Journal of pediatric orthopedics
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Salter-Harris type III and IV medial malleolar fractures (MacFarland fracture) is a joint fracture of the ankle in children. The fracture line passes through the medial part of the lower epiphyseal disk of the tibia. Prognosis is dominated by later risk of misalignment and osteoarthritis. ⋯ Surgical treatment was arthrotomy in all cases to achieve anatomical reduction under direct view, followed by osteosynthesis. We believe that it is difficult to evaluate if the reduction is perfect under the control of the intensifier screen alone. Arthrotomy did not lead to ankle stiffness, in any of our patients at longest follow-up.
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Rectus femoris transfer (RFT) is a treatment option for children with cerebral palsy (CP) who exhibit a stiff-knee gait pattern. The rectus femoris muscle is transferred to different sites to overcome problems such as tripping and falling. Indications for RFT often include preoperative decreased knee range of motion (KROM) during swing phase, reduced peak knee flexion in swing (PKFSW), abnormal rectus femoris firing patterns on electromyography recordings, and a positive Duncan-Ely test. This study investigated the effect of different RFT sites on kinematic outcome variables and evaluated the relationship between commonly used preoperative surgical indicators and postoperative changes in kinematics. ⋯ Level 3.