-
[show abstract]
[hide abstract]
ABSTRACT: Most fractures during growth affect the upper extremities. Severe fractures with an increased number of complications are mainly localized beyond the elbow joint. Displaced fractures of the elbow joint have limited potential for spontaneous correction as the bones near the elbow joint account for only 20% of growth in length and the possibility of spontaneous correction is already exhausted at the age of 7. The consequences of inadequately reduced elbow fractures, therefore, may adversely affect a patient for his lifetime. Cubitus varus and valgus are the most common deformities following insufficiently treated supracondylar humerus fractures, fractures of the radial or dislocations of the radial head. Posttraumatic deformities of the elbow are usually the result of an insufficient primary therapy and rarely the result of growth disturbances. For the attending surgeon, posttraumatic deformities on a child's elbow are challenging.
Der Orthopäde 01/2013; · 0.51 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Although equinus gait is the most common abnormality in children with spastic cerebral palsy (CP) there is no consistency in recommendations for treatment, and evidence for best practice is lacking. The Baumann procedure allows selective fractional lengthening of the gastrocnemii and soleus muscles but the long-term outcome is not known. We followed a group of 18 children (21 limbs) with diplegic CP for ten years using three-dimensional instrumented gait analysis. The kinematic parameters of the ankle joint improved significantly following this procedure and were maintained until the end of follow-up. We observed a normalisation of the timing of the key kinematic and kinetic parameters, and an increase in the maximum generation of power of the ankle. There was a low rate of overcorrection (9.5%, n = 2), and a rate of recurrent equinus similar to that found with other techniques (23.8%, n = 5). As the procedure does not impair the muscle architecture, and allows for selective correction of the contracted gastrocnemii and soleus, it may be recommended as the preferred method for correction of a mild fixed equinus deformity.
Journal of Bone and Joint Surgery - British Volume 08/2012; 94(8):1143-7. · 2.83 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Injuries in childhood and adolescence are frequent and the knee is one of the most common sites of injuries. This study aimed to analyze the epidemiology, gender distribution, age, and circumstances of knee injuries in childhood at a Level I Trauma Center in Austria.
All pediatric and adolescent trauma patients who presented in a 2-year period were recorded. Children managed with knee injuries were selected prospectively. Patients were divided into five age groups: infants (younger than 1 year); pre-school aged children (1-6 years); pre-pubertal school-aged children (7-10 years); early adolescent patients (11-14 years); and late adolescent patients (15-18 years). Five diagnosis-related groups were formed: extraarticular soft tissue injuries, intraarticular soft tissue injuries, patella disorders, fractures, and overload injuries.
The study included 23,832 patients up to the age of 18 years, who presented with 1,199 knee injuries. There was a male predominance (m:f = 58,6%:41.4%). Boys had a lower mean age at presentation (11.9 years) as girls (12.3 years). The most common accident sites were outdoors (34.8%) and sports facilities (32.8%). Leading injury mechanisms were falls on level surfaces (58.1%) and traffic accidents (13.4%). The number of knee injuries and its severity increased with age. Knee injuries did not occur in infants. In general, extraarticular soft-tissue injuries were most common and fractures were rare.
Knee injuries in children and adolescents are rare and extraarticular soft-tissue injury is the most frequent type of knee trauma. The number of knee injuries and its severity increases with age with a male predominance. Sports facilities and traffic injuries are important scenes of knee trauma. Mechanisms and patterns evaluated in this study can serve as the basis for knee-injury prevention efforts in children and adolescents and may be used for necessary precautions. Level of evidence: IV.
Archives of Orthopaedic and Trauma Surgery 02/2012; 132(6):773-9. · 1.37 Impact Factor
