Hospital Base de Valdivia, Valdivia, Chile
AO Foundation, PAEG Expert Group, Davos, Switzerland
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Hospital Base de Valdivia, Valdivia, Chile
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Hospital Base de Valdivia, Valdivia, Chile
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Hospital Base de Valdivia, Valdivia, Chile
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The physis of the distal femur contributes to 70% of femoral growth and 37% of the total limb growth; therefore, physeal injury can lead to important alterations of axes and length.
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Distal metaphyseal corner-type fracture prior to walking is classically associated with child abuse. In children aged >10 years, sports-related fractures and car accidents are significant contributors.
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Imaging includes a two-plane radiographic study of the knee. It is recommended to obtain radiographs that include the entire femur to rule out concomitant injuries. In cases of high suspicion of distal metaphyseal fractures and no radiographic evidence, CT or MRI can show the existence of hidden fractures.
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Fractures with physeal involvement are conventionally classified according to the Salter–Harris classification, but the Peterson classification is also recommended as it includes special subgroups.
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Conservative and surgical management are valid alternatives for the treatment of these fractures. Choosing between both alternatives depends on factors related to the fracture type.
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As there is a high risk of permanent physeal damage, long-term follow-up is essential until skeletal maturity is complete.
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AO Foundation, PAEG Expert Group, Davos, Switzerland
Hospital Base de Valdivia, Valdivia, Chile
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Hospital Base de Valdivia, Valdivia, Chile
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Universidad del Desarrollo, Santiago, Chile
Hospital Clínico Mutual de Seguridad, Santiago, Chile
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Fractures of the anterior tibial tuberosity during childhood are an infrequent pathology (around 3% of all proximal tibial fractures), but the incidence of this injury has risen over recent years, likely due to the increased involvement of this age group in sports activities.
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This fracture is more commonly seen in children 12–14 years old.
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It is vital to identify the anatomical structures associated with this type of fracture, along with the pathophysiological mechanisms involved.
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Treatment includes non-operative and operative options, with the goal of achieving articular congruency, restoring the extensor mechanism function, and avoiding damage to the proximal tibial physis.
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Understanding the management of this fracture, and the complications that might arise, is critical. The provision of an appropriate clinical management plan and the avoidance of complications are vital in the prevention of disability.
Cite this article: EFORT Open Rev 2020;5:260-267. DOI: 10.1302/2058-5241.5.190026
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Computer-assisted orthopaedic surgery was born in the 1990s. Nowadays, computer-assisted orthopaedic surgery is used for transpedicular screw fixation and for total knee arthroplasty.
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Patient-specific instrumentation is one type of computer-assisted surgery based on volumetric images, such as computed tomography or magnetic resonance imaging.
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In this article, possible applications of patient-specific instruments in paediatric orthopaedics are described. The use of patient-specific instrumentation for the correction of cubitus varus is given as an example with complex osteotomy. Another application for tarsal coalition resection is shown.
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A last example of using patient-specific instrumentation for both tumour resection and allograft reconstruction is illustrated.
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Patient-specific instruments based on computed tomography of the bone can increase peri-operative accuracy and decrease operative time. They are very helpful for the surgeon. Other applications are possible and will be probably developed in the future.
Cite this article: Docquier PL, Paul L, TranDuy V. Surgical navigation in paediatric orthopaedics. EFORT Open Rev 2016;1:152-159. DOI: 10.1302/2058-5241.1.000009.
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, Shoulder & Elbow and Trauma. More papers are needed in the areas of Paediatrics, Oncology, Foot & Ankle and Hand Surgery. The Journal is indexed in the Web of Science Core Collection, Google Scholar, and Scopus, as well as PubMed with free full text
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; Enrique Gómez Barrena and Bernd Grimm for Basic Science and General Orthopaedics; Philippe Kopylov for Hand & Wrist; Hermes Miozzari for Knee; Julio de Pablos for Paediatrics; Ulrich Stöckle for Trauma; and Luigi Zagra for Hip. On the administrative side
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.7 9/16 Zheng et al 102 2017 China Paediatrics Prospective cohort study II 25 12 84.0 10.9 23/24 Zheng et al 103 2017 China Paediatrics Retrospective cohort study III 11 11 36.4 6.6 18 /24 Zheng
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; 409 : 186 - 194 . 27 Arnold JC , Cannavino CR , Ross MK , et al. . Acute bacterial osteoarticular infections: Eight-year analysis of C-reactive protein for oral step-down therapy . Paediatrics 2012 ; 130 : e821
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, Deepak S. Knee pain in children. Paediatrics and Child Health 2019;29:521–527. 1 Table 1. Schenck classification of knee dislocation 2 Type 1 Description KDI Multiligament knee injury with ACL or PCL rupture
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Controversy remains regarding which risk factors should be considered for performing an ultrasound screening. The European Society of Paediatrics Radiology considers breech presentation and positive family history as the only risk factors that indicate the
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and Traumatology (EFORT) • Biomedical Alliance in Europe (BioMed Alliance) • European Academy of Paediatrics (EAP) Academic institutions • Leiden University Medical Center, The Netherlands • The University of Oxford, UK • Uppsala Clinical Research
