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Surgical treatment of displaced supracondylar fractures of the humerus in children: Analysis of 52 cases followed for 5–15 yr
211
ticular region. This tumor is the commonest non-germinal neoplasm of the scrotal contents, usually presenting as a unilateral painless, firm, moveable intrascrotal mass. Surgical therapy consisted of radical orchidectomy. Fifteen of 20 patients had a retroperitoneal exploration with I2 formal node dissections. Positive nodes were found in six patients. Chemotherapy consisted of Vincristine, Actinomycin D, and Cyclophosphamide. Radiation was given to all patients with positive nodes and to half the others. There is high incidence of tumor-involved retroperitoneal nodes, so a dissection should be performed. Patients with positive nodes should receive Radiotherapy but its use in others is questionable. The role of Chemotherapy in preventing distant metastases in Rhabdomyosarcoma is well established. Treatment is effective, with I6 of I8 evaluable patients disease free at a median of 23 mo from diagnosis. Reduction of morbidity by specific therapy is desirable as the disease has a good prognosis.-Robert Pereyra
suggests that there are at least two distinct entities: primary syndactyly due to interference with the sequence of events that normally culminate in the division of digits into discrete parts and secondary syndactyly due to readhesion of adjacent digits as a result of close contact between raw surfaces. Surgical management is determined by the complexity of the malformation. For simple cutaneous syndactyly, a zigzag incision, with proximally based flaps for the web, and skin grafting are usually sufficient. For complex deformities several planned operative procedures may be required. The surgeon must also be. vigilant to note and to correct the sequelae resulting from contractures and imbalances associated with growth.-Co/in C. Fergnson
The Management of Testicular Tumors in Children. T. B.
Fifty-two displaced supracondylar factures in children were treated with open reduction and K-wire fixation in an effort to avoid the complications of mal-union. Follow-up ranged from 5 to 15 yr. There were no non-unions, infections, or myositis ossificans. Five patients with preoperative nerve palsy had complete recovery within 2-14 days. Two patients with Y-type fractures into the joint were developing posttraumatic arthritis in the face of an anatomic operative reduction. One patient had extension loss less than IO0 and 3 had flexion loss of less than ten degrees, but 3 of these patients with contractures had had previous multiple efforts at reduction which the authors feel may have been a factor. Thirteen patients had an alteration in the carrying angle with 2 patients showing an increased varus deformity of greater than 20”. This is felt to represent technical errors of reduction technique as there were no cases showing any loss of reduction after surgery. The authors compared their series to others and feel their results with the open technique are comparable.-Anthony H. Alter
Hopkins, N. Jaffe. A. Colodny, (July), 1978.
et al. J Urol 120:96-102,
Of 43 testicular tumors in children, 33 were found to bc malignant. Twenty of the 24 malignant germinal neoplasms were embryonal cell carcinomas. Of 9 patients who underwent only orchiectomy 5 have died, whereas all I I patients who received combination therapy have survived. For malignant tumors, the authors recommend radical inguinal orchiectomy and extended unilateral retroperitoneal lymphadenectomy. Adjuvant chemotherapy with Actinomycin D, Vincristine, and Cyclophosphamide in repeated courses for two years also should be utilized. Radiotherapy should be withheld if lymphadenectomy is negative.-George Holcomb, Jr. Congenital
Absence
of the Vagina:
Surgical Reconstruction. E. fmnont.
391, (July),
Diagnosis and Plastic Ann Plas Surg l:38&
Surgical Treatment of Displaced Suprecondylar Fractures of the Humerus in Children: Analysis of 52 Cases Followed for 6-15
yr. A. J. Weiland. S. Meyer, V. T. Tolo. et al. J Bone Joint Surg 60A:657-661, (July), 1978.
1978.
A detailed experience with 20 cases of vaginal reconstruction, are presented by the author. The embryologic failure of vaginal development, diagnosis, clinical, radiologic procedures for the diagnosis of the absent vagina are listed. In addition, a presentation of the historical development of vaginal reconstruction, with their inherent advantages and disadvantages is given for the person interested. The author presents his own operative procedure which consists of creating a new vagina between the urinary and rectocolonic areas. The space is immediately skin grafted and detailed presentation of this procedure is given. The postoperative care is listed as are the anticipated results. The article does present an excellent review of the subject for the surgeon and nonsurgeon alike and is recommended to those physicians interested in this entity.-A. B. Sokol MUSCULOSKELETAL
SYSTEM
Congenital Syndectyly: A Reappraisal. M. A. Enfin. Can J Surg 21:36&364, (July), 1978. Digital syndactyly in the past has been considered a single entity. Recent information, however, provided by experimental embryology, studies of morphogenesis, and other sources,
Congenital Thoracic Lordosis. R. B. Winter, H. Moe, and D.
S. Bradford. 1978.
J Bone Joint Surg 60A:806-814,
(September),
This is a report of five cases of congenital thoracic lordosis. The literature documents the increasing pulmonary restriction this condition poses. The safest surgical procedure, based upon the review of these cases and their attendant complications, is a fusion in situ rather than an attempt to decompress the spine. This stabilizes the condition. Attempts to reduce the lordosis were associated variously with death and quadriplegia. This is a rare condition and this represents the most up-to-date surgical treatment principles available of this condition.-Anthony H. Alter Routine Oblique Radiography of the Pediatric Lumber Spine: Is it Necessary? F. F. Roberts.
M. E. Cunningham. (August), 1978.
Am
J
P. R. S. Kishore, and Roentgen01 131:297-298,
One-hundred twenty-five lumbar spine series (anteroposterior, lateral, and oblique views) reviewed retrospectively yielded 86 abnormal findings in 77 patients. Forty-three (50%) of the abnormalities were detected on the A-P and
ticular region. This tumor is the commonest non-germinal neoplasm of the scrotal contents, usually presenting as a unilateral painless, firm, moveable intrascrotal mass. Surgical therapy consisted of radical orchidectomy. Fifteen of 20 patients had a retroperitoneal exploration with I2 formal node dissections. Positive nodes were found in six patients. Chemotherapy consisted of Vincristine, Actinomycin D, and Cyclophosphamide. Radiation was given to all patients with positive nodes and to half the others. There is high incidence of tumor-involved retroperitoneal nodes, so a dissection should be performed. Patients with positive nodes should receive Radiotherapy but its use in others is questionable. The role of Chemotherapy in preventing distant metastases in Rhabdomyosarcoma is well established. Treatment is effective, with I6 of I8 evaluable patients disease free at a median of 23 mo from diagnosis. Reduction of morbidity by specific therapy is desirable as the disease has a good prognosis.-Robert Pereyra
suggests that there are at least two distinct entities: primary syndactyly due to interference with the sequence of events that normally culminate in the division of digits into discrete parts and secondary syndactyly due to readhesion of adjacent digits as a result of close contact between raw surfaces. Surgical management is determined by the complexity of the malformation. For simple cutaneous syndactyly, a zigzag incision, with proximally based flaps for the web, and skin grafting are usually sufficient. For complex deformities several planned operative procedures may be required. The surgeon must also be. vigilant to note and to correct the sequelae resulting from contractures and imbalances associated with growth.-Co/in C. Fergnson
The Management of Testicular Tumors in Children. T. B.
Fifty-two displaced supracondylar factures in children were treated with open reduction and K-wire fixation in an effort to avoid the complications of mal-union. Follow-up ranged from 5 to 15 yr. There were no non-unions, infections, or myositis ossificans. Five patients with preoperative nerve palsy had complete recovery within 2-14 days. Two patients with Y-type fractures into the joint were developing posttraumatic arthritis in the face of an anatomic operative reduction. One patient had extension loss less than IO0 and 3 had flexion loss of less than ten degrees, but 3 of these patients with contractures had had previous multiple efforts at reduction which the authors feel may have been a factor. Thirteen patients had an alteration in the carrying angle with 2 patients showing an increased varus deformity of greater than 20”. This is felt to represent technical errors of reduction technique as there were no cases showing any loss of reduction after surgery. The authors compared their series to others and feel their results with the open technique are comparable.-Anthony H. Alter
Hopkins, N. Jaffe. A. Colodny, (July), 1978.
et al. J Urol 120:96-102,
Of 43 testicular tumors in children, 33 were found to bc malignant. Twenty of the 24 malignant germinal neoplasms were embryonal cell carcinomas. Of 9 patients who underwent only orchiectomy 5 have died, whereas all I I patients who received combination therapy have survived. For malignant tumors, the authors recommend radical inguinal orchiectomy and extended unilateral retroperitoneal lymphadenectomy. Adjuvant chemotherapy with Actinomycin D, Vincristine, and Cyclophosphamide in repeated courses for two years also should be utilized. Radiotherapy should be withheld if lymphadenectomy is negative.-George Holcomb, Jr. Congenital
Absence
of the Vagina:
Surgical Reconstruction. E. fmnont.
391, (July),
Diagnosis and Plastic Ann Plas Surg l:38&
Surgical Treatment of Displaced Suprecondylar Fractures of the Humerus in Children: Analysis of 52 Cases Followed for 6-15
yr. A. J. Weiland. S. Meyer, V. T. Tolo. et al. J Bone Joint Surg 60A:657-661, (July), 1978.
1978.
A detailed experience with 20 cases of vaginal reconstruction, are presented by the author. The embryologic failure of vaginal development, diagnosis, clinical, radiologic procedures for the diagnosis of the absent vagina are listed. In addition, a presentation of the historical development of vaginal reconstruction, with their inherent advantages and disadvantages is given for the person interested. The author presents his own operative procedure which consists of creating a new vagina between the urinary and rectocolonic areas. The space is immediately skin grafted and detailed presentation of this procedure is given. The postoperative care is listed as are the anticipated results. The article does present an excellent review of the subject for the surgeon and nonsurgeon alike and is recommended to those physicians interested in this entity.-A. B. Sokol MUSCULOSKELETAL
SYSTEM
Congenital Syndectyly: A Reappraisal. M. A. Enfin. Can J Surg 21:36&364, (July), 1978. Digital syndactyly in the past has been considered a single entity. Recent information, however, provided by experimental embryology, studies of morphogenesis, and other sources,
Congenital Thoracic Lordosis. R. B. Winter, H. Moe, and D.
S. Bradford. 1978.
J Bone Joint Surg 60A:806-814,
(September),
This is a report of five cases of congenital thoracic lordosis. The literature documents the increasing pulmonary restriction this condition poses. The safest surgical procedure, based upon the review of these cases and their attendant complications, is a fusion in situ rather than an attempt to decompress the spine. This stabilizes the condition. Attempts to reduce the lordosis were associated variously with death and quadriplegia. This is a rare condition and this represents the most up-to-date surgical treatment principles available of this condition.-Anthony H. Alter Routine Oblique Radiography of the Pediatric Lumber Spine: Is it Necessary? F. F. Roberts.
M. E. Cunningham. (August), 1978.
Am
J
P. R. S. Kishore, and Roentgen01 131:297-298,
One-hundred twenty-five lumbar spine series (anteroposterior, lateral, and oblique views) reviewed retrospectively yielded 86 abnormal findings in 77 patients. Forty-three (50%) of the abnormalities were detected on the A-P and