Journal of pediatric orthopedics
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Randomized Controlled Trial Comparative Study
A prospective, randomized clinical study of osteochondral autologous transplantation versus microfracture for the treatment of osteochondritis dissecans in the knee joint in children.
The aim of this study was to compare the outcomes of the arthroscopic mosaic-type osteochondral autologous transplantation (OAT) and microfracture (MF) procedures for the treatment of osteochondritis dissecans (OCD) defects of the femoral condyles of the knee joint in children under the age of 18 years. ⋯ Level 1: randomized controlled trial, significant difference.
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Spondylolisthesis is often diagnosed and treated on the basis of measurements obtained from radiographs. Many physicians will perform surgery regardless of the patient's symptoms above a specific slip percentage. However, current methods used to assess slip percentage are vague and lack appropriate standardization, leaving physicians to devise personal evaluation techniques. This study presents a defined method to calculate slip percentage that takes advantage of modern technology, is fast and simple to perform, and shows excellent intraobserver/interobserver reliability. ⋯ Diagnostic level III.
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Burst fractures are rare in the pediatric population. There is limited information available on the best treatment for these injuries. The aims of our study were to evaluate the risk of spinal cord injury (SCI) and the potential for neurologic recovery associated with pediatric burst fractures; to compare sagittal alignment between nonoperative and operative treatment; and to determine whether functional outcomes are improved after surgery. ⋯ Prognostic level 2.
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Supracondylar distal humerus fractures are one of the most common skeletal injuries in children. The current treatment of choice in North America is closed reduction and percutaneous pin fixation. Often surgeons leave the pins exposed beneath a cast but outside the skin. Great variation exists with respect to preoperative skin preparation, and perioperative antibiotic administration. Few data exist regarding the rate of infection and other complications. The purpose of this study is to review a large series of children to evaluate the rate of infection and other complications. ⋯ Level III retrospective comparative study.
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Comparative Study
Interobserver and intraobserver reliability of Cobb angle measurement: endplate versus pedicle as bony landmarks for measurement: a statistical analysis.
The Cobb-Lippman technique measures the curve severity by measuring the angle between the upper and lower endplates of the upper-end and lower-end vertebrae, respectively, using pedicles to measure the angle when they are better visualized than the endplates. Vertebral endplates in younger children provide less distinct bony landmarks and pedicles may be more easily identifiable in these children. The purpose of this study is to evaluate the reliability of the pedicle method of the Cobb angle measurement and compare it with the conventional endplate method of measurement. ⋯ Diagnostic studies, investigating a diagnostic test, level 1.