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Contracture of Muscles of the Lower Limb – Quadriceps Contracture Secondary to Osteomyelitis of the Femur
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
X-rays of the knees showed flattening of the femoral condyles of the right femur (Figure 43.2) and genu recurvatum. The growth plates of the distal femur and the proximal tibia were normal, and the joint space was also normal.
Examination of Pediatric Shoulder
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Shoulder injuries are common and account for up to 10% of all sports injuries in high school athletes.1 Shoulder injuries in the pediatric age group differ from adults. In children and adolescents, open growth plates predispose them to unique injuries requiring special techniques to diagnose and treat them.2
Trauma
Published in Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague, Paediatric Surgical Diagnosis, 2018
Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague
Fractures are common because children play vigorously and often fail to take adequate precautionary or evasive measures. Fractures are misdiagnosed frequently as sprains because they are so close to the joint. However, since the ligaments are relatively stronger than the bones in childhood, sprains are rare. Two features that make fractures in childhood different from those in adults are the flexibility of the bone and the presence of a growth plate. Simple, deforming injuries usually produce greenstick fractures, rather than comminution. Healing is rapid, and delayed union and non-union are rare. The fracture can be reduced by manipulation under regional or general anaesthesia, and remodelling during growth will ensure a satisfactory longterm result. When the growth plate has been injured the fracture may need precise anatomical reduction, by open surgery and internal fixation. Growth arrest may occur around the knee, even when the growth plate has not been fractured.
Comparison of pre-high school and high school football quarterback injuries
Published in The Physician and Sportsmedicine, 2023
Greggory P. Kobelski, Luke C. Radel, Jacob C. Jones, Michael J. O’Brien, William P. Meehan, Dai Sugimoto
Our results also identified that Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their older counterparts (Table 3) while HS QBs experienced significantly more ligamentous injuries than Pre-HS QBs (Table 3). This is likely due to anatomical and physiological differences during the growth/maturation process. The mean age of Pre-HS QBs was 12.4 years (Table 1) so they have several years of growth remaining. In a growth spurt, growth plate/bony physis remains open; thus, it is considered more susceptible to injury than fully developed bones. There is a categorization of specific type of growth plate/bony physis injuries in skeletally immature patients such as Salter-Harris classification [17]. For this reason, Caine et.al. summarized that a musculoskeletal injury would cause a tear of the ligament or joint dislocation in an adult, while they are often resulted in the separation of a growth plate/bony physis in a child [17]. Additionally, Caine et.al. stated that most growth plate/physis injuries resolve with proper treatments and adequate rest; however there needs to be attention for potential growth disturbance and deformity in their physical growth/maturation process [17]. Our finding that Pre-HS QBs had significantly more bony/cartilaginous/labral injuries than their HS QB counterparts aligns well with the report [17]. Clinically, damage to growth plate/bony physis, therefore, needs to be recognized early and treated appropriately.
State-of-the-art, approved therapeutics for the pharmacological management of osteosarcoma
Published in Expert Opinion on Pharmacotherapy, 2021
Cristina Meazza, Sebastian Dorin Asaftei
The overall incidence of OS is 0.2–3/100,000 population a year, with a bimodal age distribution. It peaks first during adolescence (0.8–11/100,000 in 15- to 19-year-olds), then from the age of 60 years onwards [5,6]. It affects males more than females, with a ratio of 1.6:1 [6–9]. The body sites mostly involved are the long bones of the extremities, near the metaphyseal growth plates: the distal femur (45% of cases); the proximal tibia (20%); and the proximal humerus (10%) [6,10]. In patients over sixty, axial sites are more frequent and carry a worse prognosis than for appendicular skeleton OS [11]. In about 70–80% of patients localized disease is detected at baseline (presumably with micrometastases that are still subclinical or undetectable using current diagnostic methods [9,12]), while in 15–20% there is macroscopic evidence of dissemination at diagnosis (synchronous metastases) [3,5,13]. Since the mid-1970s, the treatment strategy for newly diagnosed OS has included: the ‘gold standard’ neoadjuvant chemotherapy based on three agents – doxorubicin (ADM), cisplatin (CDP), and high-dose methotrexate (HD-MTX), followed by leucovorin rescue – with or without ifosfamide (IFO) and etoposide (ETO); then surgical removal of the primary tumor, along with any clinically evident metastases; and finally systemic postoperative multidrug treatment [14–24].
Long-term outcomes after phalangeal distraction lengthening in patients with constriction band syndrome
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Kousuke Iba, Kenichi Takashima, Megumi Hanaka, Atsushi Teramoto, Makoto Emori, Akira Saito, Hikaru Hayakawa, Toshihiko Yamashita
The patients could pinch immediately after metacarpal lengthening but several patients could not pinch at the follow-up evaluation, because the different growth rates among the metacarpals caused the hand shape to change undesirably [4]. The effect of lengthening on growth cartilage has not yet been determined. Some studies have described the mechanical stresses on the growth cartilage, by which the lengthened metacarpal may be subjected to extra compressive forces [4,11,12]. In our cases, the lengthened phalanges in the patients with constriction band syndrome did not reveal any significant relative shortening in terms of bone growth. However, it is unknown that a lesion of growth plate is caused by the natural course of the disease or the mechanical stress. We, therefore, need further study to elucidate the relationship between lengthening and the growth potential of the growth plate.