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Skeletal Embryology and Limb Growth
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Rick Brown, Anish Sanghrajka, Deborah Eastwood
Most physes close in a predictable fashion, enabling radiological assessment of bone age. The Greulich and Pyle atlas, based on a hand and wrist radiograph, is probably the most commonly employed method in the UK. The Sauvegrain method employs the anteroposterior (AP) and lateral views of the elbow, and is said to be more useful during puberty. The Risser sign is based upon the lateral to medial ossification of the iliac apophysis, and is commonly used when making decisions about the management of childhood spinal deformity.
The back
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Late-onset idiopathic scoliosis is the commonest type, occurring in 90% of cases, mostly in girls. Primary thoracic curves are usually convex to the right, lumbar curves to the left; intermediate (thoracolumbar) and combined (double primary) curves also occur. Progression is not inevitable; indeed, most curves less than 20 degrees either resolve spontaneously or remain unchanged. However, once a curve starts to progress, it usually goes on doing so throughout the remaining growth period (and, to a much lesser degree, beyond that). Reliable predictors of progression are: (1) a very young age; (2) marked curvature; and (3) an incomplete Risser sign at presentation. In prepubertal children, rapid progression is liable to occur during the growth spurt.
The Back
Published in Louis Solomon, David Warwick, Selvadurai Nayagam, Apley and Solomon's Concise System of Orthopaedics and Trauma, 2014
Louis Solomon, David Warwick, Selvadurai Nayagam
This is the commonest type, occurring in 90% of cases, mostly in girls. Primary thoracic curves are usually convex to the right, lumbar curves to the left. Progression is not inevitable; most curves of less than 20 degrees either resolve spontaneously or remain unchanged. However, once a curve starts to progress, it usually goes on doing so throughout the remaining growth period (and, to a much lesser degree, beyond that). Reliable predictors of progression are: (1) a very young age; (2) marked curvature; (3) an incomplete Risser sign at presentation. In prepubertal children, rapid progression is liable to occur during the growth spurt.
Towards a predictive simulation of brace action in adolescent idiopathic scoliosis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Claudio Vergari, Zhuowei Chen, Léopold Robichon, Isabelle Courtois, Eric Ebermeyer, Raphaël Vialle, Tristan Langlais, Raphaël Pietton, Wafa Skalli
The spine (T1-L5), ribcage and pelvis of each patient was reconstructed in 3 D with previously validated methods (Humbert et al. 2009; Ghostine et al. 2017; Vergari et al. 2020), ; both before and in-brace (Figure 1). This reconstruction allowed automatic calculation of 3 D geometrical spinopelvic parameters, but it also provided 3 D models of all vertebrae, pelvis and rib cage, that were used to build a subject-specific finite element model of the trunk (Figure 1). The model was previously described in detail (Vergari et al. 2016); it implements the thoracolumbar spine, including surface contacts of articular facets and nonlinear mechanical properties of intervertebral discs and ligaments. The ribs inertial properties were based on an existing database of scoliotic adolescent ribs morphology (Sandoz et al. 2013), while their overall geometry was patient-specific and their mechanical properties were adapted to the patient’s Risser sign (Pezowicz and Głowacki 2012).
The effects of exercise on perception of verticality in adolescent idiopathic scoliosis
Published in Physiotherapy Theory and Practice, 2018
Gozde Yagci, Yavuz Yakut, Engin Simsek
The study included 32 patients with thoracic and thoracolumbar idiopathic scoliosis (thoracic Cobb angle of 32.29° ± 9.32°, lumbar Cobb angle of 28.54° ± 9.27°, and Risser sign of 2.16 ± 0.62). The inclusion criteria consisted of being an adolescent female individual between 10 and 16 years of age, previously diagnosed with idiopathic scoliosis by a physician, and continue to wear a spinal brace for at least 3 months prior to data collection. The exclusion criteria were as follows: neurological, muscular, rheumatologic, renal, cardiovascular, pulmonary, or vestibular diseases; the presence of tumors; surgical correction history; previously received or currently under exercise therapy treatment.
Higher risk of cam regrowth in adolescents undergoing arthroscopic femoroacetabular impingement correction: a retrospective comparison of 33 adolescent and 74 adults
Published in Acta Orthopaedica, 2019
Tomoya Arashi, Yoichi Murata, Hajime Utsunomiya, Shiho Kanezaki, Hitoshi Suzuki, Akinori Sakai, Soshi Uchida
The Risser ossification scale for skeletal maturity was used to evaluate maturity of the pelvis (Bitan et al. 2005). Patients with either a Risser sign of grade ≤ 4 or an open physis of the proximal femur were diagnosed with skeletal immaturity. Patient demographics, radiographs, operative details, validated preoperative, and postoperative modified Harris hip score (MHHS) and nonarthritic hip score (NHS) were collected retrospectively. To compare the clinical outcomes of adolescents and adults, 74 adult patients were recruited from the same cohort during the same time period. Those who were diagnosed with dysplasia or osteoarthritis were excluded.