3D-printed Cutting Guides for Lower Limb Deformity Correction in the Young Population.

Background: Three-dimensional (3D) virtual surgical planning technology has advanced applications in the correction of deformities of long bones by enabling the production of 3D stereolithographic models, patient-specific instruments and surgical-guiding templates. Herein, we describe the implementation of this technology in young patients who required a corrective osteotomy for a complex 3-plane (oblique plane) lower-limb deformity.

Patients And Methods: A total of 17 patients (9 males, average age 14.

Ponseti treated idiopathic clubfoot - outcome predictive factors in the test of time: analysis of 500 feet followed for five to 20 years.

Purpose: To investigate a set of risk factors on the outcome of Ponseti treated idiopathic clubfeet (ICF).

Methods: This study was approved by the institutional review board. A retrospective analysis of prospectively gathered data over a 20-year period, at a single dedicated clubfoot clinic.

Auto Strut: a novel smart robotic system for external fixation device for bone deformity correction, a preliminary experience.

Purpose: Several hexapod external fixators are used in the treatment of bone fracture and deformity corrections. One characteristic of all of them is the requirement for manual adjustment of the fixator struts. The purpose of this study was to introduce a novel robotic system that executes automatic adjustment of the struts.

Changes in the femoral osteotomy level coefficient and neck shaft angle during limb lengthening with an intramedullary magnetic nail.

Background: The intramedullary magnetic IM nail enables bone graduated distraction. Proximal femur osteotomies for ante grade IM lengthening nails have a tendency towards varus-procurvatum malalignment. We examined the effect of the level of the osteotomy and of trochanteric versus piriformis entry points on the neck shaft angle (NSA) during lengthening with the PRECICE IM magnetic nail.

The efficacy of guided growth as an initial strategy for Blount disease treatment.

Purpose: The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease.

Methods: This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion.

Updates on preoperative planning, limb deformity analysis and surgical correction for the growing children : EPOS Meeting Marseille 2015 proceedings.

Successful deformity correction depends on establishing the aetiology of the deformity. Clinical examination, additional laboratory tests and consultation with other experts may be needed to complete the workup. Imaging studies should include full-length standing X-rays in all relevant planes, and additional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) may add information on bone morphology and growth plates' anatomy.

Preoperative Planning of Orthopedic Procedures using Digitalized Software Systems.

The progression from standard celluloid films to digitalized technology led to the development of new software programs to fulfill the needs of preoperative planning. We describe here preoperative digitalized programs and the variety of conditions for which those programs can be used to facilitate preparation for surgery. A PubMed search using the keywords "digitalized software programs," "preoperative planning" and "total joint arthroplasty" was performed for all studies regarding preoperative planning of orthopedic procedures that were published from 1989 to 2014 in English.

Radiographic Indicators of Surgery and Functional Outcome in Ponseti-Treated Clubfeet.

Background: Evaluation of the results of treatment for clubfoot by the Ponseti technique is based on clinical and functional parameters. There is a need to establish universally recognized quantitative measurements to compare, better understand, and more precisely evaluate therapeutic outcome.

Methods: Nine angles were measured on standard radiographs of 145 children with idiopathic clubfeet treated between 2000 and 2010 with the Ponseti method.

Can Classic Bladder Exstrophy be Safely and Successfully Reconstructed at a Low Volume Center?

Purpose: Exstrophy reconstruction is challenging and requires expertise and experience. However, many patients are treated at low volume centers. We evaluated whether classic bladder exstrophy could be safely and successfully reconstructed at a low volume center.

Congenital tibial pseudarthrosis, changes in treatment protocol.

Ten children with congenital pseudarthrosis of the tibia were treated with resection of pathologic bone, bone grafting, intramedullary rodding, compression with circular frame, simultaneous proximal tibia lengthening, and bone morphologic proteins. Thirteen operations were performed to achieve union. Four patients underwent simultaneous lengthening and four patients received recombinant human bone morphologic protein.

Correction of Cubitus Varus After Pediatric Supracondylar Elbow Fracture: Alternative Method Using the Taylor Spatial Frame.

Background: Cubitus varus is a well-reported complication of supracondylar fracture of the humerus potentially resulting in cosmetic problems, impaired function, and malpractice claims. Traditional methods of correcting malunited distal humeral fractures involve complex osteotomies that have a high complication rate, require a large exposure, and challenging fixation. We present a technique of gradual correction using a percutaneous transverse osteotomy and 3 dimensional correction with a Taylor Spatial Frame.

Retinal nerve fibre layer thickness measurements by optical coherence tomography in patients with sleep apnoea syndrome.

Background: The study aims to investigate whether retinal nerve fibre layer (RNFL) abnormalities can be detected in patients with obstructive sleep apnoea/hypopnoea syndrome with normally appearing optic disc.

Design: This is an observational case-control study.

Participants: One hundred and eight consecutive patients with moderate or severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS) as determined by overnight polysomnography and normal looking discs and 108 age-matched healthy controls were included in the study.

The influence of brace type on the success rate of the Ponseti treatment protocol for idiopathic clubfoot.

Purpose: The success of the Ponseti method for treating idiopathic clubfoot deformity is dependent on the casting techniques and the adherence of the patient to the foot abduction brace protocol. Newly developed brace designs claim to be more comfortable, to be easier to use and to prevent dislodgement of the foot from the brace, making them more efficient and improving patient compliance. They are, however, more costly, and, therefore, accessible to fewer patients.

Intra- and interobserver reliability analysis of digital radiographic measurements for pediatric orthopedic parameters using a novel PACS integrated computer software program.

Background: The between-observer reliability of repeated anatomic assessments in pediatric orthopedics relies on the precise definition of bony landmarks for measuring angles, indexes, and lengths of joints, limbs, and spine. We have analyzed intra- and interobserver reliability with a new digital measurement system (TraumaCad Wizard™).

Methods: Five pediatric orthopedic surgeons measured 50 digital radiographs on three separate days using the TraumaCad system.

Selective laser trabeculoplasty in uncontrolled pseudoexfoliation glaucoma.

Background And Objective: To assess the efficacy and safety of selective laser trabeculoplasty (SLT) in uncontrolled pseudoexfoliation glaucoma (PEXG).

Patients And Methods: Fifty-seven eyes (57 patients) with uncontrolled PEXG and intra-ocular pressure (IOP) greater than 23 mm Hg underwent SLT. All received ophthalmic evaluation preoperatively and at intervals postoperatively.

Lowering of IOP by echothiophate iodide in pseudophakic eyes with glaucoma.

Purpose: We retrospectively investigated the intraocular pressure (IOP)-lowering effects of echothiophate iodide (EI) as adjunctive treatment for pseudophakic glaucoma patients who were receiving maximal medical therapy (MMT), including the newer class of medications, i.e., prostaglandin analogs, alpha-2 agonists, and topical carbonic anhydrase inhibitors.

Comparison of optic nerve head topography findings in eyes with non-arteritic anterior ischemic optic neuropathy and eyes with glaucoma.

Background: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness in eyes affected by non-arteritic ischemic optic neuropathy (NAION) or glaucoma as determined by optical coherence tomography (OCT).

Methods: This cross-sectional institutional study included 18 eyes with NAION (at least 6 months since the acute event) and 29 eyes with glaucoma, both having localized visual field (VF) defects confined to one hemifield. Twenty-nine normal subjects served as controls.

Growth and development of tarsal and metatarsal bones in successfully treated congenital idiopathic clubfoot: early radiographic study.

Fifteen cases of unilateral clubfoot treated according to Ponseti's technique had the talocalcaneal angles on the anteroposterior and lateral views and the size of the talus, calcaneus, I-V metatarsus measured on radiographs of both feet that were taken at a mean age of 15.2 months (range 8-23). The measurements of talocalcaneal angles and size of the talus, calcaneus, and I, II, and III metatarsi were significantly smaller on the affected side, whereas the values for the IV and V metatarsi were similar on both sides.

Giant osteofibrous dysplasia (ossifying fibroma) of the tibia: case report and review of treatment modalities.

We present a case of giant osteofibrous dysplasia (OFB) of the proximal tibia with 15 years of follow-up. The tumor recurred after first biopsy and curettage done at the age of 6 years and, again, 4 years later. Following recurrence, the option of amputation was suggested.

The effect of community-prescribed ankle-foot orthoses on gait parameters in children with spastic cerebral palsy.

Purpose: To evaluate the efficacy of ankle foot orthoses (AFOs) prescribed in the community for children with cerebral palsy (CP).

Methods: Fifty-six children (32 boys and 24 girls, mean age 8.9 years, range 4-17) who were diagnosed as having CP were enrolled.

Treatment of severe late-onset Perthes' disease with soft tissue release and articulated hip distraction: revisited at skeletal maturity.

Purpose: Late-onset Perthes' disease is diagnosed after 9 years of age. Conservative treatment and conventional surgical techniques have limited ability to reduce the pressure in the joint or change the shape of the femoral head. We used a combination of soft tissue release and joint distraction with a hinged mono-lateral external fixator for these patients.

[Current management of idiopathic clubfoot].

Idiopathic clubfoot, one of the most common problems in pediatric orthopaedics, is characterized by a complex three-dimensional deformity of the foot. The treatment of clubfoot is controversial and continues to be so. Since nonsurgical management was thought not to yield adequate correction and a durable result, most children with idiopathic clubfoot have undergone surgery with extensive posteromedial and lateral release.