Journal of pediatric orthopedics
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Although it brings satisfactory rib hump correction, concomitant thoracoplasty with surgical correction of scoliosis decreases pulmonary function values. To achieve satisfactory rib hump correction and avoid impairment to pulmonary function, we design a new kind of thoracoplasty-convex short length rib resection (CSLRR). This study is to evaluate the effect and outcome of CSLRR in conjunction with pedicle screw instrumentation. ⋯ Therapeutic-level IV retrospective study.
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Complex distal tibial physeal fractures can be difficult to characterize on plain radiographs. The role of computed tomography (CT) scans in the evaluation and treatment decision of these injuries is unclear. We aimed to determine whether or not the addition of CT would improve the reliability of fracture classification and treatment decision. ⋯ Addition of CT in complex distal tibial physeal fractures did not increase interobserver reliability to classify the fracture or the treatment decision. Surgeons reported that the CT was most useful to plan screw placement and changed their treatment decision in about a fifth of the cases.
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Lyme arthritis most commonly affects the knee. It is not commonly considered in the differential diagnosis of monoarticular hip pain. There are only a few case reports describing Lyme disease presenting with isolated hip involvement. The purpose of this study is to review our experience with primary Lyme arthritis of the hip. ⋯ Level IV, Case Series.
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Femoral head containment in Legg-Calvé-Perthes disease (LCPD) can be either surgical or nonsurgical. The Salter or innominate osteotomy is a common method of surgical containment. This is a review of the technique and results of this osteotomy in LCPD. ⋯ The Salter osteotomy in LCPD is an effective method of surgical treatment that can alter the natural history of the disease process. The main advantage of this osteotomy is its effect on femoral head remodeling during remaining growth.
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Comparative Study
Labral support shelf arthroplasty for containment in early stages of Legg-Calve-Perthes disease.
Containment of the hip has become a popular strategy for treatment of severe Legg-Calve-Perthes disease; however, the best method remains unclear. This study describes a minimal-incision variation of the labral support shelf arthroplasty, which uses arthroscopic visualization and an allograft buttress on the shelf support. The outcome in a group of hips undergoing this minimal-incision variation is compared by the Stulberg classification with a group treated by the traditional anterolateral open operative approach. In addition, the outcomes of both groups of labral support shelf arthroplasties are compared then with other containment techniques used in our hospital consisting of Petric cast, varus femoral osteotomy, and innominate osteotomy of Salter. ⋯ The labral support shelf arthroplasty by either the traditional method or the minimal-incision variation offers similar Waldenstrom class outcomes when compared with a Petric cast, a varus femoral osteotomy, or an innominate osteotomy of Salter. We believe the labral support shelf arthroplasty technique is simple to perform and does not induce a permanent deformity in the proximal femur or acetubulum.