Comparison of "Human" and Artificial Intelligence Hand-and-Wrist Skeletal Age Estimation in an Epiphysiodesis Cohort.

Background: We previously demonstrated that the White-Menelaus arithmetic formula combined with skeletal age as estimated with the Greulich and Pyle (GP) atlas was the most accurate method for predicting leg lengths and residual leg-length discrepancy (LLD) at maturity in a cohort of patients treated with epiphysiodesis. We sought to determine if an online artificial intelligence (AI)-based hand-and-wrist skeletal age system provided consistent readings and to evaluate how these readings influenced the prediction of the outcome of epiphysiodesis in this cohort.

Methods: JPEG images of perioperative hand radiographs for 76 subjects were independently submitted by 2 authors to an AI skeletal age web site (http://physis.

The Efficacy of Intra-articular Subtalar Steroid Injection for Symptomatic Talocalcaneal Coalitions: A 30-Year Single Institution Experience.

Purpose: While intra-articular steroid injection has been used anecdotally in patients with symptomatic talocalcaneal coalitions recalcitrant to traditional conservative modalities, the ability of this treatment to provide symptomatic relief and obviate or delay surgical intervention remains unknown. The purpose of this study is, therefore, to assess the treatment efficacy of intra-articular subtalar steroid injection in children with symptomatic talocalcaneal coalitions.

Methods: A retrospective study of all patients with isolated subtalar coalitions was performed at a single pediatric orthopaedic institution over a 30-year period.

Lateral Cuneiform Ossification and Tibialis Anterior Tendon Width in Children Ages 3 to 6: Implications for Interference Screw Fixation of Tibialis Anterior Tendon Transfers in Children.

Background: While the transfer of the tibialis anterior tendon (TAT) to the lateral cuneiform (LC) following serial casting has been used for nearly 60 years to treat relapsed clubfoot deformity, modern methods of tendon fixation remain largely unstudied. Interference screw fixation represents an alternative strategy that obviates concerns of plantar foot skin pressure-induced necrosis and proper tendon tensioning associated with button suspensory fixation. A better understanding of LC morphology in young children is a necessary first step in assessing the viability of this fixation technique.

Accessory Cuboid Facet Associated With Calcaneonavicular Coalitions.

Background: Calcaneonavicular (CN) coalitions are the most commonly encountered tarsal coalition. No study has assessed anatomic variations of the adjacent joints in the presence of a CN coalition. This study sought to identify differences in the anatomy of the calcaneocuboid (CC) articulation in feet with and without CN coalitions.

Do We Really Need to Worry About Calcaneocuboid Subluxation During Lateral Column Lengthening for Planovalgus Foot Deformity?

Background: Although lengthening of the lateral column through an osteotomy of the anterior calcaneus is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, the procedure has been implicated in iatrogenic calcaneocuboid (CC) subluxation and subsequent degenerative changes at the CC articulation. The purpose of this study is to characterize alterations at the CC joint after lateral column lengthening (LCL) and determine if Steinmann pin stabilization of the CC joint before distraction maintains a normal relationship.

Methods: Seven matched pairs of fresh-frozen cadaveric feet underwent preprocedure plain radiography and cross-sectional computed tomography (CT) imaging.

Effect of Lateral Column Lengthening on Subtalar Motion in a Cadaveric Model.

Background: Although lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, concern exists as to the effect of this intra-articular osteotomy on subtalar motion. The purpose of this study was to quantify the alterations in subtalar motion following lateral column lengthening (LCL).

Methods: The subtalar motion of 14 fresh-frozen cadaveric feet was assessed using a 3-dimensional motion capture system and materials testing system (MTS).

Imaging of the Pediatric Temporomandibular Joint.

Imaging of the temporomandibular joint in pediatric patients is a critical component in the evaluation and treatment of children with temporomandibular joint symptoms. MRI can provide detailed joint anatomy and identify inflammation, sometimes before symptom onset. Ultrasound scan is a convenient emerging modality to evaluate the joint and guide therapeutic injections.

The influence of education on appropriateness rates for CT pulmonary angiography in emergency department patients.

Rationale And Objectives: To evaluate appropriate utilization rates for computed tomography (CT) pulmonary angiography (CTPA) in a tertiary center emergency department (ED), before and after a health care provider educational intervention.

Materials And Methods: Institutional Review Board-approved retrospective study. Records for 100 consecutive CTPA studies ordered by the ED were retrieved from a radiology database.

Sonographically guided patellar tendon fenestration: prognostic value of preprocedure sonographic findings.

Objectives: The purpose of this study was to determine whether any sonographic features of jumper's knee can predict the outcome after sonographically guided percutaneous patellar tendon fenestration.

Methods: Patients were identified between July 2001 and March 2009 who had clinical and sonographic findings of jumper's knee, who had failed conservative treatment, and who had sonographically guided percutaneous fenestration of the patellar tendon. Pain levels were assessed before and 4 weeks after fenestration.

Embolization of intracranial aneurysms with second-generation Matrix-2 detachable coils: mid-term and long-term results.

Background: Bioactive polyglycolic/polylactic acid (PGLA)-coated Matrix detachable coils were reported to incite intra-aneurysmal inflammation and fibrosis. Multiple large case series with Matrix-1 coils have shown no advantage with respect to aneurysm recurrence. Second-generation Matrix-2 coils were designed with improved platinum support and reduced copolymer friction.

Magnetic resonance characterization of pheochromocytomas in the abdomen and pelvis: imaging findings in 18 surgically proven cases.

Purpose: To study the magnetic resonance imaging characteristics of adrenal and extra-adrenal pheochromocytomas in the abdomen and pelvis.

Methods: We retrospectively reviewed 18 cases of pathologically proven cases of pheochromocytomas in the abdomen and pelvis. These patients have undergone magnetic resonance imaging evaluation before surgery.

Treatment of ruptured intracranial aneurysms since the International Subarachnoid Aneurysm Trial: practice utilizing clip ligation and coil embolization as individual or complementary therapies.

Object: The aim of this study was to analyze the therapeutic decision-making process and outcome in 100 consecutive patients with aneurysmal subarachnoid hemorrhage (SAH) treated since the completion of the International Subarachnoid Aneurysm Trial (ISAT). All patients were evaluated and treated by a neurosurgeon with subspecialty training in both cerebrovascular and neuroendovascular surgery.

Methods: One hundred consecutive patients with aneurysmal SAH who had been admitted within 1 week posthemorrhage and who had been treated using either surgical clip application or endovascular coil embolization were included in this analysis.

Emerging concepts in the treatment of intracranial aneurysms: stents, coated coils, and liquid embolic agents.

Endovascular techniques for the treatment of intracranial aneurysms are rapidly evolving. Modifications of more traditional coils have been introduced. Such modifications include newer coils coated with various polymers to increase both coil thrombogenicity and degree of aneurysm packing.

Evolution of endovascular therapy for aneurysm treatment. Historical overview.

The endovascular treatment of intracranial aneurysms has recently become an established therapeutic option. The foundation of this treatment modality was laid by the work done in ground-breaking cases, combined with technological advances since the first half of the 19th century. In this historical overview the authors describe the steps taken by the early pioneers and the results of their work, which was often done under challenging circumstances.