Frontal plane and sagittal plane balance following Cotrel-Dubousset instrumentation for idiopathic scoliosis.

Postoperative decompensation has been reported following Cotrel-Dubousset instrumentation for right thoracic idiopathic scoliosis. The authors examined balance in the frontal and sagittal planes in 53 patients to determine optimal levels for fusion. King et al Type II curves, particularly larger ones, shifted to the left when the thoracic curve was fused to the stable vertebra or just below.

Parent involvement in physical therapy: a controversial issue.

Children with physical disabilities are often treated in physical therapy without a parent present, under the assumption that the parent may "interfere" with therapy and/or the child will be too distracted if a parent is present. The effectiveness of a therapy program with parental involvement was compared to a program without parents involved. Results indicate that training with the mother present was as effective as training without the mother.

One-stage treatment of congenital dislocation of the hip in older children, including femoral shortening.

We reviewed the results of primary operative treatment in twenty-five patients (thirty-three hips) who were two years or older and had congenital dislocation of the hip. None of the patients had had previous treatment for the dislocation. Preliminary traction was not used in any patient.

Monostotic fibrous dysplasia of the lumbar spine: case report and review of the literature.

Fibrous dysplasia has been frequently reported to involve the spine in the polyostotic form, but only rarely has monostotic fibrous dysplasia been noted. In the only previously reported case involving the lumbar spine, the disease was confined to the transverse process. The present case demonstrates monostotic fibrous dysplasia involving the vertebral body in addition to the posterior elements.

Cotrel-Dubousset instrumentation in idiopathic scoliosis. A preliminary report.

This is a preliminary report on Cotrel-Dubousset (CD) instrumentation for the surgical management of idiopathic thoracic scoliosis. From September 1985 through April 1986, 37 patients were treated at the authors' hospital, by posterior spinal fusion with CD instrumentation. Twelve patients had surgical treatment of spinal deformity associated with other disorders or had revision surgery.

The posterior tether in scoliosis.

The hypothesis that a localized lordosis, or tethering of the posterior elements of the spine, is the primary cause of the vertebral rotation in idiopathic scoliosis was investigated in anatomic specimens of human and calf spinal columns. The specimens were axially loaded with and without a posterior tether created using Zielke instrumentation. Lateral deflection and axial rotation were monitored roentgenographically.

Mechanical testing of spinal instrumentation.

Clinically, implant failure is often the result of fatigue from continuous cyclic loading. Because of the inadequacies of long-run cyclic testing, fatigue susceptibility of implants was investigated by means of strain measurements and stress analysis under physiologic loads. The implants were equipped with strain gauges during load-deformation testing, and the tensile stress (the component of stress-producing fatigue failure in metals) was calculated for that site on the implant.

Lumbar Scheuermann's. A clinical series and classification.

Scheuermann's disease of the thoracic spine is a well-defined entity, although its exact etiology is unknown. In the thoracolumbar or lumbar spine however, the criteria are much less strict for the application of this eponym. A retrospective review of all the cases of lumbar Scheuermann's disease seen at the Texas Scottish Rite Hospital revealed two distinct radiographic pictures.

Disarticulation of the knee in children. A functional assessment.

We assessed the functional abilities of six patients who had had disarticulation of nine knees during childhood by analyzing their gait using electrocardiographic telemetry. Those who were more than five years old were further studied by timing them as they ran the fifty-yard (45.7-meter) dash and by testing the strength of the musculature of the hip girdle using a Cybex dynamometer.

Spinal deformity in Marfan syndrome.

Fourteen patients with classic Marfan syndrome and spinal deformity treated at Texas Scottish Rite Hospital for Crippled Children (Dallas, TX) after 1975 have been conservatively treated to maturity or are at least 2 years after spinal fusion. Brace treatment was successful in one of nine patients. Nine patients underwent fusion.

Fibular transfer for congenital absence of the tibia: a reassessment.

Six children (nine limbs) underwent fibular centralization for complete paraxial tibial hemimelia. The preoperative, intraoperative, and postoperative criteria as described by Brown (J Bone Joint Surg [Am] 1965; 47:695-704) were strictly met. At initial postoperative evaluation, three limbs had active knee extension, and five limbs had minimal flexion contractures.