Journal of pediatric orthopedics
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Nine of 212 cases of traumatic anterior shoulder dislocations occurred in children with clearly open epiphyses (4.7% incidence). All cases associated with psychological or physical abnormalities were excluded. A high recurrence rate of 80% (8 of 10) was noted requiring operative intervention. Two of the three remaining unoperated cases had a history of "subluxation" after their initial dislocation.
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Case Reports
Roentgen stereophotogrammetric analysis of growth pattern after supination--eversion ankle injuries in children.
In a prospective study of ankle fractures in children, the growth rate was registered with a roentgen stereophotogrammetric method. The injuries were classified traumatologically according to Gerner-Smidt and anatomically according to Salter and Harris. Twenty-six ankle fractures were classified as supination--eversion injuries. ⋯ However, factors such as trauma, displacement, skeletal maturity, and treatment must be considered. The roentgen stereophotogrammetric method permits early determination of the growth pattern with high accuracy. The growth disturbance can be registered months before this is evident from conventional radiographic examinations.
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The transposition of the latissimus dorsi myocutaneous flap is described in 2 pediatric patients: one with complete loss of elbow flexion, and the other with severe axillary burn contracture. A simplified, secure, one-stage reconstruction with the myocutaneous flap resulted in an excellent substitute of biceps function and skin coverage. The axillary reconstruction allowed immediate full over-the-head abduction, without recurrence of the contracture. In any nonforcible shoulder activity, the function of the latissimus dorsi muscle will not be missed, because of the numerous substitute muscles.
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Case Reports Comparative Study
Computed tomography of intraarticular supination - eversion fractures of the ankle in adolescents.
Intraarticular fractures of the ankle in children known as the Tillaux and triplane fractures of the distal tibia are caused by supination-eversion. In order to determine the three-dimensional configuration of these fractures and the relation of the fracture to the growth plate and the joint, computed tomography (CT) was performed in one case with Tillaux fracture and in four cases with triplane fracture, besides conventional radiography and tomography. The Tillaux fracture showed two fragments. ⋯ In one case with a three fragment diagnosed by conventional tomography and CT, a four fragment fracture was revealed at operation. This patient had, in addition, a fracture through the anteromedial part of the growth plate without displacement. According to this and previous investigations, the Tillaux and triplane fractures represent at least five different anatomical pattern of intraarticular supination-eversion injuries.