Recurrent patellar dislocations in adolescents result in decreased knee flexion during the entire gait cycle.

Purpose: To evaluate the kinematics/kinetics of the ankle, knee, hip in the sagittal plane in adolescents with recurrent patellar dislocation in comparison to a healthy control.

Methods: Case-control study. Eighty-eight knees (67 patients) with recurrent patellar dislocation (mean age 14.

Knee Moment-Angle Characteristics and Semitendinosus Muscle Morphology in Children with Spastic Paresis Selected for Medial Hamstring Lengthening.

To increase knee range of motion and improve gait in children with spastic paresis (SP), the semitendinosus muscle (ST) amongst other hamstring muscles is frequently lengthened by surgery, but with variable success. Little is known about how the pre-surgical mechanical and morphological characteristics of ST muscle differ between children with SP and typically developing children (TD). The aims of this study were to assess (1) how knee moment-angle characteristics and ST morphology in children with SP selected for medial hamstring lengthening differ from TD children, as well as (2) how knee moment-angle characteristics and ST morphology are related.

Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents.

Purpose: To evaluate efficacy and safety of extraphyseal tibial eminence avulsion fracture repair with absorbable sutures and a distal bone bridge fixation in comparison to previously described technique with non-absorbable sutures and distal screw fixation.

Methods: In a physeal-sparing technique, tibial eminence fractures (n = 25; McKeever type II/III n = 11/14) were either treated in group A (n = 15, follow-up 28.1 months) using an absorbable suture fixed over a bone bridge or in group B (n = 10, follow-up 47.

Factors associated with recurrence after femoral derotation osteotomy in cerebral palsy.

Femoral derotation osteotomy (FDO) as gold standard treatment for internal rotation gait in cerebral palsy (CP) leads to satisfying short-term results, whereas rates of recurrence up to 33% are reported in long-term outcome studies. The purpose of this study was therefore to identify factors contributing to recurrence of internal rotation gait in patients with CP who were treated with FDO in childhood. 70 patients (age: 10 (± 3.

The effect of knee flexion and rotation on the tibial tuberosity-trochlear groove distance.

Purpose: The purpose was to measure the effect of flexion and additional rotation of the femur relative to the tibia on the tuberosity-trochlear groove distance (TT-TG) in the same subject in 20 cadaveric knees joint.

Methods: In 20 human adult cadavers, formal fixed knees (age: 81.9 years, SD 12.

Implant failure after biodegradable screw fixation in osteochondritis dissecans of the knee in skeletally immature patients.

Purpose: The primary purpose of this study was to retrospectively assess the incidence of bioabsorbable screw failure in skeletally immature patients treated for osteochondritis dissecans (OCD) of the knee. The second purpose was to assess implant degradation, focusing on differential breakdown of the intraosseous and extraosseous parts of the screw on magnetic resonance imaging (MRI).

Methods: In this retrospective study, 24 patients (30 knees) with MRI-confirmed OCD were treated with a total of 61 biodegradable screws and followed up for a minimum of 2 years or until the onset of new symptoms.

Superior functional outcome after femoral derotation osteotomy according to gait analysis in cerebral palsy.

The femoral derotation osteotomy (FDO) is seen as the golden standard treatment in children with cerebral palsy and internal rotation gait. Variable outcomes with cases of over- and undercorrection mainly in the less involved patients have been reported. The determination of the amount of derotation is still inconsistent.

Poor outcome at 7.5 years after Stanisavljevic quadriceps transposition for patello-femoral instability.

Introduction: Congenital dislocation of the patella and recurrent symptomatic dislocation in adolescents are difficult pathologies to treat. Stanisavljevic described an extensive release procedure essentially involving medializing the entire lateral quadriceps and medial soft tissue stabilization. There are no significant series reporting the success of this method.

Septic arthritis of the paediatric hip - A review of current diagnostic approaches and therapeutic concepts.

A misdiagnosed septic arthritis (SA) of the paediatric hip is a nightmare for many physicians. The authors tried to trace the most recent information about this problem. A Medline search, using PubMed interface, was focused on the period from 01.

Distal femoral osteotomy using the LCP pediatric condylar 90-degree plate in patients with neuromuscular disorders.

Background: In patients with cerebral palsy and other neuromuscular disorders, correction of a fixed knee flexion deformity is thought to be crucial for the improvement of gait. The distal femoral extension osteotomy (DFO) is one method to achieve this goal. The standard implant for fixation of the 2 fragments in DFO is the conventional AO blade plate.

Multilevel surgery improves gait in spastic hemiplegia but does not resolve hip dysplasia.

Background: Multilevel orthopaedic surgery may improve gait in Type IV hemiplegia, but it is not known if proximal femoral osteotomy combined with adductor release as part of multilevel surgery in patients with hip dysplasia improves hip development.

Questions/purposes: We asked whether varus derotational osteotomy of the proximal femur, combined with adductor release, influenced hip development in patients with Type IV hemiplegia having multilevel surgery.

Patients And Methods: We retrospectively reviewed 11 children and adolescents with Type IV hemiplegia who had a proximal femoral osteotomy due to unilateral hip displacement to correct gait dysfunction between 1999 and 2006.

Tibialis anterior tendon shortening in combination with Achilles tendon lengthening in spastic equinus in cerebral palsy.

Equinus is the commonest deformity in cerebral palsy (CP). Many different surgical procedures have been described for the treatment of spastic equinus. In long standing equinus deformities the tibialis anterior muscle becomes elongated which is one reason for muscle weakness.

Preoperative botulinum toxin test injections before muscle lengthening in cerebral palsy.

Background: Muscle weakening is a well-known side effect of muscle-tendon lengthening. Botulinum toxin A (BTX-A) weakens the muscle temporarily by blocking the neuromuscular junction. Hence application of the drug is a logical step to test whether weakness deteriorates function prior to an operation.

Laparoscopy-assisted single-port appendectomy in children: is the postoperative infectious complication rate different?

Aim: In childhood, laparoscopy-assisted single-port appendectomy (SPA), including the advantages of open and laparoscopic surgery, is not widely used. However, there is debate whether the retrieval of the infected appendix via the umbilicus results in a higher infection rate compared with other laparoscopic or open techniques. The aim of the study was to determine the postoperative infection rate and possible risk factors for infection after SPA in children.

The pediatric LCP hip plate for fixation of proximal femoral osteotomy in cerebral palsy and severe osteoporosis.

Background: Hip dislocation or subluxation together with poor nutrition, reduced weight bearing, and osteoporosis is a frequent condition in severe cerebral palsy (CP). Severe osteoporosis may cause difficulties in fixing a proximal femoral osteotomy with a conventional blade plate. The Pediatric locking compression plate (LCP) Hip Plate system offers better grip and more stable fixation.

Mechanical Complication with Broviac Repair Kit in a 4-Year-Old Boy with MEN 2a.

Background. Mechanical complications in the use of indwelling central venous catheters (CVCs) such as the Broviac catheter (BC) include kinking, occlusion, dislocation or leaking. We report on a mechanical complication after using a repair kit for the BC.

Fractures and dislocations of the foot in children.

The challenge of managing pediatric foot injuries is the identification of the rare injuries that require operative treatment and the management of complications such as compartment syndrome, post-traumatic foot deformities, and avascular necrosis. With these complications in mind, the authors discuss fractures of the talus, calcaneus, lesser tarsal bones, Lisfranc's joint, metarsals, and phalanges. Dislocation of metatarsophalangeal or interphalangeal joints is also discussed.