Journal of pediatric orthopedics
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Osteochondritis dissecans of the knee is an increasingly frequent diagnosis in the skeletally immature, in whom it is known as juvenile osteochondritis dissecans (JOCD). Although many stable lesions heal with nonoperative treatment, surgical management may be necessary when this treatment fails. Our objective is to determine if extraarticular drilling is an effective treatment for JOCD. ⋯ Level IV case series.
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Comparative Study
Comparison of bioabsorbable versus metallic implant fixation for physeal and epiphyseal fractures of the distal tibia.
Transepiphyseal screw fixation of displaced distal tibial epiphyseal fractures is the most common method of treatment for these intraarticular injuries. Recent literature indicates that retained transepiphyseal metallic screws cause an increase in ankle joint contact pressure, thus favoring screw removal. Our hypothesis is that bioabsorbable screw fixation is an alternative to metallic fixation, which offers similar results without the need for screw removal. ⋯ Level III, case-control study.
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The optimal treatment of femoral shaft fractures in older children and adolescents remains controversial. We hypothesized that fixation with a flexible interlocking intramedullary nail (FIIN) reduces perioperative complications and improves outcomes, including leg-length discrepancy, time to healing, and time to weight bearing compared with other fixation procedures (OFPs) including standard elastic nail implants. ⋯ Level III, therapeutic study.
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Legg-Calvé-Perthes disease is a childhood hip disorder that may result in a deformed and poorly functioning hip. The purpose of this study was to evaluate the correlation between hip deformity at skeletal maturity and degenerative osteoarthritis and to present the long-term results of proximal femoral varus derotational osteotomy in Legg-Calvé-Perthes disease. ⋯ Level IV, therapeutic study.
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Severe complex hypoplastic chest wall and spine deformity with thoracic insufficiency syndrome may be associated with premature death secondary to multisystem involvement. The vertical expandable prosthetic titanium rib (VEPTR) reconstructs the chest wall to address the thoracic insufficiency seen in this patient population. The purpose of this study is to report the mortality and life-threatening adverse events in a cohort of subjects with severe hypoplastic chest wall deformity, specifically with Jeune syndrome and Jarcho-Levin syndrome, after treatment with the VEPTR device. ⋯ Therapeutic study, Level IV (case series, no comparison group).