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Progression in idiopathic scoliosis
ABSTRACTS
of function was seen between 3 mo and 9 yr. Five children had permanent sequellae, which is less than half of those observed with brachial plexus palsy without fracture. Epiphyseal separation, seen with increasing frequency, is more difficult to recognize and diagnose, because these areas are initially radiolucent and not demonstrable. Arthrograms are sometimes necessary for confirmation, and attention should be payed to late radiograms (8 to 10 days) where calcified periosteum and pseudo-luxation can be seen. Each location has a peculiar clinical aspect which confuses the initial diagnosis. Early conservative treatment with traction and anatomic alignment usually avoids sequellae, but occasionally results in malrotation. Definitive surgical management in these cases is delayed.--J. Deevey Congenital Radio-Ulnar Synostosis in Children. G. Finidori,
499
traction and entrapment. This report of the extensive findings in a single case is published with a plea for the careful examination of the spinal column and cord should such become available.--M. G. H. Smith Perthes" Disease of the Hip in Three Regions of England.
D. J. P. Barker, E. Dixon, and J. F. Taylor. J Bone Joint Surg 60B:478~180, (November), 1978. This study is based on three regions of England--Mersey, Trent, and Wessex--of children presenting to Orthopedic Surgeons in those regions in 1976. The incidence, sex ratio, and age of affected males varied significantly between the regions. These findings suggest that environmental influences may have a major role in the cause of this disease.--M. G. H. Smith
P. Rigault, F. Barthel, et al. Chirurgie P6diatrique, Paris, 19:211-217, (July-August), 1978.
Perthes" Disease. R. G. Burwell, P. H. Dangerfield, D. J.
This rare affection is characterized by a synostosis of the proximal radio-ulnar articulation, causing a diminished ability of supination and pronation. The authors review 28 cases of synostoses in 16 children. Most often, the affectation is bilateral. When unilateral, neither side was seen more frequently. Both sexes were equally affected. The problem is usually discovered around the age of 2-3 yr or when the child starts school. The functional disability depends on the position of fixation. A forearm fixed in supination was not seen. An intermediate position of 90 ~ (16 cases) or pronation of 135 ~ was not frequently observed. In all these cases, the function of the hand was excellent, the defect being partially compensated by shoulder movements. Adaptation was so good that many cases fixed in intermediate position went undiscovered until sought for. Most cases, therefore, do not require operation. Surgery should not be attempted to restore pro-supination, as this can lead to severe complications.--J. Deevey
This study of 232 children between 5 and 10 yr, with Perthes' disease was carried out in three centers in England. A wide variety of skeletal measurements were made. These measurements were compared with similar measurements in healthy child populations in two of these centers. There was no significant difference between the affected boys in all three centers when compared with normal children however, one center (Liverpool) had no difference, but in the other two centers (Birmingham and Nottingham) affected boys were found to have impaired growth. This disproportionate growth was not due to orthopedic management as it was found in measurements within 2 mo of diagnosis. The findings are consistent with the view that children with Perthes' disease have an abnormal growth pattern. The Liverpool findings of a normal population with smaller stature are probably explicable on a socio-economic basis.--M. G. H. Smith
"Step-Off" Vertebral Body: Gaucher's Disease Versus Sickle Cell Hemoglobinopathy. A. M. Schwartz, M, J.
Equalization of Leg Lengths. H. C. Amstutz and D. N. Sakai. Clin Orth 136-225, 1978.
Homer, and R. G. K. McCauley. Am J. Roentgenol 132:8185, (January), 1979.
This is a symposium of articles on the indication and contraindications for lengthening and/or shortening procedures of the femur or tibia for leg length abnormalities. The discussion includes the techniques of plotting limb growth abnormalities of Dr. Green et al. as well as a newer method, the straight line graft method, of Dr. C. F. Mosley. The femoral lengthening procedures include an article by Dr. Cauchoix et al. with variations on his technique by other authors as well as the new technique described by Dr. Heinz Wagner. The tibial techniques include the Anderson technique discussion as well as variations of the Wagner technique. This is a thorough review of the problems by today's acknowledged experts in the field and should be read by all who deal with the surgical treatment of leg length abnormalities.--Anthony H. Alter
Two cases of "H'" or "step-off" vertebra in patients with Gaucher's disease increase the reported cases to four. This deformity is classically associated with sickle cell disease. Serial x-rays reveal the process to involve collapse of the entire vertebral body with more growth in the peripheral plate in Gaucher's disease. In sickle cell disease there is a failure of growth in the central plate which results in the deformity.--Randall W. Powell Progression in Idiopathic Scoliosis. G. C. Lloyd-Roberts, J. R. Pincott, P. McMeniman, et al. J Bone Joint Surg 60B:451-460, (November), 1978.
Based upon the macroscopic and histologic study of an entire spinal column of a 6-wk-old infant with structural scoliosis who had died of congenital heart disease, a possible mechanism for the progression of the scoliotic curve is porposed. The authors found that although the spinal cord had moved towards the concavity of the curve, it had not rotated with the vertebrae, thus exposing the nerve roots to
Hall, et al. J Bone Joint Surg 60B:461-477, (November), 1978,
Chronic Impairment of Leg Muscle Blood Flow Following Cardiac Catheterization in Childhood. J. Skovranek and M.
Samanek. Am J Roentgenol 132:71-75, (January), 1979. Ninety-nine patients who underwent cardiac catheterization for congenital heart disease or chronic pulmonary
of function was seen between 3 mo and 9 yr. Five children had permanent sequellae, which is less than half of those observed with brachial plexus palsy without fracture. Epiphyseal separation, seen with increasing frequency, is more difficult to recognize and diagnose, because these areas are initially radiolucent and not demonstrable. Arthrograms are sometimes necessary for confirmation, and attention should be payed to late radiograms (8 to 10 days) where calcified periosteum and pseudo-luxation can be seen. Each location has a peculiar clinical aspect which confuses the initial diagnosis. Early conservative treatment with traction and anatomic alignment usually avoids sequellae, but occasionally results in malrotation. Definitive surgical management in these cases is delayed.--J. Deevey Congenital Radio-Ulnar Synostosis in Children. G. Finidori,
499
traction and entrapment. This report of the extensive findings in a single case is published with a plea for the careful examination of the spinal column and cord should such become available.--M. G. H. Smith Perthes" Disease of the Hip in Three Regions of England.
D. J. P. Barker, E. Dixon, and J. F. Taylor. J Bone Joint Surg 60B:478~180, (November), 1978. This study is based on three regions of England--Mersey, Trent, and Wessex--of children presenting to Orthopedic Surgeons in those regions in 1976. The incidence, sex ratio, and age of affected males varied significantly between the regions. These findings suggest that environmental influences may have a major role in the cause of this disease.--M. G. H. Smith
P. Rigault, F. Barthel, et al. Chirurgie P6diatrique, Paris, 19:211-217, (July-August), 1978.
Perthes" Disease. R. G. Burwell, P. H. Dangerfield, D. J.
This rare affection is characterized by a synostosis of the proximal radio-ulnar articulation, causing a diminished ability of supination and pronation. The authors review 28 cases of synostoses in 16 children. Most often, the affectation is bilateral. When unilateral, neither side was seen more frequently. Both sexes were equally affected. The problem is usually discovered around the age of 2-3 yr or when the child starts school. The functional disability depends on the position of fixation. A forearm fixed in supination was not seen. An intermediate position of 90 ~ (16 cases) or pronation of 135 ~ was not frequently observed. In all these cases, the function of the hand was excellent, the defect being partially compensated by shoulder movements. Adaptation was so good that many cases fixed in intermediate position went undiscovered until sought for. Most cases, therefore, do not require operation. Surgery should not be attempted to restore pro-supination, as this can lead to severe complications.--J. Deevey
This study of 232 children between 5 and 10 yr, with Perthes' disease was carried out in three centers in England. A wide variety of skeletal measurements were made. These measurements were compared with similar measurements in healthy child populations in two of these centers. There was no significant difference between the affected boys in all three centers when compared with normal children however, one center (Liverpool) had no difference, but in the other two centers (Birmingham and Nottingham) affected boys were found to have impaired growth. This disproportionate growth was not due to orthopedic management as it was found in measurements within 2 mo of diagnosis. The findings are consistent with the view that children with Perthes' disease have an abnormal growth pattern. The Liverpool findings of a normal population with smaller stature are probably explicable on a socio-economic basis.--M. G. H. Smith
"Step-Off" Vertebral Body: Gaucher's Disease Versus Sickle Cell Hemoglobinopathy. A. M. Schwartz, M, J.
Equalization of Leg Lengths. H. C. Amstutz and D. N. Sakai. Clin Orth 136-225, 1978.
Homer, and R. G. K. McCauley. Am J. Roentgenol 132:8185, (January), 1979.
This is a symposium of articles on the indication and contraindications for lengthening and/or shortening procedures of the femur or tibia for leg length abnormalities. The discussion includes the techniques of plotting limb growth abnormalities of Dr. Green et al. as well as a newer method, the straight line graft method, of Dr. C. F. Mosley. The femoral lengthening procedures include an article by Dr. Cauchoix et al. with variations on his technique by other authors as well as the new technique described by Dr. Heinz Wagner. The tibial techniques include the Anderson technique discussion as well as variations of the Wagner technique. This is a thorough review of the problems by today's acknowledged experts in the field and should be read by all who deal with the surgical treatment of leg length abnormalities.--Anthony H. Alter
Two cases of "H'" or "step-off" vertebra in patients with Gaucher's disease increase the reported cases to four. This deformity is classically associated with sickle cell disease. Serial x-rays reveal the process to involve collapse of the entire vertebral body with more growth in the peripheral plate in Gaucher's disease. In sickle cell disease there is a failure of growth in the central plate which results in the deformity.--Randall W. Powell Progression in Idiopathic Scoliosis. G. C. Lloyd-Roberts, J. R. Pincott, P. McMeniman, et al. J Bone Joint Surg 60B:451-460, (November), 1978.
Based upon the macroscopic and histologic study of an entire spinal column of a 6-wk-old infant with structural scoliosis who had died of congenital heart disease, a possible mechanism for the progression of the scoliotic curve is porposed. The authors found that although the spinal cord had moved towards the concavity of the curve, it had not rotated with the vertebrae, thus exposing the nerve roots to
Hall, et al. J Bone Joint Surg 60B:461-477, (November), 1978,
Chronic Impairment of Leg Muscle Blood Flow Following Cardiac Catheterization in Childhood. J. Skovranek and M.
Samanek. Am J Roentgenol 132:71-75, (January), 1979. Ninety-nine patients who underwent cardiac catheterization for congenital heart disease or chronic pulmonary