Scoliosis in Non-Ambulatory Cerebral Palsy: Challenges and Management.

In non-ambulatory patients with cerebral palsy, the presence of scoliosis has a major impact on health and quality of life. The aim of this review is to raise awareness of caregivers from various professions to the extent of the problem, to explain the natural history of neuromuscular scoliosis and its pathophysiology, and to describe up-to-date optional conservative and surgical treatments.

Percutaneous aspiration and irrigation technique for the treatment of pediatric septic hip: effectiveness and predictive parameters.

Unlabelled: Septic arthritis of the hip has been treated traditionally by surgical drainage. Recent reports have described repeated aspirations as an adequate and safe treatment. The aim of the present study was to assess the success of treatment of septic arthritis of the hip by repeated aspirations and to identify predictive factors for failure.

Chronic osteomyelitis in children: treatment by intramedullary reaming and antibiotic-impregnated cement rods.

Background: Chronic osteomyelitis (CO) is rarely encountered in developed countries and is especially rare in children and adolescents. However, on occurrence, it can pose a difficult therapeutic challenge necessitating a combination of aggressive surgical treatment and prolonged antibiotic administration.

Methods: Four patients were treated for CO in the Pediatric Orthopaedic Unit at Schneider Children's Medical Center between June 2005 and December 2006 and were reviewed retrospectively.

Intraoperative C-arm radiation affecting factors and reduction by an intervention program.

Background: The increase in the utilization of fluoroscopy during surgical procedures carries with it an inherent increase in the exposure of both patients and surgical staff to ionizing radiation. The purpose of this study was to examine the ability to reduce radiation doses by the implementation of an intervention program targeted at the staff operating the fluoroscopy machinery and attempting to make a behavioral change in its utilization.

Methods: (1) Fluoroscopy technique was optimized after a series of simulation fluoroscopies.

Reference accuracy in peer-reviewed pediatric orthopaedic literature.

Background: Reference accuracy of articles published in the biomedical literature is determined by the presence of citation and quotation errors. A recent review demonstrated that the median citation error rate per biomedical journal was 39%, and the median quotation error rate per journal was 20%. Reference accuracy in pediatric orthopaedic articles has not been previously reported, to our knowledge.

Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates.

Background: We describe a new method for corrective osteotomy and the fixation of lower limb deformities in children.

Methods: Following osteotomy, the desired position is obtained and temporarily stabilized using an external fixator. Definitive fixation is performed with a plate and locking screws inserted percutaneously under fluoroscopic guidance.

Treatment of severe early onset Blount's disease by an intra-articular and a metaphyseal osteotomy using the Taylor Spatial Frame.

Purpose: Severe Blount's disease results in a multiplanar deformity of the lower limb. The mechanical axis is disrupted, there is a rotational deformity, and also shortening of the limb. A depression of the medial tibial plateau causes joint incongruity and instability.

Correction of lower limb deformities in children with renal osteodystrophy by the Ilizarov method.

Background: Children with renal osteodystrophy (ROD) may develop severe angular deformities of the limbs. Various methods, both medical and surgical, have been described for correction of these deformities, but a literature search showed only 1 child previously treated by the Ilizarov method. The purpose of this study was to characterize the deformities found in our group of patients and to describe our experience in treating these patients with the Ilizarov method.

Botulinum toxin for the treatment of spasticity in children: attainment of treatment goals.

Forty patients (mean age 5 years) with a spastic disorder treated by botulinum injections (53 sessions) were evaluated for functional outcome in terms of achievement of their individual predetermined goals of treatment, rated on a modified Goal Attainment Scale from 1 (worsening function) to 4 (improved gross motor function). At the 2-week follow-up, 40% had a score of 1, 33% a score of 2, and 13% a score of 3; 12% showed no functional change. Botulinum treatments failed to significantly improve the gross motor function in this patient group.