Search PubMed⌕ Search

Biomedical subjects

J C Cheng

Publications and source records attributed to J C Cheng.

155 records · Page 9Linked to original sources
PubMedDate not supplied

Joint laxity in children.

Joint laxity was measured clinically in 2,360 normal Chinese children aged 3-13 years with equal sex distribution using the Carter Wilkinson five tests and scoring system. Results showed minimal differences due to gender. The degree of joint laxity diminished with age. The knee extension and ankle extension tests were more sensitive than other tests. Chinese children were far more lax throughout the age range, with 100% "laxity" at age 3, 67% laxity at age 6, and 28% laxity at age 12, in contrast to 50, 5, and 1% laxity in the same age group respectively, in large series of Caucasian children.

Adolescent↗
PubMedDate not supplied

Ultrasonographic hip morphometry in infants.

Ultrasonographic study of 463 normal children (926 hips) from birth to 6 months of age with equal sex distribution was performed. Hip morphometry, including Graf's alpha and beta angles. Morin's head coverage percentage, and head size were measured. Using the same technique, a group of 52 babies was measured longitudinally from birth to 6 months of age, with three measurements taken for each hip for a total of 312 measurements. Results showed that the boys had a consistently higher alpha angle, a lower beta angle, better head coverage, and larger head size through the 6 months. Differences between the right and left hips were only noted in the beta angle. The containment of the hip was found to increase rapidly in the first 4 months. Comparing data from the longitudinal versus the cross-sectional group, no statistically significant differences were detectable in all the parameters measured. Intraobserver variations were found to be best with alpha angle measurements, with a standard deviation of 3.22 degrees.

Age Distribution↗
PubMedDate not supplied

Decompression and stable internal fixation of femoral neck fractures in children can affect the outcome.

Pediatric femoral neck fracture is rare and known to be associated with a high complication rate. The effect of early decompression and operative fixation is not frequently reported in the literature. This is a retrospective study of 14 patients younger than 16 years with traumatic fractures of the femoral neck and intertrochanteric region over a 10-year period with a follow-up of 2-11 years (mean, 4.6 years). Road traffic accidents and falls from a height were the main causative factors, and the fractures were subclassified into transcervical, 58%; intertrochanteric, 29%; transepiphyseal, 7%; and cervicotrochanteric, 7%. Of all the fractures, 10 (71%) were displaced. Decompression of the hip by aspiration and closed reduction and internal fixation was performed for all the displaced fractures within 24 h after admission. Three cases required open reduction. Complete fracture healing and functional recovery was achieved in 13 patients with only one delayed union. No patient had radiographic evidence of avascular necrosis. When compared with earlier studies, the current aggressive management protocol for displaced fracture significantly minimized the complications of avascular necrosis, non-union, delayed union, and premature physeal closure.

Adolescent↗
PubMedDate not supplied

A 10-year study of the changes in the pattern and treatment of 6,493 fractures.

A total of 6,493 fractures was studied from 6,389 children younger than 16 years admitted as inpatients to one center in a 10-year period. The boy-to-girl ratio increased from 1.4:1 in the infants to 4.9:1 in the adolescents. The most common fractures were the distal radius (20.2%), supracondylar fracture of the humerus (17.9%), forearm shaft (14.9%), and the tibial shaft (11.9%). A distinct age-specific fracture pattern also was found, with supracondylar fracture of the humerus being the most common fracture in the age 0- to 3-year (26.7%) and the 4- to 7-year (31.6%) groups and distal radius in the 8- to 11-year and the 12- to 16-year groups (24.3 and 25.7%, respectively). Although the overall pattern of the major fractures had not changed over the 10-year period, significant changes in the treatment pattern were observed. The closed-reduction and percutaneous pinning rates increased from 9.5 to 38.7% in fracture of the distal radius, 4.3 to 40% in the supracondylar humerus, and 1.8 to 22% in the forearm shaft. The changes in treatment pattern were also accompanied by a corresponding decrease in the open-reduction rate and hospital stay periods from <10% to 38% of patients being discharged within 1 day of admission in the 10-year period.

Adolescent↗
PubMedDate not supplied

Significance of non-level walking on transtibial prosthesis fitting with particular reference to the effects of anterior-posterior alignment.

Despite the fact that non-level walking is known to be important for prosthesis fitting, its clinical significance has not been investigated. In this study, the acceptable prosthesis alignment ranges of six subjects with transtibial amputation on level and non-level walking were determined and compared. With the aid of a recently developed alignment jig, prosthesis fitting was performed for each subject with varied anterior-posterior (AP) alignments. Conventional assessments and the subjects' comment were used to determine whether the alignment was acceptable or not. The results showed that the acceptable alignment range for non-level walking consistently fell within and was significantly smaller than that for level walking with p<0.05. It was evident that non-level walking is important for better approximation of optimum alignment and should be included in routine prosthesis fitting.

Adult↗
PubMedDate not supplied

Modified functional bracing in the ambulatory treatment of femoral shaft fractures in children.

Thirty children aged between 2 and 10 years with fractures of the femoral shaft were involved in a prospective study of a treatment method that requires a short period of traction followed by full weightbearing with a modified hinged functional brace and return to school after an average of 32.5 days. At an average follow-up period of 2 years, no case has shown residual angulation or rotational deformities greater than 10 and 15 degrees. No shortening was demonstrated. Overgrowth of the fractured femur was common, with a maximum of 1.5 cm. No strong correlation between overgrowth and age, site, and type of fracture was found. Results were uniformly good for proximal, middle, and distal third fractures.

Ambulatory Care↗
PubMedDate not supplied

Symptomatic hyponatremia: pathophysiology and management.

In summary, we believe that the osmotic difference between the brain cell and the extracellular fluid is the critical parameter in determining therapy. A gradient of 30 mosm/kg or more produces significant shifts of intracellular water and cell damage. Seizure and coma are the neurologic signs associated with acute life-threatening osmotic imbalance between swelling brain cells and the extracellular space. Treatment is designed to decrease this osmotic gradient to less than 30 mosm/kg to prevent this cell swelling. Thus in acute symptomatic hyponatremia, treatment (fluid restriction alone if urine osmolality is less than 100 mosm/kg or 3% saline if needed or both) is needed to decrease this osmotic gradient. If hyponatremia is chronic and brain osmotic adaptations have already taken place, increased extracellular osmolality would cause brain cells to undergo water loss, which may result in cell shrinkage and neurologic damage (for example, central pontine myelinosis). Unfortunately, there is as yet no clinically available tool to rapidly assess intracellular brain osmolality. Clinical judgment is therefore mandatory in trying to estimate the osmotic gradient between the intracellular and extracellular environment. Appropriate treatment must be initiated to prevent excessive changes in cell volume.

Adolescent↗
PubMedDate not supplied

Infantile torticollis: a review of 624 cases.

We reviewed 624 cases of infantile torticollis in one centre over a period of 7 years. The incidence of torticollis was found to be 1.3% in Chinese children. Boy-to-girl ratio was 3:2. Obstetric histories of the mothers showed a total of 62.2% with difficult labour, breech deliveries, or caesarean section, and 6.04% had associated congenital anomalies. Of all the cases, 27.88% were found to be postural, 35.4% had torticollis that presented with sternomastoid tumor, and 36.7% presented with muscular torticollis alone. When limitation of neck range was considered, 36.7% had a passive rotation deficit > 15 degrees. In patients presenting in the early stages, 97% of all infantile torticollis cases resolved with conservative treatment, active stimulation, and a passive stretching program. For those responding to treatment, the mean treatment period was < 6 months for varying degrees of neck rotational deficit. Patients with cord-like muscular torticollis and a rotational > 30 degrees were more likely to need surgery. Presence of sternomastoid tumor alone was not found to increase the likelihood of surgery. Musculoskeletal sequelae after torticollis had resolved included intermittent head tilt and persistence of mild craniofacial asymmetry. We recommend continuous follow-up in cases of infantile torticollis, particularly in patients with progression of sternomastoid tumor to muscular torticollis.

Abnormalities, Multiple↗
PubMedDate not supplied

A new look at the sequential development of elbow-ossification centers in children.

The pattern and sequence of ossification of the six secondary ossification centers around the elbow in the child were mainly derived from studies done >30 years ago. This series reexamined the sequence and pattern based on a cross-sectional study of the elbow radiographs of 1,577 Chinese children with elbow injuries; age range, from newborn to 17 years. The ratio of girls to boys was 1:2. Each child had a radiograph of the normal and the injured elbow giving a total of 3,154 radiographs. A percentile chart of ossification was constructed for each of the ossification centers in both sexes for easy reference. No differences in the timing and ossification pattern were found between the right and left elbow or between the normal and injured elbow in this study. The sequence of ossification in both boys and girls was found to be the same (i.e., the capitulum first, followed by the radial head, medial epicondyle, olecranon, trochlea, and last, the lateral epicondyle). The ages at which 50% of the girls were found to have positive radiologic ossification for each of these centers were ages 1, 5, 5, 9, 9, and 10 years, respectively. In boys, with the exception of the capitulum, an average delay of 2 years was found in each of the ossification centers, although the sequence remained similar.

Adolescent↗
PubMedDate not supplied

Can we predict body height from segmental bone length measurements? A study of 3,647 children.

It is well known that significant differences exist in the anthropometric data of different races and ethnic groups. This is a cross-sectional study on segmental bone length based on 3,647 Chinese children of equal sex distribution aged 3-18 years. The measurements included standing height, weight, arm span, foot length, and segmental bone length of the humerus, radius, ulna, and tibia. A normality growth chart of all the measured parameters was constructed. Statistical analysis of the results showed a very high linear correlation of height with arm span, foot length, and segmental bone lengths with a correlation coefficient of 0.96-0.99 for both sexes. No differences were found between the right and left side of all the segmental bone lengths. These Chinese children were found to have a proportional limb segmental length relative to the trunk.

Adolescent↗