Adolescent spinal pain: The pediatric orthopedist's point of view.

Introduction: Ten to twenty percent of persons experience spinal pain during growth. Causes are diverse in adolescents, and it is essential to determine etiology rapidly so as to guide optimal management.

Hypothesis: It is important for the pediatric orthopedist to understand the natural history of conditions inducing spinal pain.

Reduced inotropic reserve is predictive of further degradation in left ventricular ejection fraction in patients with Duchenne muscular dystrophy.

Aims: Duchenne muscular dystrophy (DMD), an inherited X-linked muscular disease, is associated with dilated cardiomyopathy that is responsible for death in 40% of patients. Our objective was to determine whether inotropic reserve is predictive of LV trend over time.

Methods And Results: A total of 69 DMD patients (age 12.

Upper limb strength and function changes during a one-year follow-up in non-ambulant patients with Duchenne Muscular Dystrophy: an observational multicenter trial.

Introduction: Upper limb evaluation of patients with Duchenne Muscular Dystrophy is crucially important to evaluations of efficacy of new treatments in non-ambulant patients. In patients who have lost ambulation, there are few validated and informative outcome measures. In addition, longitudinal data demonstrating sensitivity to clinical evolution of outcome measures over short-term periods are lacking.

Innovative methods to assess upper limb strength and function in non-ambulant Duchenne patients.

Upper limb assessment in non-ambulant patients remains a challenge. We have designed new tools to precisely assess pinch (MyoPinch), grip (MyoGrip), wrist flexion and extension (MyoWrist) strength. We have also designed a new tool to assess the ability of patients to produce repetitive flexion/extension movements of wrist and fingers (MoviPlate).

[Foot deformities in children].

The child comes in specialist consultation very often. Only after a good examination, we can quiet parents. Flatfoot, cavus foot toewalking can be alone symptom for a general disease.

[Congenital club foot: treatment in childhood, outcome and problems in adulthood].

Unlabelled: PURPOSE OF THE SYMPOSIUM: Treatment of idiopathic talipes varus, or congenital clubfoot, is designed to re-align the foot to alleviate pain and allow plantigrade weight bearing with adequate joint motion despite the subnormal radiographic presentation. This symposium was held to review current management practices for congenital clubfoot in children and to analyze outcome in adults in order to propose the most appropriate therapeutic solutions.

Management Of Congenital Clubfoot In Children: Idiopathic talipes varus can be suspected from the fetal ultrasound.

Functional treatment of clubfoot: a new series of 350 idiopathic clubfeet with long-term follow-up.

A new series of 350 previously unreported cases of clubfoot treated by the functional method are reported. One hundred and eighteen clubfeet were unilateral and 116 were bilateral. The follow-up ranged from 11 to 18 years, with an average of 14 years.

Primary adhalinopathy (alpha-sarcoglycanopathy): clinical, pathologic, and genetic correlation in 20 patients with autosomal recessive muscular dystrophy.

Primary adhalin (or alpha-sarcoglycan) deficiency due to a defect of the adhalin gene localized on chromosome 17q21 causes an autosomal recessive myopathy. We evaluated 20 patients from 15 families (12 from Europe and three from North Africa) with a primary adhalin deficiency with two objectives: characterization of the clinical phenotype and analysis of the correlation with the level of adhalin expression and the type of gene mutation. Age at onset and severity of the myopathy were heterogeneous: six patients were wheel-chair bound before 15 years of age, whereas five other patients had mild disease with preserved ambulation in adulthood.

Ultrasonographic approach to the neonatal foot: preliminary study.

We report our preliminary experience with use of ultrasound in clubfoot and describe our protocol and initial results in the use of this technique.

[Echography of the foot in newborn infants. Preliminary study].

Xrays are of a poor help in the diagnosis of the deformities of the foot in the neonate. As a modern imagying, ultrasounds allow to show the cartilaginous frames and also the soft-tissues. Some special views are used which can give interesting informations about the abnormal connexions of the hindfoot and also the midtarsal joint.

[Value of ultrasonic diagnosis in the evaluation of hip dislocation in neonates and infants. Apropos of 340 cases].

Ultrasound imaging of hip (UIH) was performed in 170 children (340 hips) with normal (193) and dysplasic (147) hips and findings compared with results of clinical and radiologic examinations. Ultrasound demonstrated 100% sensitivity in cases with abnormal clinical and radiologic finding, and 94% specificity for UIH when clinical and radiologic examinations were negative. Sensitivity and specificity of ultrasound screening (respectively 96 and 81%) were comparatively superior to those of radiography of the pelvis (83 and 78%) in relation to the clinical examinations.

The functional anatomy of clubfoot.

The authors have studied anatomical specimens and findings at time of surgery to determine the functional anatomy of clubfoot. The importance of the midtarsal joints (especially of the talonavicular joint) is emphasized as well as the importance of the tibialis posterior. The findings of the authors concerning the function of these elements have allowed them to develop a new approach to the treatment of clubfoot.

[Study of the foot ground pressure pattern in children (author's transl)].

The use of a new apparatus has enabled the authors to study the distribution to the ground of the plantar pressures by the way of ciphering each support area. This procedure is valuable and very precise as 500 pressure pick-up are used which give reliable, numerous and regularly distributed informations. The normal footprint has first been evaluated.