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Preoperative Gallows traction as an adjunct to hip open reduction surgery: Is it safe and is it effective? 术前胆囊牵引作为髋关节开放缩窄手术的辅助手段:是否安全有效?
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-10-08 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241283235
Andreas Rehm, Matthew Seah, Silvester Kabwama, Victoria Dorrell, Sebastian Ho, Elizabeth Ashby
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引用次数: 0
Pre-operative Gallows traction as an adjunct to hip open reduction surgery: Is it safe and is it effective? 术前胆囊牵引作为髋关节开放缩窄手术的辅助手段:是否安全有效?
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-10-08 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241283249
Nicholas C Uren, Julia Judd, Edward A Lindisfarne, Kirsten G Elliott, Alexander Aarvold
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引用次数: 0
One-bone forearm for the treatment of supination contractures secondary to neonatal brachial plexus injury. 单骨前臂用于治疗新生儿臂丛神经损伤继发的上举挛缩。
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-28 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241276348
Juliana Rojas-Neira, Camilo Chaves, Paula Díaz-Gallardo, Trong-Quynh Nguyen, Juan J Dominguez-Amador, Francisco Soldado

Background: The one-bone forearm procedure has been considered as a potential treatment for severe forearm deformities. However, its primary limitation lies in the elevated risks of nonunion and infection. In order to enhance union rates, a technical modification was introduced, aiming not only to establish end-to-end radio-ulnar fixation but also to incorporate an additional overlay and fixation between the proximal and distal radius osteotomy stumps. This technique, initially applied in a heterogeneous patient population including individuals with neurological, tumoral, and congenital conditions, yielded promising results, achieving a consolidation rate of 100% and enabling supination corrections of up to 120°.

Methods: In this study, we present a retrospective cohort of 28 patients, with an average age of 9 years, all afflicted by forearm supination contracture exceeding 90° secondary to neonatal brachial plexus injury. These patients underwent treatment with the modified technique.

Results: The mean correction achieved in forearm rotation was 116°, and the average follow-up period extended to 43 months. Remarkably, all patients exhibited bone union within an average period of 6.6 weeks, without any complications.

Conclusion: Our findings underscore the efficacy of this modified technique, which enables substantial rotational corrections, boasts a high union rate, and maintains a low incidence of complications. This approach is particularly valuable for young patients suffering from neonatal brachial plexus injury with severe fixed supination deformities.

Case series level of evidence: IV.

背景:单骨前臂手术一直被认为是治疗严重前臂畸形的潜在方法。然而,其主要局限性在于不愈合和感染的风险较高。为了提高愈合率,我们引入了一种技术改造,其目的不仅是建立端对端射频-桡骨固定,还包括在桡骨近端和远端截骨残端之间进行额外的覆盖和固定。这项技术最初应用于包括神经系统、肿瘤和先天性疾病患者在内的不同患者群体,取得了良好的效果,巩固率达到 100%,上翻矫正度高达 120°:在这项研究中,我们对 28 名患者进行了回顾性队列分析,这些患者平均年龄为 9 岁,均因新生儿臂丛神经损伤而导致前臂上举挛缩超过 90°。这些患者均接受了改良技术的治疗:结果:前臂旋转的平均矫正角度为 116°,平均随访时间为 43 个月。值得注意的是,所有患者都在平均 6.6 周内实现了骨结合,且未出现任何并发症:我们的研究结果强调了这种改良技术的有效性,它可以实现大幅度的旋转矫正,具有较高的骨结合率,并保持较低的并发症发生率。这种方法对于患有新生儿臂丛神经损伤并伴有严重固定性上翻畸形的年轻患者尤为重要:病例系列证据级别:IV。
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引用次数: 0
Acute postoperative complications after spine deformity correction in patients with Down syndrome. 唐氏综合征患者脊柱畸形矫正术后的急性并发症。
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-26 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241277031
Claire W Bonnyman, Lydia N Klinkerman, Brandon A Ramo, Megan E Johnson

Introduction: Down syndrome, or trisomy 21, is the most diagnosed chromosomal abnormality and is associated with multiple orthopedic concerns, including scoliosis. We sought to examine the surgical treatment of scoliosis associated with Down syndrome with an emphasis on specific complications in this population.

Methods: A retrospective review of 13 patients with Down syndrome who underwent surgical intervention for spinal deformity between 2000 and 2018 were identified. Postoperative complications were classified using the modified Clavien-Dindo-Sink system. Perioperative and final follow-up radiographic data were analyzed.

Results: The mean age at surgery was 14.2 years (11-19) with a mean follow-up of 3.6 years (0.4-6.2) at the time of data collection. Seven (54%) patients had postoperative complications, all related to wound healing. Three patients (23%) had major complications (Clavien-Dindo-Sink grade ≥3). These included one deep surgical site infection, one hematoma, and one seroma, all requiring surgical drainage. Four additional patients (31%) had minor complications (Clavien-Dindo-Sink grade ≤2).

Discussion: Surgical intervention for scoliosis in patients with Down syndrome is associated with high complication rates despite the use of more modern surgical techniques and implant types. Complications in this cohort primarily involved wound healing, whereas previous studies described high rates of postoperative implant failure, pseudoarthrosis, and significant curve progression, which were not experienced by the patients in this study. Although the etiology of wound-related complications is unknown, awareness of this risk may help surgeons optimize surgical technique, postoperative monitoring, and preoperative counseling of families.

Level of evidence: IV-single-institution retrospective case series.

导言:唐氏综合征或 21 三体综合征是最常见的染色体异常,与包括脊柱侧弯在内的多种骨科问题有关。我们试图研究与唐氏综合征相关的脊柱侧凸的手术治疗,重点关注这一人群的特殊并发症:我们对 2000 年至 2018 年间接受脊柱畸形手术治疗的 13 名唐氏综合征患者进行了回顾性研究。术后并发症采用改良的Clavien-Dindo-Sink系统进行分类。对围手术期和最终随访的放射学数据进行了分析:手术时的平均年龄为14.2岁(11-19岁),数据收集时的平均随访时间为3.6年(0.4-6.2年)。七名患者(54%)出现术后并发症,均与伤口愈合有关。三名患者(23%)出现了严重并发症(Clavien-Dindo-Sink 等级≥3)。其中包括一次深部手术部位感染、一次血肿和一次血清肿,均需要手术引流。另有四名患者(31%)出现轻微并发症(Clavien-Dindo-Sink分级≤2):讨论:尽管采用了更先进的手术技术和植入物类型,但唐氏综合征患者脊柱侧凸的手术治疗并发症发生率很高。本组患者的并发症主要涉及伤口愈合,而之前的研究则描述了术后植入失败、假关节和明显的曲线恶化等高发生率,但本研究中的患者并没有遇到这些情况。虽然伤口相关并发症的病因尚不清楚,但对这一风险的认识可能有助于外科医生优化手术技巧、术后监测和对家属的术前咨询:证据级别:IV-单一机构回顾性病例系列。
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引用次数: 0
Odontoid fractures in the pediatric population: a systematic review and management algorithm. 小儿牙槽骨骨折:系统回顾和处理算法。
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-19 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241283232
Anjali M Prabhat, David S Liu, Lara Cohen, Daniel Gabriel, Kristen E Hines, Grant D Hogue

Purpose: The management of odontoid fractures in adult patients has been widely described. However, there is sparse literature about this injury in the pediatric population. This study aimed to review published literature regarding the management and outcomes of pediatric odontoid fractures to develop a stepwise treatment algorithm.

Methods: A literature review was conducted using PRISMA guidelines on PubMed to identify studies between 1960 and 2023 that reported on the management and outcomes of odontoid fracture in pediatric patients. Studies were included if they were published in English and if their sample included at least four patients aged 0-18, minimum follow-up of 6 weeks, and outcomes for each patient clearly differentiated.

Results: In total, 15 studies including 125 pediatric patients with odontoid fractures were included. Treatment options varied from non-operative management with immobilization in rigid collars, halo vests, cervicothoracic orthosis, or soft collars to surgical management with fixation and/or arthrodesis. There were 73 patients initially treated nonoperatively, 47 initially treated surgically, 2 who healed with observation alone, and 3 who died acutely of concomitant injuries. The nonunion rate for nonoperative management was 5.5%. Surgery was successful, demonstrating bony union at final follow-up, in 94.6% of cases treated via a posterior approach and 85.7% of cases treated with an anterior approach.

Conclusions: Odontoid fractures must be considered in pediatric patients with cervical spine trauma. This is the largest literature review of pediatric odontoid fractures. Various management strategies exist and can be considered. The proposed algorithm offers an evidence-based framework for the management of pediatric odontoid fractures.

目的:成人患者蝶骨骨折的治疗方法已被广泛描述。然而,关于小儿患者这种损伤的文献却很少。本研究旨在回顾已发表的有关小儿寰枢椎骨折的治疗和结果的文献,以制定一个循序渐进的治疗算法:方法:采用PRISMA指南在PubMed上进行文献综述,以确定1960年至2023年间有关小儿蝶骨骨折的治疗和结果的研究。如果研究是用英语发表的,且样本中至少有四名0-18岁的患者,随访时间至少为6周,并对每名患者的治疗结果进行了明确区分,则可纳入研究:结果:共纳入15项研究,包括125名蝶骨骨折的儿科患者。治疗方案多种多样,从使用硬袢固定、晕背心、颈胸椎矫形器或软袢固定的非手术治疗,到使用固定和/或关节置换术的手术治疗。最初接受非手术治疗的患者有 73 人,最初接受手术治疗的患者有 47 人,仅通过观察就痊愈的患者有 2 人,因并发症急性死亡的患者有 3 人。非手术治疗的不愈合率为 5.5%。94.6%的病例通过后路手术治疗成功,85.7%的病例通过前路手术治疗成功,并在最后随访时显示骨结合:结论:对于颈椎外伤的儿科患者,必须考虑到齿状突骨折。这是关于小儿蝶骨骨折的最大规模的文献综述。有多种治疗策略可供参考。建议的算法为小儿寰枢椎骨折的治疗提供了循证框架。
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引用次数: 0
Allograft-prosthesis composite after proximal femur bone tumor resection in pediatric age: Is it effective in preserving bone stock? 儿童股骨近端骨肿瘤切除术后的异体移植-假体复合技术:它能有效保留骨量吗?
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-17 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241269338
Domenico Andrea Campanacci, Roberto Scanferla, Francesco Muratori, Federico Scolari, Guido Scoccianti, Angela Tamburini, Giovanni Beltrami

Purpose: The purpose of the study was to answer the following questions. What was functional results of pediatric patients receiving a short stem allograft-prosthesis composite of the proximal femur? What was complication rate and revision-free implant survival? Was it possible to preserve the bone stock of the proximal femur in pediatric patients?

Methods: We reviewed 10 pediatric patients treated with proximal femur resection for a primary bone tumor and reconstruction with short stem allograft-prosthesis composite, with at least 24 months follow-up. The median age was 9 years (4-13) at surgery. The mean resection length was 15 cm (6-29). In six cases, fixation was performed with a short plate positioned under the great trochanter while in four cases a long plate extended over the great trochanter was employed.

Results: Nine complications that required surgical revision were assessed in six patients (one wound dehiscence, two nonunions, two fractures, one acetabular wear, three hypometria), while allograft-prosthesis composite removal was required in three patients. The revision-free survival was 57% (95% confidence interval 33%-100%) at 5 and 10 years. The graft removal-free survival was 75% (95% confidence interval 50%-100%) at 5 and 10 years. The mean Musculo-Skeletal Tumor Society Score was 28 (20-30).

Conclusions: Allograft-prosthesis composites with short stem and compression plate represents an effective reconstructive option after proximal femur resection for primary bone tumors in growing patients, preserving bone stock. The use of a compression plate extended over the greater trochanter seemed to reduce failure rate.

目的:本研究旨在回答以下问题。接受股骨近端短柄异体移植物-假体复合体的儿童患者的功能效果如何?并发症发生率和植入物无翻修存活率如何?是否可以保留儿童患者股骨近端的骨量?我们回顾了10例因原发性骨肿瘤而接受股骨近端切除术并用短柄同种异体假体复合体进行重建的儿童患者,随访时间至少24个月。手术时的中位年龄为 9 岁(4-13 岁)。平均切除长度为 15 厘米(6-29 厘米)。在六个病例中,使用了位于大转子下方的短钢板进行固定,而在四个病例中则使用了延伸至大转子上方的长钢板:结果:经评估,6例患者出现了9种需要手术翻修的并发症(1例伤口裂开、2例不愈合、2例骨折、1例髋臼磨损、3例髋臼厚度不足),3例患者需要移除异体移植物-假体复合体。5年和10年的无翻修存活率为57%(95%置信区间为33%-100%)。5年和10年的无移植物存活率为75%(95%置信区间为50%-100%)。肌肉骨骼肿瘤协会平均评分为28分(20-30分):结论:对于生长期患者,在原发性骨肿瘤股骨近端切除术后,同种异体移植物-假体复合体与短骨干和加压钢板是一种有效的重建选择,可保留骨量。使用延伸至股骨大转子的加压板似乎能降低失败率。
{"title":"Allograft-prosthesis composite after proximal femur bone tumor resection in pediatric age: Is it effective in preserving bone stock?","authors":"Domenico Andrea Campanacci, Roberto Scanferla, Francesco Muratori, Federico Scolari, Guido Scoccianti, Angela Tamburini, Giovanni Beltrami","doi":"10.1177/18632521241269338","DOIUrl":"https://doi.org/10.1177/18632521241269338","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to answer the following questions. What was functional results of pediatric patients receiving a short stem allograft-prosthesis composite of the proximal femur? What was complication rate and revision-free implant survival? Was it possible to preserve the bone stock of the proximal femur in pediatric patients?</p><p><strong>Methods: </strong>We reviewed 10 pediatric patients treated with proximal femur resection for a primary bone tumor and reconstruction with short stem allograft-prosthesis composite, with at least 24 months follow-up. The median age was 9 years (4-13) at surgery. The mean resection length was 15 cm (6-29). In six cases, fixation was performed with a short plate positioned under the great trochanter while in four cases a long plate extended over the great trochanter was employed.</p><p><strong>Results: </strong>Nine complications that required surgical revision were assessed in six patients (one wound dehiscence, two nonunions, two fractures, one acetabular wear, three hypometria), while allograft-prosthesis composite removal was required in three patients. The revision-free survival was 57% (95% confidence interval 33%-100%) at 5 and 10 years. The graft removal-free survival was 75% (95% confidence interval 50%-100%) at 5 and 10 years. The mean Musculo-Skeletal Tumor Society Score was 28 (20-30).</p><p><strong>Conclusions: </strong>Allograft-prosthesis composites with short stem and compression plate represents an effective reconstructive option after proximal femur resection for primary bone tumors in growing patients, preserving bone stock. The use of a compression plate extended over the greater trochanter seemed to reduce failure rate.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Femoral neck-shaft angle changes based on the severity of neurologic impairment in children with cerebral palsy and spinal muscular atrophy. 根据脑瘫和脊髓性肌肉萎缩症患儿神经功能受损的严重程度确定股骨颈轴角的变化。
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-10 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241277023
Luiz Carlos Almeida da Silva, Yusuke Hori, Burak Kaymaz, Kenneth J Rogers, Arianna Trionfo, James Richard Bowen, Jason J Howard, Michael Wade Shrader, Freeman Miller

Introduction: The neck-shaft angle and head-shaft angle in children with varying levels of neurological disability were evaluated to define change over different ages.

Methods: Children aged 1-12 years with spastic cerebral palsy, spinal muscular atrophy types 1 and 2, or typical development were reviewed to evaluate the neck-shaft angle and head-shaft angle. Patients were divided into five groups: Gross Motor Function Classification System levels I and II, Gross Motor Function Classification System level III, Gross Motor Function Classification System levels IV and V, spinal muscular atrophy types 1 and 2, and typical development. A linear mixed model was utilized to evaluate neck-shaft angle and head-shaft angle.

Results: Data from 196 children (mean age 4.8 ± 4.5 years) were included. Gross Motor Function Classification System levels I and II: 22 children, 130 hip radiographs measured, neck-shaft angle 143.7 ± 7.4, and head-shaft angle 160.0 ± 7.1. Gross Motor Function Classification System level III: 8 children, 33 hips evaluated, neck-shaft angle 153.1 ± 4.3, and head-shaft angle 163.4 ± 4.2. Gross Motor Function Classification System levels IV and V: 30 children, 137 hip radiographs measured, neck-shaft angle 156.4 ± 5.6, and head-shaft angle 167.9 ± 6.8. Spinal muscular atrophy types 1 and 2: 32 children, 83 hip radiographs measured, neck-shaft angle 161.9 ± 9.7, and head-shaft angle 173.4 ± 7.4. Typical development: 104 children, 222 hip radiographs measured, neck-shaft angle 138.6 ± 7.0, and head-shaft angle 156.4 ± 5.9. There were significant statistical differences when comparing neck-shaft angle and head-shaft angle.

Conclusion: As children grow, neck-shaft angle and head-shaft angle tend to decrease in typical development and Gross Motor Function Classification System levels I and II groups. However, in low-tone (spinal muscular atrophy types 1 and 2) and high-tone groups (Gross Motor Function Classification System levels IV and V), neck-shaft angle and head-shaft angle tend to increase with age. In both low-tone and high-tone groups, coxa valga is observed. When evaluating the effect of proximal femur-guided growth, these defined normal growth patterns should be considered.

Level of evidence: Level III Retrospective comparative study.

引言对不同程度神经残疾儿童的颈轴角和头轴角进行评估,以确定不同年龄段的变化:方法:对 1-12 岁患有痉挛性脑瘫、脊髓性肌萎缩症 1 型和 2 型或典型发育的儿童进行复查,以评估颈轴角和头轴角。患者被分为五组:粗大运动功能分级系统 I 级和 II 级组、粗大运动功能分级系统 III 级组、粗大运动功能分级系统 IV 级和 V 级组、脊髓性肌萎缩 1 型和 2 型组以及典型发育组。采用线性混合模型评估颈轴角和头轴角:结果:共纳入了 196 名儿童(平均年龄为 4.8 ± 4.5 岁)的数据。粗大运动功能分级系统 I 级和 II 级:22 名儿童,测量了 130 张髋关节 X 光片,颈轴角为 143.7 ± 7.4,头轴角为 160.0 ± 7.1。粗大运动功能分级系统 III 级:8 名儿童,评估 33 个髋关节,颈轴角为 153.1 ± 4.3,头轴角为 163.4 ± 4.2。粗大运动功能分级系统 IV 级和 V 级:30 名儿童,测量 137 个髋关节 X 光片,颈轴角 156.4 ± 5.6,头轴角 167.9 ± 6.8。脊髓性肌肉萎缩症 1 型和 2 型:32 名儿童,83 张髋关节 X 光片,颈轴角 161.9 ± 9.7,头轴角 173.4 ± 7.4。典型发育:104名儿童,测量222张髋关节X光片,颈轴角为138.6 ± 7.0,头轴角为156.4 ± 5.9。颈轴角和头轴角比较有明显的统计学差异:结论:随着儿童的成长,颈轴角和头轴角在典型发育组和粗大运动功能分级系统 I 级和 II 级组中呈下降趋势。然而,在低音调组(脊髓性肌肉萎缩症 1 型和 2 型)和高音调组(粗大运动功能分类系统 IV 级和 V 级)中,颈轴角和头轴角往往会随着年龄的增长而增大。在低音调组和高音调组中,均可观察到髋臼。在评估股骨近端引导生长的效果时,应考虑这些确定的正常生长模式:证据等级:III 级 回顾性比较研究。
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引用次数: 0
Solitary medial proximal tibial osteochondromas cause pes anserinus syndrome in adolescents. 孤独性胫骨近端内侧骨软骨瘤导致青少年拇趾趾骨综合征。
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-08 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241276323
Fevzi Saglam, Muhammed Fatih Serttas

Objective: Osteochondromas are common bone tumors with hyaline cartilage-covered heads, arising from cortical and medullary bone. Solitary medial proximal tibial osteochondromas (MPTOs) can cause pes anserinus syndrome via compression. However, the literature lacks comprehensive studies on MPTO-related pes anserinus syndrome and its surgical outcomes.

Material and method: The study reviewed 227 patients diagnosed with osteochondroma between January 2018 and January 2022, with 21 patients meeting inclusion criteria: under 19 years, MPTO, surgical excision, histological diagnosis, ≥1-year follow-up. Cases with irregular follow-ups and multiple hereditary exostoses were excluded. Different surgical techniques were employed based on lesion characteristics. Postoperative weight bearing was allowed, and follow-ups involved postoperative complications assessment, clinical data collection, imaging, and functional evaluations using the International Knee Documentation Committee (IKDC) and Hospital for Special Surgery Pediatric Functional Activity Brief Scale scoring systems.

Results: The study involved 21 adolescents (15 ± 2 years). Lesion types were predominantly pedunculated (86%) and surgical interventions involved pes anserinus split (76%) or tenoplasty (24%). No significant correlations were observed between lesion dimensions and IKDC scores. Split intervention led to a significant improvement in IKDC scores (p < 0.01), while tenoplasty showed similar results (p < 0.05). Athlete status did not affect IKDC scores significantly, but both athletes and non-athletes demonstrated improvements (p < 0.05).

Conclusion: The negative impact of MPTOs causing pes anserinus tendinitis on the patient's quality of life and activity can be completely corrected with surgical treatment. Complete pes anserinus tendon cutting and subsequent repair are recommended if they facilitate surgery. The study underscores the importance of surgical management for MPTO-related pes anserinus syndrome and provides insights into the effectiveness of different surgical techniques.

目的:骨软骨瘤是一种常见的骨肿瘤,其头部为透明软骨覆盖,产生于皮质和髓质骨。单发的胫骨近端内侧骨软骨瘤(MPTO)可通过压迫引起趾骨综合征。然而,文献缺乏对 MPTO 相关拇趾综合征及其手术效果的全面研究:研究回顾了2018年1月至2022年1月期间确诊的227例骨软骨瘤患者,其中21例患者符合纳入标准:19岁以下、MPTO、手术切除、组织学诊断、随访≥1年。随访不规律和多发性遗传性外软骨病病例被排除在外。根据病变特点采用不同的手术方法。术后允许负重,随访包括术后并发症评估、临床数据收集、影像学检查以及使用国际膝关节文献委员会(IKDC)和特殊外科医院儿科功能活动简易量表评分系统进行的功能评估:研究涉及 21 名青少年(15 ± 2 岁)。病变类型主要为足底型(86%),手术干预包括踝趾分离术(76%)或腱成形术(24%)。病变尺寸与IKDC评分之间无明显相关性。劈裂干预可显著改善 IKDC 评分(p p p 结论:通过手术治疗,可以完全纠正由 MPTO 引起的拇趾腱鞘炎对患者生活质量和活动能力的负面影响。如果方便手术,建议对拇趾肌腱进行完全切断并随后进行修复。该研究强调了手术治疗 MPTO 相关趾踝综合征的重要性,并对不同手术技术的有效性进行了深入探讨。
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引用次数: 0
Response to Letter to the Editor-Plate fixation versus flexible intramedullary nails for management of closed femoral shaft fractures in the paediatric population: A systematic review and meta-analysis of the adverse outcomes (J Child Orthop 2023,17(5),442-452). 对致编辑的信的回复--在治疗儿科闭合性股骨干骨折时使用钢板固定与柔性髓内钉:不良结果的系统回顾和荟萃分析》(J Child Orthop 2023,17(5),442-452).
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-02 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241264133
Abhinav Singh, William Bierrum, Justin Wormald, Manoj Ramachandran, Gregory Firth, Deborah Eastwood
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引用次数: 0
Plate fixation versus flexible intramedullary nails for management of closed femoral shaft fractures in the pediatric population: A systematic review and meta-analysis of the adverse outcomes. 在治疗儿科闭合性股骨干骨折时,钢板固定与柔性髓内钉的对比:不良后果的系统回顾和荟萃分析。
IF 1.3 4区 医学 Q3 ORTHOPEDICS Pub Date : 2024-09-02 eCollection Date: 2024-10-01 DOI: 10.1177/18632521241264129
Andreas Rehm, Jehan Butt, Ramy Shehata, Katerina Hatzantoni, Nicholas Judkins
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引用次数: 0
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Journal of Childrens Orthopaedics
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