How to avoid genu recurvatum in leg-length discrepancy treated with tension-band plates. A volumetric magnetic resonance analysis.

Aims And Objectives: Genu recurvatum deformity after treatment of leg-length discrepancy (LLD) with tension-band plating is a recognized, but poorly described phenomenon in medical literature. The aim of this study was to evaluate clinical and radiological features of patients treated with tension-band plating for LLD assessing the development of a recurvatum deformity and its relationship to plate and screw disposition in a transversal plane, thus attempting to establish optimal plate positioning.

Materials And Methods: Retrospective study of children with LLD treated with tension-band plating.

Executive summary: Guidelines for the diagnosis and treatment of septic arthritis in adults and children, developed by the GEIO (SEIMC), SEIP and SECOT.

Infection of a native joint, commonly referred to as septic arthritis, is a medical emergency because of the risk of joint destruction and subsequent sequelae. Its diagnosis requires a high level of suspicion. These guidelines for the diagnosis and treatment of septic arthritis in children and adults are intended for use by any physician caring for patients with suspected or confirmed septic arthritis.

Lateralized overgrowth as a guiding sign of abdominal neoplasms for pediatric orthopedic surgeons.

Objectives: This study aims to increase the awareness of the association between lateralized overgrowth (LO) and abdominal tumor among the pediatric orthopedic community and to evaluate its incidence in our center.

Patients And Methods: Between January 1997 and December 2021, a total of 166 patients with Wilms tumors and hepatoblastomas were retrospectively analyzed. Data including age, sex, initial clinical signs (hematuria, abdominal mass with or without general discomfort), type of asymmetric regional body overgrowth (isolated or in relation with any syndrome), and tumor stage at diagnosis were recorded.

Poland syndrome: a new classification system based on a retrospective analysis of 74 cases.

III.

Seymour fracture: Better do not underestimate it.

Objectives: This study aims to analyze the functional results, management, and complications of acute Seymour fracture treatment and to generalize the understanding of Seymour fractures, as well as awareness about its controversial treatment and critical sequelae.

Patients And Methods: Between January 1994 and December 2019, a total of 29 patients (20 males, 9 females; mean age: 7.9±3.

Post-cholecystectomy Hepatic Artery Pseudoaneurysm Rupture.

Pseudoaneurysm of the hepatic and/or less frequently the cystic artery is a rare but potentially fatal complication following laparoscopic cholecystectomy. While the procedure is safe with minimal morbidity, complications do occur even in experienced hands. Moreover, patient selection is of utmost importance.

Non-axial osteoarticular tuberculosis in the paediatric age.

Introduction And Objectives: Osteoarticular tuberculosis, caused by a member of the Mycobacterium genus, represents approximately 10% of the total extrapulmonary tuberculosis in pediatric patients. Its low prevalence and nonspecific clinical presentation lead to a late diagnosis and elevated risk of sequelae.

Patients And Methods: This retrospective study included seven pediatric patients with non-vertebral osteoarticular tuberculosis diagnosed between 2006 and 2019.

How the COVID-19 pandemic is affecting paediatric orthopaedics practice: a preliminary report.

Purpose: Since the state of alarm was decreed in Spain on 14 March 2020, the coronavirus disease 2019 (COVID-19) pandemic has had an extraordinary impact in paediatric hospitals. This study shows the effect of the pandemic on our practice in paediatric orthopaedics in a referral third level paediatric hospital.

Methods: We performed a single-centre retrospective review of the official census from a third level paediatric hospital from 14 March to 14 April for the years 2018, 2019 and 2020.

Evaluation by ultrasound of the hips of babies carried in baby carriers.

Background And Objective: Hip dysplasia has been associated with risk factors such as breech presentation, female gender or family history. However, external factors, such as the use of baby carriers, seem to influence the development of the hip in the first months of life. The aim of this study is to evaluate the position of the hips of babies placed in different types of baby carriers by ultrasound image.

Elbow flexion reconstruction with nerve transfer or grafting in patients with brachial plexus injuries: A systematic review and comparison study.

Introduction: Posttraumatic brachial plexus (BP) palsy was used to be treated by reconstruction with nerve grafts. For the last two decades, nerve transfers have gained popularity and believed to be more effective than nerve grafting. The aim of this systematic review was to compare elbow flexion restoration with nerve transfers or nerve grafting after traumatic BP injury.

Comparison of surgical incision complete closure versus leaving skin open in wound class IV in emergent colon surgery.

Introduction: Our aim was to compare the effect of techniques of wound closure in the emergent colon surgery with wound class IV.

Methods: Using 2014 the colectomy targeted ACS-NSQIP dataset; we identified patients undergoing emergent colectomy with wound class IV. Comparison of surgical incision complete closure versus leaving the skin open and multivariate logistic regression analyses was performed.

Isolation, characterization, and differentiation of multipotent neural progenitor cells from human cerebrospinal fluid in fetal cystic myelomeningocele.

Despite benefits of prenatal in utero repair of myelomeningocele, a severe type of spina bifida aperta, many of these patients will still suffer mild to severe impairment. One potential source of stem cells for new regenerative medicine-based therapeutic approaches for spinal cord injury repair is neural progenitor cells (NPCs) in cerebrospinal fluid (CSF). To this aim, we extracted CSF from the cyst surrounding the exposed neural placode during the surgical repair of myelomeningocele in 6 fetuses (20 to 26weeks of gestation).

Open and Endovascular Abdominal Aortic Injury Repair Outcomes in Polytrauma Patients.

Introduction: The management of patients with abdominal aortic injury (AAI) remains challenging. Open repair of AAI is still the standard of care although it is associated with high mortality. In past few years, endovascular surgery has evolved as a less invasive alternative to open surgery in emergency settings.

[Vascular interventional radiology: a fundamental procedure for the management of paediatric trauma].

Introduction: The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment.

Aim: The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs.

Femoral head bone viability after free vascularized fibular grafting for osteonecrosis: SPECT/CT study.

Purpose: To evaluate femoral head bone viability following free vascularized fibular grafting (FVFG) for osteonecrosis using SPECT/CT imaging.

Methods: Ten hips (9 patients) with osteonecrosis of the femoral head (ONFH) undergoing FVFG were prospectively enrolled. Four cases showed ARCO stage II, while six showed ARCO stage III.

Thoracic wall reconstruction with bioabsorbable plates in pediatric malignant thoracic wall tumors.

Aim: Childhood malignant chest wall tumors may require extensive surgical resection and reconstruction with musculoskeletal flaps or non-resorbable prosthetic materials. Implant-related complications and scoliosis often occur. This study analyzes the outcomes of chest wall reconstruction using resorbable plates as an alternative approach.

Chronic Recurrent Multifocal Osteomyelitis and Thalidomide in Chronic Granulomatous Disease.

Chronic granulomatous disease (CGD) is a primary immunodeficiency that leads to severe recurrent infection and inflammatory complications that are usually difficult to diagnose and treat. Several hyperinflammation mechanisms, such as decreased neutrophil apoptosis, toll-like receptor activation imbalance, Th17 cell induction, Nrf2 activity deficiency, and inflammasome activation, have been described in CGD patients However, there have been no reports of chronic recurrent multifocal osteomyelitis as an inflammatory complication in CGD, and the differential diagnosis of this condition with infectious osteomyelitis is challenging. Thalidomide has been used to treat several inflammatory manifestations in CGD patients with good clinical results.

Severe Sprengel deformity associated with Klippel-Feil syndrome and a complex vascular abnormality that determined the corrective surgery technique.

Sprengel deformity (SD), a congenital condition characterized by elevation of the scapula, is a cause of functional and aesthetic defects that can be improved by surgical correction. Many cases of SD are associated with Klippel-Feil syndrome (KFS), in which there may be abnormalities of the supra-aortic vessels. We present the case of an 11-year-old girl with severe SD and KFS.

The role of subscapularis muscle denervation in the pathogenesis of shoulder internal rotation contracture after neonatal brachial plexus palsy: a study in a rat model.

We assessed the role of subscapularis muscle denervation in the development of shoulder internal rotation contracture in neonatal brachial plexus injury. Seventeen newborn rats underwent selective denervation of the subscapular muscle. The rats were evaluated at weekly intervals to measure passive shoulder external rotation.

The role of muscle imbalance in the pathogenesis of shoulder contracture after neonatal brachial plexus palsy: a study in a rat model.

Background: An internal rotation contracture of the shoulder is common after neonatal brachial plexus injuries due to subscapularis shortening and atrophy. It has been explained by 2 theories: muscle denervation and muscle imbalance between the internal and external rotators of the shoulder. The goal of this study was to test the hypothesis that muscle imbalance alone could cause subscapularis changes and shoulder contracture.

Reduction in neural injury with earlier delivery in a mouse model of congenital myelomeningocele: laboratory investigation.

Object: The authors undertook this study to assess the effect of preterm delivery with respect to neural protection in a congenital myelomeningocele (MMC) mouse model.

Methods: After confirmation of pregnancy in 15 female mice, a congenital MMC model was produced by administration of retinoic acid on the 7th day of gestation. The pregnant mice underwent cesarean sections on Days 15 (n = 5, Group E15), 17 (n = 5, Group E17), and 19 (n = 5, Group E19).

Single-Access Fetal Endoscopy (SAFE) for myelomeningocele in sheep model I: amniotic carbon dioxide gas approach.

Background: This study aimed to assess the feasibility of single-access fetal endoscopy (SAFE) for the management of myelomeningocele (MMC) using intrauterine carbon dioxide as a distension medium in a sheep model.

Methods: This prospective experimental case-control study investigated 12 lamb fetuses that had a myelomeningocele-like defect surgically created on the 75th day of gestation. Four fetuses remained untreated (control group), and eight fetuses had MMC repair using two fetoscopic approaches with carbon dioxide used to distend the amniotic cavity.

Evaluation of bone viability.

Bone scintigraphy is an excellent tool to assess bone viability. The functional information provided is crucial in several clinical settings, like the detection of avascular necrosis, septic embolism, frostbite lesions and osteonecrosis, and to evaluate the results of surgical treatment in cases of avascular necrosis. Mechanisms to obtain molecular images, as well as different kind of techniques, are detailed.