Developmental Dysplasia of the Hip - Part 1.

Developmental dysplasia of the hip (DDH) is a condition characterized by changes in joint formation within the last months of intrauterine life or the first months after birth. Developmental dysplasia of the hip presentation ranges from femoroacetabular instability to several stages of dysplasia up to complete dislocation. Early diagnosis is essential for successful treatment.

The Baumann Angle: An Analysis from Theory to Practice.

 To analyze how the Baumann angle (BA) is affected by inadequate radiographic inclinations.  The study was performed from radiographs of the distal humerus of children aged 3 to 10 years. The BA measurements performed by five observers were compared, and each radiograph was evaluated for its quality as "adequate" or "inadequate.

Growth modulation for angular knee deformities: a practical guideline.

Purpose Of Review: This study aimed to review the established concepts and advances related to growth modulation for treating knee angular deformities. Although they are considered well tolerated procedures, careful indications and accurate techniques are necessary to ensure good results.

Recent Findings: In addition to general clinical and radiographic evaluations, new tools such as two-dimensional low-dose radiography and gait analysis have been used to clarify angular and torsional combinations and the impact of mild angulations on the knee joint.

The trochlear physeal line angle: a novel method to assess coronal plane alignment of the paediatric distal humerus.

Supracondylar humeral fractures account for 60% of elbow fractures in childhood, with cubitus varus being its most common complication. It can be avoided by accurate assessment of distal humeral alignment after fracture reduction, and the Baumann angle is the usual measurement for this purpose. However, several reports demonstrate an inconsistency of this angle, and our hypothesis is that reliability could be improved with angles drawn between the trochlear physeal line and the humeral longitudinal axis.

Percutaneous hemiepiphysiodesis using transphyseal screws for adolescent tibia vara.

Hemiepiphysiodesis around the knee is becoming the mainstay procedure in adolescents for a wide range of aetiological deformities, when considering adolescent tibia vara (ATV), the published series have variable results. The purpose of this study was to review our experience with the percutaneous transphyseal screw (PETS) in these patients followed until bone maturity. We analysed the charts from 13 patients (20 knees) that underwent lateral tibial hemiepiphysiodesis using PETS.

Medial hip arthroscopy portals: a novel approach for hip pathologies. Is it feasible?

Purpose: To report 3 patients operated on using medial hip arthroscopic portals, describe the surgical technique and clinical outcomes.

Methods: Three medial portals were made, the first one at the posterior edge of the adductor longus muscle (posterior medial portal), the second one at the anterior (anterior medial portal) and the third at the posterior border of the adductor longus, 5 cm distal to the inguinal crease (distal posterior medial portal). The first case was an 8-year-old boy with a lytic lesion at the posteromedial region of the femoral neck suggestive of sub-acute osteomyelitis.

PELVIC INJURY IN CHILDHOOD: WHAT IS ITS CURRENT IMPORTANCE?

Objective: The purpose of this study was to assess the importance of pelvic fractures in childhood by analyzing epidemiological characteristics and associated injuries.

Methods: This is a retrospective study performed between 2002 and 2012 at two trauma referral centers in São Paulo. We identified 25 patients aged 16 years old or younger with pelvic fracture.

Chronic slipped capital femoral epiphysis: a radiographic evaluation of the Southwick osteotomy.

The aim of this study was to evaluate the radiographic correction and the complications in Southwick osteotomy for slipped capital femoral epiphysis (SCFE) on the basis of radiographic evaluation. We retrospectively analyzed the charts of 37 patients with chronic, unilateral, moderate, or severe SCFE, who underwent the procedure, verifying Southwick angles, articulotrochanteric distance, and the articular narrowing on preoperative, postoperative periods, and in the last follow-up evaluation, using the contralateral, healthy hip, for comparison. Southwick's angle changed from 117.

Slipped capital femoral epiphysis: reduction as a risk factor for avascular necrosis.

Complication rates after the treatment of slipped capital femoral epiphysis (SCFE) were retrospectively evaluated to identify possible risk factors. Twenty-six patients with SCFE underwent reduction and fixation with a single screw or multiple wires. The prevalence of avascular necrosis (AVN) of the hip or chondrolysis was 14.

Trapezoidal bony correction of the femoral neck in the treatment of severe acute-on-chronic slipped capital femoral epiphysis.

Purpose: To present the first technical description of a modified surgical technique for trapezoidal bony correction of the femoral neck in the treatment of slipped capital femoral epiphysis (SCFE), performed entirely by arthroscopy.

Methods: From December 2005 to January 2008, 5 patients with severe SCFE underwent trapezoidal femoral neck bone correction through arthroscopy. Their mean age at the time of surgery was 13.

EVOLUTION OF SLIPPED CAPITAL FEMORAL EPIPHYSIS AFTER NONSURGICAL TREATMENT.

Unlabelled: To evaluate the efficacy of conservative treatment of patients with slipped capital femoral epiphysis (SCFE) and the complications due to the progression of the disease.

Methods: 18 patients (26 hips) seen consecutively from December 1996 to August 2006 at the Orthopedics Service of Santa Casa de Misericórdia de São Paulo, who had been referred from other services with a diagnosis of SCFE and were treated without surgery, were retrospectively analyzed.

Results: Slip progression occurred in 19 hips (73%).