Silver POSICON 2019

Volume 5 | Issue 1 | Jan-Apr 2019 | Page: 3| Rujuta Mehta.

Authors : Rujuta Mehta [1,2]

1 B J Wadia Hospital For Children, Parel, Mumbai India

2 Nanavati Superspeciality Hospital, Mumbai, India

Address of Correspondence
Dr Rujuta Mehta

HOD, Dept. of Paediatric Orthopaedics, B J Wadia Hospital, Nanavati Hospital, Jaslok Hospital & Shushrusha Hospital.

Email: rujutabos@gmail.co

Passion is energy. Feel the power that comes from focussing on what excites you. -Oprah Winfrey

Welcome to this special issue of International Journal of Paediatric Orthopaedic for the Silver Jubilee conference of our beloved association POSI (Paediatric orthopaedic society of India). Silver Jubilee POSICON 2019 is a journey we have lived with great passion and every aspect of which we have crafted with love and enthusiasm with a vision of creating a never before conference experience for faculty and delegates.
POSI and POSICON are known for the excellent academic content and we have the responsibility to live up to the xpectations. However, with expert guidance from Dr Ashok Johari our organising Chairman and co-operation of all our members of Organising Committee we believe, we are able to meet the challenge. Several First time features make the journey of this event stand out from the rest. The enriching Scientific Program well worked out and detailed to the minute was ready and released almost 2 months in advance. The faculty lectures and hand outs are all uploaded online, enabling a dry run thus avoiding audio visual glitches and making the faculty stress free. Two collaborative post conference activities the Congenital Limb Deficiency course and The Master class on spine have added great value to those looking for a focussed experience. In our Go green endeavour, the entire publications are in digital format including the final scientific program and brochure with handouts. The logo was designed by a child artist and the mascot Pihu the peacock was created who changed his form with every stage of the conference and every announcement. The conference with a mission- a social awareness about the endangered species: our small contribution towards conservation. The contribution of the creative and enhanced use of social media in the form of You tube, face book, twitter, WhatsApp and telegram and the ever changing new visuals gifs and videos used for promotions has been outstanding. Four nights of scintillating entertainment including a theme party with a shining star contest at the grand gala night in the form of a theme party will give ample opportunity to the delegates to participate. Western and Indian Jugalbandi and folk dances will add to the festivity and vibrance of the occasion. The social programs and spouses programs are lovely mix of holistic health beauty an self-exploration topics along with excursions to feel the heritage and pulse of the city. Unconventional memorabilia and limited edition exclusively crafted gifts will make your joys of attending the conference double. The jewel in the crown being the august presence of an Iconic personality Mr Sachin Tendulalkar for our inaugural is indeed a matter of great pride and privilege to the journey of POSICON 2019. We have labouriously crafted out themed menus in order to make every meal special and showcase the rich variety of cuisine in India . But as they say the final proof of the pudding is in the eating: hence we hope that each and every person goes back with their hearts full of memories and minds full of knowledge in every sphere.

How to Cite this Article: Mehta R. Silver POSICON 2019. International Journal of Paediatric Orthopaedics Jan-April 2019;5(1):3.

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Amazing Journey of POSI and POSICON’s

Volume 5 | Issue 1 | Jan-Apr 2019 | Page: 1-2 | Ashok Johari, Taral Nagda, Sandeep Patwardhan, Ashok Shyam.

Authors : Ashok Johari [1] , Taral Nagda [2] , Sandeep Patwardhan [3], Ashok Shyam [3,4]

1 Enable International Center for Paediatric Musculoskeletal Care, Mumbai 400016, India

2 Institute of Pediatric Orthopedic Disorders Mumbai India.

3 Sancheti Instittue for orthopaedics and Rehabilitation, Pune, India.

4 Indian Orthopaedic Research Group, Thane, India

Address of Correspondence
Dr Ashok Shyam

IORG House, Mantahn Apts, shreesh CHS, Hajuri Road, Thane

Email: drashokshyam@gmail.com

Paediatric orthopaedic society of India (POSI) is the premier body of Paediatric orthopaedic surgeons in India. Conceptualised together by Dr Ashok Johari and Dr Benjamin Joseph, the organisation started in 1994. POSI and its annual conference POSICON have come a long way since then.
The first meeting of POSI was held in Mumbai organised by Dr Ashok Johari and the POSI as a body was conceptualised and initiated at the meeting. The first POSICON was held in Manipal with Dr Benjamin Joseph as organising secretary. It was held for three days from 6-8 Jan 1995 and was the first formal meeting of the POSI. The next four annual meetings were held in Chennai, Chandigarh, Pune, Bangalore. POSICON 2000, the Millennial POSICON as it was dubbed, was held in Mumbai with Dr Ashok Johari as the Organising Secretary. It was the 6th POSICON and is the major Landmark in history of POSICON’s. Orthopaedic surgeons as well as allied branches were invited including PG’s and had more than 800 delegates in attendance. Many national and International faculty delivered their lectures. There were a number of workshops on speciality topics like paediatric trauma, cerebral palsy, ultrasound course, pelvic osteotomies and for each course a book was released which contained up-to-date information on the subject. The first POSI postgraduate course was also held in the same meeting. For the first time there was a website and logo for POSICON conference.

We are now in 2019, attending the 25th Silver Jubilee POSICON. The scale is much bigger and grand but at the core it remains one of the most academically rich conferences. The Scientific program is the main hero of every POSICON and this tradition has been maintained over last 25 years. Many new creative things have been planned for 25th POSICON which is based on concepts of Instructional Course Lectures (ICL). Twenty ICL’s are planned with help from gracious faculty from around the world. Janus the God of January is kept in the concept with the main conference conceptualise on theme ‘Looking back, Marching forwards’. this will give everyone a perspective on how the field is growing. The main conference is followed by the Dorr Paley’s Course which is another first for POSICON.

Over the years POSI, as an organisation, has grown from strength to strength [borrowing from Dr Benjamin Joseph’s Interview in this issue [1]]. The membership grew steadily but POSI always had a close family structure. POSI also liaised with POSNA, EPOS and IFPOS to bring best of academic content to its members. The POSI and POSNA started conducting Joint workshops at POSICON’s since 2006. The first workshop was held in Vellore in 2006 and are held every alternate year in collaboration with POSICON’s. This add a great international flavor to the meeting and also increases the academic bonding between two organizations.

The SILVER POSICON is indeed a special one with a galaxy of stars from across the globe. International Journal of Paediatric Orthopaedics is honoured to release the Special POSICON 2019 Issue which has compiled interviews of both the founding members of POSI, Dr Ashok Johari [2,3] and Dr Benjamin Joseph [1]. Both the interviews are an amazing piece of history as well as outstanding tales of personal excellence. We recommend all our readers to devour every word of these interviews to understand making of Legends of highest strata. This issue also has a guest editorial from Dr Rujuta Mehta [4], the organising secretary of POSICON 2019.
The International Journal of Paediatric Orthopaedics is now in its Fifth Year and is well established Journal. The academic content of this issue has the Part 1 of symposium on Slipped Capital Femoral Epiphysis with original articles and case reports. We welcome all readers to this issue and hope you enjoy it. Do send us your comments and suggestions on editor.ijpo@gmail.com

References 

1. Joseph B. Dr Benjamin Joseph – A Life Less Ordinary. International. Journal of Paediatric Orthopaedics Jan-April 2019;5(1):2-7.

2. AN Johari. Dr Ashok Johari – A Unique Journey of a Paediatric Orthopaedic Surgeon Part -1. International Journal of Paediatric Orthopaedics May-Aug 2017;2(2):2-7.

3. AN Johari. Dr Ashok Johari – A Unique Journey of a Paediatric Orthopaedic Surgeon. Part 2. International Journal of Paediatric Orthopaedics Sep-Dec 2016;2(2):2-7.

4. Mehta R. Editorial – Silver POSICON 2019. International Journal of Paediatric Orthopaedics JanApril 2019;5(1):8.

How to Cite this Article: Johari A, Nagda T, Patwardhan S, Shyam AK. Amazing Journey of POSI and POSICON’s. International Journal of Paediatric Orthopaedics Jan-April 2019;5(1):1-2

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Stop Maligning the Asymptomatic Child’s Flatfoot

Volume 4 | Issue 2 | July-December 2018 | Page: 01-02 | Benjamin Joseph

Authors: Benjamin Joseph [1]

[1] Aster Medcity, Kochi, Kerala, India.

Address for correspondence:
Prof. Benjamin Joseph,
18 H.I.G. Colony, Manipal − 576 104, Karnataka, India
E-mail: bjosephortho@yahoo.co.in

Recently, a lady met me and gave me some very colourful pamphlets about a range of fancy foot wear and shoe inserts for toddlers and young children designed to ’correct’ flatfeet. I asked her why asymptomatic flatfeet need to be treated. I patiently listened to her as she listed several ‘harmful effects of flatfeet’ including a predilection for foot injury, back ache and so on, which, according to her could be avoided by using the shoes and shoe inserts she was promoting. Needless to say, there were no scientific data to support these claims. After she left, I reflected about what the scientific literature had to say about flatfoot and also recollected my personal experience of dealing with flatfeet in young children in my practice.

There has been a long-held notion that flatfeet are bad and that they may interfere with strenuous physical activity. On the basis of this, young men with flatfeet were rejected from recruitment into the armed forces. However, Cowan et al.[1] did a study on army recruits in the USA and could not demonstrate a higher frequency of injuries in those with flatfeet. Esterman and Pilotto[2] did a similar study in Australia and concluded that ’foot shape has little impact on pain, injury and function’. Tudor et al.[3] studied athletic performance in school children with flatfoot and normal arches and documented no difference in performance in 17 different tasks. So it is high time we dispel the erroneous notion that the flatfoot is in some way inferior to feet with a well-formed arch.

Stemming from the belief that flatfoot is undesirable, concerted efforts have been made to ‘treat’ young children with shoe modifications and various types of shoe inserts that elevate the medial longitudinal arch or control the hindfoot valgus. Despite the fact that Wenger et al.,[4] in as early as 1989, demonstrated clearly that shoes and shoe inserts in no way alter the natural history of flatfoot, orthopaedic surgeons continue to prescribe them. This wasteful and meaningless practice needs to stop.

The natural history of asymptomatic flexible flatfoot is that of resolution in the vast majority of children because the arch develops by the age of 6–7 years. This is very evident as at 1 year of age, 95% of children have flatfeet and by the age of 10, the prevalence is as low as 5%. The increase in the tone of muscles that support the arch and spontaneous reduction in joint laxity as the child grows facilitate the arch to develop. Barefoot activity in early childhood also facilitates the arch to develop while shoe-wearing appears to be detrimental to the development of the arch. This was demonstrated in two large cross-sectional surveys, which showed that the prevalence of flatfoot was highest among children who wore closed-toe shoes below the age of 6 years and lowest in the unshod.[5,6] The frequency of flatfoot in children who wore sandals and slippers fell between these two. With this evidence, it seems hardly logical to prescribe shoes for a young child with flatfoot. Instead, we need to spread the message to encourage children to play barefoot outdoors on sand and gravel. We could also encourage school authorities to have sandals rather than shoes as the regulation footwear. These suggestions are perfectly appropriate in the warm climate in India.

In my practice, I have never had parents from the lower socio-economic strata bring a child for the treatment of flatfoot. Every single child brought to me with the complaints of flatfoot has been from an affluent family. Often it has been a paediatrician, or family physician, who referred the child with flatfoot to me. For a long time, I wondered why there was this socio-economic difference in my flatfoot practice. It then dawned on me; the poor child is unshod and in early childhood has played barefoot, and the poor child consequently is unlikely to have flatfoot. Even if the poor child has flatfeet, they cause no pain and the feet function perfectly well. The child’s parents have no access to the internet, so they have never heard anyone maligning their child’s feet. No wonder, I never saw a poor child with flatfoot in my clinic.

Benjamin Joseph
Aster Medcity, Kochi, Kerala, India
Address for correspondence: Prof. Benjamin Joseph, 18 H.I.G. Colony,
Manipal − 576 104, Karnataka, India
E-mail: bjosephortho@yahoo.co.in

References 

1. Cowan DN, Jones BH, Robinson JR. Foot morphologic characteristics
and risk of exercise-related injury. Arch Fam Med 1993;2:
773-7.
2. Esterman A, Pilotto L. Foot shape and its effect on functioning in Royal
Australian Air Force recruits. Part 1: Prospective cohort study. Mil Med
2005;170:623-8.
3. Tudor A, Ruzic L, Sestan B, Sirola L, Prpic T. Flat-footedness is not a
disadvantage for athletic performance in children aged 11 to 15 years.
Pediatrics 2009;123:e386-92.
4. Wenger DR, Mauldin D, Speck G, Morgan D, Lieber RL. Corrective
shoes and inserts as treatment for flexible flatfoot in infants and
children. J Bone Joint Surg Am 1989;71:800-10.
5. Rao UB, Joseph B. The influence of footwear on the prevalence of flat
foot. A survey of 2300 children. J Bone Joint Surg Br 1992;74:525-7.
6. Sachithanandam V, Joseph B. The influence of footwear on the
prevalence of flat foot. A survey of 1846 skeletally mature persons. J
Bone Joint Surg Br 1995;77:254-7.

How to Cite this Article:  Joseph B |  Stop Maligning the Asymptomatic Child’s Flatfoot | July-
December 2018; 4(2): 01-02.

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10-Year Radiological Follow-Up of Multifocal Recurrent Eosinophilic Granuloma With Vertebra Plana: A Case Report and Review of Literature

Volume 4 | Issue 2 | July-December 2018 | Page: 32-36 | Amit Kumar, Shivam Sinha, Shyam Kumar Saraf, Vineeta Gupta, Deepa Rani, Jyoti Kumari

DOI- 10.13107/ijpo.2018.v04i02.016

Authors: Amit Kumar, Shivam Sinha, Shyam Kumar Saraf, Vineeta Gupta [1], Deepa Rani [2], Jyoti Kumari [3]

 

Departments of Orthopedics, [1] Pediatrics and, [2] Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, [3] Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

Address of Correspondence
Dr. Amit Kumar,
Department of Orthopaedics, Institute of Medical Sciences, Banaras Hindu University, Varanasi − 221 005, Uttar Pradesh, India.
E-mail: amit2k03@gmail.com

Abstract

Eosinophilic granuloma (EG) is the benign localized form of histiocytosis. Owing to the relative rarity of the condition, diagnosis is often delayed or missed, and many questions remain unanswered, ranging from cause and pathogenesis to therapy. Observation and immobilization are adequate for improvement of the condition in most patients. However, treatment other than simple observation is recommended in patients with symptomatic EG. This article presents a 10-year follow-up study of a 15-year-old girl with a symptomatic multifocal EG treated effectively by monitored chemotherapy and orthosis.
Keywords: Eosinophilic granuloma, langerhans cell histiocytosis, osteochondritis, osteogenesis imperfecta, tuberculosis, vertebra plana

References 

1. Willman CL, Busque L, Griffith BB, Favara BE, McClain KL, Duncan MH, et al. Langerhans histiocytosis (histiocytosis X): A clonal proliferative disease. New Engl J Med 1994;331:154-60.
2. Lichtenstein L. Histiocytosis X (eosinophilic granuloma of bone ‘Letterer-Siwe disease and Schuller-Christian disease’): Further observations of pathological and clinical importance. J Bone Joint Surg Am 1964;46:76-90.
3. Ladish S, Jaffe ES. The histiocytocis. In: Pizzo PA, Poplack DG, editors. Principles and Practices of Pediatric Oncology. Philadelphia: J. B. Lippincott Company; 1989. p. 491-504.
4. Huvos AG. Bone tumors. Diagnosis, Treatment and Prognosis. 2nd ed. Philadelphia: WB Saunders; 1990.
5. Sweasey TA, Dauser RC. Eosinophilic granuloma of the cervicothoracic junction. J Neurosurg 1989;71:942-4.
6. Nesbit ME Jr. Bone tumours in infants and children. Paediatrician 1972 /73;1:273-87.
7. Tanaka N, Fujimoto Y, Okuda T, Nakanishi K, Sumida T, Manabe H, et al. Langerhans cell histiocytosis of the atlas. A report of three cases. J Bone Joint Surg Am 2005;87:2313-7.
8. Dickinson LD, Farhat SM. Eosinophilic granuloma of the cervical spine. A case report and review of the literature. Surg Neurol 1991;35: 57-63.
9. Bertram C, Madert J, Eggers C. Eosinophilic granuloma of the cervical spine. Spine (Phila Pa 1976) 2002;27:1408-13.
10. Capanna R, Springfield DS, Ruggieri P, Biagini R, Picci P, Bacci G, et al. Direct cortisone injection in eosinophilic granuloma of bone: A preliminary report on 11 patients. J Pediatr Orthop 1985;5:339-42.
11. Garg S, Mehta S, Dormans JP. Langerhans cell histiocytosis of the spine in children long-term follow-up. J Bone Joint Surg Am 2004;86: 1740-50.
12. Bechan GI, Egeler RM, Arceci RJ. Biology of Langerhans cells and Langerhans cell histiocytosis. Int Rev Cytol 2006;254:1-43.
13. Egeler RM, Favara BE, van Meurs M, Laman JD, Claassen E. Differential in situ cytokine profiles of Langerhans-like cells and T cells in Langerhans cell histiocytosis: Abundant expression of cytokines relevant to disease and treatment. Blood 1999;94:4195-201.
14. Seimon LP. Eosinophil granuloma of the spine. J Pediatr Orthop 1981;1:371-6.
15. Brown CW, Jarvis JG, Letts M, Carpenter B. Treatment and outcome of vertebral Langerhans cell histiocytosis at the Children’s Hospital of Eastern Ontario. Can J Surg 2005;48:230-6.
16. Greenlee JD, Fenoy AJ, Donovan KA, Menezes AH. Eosinophilic granuloma in the pediatric spine. Pediatr Neurosurg 2007;43: 285-92.
17. Yeom JS, Lee CK, Shin HY, Lee CS, Han CS, Chang H. Langerhans’ cell histiocytosis of the spine. Analysis of twenty-three cases. Spine 1999;24:1740-9.
18. Plasschaert F, Craig C, Bell R, Cole WG, Wunder JS, Alman BA. Eosinophilic granuloma. A different behaviour in children than in adults. J Bone Joint Surg Br 2002;84:870-2.
19. Levy EI, Scarrow A, Hamilton RC, Wollman MR, Fitz C, Pollack IF. Medical management of eosinophilic granuloma of the cervical spine. Pediatr Neurosurg 1999;31:159-62.
20. Fernández-Latorre F, Menor-Serrano F, Alonso-Charterina S, Arenas- Jiménez J. Langerhans’ cell histiocytosis of the temporal bone in pediatric patients. AJR Am J Roentgenol 2000;174:217-21.
21. Kamimura M, Kinoshita T, Itoh H, Yuzawa Y, Takahashi J, Ohtsuka K. Eosinophilic granuloma of the spine: Early spontaneous disappearance of tumor detected on magnetic resonance imaging. J Neurosurg 2000;93(2 Suppl):312-6.
22. O’Donnell J, Brown L, Herkowitz H. Vertebra plana-like lesions in children: Case report with special emphasis on the differential diagnosis and indications for biopsy. J Spinal Disord 1991;4: 480-5.
23. Egeler RM, Thompson RC Jr, Voûte PA, Nesbit ME Jr. Intralesional infiltration of corticosteroids in localized Langerhans cell histiocytosis. J Pediatr Orthop 1992;12:811-4.
24. Grois N, Pötschger U, Prosch H, Minkov M, Arico M, Braier J, et al. Risk factors for diabetes insipidus in Langerhans cell histiocytosis. Pediatr Blood Cancer 2006;46:228-33.
25. Munn SE, Olliver L, Broadbent V, Pritchard J. Use of indomethacin in Langerhans cell histiocytosis. Med Pediatr Oncol 1999;32:247-9.
26. da Costa CE, Annels NE, Faaij CM, Forsyth RG, Hogendoorn PC, Egeler RM. Presence of osteoclast-like multinucleated giant cells in the bone and nonostotic lesions of Langerhans cell histiocytosis. J Exp Med 2005;201:687-93.
27. Raab P, Hohmann F, Kuhl J, Krauspe R. Vertebral remodelling in eosinophilic granuloma of the spine: A long-term follow-up. Spine 1998;23:1351-4.
28. KasteSC,Rodriguez-GalindoC,McCarvilleME,ShulkinBL.PET-CTin pediatric Langerhans cell histiocytosis. Pediatr Radiol 2007;37:615-22.
29. Lau LM, Stuurman K, Weitzman S. Skeletal Langerhans cell histiocytosis in children: Permanent consequences and health-related quality of life in long term survivors. Pediatr Blood Cancer 2008;50: 607-12. Kumar, et al.: Multifocal recurrent eosinophilic granuloma with vertebra plana : A case report 76

How to Cite this Article:  Kumar A, Sinha S, Saraf SK, Gupta V, Rani D, Kumari J | Year Radiological Follow-Up of Multifocal Recurrent Eosinophilic Granuloma With Vertebra Plana: A Case Report and Review of Literature | July-December 2018; 4(2): 32-36.
 

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The Role of Imaging in Diagnosis and Management of Congenital High Scapula (Sprengel’s Deformity): Case Report and Review

Volume 4 | Issue 2 | July-December 2018 | Page: 27-31 | Nada Garrouche, Saida Jerbi, Nedra Chouchane, Wassia Kessomtini, Hssine Hamza

DOI- 10.13107/ijpo.2018.v04i02.015

Authors: Nada Garrouche, Saida Jerbi, Nedra Chouchane, Wassia Kessomtini [1], Hssine Hamza

Departments of Radiology and, [1] Physical Medicine Rehabilitation, Taher Sfar University Hospital, Mahdia- Tunisia

Address of Correspondence
Dr. Nada Garrouche,
Rue Habib Zine el Abidine n°200 (7) Sahloul 2 Sousse 4054-Tunisia.
E-mail: nadagarrouche@yahoo.fr

Abstract

Sprengel’s deformity is the congenital failure of descent of the scapula. The diagnosis is based on a clinical examination and radiological procedures. Volume rendering three-dimensional computed tomography reconstructions analyze the precise topography and spatial proportions of examined bone structures. It enables an optional rotation of visualized bone structures to clarify the anatomical abnormalities. Ultrasound and magnetic resonance are useful in prenatal management and for the diagnosis of concomitant abnormalities. In this paper, we report our imaging experience from one child with Sprengel’s deformity and discuss the importance of imaging techniques with a particular focus on the role of three-dimensional reconstructions.
Keywords: Congenital high scapula, CT, MRI, Sprengel’s deformity, ultrasound, volume rendering 3D-CT

References 

1. Cho TJ, Choi IH, Chung CY, Hwang JK. The Sprengel deformity. Morphometric analysis using 3D-CT and its clinical relevance. J Bone Joint Surg Br 2000;82:711-8.
2. Dilli A, Ayaz UY, Damar C, Ersan O, Hekimoglu B. Sprengel deformity: Magnetic resonance imaging findings in two pediatric cases. J Clin Imaging Sci 2011;1:13.
3. Horwitz AE. Congenital elevation of the scapula–Sprengel’s deformity. Am J Orthop Surg 1908;s2-6:260-311.
4. Grogan DP, Stanley EA, Bobechko WP. The congenital undescended scapula. Surgical correction by the Woodward procedure. Bone Joint J 1983;65:598-605.
5. Gonen E, Simsek U, Solak S, Bektaser B, Ates Y, Aydin E. Long-ter results of modified Green method in Sprengel’s deformity. J Chil Orthop 2010;4:309-14.
6. Bindoudi A, Kariki EP, Vasiliadis K, Tsitouridis I. The rare Sprengel deformity: Our experience with three cases. J Clin Imaging Sci 2014;4:55.
7. Siu KK, Ko JY, Huang CC, Wang FS, Chen JM, Wong T. Woodwar procedure improves shoulder function in Sprengel deformity. Chang Gung Med J 2011;34:403-9.
8. Nakamura N, Inaba Y, Machida J, Saito T. Use of glenoid inclination angle for the assessment of unilateral congenital high scapula. J Pediatr Orthop B 2016;25:54-61.
9. Stein-Wexler R. The Shoulder: Congenital and Developmental Conditions. Pediatric Orthopedic Imaging. Berlin Heidelberg: Springer; 2015. p. 129-39.
10. Greitemann B, Rondhuis JJ, Karbowski A. Treatment of congenital elevation of the scapula: 10 (2–18) year follow-up of 37 cases of Sprengel’s deformity. Acta Orthop Scand 1993;64:365-8.
11. Füllbier L, Tanner P, Henkes H, Hopf NJ. Omovertebral bone associated with Sprengel deformity and Klippel-Feil syndrome leading to cervical myelopathy. J Neurosurg Spine 2010;13:224-8.
12. Chinn DH. Prenatal ultrasonographic diagnosis of Sprengel’s deformity. J Ultrasound Med 2001;20:693-7.
13. Cavendish ME. Congenital elevation of the scapula. J Bone Joint Surg Br 1972;54:395-408.
14. Rockwood CA. Rockwood and Matsen’s the shoulder. Elsevier; 2017.
15. van der Molen AJ, Prokop M, Galanski M, Schaefer-Prokop CM. Spiral and Multislice Computed Tomography of the Body. Stuttgart, New York: Georg Thieme Verlag; 2003.
16. Yuksel M, Karabiber H, Yuksel KZ, Parmaksiz G. Diagnostic importance of 3D CT images in Klippel-Feil syndrome with multiple skeletal anomalies: A case report. Korean J Radiol 2005;6:278-81.
17. Rasul ME, Reddy AV. The sprengel deformity. Int J Res Med Sci 2015;3:3869-71.
18. Rockwood CA. The shoulder. Vol. 1, Ch. 3, Elsevier Health Sciences;2009. p. 120-4.
19. Andrin J, Macaron C, Pottecher P, Martz P, Baulot E, Trouilloud P, et al. Determination of a new computed tomography method for measuring the glenoid version and comparing with a reference method. Radio-anatomical and retrospective study. Int Orthop 2016;40:525-9.
20. Friedman RJ, Hawthorne KB, Genez BM. The use of computerized tomography in the measurement of glenoid version. J Bone Joint Surg Am 1992;74:1032-7.
21. Nyffeler RW, Jost B, Pfirrmann CW, Gerber C. Measurement of glenoid version: conventional radiographs versus computed tomography scans. J Shoulder Elbow Surg 2003;12:493-6.
22. Hamner DL, Hall JE. Sprengel’s deformity associated witmultidirectional shoulder instability. J Pediatr Orthop 1995;15: 641-3.
23. Guillaume R, Nectoux E, Bigot J, Vandenbussche L, Fron D, Mézel A, et al. Congenital high scapula (Sprengel’s deformity): Four cases. Diagn Interv Imaging 2012;93:878-83.
24. Wada A, Nakamura T, Fujii T, Takamura K, Yanagida H, Yamaguchi T, et al. Sprengel deformity: Morphometric assessment and surgical treatment by the modified green procedure. J Pediatr Orthop 2014;34:55-62.
25. Woodward JW. Congenital elevation of the scapula. J Bone Joint Surg Am 1961;43:219-28.

How to Cite this Article:  Garrouche N, Jerbi S, Chouchane N, Kessomtini W, Hamza H The Role of Imaging in Diagnosis and Management of Congenital High Scapula (Sprengel’s Deformity): Case Report and Review | July-December 2018; 4(2): 27-31.

 

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Amputation Following Meningococcal Septicaemia in Children: the Surgical Management of the Residual Limb

Volume 4 | Issue 2 | July-December 2018 | Page: 20-26 | Brigid M. Aherne, Fergal P. Monsell

DOI- 10.13107/ijpo.2018.v04i02.014

Authors: Brigid M. Aherne, Fergal P. Monsell [1]

 

Medical Student, University of Bristol, [1] Consultant Orthopaedic Surgeon, Bristol Royal Hospital for Children, Bristol, England, United Kingdom.

Address of Correspondence
Mr. Fergal P. Monsell,
Bristol Royal Hospital for Children, Upper Maudlin St, Bristol BS2 8BJ, England, United Kingdom.
E-mail: Fergal.Monsell@UHBristol.nhs.uk

Abstract

Background: Meningococcal septicaemia is a potentially life-threatening disease and remains the most common infective cause of mortality in the UK. Improvements in healthcare have led to early recognition and treatment, and a decrease in mortality. As more children now survive the initial acute illness, the long-term musculoskeletal consequences have become more prevalent. These include growth plate injury, tissue loss and amputation. Patients with limb loss present specific difficulties due to the effect of remaining longitudinal growth on the function of the residual limb, and often require surgical treatment that continues throughout childhood.
Patients and Methods: This case series reviews the histories of 13 children who underwent amputation as a complication of meningococcal septicaemia. All patients attend a specialist clinic and our experience in the management of the residual limb is described.
Results: Thirteen patients, with a mean age of 16 months at the onset of meningococcal septicaemia, required amputation in the management of the skeletal consequences of the infection. Revision surgery was necessary for all 13 patients and involved management of bone overgrowth, growth arrest, scar and soft tissue contracture, neuroma development, and infection. The details of our approach to each of these complications is described.
Conclusion: Due to improvements in diagnosis and initial management, a significant proportion of patients are surviving infantile meningococcal septicaemia. Many develop musculoskeletal consequences including amputation, and this case series serves to increase knowledge in the complex managements of the residual limb in these patients.
Keywords: Amputation, meningococcal septicaemia, residual limb

References 

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2. Maat M, Buysse CM, Emonts M, Spanjaard L, Joosten KF, De Groot R, et al. Improved survival of children with sepsis and purpura: Effects of age, gender, and era. Crit Care 2007;11:R112.
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How to Cite this Article:  Aherne BM, Monsell FP | Amputation Following Meningococcal Septicaemia in Children: the Surgical Management of the Residual Limb | July-December 2018; 4(2): 20-26.
 

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