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Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation. 股骨骨骺滑动患者术前髋关节磁共振成像对股骨后翻的评估:对髋关节撞击风险评估的理论意义。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521221149044
Till D Lerch, Tilman Kaim, Markus S Hanke, Florian Schmaranzer, Simon D Steppacher, Jasmin D Busch, Eduardo N Novais, Kai Ziebarth

Purpose: Slipped capital femoral epiphysis is a common pediatric hip disease and was associated with femoral retroversion, but femoral version was rarely measured. Therefore, mean femoral version, mean femoral neck version, and prevalence of femoral retroversion were analyzed for slipped capital femoral epiphysis patients.

Methods: A retrospective observational study evaluating preoperative hip magnetic resonance imaging of 27 patients (49 hips) was performed. Twenty-seven untreated slipped capital femoral epiphysis patients (28 slipped capital femoral epiphysis hips and 21 contralateral hips, age 10-16 years) were evaluated (79% stable slipped capital femoral epiphysis, 22 patients; 43% severe slipped capital femoral epiphysis, 12 patients). Femoral version was measured using Murphy method on magnetic resonance imaging (January 2014-December 2021, rapid bilateral 3-dimensional T1 water-only Dixon-based images of pelvis and knee). All slipped capital femoral epiphysis patients underwent surgery after magnetic resonance imaging.

Results: Mean femoral version of slipped capital femoral epiphysis patients (-1° ± 15°) was significantly (p < 0.001) lower compared to contralateral side (15° ± 14°). Femoral version of slipped capital femoral epiphysis patients had significantly (p < 0.001) wider range from -42° to 35° (range 77°) compared to contralateral side (-5° to 44°, range 49°). Mean femoral neck version of slipped capital femoral epiphysis patients (6° ± 15°) was lower compared to contralateral side (11° ± 12°). Fifteen slipped capital femoral epiphysis patients (54%) had absolute femoral retroversion (femoral version < 0°). Six of the 12 hips (50%) with severe slips and 4 of the 8 hips (50%) with mild slips had absolute femoral retroversion (femoral version < 0°). Ten slipped capital femoral epiphysis patients (40%) had absolute femoral neck retroversion (femoral neck version < 0°).

Conclusion: Although slipped capital femoral epiphysis patients showed asymmetrically lower femoral version compared to contralateral side, there was a wide range of femoral version, underlining the importance of patient-specific femoral version analysis on preoperative magnetic resonance imaging. Absolute femoral retroversion was prevalent in half of slipped capital femoral epiphysis patients, in half of severe slipped capital femoral epiphysis patients, and in half of mild slipped capital femoral epiphysis patients. This has implications for anterior hip impingement and for surgical treatment with in situ pinning or femoral osteotomy (e.g. proximal femoral derotation osteotomy) or other hip preservation surgery.

目的:股骨头骨骺滑动是一种常见的儿童髋关节疾病,与股后移有关,但很少测量股后移。因此,我们分析了股骨骨骺滑动患者的平均股骨内径、平均股骨颈内径和股骨后翻的发生率。方法:回顾性观察27例患者(49髋)术前的髋关节磁共振成像。27例未经治疗的股骨头骨骺滑动患者(28例为股骨头骨骺髋关节滑动,21例为对侧髋关节滑动,年龄10-16岁)进行评估(79%为稳定股骨头骨骺滑动,22例;严重股骨头骨骺滑动43%(12例)。股骨版本使用磁共振成像Murphy法测量(2014年1月- 2021年12月,快速双侧3维T1骨盆和膝关节仅水dixon图像)。所有股骨骨骺滑动患者均在磁共振成像后行手术治疗。结果:股骨骨干骨骺滑动患者的平均股骨版本(-1°±15°)显著(p)。结论:尽管股骨骨干骨骺滑动患者的股骨版本与对侧相比不对称,但股骨版本的范围很广,强调了术前磁共振成像中患者特异性股骨版本分析的重要性。一半的股骨骨骺滑动患者、一半的严重股骨骨骺滑动患者和一半的轻度股骨骨骺滑动患者存在绝对股后翻。这对髋前撞击和原位钉钉或股骨截骨术(如股骨近端旋转截骨术)或其他髋关节保存手术治疗具有重要意义。
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引用次数: 1
Return to sport after forearm fractures in children: A scoping review and survey. 儿童前臂骨折后恢复运动:范围回顾和调查。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521231156434
Ameya Bhanushali, Rebecca Bright, Louis Xu, Peter Cundy, Nicole Williams

Purpose: A common question faced by clinicians is when a child may return to sport after treatment for a pediatric forearm fracture. There are few published recommendations and fewer supported by evidence. The aims of this study were to summarize existing published recommendation for return to sport after pediatric forearm fractures and to conduct a survey to determine usual clinical recommendations.

Methods: A scoping review was performed on Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Google Scholar in accordance with the Joanna Briggs Institute guidelines. In addition, 64 orthopedic surgeons were anonymously surveyed asking for recommendations regarding return to sport after pediatric forearm fractures. Participants were to assume children were 9 years old and played a sport with an average risk of forearm injury.

Results: Twenty-two publications for return to sport were retrieved. Children with distal radius buckle fractures safely commonly returned to sport by 4 weeks after initial injury, while survey respondents recommended over 6 weeks. Survey respondents valued fracture stability the highest when making return to sport recommendations. Children with simple, metaphyseal, single-bone fractures were usually allowed to return to sport at 8-10 weeks post-injury. Diaphyseal and complete fractures were prescribed longer return to sport intervals. Australian respondents also prescribed longer return to sport intervals.

Conclusion: Children with distal radius buckle fractures may return to sport by 4 weeks after initial injury, sooner than recommended. Published recommendations remain limited for other fractures. However, our survey suggests children with simple, metaphyseal, single-bone fractures may return to sport at 8-10 weeks. Children with diaphyseal and complete fractures should abstain from sport for longer than metaphyseal and greenstick fractures, respectively.

Level of evidence: level V.

目的:临床医生面临的一个常见问题是,儿童前臂骨折治疗后,儿童何时可以恢复运动。发表的建议很少,证据支持的更少。本研究的目的是总结现有发表的关于儿童前臂骨折后恢复运动的建议,并进行一项调查以确定通常的临床建议。方法:根据乔安娜布里格斯研究所的指南,在Ovid MEDLINE、Cochrane中央对照试验登记册、Embase、Scopus和Google Scholar上进行范围综述。此外,对64位骨科医生进行了匿名调查,询问他们对儿童前臂骨折后重返运动的建议。参与者假设孩子们9岁,从事前臂受伤风险为平均水平的运动。结果:共检索到22篇关于回归运动的出版物。桡骨远端屈曲骨折的儿童通常在初始损伤后4周安全恢复运动,而调查受访者建议超过6周。在提出回归运动的建议时,受访者最看重骨折的稳定性。单纯性、干骺端、单骨骨折的儿童通常在受伤后8-10周允许恢复运动。骨干骨折和完全性骨折需要更长的恢复运动间隔。澳大利亚受访者还建议延长重返运动的时间间隔。结论:桡骨远端屈曲骨折患儿可在初始损伤后4周恢复运动,比推荐时间早。对于其他骨折,已发表的建议仍然有限。然而,我们的调查显示,单纯性干骺端骨折的儿童可以在8-10周后恢复运动。干骺端骨折和完全性骨折患儿应分别比干骺端骨折和绿枝骨折患儿更长的时间内避免运动。证据等级:V级。
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引用次数: 0
Femoral morphology in Ortolani's anatomical collection of developmental dysplasia of the hip: Anteversion is unrelated to severity of infantile dysplasia. Ortolani解剖收集的发育性髋关节发育不良的股骨形态:前倾与婴儿发育不良的严重程度无关。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521231152282
Victor Huayamave, Tamara Chambers, Ilaria Fantoni, Carla Stecco, Raffaele De Caro, Charles T Price

Purpose: This study evaluated and quantified femoral anteversion and femoral head sphericity in healthy and dysplastic hips of post-mortem infant specimens from Ortolani's collection.

Methods: Healthy hips and hips with cases of dysplasia, with a large variety of severity, were preserved. Morphological measurements were taken on 14 specimens (28 hips), with a mean age of 4.68 months. The degree of dysplasia was classified as mild (A) to severe (D); 11 hips were Grade A, 6 hips were Grade B, 7 hips were Grade C, and 4 hips were Grade D. The femoral anteversion angle, the minimum femoral head diameter, and the maximum femoral head diameter were measured. The minimum and maximum femoral head diameters were used to estimate femoral head sphericity.

Results: The mean femoral anteversion angle was 30.81 degrees ± 11.07 degrees in cases and 29.69 degrees ± 12.69 degrees in controls. There were no significant differences between the normal-to-mild group and moderate-to-severe group when comparing the femoral anteversion angle (p = 0.836). The mean estimated sphericity was 1.08 mm ± 0.50 mm in cases and 0.81 mm ± 0.65 mm in controls, with no statistically significant difference between the groups (p = 0.269).

Conclusion: Ortolani's collection showed no significant differences between healthy and dysplastic hips in specimens under 1 year of age. While the femoral head appeared slightly more flattened in dysplastic hips, it was not statistically significant. The findings in the unique collection add to the knowledge of the pathoanatomy of infantile hip dysplasia.

Clinical relevance: Femoral anteversion may not play a role in the etiology and pathogenesis of DDH.

目的:本研究评估和量化来自Ortolani收集的死后婴儿标本的健康和发育不良髋的股骨前倾和股骨头球形度。方法:保留健康髋关节和严重程度不同的髋关节发育不良病例。对14个标本(28髋)进行了形态学测量,平均年龄为4.68个月。发育不良程度分为轻度(A)至重度(D);A级11例,B级6例,C级7例,d级4例。测量股骨前倾角、股骨头最小径、最大径。最小和最大股骨头直径用来估计股骨头的球形度。结果:患者股骨前倾角平均为30.81°±11.07°,对照组为29.69°±12.69°。正常至轻度组与中度至重度组股骨前倾角比较差异无统计学意义(p = 0.836)。平均估计球度,病例为1.08 mm±0.50 mm,对照组为0.81 mm±0.65 mm,组间差异无统计学意义(p = 0.269)。结论:Ortolani收集的1岁以下的健康和发育不良髋关节标本没有显著差异。而在发育不良的髋关节中,股骨头略显扁平,但没有统计学意义。在独特的收集结果增加了婴儿髋关节发育不良病理解剖学的知识。临床相关性:股骨前倾可能在DDH的病因和发病机制中不起作用。
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引用次数: 0
Back pain in adolescent idiopathic scoliosis: A comprehensive review. 青少年特发性脊柱侧凸的背痛:一项全面的综述。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521221149058
Juhyung K An, Daniel Berman, Jacob Schulz

Purpose: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity that affects millions of children worldwide. A variety of treatment algorithms exist for patients based on radiographic parameters such as the Cobb angle and the Risser stage. However, there has been a growing focus on nonradiographic outcomes such as back pain, which can cause functional disability and reduced quality of life for patients. In spite of this, back pain in AIS is poorly characterized in the literature. We aimed to summarize various factors that may influence back pain in AIS and the impact of different treatment methods on pain reduction.

Methods: A comprehensive systematic review was undertaken using the PubMed and Cochrane database. Keywords that were utilized and combined with "Adolescent Idiopathic Scoliosis" included, "back pain," "treatment," "biomechanics," "biochemistry," "epidemiology," and "biopsychosocial." The literature was subsequently evaluated and deemed relevant or not relevant for inclusion.

Results: A total of 93 articles were ultimately included in this review. A variety of contradictory literature was present for all sections related to epidemiology, underlying biomechanics and biochemistry, biopsychosocial factors, and treatment methodologies.

Conclusion: Back pain in AIS is common but remains difficult to predict and treat. The literature pertaining to causative factors and treatment options is heterogeneous and inconclusive. Longer-term prospective studies combining biopsychosocial intervention in conjunction with existing curve correction techniques would be meaningful.

目的:青少年特发性脊柱侧凸(AIS)是一种常见的脊柱畸形,影响着全世界数百万儿童。根据放射学参数,如Cobb角和Risser分期,存在多种治疗算法。然而,人们越来越关注非放射学结果,如背部疼痛,这可能导致功能障碍和患者生活质量下降。尽管如此,在文献中对AIS患者的腰痛描述甚少。我们的目的是总结可能影响AIS患者背部疼痛的各种因素以及不同治疗方法对减轻疼痛的影响。方法:使用PubMed和Cochrane数据库进行全面的系统评价。与“青少年特发性脊柱侧凸”结合使用的关键词包括:“背部疼痛”、“治疗”、“生物力学”、“生物化学”、“流行病学”和“生物心理社会”。随后对文献进行评估,并确定是否与纳入相关。结果:共有93篇文章最终纳入本综述。有关流行病学、基础生物力学和生物化学、生物心理社会因素和治疗方法的所有部分都存在各种相互矛盾的文献。结论:腰痛在AIS患者中很常见,但仍难以预测和治疗。有关致病因素和治疗方案的文献是异质和不确定的。将生物社会心理干预与现有曲线校正技术相结合的长期前瞻性研究将是有意义的。
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引用次数: 1
A 10.5-year follow-up of walking with unilateral spastic cerebral palsy. 单侧痉挛性脑瘫行走患者10.5年随访分析。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521231154975
Alice Bonnefoy-Mazure, Geraldo De Coulon, Pierre Lascombes, Aline Bregou, Stéphane Armand

Purpose: The purpose of this study was to describe gait evolution in patients with unilateral spastic cerebral palsy (USCP) using modified Gait Profile Score (mGPS without hip rotation), Gait Variable Score (GVS), walking speed, and the observed effects of single-level surgery (SLS) after 10 years.

Methods: Fifty-two patients with USCP (Gross Motor Function Classification System I) and data from two Clinical Gait Analyses (CGAs) were included. The evolution of patients' mGPS, GVS, and walking speed were calculated. Two "no surgery" and "single-level surgery" patient categories were analyzed. Paired t-tests were used to compare the data between CGAs and as a function of treatment category. Pearson's correlations were used to examine relationships between baseline values and evolutions in mGPS and walking speed.

Results: Mean ages (SD) at first and last CGAs were 9.3 (3.2) and 19.7 (6.0) years old, respectively, with an average follow-up of 10.5 (5.6) years. Mean mGPS for the patients' affected side was significantly lower at the last CGA for the full cohort: baseline = 8.5° (2.1) versus follow-up = 7.2° (1.6), effect size = 0.73, p < 0.001. Significant improvements in mGPS and GVS for ankle and foot progression were found for the SLS group. The mGPS change and mGPS at baseline (r = -0.79, p < 0.001) were negatively correlated.

Conclusions: SLS patients demonstrated a positive long-term change in gait pattern over time. The group that had undergone surgery had worse gait scores at baseline than the group that had not, but the SLS group's last CGA scores were relatively closer to those of the "no surgery" group.

Level of evidence: This was a retrospective comparative therapeutic study (level III).

目的:本研究旨在描述单侧痉挛性脑瘫(USCP)患者的步态演变,采用改良步态特征评分(mGPS),步态可变评分(GVS),步行速度,以及10年后单节段手术(SLS)的观察效果。方法:纳入52例USCP(大运动功能分类系统I)患者和两项临床步态分析(CGAs)的数据。计算患者的mGPS、GVS和步行速度的演变。对“不手术”和“单级手术”两类患者进行分析。配对t检验用于比较CGAs之间的数据和治疗类别的函数。Pearson相关性用于检验基线值与mGPS进化和步行速度之间的关系。结果:首次和最后一次CGAs的平均年龄(SD)分别为9.3(3.2)岁和19.7(6.0)岁,平均随访10.5(5.6)年。在整个队列中,患者受影响侧的平均mGPS在最后一次CGA时显着降低:基线= 8.5°(2.1),而随访= 7.2°(1.6),效应值= 0.73,p。结论:SLS患者表现出积极的长期步态模式变化。手术组的基线步态评分比未手术组差,但SLS组的最后CGA评分相对接近“未手术”组。证据水平:这是一项回顾性比较治疗研究(III级)。
{"title":"A 10.5-year follow-up of walking with unilateral spastic cerebral palsy.","authors":"Alice Bonnefoy-Mazure,&nbsp;Geraldo De Coulon,&nbsp;Pierre Lascombes,&nbsp;Aline Bregou,&nbsp;Stéphane Armand","doi":"10.1177/18632521231154975","DOIUrl":"https://doi.org/10.1177/18632521231154975","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to describe gait evolution in patients with unilateral spastic cerebral palsy (USCP) using modified Gait Profile Score (mGPS without hip rotation), Gait Variable Score (GVS), walking speed, and the observed effects of single-level surgery (SLS) after 10 years.</p><p><strong>Methods: </strong>Fifty-two patients with USCP (Gross Motor Function Classification System I) and data from two Clinical Gait Analyses (CGAs) were included. The evolution of patients' mGPS, GVS, and walking speed were calculated. Two \"no surgery\" and \"single-level surgery\" patient categories were analyzed. Paired <i>t</i>-tests were used to compare the data between CGAs and as a function of treatment category. Pearson's correlations were used to examine relationships between baseline values and evolutions in mGPS and walking speed.</p><p><strong>Results: </strong>Mean ages (SD) at first and last CGAs were 9.3 (3.2) and 19.7 (6.0) years old, respectively, with an average follow-up of 10.5 (5.6) years. Mean mGPS for the patients' affected side was significantly lower at the last CGA for the full cohort: baseline = 8.5° (2.1) versus follow-up = 7.2° (1.6), effect size = 0.73, <i>p</i> < 0.001. Significant improvements in mGPS and GVS for ankle and foot progression were found for the SLS group. The mGPS change and mGPS at baseline (r = -0.79, <i>p</i> < 0.001) were negatively correlated.</p><p><strong>Conclusions: </strong>SLS patients demonstrated a positive long-term change in gait pattern over time. The group that had undergone surgery had worse gait scores at baseline than the group that had not, but the SLS group's last CGA scores were relatively closer to those of the \"no surgery\" group.</p><p><strong>Level of evidence: </strong>This was a retrospective comparative therapeutic study (level III).</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 2","pages":"173-183"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/e4/10.1177_18632521231154975.PMC10080234.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283523","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
A comparison of three- and two-rod constructs in the correction of severe pediatric scoliosis. 三杆和两杆结构在小儿重度脊柱侧凸矫正中的比较。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521231156438
Masayoshi Machida, Brett Rocos, Reinhard Zeller, David E Lebel

Purpose: Managing severe scoliosis is challenging and risky with a significant complication rate regardless of treatment strategy. In this retrospective comparative study, we report our results using a three-rod compared to two-rod construct in the surgical treatment of severe spine deformities to investigate which technique is safer, and which provides superior radiological outcomes.

Methods: Forty-six consecutive patients undergoing posterior spine fusion for scoliosis between 2006 and 2017 were identified in our institutional records. Inclusion criteria were minimum coronal deformity of 90°, age < 18 years at the time of surgery and a minimum 2 years of follow-up. Radiographic and clinical parameters, as well as post-operative complications were compared between the two groups.

Results: There were 21 patients in the three-rod group and 25 in the two-rod group. The mean preoperative major coronal deformity was 100°± 9 and 102°± 10 in the three-rod and two-rod, respectively (p = 0.6). The average major curve correction was 51% and 59% in three-rod and two-rod groups, respectively (p = 0.03). The post-operative thoracic kyphosis was 30°± 11 and 21°± 12 in the three-rod and the two-rod groups, respectively (p = 0.01). The surgical time was 476 ± 52 and 387 ± 84 min in three-rod and two-rod, respectively (p < 0.01). One patient in the two-rod cohort showed permanent post-operative sensory deficit. There were three unplanned returns to operating theater in the two-rod group.

Conclusions: Coronal correction was better with two-rod, whereas sagittal balance was superior with three-rod. Both techniques achieved balanced spine treating severe scoliosis. The two-rod technique was associated with a higher likelihood of requiring revision surgery.

Level of evidence: level 3.

目的:无论采用何种治疗策略,治疗严重脊柱侧凸都是具有挑战性和风险的,并发症发生率很高。在这项回顾性比较研究中,我们报告了在严重脊柱畸形的手术治疗中使用三杆与两杆结构的结果,以调查哪种技术更安全,哪种技术能提供更好的放射学结果。方法:在2006年至2017年期间,在我们的机构记录中确定了46例连续接受后路脊柱融合术治疗脊柱侧凸的患者。纳入标准为最小冠状畸形90°,年龄。结果:三棒组21例,两棒组25例。术前三杆和两杆的平均主要冠状畸形分别为100°±9和102°±10 (p = 0.6)。三棒组和两棒组的平均主曲线矫正率分别为51%和59% (p = 0.03)。三杆组术后胸后凸30°±11°,两杆组术后胸后凸21°±12°(p = 0.01)。三棒和两棒的手术时间分别为476±52 min和387±84 min (p)。结论:两棒冠状面矫正效果较好,三棒矢状面矫正效果较好。这两种技术都达到了平衡脊柱治疗严重脊柱侧凸。双棒技术与需要翻修手术的可能性较高相关。证据等级:三级。
{"title":"A comparison of three- and two-rod constructs in the correction of severe pediatric scoliosis.","authors":"Masayoshi Machida,&nbsp;Brett Rocos,&nbsp;Reinhard Zeller,&nbsp;David E Lebel","doi":"10.1177/18632521231156438","DOIUrl":"https://doi.org/10.1177/18632521231156438","url":null,"abstract":"<p><strong>Purpose: </strong>Managing severe scoliosis is challenging and risky with a significant complication rate regardless of treatment strategy. In this retrospective comparative study, we report our results using a three-rod compared to two-rod construct in the surgical treatment of severe spine deformities to investigate which technique is safer, and which provides superior radiological outcomes.</p><p><strong>Methods: </strong>Forty-six consecutive patients undergoing posterior spine fusion for scoliosis between 2006 and 2017 were identified in our institutional records. Inclusion criteria were minimum coronal deformity of 90°, age < 18 years at the time of surgery and a minimum 2 years of follow-up. Radiographic and clinical parameters, as well as post-operative complications were compared between the two groups.</p><p><strong>Results: </strong>There were 21 patients in the three-rod group and 25 in the two-rod group. The mean preoperative major coronal deformity was 100°± 9 and 102°± 10 in the three-rod and two-rod, respectively (<i>p</i> = 0.6). The average major curve correction was 51% and 59% in three-rod and two-rod groups, respectively (<i>p</i> = 0.03). The post-operative thoracic kyphosis was 30°± 11 and 21°± 12 in the three-rod and the two-rod groups, respectively (<i>p</i> = 0.01). The surgical time was 476 ± 52 and 387 ± 84 min in three-rod and two-rod, respectively (<i>p</i> < 0.01). One patient in the two-rod cohort showed permanent post-operative sensory deficit. There were three unplanned returns to operating theater in the two-rod group.</p><p><strong>Conclusions: </strong>Coronal correction was better with two-rod, whereas sagittal balance was superior with three-rod. Both techniques achieved balanced spine treating severe scoliosis. The two-rod technique was associated with a higher likelihood of requiring revision surgery.</p><p><strong>Level of evidence: </strong>level 3.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 2","pages":"148-155"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/e1/10.1177_18632521231156438.PMC10080239.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283521","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
An investigation of maternal psychological status of children with congenital talipes equinovarus treated with the Ponseti method. Ponseti法治疗先天性马蹄足患儿母亲心理状态的研究。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521221145479
Wentao Dong, Ningning Shi, Chunyu Wen, Yong Zhang

Objectives: To investigate maternal psychological status of children with congenital talipes equinovarus in different periods, and to clarify the influence on maternal psychological status of congenital talipes equinovarus treated with the Ponseti method.

Methods: Sixty-seven mothers of children with congenital talipes equinovarus were investigated. Self-rating Depression Scale and Self-rating Anxiety Scale were used to evaluate the psychological stress of the mothers at different periods. Paired-samples t-test was used to analyze the results.

Results: The mothers of 67 children with congenital talipes equinovarus ranged from 25 to 38 years old, with an average of 33.5 years old. Before prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 42.537 ± 10.476, and the average score of Self-rating Depression Scale was 47.254 ± 12.846; after prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 54.224 ± 13.050, and the average score of Self-rating Depression Scale was 57.403 ± 13.649 points. Before the postpartum treatment of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 53.388 ± 12.716, the average score of Self-rating Depression Scale was 56.284 ± 13.617; after the treatment of congenital talipes equinovarus with the Ponseti method, the average score of Self-rating Anxiety Scale was 47.731 ± 12.259, and the average score of Self-rating Depression Scale was 51.910 ± 13.878 points. The above differences were statistically significant (P < 0.001).

Conclusion: The prenatal diagnosis of congenital talipes equinovarus will increase the maternal psychological stress, and the maternal psychological status will be significantly improved after the deformity of congenital talipes equinovarus is corrected effectively by the Ponseti method.

Level of evidence: level III, retrospective study.

目的:探讨先天性马蹄足患儿不同时期的产妇心理状态,阐明Ponseti法治疗先天性马蹄足患儿对产妇心理状态的影响。方法:对67例先天性马蹄内翻患儿的母亲进行调查。采用抑郁自评量表和焦虑自评量表对不同时期母亲的心理压力进行评估。采用配对样本t检验对结果进行分析。结果:67例先天性马蹄足内翻患儿的母亲年龄25 ~ 38岁,平均年龄33.5岁。产前诊断先天性马蹄内翻前,焦虑自评量表平均得分为42.537±10.476分,抑郁自评量表平均得分为47.254±12.846分;产前诊断为先天性马蹄内翻后,焦虑自评量表平均得分为54.224±13.050分,抑郁自评量表平均得分为57.403±13.649分。产后治疗前先天性马蹄内翻患者焦虑自评量表平均得分为53.388±12.716分,抑郁自评量表平均得分为56.284±13.617分;Ponseti法治疗先天性马蹄内翻后,焦虑自评量表平均得分为47.731±12.259分,抑郁自评量表平均得分为51.910±13.878分。结论:产前诊断先天性马蹄足会增加产妇的心理压力,经Ponseti法有效矫正先天性马蹄足畸形后,产妇的心理状态会得到明显改善。证据等级:III级,回顾性研究。
{"title":"An investigation of maternal psychological status of children with congenital talipes equinovarus treated with the Ponseti method.","authors":"Wentao Dong,&nbsp;Ningning Shi,&nbsp;Chunyu Wen,&nbsp;Yong Zhang","doi":"10.1177/18632521221145479","DOIUrl":"https://doi.org/10.1177/18632521221145479","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate maternal psychological status of children with congenital talipes equinovarus in different periods, and to clarify the influence on maternal psychological status of congenital talipes equinovarus treated with the Ponseti method.</p><p><strong>Methods: </strong>Sixty-seven mothers of children with congenital talipes equinovarus were investigated. Self-rating Depression Scale and Self-rating Anxiety Scale were used to evaluate the psychological stress of the mothers at different periods. Paired-samples t-test was used to analyze the results.</p><p><strong>Results: </strong>The mothers of 67 children with congenital talipes equinovarus ranged from 25 to 38 years old, with an average of 33.5 years old. Before prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 42.537 ± 10.476, and the average score of Self-rating Depression Scale was 47.254 ± 12.846; after prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 54.224 ± 13.050, and the average score of Self-rating Depression Scale was 57.403 ± 13.649 points. Before the postpartum treatment of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 53.388 ± 12.716, the average score of Self-rating Depression Scale was 56.284 ± 13.617; after the treatment of congenital talipes equinovarus with the Ponseti method, the average score of Self-rating Anxiety Scale was 47.731 ± 12.259, and the average score of Self-rating Depression Scale was 51.910 ± 13.878 points. The above differences were statistically significant (P < 0.001).</p><p><strong>Conclusion: </strong>The prenatal diagnosis of congenital talipes equinovarus will increase the maternal psychological stress, and the maternal psychological status will be significantly improved after the deformity of congenital talipes equinovarus is corrected effectively by the Ponseti method.</p><p><strong>Level of evidence: </strong>level III, retrospective study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":"17 2","pages":"184-190"},"PeriodicalIF":1.4,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/aa/10.1177_18632521221145479.PMC10080240.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283527","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
Less correction with minimally invasive surgery for adolescent idiopathic scoliosis compared to open surgical correction. 与开放式手术矫正相比,微创手术矫正青少年特发性脊柱侧凸的次数较少。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521221146642
Ayrat R Syundyukov, Nikolai S Nikolaev, Sergei V Vissarionov, Pavel N Kornyаkov, Kalind S Bhandarkar, Vladimir U Emelianov

Purpose: In this study, we investigated the relationship between the results of thoracic curve correction using minimally invasive surgeries in 35 patients and open surgical correction in 47 patients with adolescent idiopathic scoliosis.

Methods: The correlations between the Cobb's angle of the primary and postoperative curves, angle of thoracic kyphosis and lumbar lordosis, correction percentage, derotation values, estimated blood loss, duration of surgery, and period of hospitalization after surgery were assessed by calculating the mean and standard deviation. Calculation and comparison were performed using Pearson correlation.

Results: The Cobb's angle correction ranged from 53.4° ± 11.8° to 6.7° ± 5.2° (p < 0.001) in the open surgical correction group and from 51.2° ± 11.4° to 11.7° ± 5.8° (p < 0.001) in the minimally invasive surgery group before and after surgery, respectively. The percentage of curvature correction was 88.2% ± 8.0% and 77.7% ± 10.7% (p < 0.001) in the open surgical correction and minimally invasive surgery groups, respectively. The estimated blood loss was higher in the open surgical correction group than in the minimally invasive surgery group (208.7 ± 113.4 vs 564.3 ± 242.7 mL). Axial rotation was changed from 29.1°± 7.5 to 17.1°± 6.8 (p < 0.001) in the open surgical correction group and from 28.9°± 7.8 to 19.4°± 6.4 (p < 0.001) in the minimally invasive surgery group. The duration of surgery was shorter in the open surgical correction group than in the minimally invasive surgery group (266.6 ± 64.3 vs 346.2 ± 70.5 min). A positive correlation between time of operation and Cobb's angle correction (in °) in open surgical correction (r = 0.37) and minimally invasive surgery (r = 0.43) was found.

Conclusion: The open surgical correction procedures were more effective than minimally invasive surgery in correcting the spinal curve. The increase in the duration of open surgical correction increases the estimated blood loss, but it also more significantly improves the correction of Cobb's angle.

Level of evidence: III.

目的:在本研究中,我们研究了35例青少年特发性脊柱侧凸的微创手术和47例开放性手术矫正的结果之间的关系。方法:通过计算平均值和标准差,评价手术前后曲线Cobb角、胸后凸角和腰椎前凸角、矫正率、旋转值、预估失血量、手术时间、术后住院时间的相关性。使用Pearson相关进行计算和比较。结果:Cobb角矫正范围为53.4°±11.8°~ 6.7°±5.2°(p p p p r = 0.37),发现微创手术(r = 0.43)。结论:开放性手术矫正脊柱弯曲比微创手术更有效。开放手术矫正持续时间的增加增加了估计失血量,但也更显著地改善了Cobb角的矫正。证据水平:III。
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引用次数: 1
Hip morphology on initial ultrasound predicts hip morphology at one year in developmental dysplasia of the hip. 髋关节的初始超声形态预测髋关节发育不良一年的髋关节形态。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521221141085
Ajay C Kanakamedala, Neha S Jejurikar, Pablo Castañeda

Purpose: This study aimed to determine whether point-of-care ultrasound performed during the Pavlik method treatment of developmental dysplasia of the hip predicts acetabular morphology at 12 months of age.

Methods: We reviewed the medical records, ultrasounds, and radiographs of patients treated successfully with the Pavlik method between 2017 and 2019. We performed sonographic measurements on point-of-care ultrasound at the initial presentation, the Pavlik discontinuation, and an additional sonographic follow-up. We measured the acetabular index on a plain anteroposterior radiograph of the pelvis obtained at a minimum of 12 months of age. Spearman's rank correlation coefficient was used to analyze for correlation between sonographic measurements and the acetabular index.

Results: A total of 72 patients were included in the final analysis. There were no residual or late dysplasia cases at the last radiographic follow-up (mean age = 14.8 ± 2.7 months). Sonographic parameters at the initial presentation significantly correlated with the acetabular index at the final radiographic follow-up (p < 0.001). Patients with worsening degrees of developmental dysplasia of the hip based on stability on sonographic testing (stable, unstable, or dislocated) had higher acetabular indices at the final radiographic follow-up (p < 0.05).

Conclusion: Point-of-care ultrasound at initial presentation and the Pavlik discontinuation significantly correlate with acetabular morphology at 1-1.5 years of age. At initial presentation, hips that were unstable or dislocated on point-of-care ultrasound had significantly greater acetabular indices than stable hips at the final follow-up.

Level of evidence: level IV case series.

目的:本研究旨在确定在帕夫利克方法治疗发育性髋关节发育不良期间进行的点护理超声是否能预测12月龄时髋臼形态。方法:回顾2017年至2019年帕夫利克法治疗成功患者的病历、超声和x线片。我们在初次就诊、Pavlik停药和额外的超声随访时对护理点超声进行了超声测量。我们在至少12个月大的骨盆正位平片上测量了髋臼指数。采用Spearman秩相关系数分析超声测量值与髋臼指数的相关性。结果:72例患者纳入最终分析。最后一次x线随访(平均年龄= 14.8±2.7个月)无残留或晚期发育不良病例。初诊时的超声参数与最终x线随访时的髋臼指数显著相关(p结论:初诊时的即时超声和Pavlik停药与1-1.5岁时的髋臼形态显著相关。在初次就诊时,超声检查发现髋臼指数不稳定或脱位的髋臼指数明显高于最终随访时髋臼指数稳定的髋臼指数。证据级别:IV级病例系列。
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引用次数: 0
Diagnosis and treatment of 10 cases of idiopathic chondrolysis of the hip. 特发性髋关节软骨松解10例的诊断与治疗。
IF 1.4 4区 医学 Q3 ORTHOPEDICS Pub Date : 2023-04-01 DOI: 10.1177/18632521221144061
Tianan Guan, Dun Zhao, Hao Xiong, Bin Fang, Yue Li

Objective: To analyze the clinical characteristics, X-ray and magnetic resonance imaging manifestations, and treatment efficacy of idiopathic chondrolysis of the hip.

Methods: Ten patients with idiopathic chondrolysis of the hip treated at our hospital from September 2013 to April 2022 were collected, and their clinical features, X-ray and magnetic resonance imaging manifestations, and treatment outcomes were analyzed.

Results: Their main clinical features included single hip pain, claudication gait, and pelvic tilt, without specific clinical symptoms and signs. Laboratory tests such as blood analysis, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, autoimmune test, coagulation function, interferon release test for tuberculosis infection, and tuberculosis antibody test were normal. In the late stage, the imaging shows degeneration or ankylosis of the joint. The disease progresses rapidly, and joint degeneration can occur in adolescence without effective treatment. Herein, seven patients were treated with recombinant human tumor necrosis factor receptor-antibody type II fusion protein. Among them, four (according to Camarnat magnetic resonance imaging classification, three were Stage I and one was Stage II) showed improved symptoms and function, while two (Stage III) had progressed. One patient (Stage I) who received recombinant human tumor necrosis factor receptor had no significant relief of symptoms, for whom anterior capsular release surgery significantly improved the hip joint motion. Of the four patients who underwent hip release surgery, three showed progression.

Conclusion: Idiopathic chondrolysis of the hip has no specific clinical and laboratory tests and a high misdiagnosis rate. Thus, early magnetic resonance imaging is a critical reference for diagnosis. We recommend that patients with magnetic resonance imaging Stage II or earlier be actively treated with recombinant human tumor necrosis factor receptor and start treatment as early as possible. In the third stage, the treatment effect is mediocre, and the narrowed hip space is difficult to change.

目的:分析特发性髋关节软骨松解症的临床特点、x线及磁共振成像表现及治疗效果。方法:收集我院2013年9月至2022年4月收治的10例特发性髋关节软骨溶解症患者,分析其临床特征、x线及磁共振成像表现及治疗效果。结果:患者的主要临床特征为单髋关节疼痛、步态跛行、骨盆倾斜,无特异性临床症状和体征。血液分析、红细胞沉降率、c反应蛋白、类风湿因子、自身免疫试验、凝血功能、结核感染干扰素释放试验、结核抗体试验等实验室检查均正常。晚期,影像学显示关节退行性变或强直。这种疾病进展迅速,在没有有效治疗的情况下,可以在青春期发生关节变性。7例患者采用重组人肿瘤坏死因子受体-抗体II型融合蛋白治疗。其中4例(按Camarnat磁共振成像分级,3例为ⅰ期,1例为ⅱ期)症状和功能改善,2例(ⅲ期)病情进展。1例接受重组人肿瘤坏死因子受体治疗的患者(I期)症状无明显缓解,其前囊释放手术明显改善了髋关节运动。在接受髋关节松解手术的4名患者中,有3名出现进展。结论:髋关节特发性软骨松解无特异性临床和实验室检查,误诊率高。因此,早期磁共振成像是诊断的重要参考。我们建议磁共振成像ⅱ期或更早的患者积极应用重组人肿瘤坏死因子受体治疗,尽早开始治疗。第三阶段,治疗效果一般,髋间隙变窄难以改变。
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引用次数: 0
期刊
Journal of Childrens Orthopaedics
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