Selection of Lower instrumented vertebra in early-onset scoliosis at index growth rod insertion- can we predict distal add-on at graduation surgery?

Background: There are still no consensus criteria on how to select the lower instrumented vertebra (LIV) for growing rods (GRs) at index surgery. The aim was to evaluate whether the criteria used for adolescent idiopathic scoliosis fusion adapts to early-onset scoliosis (EOS).

Materials And Methods: Retrospective analysis of prospectively collected data in a consecutive cohort of patients with EOS treated with GR, expanding from index surgery to 2 years after graduation.

The Relationship Between Diet, Gut Microbiota, and Serum Metabolome of South Asian Infants at 1 Year.

Background: Diet is known to affect the gut microbiota and the serum metabolome in adults, but this has not been fully explored in infants. Infancy is an important developmental period that may influence a person's long-term health. Infant development can be affected by diet, which also interacts with the developing gut microbiota.

'It's my back…'; developing the coming to spinal clinic resource to improve the health literacy of young people with adolescent idiopathic scoliosis and their parents.

This study focussed on identifying the key concerns and information needs of young people with Adolescent Idiopathic Scoliosis (AIS) and their parents and examined what resources might help improve young people's 'participativeness' and health literacy during clinic consultations. A qualitative participatory design underpinned the study. Workshops involving multiple methods were used to engage with young people with AIS and their parents, who were recruited through a regional children's hospital.

Preoperative and Postoperative, Three-dimensional Gait Analysis in Surgically Treated Patients With High-grade Spondylolisthesis.

Background: High-grade spondylolisthesis (HGS) (Myerding grade III-V) in adolescents can lead to a marked alteration of gait pattern and maybe the presenting symptom in these patients. This characteristic gait pattern in patients with HGS has been referred to as the "pelvic waddle." Modern 3-dimensional (3D) gait analysis serves an important tool to objectively analyze the different components of this characteristic gait preoperatively and postoperatively and is an objective measure of postoperative improvement.

The Salter innominate osteotomy does not lead to acetabular retroversion.

In children with developmental dysplasia of the hip (DDH), Salter's innominate osteotomy aims to surgically manipulate the acetabulum to increase anterior coverage and aid joint support. Consequently, this procedure may retrovert the acetabulum, predisposing patients to pain, osteoarthritis, impingement, or further surgical intervention. In this study, we aim to address whether the innominate osteotomy leads to acetabular retroversion postoperatively or at follow-up.

A novel technique for the subfascial insertion of magnetically controlled growing rods - The Alder Hey technique.

Purpose: In this study, we would like to describe a novel technique for subfascial insertion of magnetically controlled growing rods using chest drain during surgery for early-onset scoliosis.

Materials And Methods: Posterior approach, surgical dissection to the spine is performed exposing the relevant anatomy to allow placement of pedicle screws always in the distal construct and pedicle screws or hooks in the proximal construct. To allow easy passage of the Magnetic Expansion Control (MAGEC) rod, as well as easy maneuvering of the rod in either the cranial to caudal direction, we use a chest drain of size 24 French diameter as a tunnel.

Intramedullary devices in the management of Judet III and IV paediatric radial neck fractures.

Purpose: The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique.

Methods: Thirty patients with isolated Judet III and IV fractures were included in this prospective study. Judet I and II fractures and radial neck fractures associated with other injuries were excluded.

Pelvic pyomyositis in children: changing trends in occurrence and management.

Aims: We present the largest series of paediatric pelvic pyomyositis from a temperate country, analyse the factors influencing long term prognosis and suggest a diagnostic protocol.

Materials And Method: We included 41 patients diagnosed with primary paediatric pelvic pyomyositis between 1998 and 2016, in this study with a mean age of 7.5 years.

Wrist Arthroscopy in Children and Adolescent With Chronic Wrist Pain: Arthroscopic Findings Compared With MRI.

Background: Wrist arthroscopy is a dynamic diagnostic procedure and its indications are growing as a treatment modality in the adult population. The aim of the study was to retrospectively report our series of pediatric and adolescence with chronic wrist pain, with or without wrist instability who underwent wrist arthroscopy after failing at least 4 months of conservative management. Our secondary aim was to report the sensitivity and specificity of clinical examination and magnetic resonance imaging evaluation for various injury subgroups against the gold standard of the arthroscopic findings.

Stability-based assessment of Monteggia-type injuries predicts failure of treatment.

Paediatric Monteggia-type injuries are complicated by treatment failure and posterior interosseous nerve palsy, without reliable predictive indicators. Outcome is considered to be good, with little patient-reported evidence. We propose novel radiographic parameters.

Treatment of complex idiopathic clubfoot using the modified Ponseti method: up to 11 years follow-up.

Unlabelled: Complex idiopathic clubfeet are distinguished by significant shortening, rigid equinus with a deep crease above the heel, severe plantar flexion of all metatarsals, a deep plantar crease seven across the full width of the sole of the foot and high cavus with a short and hyperextended big toe. Ponseti has devised a modified technique for treating complex clubfeet. We retrospectively identified 11 children (nine males and two females) with 17 complex clubfeet who were treated with the modified Ponseti method.

Hyperactivity and the psychological burden of Perthes disease: a case-control study.

Background: Legg-Calve-Perthes Disease (LCPD) is a childhood precursor to hip osteoarthritis, for which the etiology is unknown. There is a widespread belief that affected individuals are "hyperactive," propagating a theory that such children may have sustained an epiphyseal injury that precipitated the onset of LCPD. This study seeks to quantify the association with hyperactivity, and the wider psychological burden of the disease.

Shelf acetabuloplasty for Perthes disease in patients older than eight years of age: an observational cohort study.

This is a retrospective review of 24 patients with late-onset Perthes disease treated with shelf acetabuloplasty. The mean age of the patients was 9.8 years.

Perthes' disease of the hip: socioeconomic inequalities and the urban environment.

Introduction: Perthes' disease is a puzzling childhood hip disorder for which the aetiology is unknown. It is known to be associated with socioeconomic deprivation. Urban environments have also been implicated as a risk factor, however socioeconomic deprivation often occurs within urban environments and it is unclear if this association is the result of confounding.

The use of routine preoperative magnetic resonance imaging in identifying intraspinal anomalies in patients with idiopathic scoliosis: a 10-year review.

Purpose: This study sought to quantify the frequency of previously unidentified spinal cord anomalies identified by routine preoperative magnetic resonance imaging (MRI), in patients planned for surgical scoliosis correction.

Methods: Our study group comprised 206 patients with idiopathic scoliosis who underwent deformity correction from 1998 to 2008. Clinical records of all the patients were retrospectively reviewed to ascertain the proportion having a neural abnormality on preoperative MRI scan.

Abnormalities of vascular structure and function in children with Perthes disease.

Background And Objectives: Perthes disease is a childhood precipitant to osteoarthritis of the hip, for which the etiology and mechanism are unknown. There is mounting evidence to suggest a vascular insult is responsible for disease, and it is suggested that this may have long-term implications for the vascular health of affected individuals. This study sought to use ultrasound measures to investigate vascular structure and function in children affected by Perthes disease.

Racial and geographic factors in the incidence of Legg-Calvé-Perthes' disease: a systematic review.

Legg-Calvé-Perthes' disease (Perthes' disease) is a childhood osteonecrosis of the hip for which the disease determinants are poorly understood. In this review, the authors identify studies of Perthes' disease incidence published up to December 2010 and make denominator populations comparable in order to allow meaningful between-study evaluation. Incidence rates and confidence intervals were determined, and, where appropriate, denominator populations were obtained from national statistical offices.

Legg-Calvé-Perthes disease in the UK: geographic and temporal trends in incidence reflecting differences in degree of deprivation in childhood.

Objective: Little is known about Legg-Calvé-Perthes disease, a common childhood precursor to osteoarthritis of the hip. This study was undertaken to analyze the incidence of Legg-Calvé-Perthes disease in the UK, with respect to geographic and temporal trends over a 19-year period.

Methods: The General Practice Research database was analyzed to identify incident cases between 1990 and 2008 in children ages 0-14 years.

Perthes' disease: deprivation and decline.

Introduction: Perthes' disease is a childhood hip disorder which frequently precipitates premature osteoarthritis necessitating joint replacement in young adults. The highest incidence reported worldwide is in Merseyside, UK, where a unique disease register is maintained.

Objective: To describe the temporal trends in disease incidence in a geographically defined area of Merseyside, and to examine the relationship to area deprivation.