Techniques for surgical stabilization of the patella in children.

Patellar instability can be defined as dislocation or subluxation of the patella relative to the femoral trochlea. It is a common reason for consulting a pediatric orthopedic surgeon. Its etiology is multifactorial.

Diagnosis and treatment of cervical spine injuries in children.

Cervical spine injuries in children are a common reason for emergency room visits, while bone, ligament or spinal cord cervical lesions are relatively rare (1-1.5% of severe trauma in children) and mainly involve the upper cervical spine. The main causes are sports injuries, accidents at home and traffic accidents.

L-pinning for fifth metacarpal neck fracture in adolescents.

Introduction: Fifth metacarpal neck fracture is the most frequent type of hand fracture in adolescents between 13 and 16 years of age. It mainly affects males and the dominant hand. The L-pinning technique combines intramedullary anterograde pinning and transverse pinning between the 4 and 5 metacarpals.

Outcomes of isolated soft tissue surgery for in-toeing gait in patients with ambulatory cerebral palsy.

Background: Soft tissue surgery to address in-toeing gait in young cerebral palsy (CP) patients may be an alternative in some cases to femoral derotation osteotomy (FDO), which is the currently accepted treatment. The relative contribution of muscular contracture, spasticity and bone deformity is still controversial. In this study, we determined the outcomes of soft tissue surgery on hip internal rotation (HIR) when femoral anteversion was less than 45° and the soft tissues were identified as being the cause.

Intra-medullary osteosclerosis of the tibia in children.

Background: Intra-medullary osteosclerosis of the tibia is a rare condition characterised by chronic pain due to diaphyseal hyperostosis with no detectable triggering factor. The main differential diagnoses are stress fracture and osteoid osteoma. Of the few cases reported to date, most were in adults.

The National Pediatric Surgery Simulation Program in France: A tool to develop resident training in pediatric surgery.

Background/purpose: To implement resident curriculum in France based on theoretical teaching and bed side training, the national council known as the "Collège Hospitalier et Universitaire de Chirurgie Pédiatrique" examined the relevance and feasibility of systematically introducing simulation program in the pediatric surgery resident training.

Material And Methods: A national simulation training program was developed and took place in a 2-day session organized in 7 simulation centers in France. The program included technical (laparoscopic/suturing technique on low-fidelity models) and nontechnical (6 scenarios for standardized consultation, and a team work scenario based on errors prevention in the operative room) skills.

The spastic hip in children and adolescents.

The hip is the joint most exposed to orthopaedic complications in cerebral palsy (CP), which is the main cause of spasticity in paediatric patients. The initial immaturity of the hip allows the forces applied by the spastic and retracted muscles to displace the femoral head, eventually causing it to dislocate. The risk of hip dislocation increases with the severity and extent of CP, exceeding 70% in the most severe cases.

Gait parameters database for young children: The influences of age and walking speed.

Background: Reference databases are mandatory in orthopaedics because they enable the detection of gait abnormalities in patients. Such databases rarely include data on children under seven years of age. In young children, gait is principally influenced by age and walking speed.

Masquelet's procedure and bone morphogenetic protein in congenital pseudarthrosis of the tibia in children: a case series and meta-analysis.

Purpose: A type 2 recombinant human bone morphogenetic protein (rhBMP2) and Masquelet's procedure were used in three children presenting with congenital pseudarthrosis of the tibia (CPT). Recent studies on CPT suggested the presence in situ of pathologic tissues promoting pseudarthrosis. The authors hypothesized that large segmental resection of pseudarthrosis could improve prognosis of the CPT.

Biomechanical maturation of joint dynamics during early childhood: updated conclusions.

Dynamic parameters have been commonly explored to characterize the biomechanical maturation of children's gaits, i.e., age-revealing joint moment and power patterns similar to adult patterns.

The effect of heparan sulfate application on bone formation during distraction osteogenesis.

Bone morphogenetic proteins (BMPs) are recognized for their ability to induce bone formation in vivo and in vitro. Their osteogenic and osteoinductive properties are tightly regulated by the secretion of specific BMP antagonists, which have been shown to physically bind and sometimes be blocked by the extracellular proteoglycan heparan sulphate side chains (from hereon referred to as HS). The purpose of this study was to investigate if local application of 5 µg of HS proteoglycan to a bone regenerate site in a mouse model of distraction osteogenesis (DO) can accelerate bone healing and affect the expression of key members of the BMP signaling pathway.

Foot mechanics during the first six years of independent walking.

Recognition of the changes during gait that occur normally as a part of growth is essential to prevent mislabeling those changes from adult gait as evidence of gait pathology. Currently, in the literature, the definition of a mature age for ankle joint dynamics is controversial (i.e.

Bone metabolism in oxalosis: a single-center study using new imaging techniques and biomarkers.

The deposition of calcium oxalate crystals in the kidney and bone is a hallmark of primary hyperoxaluria type 1 (PH1). We report here an evaluation of the bone status of 12 PH1 children based on bone biomarkers [parathyroid hormone, vitamin D, fibroblast growth factor 23 (FGF23)] and radiological assessments (skeletal age, three-dimensional high-resolution peripheral quantitative computed tomography, HR-pQCT) carried out within the framework of a cross-sectional single-center study. The controls consisted of healthy and children with chronic kidney disease already enrolled in local bone and mineral metabolism studies.

Enhancement of difficult nonunion in children with osteogenic protein-1 (OP-1): early experience.

Unlabelled: Numerous studies have described the use of osteogenic protein-1 (OP-1) in adults, but there are few reports in children. The objectives of this short-term followup cohort study were (1) to examine clinical and radiographic healing of persistent nonunions after OP-1 application in children; and (2) to determine the safety of OP-1 use in this sample. Clinical healing was defined by absence of pain and tenderness at the nonunion site and the ability to fully weight bear on the affected limb.

Panton-Valentine leukocidin is expressed at toxic levels in human skin abscesses.

Pus samples were prospectively collected from patients with Staphylococcus aureus skin infections and tested for Panton-Valentine leukocidin (PVL). PVL was detected at concentrations that were toxic for rabbit skin in all specimens from patients infected with strains harbouring PVL genes.

[Skiing and snowboarding trauma in children: epidemiology, physiopathology, prevention and main injuries].

Skiing and snowboarding are leading to a risk of injuries in children. Beginners and experienced have higher risk of injuries, however, the first have less severe injuries than the latest. Risk factors of injury are: ability and experience, binding adjustment, slope characteristics, speed, collisions with objects or jumping and risky behavior of the young skiers and snowboarders.

[Osteochondral autograft for osteochondritis dissecans of the capitulum in adolescent: report of six cases and review of the literature].

Purpose Of The Study: We present the cases of six adolescents (four high-level gymnastics specialists) with osteochondritis dissecans of the capitulum who were treated with an en bloc osteochondral autograft. There are few series of this rare condition reported in the literature.

Material And Methods: All six patients presented pain over the lateral aspect of the elbow and limited extension; pronosupination was unaffected.

[Permanent, habitual dislocation and recurrent dislocation of the patella in children: surgical management by patellar ligamentous transfer in 50 knees].

Purpose Of The Study: Appropriate treatment of patellar dislocation in children and adolescents remains a subject of debate. Ligamentous transfer or "soft rod" is a technique for realigning the extensor mechanism that can be adapted to children. We analyzed results obtained in our patients.