESULTS: The neurological problems of both patients improved, and are currently having a normal life for their age. CONCLUSION: Occipital-cervical arthrodesis with decompression provides a safe biomechanical environment that prevents neurological involvement. It should be indicated before the appearance of symptoms or mechanical instability.