Journal of pediatric orthopedics. Part B
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Botulinum toxin acts at neuromuscular junctions close to muscle motor points and is used to help manage spastic upper-limb deformities. To develop a system allowing clinicians to identify optimal injection sites by an easily reproducible technique, forearm flexor muscles were dissected in 20 formalin-preserved human limbs. Motor points for flexor carpi ulnaris, flexor carpi radialis, flexor digitorum superficialis and pronator teres were (1) identified, (2) related to a reference grid based on lines (proximal, distal, lateral, medial and diagonals) drawn between forearm anatomical landmarks, and (3) defined in terms of their percentage distances along the established grid lines.
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We describe our experience with a novel surgical exsanguination tourniquet (S-MART; OHK Medical Devices, Haifa, Israel) in clinical pediatric orthopedics. We evaluated the surgical exsanguination tourniquet's properties and clinical use in 51 patients and compared our observations with our long-standing experience with the Esmarch bandage, pneumatic tourniquet and sterile stockinet. ⋯ After removal, the skin under the ring was intact in all cases. We conclude that the surgical exsanguination tourniquet is safe and valuable in our practice.
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Growth velocities, curve magnitudes, curve patterns and Risser signs of 80 consecutive untreated boys with adolescent idiopathic scoliosis were studied retrospectively and compared with the progression velocity of the curves. Growth velocity >or=4 cm/year with curves >or=25 degrees increased progression velocity of curves significantly (P<0.001). Growth velocity was fastest at skeletal ages 12-13 years but continued moderately after the age of 16 years. The major right thoracic curves were the most progressive.