The early detection and management of unstable concentric closed reduction of DDH with percutaneous K-wire fixation in infants 6 to 12 months of age.

Background: In some infants with developmental dysplasia of the hip, concentric closed reduction, although initially achievable, cannot be maintained even by casting because of a deficient posterior acetabular wall. Usually, these hips will redislocate in the cast and a rereduction will be necessary, often requiring an open reduction subsequently.

Methods: A 3-year retrospective review of 88 infants, (M/F; 14/74) 6 to 12 months of age with 124 dislocated hips, was conducted to assess the efficacy of percutaneous Kirschner wire fixation in achieving permanent hip stability.

Treatment and outcome of vertebral Langerhans cell histiocytosis at the Children's Hospital of Eastern Ontario.

Background: We wished to evaluate the treatment methods for vertebral Langerhans cell histiocytosis (LCH) (a rare reticuloendothelial disorder) at a tertiary care pediatric centre and compare treatment and outcomes with those reported in the recent literature.

Methods: A total of 55 charts were retrieved between 1980 and 2003 for children with LCH. Only those children who were under 18 years of age, had a diagnosis of LCH, histiocytosis X or eosinophilic granuloma and had documented vertebral involvement were included.

Injuries associated with fracture of the femur secondary to motor vehicle accidents in children.

A retrospective review of the medical records of 149 children < 18 years old who sustained femur fractures secondary to a motor vehicle accident found 159 fractured femurs; 89.3% were closed. One hundred seventy-nine associated injuries occurred in 87 patients (58.

Analysis of a school bus collision: mechanism of injury in the unrestrained child.

Introduction: The most common type of school bus crash resulting in injury and death involves the "rollover" mechanism, which may be linked to bus design. To investigate this possibility, we carried out a detailed investigation of a severe school bus crash.

Methods: The crash involved 12 children, passengers in the school bus.

Triple major curves in children.

Introduction: The predominant classification systems for scoliosis have been based either on etiology or curve pattern. Traditionally triple curves have not been included in either classification system.

Methods: We reviewed the records of all children with an idiopathic triple scoliotic curve seen between 1988 and 2001 at the Children's Hospital of Eastern Ontario, Ottawa, a major pediatric referral centre.

Necrotizing fasciitis secondary to chickenpox infection in children.

Background: Necrotizing fasciitis is an uncommon but serious complication of chickenpox infection in young children. Because many of these infections affect the musculoskeletal tissues, orthopedic surgeons are often the first caregivers to be involved in diagnosis and treatment. Our objective was to review the diagnostic features of necrotizing fasciitis and analyze treatment methods to control and eradicate the musculoskeletal infection.

Orthopaedic manifestations of campomelic dysplasia.

Campomelic dysplasia is a rare form of congenital dwarfism associated with potentially fatal respiratory insufficiency. There are several types of campomelic dysplasia; however, it is characterized by the presence of anteriorly bowed tibias with cutaneous dimpling, anterolaterally bowed femurs, thoracic kyphoscoliosis, hypoplastic scapulas, and absence or delayed ossification of thoracic pedicles. With improving treatment of respiratory insufficiency, the survival rate of affected infants has increased, thereby necessitating treatment of the musculoskeletal malformations to prevent additional morbidity.

Multiple trauma in children: predicting outcome and long-term results.

Objective: To analyze the management of pediatric trauma and the efficacy of the Pediatric Trauma Score (PTS) in classifying injury severity and predicting prognosis.

Design: A retrospective case series.

Setting: The Children's Hospital of Eastern Ontario, a major pediatric trauma centre.