Follow-up ranging from 2 to 14 years (mean 6 years) was obtained for 30 fractures of the external humeral condyle in children aged from 2 to 11 years; the patients had been submitted to reduction-osteosynthesis. Twelve patients were at the end of the growth period when followed-up. All of the patients were classified as Lagrange and Rigault grades II and III. Synthesis always involved two or three Kirschner wires bent under the skin. There were 24 perfect results and 6 good ones. Valgus equal to less than 10 degrees was present in 2 cases. Deficit in flexion-extension, present in 4 cases, did not exceed 20 degrees overall. Another case showed "fish-tail" radiographic deformity (due to epiphysiodesis) which did not interfere with function. Despite the potential danger of the lesion, the authors believe that careful surgical treatment provides very satisfactory results.

Child↗

PubMedDate not supplied

Complications of varus derotation osteotomy in the treatment of CHD during growth.

Complications of varus derotation osteotomies in the treatment of congenital hip displacement (CHD) are reported. Only "true" complications were considered, that is, those related to errors in technique, while those related to errors in indications were excluded. An analysis of 150 cases with a mean follow-up of 4.2 years revealed that "true" complications are a rare occurrence. Among these the most frequent are dysmetria (20%), and infection (2.6%). There was only one case of osteochondrosis (0.6%). The dysmetria (usually under 2 cm) rarely required further surgical treatment involving temporary epiphysiodesis of the homolateral knee, while the infection responded satisfactorily to combined conservative and surgical treatment.

Acetabulum↗

PubMedDate not supplied

Traumatic lesions of the acetabular triradiate cartilage (presentation of four cases and considerations on treatment).

Four cases of fracture of the triradiate cartilage (TC) are reported, all of which may be classified as epiphyseal detachments. Two of the patients were submitted to osteosynthesis of the posterior column: results were very satisfactory in one of the cases for which long-term follow-up was obtained. The other two cases, treated non-surgically, developed meta-traumatic actabular dysplasia probably due to association with crushing phenomena (Salter-Harris V) in the germinative area of TC. Despite the favorable results obtained in the case that was submitted to surgery, the authors believe that conservative treatment is best in this type of lesion, and that surgical reduction should be performed only in cases of instability and severe displacement, once surgical reduction has failed.

Acetabulum↗

PubMedDate not supplied

The treatment of congenital hip dysplasia.

The authors take into consideration the different phases of the treatment of congenital hip dysplasia (CHD) as it is related to age and natural development. Within the first year of age three objectives must be aimed at: reduction of the epiphysis, its retention and immobilization, maturation of the hip. After three years of age, once the epiphysis has been reduced, reconstructive and stabilizing surgery must be performed (acetabuloplasty and femoral osteotomy) in order to correct the modified joint parameters. After ten years of age and until the end of growth the degree of dysplasia influences treatment, as intervention is justified (preferably with biological reconstruction of the acetabulum) in forms of severe dysplasia caused by the definite occurrence of pain at an early age. We emphasize the importance of adapting treatment to the specific phase of evolution of the hip understood to be dynamic reality.

Age Factors↗

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Complications in acetabuloplasty in the treatment of CHD during the growth age.

The authors analyze the complications of acetabuloplasty in the treatment of CHD during the growth age, evaluating the incidence and the possible causes, that emerged from a review of cases at the Rizzoli Orthopaedic Institute including 238 patients treated from 1970 to 1986 using different methods. The techniques adopted were: acetabuloplasty for lowering in 100 cases, Salter osteotomy in 30 cases, triple pelvic osteotomy in 48 cases and acetabuloplasty according to the Chiari method in 50 cases. Complications of various types were observed in 9.6% of the cases after a mean follow-up of 5 years. It is the purpose of ths study to discuss the complications that are observed during each operation, and to compare them with those reported in the literature, as well as to present a pathogenetic interpretation. A study of complications influences indications and surgical technique.

Acetabulum↗

PubMedDate not supplied

Joint fractures of the proximal end of the femur during childhood.

A total of 18 joint fractures of the proximal end of the femur in patients aged under 16 years (all treated non-surgically) are reported. Complete clinical-radiographic documentation was available for all 16 of them, with a minimum follow-up of 2 years. Results were evaluated based on the Ratliff criteria. The incidence of complications (in particular, avascular necrosis) was related to the type of fracture (Delbet classification) and to the degree of shifting of the segments (Boitzy).

Accidents↗

PubMedDate not supplied

Arthroscopic surgery of the discoid meniscus during childhood.

A total of 43 lateral discoid menisci in 38 patients submitted to arthroscopy between 1990 and 1995 is discussed. Age ranged from 2 to 14 years. Morphological changes of the lateral meniscus were classified according to Watanabe criteria. The features of preoperative symptoms were related to the type of meniscal lesion and to the age of the patient, and the results evaluated according to the Ikeuchi scale.

Adolescent↗