ABSTRACT
Six cases of congenital dislocation of the knee (CDK) reduced spontaneously or with minimal treatment were investigated. Reduction was achieved from 4 days to 3 months after birth. Clinical results were good, although in four cases, hyperextension < or = 20 degrees persisted. In view of the perinatal complications and associated anomalies, CDK reduced with no or minimal treatment is supposed to be a category of congenital postural deformity. We believe that it is advisable to wait 1 month for spontaneous reduction of CDK in cases not associated with clubfoot, arthrogryposis multiplex congenita, and Larsen's syndrome.
Subject(s)
Joint Dislocations/therapy , Knee Joint , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Joint Dislocations/congenital , Male , Range of Motion, Articular , Remission, Spontaneous , Treatment OutcomeABSTRACT
STUDY DESIGN: This retrospective study reviewed five patients with scoliosis associated with cerebral gigantism (Sotos syndrome). OBJECTIVE: To clarify the clinical characteristics and progression of scoliosis in patients with cerebral gigantism. SUMMARY OF BACKGROUND DATA. Little has been reported about spinal deformity in this syndrome. METHODS: The records and radiographs of five patients were reviewed. RESULTS: Scoliosis was first noticed at the age of 5 years in one case and at 6-16 months in the others. Their curve patterns were not consistent. Cobb's angles increased rapidly by 4 years of age and after 8 years of age despite attempts at bracing. CONCLUSIONS: Excessive growth in infancy and growth-spurt period after 8 years of age may be related to the rapid progression of scoliosis in the same period.
Subject(s)
Brain/abnormalities , Gigantism/complications , Scoliosis/complications , Child, Preschool , Female , Growth/physiology , Humans , Infant , Male , Radiography , Retrospective Studies , Scoliosis/surgery , Spine/diagnostic imaging , Spine/pathology , Spine/surgeryABSTRACT
We treated three patients with spina bifida who had atrophy of the cervical spinal cord. One patient presented with a gradually progressive paresis of the upper right extremity, and two patients developed tetraparesis. MRI (magnetic resonance imaging) of the cervical spine demonstrated cord atrophy with enlargement of the subarachnoid space. The three patients were treated by releasing the tethered spinal cord in the lumbosacral area. Two of the three patients had neurological recovery soon after the operation, but this was transient and was followed by later deterioration; and the third patient showed no recovery. The transient recovery suggests that the tethering in the lumbosacral region affects the entire spinal cord and causes atrophy of the cervical spinal cord.
Subject(s)
Spinal Cord Diseases/etiology , Spinal Cord/pathology , Spinal Dysraphism/complications , Adult , Atrophy , Female , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging , Spinal Cord Diseases/pathologyABSTRACT
Three patients with Kabuki make-up syndrome (KMS) who had recurrent dislocation of the patella are reported. In all, dislocation of the patella developed in adolescence, and they had generalized ligamentous laxity and dysplasia of the patellofemoral joints. In two of the three patients, surgical intervention was required; the operation was successful in one, but yielded poor results in the other. In the third patient, cardiac complications precluded operation. Orthopedists should be aware of this possible complication when treating patients with KMS.
Subject(s)
Abnormalities, Multiple , Facial Expression , Joint Dislocations/etiology , Joint Instability/complications , Patella/injuries , Adolescent , Child , Female , Humans , Intellectual Disability , Recurrence , SyndromeABSTRACT
For the purpose of preventing postoperative orthopedic infections, investigation was carried out on effectiveness and safety of amikacin (AMK) after washing wound surface with its solution. 500 ml saline solution containing 400 mg AMK was used for washing. As the result, no postoperative infections were observed in all the 19 patients operated in our department. Neither abnormal findings to be regarded as abnormalities in blood test nor side-effects caused by washing were also observed. The blood samples obtained after washing did not show measurable AMK in all cases. It is said that use of antibiotics with 1) a wide-range of spectrum, 2) a bactericidal action and 3) low cross resistance against other antibiotics is preferable in washing wound surface in order to prevent postoperative infections. Under these circumstances, administration of aminoglycoside antibiotics is used frequently. Concerning the use of aminoglycoside antibiotics, however, it is necessary to pay attention to auditory and renal impairment. The previous study has revealed that AMK is lower in auditory and renal toxicity than other aminoglycoside antibiotics. AMK is thought, therefore, to be free from fear of auditory and renal impairment after washing and also to be one of effective antibiotics.
