Vascular compression of the duodenum associated with treatment of scoliosis: Review of the literature and report of eighteen cases

ABSTRACTS The treatment conclusions, according to the types, are as follows: Type I-circumferential ligation at birth; Type II-removal of the accessory digit as early as feasible to get rid of the deforming influence, with the goal of placing function above cosmesis to avoid extra surgical procedures; Type IIIrarely seen and occasionally requires total ray excision to narrow the hand.-A. H. Alter VASCULAR COMPRESSIONOF THE DUODENUM ASSOCIATEDWITH TREATMENT OF SCOLIOSIS: REVIEW OF THE LITERATURE AND REPORT OF EIGHTEEN CASES. C. M. Eva&, R. D. Winter, and J. E. Hall. J. Bone Joint Surg. 53-A:431444, 1971. The authors present 18 cases and a review of the literature of 17 further reported cases of vascular duodenal obstruction. These are seen in patients who are in treatment for correction of scoliosis with the etiology thought to be due to the acute angle of departure of the superior mesenteric arterial trunk with the acuteness increased by COTrection of the scoliotic curvature. Treatment is discussed.-A. H. Alter SCOLIOSIS IN CHILDHOOD MUSCULAR DYSTROPHY. G. C. Robin and L. P. Brief. J. Bone Joint Surg. 53A:366-476, 1971. Twenty-three dystrophic children in adolescence were followed for a progressive scoliosis thought to be due to absence of active trunk muscles. The failure of conservative therapy is documented as well as the problems of extensive surgical spine fusion, the treatment of choice.-A. H. Alter SUPPURATME ARTHRITIS OF THE HIP JOINT IN INFANCY: A PERSISTENT DIAGNOSTIC PROBLEM AND POSSIBLECOMPLICATION OF FEMORAL VENIPUNCTURE. P. D. Chacha. J. Bone Joint Surg. 53A:538-544, 1971. Sixteen cases of septic pyarthrosis of the hip over a 3-yr period in 15 infants who had had previous femoral venipuncture were reviewed. Complete documentation of the venipuncture etiology could not be obtained, but this was the author’s supposition. The time interval between femoral venipunctnre atid first symptoms or signs ranged from 1 to 28 days, with the average being IO days. All children were admitted with prior medi-

cal problems. Clinical and X-ray measures were reviewed. The surgmy performed early in the course produced the best results.A. H. Alter SYNOVITISOF THE HIP IN CHILDREN AND ITS SIGNIFICANCE. B. Jacobs. Pediatrics 47: 558-566 (March) 1971. Transient synovitis of the hip is the most common cause of painful hip in children and is characterized by pain and limp of acute onset, which is short-lived, and the absence of X-ray findings. Legg-Cal&-Perthes disease or necrosis of the femoral capital epiphysis may be preceded by a stage of synovitis indistinguishable from transient synovitis, which is self-limiting. Since 11 out of 62 cases of transient synovitis developed LeggCal&-Perthes disease, the author stresses the importance of closely observing all children with diagnosed transient synovitis-C. L. Rubin ASSOCIATIONOF PERTHESDISEASEWITH CONGENITAL ANOMALIES OF GENITOURINARY TRACT AND INGUINAL REGION. A. Catterall; G. C. Lloyd Roberts, and Ruth WynneDavis. Lancet 1:996-997 (May 15) 1971. In a study of 282 patients with LeggCalv&Perthes disease ( pseudocoxalgia) from Edinburgh and London, clinical and genetic studies suggest a relationship between Perthes disease of the hip and congenital anomalies of the genitourinary tract and inguinal region. Seventeen of 229 male patients had inguinal hernias (expected incidence 7.9 per lOOO)-approximately eight times the expected figure. Seven patients also had undescended testes. A definite disorder of the urinary tract (kidney, ureter, urethra) in patients with Perthes disease was present in 12 of 282 (4.3%). The anomalies include double kidney, pelviureteric obstruction, renal calculi, and hypospadias. The same type of anomaly was found among second- and thirddegree relatives and serious renal disorders were found in 1.8% of parents. The association between Perthes disease and the anomalies described suggest a common etiological factor. In Perthes disease accompanied by these anomalies there is a tendency for the disease to be bilateral and of a mild type.-W. M. Dennison