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Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Volume 8 | Issue 3 | September-December 2022 | Page: 16-21| Anil Agarwal DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.145 Authors: Anil Agarwal [1] MS Ortho. [1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India. Address of Correspondence Dr. Anil Agarwal, Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India. E-mail: anilrachna@gmail.com Abstract Background: […]

Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria

Volume 8 | Issue 3 | September-December 2022 | Page: 06-10| Selema B. Bob-Manuel, Richard C. Echem, Somiari L. Harcourt DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.143 Authors: Selema B. Bob-Manuel FWACS (Ortho) [1], Richard C. Echem FWACS (Ortho) [1], Somiari L. Harcourt FMCS (Ortho) [1] [1] Department of Orthopaedic Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers […]

Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria

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Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Volume 8 | Issue 3 | September-December 2022 | Page: 16-21| Anil Agarwal

DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.145

Authors: Anil Agarwal [1] MS Ortho.

[1] Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.

Address of Correspondence
Dr. Anil Agarwal,
Department of Paediatric Orthopaedics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India.
E-mail: anilrachna@gmail.com

Abstract

Background: The septic sequelae of knee following infantile infection is scantily described in literature. This case series depicts the various anatomical zones affected, the radiological presentation and proposes a vascular hypothesis for the sequelae.
Methods and results: Sequelae presented with three distinct radiological findings namely, unicondylar loss of lateral distal femur (n=4), hemicondylar loss of anterior portion of proximal tibia (n=3), and epiphyseal overgrowth and deficient tibial metaphysis of medial/ lateral side (n=4). The anatomical zones for above findings were seen approximately matching with the supply of specific genicular arteries around knee. On corroborating the early post infective radiographs and the sequelae radiographs, it was found that most patients had concomitant osteomyelitis, sometimes extensive.
Conclusions: We could recognize three distinct anatomical patterns of septic sequelae of knee following osteoarticular knee infection in infancy. An ischemic etiopathogenesis is suggested based on consistent radiological findings and the vascular supply zones. Most cases followed concomitant occurrence of septic arthritis and extensive osteomyelitis.
Keywords: Knee, Sepsis, Sequelae, Ischemia, Infants

References

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3. Langenskiöld A. Growth disturbance after osteomyelitis of femoral condyles in infants. Acta Orthop Scand. 1984;55:1-13.
4. Morsy M, Sur YJ, Akdag O, Eisa A, El-Gammal TA, Lachman N, Moran SL. Anatomic and high-resolution computed tomographic angiography study of the lateral femoral condyle flap: Implications for surgical dissection. J Plast Reconstr Aesthet Surg. 2018;71:33-43.
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How to Cite this Article: Agarwal A | Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis | International Journal of Paediatric Orthopaedics | September-December 2022; 8(3): 16-21 | https://doi.org/10.13107/ijpo.2022.v08.i03.145

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Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria

Volume 8 | Issue 3 | September-December 2022 | Page: 06-10| Selema B. Bob-Manuel, Richard C. Echem, Somiari L. Harcourt

DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.143

Authors: Selema B. Bob-Manuel FWACS (Ortho) [1], Richard C. Echem FWACS (Ortho) [1], Somiari L. Harcourt FMCS (Ortho) [1]

[1] Department of Orthopaedic Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.

Address of Correspondence

Dr. Bob-Manuel Selema Benibo
Department of Orthopaedic Surgery, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
E-mail: selema_md@yahoo.com

Abstract

Background: Scoring systems are being employed in the objective assessment of the severity of idiopathic clubfoot deformities . Popular among these scoring systems are the Diméglio and Pirani Scoring Systems. This study aims to find the correlation of idiopathic club foot scores (Pirani and Diméglio) with the number of castings by Ponseti method.
Methodology: It was a prospective study carried out over a 12-month period in a tertiary hospital. Children with idiopathic congenital talipes equinovarus under 3 years were included in the study. All data was analysed with the Statistical Package for Social Sciences (SPSS) version 20 for Windows. Pearson correlation coefficient was used to determine the correlation between clubfoot scores and number of castings done.
Results: The study comprised of 42 subjects with a total of 58 feet . Male and females were 45.2% (19) and 54.8% (23) respectively. Idiopathic clubfoot was unilateral in 61.9% of cases. The mean Pirani and Diméglio scores at presentation were 4.58± 1.42 and 14.28± 3.37 respectively. The mean number of casting sessions required to achieve correction was 4.00±1.19. There was a significant positive correlation between total number of castings with both Pirani scores (r=0.449, p<0.05) and Diméglio scores (r=0.619, p<0.05). Fifty percent (50%) of feet required percutaneous tenotomy in the final stages of correction.
Conclusion: Pirani and Diméglio scores have significant correlation with number of casts a patient will require for correction. Thus, either of these scores can be used and are useful tools in the monitoring of patients’ treatment with Ponseti method.
Keywords: Idiopathic Clubfoot, Ponseti, Pirani Score, Diméglio Score, Manipulation and casting.

References

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3. Staheli L. Clubfoot: Ponseti Management. 3rd ed. Global Help; 2009. Available from: https://storage.googleapis.com/global-help-cdn/2020/07/5e0684b9-help_cfponseti.pdf
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7. Gao R, Tomlinson M, Walker C. Correlation of Pirani and Dimeglio scores with number of Ponseti casts required for clubfoot correction. J Pediatr Orthop. 2014;34(6):639–42.
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10. Mejabi JO, Esan O, Adegbehingbe OO, Orimolade EA, Asuquo J, Badmus HD, Anipole AO. The Pirani scoring system is effective in assessing severity and monitoring treatment of clubfeet in children. Br J Med Med Res. 2016;17(4):1-9.
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How to Cite this Article: Bob-Manuel SB, Echem RC, Harcourt SL | Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria | International Journal of Paediatric Orthopaedics | September-December 2022; 8(3): 06-10. https://doi.org/10.13107/ijpo.2022.v08.i03.143

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Half Sized Blog Element (Multi Author Style)

Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria

Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria

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Specific Anatomical Patterns of Septic Sequelae of Knee in Children: Possibility of a Vascular Etiopathogenesis

Authors: Anil Agarwal [1] MS Ortho.

Abstract

(Article Text HTML) (Full Text PDF)

Correlation of Idiopathic Clubfoot Scores with Number of Manipulations and Castings Using Ponseti Method: A Prospective Study in Port Harcourt, Nigeria

Authors: Selema B. Bob-Manuel FWACS (Ortho) [1], Richard C. Echem FWACS (Ortho) [1], Somiari L. Harcourt FMCS (Ortho) [1]

Abstract

(Article Text HTML) (Full Text PDF)

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