The shorthand bone age assessment: a simpler alternative to current methods.

Background: Radiographic assessment of skeletal age in pediatric patients is a common practice among orthopaedic surgeons. Current methods of assessment remain labor intensive and require special resources. This study sought to investigate a novel, abridged method of bone age assessment that may serve as a simpler and more efficient alternative to the current standard.

Long-term magnetic resonance imaging follow-up demonstrates minimal transitional level lumbar disc degeneration after posterior spine fusion for adolescent idiopathic scoliosis.

Study Design: Retrospective cohort study.

Objective: To describe long-term clinical and imaging results focusing on the uninstrumented lumbar spine after posterior spinal fusion for adolescent idiopathic scoliosis.

Summary Of Background Data: Although previous studies found rates of low back pain after long fusion for adolescent idiopathic scoliosis which are comparable to rates found in the general population, many surgeons believe that the long lever arm associated with the fusion mass will result in increased stress at uninstrumented caudal intervertebral discs and accelerated degenerative changes.

Bone mineral density determinations by dual-energy x-ray absorptiometry in the management of patients with Marfan syndrome--some factors which affect the measurement.

Reduced bone mineral density (BMD) was sporadically reported in patients with Marfan syndrome. This may or may not place the Marfan patient at increased risk for bone fracture. In comparing the BMDs of our patients with those reported in the literature, it seemed that agreement between values, and hence the degree of osteoporosis or osteopenia reported, was dependent on the instrumentation used.

The relationship between developmental dysplasia of the hip and congenital muscular torticollis.

Multiple studies report a correlation between congenital muscular torticollis (CMT) and developmental dysplasia of the hip (DDH) at a rate between 2% and 29%. Most of these studies were completed before the routine use of hip ultrasound. This study assesses the incidence of DDH in a referral population with CMT and the incidence of CMT in a referral population with DDH.

The treatment of large (>70 degrees) thoracic idiopathic scoliosis curves with posterior instrumentation and arthrodesis: when is anterior release indicated?

Study Design: Retrospective clinical study from 2 centers.

Objective: To analyze the efficacy of posterior instrumentation and arthrodesis for thoracic idiopathic scoliosis curves more than 70 degrees.

Summary Of Background Information: The increasing use of thoracoscopic techniques in deformity surgery has led several investigators to advocate anterior release followed by posterior instrumentation when treating "stiff" thoracic curves 60 degrees-70 degrees.

Not all spondylolisthesis grading instruments are reliable.

Spondylolisthesis is the slippage of one vertebral body on an adjacent level, and occurs commonly at the lumbosacral junction in children. Many radiographic measurement instruments have been described to predict progression and need for intervention. We evaluated the reliability of eight common grading instruments.

Radical soft-tissue release of the arthrogrypotic clubfoot.

The purpose of this study was to evaluate the results of primary radical soft-tissue release of arthrogrypotic clubfeet in children less than 1 year of age. We performed a retrospective review of six patients (12 feet) who underwent radical release of clubfoot deformity. Primary surgery was performed at an average of 7.

Scheuermann kyphosis: safe and effective surgical treatment using multisegmental instrumentation.

Study Design: A retrospective review was conducted on 23 consecutive patients who underwent surgical correction of Scheuermann kyphosis using modern multisegmental instrumentation.

Objective: To evaluate Scheuermann kyphosis correction and complication rates.

Summary Of Background Data: The surgical treatment of Scheuermann kyphosis remains a topic of debate.

Sports participation of children with Down syndrome.

Patients with Down syndrome, by virtue of ligamentous laxity, are prone to a number of orthopedic problems with potentially serious sequelae. These disorders need to be evaluated throughout childhood and, when detected, appropriately managed. Given such management, the child with Down syndrome should be able to participate actively in and derive benefits from sports activities.

Assessment of bone mineral density in adults and children with Marfan syndrome.

Recent studies indicate that decreased bone mineral density (BMD) occurs in the spine, femoral necks and greater trochanters of some adults and children with Marfan syndrome. Because there is uncertainty regarding the BMD status of patients with Marfan syndrome, we undertook an analysis of BMD in both adults and children with Marfan syndrome. Dual energy X-ray absorptiometry analysis was performed on a convenience sample of 51 patients (30 adults and 21 children) with diagnosed Marfan syndrome from 1993 to 2000.

Pancreatitis after surgery in adolescent idiopathic scoliosis: incidence and risk factors.

Acute pancreatitis has been documented as a postoperative complication in both the general surgery and orthopaedic literature. The etiology of pancreatitis in the postoperative orthopaedic population is not clear. The purpose of this study was to determine the incidence and possible predisposing factors for acute pancreatitis after scoliosis surgery in adolescent patients.