Defining ulnar variance in the adolescent wrist: measurement technique and interobserver reliability.

Purpose: The measurement technique for ulnar variance in the adolescent population has not been well established. The purpose of this study was to assess the reliability of a standard ulnar variance assessment in the adolescent population.

Methods: Four orthopedic surgeons measured 138 adolescent wrist radiographs for ulnar variance using a standard technique.

Open surgical treatment of posttraumatic elbow contractures in children.

Posttraumatic elbow stiffness in children can be a severe obstacle to accomplishing basic activities of daily living, including dressing, and participating in recreational activities. The etiology of this stiffness is typically extrinsic or instrinsic pathology caused by an earlier supracondylar humerus fracture, elbow dislocation, or elbow fracture-dislocation. Children with functional limitations, typically associated with flexion contractures greater than 30 degrees or less than a functional arc (30 to 130 degrees) can benefit from surgical contracture release, which consistently improves range of motion.

Surgical correction of clinodactyly: two straightforward techniques.

Clinodactyly, a deviation of the thumb or finger in the coronal plane, is rarely functionally limiting and in most cases is treated nonoperatively. Those with functional limitations, typically associated with angulation greater than 25 degrees, may benefit from surgical correction. We have used 2 different surgical procedures, a physiolysis in younger children and an opening-wedge osteotomy in older children, to manage this deformity in selected children with a functional limitation.