Vol 11 | Issue 3 | September-December 2025 Archives - International Journal of Paediatric Orthopaedics

Bilateral Trevor’s Disease of Ankle: A Rare Presentation and Treatment Consideration

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.250

Open Access License: CC BY-NC 4.0

Submitted: 29/09/2025; Reviewed: 18/10/2025; Accepted: 13/11/2025; Published: 10/12/2025

Authors: Gaurav Kumar MS Ortho [1], Amitosh Mishra D. Ortho, DNB Ortho [2], Abhishek Verma DNB Ortho [1], Anuj Rastogi D. Ortho, DNB Ortho [2]

[1] Department of Orthopaedics, Hind Institute of Medical Sciences, Sitapur, UP, India.
[2] Department of Orthopaedics, Integral Institute of Medical Sciences & Research, Lucknow, UP, India.

Address of Correspondence
Dr. Amitosh Mishra,
Department of Orthopaedics, Integral Institute of Medical Sciences & Research, Lucknow, UP, India.
E-mail: dramitoshmishra@gmail.com

Abstract

Trevor’s Disease, also referred to as Dysplasia epiphysealis hemimelica (DEH), is an uncommon skeletal developmental disorder which is characterized by an asymmetrical growth of the epiphyseal cartilage. A 5-year-old boy presented with bilateral painless swelling on the medial aspect of both feet for 3 years which had progressively increased in size. X-ray and magnetic resonance imaging (MRI) showed swelling from the inferomedial aspect of the talus. It was managed surgically by excision of the swelling. Histopathology revealed an osteochondroma of the talus arising from the epiphysis. Early diagnosis and treatment are necessary to prevent articular dysfunction of the tibiotalar and subtalar joints.
Keywords: Epiphyseal tumors, Ankle osteochondroma, Ankle swelling, Dysplasia epiphysealis hemimelica, Trevor’s disease

References

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How to Cite this Article: Kumar G, Mishra A, Verma A, Rastogi A. Bilateral Trevor’s Disease of Ankle: A Rare Presentation and Treatment Consideration. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3):24-27.

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Neglected Convergent Elbow Dislocation in a Paediatric Patient: A Case Report

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.248

Open Access License: CC BY-NC 4.0

Submitted: 21/09/2025; Reviewed: 14/10/2025; Accepted: 10/11/2025; Published: 10/12/2025

Authors: Vivek Singh MS Ortho [1], Rahul Baishya MS Ortho [1], Rahul Mishra MS Ortho [1], Manish Kumar Shah MBBS [1], Dhaval Patel MBBS [1], Aditya K.S. Gowda MS Ortho [1]

[1] Department of Orthopedics, Paediatric Orthopaedics Unit, AIIMS, Rishikesh, Uttarakhand, India.

Address of Correspondence
Dr. Aditya K.S. Gowda,
Department of Orthopaedics, AIIMS, Rishikesh, Uttarakhand, India, 249203
E-mail: adityajr.orth@aiimsrishikesh.edu.in

Abstract

Background: Convergent elbow dislocation is a rare paediatric injury with medial translocation of both radius and ulna. Subtle radiographic signs lead to missed diagnoses and delayed treatment.
Case presentation: We evaluated an 11-year-old girl with persistent restriction of forearm rotation and ulnar-nerve symptoms two months after a “simple” elbow dislocation that underwent a closed reduction. The diagnostic work-up included targeted review of the radiographs and non-contrast computerized tomography (CT). Operative management was performed through a posterior approach to the elbow with release of the scar tissue, ulnar-nerve decompression, open reduction, and Kirschner wire (K-wire) stabilization of the radiocapitellar joint.
Results: Pre-operative imaging confirmed convergent radioulnar translocation and anterior calcification (“radial horn”). After K-wire removal and rehabilitation, the patient achieved functional pronation–supination and resolution of ulnar neuropathy. At 24 months follow-up, radiographs showed maintained reduction and a stable, painless elbow with symmetric range of motion.
Conclusions: In the management of trauma to the elbow in children, post-reduction restriction of forearm rotation should raise the suspicion of rare injury patterns such as convergent radioulnar dislocation. In case of delayed presentation, prompt recognition and comprehensive soft-tissue release with nerve decompression can yield excellent function.
Keywords: Elbow dislocation, Convergent dislocation, Child, Ulnar neuropathy, Open reduction.

References

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How to Cite this Article: Singh V, Baishya R, Mishra R, Shah MK, Patel D, Gowda AKS. Neglected Convergent Elbow Dislocation in a Paediatric Patient: A Case Report. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3): 20-23.

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Unilateral Perthes Disease Followed by Contralateral Pre-slip SCFE: A Case with Sequential Hip Disorders

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.246

Open Access License: CC BY-NC 4.0

Submitted: 19/09/2025; Reviewed: 30/09/2025; Accepted: 24/11/2025; Published: 10/12/2025

Authors: Tariq Altaf Mir MS Ortho [1], Muhammad Haseeb Gani MS Ortho [1]

[1] Paediatric Orthopaedics Department, Paras Health, Srinagar, India.

Address of Correspondence
Dr. Tariq Altaf Mir,
Consultant, Paediatric Orthopaedics Department, Paras Health, Srinagar, India.
E-mail: mirdadtariq@protonmail.com

Abstract

Background: Perthes disease and Slipped Capital Femoral Epiphysis (SCFE) are distinct paediatric hip disorders, rarely reported to occur sequentially in the same patient.
Case report: We report a case of a 7-year-old boy with Perthes disease of the Right hip treated by proximal femoral osteotomy. At the age of 9 years, he complained of Left hip pain, which on evaluation was found to be a pre-slip SCFE. He underwent in-situ pinning on the Left side and was asymptomatic at the last follow-up.
Conclusion: Recognition of this sequential presentation is important for surveillance and timely management.
Keywords: SCFE, Perthes disease, Vitamin D deficiency

References

1. Karkenny AJ, Tauberg BM, Otsuka NY. Pediatric hip disorders: Slipped capital femoral epiphysis and Legg-Calvé-Perthes disease. Pediatr Rev. 2018 Sep;39(9):454–63. doi:10.1542/pir.2017-0197. PMID: 30171056.
2. Markheim HR. Legg-Perthes disease and slipped epiphysis in the same patient: a case report. J Bone Joint Surg Am. 1949;31A:666–8.
3. Graziano GP, Kernek CB, DeRosa GP. Coexistent Legg-Calvé-Perthes disease and slipped capital femoral epiphysis in the same child. J Pediatr Orthop. 1987;7:61–2. doi:10.1097/01241398-198701000-00012.
4. Singh KA, Madegowda A, Shah H. Slipped capital femoral epiphysis in a healed Perthes hip. BMJ Case Rep CP. 2021;14:e243977.
5. Madhuri V, Arora SK, Dutt V. Slipped capital femoral epiphysis associated with vitamin D deficiency: a series of 15 cases. Bone Joint J. 2013 Jun;95-B(6):851–4. doi:10.1302/0301-620X.95B6.30806. PMID: 23723284.

How to Cite this Article: Mir TA, Gani MH. Unilateral Perthes Disease Followed by Contralateral Pre-slip SCFE: A Case with Sequential Hip Disorders. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3): 16-19.

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Management of Stress Fracture in the Femoral Neck with an Existing Implant in Osteogenesis Imperfecta: A Case Report

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.244

Open Access License: CC BY-NC 4.0

Submitted: 14/04/2025; Reviewed: 07/05/2025; Accepted: 12/08/2025; Published: 10/12/2025

Authors: Venkatadass K MS Ortho [1], Mithun D MS Ortho [1]

[1] Department of Paediatric Orthopaedics, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. Mithun D,
Department of Paediatric Orthopaedics, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, Tamil Nadu, India.
E-mail: dr.mithun_ortho@yahoo.com

Abstract

Introduction: Stress fracture of the neck of the femur with implant in-situ in osteogenesis imperfecta is not reported, and the management of such a scenario could be challenging. Often, the size of the neck in these patients poses a challenge regarding surgical technique and implant selection.
Case Presentation: An 18-year-old male, diagnosed to have osteogenesis imperfecta, presented with chronic left hip pain after sudden abnormal loading to the hip joint. He was diagnosed to have stress fracture of the neck of left femur despite a screw in the neck through a reconstruction type of interlocking nail spanning the femur. He was treated by valgus osteotomy and extra-cortical fibular strut grafting and fixation with a paediatric valgus osteotomy plate. Both the fracture and the osteotomy healed well and our patient had a satisfactory outcome and returned to his pre-fracture functional status.
Discussion: The management of stress fractures in hips with abnormal morphology is challenging, especially in the presence of a retained implant. In patients with osteogenesis imperfecta, bone size may be significantly decreased, impacting the surgical fixation technique.
Conclusion: This rare case illustrates that a stress fracture can happen in the neck of femur with coxa vara even when the neck is protected with a screw. Correction of coxa vara, which in turn normalizes the weight-bearing forces across the neck, is the key to success in this patient group.
Keyword: Osteogenesis, Imperfecta, Neck, Femur, Fracture, Stress.

References

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How to Cite this Article: Hudna AS, Al-Zuhairi MM, Mohammed RM, Farwan YM, Khamis AY, Yousef KW, Al-wardi ZA. Patterns, Anatomical Distribution and Etiologies of Paediatric Fractures in a Tertiary Care Hospital in Sana’a City, Yemen: A Five-Year Retrospective Analysis. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3): 02-09

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Patterns, Anatomical Distribution and Etiologies of Paediatric Fractures in a Tertiary Care Hospital in Sana’a City, Yemen: A Five-Year Retrospective Analysis

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.242

Open Access License: CC BY-NC 4.0

Submitted: 15/08/2025; Reviewed: 08/09/2025; Accepted: 09/11/2025; Published: 10/12/2025

Authors: Ahmed S. Hudna MD [1], Mohammed M. Al-Zuhairi MBBS [2], Reham M. Mohammed MBBS [1], Yahya M. Farwan MBBS [3], Abdulrahman Y. Khamis MBBS [4], Kamal W. Yousef MBBS [4], Zinab A. Al-wardi MBBS [5]

[1] Department of Paediatrics, Faculty of Medicine and Health Sciences, University of Science and Technology (USTY), Sana’a, Yemen.
[2] Department of Obstetrics, Al-Thawra Modern General Hospital, Sana’a, Yemen
[3] Department of Surgery, University of Science and Technology Hospital, Sana’a, Yemen
[4] Department of Medicine, University of Science and Technology Hospital, Sana’a, Yemen
[5] Al-Aliaa International Hospital, Sana’a, Yemen

Address of Correspondence
Dr. Ahmed Saleh Hudna,
Associate Professor of Paediatrics, Faculty of Medicine and Health Sciences, University of Science and Technology. Sana’a, Yemen,
drahmedhudna@gmail.com

Abstract

Background: Fractures in children are a major global health concern, contributing to morbidity, healthcare burden, and potential long-term disability. In Yemen, the epidemiology and management of paediatric fractures remain poorly documented. Therefore, this study aimed to investigate the patterns, anatomical distribution, etiologies and concomitant injuries associated with paediatric fractures over a five-year period from 2020 to 2024.
Methods: A retrospective cross-sectional study was conducted at the University of Science and Technology Hospital in Sana’a between January 2020 and December 2024 involving 466 medical records of children aged ≤18 years and with documented fractures. Data on demographics, fracture characteristics, etiology, and associated systemic injuries were extracted using a structured data collection sheet. Data were summarized using appropriate descriptive statistics.
Results: Among 466 children with fractures, the majority were boys (78.8%). The mean age was 11.0 ± 4.4 years, with 52.8% aged ≤11 years. Fractures were almost equally distributed between left and right sides (50.6% vs. 49.4%) and upper and lower limbs (46.6% vs. 45.3%), with pelvic fractures being rare (0.9%). Single fractures predominated (68%), while 32% involved multiple fractures; 7.3% had fractures at multiple anatomical sites. In the upper limbs, the radius (32.2%) and humerus (29.4%) were most frequently fractured. In the lower limbs, the femur (40.1%) and tibia (35.5%) fractures predominated. Multiple-site fractures most often involved phalanges of the hand with the tibia and fibula (26.5%). Quotidian injuries were the leading cause (72.1%), followed by road traffic accidents (21.5%). Concomitant injuries occurred in 4.5% of cases, primarily affecting the nervous system (76.2%).
Conclusions: Paediatric fractures in Sana’a predominantly affected boys and children aged ≤11 years, with an almost equal distribution between limbs and sides. The radius, humerus, femur, and tibia were most frequently affected. Injuries sustained during routine activities were the leading cause, followed by road traffic accidents. Concomitant injuries, mainly neurological were uncommon.
Keywords: Paediatric fractures, Daily-life injuries, Sport injuries, Yemen

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