Publications by authors named "Chia Hsieh Chang"
Background: Reoperation is a major adverse event following surgical treatment but has yet to be used as a primary outcome measure in population studies to assess current treatments for developmental dysplasia of the hip (DDH). The purpose of the present study was to explore the risk factors associated with reoperations following procedures under anesthesia ("operations") for DDH in patients between the ages of 1 and 3.00 years, with the goal of deriving treatment recommendations.
View Article and Find Full Text PDFBackground: Pediatric supracondylar humeral fractures present considerable surgical challenges due to the difficulty of achieving proper fracture alignment and stable fixation while avoiding injury to the ulnar nerve. This study assesses the biomechanical performance of a novel Kirschner wire (K-wire) fixation device (KFD), designed to enhance stability and reduce complications linked to traditional K-wire configurations.
Methods: Using finite element analysis (FEA), we evaluated four fixation strategies for treatment of pediatric supracondylar humeral simple transverse fractures: crossed pin fixation, crossed pin fixation with KFD, two lateral pin fixation, and two lateral pin fixation with KFD, under various mechanical loads.
Article Synopsis
- - The study investigates whether winter-born babies are more likely to have developmental dysplasia of the hip (DDH) due to various factors, including external temperatures surrounding birth.
- - Data from over 10,000 newborns showed that being born in winter isn't linked to abnormal hip conditions at birth, but cooler external temperatures showed a correlation with hip issues.
- - The findings suggest that while winter birth itself isn't a risk factor for immediate hip problems, there’s a need for increased awareness and possible screening beyond the neonatal phase due to potential late diagnoses of DDH.
Background: Established associated factors for DDH include female sex, breech presentation, family history, congenital malformations, oligohydramnios, and maternal hyperthyroidism. However, evidence for environmental factors that may contribute to DDH is limited and inconsistent.
Methods: A systematic review of medical literature was conducted to collect data on environmental factors, including latitude, longitude, average yearly precipitation, average yearly temperature, minimum monthly temperature, and maximum monthly temperature, from all institutions that published articles on DDH.
Article Synopsis
- The study developed a new algorithm for classifying thumb polydactyly based on physical characteristics rather than just radiographic levels of duplication.
- It categorized conditions into hypoplastic, symmetric (adequate/inadequate), and asymmetric (ulnar/radial dominant) types using four key traits: floating, symmetry, dominant side, and joint characteristics.
- A retrospective analysis of 500 patients showed that the new classification effectively predicted treatment options, helping pediatricians and parents navigate surgical decisions despite not detailing surgical techniques.
Article Synopsis
- This study investigates how the structure of the acetabulum (part of the hip joint) is affected by hip disorders, particularly in children with cerebral palsy, by analyzing the relationship between structural changes and migration percentage.
- Researchers reviewed clinical data from 70 children with spastic cerebral palsy and used advanced imaging techniques to measure the acetabular index.
- Findings indicate a significant correlation between increased migration percentage and acetabular index changes, identifying a 30% migration percentage as a critical threshold for the onset of hip disorders.
Background: Soft tissue release (STR) is an established treatment for spastic hip displacement, but recurrence of hip displacement is not uncommon. This study aims to (1) evaluate the recurrence of hip displacement after STR, (2) define associated factors of recurrence, and (3) elucidate the effects of guided growth on hip displacement recurrence.
Methods: The study subjects included 66 individuals with spastic cerebral palsy treated by STR with or without guided growth for hip displacement.
Congenital radioulnar synostosis: is prenatal diagnosis possible? - A case report.
Taiwan J Obstet Gynecol
March 2023
Article Synopsis
- The case report discusses prenatal ultrasound findings of congenital radioulnar synostosis and reviews existing literature on the condition.
- A child diagnosed at eight months old exhibited limited movement in the left forearm, with no history of trauma or family bone issues; radiography confirmed the diagnosis.
- The report emphasizes the rarity of detecting isolated congenital radioulnar synostosis before birth and suggests enhanced screening for high-risk groups to improve early detection and intervention.
Background: The Wassel classification is commonly used for cases of radial polydactyly but has not been used to predict surgical outcomes. This study aimed to investigate the predictive factors of surgical outcomes using the Wassel type and symmetry of duplication.
Methods: Forty-five patients with 47 radial polydactylies were reviewed using the Japanese Society for Surgery of the Hand (JSSH) scores 4.
Article Synopsis
- The study examines the incidence and risk factors of wound complications in minor pediatric orthopaedic surgeries, particularly growth modification procedures.
- It evaluated data from 622 patients, revealing a complication rate of 6.9% in growth modifications compared to 1.0% in osteotomies, highlighting the significant differences based on surgical techniques and locations.
- Findings suggest that complications are notably higher with certain implant types and at specific surgical sites, recommending transphyseal screws as a safer option for these surgeries.
Buschke-Ollendorff syndrome presenting with asymptomatic yellowish papules and leg length discrepancy: A case report.
J Musculoskelet Neuronal Interact
June 2022
Article Synopsis
- Buschke-Ollendorff syndrome (BOS) is a rare genetic condition primarily characterized by benign skin growths and bone abnormalities, affecting about 0.005% of the population.
- A case study details a 9-year-old girl with multiple skin plaques and significant leg length discrepancy, which led to surgical intervention after confirming BOS through a biopsy and genetic analysis.
- The surgery aimed to correct her leg length discrepancy proved successful, highlighting that while severe bone issues in BOS are uncommon, orthopedic treatments can achieve positive results.
Article Synopsis
- - Distal femur extension osteotomy (DFEO) is a surgery used for treating knee flexion contractures in children with cerebral palsy (CP), but it can lead to genu valgum deformities (knock-knees) in younger patients.
- - A study of 25 children found significant valgus changes in the femur after DFEO within the first year, with 82% of limbs showing these changes; 20% of patients required further surgery to correct the issue.
- - The researchers suggest that to counteract the likelihood of developing genu valgum after DFEO, surgeons should aim for a slight varus alignment (bow-legged) during the initial surgery.
Background: Newborn hip screening aims to prevent the late diagnosis of and subsequent surgical procedures for developmental dysplasia of the hip (DDH). Weather may affect how parents swaddle their babies in early life, but weather has never been formally regarded as a risk factor in hip screening. This study investigates the association between the incidence of surgically treated DDH and the outdoor temperature.
View Article and Find Full Text PDFBackground: Double diapering may help to maintain a baby's hips in flexion and abduction posture, but the efficacy in facilitating hip maturation has never been verified. We investigated whether double diapering results in greater improvement of the alpha angle in newborn babies.
Methods: This prospective study enrolled newborns with Graf type IIa immature hips and assigned them to the double-diaper or single-diaper group by the day of birth in a week.
Article Synopsis
- The study investigates flatfoot (Pes Planus) in children, focusing on how the footprint index (CSI) changes as foot arches develop and what factors predict this development.
- In a longitudinal study of 572 children, significant changes in the CSI were observed in those who developed foot arches, particularly linked to physical fitness and balance.
- The findings indicate that foot arch development is associated with maturation and improved motor control of the ankle, highlighting the importance of monitoring this condition in growing children.
Long-term follow-up studies on children with surgically treated developmental dysplasia of the hip (DDH) have shown that not only the affected side progresses to premature osteoarthritis, but the unaffected side may also suffer from insidious hip dysplasia or osteonecrosis. The current gait analysis study identified the loading and unloading rates of the ground reaction forces (GRF) and lower limb joint axial forces during gait, and their correlations with the hip morphology in twenty juvenile patients with surgically treated unilateral DDH during toddlerhood. In a gait laboratory, each subject walked at preferred speed on a 10-m walkway while the kinematics and the GRF were measured.
View Article and Find Full Text PDFPurpose: This study aimed to compare the efficacy of decreasing leg-length discrepancy (LLD) and postoperative complications between tension band plates (TBP) and percutaneous transphyseal screws (PETS).
Methods: This retrospective study reviewed LLD patients who underwent temporary epiphysiodesis at the distal femur and/or proximal tibia from 2010 to 2017 (minimum two years follow-up). Efficacy of decreasing LLD was assessed one and two years postoperatively.
Article Synopsis
- Many experts suggest delaying orthopedic surgery for children with cerebral palsy, but this study examines how delaying surgery may lead to worse outcomes due to age-related musculoskeletal issues.
- The study observed two groups of children (younger and older than 10) who underwent myofascial release surgery and measured their motor function and physical capacity before and after the procedure.
- Results showed that older children had more severe motion limitations and experienced less improvement in their motor skills and physical capacity post-surgery compared to younger children, indicating the need for timely intervention.*
Longitudinal Trends of Participation in Relation to Mental Health in Children with and without Physical Difficulties.
Int J Environ Res Public Health
November 2020
Article Synopsis
- * The study involved parents of 77 children with PD and 94 TD children, who were assessed four times over a year to explore the relationship between independence in activities, attendance frequency, and perceived mental health.
- * Results showed that while independence is important, the frequency of attending activities may play a bigger role in reducing mental health issues, emphasizing the need to support children's participation in daily activities.
Article Synopsis
- This study explored how correcting knee flexion during walking might affect muscle excitability and gait in children with cerebral palsy.
- The researchers monitored 23 children after surgery, measuring changes in their motor functions, joint movement, and muscle tightness over six months.
- They found that some patients showed a reduction in muscle tightness without additional surgical intervention, particularly those who initially had more severe knee bending issues.
Article Synopsis
- The study examined the effects of pulsed radiofrequency (PRF) on spasticity and locomotion in rats with spinal cord injury and spasticity, comparing results with a sham operation group.
- Results indicated that PRF effectively reduced muscle tension from spasticity but also led to a temporary decline in locomotive function, as measured by BBB scores.
- The findings suggest that while PRF can suppress spasticity, it may negatively impact movement, highlighting the need for careful consideration of its use in treating patients with mobility issues.
Article Synopsis
- Developmental dysplasia of the hip (DDH) is a treatable disorder in children that can be detected early through hip ultrasound, but optimal timing for these screenings is debated due to cost and efficiency concerns.
- A study analyzed registry data from 2016 on 1,683 newborns, showing that delaying initial hip ultrasounds until after 28 days increased screening accuracy and reduced the number of follow-up visits needed.
- The findings suggest that performing hip ultrasounds post-28 days lowers false positives and healthcare costs while potentially easing parental anxiety, leading researchers to recommend this timing for routine screenings.
Guided growth for caput valgum in developmental dysplasia of the hip.
J Pediatr Orthop B
November 2018
Article Synopsis
- This study focused on the effects of guided growth for caput valgum deformity in children with unilateral hip dysplasia.
- Ten children underwent a procedure using an eccentric transphyseal screw, starting at an average age of 9.1 years, and were followed for at least 2 years.
- Results showed positive changes in hip angles and distances, indicating that growth modifications led to improved symmetry and development in the affected hip.
Treatment of displaced flexion-type pediatric supracondylar humeral fractures in the prone position.
J Orthop Surg (Hong Kong)
January 2017
Article Synopsis
- The study introduces a new technique for treating displaced flexion-type supracondylar fractures in children by using traction and gradual elbow extension while the patient is in a prone position.
- A review of ten children treated between 2007 and 2013 showed that most fractures were successfully fixed with K-wires after closed reduction, while two required open reduction.
- The results indicated that the method is effective and safe, with most children achieving excellent clinical outcomes according to Flynn's criteria, and alternative approaches available for challenging cases.