This article aims to describe a multicenter cohort of atypical triplane ankle fractures with intramalleolar involvement of the epiphysis, providing insights into the affected population, treatment outcomes, and complications. In addition, we propose a treatment strategy for such fractures based on our findings. A retrospective analysis was conducted on adolescent patients diagnosed with triplane ankle fractures.
View Article and Find Full Text PDFForearm fractures involving both bones are prevalent among pediatric patients. Elastic stable intramedullary nailing (ESIN) is an excellent option for forearm fractures that require surgical stabilization in children and adolescents. Proximal third fractures can be particularly challenging to reduce using closed techniques, and multiple unsuccessful attempts at nail insertion can increase the risk of compartment syndrome.
View Article and Find Full Text PDFProximal humerus fractures account for approximately 3 to 5% of all pediatric-adolescent fractures, with a higher incidence observed in older children, particularly between the ages of 10 and 15 years. Non-displaced or minimally displaced fractures can often be treated conservatively. However, the management of displaced or unstable proximal humerus fractures in adolescents may involve surgical intervention, with closed reduction and percutaneous pinning (CRPP) being commonly employed techniques.
View Article and Find Full Text PDFBackground: This study aimed to review the clinical, radiographic, and magnetic resonance imaging (MRI) outcomes of osteochondral autograft transplantation applied to patellar cartilage lesions of patients under 18 years of age.
Methods: Data from nine consecutive patients were retrospectively analyzed for indications, preoperative complications, and clinical-radiographic outcomes. Patients were clinically evaluated using the Pedi-IKDC and Lysholm scores.
Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration.
View Article and Find Full Text PDFPatellofemoral instability (PFI) is a common disorder in children and adolescents. Surgical stabilization of the patella poses challenges in skeletally immature patients due to anatomical peculiarities at this stage, leading to the absence of an established standard reconstruction technique. Recently, there has been a notable interest in the medial patellofemoral complex (MPFC), encompassing the medial patellofemoral ligament (MPFL) and the medial quadriceps tendon femoral ligament (MQTFL), owing to their role in restricting lateral patellar displacement.
View Article and Find Full Text PDFAmniotic band syndrome (ABS) and clubfoot are distinct congenital musculoskeletal conditions that can occasionally co-occur, creating unique challenges in their management. This paper summarizes the comprehensive discussion on the management of amniotic band syndrome (ABS) and clubfoot, emphasizing the critical role of the Ponseti method and the challenges faced in treatment, thereby providing a basis for further research and improved patient care.
View Article and Find Full Text PDFIntroduction: there is scarce information on meniscal repair in the paediatric population in terms of outcomes of this technique. The aim of this study was to evaluate the clinical outcomes and complications of meniscal repair in paediatric population with isolated lesions, associated with ACL rupture and discoid meniscus with unstable lesions.
Material And Methods: data from 78 patients 18 years of age, with arthroscopic diagnosis of isolated meniscal lesion, associated with ACL tear or discoid meniscus, in whom arthroscopic repair was performed, were retrospectively analyzed for demographic characteristics, surgical technique, and perioperative complications.
Introduction: our aim was to evaluate the clinical outcomes and complications of anterior tibialis tendon transfer (ATTT) in children with dynamic supination after clubfoot treatment.
Material And Methods: children with dynamic supination after initial treatment with Ponseti method or surgery who underwent ATTT between 2008 and 2020 were included for evaluation. Demographic data, previous treatment, associated procedures and fixation method were analyzed.
Acta Ortop Mex
February 2024
Complex clubfoot is a term used to describe a subset of patients that received previous treatment, and have distinctive anatomical features: severe equinus, with short first metatarsal, hyperextended big toe, severe plantar flexion of all metatarsals and deep folds through the sole of the foot and above the heel. Most complex clubfeet appear to be idiopathic and is usually associated with a poor casting technique. Complex clubfoot requires an early recognition and an adjustment of the casting protocol using the four finger Ponseti technique.
View Article and Find Full Text PDFBackground: There is a higher rate of failure of isolated MPFL reconstruction in skeletally immature patients with patellar instability compared to skeletally mature patients. Genu valgum is a known risk factor for patellar instability. There is potential for concomitant surgical correction of genu valgum to achieve better clinical outcomes and to decrease failure rates of MPFL reconstruction.
View Article and Find Full Text PDFRev Bras Ortop (Sao Paulo)
December 2023
To review knee magnetic resonance imaging (MRI) scans for the analysis of the location of neurovascular structures (NVSs), and to define the risk of bicortical fixation. Distances between the posterior cortex and the popliteal NVSs were measured on the MRI scans of 45 adolescents (50 knees) at 3 levels (C1: center of the proximal tibial epiphysis; C2: 10 mm distal to the physis; and C3: 20 mm distal to the physis). The NVSs located between 5 mm and 10 mm from the incision were considered in a zone of moderate risk for damage, while those less than 5 mm from the incision were considered in a zone of high risk for damage, and those more than 10 mm from the incision were considered to be in a zone of low risk for damage.
View Article and Find Full Text PDFObjectives: Lateral humeral condyle fractures account for 12% to 17% of all distal humerus fractures in children, and usually occur as an isolated injury or are associated with radial neck and/or proximal ulna fractures. The presentation with a concomitant dislocation of the elbow is rare. Therefore, literature on young patients with this uncommon combination is sparse and mostly limited to case reports and small case series.
View Article and Find Full Text PDFThis study aimed to describe the femoral groove morphology using ultrasound in children under 6 months, estimate the incidence of trochlear dysplasia, and evaluate associated risk factors. A prospective study included 298 patients who underwent universal ultrasound screening for hip dysplasia [developmental dysplasia of the hip (DDH)] and knee ultrasound. Measurements of sulcus angle (SA), trochlear depth (TD), and trochlear facet asymmetry (TFA) were analyzed.
View Article and Find Full Text PDFA spontaneous rupture of the extensor pollicis longus (EPL) tendon after a fracture of the distal radius is a known complication in adults. In contrast, there are a paucity of reports concerning EPL tendon ruptures in children and adolescents. The authors present a case of a spontaneous rupture of the EPL tendon in a 15-year-old girl after a non-displaced distal radius fracture.
View Article and Find Full Text PDFOsteochondral lesions of the talus (OLTs) are defined as damage to the talar cartilage, with pathological changes in the underlying bone. They include a group of injuries that involve juvenile osteochondritis dissecans (JOCD) and osteochondral fractures of the talus. The etiology of OLT remains not fully clarified but is more common in young and active patients.
View Article and Find Full Text PDFObjectives: The primary objective of the present study is to compare the radiographic outcomes and complications of two different techniques for lateral closing-wedge osteotomy in pediatric patients with cubitus varus.
Methods: We retrospectively identified patients treated at five tertiary care institutions: 17 underwent the Kirschner-wire (KW) technique, and 15 patients were treated with the mini external fixator (MEF) technique. Demographic data, previous treatment, pre- and postoperative carrying angle (CA), complications and additional procedures were recorded.
Acta Ortop Mex
December 2022
Fractures about the knee are common in children and adolescents. Characteristics of the growing skeleton make children susceptible to specific fractures that do not occur in adults. Understanding the relevant anatomy, pathophysiology, diagnosis, and treatment options are important to decrease the risk of complications.
View Article and Find Full Text PDFThe aim of this study was to assess which femoral fixation site, distal to the physis, most closely emulates the native medial patellofemoral ligament (nMPFL) length relationship in the pediatric knee. Lateral knee radiographs were taken incrementally, from 0° to 120° of flexion. The femoral origin of the nMPFL and 3 other MPFL femoral fixation sites distal to the physis were identified (P1, 1 cm distal to physis along the posterior femoral cortex; P2, 2 cm distal to physis along the posterior femoral cortex; P3, 1 cm distal and 1 cm anterior).
View Article and Find Full Text PDFBackground: Lateral humeral condyle fractures are the second most common fracture around the elbow in children. However, the association of an elbow dislocation is a rare entity. Therefore, literature on young patients with this uncommon combination is sparse.
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