Journal of pediatric orthopedics
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Nine of 212 cases of traumatic anterior shoulder dislocations occurred in children with clearly open epiphyses (4.7% incidence). All cases associated with psychological or physical abnormalities were excluded. A high recurrence rate of 80% (8 of 10) was noted requiring operative intervention. Two of the three remaining unoperated cases had a history of "subluxation" after their initial dislocation.
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Case Reports
Roentgen stereophotogrammetric analysis of growth pattern after supination--eversion ankle injuries in children.
In a prospective study of ankle fractures in children, the growth rate was registered with a roentgen stereophotogrammetric method. The injuries were classified traumatologically according to Gerner-Smidt and anatomically according to Salter and Harris. Twenty-six ankle fractures were classified as supination--eversion injuries. ⋯ However, factors such as trauma, displacement, skeletal maturity, and treatment must be considered. The roentgen stereophotogrammetric method permits early determination of the growth pattern with high accuracy. The growth disturbance can be registered months before this is evident from conventional radiographic examinations.
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The transposition of the latissimus dorsi myocutaneous flap is described in 2 pediatric patients: one with complete loss of elbow flexion, and the other with severe axillary burn contracture. A simplified, secure, one-stage reconstruction with the myocutaneous flap resulted in an excellent substitute of biceps function and skin coverage. The axillary reconstruction allowed immediate full over-the-head abduction, without recurrence of the contracture. In any nonforcible shoulder activity, the function of the latissimus dorsi muscle will not be missed, because of the numerous substitute muscles.
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Avulsion fracture of the tibial tubercle is an uncommon but severe injury of the proximal tibial physis in adolescents. These fractures are all Salter Type III injuries. The fracture line may extend through the proximal tibial articular surface. ⋯ Five of eight injuries were treated with open reduction and internal fixation. When the proximal tibial articular surface was involved in the fracture, anatomic reduction was the primary goal. This review demonstrates that this particular epiphyseal plate injury in the adolescent knee heals well without deformity or functional loss once adequate reduction and fixation of the fracture fragments have been achieved.