Pub Date : 2025-02-01DOI: 10.1016/j.mporth.2024.12.010
{"title":"CME questions on Knee Arthroplasty","authors":"","doi":"10.1016/j.mporth.2024.12.010","DOIUrl":"10.1016/j.mporth.2024.12.010","url":null,"abstract":"","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"39 1","pages":"Pages 81-82"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.mporth.2024.10.004
Samuel W King
Legg–Calvé–Perthes (LCP) disease is a common topic for final professional examinations. It is an important differential diagnosis to recognize in children presenting with a limp. Its diagnosis requires the exclusion of diagnoses requiring more immediate action, such as infection or malignancy. It may also present with subtle, or no, signs on routine investigations. LCP disease may resolve spontaneously without long term sequelae or result in debilitating hip pathology requiring operative management. Its aetiology and most appropriate management are topics for debate, and knowledge of the classical papers and commonly used classification systems allow candidates to discuss these in more depth.
{"title":"Legg–Calvé–Perthes disease: pertinent information for orthopaedic exam candidates","authors":"Samuel W King","doi":"10.1016/j.mporth.2024.10.004","DOIUrl":"10.1016/j.mporth.2024.10.004","url":null,"abstract":"<div><div>Legg–Calvé–Perthes (LCP) disease is a common topic for final professional examinations. It is an important differential diagnosis to recognize in children presenting with a limp. Its diagnosis requires the exclusion of diagnoses requiring more immediate action, such as infection or malignancy. It may also present with subtle, or no, signs on routine investigations. LCP disease may resolve spontaneously without long term sequelae or result in debilitating hip pathology requiring operative management. Its aetiology and most appropriate management are topics for debate, and knowledge of the classical papers and commonly used classification systems allow candidates to discuss these in more depth.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 360-364"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.mporth.2024.10.002
Jemma Oberman, Olivia Byrne, Maheshi P Wijesekera, Patrick Foster
Congenital lower limb differences are rare but can cause significant effects on the developing child. The term encompasses a broad spectrum of conditions, with varying degrees of severity. When evaluating these conditions, children should be managed on an individual basis due to the variety of presentations. This review provides the reader with an introduction to congenital limb differences of the lower limb, describing the common presentations, classifications and the orthopaedic management of these conditions.
{"title":"Congenital lower limb differences: an overview and common presentations","authors":"Jemma Oberman, Olivia Byrne, Maheshi P Wijesekera, Patrick Foster","doi":"10.1016/j.mporth.2024.10.002","DOIUrl":"10.1016/j.mporth.2024.10.002","url":null,"abstract":"<div><div>Congenital lower limb differences are rare but can cause significant effects on the developing child. The term encompasses a broad spectrum of conditions, with varying degrees of severity. When evaluating these conditions, children should be managed on an individual basis due to the variety of presentations. This review provides the reader with an introduction to congenital limb differences of the lower limb, describing the common presentations, classifications and the orthopaedic management of these conditions.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 399-404"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.mporth.2024.09.003
Sarah Rubin, Christopher Edward Bache
Developmental hip dysplasia is a common problem encountered in orthopaedic practice; early diagnosis and closed containment of the femoral head in younger children aims to allow remodelling to occur. For older children, with less remodelling potential, surgical intervention with femoral and/or pelvic/acetabular osteotomies may be required. There are many osteotomies described, all with a common goal of normalizing anatomy and preventing long term degenerative changes. Individual osteotomies can be classified as redirectional or salvage subtypes, then indications by the age of the child/degree of skeletal maturity. The osteotomy options and outcomes from available literature are explained and a flowchart to summarize the authors recommended choices is provided.
{"title":"Developmental hip dysplasia: which osteotomy, when?","authors":"Sarah Rubin, Christopher Edward Bache","doi":"10.1016/j.mporth.2024.09.003","DOIUrl":"10.1016/j.mporth.2024.09.003","url":null,"abstract":"<div><div>Developmental hip dysplasia is a common problem encountered in orthopaedic practice; early diagnosis and closed containment of the femoral head in younger children aims to allow remodelling to occur. For older children, with less remodelling potential, surgical intervention with femoral and/or pelvic/acetabular osteotomies may be required. There are many osteotomies described, all with a common goal of normalizing anatomy and preventing long term degenerative changes. Individual osteotomies can be classified as redirectional or salvage subtypes, then indications by the age of the child/degree of skeletal maturity. The osteotomy options and outcomes from available literature are explained and a flowchart to summarize the authors recommended choices is provided.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 349-359"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/j.mporth.2024.09.004
Marjan Raad, Kyle James, Enis Guryel, Alastair Robertson
This article will discuss the basic principles of lower limb deformity correction. Many final professional examinations in Trauma and Orthopaedic Surgery, including the UK Intercollegiate Fellowship Examination FRCS (Tr&Orth), require a basic understanding of deformity planning and this article aims to be an essential tool for preparation. It provides a framework for clinical and radiographic assessment of lower limb deformity, and how to plan for lower limb deformity correction using the Centre of Rotation and Angulation (CORA) method, providing a pocket-sized guide for all trauma and orthopaedic trainees working towards their exams.
{"title":"Deformity planning: a primer for exam candidates","authors":"Marjan Raad, Kyle James, Enis Guryel, Alastair Robertson","doi":"10.1016/j.mporth.2024.09.004","DOIUrl":"10.1016/j.mporth.2024.09.004","url":null,"abstract":"<div><div>This article will discuss the basic principles of lower limb deformity correction. Many final professional examinations in Trauma and Orthopaedic Surgery, including the UK Intercollegiate Fellowship Examination FRCS (Tr&Orth), require a basic understanding of deformity planning and this article aims to be an essential tool for preparation. It provides a framework for clinical and radiographic assessment of lower limb deformity, and how to plan for lower limb deformity correction using the Centre of Rotation and Angulation (CORA) method, providing a pocket-sized guide for all trauma and orthopaedic trainees working towards their exams.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 386-398"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/j.mporth.2024.09.002
Benjamin Dougal Chatterton, Kyle James
Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting adolescents, and can be encountered by any surgeon who sees children as part of their on-call commitment. There are a number of diagnostic and management challenges associated with this condition, in particular in how to manage children with severe and unstable disease. This article covers the diagnosis and classification of SCFE, allowing recognition of those patients requiring specialist paediatric referral. The surgical management of SCFE, including complex cases, is also discussed.
{"title":"Slipped capital femoral epiphysis: diagnosis, classification and controversies in management","authors":"Benjamin Dougal Chatterton, Kyle James","doi":"10.1016/j.mporth.2024.09.002","DOIUrl":"10.1016/j.mporth.2024.09.002","url":null,"abstract":"<div><div>Slipped capital femoral epiphysis (SCFE) is the most common hip disorder affecting adolescents, and can be encountered by any surgeon who sees children as part of their on-call commitment. There are a number of diagnostic and management challenges associated with this condition, in particular in how to manage children with severe and unstable disease. This article covers the diagnosis and classification of SCFE, allowing recognition of those patients requiring specialist paediatric referral. The surgical management of SCFE, including complex cases, is also discussed.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 365-370"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/j.mporth.2024.10.001
Alexander Beer
Paediatric foot deformities are common and can have a significant impact on function and quality of life. They represent a diverse group of clinical presentations from benign normal variants to complex deformity. It is crucial to have a good understanding of this subject matter, as they present commonly and early diagnosis can often improve outcomes. There has been an evolution in the management foot deformities, with surgeons moving from large open procedures to less invasive and non-surgical procedures, such as serial casting. However, there remains a role for open surgery, particularly in complex, rigid and severe cases. Common deformities that affect the paediatric foot are discussed in terms of their aetiology, clinical presentation, diagnosis and management.
{"title":"Common foot deformities in children","authors":"Alexander Beer","doi":"10.1016/j.mporth.2024.10.001","DOIUrl":"10.1016/j.mporth.2024.10.001","url":null,"abstract":"<div><div>Paediatric foot deformities are common and can have a significant impact on function and quality of life. They represent a diverse group of clinical presentations from benign normal variants to complex deformity. It is crucial to have a good understanding of this subject matter, as they present commonly and early diagnosis can often improve outcomes. There has been an evolution in the management foot deformities, with surgeons moving from large open procedures to less invasive and non-surgical procedures, such as serial casting. However, there remains a role for open surgery, particularly in complex, rigid and severe cases. Common deformities that affect the paediatric foot are discussed in terms of their aetiology, clinical presentation, diagnosis and management.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 343-348"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The gait cycle involves a repeated sequence of tasks that result in walking. The cycle is divided into two phases: the stance and swing phase. Both phases have further sub-phases. The stance phase may be considered from the perspective of the three functional foot-ankle fulcrums or ‘rockers’. Gait analysis is defined as the assessment of gait and identification of abnormalities. The different classes of gait data include temporal-spatial parameters, kinematics, and kinetics. Instrumented gait analysis uses motion capture systems and instrumented walkways to record gait data in these various classes. Evolving technologies for gait analysis include two–dimensional camera systems and wearable devices. Inertial measuring units are small electronic wearable devices containing sensors, which record temporal-spatial gait parameters. There is potential to use inertial measuring units in conjunction with machine learning to estimate more detailed gait data. The identification of abnormal gait patterns in patients with certain neurological disorders helps guide clinical decision-making. Pattern recognition and kinematic data have been used to develop a classification system for sagittal plane gait deviations in the spastic diplegic variant of cerebral palsy. Five common patterns are recognized. These are equinus, jump, apparent equinus, crouch and asymmetric gait patterns. Orthotics are important non-operative management devices. Surgery may be used to address specific primary or secondary pathology.
{"title":"Understanding gait assessment and analysis","authors":"Tarlochan Singh Bhambra, Abdal Qadir Zafar, Adelle Fishlock","doi":"10.1016/j.mporth.2024.10.003","DOIUrl":"10.1016/j.mporth.2024.10.003","url":null,"abstract":"<div><div>The gait cycle involves a repeated sequence of tasks that result in walking. The cycle is divided into two phases: the stance and swing phase. Both phases have further sub-phases. The stance phase may be considered from the perspective of the three functional foot-ankle fulcrums or ‘rockers’. Gait analysis is defined as the assessment of gait and identification of abnormalities. The different classes of gait data include temporal-spatial parameters, kinematics, and kinetics. Instrumented gait analysis uses motion capture systems and instrumented walkways to record gait data in these various classes. Evolving technologies for gait analysis include two–dimensional camera systems and wearable devices. Inertial measuring units are small electronic wearable devices containing sensors, which record temporal-spatial gait parameters. There is potential to use inertial measuring units in conjunction with machine learning to estimate more detailed gait data. The identification of abnormal gait patterns in patients with certain neurological disorders helps guide clinical decision-making. Pattern recognition and kinematic data have been used to develop a classification system for sagittal plane gait deviations in the spastic diplegic variant of cerebral palsy. Five common patterns are recognized. These are equinus, jump, apparent equinus, crouch and asymmetric gait patterns. Orthotics are important non-operative management devices. Surgery may be used to address specific primary or secondary pathology.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 371-377"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/j.mporth.2024.09.005
Marjan Raad, Kyle James, Christopher James, Jai Relwani
Bone and joint infection is an extremely common emergency procedure in paediatric orthopaedics. An arthrotomy is a surgical exploration of a joint and is commonly needed to be performed for septic arthritis on an emergency basis. Although there is an increasing trend towards arthroscopic irrigation and washout, open arthrotomy is still an important tool for orthopaedic surgeons. It also has other therapeutic purposes, and these include: debridement/removal of loose bodies, ligament reconstruction, fracture fixation, disarticulation, joint replacement and tumour excision. We describe the most commonly used approaches to perform arthrotomy in the hip, knee, ankle, shoulder, elbow, wrist, hand and fingers. Orthopaedic surgeons must be aware of common pitfalls and neurovascular structures present when performing an arthrotomy of common joints. This article provides an illustrative overview to approach each joint and will be a quick-reference guide especially for junior orthopaedic surgeons.
{"title":"Surgical approaches for septic arthritis","authors":"Marjan Raad, Kyle James, Christopher James, Jai Relwani","doi":"10.1016/j.mporth.2024.09.005","DOIUrl":"10.1016/j.mporth.2024.09.005","url":null,"abstract":"<div><div>Bone and joint infection is an extremely common emergency procedure in paediatric orthopaedics. An arthrotomy is a surgical exploration of a joint and is commonly needed to be performed for septic arthritis on an emergency basis. Although there is an increasing trend towards arthroscopic irrigation and washout, open arthrotomy is still an important tool for orthopaedic surgeons. It also has other therapeutic purposes, and these include: debridement/removal of loose bodies, ligament reconstruction, fracture fixation, disarticulation, joint replacement and tumour excision. We describe the most commonly used approaches to perform arthrotomy in the hip, knee, ankle, shoulder, elbow, wrist, hand and fingers. Orthopaedic surgeons must be aware of common pitfalls and neurovascular structures present when performing an arthrotomy of common joints. This article provides an illustrative overview to approach each joint and will be a quick-reference guide especially for junior orthopaedic surgeons.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 378-385"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1016/j.mporth.2024.09.001
Tom Barrow, Kyle James, Naidu Maripuri, Thomas Crompton
Musculoskeletal conditions in children frequently lead to referrals to paediatric orthopaedic clinics, driven by anxiety among parents and primary care providers. Normal variants, which represent a substantial proportion of these referrals, require thorough understanding to distinguish them from pathologic conditions and provide appropriate reassurance. This review outlines common normal variants and disorders of growth, categorized by presenting complaints, anatomical location, and age group. Effective management often involves parental reassurance, observation, and conservative measures such as physiotherapy and activity modification. Surgical interventions are rarely required. Emphasizing the importance of collaboration between paediatric orthopaedic surgeons and primary care providers, this review highlights the importance of musculoskeletal education to reduce unnecessary referrals and optimize patient care.
{"title":"Normal variants and disorders of growth: apophysitis","authors":"Tom Barrow, Kyle James, Naidu Maripuri, Thomas Crompton","doi":"10.1016/j.mporth.2024.09.001","DOIUrl":"10.1016/j.mporth.2024.09.001","url":null,"abstract":"<div><div>Musculoskeletal conditions in children frequently lead to referrals to paediatric orthopaedic clinics, driven by anxiety among parents and primary care providers. Normal variants, which represent a substantial proportion of these referrals, require thorough understanding to distinguish them from pathologic conditions and provide appropriate reassurance. This review outlines common normal variants and disorders of growth, categorized by presenting complaints, anatomical location, and age group. Effective management often involves parental reassurance, observation, and conservative measures such as physiotherapy and activity modification. Surgical interventions are rarely required. Emphasizing the importance of collaboration between paediatric orthopaedic surgeons and primary care providers, this review highlights the importance of musculoskeletal education to reduce unnecessary referrals and optimize patient care.</div></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 6","pages":"Pages 336-342"},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142698513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号