Correlation between transverse plan kinematics and foot progression angle in children with spastic diplegia.

In diplegic patients, the orientation of foot progression depends on multiple factors. We investigated the relationship between foot progression alignment, hip and pelvic rotations during gait, femoral anteversion, and tibial torsion. Kinematic and clinical parameters were evaluated for 114 children who walked independently and had not undergone previous surgery.

Can turned inward patella predict an excess of femoral anteversion during gait in spastic diplegic children?

Background: Determining patellar orientation in the transverse plane during observational gait analysis is a fundamental aspect of physical examinations. Many physicians consider that an abnormal position of the patella in the transverse planes is only explained by a rotational abnormality of the proximal femur.

Methods: A total of 188 spastic diplegic children with cerebral palsy were reviewed (376 lower limbs).

The gait variability index: a new way to quantify fluctuation magnitude of spatiotemporal parameters during gait.

This article describes a conglomerate measure of gait variability based on nine spatiotemporal parameters: the Gait Variability Index (GVI). Concurrent validity, inter-session reliability and minimum detectable change (MDC) were evaluated in 31 patients with Friedreich's Ataxia (FRDA), through comparisons with classically used evaluation tools such as the International Cooperative Ataxia Rating Scale (ICARS). GVI scores for the healthy population were 100.

Comparative study of 2 commissural dorsal flap techniques for the treatment of congenital syndactyly.

Background: Many commissural reconstruction techniques have been described for the treatment of syndactyly. This study is the first to compare long-term results of 2 commissural dorsal flap procedures (T-flap and omega-flap).

Methods: Fifty-nine web-spaces in 39 patients, operated on between 1991 and 2008, were retrospectively analyzed.

Forearm deformities in hereditary multiple exostosis: clinical and functional results at maturity.

Background: Thirty to 60% of hereditary multiple exostoses patients have forearm deformities. There is no consensus regarding optimal therapy. This long-term retrospective study is the first to compare radiologic and clinical data with patient assessments, to define more precise surgical indications.

Upper limb motion analysis in children with hemiplegic cerebral palsy: proximal kinematic changes after distal botulinum toxin or surgical treatments.

Purpose: The purpose of this study is to describe the kinematic changes in children with cerebral palsy (CP) after treatments performed on the forearm, wrist or thumb, with specific attention to the changes around the trunk, shoulder and elbow kinematics.

Methods: With the use of a specific kinematic protocol, we first described the upper limb kinematics in a group of 27 hemiplegic patients during two simple daily tasks. Eight of these children were treated with botulinum toxin (Botox(®), Allergan) injection or surgery and were, thereafter, evaluated with another kinematic analysis in order to compare the pre- and post-therapeutic condition.

Circumferential fusion with anterior strut grafting and short-segment multipoint posterior fixation for burst fractures in skeletally immature patients: a preliminary report.

Background: The Universal Clamp (UC) is a novel vertebral anchor consisting of a sublaminar polyester band connected to fusion rods by a titanium jaw locked with a screw. The authors prospectively studied patients treated for thoracic or lumbar burst fractures with short pedicle screw constructs reinforced with UCs to prevent screw pullout.

Methods: Eleven patients below 18 years of age underwent 2-stage circumferential fusion for complete burst fractures (Magerl A 3.

Rectus femoris distal tendon resection improves knee motion in patients with spastic diplegia.

Background: Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris transfer has been recommended to enhance knee flexion during swing.

Thoracoscopy in children less than 20 kg for the management of spinal disorders: efficacy at long-term follow-up.

Background: Thoracoscopy is now considered a safe and feasible method for surgical management of spinal disorders in both adults and children. Nevertheless, a weight less than 20 kg has been reported as a relative contraindication because of the small volume of the thoracic cage and the anticipated difficulties of single-lung ventilation. The aim of this study was to evaluate the feasibility, as well as the safety and efficacy, of thoracoscopic procedures in such patients.

Validity of Functional Ambulation Performance Score for the evaluation of spatiotemporal parameters of children's gait.

Gait characteristics of a healthy adult population have been used to develop the Functional Ambulation Profile (FAP) score to evaluate gait in patients with neuromuscular or musculoskeletal involvement (A. J. Nelson, 1974).

Hybrid constructs for tridimensional correction of the thoracic spine in adolescent idiopathic scoliosis: a comparative analysis of universal clamps versus hooks.

Study Design: Retrospective study of prospectively collected data.

Objective: Compare Universal Clamps (UCs) and hooks for the thoracic correction of adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: In scoliosis surgery, sagittal correction is as important as frontal correction due to the risk of junctional kyphosis.

Intrasacral rod fixation for pediatric long spinal fusion: results of a prospective study with a minimum 5-year follow-up.

Background: Lumbosacral fusion is often needed in cases of pediatric neuromuscular spinal deformities. Despite the numerous fixation techniques described, the procedure remains challenging. Jackson has described a method of intrasacral fixation providing immediate 3-dimensional stability and promising clinical results.

The results of Chiari pelvic osteotomy in adolescents with a brief literature review.

Purpose: Chiari medial displacement osteotomy is a procedure that uses the cancellous bone of the ilium to contain the femoral head and bear weight. It is the most contraversial osteotomy of the hip joint. This study was therefore conducted to determine the results of this osteotomy with mid-term follow-up in children.

Efficacy and safety of posteromedial translation for correction of thoracic curves in adolescent idiopathic scoliosis using a new connection to the spine: the Universal Clamp.

Correction of adolescent idiopathic scoliosis (AIS) has been reported with various systems. All-screw constructs are currently the most popular, but they have been associated with a significant decrease in thoracic kyphosis, with a potential risk of junctional kyphosis, not observed with hybrid constructs in the literature. In addition, it is important to weigh potential advantages of pedicle screw fixation against risks specific to its use.

How to determine the upper level of instrumentation in Lenke types 1 and 2 adolescent idiopathic scoliosis: a prospective study of 132 patients.

Background: The selection of fusion levels continues to be controversial in adolescent idiopathic scoliosis (AIS). The classifications of King and Lenke remain the most widely used, but recent studies have demonstrated their shortcomings, including poor interobserver reproducibility. We propose a method of preoperative planning that is independent of anatomical classifications, based on the anticipated effect of curve reduction.

Bioactive glass as a bone substitute for spinal fusion in adolescent idiopathic scoliosis: a comparative study with iliac crest autograft.

Background: Iliac crest autograft is currently the gold standard material for spinal fusion. However, its use is limited by additional operative time, increased blood loss, and morbidity. Recently, a synthetic osteoconductive bone graft material composed of bioactive glass has been described, with high effectiveness in animal models.

Video-assisted thoracoscopic surgery (VATS) for the treatment of scolioticrib hump deformity.

A retrospective study of 21 patients with idiopathic scoliosis who underwent endoscopic thoracoplasty was done. The objective of the study was to report and assess the morbidity and mid term outcomes of video-assisted thoracoplasty in idiopathic scoliosis. Patients with idiopathic scoliosis often present cosmetic complaints due to their rib deformity.

Jackson's intrasacral fixation in the management of high-grade isthmic spondylolisthesis.

The aim of this study is to describe a surgical procedure proposed for high-grade isthmic spondylolisthesis, with intraoperative reduction using Jackson's intrasacral fixation. The procedure is performed using a single posterior approach. The intraoperative correction of the deformity is obtained by sacral dome resection and reduction of the lumbosacral kyphosis using Jackson's fixation to rotate the sacrum.

Long-term prognosis of Salter-Harris type 2 injuries of the distal femoral physis.

The objective of this study was to assess long-term sequelae of Salter-Harris type 2 injuries on growth of the distal femoral physis. A retrospective study of 20 patients with Salter-Harris type 2 distal femoral injuries, who were managed between 1994 and 2003, was carried out. The average period of follow-up was 4 years and 2 months.

Kinematic analysis of the upper limb: a useful tool in children with cerebral palsy.

Upper limb involvement in cerebral palsy is usually more complex than lower limb involvement. Each child has a specific brain lesion and the clinical pattern is highly variable. Current clinical methods of assessment do not fully evaluate the kinematic activity during simple activities of daily life.

Aneurysmal bone cysts in children: complications of fibrosing agent injection.

Purpose: To report complications of direct fibrosing agent injection in the treatment of aneurysmal bone cysts (ABCs) in children.

Materials And Methods: The authors retrospectively analyzed all cases of ABCs treated with direct fibrosing agent injection (Ethibloc; Ethnor Laboratories, Ethicon, Noderstedt, Germany) at Robert Debré Hospital since 1994. Histologic diagnosis was assigned by means of surgical biopsy findings prior to treatment.

Buruli's ulcer: three cases diagnosed and treated in France.

The authors report three cases of skin ulcer, called Buruli's ulcer. This is a tropical disease, caused by Mycobacterium ulcerans. The diagnosis is often belated, because the infection is rare in Europe.

Congenital high scapula.

Congenital high scapula is also known as Sprengel's deformity. The elevation of the scapula is accompanied by its rotation to a varus position. A series of 19 cases is presented, with 4 bilateral cases.