Anterior Distal Tibial Guided Growth for recurrent equinus deformity in idiopathic Congenital Talipes Equinovarus treated with the Ponseti method.

Introduction: Distal Anterior Tibial Guided Growth has been shown to be useful to correct recurrent equinus deformity after open surgical release for Congenital Talipes Equinovarus. This has not been evaluated in a recurrence after use of the Ponseti method, where soft tissue releases are currently understood as the mainstay of treatment.

Methods: Patients with recurrence of equinus component of CTEV, who underwent DATGG with at least 6-month follow-up were identified retrospectively.

Loss of cardiac myosin light chain kinase contributes to contractile dysfunction in right ventricular pressure overload.

Nearly 1 in every 100 children born have a congenital heart defect. Many of these defects primarily affect the right heart causing pressure overload of the right ventricle (RV). The RV maintains function by adapting to the increased pressure; however, many of these adaptations eventually lead to RV hypertrophy and failure.

A systematic review of total arthroplasty and arthrodesis for end-stage hallux rigidus: A biomechanical perspective.

Background: Both arthrodesis and total arthroplasty are acceptable surgical options for end stage hallux rigidus without significant angular deformity. Total arthroplasty preserves first metatarsophalangeal joint (MTPJ) motion, which may help restore a more physiological gait pattern.

Research Question: Is there a difference in the findings of gait studies after 1st MTPJ total arthroplasty or arthrodesis for end-stage hallux rigidus?

Methods: PRISMA guidelines were followed to conduct a systematic review of literature for studies reporting gait analysis after the above procedures.

Attaining a British consensus statement on managing idiopathic congenital talipes equinovarus (CTEV) through a Delphi process: a study protocol.

Introduction: Idiopathic congenital talipes equinovarus (CTEV) is the most common congenital limb deformity. Non-operative intervention using the Ponseti method has shown to be superior to soft tissue release and has become the gold standard for first-line treatment. However, numerous deviations from the Ponseti protocol are still reported following incomplete correction or deformity relapse.

Retrograde Fixation of the Ulna in Pediatric Forearm Fractures Treated With Elastic Stable Intramedullary Nailing.

Introduction This study analyzes the outcomes of retrograde fixation of the ulna in pediatric forearm fractures treated with elastic stable intramedullary nailing (ESIN). Materials and Methods A retrospective analysis was conducted by reviewing patient records of forearm fractures treated with ESIN by retrograde fixation. The study included 30 children (26 boys and 4 girls).

Prospective Early Clinical, Radiological, and Kinematic Pedobarographic Analysis Following Subtalar Arthroereises for Paediatric Pes Planovalgus.

Introduction Arthroereises implants mechanically block eversion and limit subtalar motion. They are used in children with pes planovalgus in order to correct the valgus deformity. In this study, we aimed to objectively assess children with flatfoot before and after the insertion of the Kalix II implant, clinically, radiologically and by kinematic pedobarographic analysis.

Outcome following first metatarsophalangeal joint replacement using TOEFIT-PLUS™: A mid term alert.

Background: We aim to evaluate the mid-term results of first metatarsophalangeal joint replacement for hallux rigidus using Toefit-Plus™ in a single surgeon series.

Methods: We prospectively studied the outcomes of 86 toes in 73 patients using the AOFAS-HMI score and radiological follow up. The mean follow up was 33 months (2-72).

Case report of pigmented villonodular synovitis arising from the calcaneocuboid joint in a 12 year old male.

Introduction: Pigmented villonodular synovitis (PVNS) is a benign proliferative disorder of the synovium of unknown aetiology. It usually presents in adults between the ages of 30 and 40 years of age and is rare in the paediatric population. In the literature, there are a total of 43 cases of PVNS affecting the paediatric population and only one case affecting the calcaneocuboid joint.

Distal metatarsal synostosis: a case report.

We report a rare case of distal metatarsal synostosis of the 4th and 5th metatarsals in an 11 year old male. He was referred with forefoot pain. Clinical examination and radiographs have confirmed an osseous connection of the distal 4th and 5th metatarsal.

Early results of first metatarsophalangeal joint replacement using the ToeFit-Plus™ prosthesis.

The aim of the present study was to investigate the outcomes of first metatarsophalangeal replacement for hallux rigidus using the Smith & Nephew ToeFit-Plus™ implant. We assessed the outcomes of 69 first metatarsophalangeal joint replacements using the American Orthopaedic Foot and Ankle Society score preoperatively and annually postoperatively, with retrospective radiologic review. All operations were performed by the same surgeon within 2 centers.

Legg-Calvé-Perthes: interobserver and intraobserver reliability of the modified Herring lateral pillar classification.

Background: The purpose of our study was to independently assess the reliability of the modified Herring lateral pillar classification.

Methods: Thirty-five standardized true anteroposterior radiographs of children in the fragmentation phase were independently assessed by 6 senior observers on 2 separate occasions (6 wk apart). The κ analysis was used to assess the interobserver and intraobserver agreement.

Elastic stable intramedullary nailing for displaced proximal humeral fractures in older children.

Purpose: To demonstrate the effectiveness of intramedullary fixation of severely displaced proximal humeral physeal fractures in skeletally immature children using the elastic stable intramedullary nail (ESIN).

Methods: Retrospective recruitment of 14 patients aged 10-15-years old with severely displaced proximal humeral physeal fractures between 1999 and 2004 in a single regional specialist paediatric orthopaedic hospital. The fractures were graded using the Neer classification; severe displacement constituted Neer II-IV or displacement >1 cm and angulation >45 degrees .

Ten- to twelve-year follow-up of the furlong hydroxyapatite-coated femoral stem and threaded acetabular cup in patients younger than 65 years.

We reviewed 82 patients who had 92 primary Furlong uncemented hydroxyapatite (HA)-coated total hip replacements inserted between 1988 and 1992. All patients had the Furlong HA-coated stem and screw in acetabular cup with a 28-mm alumina oxide ceramic modular head. The mean age at the time of primary total hip arthroplasty was 54 years (range, 31-67 years).

Does smoking affect the quality of bone regenerate in paediatric limb reconstructive surgery?

Purpose: To bring to the attention of the orthopaedic fraternity that adolescent children smoke and this has an adverse effect on the bone regenerate during limb deformity corrective surgery.

Methods: Retrospective review of patients undergoing limb deformity corrective surgery with a prolonged frame time and bone-healing index. Patients operated on between 1993 and 2005 in a single regional specialist paediatric orthopaedic hospital.

Contralateral slip prediction in slipped capital femoral epiphysis: is bone age the answer?

Prophylactic pinning of an asymptomatic hip in Slipped Capital Femoral Epiphysis (SCFE) is controversial. Bone age has been used as a predictor of future contralateral slip risk and also in the decision making for prophylactic intervention. The efficacy of bone age at predicting a contralateral slip was tested in this study.

Head-at-risk signs in Legg-Calvé-Perthes disease: poor inter- and intra-observer reliability.

Background: The head-at-risk signs are used as prognostic indicators in Legg-Calvé-Perthes disease. These signs have been assessed only once regarding inter-observer reliability, however. Intra-observer reliability seems not to have been studied to date.

No need for outpatient physiotherapy following total knee arthroplasty: a randomized trial of 120 patients.

Background: We have not found any reports on the effect of physiotherapy after knee replacement.

Patients And Methods: In a prospective randomized controlled trial, we randomized two groups to receive or not receive outpatient physiotherapy following total knee arthroplasty. 120 patients were recruited over 2 years, each followed up for 1 year.

Floating lesser metatarsals associated with Lisfranc type C--total displacement injury.

We present a 30-year-old woman with a complex foot injury including floating lesser metatarsals, an intact base of second metatarsal and an irreducible fifth metatarsophalangeal joint. The recognition of potential associated injuries together with a Lisfranc fracture-dislocation must not be overlooked.