Journal of pediatric orthopedics
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The pathology of late-onset Legg-Calve-Perthes disease (LCPD) is similar to that of avascular necrosis of the femoral head in adult and is associated with poorer prognosis of the hip. The optimal treatment for this condition is still controversial. The purpose of this study was to evaluate the long-term clinical results of the transtrochanteric rotational osteotomy for the patients with LCPD onset at more than 9 years of age. ⋯ Transtrochanteric rotational osteotomy is an effective procedure to salvage the hips of the late-onset LCPD. Amount of head involvement, posterior and lateral pillar had influences on the surgical outcomes.
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A pathognomonic finding of slipped capital femoral epiphysis (SCFE) is a combination of the decrease in the height of the slipped epiphysis and the position of external rotation and flexion of hip. We believe that decrease in the acetabulotrochanteric distance (ATD) on an anteroposterior (AP) radiograph represents this finding. ⋯ Level IV.
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Hip replacement arthroplasty is a very reliable and effective therapeutic modality for patients with end-stage degenerative coxarthrosis secondary to Legg-Calvé-Perthes disease (LCPD). Long-term results of the conventional total hip arthroplasty for patients with LCPD have been reported to be satisfactory similar to those for patients with primary arthritis. For selective patients, resurfacing arthroplasty can be performed successfully. We described special aspects of patients with LCPD in conventional total hip arthroplasty and resurfacing arthroplasty.
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Despite the significant morbidity and mortality associated with all-terrain vehicle (ATV) use in children, their use continues to increase dramatically. To determine the frequency and impact of spinal fractures in children and adolescents injured in ATV accidents, we reviewed all 4 of the available Kids' Inpatient Databases. ⋯ Multiple injuries are frequent in children involved in ATV accidents and may be related to the high-energy nature of ATV accidents. It is important to have a high index of suspicion for multiple injuries, not only within the spine, but in other organ systems as well.
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The radiocapitellar line (RCL) is recommended for evaluating radiocapitellar alignment in skeletally immature elbows, yet its parameters have not been clearly defined. This study systematically assesses the RCL relationship in normal elbows, investigating the impacts of radiographic view, choice of anatomic landmarks, patient age, forearm position, and observer bias on the manner in which the RCL intersects the capitellum. ⋯ Diagnostic Level 3.