Fractures and refractures after femoral locking compression plate fixation in children and adolescents.

Background: Locking compression plates (LCPs) are being increasingly utilized in fixation of fractures and osteotomies in the pediatric population. However, plate insertion or removal may pose a risk of femoral fractures or refractures. The goal of this study was to analyze failure patterns associated with LCPs and identify possible contributing factors.

Short-term after-effect of forearm cast removal in children.

Purpose: To investigate the sensation in the hand after forearm cast removal in children.

Methods: The study group included 33 consecutive children who were treated nonoperatively for a forearm fracture at our center over a 1-year period. The children were asked to report any sensation in the ipsilateral hand after cast removal, and the findings were analyzed against background and fracture-related data.

Postaxial type B polydactyly treated by excision in the neonatal nursery.

Background: Postaxial type B polydactyly is characterized by the presence of a rudimentary extra digit on the small finger side attached by a soft tissue stalk. The recommended treatment is ligation in the neonatal nursery. The purpose of this study was to evaluate the result of excision of the supernumerary digit under topical anesthesia.

Chronic osteomyelitis in children: treatment by intramedullary reaming and antibiotic-impregnated cement rods.

Background: Chronic osteomyelitis (CO) is rarely encountered in developed countries and is especially rare in children and adolescents. However, on occurrence, it can pose a difficult therapeutic challenge necessitating a combination of aggressive surgical treatment and prolonged antibiotic administration.

Methods: Four patients were treated for CO in the Pediatric Orthopaedic Unit at Schneider Children's Medical Center between June 2005 and December 2006 and were reviewed retrospectively.

Intraoperative C-arm radiation affecting factors and reduction by an intervention program.

Background: The increase in the utilization of fluoroscopy during surgical procedures carries with it an inherent increase in the exposure of both patients and surgical staff to ionizing radiation. The purpose of this study was to examine the ability to reduce radiation doses by the implementation of an intervention program targeted at the staff operating the fluoroscopy machinery and attempting to make a behavioral change in its utilization.

Methods: (1) Fluoroscopy technique was optimized after a series of simulation fluoroscopies.

Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates.

Background: We describe a new method for corrective osteotomy and the fixation of lower limb deformities in children.

Methods: Following osteotomy, the desired position is obtained and temporarily stabilized using an external fixator. Definitive fixation is performed with a plate and locking screws inserted percutaneously under fluoroscopic guidance.

Children's daily living activities during immobilization of upper-limb fractures with an above- or below-elbow cast.

Background: The purpose of this prospective study was to assess the impact of cast immobilization on the activities of daily living in children with fractured upper limbs.

Methods: Using the Activities Scale for Kids (ASK), 52 consecutive children (17 girls, 35 boys), aged 5-15 years (mean, 9 years), with upper limb fractures treated by means of above- or below-elbow casts were assessed. The files were reviewed for background and fracture-related data.

Are frequent radiographs necessary in the management of closed forearm fractures in children?

Introduction: A prospective pooled case series was used to assess the value of frequent radiographic examinations during treatment of closed forearm fractures in children from major university pediatric medical centers in Israel and China.

Methods: The sample consisted of 202 consecutive children (mean age 7 years; range 3-12 years) with closed forearm fractures treated nonoperatively. Children with open, growth-plate fractures or fractures associated with dislocation of the nearby joint (i.

Treatment of severe early onset Blount's disease by an intra-articular and a metaphyseal osteotomy using the Taylor Spatial Frame.

Purpose: Severe Blount's disease results in a multiplanar deformity of the lower limb. The mechanical axis is disrupted, there is a rotational deformity, and also shortening of the limb. A depression of the medial tibial plateau causes joint incongruity and instability.

Correction of lower limb deformities in children with renal osteodystrophy by the Ilizarov method.

Background: Children with renal osteodystrophy (ROD) may develop severe angular deformities of the limbs. Various methods, both medical and surgical, have been described for correction of these deformities, but a literature search showed only 1 child previously treated by the Ilizarov method. The purpose of this study was to characterize the deformities found in our group of patients and to describe our experience in treating these patients with the Ilizarov method.

Botulinum toxin for the treatment of spasticity in children: attainment of treatment goals.

Forty patients (mean age 5 years) with a spastic disorder treated by botulinum injections (53 sessions) were evaluated for functional outcome in terms of achievement of their individual predetermined goals of treatment, rated on a modified Goal Attainment Scale from 1 (worsening function) to 4 (improved gross motor function). At the 2-week follow-up, 40% had a score of 1, 33% a score of 2, and 13% a score of 3; 12% showed no functional change. Botulinum treatments failed to significantly improve the gross motor function in this patient group.

Normal range of fetal finger movements.

A congenital limitation of finger movements is associated with many syndromes that interfere with child well-being. The normal range of fetal finger movements during the second and third trimester is unknown. The aim of this study was to measure the normal range.

Ossification of femoral head: normal sonographic standards.

The aim of the study was to establish normal reference standards for the appearance of the femoral head ossification center according to age, sex, and gestational age. Sonographic examination of the hip was performed in 1,800 healthy Indian and Israeli infants (900 each) aged 2 to 24 weeks. There were an equal number of boys and girls.