Alina Badina

Extensor Tendon Injuries in Children

Introduction: This study retrospectively analyzes primary extensor tendon repairs in children younger than 15 years. Methods: Exclusion criteria were skin loss, devascularization, fractures, or flexor tendon injuries. Fifty patients who had sustained extensor tendon laceration with 53 digits injured were available for review. Treatment consisted of primary repair of the extensor tendon injury within the first 24 hours. The results were assessed by means of total active motion system and by Millers rating system. The mean follow-up was 2 years. Results: Although 98% of the digits were rated as good or excellent according to the total active motion system and 95% according to Millers classification, 22% of the fingers showed extension lag or loss of flexion at the last follow-up. Discussion: Pejorative influencing factors were injuries in zones I, II, and III; children younger than 5 years (P < 0.05), and complete tendon laceration. Articular involvement had no significant influence on final outcome.

Case Reports: Treatment of Traumatic Triradiate Cartilage Epiphysiodesis: What is the Role of Bridge Resection?

BackgroundAcetabular fractures are rare in children and can be complicated by premature fusion of the triradiate cartilage resulting in secondary acetabular dysplasia. Early recognition and treatment of a physeal bar in this location can be difficult. The purpose of this case report was to investigate whether early intervention could restore acetabular growth and prevent secondary acetabular dysplasia as measured on plain radiographs.Case DescriptionWe report a series of three patients (3, 4, and 5 years old) who underwent physeal bridge resection and methylmethacrylate or fat interposition through an extended Pfannenstiel approach. The mean followup was 6 years. After resection of the osseous bridge the physis initially remained open with evident acetabular growth in all three patients. In one patient, the bridge reformed 6 years after the procedure. All patients had a slight increase in the thickness of the acetabular wall relative to the contralateral side but no radiographic evidence of acetabular dysplasia.Literature ReviewTo our knowledge, there are only two reports of physeal arrest resection of triradiate cartilage with one successful result.Clinical RelevancePosttraumatic, partial physeal arrest of the triradiate cartilage may be treated with resection of the bone bridge resection through an extended Pfannenstiel approach. The potential benefits of this treatment must be weighed against the risks.

Detección y tratamiento de las anomalías ortopédicas congénitas

La deteccion de las anomalias ortopedicas al nacimiento es la prolongacion de la deteccion de estas mismas anomalias mediante ecografia durante el embarazo. Las anomalias congenitas de formacion de los miembros pueden ser benignas o formar parte de malformaciones regionales mas complejas y de pronostico funcional reservado. La inestabilidad congenita de las caderas puede ser la causa de una luxacion de la articulacion y de graves secuelas ortopedicas en ausencia de un tratamiento precoz. Su deteccion, aunque obligatoria, siempre es un tema de actualidad y se mantiene como una de las etapas fundamentales de la exploracion fisica del recien nacido. El tratamiento de algunas actitudes viciosas y deformaciones de los pies (pie equinovaro, pie convexo) tambien es crucial y debe empezar sin demora. El descubrimiento de una anomalia ortopedica, incluso de aspecto benigno y puramente postural, debe hacer buscar una lesion mas difusa del aparato locomotor y una posible afeccion neuroortopedica causal.