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Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study!

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 2-5| Vasu sharma, Vikas Gupta, Daipayan chatterjee, Akshat Sharma Authors : Vasu sharma [1], Vikas Gupta [2], Daipayan chatterjee [1], Akshat Sharma [1]. [1] Senior Resident, Central Institute of orthopaedics, VMMC & Safdarjung Hospital, New Delhi. India. [2] Professor, Central Institute of orthopaedics, VMMC & Safdarjung Hospital, New Delhi. India. Address of Correspondence Dr. Vasu Sharma […]

Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 6-8 | Chirag Borana, Naeem Jagani, Nadir Shah, Lokesh Sharoff, Sunirmal Mukherjee Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5]. [1,2,4] Consultant, Dept of Orthopaedics, Masina Hospital, Byculla, Mumbai. [3] Asst. Professor, Dept of Orthopaedics, Sir […]

Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study!

Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

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Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study!

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 2-5| Vasu sharma, Vikas Gupta, Daipayan chatterjee, Akshat Sharma

Authors : Vasu sharma [1], Vikas Gupta [2], Daipayan chatterjee [1], Akshat Sharma [1].

[1] Senior Resident, Central Institute of orthopaedics, VMMC & Safdarjung Hospital, New Delhi. India.

[2] Professor, Central Institute of orthopaedics, VMMC & Safdarjung Hospital, New Delhi. India.

Address of Correspondence
Dr. Vasu Sharma

Central Institute of orthopaedics,

VMMC & Safdarjung Hospital,

New Delhi 110029, India.

Email: dr.vasusharma@gmail.com

Abstract

Background: To evaluate Idiopathic clubfoot deformity of foot, several scoring systems have been proposed and modified Pirani score and Dimeglio score have stood the test of time. There is scarcity of literature comparing the two systems in depth. We tried to compare the scoring systems on user friendliness and predictability to find out whether any superiority exists, if any. We also tried out if Dimeglio score could be used as a guideline for performing tenotomy.
Methods: 82 feet of idiopathic clubfoot deformity were treated by Ponseti’s Plaster technique and evaluated by both modified Pirani and Dimeglio score simultaneously with each cast until full correction was achieved. The scores were compared using standard statistical techniques comparing predictability and user friendliness. Tenotomy was done as per guidelines given by Pirani and corresponding Dimeglio score was assessed and evaluated.
Results: Dimeglio score took longer time as compared to Modified Pirani score. Strong positive correlation was found between corresponding Modified Pirani and Dimeglio Score. Pirani score had statistical significant Plateauing just prior to tenotomy. Dimeglio score of 5 or 6 was found in all cases where tenotomy was done with Equinus score 3 or 2, Curvature of lateral border and Derotation of carpopedal block and Forefoot adduction score 0 or 1, with Cavus, Medial, Posterior crease, Muscle status score 0.
Conclusion: Both Dimeglio and Modified Pirani score have their advantages and shortcomings but most of the scoring correlate well. Dimeglio score can also be used to decide when to do tenotomy.

References

1. Turco VJ. Clubfoot: Current Problems in Orthopaedics. New York: Churchill Livingstone; 1981.
2. Ponseti IV. Introduction Congenital Clubfoot: Fundamentals of Treatment. Ch. 1. Oxford: Oxford University Press; 1996. p. 1-8.
3. Stern C. Anomalies of genetic origin. Pediatrics 1950;5(2):324-328.
4. Shabtai L, Specht SC, Herzenberg JE. Worldwide spread of the Ponseti method for clubfoot. World J Orthop 2014;5(5):585-590.
5. Göksan SB. Treatment of congenital clubfoot with the Ponseti method. Acta Orthop Traumatol Turc 2002;36(4):281-287.
6. Lehman WB, Mohaideen A, Madan S, Scher DM, Van Bosse HJ, Iannacone M, et al. A method for the early evaluation of the Ponseti (Iowa) technique for the treatment of idiopathic clubfoot. J Pediatr Orthop B 2003;12(2):133-140.
7. Ponseti IV, Smoley EN. Congenital club foot: The results of treatment. J Bone Joint Surg Am 1963;45-A:261-344.
8. Catterall A. A method of assessment of the clubfoot deformity. Clin Orthop Relat Res 1991;264:48-53.
9. Diméglio A, Bensahel H, Souchet P, Mazeau P, Bonnet F. Classification of clubfoot. J Pediatr Orthop B 1995;4(2):129-136.
10. Harrold AJ, Walker CJ. Treatment and prognosis in congenital club foot. J Bone Joint Surg Br 1983;65(1):8-11.
11. Canale ST, beaty JJH, Campbell’s Operative orthopedics. 12th edition. 2013. Elseviers Mosby; . Ch 29: p. 997-1001.
12. Flynn JM, Donohoe M, Mackenzie WG. An independent assessment of two clubfoot-classification systems. J Pediatr Orthop 1998;18(3):323-327.
13. Chu A, Labar AS, Sala DA, van Bosse HJ, Lehman WB. Clubfoot classification: correlation with Ponseti cast treatment. J Pediatr Orthop 2010;30(7):695-699.
14. Wainwright AM, Auld T, Benson MK, Theologis TN. The classification of congenital talipes equinovarus. J Bone Joint Surg Br 2002;84(7):1020-1024.
15. Cosma D, Vasilescu DE. A clinical evaluation of the pirani and dimeglio idiopathic clubfoot classifications. J Foot Ankle Surg 2015;54(4):582-585.

How to Cite this Article: Sharma V, Gupta V, Chatterjee D, Sharma A: Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study! International Journal of Paediatric Orthopaedics Jan-June 2017;3(1):2-5.

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Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Volume 3 | Issue 1 | Jan-Jun 2017 | Page 6-8 | Chirag Borana, Naeem Jagani, Nadir Shah, Lokesh Sharoff, Sunirmal Mukherjee

Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5].

[1,2,4] Consultant, Dept of Orthopaedics, Masina Hospital, Byculla, Mumbai.
[3] Asst. Professor, Dept of Orthopaedics, Sir JJ Group of Hospitals, Mumbai.
[5] Senior Resident, Dept of Orthopaedics, Sir JJ Group of Hospitals, Mumbai.

Address of Correspondence
Dr. Lokesh Sharoff,
42, Madhur Milan Society,14th B Road, Khar West, Mumbai 400052.
Email: drlokeshsharoff@outlook.com

Abstract

Background: Supracondylar humerus fracture with forearm fractures are rare with reported incidence ranging from 3% to 13%.
Materials and Methods: We have treated 10patients with ipsilateral supracondylar humerus fracture with distal radius fracture. One had a Gustilo-Anderson Grade 2 open supracondylar humerus fracture. All displaced fractures were treated with K-wire fixation by aclosed method except the open fracture which warranted wound debridement and subsequent open reduction. A follow-up of at least 6 months is available for all our patients.
Results: All fractures showed signs of union by 6 weeks when K-wires were removed. At6 months, 9 patients had excellent outcome while one patient with recovering radial nerve palsy had afair outcome. No cases of non-union or loss of reduction were seen in the post-operative period. Pin tract site infection was seen in one patient with anopen fracture which resolved after K-wire removal and antibiotic coverage.
Conclusion and Learning: This study recommends screening radiographs of forearm and wrist in patients with supracondylar humerus fractures to rule out any associated forearm/wrist injury. We also recommend closed reduction and K-wire fixation of the displaced supracondylar humerus as well as distal radius fractures.
Keywords: Pediatric fractures; Double fractures; Adolescent fractures; Immature skeletal fractures; upper-extremity fractures.

References

1. McLauchlan GJ, Walker CR, Cowan B, Robb JE, Prescott RJ. Extension of the elbow and supracondylar fractures in children. J Bone Joint Surg Br 1999;81(3):402-405.
2. Dhoju D, Shrestha D, Parajuli N, Dhakal G, Shrestha R. Ipsilateral supracondylar fracture and forearm bone injury in children: A retrospective review of thirty one cases. Kathmandu Univ Med J (KUMJ) 2011;9(34):11-16.
3. Siemers F, Obertacke U, Fernandez ED, Olivier LC, Neudeck F. Combination of ipsilateral supracondylar humeral-and forearm fractures in children. ZentralblChir 2002;127(3):212-217.
4. Tabak AY, Celebi L, Muratli HH, Yagmurlu MF, Aktekin CN, Biçimoglu A. Closed reduction and percutaneous fixation of supracondylar fracture of the homers and ipsilateral fracture of the forearm in children. J Bone Joint Surg Br 2003;85(8):1169-11672.
5. Powell RS, Bowe JA. Ipsilateral supracondylar homers fracture and Monteggia lesion: A case report. J Orthop Trauma 2002;16(10):737-740.
6. Rouhani AR, Navali AM, Sadegpoor AR, Soleimanpoor J, Ansari M. Monteggia lesion and ipsilateral humeral supracondylar and distal radial fractures in a young girl. Saudi Med J 2007;28(7):1127-1128.
7. Cobanoglu M, Savk SO, Cullu E, Duygun F. Ipsilateral supracondylar homers fracture and Monteggia lesion with a 5-year follow-up: A rare injury in a young girl. BMJ Case Rep 2015;2015. pii: Bcr2014206313.
8. Peters CL, Scott SM, Stevens PM. Closed reduction and percutaneous pinning of displaced supracondylar homers fractures in children: Description of a new closed reduction technique for fractures with brachialis muscle entrapment. J Orthop Trauma 1995;9(5):430-434.
9. Biyani A, Gupta SP, Sharma JC. Ipsilateral supracondylar fracture of homers and forearm bones in children. Injury 1989;20(4):203-207.
10. Flynn JC, Matthews JG, Benoit RL. Blind pinning of displaced supracondylar fractures of the homers in children. Sixteen years’ experience with long-term follow-up. J Bone Joint Surg Am 1974;56(2):263-272.
11. Templeton PA, Graham HK. The ‘floating elbow’ in children. Simultaneous supracondylar fractures of the homers and of the forearm in the same upper limb. J Bone Joint Surg Br 1995;77(5):791-796.

How to Cite this Article: Borana C, Jagani N, Shah N, Sharoff L, Mukherjee S. Osteochondroma Arising from the Head of the Fibula: A Rare Cause of Drop Foot in Pediatric Age. International Journal of Paediatric Orthopaedics Jan-June 2017;3(1):6-8.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study!

Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study!

Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

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Analysis of Dimeglio Score with Modified Pirani Score for Assessment of Idiopathic Clubfoot Deformity in Infants: A Comparative Study!

Authors : Vasu sharma [1], Vikas Gupta [2], Daipayan chatterjee [1], Akshat Sharma [1].

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

Ipsilateral Supracondylar Humerus Fracture with Distal End Radius Fracture in Children: A Series of 10 Cases

Authors : Chirag Borana [1], Naeem Jagani [2], Nadir Shah [3], Lokesh Sharoff [4], Sunirmal Mukherjee [5].

Abstract

References

(Abstract) (Full Text HTML) (Download PDF)

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