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Acute haematogenous osteomyelitis in childhood
lN7‘EI1h-ATIONAI,
ABSTRACTS
OF
PEDIATRIC
:\CUTE HAEXIATOGENOUSOSTEOXYELITISIN CHILDHOOD. 196’7.
W. Conhem
Piidiat.
Prax.
:331
SURGERY
6:599-607,
The prognosis of acute hematogenous osteomyelitis depends largely on early diagnosis. This may he difficult since local and general symptoms arr often uncharacteristic in the beginning. Course and expressivity depend on the immunological status and special reactivity in different age groups. The same is true with respect to localisation. extension and typical complications. The first choice antiobiotic is penicillin-C in high dosage. When temperatllres do not drop to almost normal within 24 hours, antiobiotic treatment has to be changed to oxacillin, methicillin, erythromycin or oleandomycin. Antibiotic therapy should be followed for at least 12 weeks and should not be terminated before the blood sedimentation rate remains normal for 4 weeks. Operative procedures are rarely necessary except for punctures of subperiostal absc,esses.-W. Leuterer. J”ANNEH’S ILLNESS (ASCEPTIC NECROSIS OF THE HEAD OF THE HU~~ERUS). S. Hofmnnn. Z. Kinder. Chir. 5:98-103, 1967. A case of the rare form of asceptic necrosis of the head of the humerus is described. Thirty-four cases have been reported in the world literature. The prognosis of this particular illness is good and as the arm is not weight bearing, the unfavorable circumstances of asceptic necrosis in the lower limb bones are not present. The treatment is immobilization of the arm over several months. The clinical prognosis is described and the regeneration process is demonstrated by x-rays. S. Ilofmnnn and H. B. E&stein. QUADRICEPS CONTRACTURE IN CHILDREN. M. N. Shahune and L. N. Vera. Indian J, Surg. 29: 372-379. 1967. The authors report 11 cases (8 girls and 3 boys) of quadriceps contracture, which is a serious disability particularly in Indian children who have to squat down for toilet purposes. Nine of these had a history of injection or infusion in the thigh. An interesting observation was that this complication occurred only in marasmic or acutely ill children who failed to move the limh after the injection. The contractnre was confined to vastus intermetlius. The affected thigh looked thinner and in long-standing, unilateral cases the patella was underdeveloped. All cases were treated by surgery-excision of vastus intermedins with or without cluadricqs lengthening-with good results.--R. K. Cfl11dlti.
TKE SNAPPING T~ru&m IN CHILDHOOD.W. Tischer and W. Wagner.
Psdiat.
Prax. 6~641-648,
1967.
The snapping thumb is a typical condition in early childhood which usually goes along with contraction and difficult extension of the interphalangeal joint. The cause is a nodule in the tendon sheath of the flexor of the thumb. The authors discuss the different theories of etiology and therapeutically prefer the subcuteaneous dissection of the tendon sheath and the annular ligament. Conservative treatment is usually unsuccc,ssfnl.-W. Lcrrterer. NERVOUS
SYSTEM
PEHITONEAL SHUNTS IN THE MANAGEXIEST OF HYDROCEPHALUS.F. Murtagh and R. Lehman. JAMA 202: 1010-1014, December 11, 1967. In a series of 133 patients with hydrocephalus for whom follow-up data are known, cerebrospinal fluid was shunted to the peritoneal cavity in 53. Forty six of these were shunts from the lumbar subarachnoid space in patients with communicating hydrocephalus. Seven were ventriculo-peritoneal shunts. The ventricnlo-peritoneal shunt can not be evaluated from the date because 4 were done in the last 2 months. However, the lumbar subarachnoid peritoneal shunt seems to be effective in patients with hydrocephalus secondary to meningitis or intracranial hemorrhage, or as an interim procedure. In these instances its long-term effectiveness remains as high as 75 per cent. The use of this shunt appears valuable when the anticipated need is for effective function for a transient hydrocephalus. Occasionally it may function for several years. If the system fails, a revision is permissible. Failure of the revision rarely allows one to obtain a satisfactory functioning system.-.l. E. Lecuis, Jr. COS~PLICATIOKSOF VENTIUCULO ATRIAL SHUNTS AND THEIR PREVENTIOK.R. Hemmer. Z. Kinder. Chir. 5:1-15, 1967. The author reviews 176 infants who were treated in the years 1961 to 1965 either with the Holter or Pruclenz valve. Forty-three per cent of all complications occurred in the region of the distal catheter. 47 per cent of complications in the region of the ventricular catheter and 10 per cent had infection of uncertain etiology. Most of the surgical revision procedures had to be carried out in the first year of life. In 102 of the 176 children there were 121 complications which are tabulated. The methods of avoiding these complications are discusstd-S. Ifofmnfln nnd 17. R. Eckstein.
ABSTRACTS
OF
PEDIATRIC
:\CUTE HAEXIATOGENOUSOSTEOXYELITISIN CHILDHOOD. 196’7.
W. Conhem
Piidiat.
Prax.
:331
SURGERY
6:599-607,
The prognosis of acute hematogenous osteomyelitis depends largely on early diagnosis. This may he difficult since local and general symptoms arr often uncharacteristic in the beginning. Course and expressivity depend on the immunological status and special reactivity in different age groups. The same is true with respect to localisation. extension and typical complications. The first choice antiobiotic is penicillin-C in high dosage. When temperatllres do not drop to almost normal within 24 hours, antiobiotic treatment has to be changed to oxacillin, methicillin, erythromycin or oleandomycin. Antibiotic therapy should be followed for at least 12 weeks and should not be terminated before the blood sedimentation rate remains normal for 4 weeks. Operative procedures are rarely necessary except for punctures of subperiostal absc,esses.-W. Leuterer. J”ANNEH’S ILLNESS (ASCEPTIC NECROSIS OF THE HEAD OF THE HU~~ERUS). S. Hofmnnn. Z. Kinder. Chir. 5:98-103, 1967. A case of the rare form of asceptic necrosis of the head of the humerus is described. Thirty-four cases have been reported in the world literature. The prognosis of this particular illness is good and as the arm is not weight bearing, the unfavorable circumstances of asceptic necrosis in the lower limb bones are not present. The treatment is immobilization of the arm over several months. The clinical prognosis is described and the regeneration process is demonstrated by x-rays. S. Ilofmnnn and H. B. E&stein. QUADRICEPS CONTRACTURE IN CHILDREN. M. N. Shahune and L. N. Vera. Indian J, Surg. 29: 372-379. 1967. The authors report 11 cases (8 girls and 3 boys) of quadriceps contracture, which is a serious disability particularly in Indian children who have to squat down for toilet purposes. Nine of these had a history of injection or infusion in the thigh. An interesting observation was that this complication occurred only in marasmic or acutely ill children who failed to move the limh after the injection. The contractnre was confined to vastus intermetlius. The affected thigh looked thinner and in long-standing, unilateral cases the patella was underdeveloped. All cases were treated by surgery-excision of vastus intermedins with or without cluadricqs lengthening-with good results.--R. K. Cfl11dlti.
TKE SNAPPING T~ru&m IN CHILDHOOD.W. Tischer and W. Wagner.
Psdiat.
Prax. 6~641-648,
1967.
The snapping thumb is a typical condition in early childhood which usually goes along with contraction and difficult extension of the interphalangeal joint. The cause is a nodule in the tendon sheath of the flexor of the thumb. The authors discuss the different theories of etiology and therapeutically prefer the subcuteaneous dissection of the tendon sheath and the annular ligament. Conservative treatment is usually unsuccc,ssfnl.-W. Lcrrterer. NERVOUS
SYSTEM
PEHITONEAL SHUNTS IN THE MANAGEXIEST OF HYDROCEPHALUS.F. Murtagh and R. Lehman. JAMA 202: 1010-1014, December 11, 1967. In a series of 133 patients with hydrocephalus for whom follow-up data are known, cerebrospinal fluid was shunted to the peritoneal cavity in 53. Forty six of these were shunts from the lumbar subarachnoid space in patients with communicating hydrocephalus. Seven were ventriculo-peritoneal shunts. The ventricnlo-peritoneal shunt can not be evaluated from the date because 4 were done in the last 2 months. However, the lumbar subarachnoid peritoneal shunt seems to be effective in patients with hydrocephalus secondary to meningitis or intracranial hemorrhage, or as an interim procedure. In these instances its long-term effectiveness remains as high as 75 per cent. The use of this shunt appears valuable when the anticipated need is for effective function for a transient hydrocephalus. Occasionally it may function for several years. If the system fails, a revision is permissible. Failure of the revision rarely allows one to obtain a satisfactory functioning system.-.l. E. Lecuis, Jr. COS~PLICATIOKSOF VENTIUCULO ATRIAL SHUNTS AND THEIR PREVENTIOK.R. Hemmer. Z. Kinder. Chir. 5:1-15, 1967. The author reviews 176 infants who were treated in the years 1961 to 1965 either with the Holter or Pruclenz valve. Forty-three per cent of all complications occurred in the region of the distal catheter. 47 per cent of complications in the region of the ventricular catheter and 10 per cent had infection of uncertain etiology. Most of the surgical revision procedures had to be carried out in the first year of life. In 102 of the 176 children there were 121 complications which are tabulated. The methods of avoiding these complications are discusstd-S. Ifofmnfln nnd 17. R. Eckstein.