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School screening for scoliosis in athens
ABSTRACTS
upper limit of normal. The authors wrote the paper to refute the previous literature and establish that surgery can have a successful role in selected cases with adolescent thoracic kyphosis.---Anthony H. Alter The Thoracic Suspension Orthosis. J. C. Drenan, T. S. Renshaw, and P. H. Curtis. Clin Orth 139:33-39, ( M a r c h April), 1979.
Sixty-four patients, managed at the New England Children's Hospital with a thoracic suspension orthosis were studied. The orthosis is made of plastic. It grasps the chest, suspending the patient in the chair so that his buttocks are free of contact. The protocol for teaching patients tolerance to the device as well as details relating to its construction are included in the article. Fifty-nine patients were definitely improved, either in terms of respiratory function, appearance, curvature correction and function. Five patients failed to improve because of lack of cooperation between the patient and/or family, gross obesity, hip joint stiffness interfering with the ability to sit, severe athetoid cerebral palsy and slippage through the orthosis because of progressive cachexia. This equipment should be in the armamentarium of all pediatricians managing the neurologically handicapped children with their progressive spinal deformities.--Anthony H. Alter Management of Severe Spondylolisthesis in Children and Adolescence. D. Boxall, D. S. Bradford, R. B. Winter et al.
J Bone Joint Surg 61A:479~,95, (June), 1979. Forty-three patients with an L-5-S-1 spondylolisthesis greater than 50% were studied. The article reviews the techniques of recording measurements on x-rays as well as the findings at physical examination. Thirty-four patients were treated nonoperatively. The 39 remaining patients had surgery consisting of fusion in 11 patients, laminectomy and fusion in 18 patients plus attempts at reduction with fusion in 10 other patients. Thirty-four of the fusions were of the transverse process type. Myelography was found to be of no value in preoperative assessment except to rule out tumor of the cauda equina. Preoperative assessment revealed significant increase in degree of displacement as the patient was taken from the supine to an upright position. Fusion with or without laminectomy when successful achieved excellent functional results. The authors used Harrington rod instrumentation for spondylolisthesis with a "angle of slipping" of 55 ~ greater. Postoperative management consisted of bilateral leg extension casts, but nonetheless, significant loss in reduction from the initial operative result usually occurred. There is a 25% overall pseudarthrosis rate, felt to be a function of the severe displacement in the cases selected for this paper. The authors concluded there is little place for the nonsurgical treatment of patients with severe displacement. The transverse process fusion has the highest likelihood of success. Postoperative casting seems to make little difference except in the small immature patient.--Anthony H. Alter School Screening for Scoliosis in Athens. P. N. Smyrnis, J,
Valavanis, A. Alexopoulos, et al. J Bone Joint Surg 61B:215-217, (May), 1979.
111
In the screening of school children by the bending test to reveal rib hump or lumbar protrusion, the authors then confirmed the presence of spinal curvature by radiographs, revealing in a random sample of 3494 children, mostly between 11 and 12 yr, an incidence of scoliosis of 9.1% in girls and 3.9% in boys. When curves of 10~ or more were analysed, 4.6% of girls and 1.1% of boys were affected. The incidence of scoliosis in children with fair hair and blue eyes was twice that of those children with dark complexions. No correlation between weight, height and onset of puberty could be found in the development of scoliosis.--M. G. H. Smith Spine Deformity in Neurofibromatosis: A Review of 102 Patients. R. B. Winter, J. H. Moe, D. S. Bradford, el al. J
Bone Joint Surg 61A:677-694, (July), 1979. This is a review article, based on a study of 102 patients with Von Recklinghausen's neurofibromatosis. Eighty patients had curves secondary to dystrophic bone formation associated with neurofibromatosis. The dystrophic curves were refractory to brace correction and required both anterior and posterior fusion to achieve the treatment goals. The results included 16 patients with spinal cord and/or cauda equina compression problems. The nondystrophic curves behaved the same as conventional idiopathic scoliosis. This is a thorough article, based upon a personal e x p e r i e n c e . Anthony H. Alter Fracture-Separation of the Distal Humeral Epiphysis in
Young Children. K. Mizuno, K. Hirohata, and D. Kashiwagi. J Bone Joint Surg 61A:570-573, (June), 1979.
Six epiphyseal fractures of the humerus were reviewed. The arthrographic findings, surgical management and prognosis in this previously rarely described injury were shown. The injury probably exists more frequently than is now known. The problem remains the appropriate technique of diagnosing the injury. The prognosis is good for this injury, assuming adequate reduction.--Anthony H. Alter Lengthening of the Elbow Flexors in Cerebral Palsy. M. A.
Mital. J Bone Joint Surg 61A:515-522, (June), 1979. Six patients with spastic cerebral palsy and associated elbow flexion contractures had a surgical procedure, including Z-lengthening of the biceps brachii and fractional lengthening of the brachialis. The technique is described. All patients had improved cosmetic results, range of motion. Four patients had considerable objective functional improvement. The only complications were keloid formation in the scar. The auth6r concludes, based upon the longest follow-up of 6 yr, that this is a valid procedure in the management of elbow flexion contractures in cerebral palsy.--Anthony H. Alter Congenital Radio-Ulnar Synostosis: Surgical Treatment.
IV. T. Green and M. A. Mital. J Bone Joint Surg 61A:738743, (July), 1979. Thirteen patients with congenital radio-ulnar synostosis were studied 10-25 yr after surgery. The surgical technique
upper limit of normal. The authors wrote the paper to refute the previous literature and establish that surgery can have a successful role in selected cases with adolescent thoracic kyphosis.---Anthony H. Alter The Thoracic Suspension Orthosis. J. C. Drenan, T. S. Renshaw, and P. H. Curtis. Clin Orth 139:33-39, ( M a r c h April), 1979.
Sixty-four patients, managed at the New England Children's Hospital with a thoracic suspension orthosis were studied. The orthosis is made of plastic. It grasps the chest, suspending the patient in the chair so that his buttocks are free of contact. The protocol for teaching patients tolerance to the device as well as details relating to its construction are included in the article. Fifty-nine patients were definitely improved, either in terms of respiratory function, appearance, curvature correction and function. Five patients failed to improve because of lack of cooperation between the patient and/or family, gross obesity, hip joint stiffness interfering with the ability to sit, severe athetoid cerebral palsy and slippage through the orthosis because of progressive cachexia. This equipment should be in the armamentarium of all pediatricians managing the neurologically handicapped children with their progressive spinal deformities.--Anthony H. Alter Management of Severe Spondylolisthesis in Children and Adolescence. D. Boxall, D. S. Bradford, R. B. Winter et al.
J Bone Joint Surg 61A:479~,95, (June), 1979. Forty-three patients with an L-5-S-1 spondylolisthesis greater than 50% were studied. The article reviews the techniques of recording measurements on x-rays as well as the findings at physical examination. Thirty-four patients were treated nonoperatively. The 39 remaining patients had surgery consisting of fusion in 11 patients, laminectomy and fusion in 18 patients plus attempts at reduction with fusion in 10 other patients. Thirty-four of the fusions were of the transverse process type. Myelography was found to be of no value in preoperative assessment except to rule out tumor of the cauda equina. Preoperative assessment revealed significant increase in degree of displacement as the patient was taken from the supine to an upright position. Fusion with or without laminectomy when successful achieved excellent functional results. The authors used Harrington rod instrumentation for spondylolisthesis with a "angle of slipping" of 55 ~ greater. Postoperative management consisted of bilateral leg extension casts, but nonetheless, significant loss in reduction from the initial operative result usually occurred. There is a 25% overall pseudarthrosis rate, felt to be a function of the severe displacement in the cases selected for this paper. The authors concluded there is little place for the nonsurgical treatment of patients with severe displacement. The transverse process fusion has the highest likelihood of success. Postoperative casting seems to make little difference except in the small immature patient.--Anthony H. Alter School Screening for Scoliosis in Athens. P. N. Smyrnis, J,
Valavanis, A. Alexopoulos, et al. J Bone Joint Surg 61B:215-217, (May), 1979.
111
In the screening of school children by the bending test to reveal rib hump or lumbar protrusion, the authors then confirmed the presence of spinal curvature by radiographs, revealing in a random sample of 3494 children, mostly between 11 and 12 yr, an incidence of scoliosis of 9.1% in girls and 3.9% in boys. When curves of 10~ or more were analysed, 4.6% of girls and 1.1% of boys were affected. The incidence of scoliosis in children with fair hair and blue eyes was twice that of those children with dark complexions. No correlation between weight, height and onset of puberty could be found in the development of scoliosis.--M. G. H. Smith Spine Deformity in Neurofibromatosis: A Review of 102 Patients. R. B. Winter, J. H. Moe, D. S. Bradford, el al. J
Bone Joint Surg 61A:677-694, (July), 1979. This is a review article, based on a study of 102 patients with Von Recklinghausen's neurofibromatosis. Eighty patients had curves secondary to dystrophic bone formation associated with neurofibromatosis. The dystrophic curves were refractory to brace correction and required both anterior and posterior fusion to achieve the treatment goals. The results included 16 patients with spinal cord and/or cauda equina compression problems. The nondystrophic curves behaved the same as conventional idiopathic scoliosis. This is a thorough article, based upon a personal e x p e r i e n c e . Anthony H. Alter Fracture-Separation of the Distal Humeral Epiphysis in
Young Children. K. Mizuno, K. Hirohata, and D. Kashiwagi. J Bone Joint Surg 61A:570-573, (June), 1979.
Six epiphyseal fractures of the humerus were reviewed. The arthrographic findings, surgical management and prognosis in this previously rarely described injury were shown. The injury probably exists more frequently than is now known. The problem remains the appropriate technique of diagnosing the injury. The prognosis is good for this injury, assuming adequate reduction.--Anthony H. Alter Lengthening of the Elbow Flexors in Cerebral Palsy. M. A.
Mital. J Bone Joint Surg 61A:515-522, (June), 1979. Six patients with spastic cerebral palsy and associated elbow flexion contractures had a surgical procedure, including Z-lengthening of the biceps brachii and fractional lengthening of the brachialis. The technique is described. All patients had improved cosmetic results, range of motion. Four patients had considerable objective functional improvement. The only complications were keloid formation in the scar. The auth6r concludes, based upon the longest follow-up of 6 yr, that this is a valid procedure in the management of elbow flexion contractures in cerebral palsy.--Anthony H. Alter Congenital Radio-Ulnar Synostosis: Surgical Treatment.
IV. T. Green and M. A. Mital. J Bone Joint Surg 61A:738743, (July), 1979. Thirteen patients with congenital radio-ulnar synostosis were studied 10-25 yr after surgery. The surgical technique