Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children.

Six tarsal coalitions in children were managed surgically using a deepithelialized skin flap for interposition after resection of the bony, fibrous or cartilaginous coalition. The advantage of this technique is that due to positioning the skin flap, joint motion can be preserved. The clinical results using the Ankle Hindfoot Scale of the American Orthopedic Foot and Ankle Society were excellent in two and good in four cases.

Application of generalized dynamic neural networks to biomedical data.

This paper reviews the application of continuous recurrent neural networks with time-varying weights to pattern recognition tasks in medicine. A general learning algorithm based on Pontryagin's maximum principle is recapitulated, and possibilities of improving the generalization capabilities of these networks are given. The effectiveness of the methods is demonstrated by three different real-world examples taken from the fields of anesthesiology, orthopedics, and radiology.

Leg lengthening as part of gait improvement surgery in cerebral palsy: an evaluation using gait analysis.

Eleven children with hemiplegic or an asymmetric diplegic cerebral palsy who had a preoperative leg length discrepancy of more than 2.5 cm underwent gait improvement surgery which included leg length equalisation. Sagittal plane kinematics and kinetics before and about 3 years after surgery for the lengthened limb and contralateral limb were evaluated.

Gait improvement surgery in diplegic children: how long do the improvements last?

Gait improvement surgery in ambulatory children with cerebral palsy performed as single-event multilevel surgery is today a well-established modality of treatment, but follow-up studies are lacking. Preoperative and follow-up gait analysis data of 32 diplegic children who underwent single-event multilevel surgery for gait improvement between 1995 and 1998 were evaluated retrospectively. Relevant sagittal plane kinematic parameters of the hip, knee, and ankle joint and time-distance parameters were considered for outcome measures in this study.

Phenotypes of the N88S Berardinelli-Seip congenital lipodystrophy 2 mutation.

Recently, two missense mutations (N88S, S90L) in the Berardinelli-Seip congenital lipodystrophy gene have been identified in autosomal dominant distal hereditary motor neuropathy and Silver syndrome. We report the phenotypic consequences of the N88S mutation in 90 patients of 1 large Austrian family and two unrelated German families. Variation in the clinical and electrophysiological phenotype enabled us to distinguish six subtypes.

Tibial lengthening over nails in children using modified Ender nails: preliminary results of a new treatment.

Tibial lengthening over nails, using modified Ender nails, was performed in nine children whose mean age at surgery was 12.8 years. The prerequisite for using this technique was the absence of axial malalignment and an indication for tibial lengthening only.

Treatment of unicameral calcaneal bone cysts in children: review of literature and results using a cannulated screw for continuous decompression of the cyst.

Nine unicameral bone cysts of the calcaneus in children were managed surgically using the technique of continuous decompression with titanium cannulated cancellous screws. The average age of the patients at surgery was 12.8 years.

Improving generalization capabilities of dynamic neural networks.

This work addresses the problem of improving the generalization capabilities of continuous recurrent neural networks. The learning task is transformed into an optimal control framework in which the weights and the initial network state are treated as unknown controls. A new learning algorithm based on a variational formulation of Pontrayagin's maximum principle is proposed.

Effect of derotation osteotomy of the femur on hip and pelvis rotations in hemiplegic and diplegic children.

The purpose of this study was to evaluate hip and pelvis rotations in groups of hemiplegic and diplegic children before and after surgical correction of fixed internal rotation deformity of the hip. Twenty-two children with cerebral palsy (eight diplegia, 14 hemiplegia) having fixed internal rotation deformity at the hip were treated by multilevel surgery which included derotation osteotomy of the femur. Evaluation was done before and at a mean of 3.

Multilevel surgery in spastic diplegia: evaluation by physical examination and gait analysis in 25 children.

Gait improvement surgery was performed on 25 ambulatory children with the diplegic type of cerebral palsy. Multiple soft tissue and bony procedures were performed (mean 8.2 procedures) according to criteria defined on the basis of physical examination and gait analysis.