9780126386516

Pediatric Orthopedic Deformities

by
  • ISBN13:

    9780126386516

  • ISBN10:

    012638651X

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2002-01-07
  • Publisher: Elsevier Science
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Summary

Specific operative and nonoperative techniques and their results are stressed. The book is extensively illustrated with drawings, most of which were made for this book, microscopy photos, and serial radiographs. The reader learns of pediatric orthopedic deformity in relation to normal and abnormal developmental biology, the worsening of untreated disease with growth, and the diagnostic and treatment interventions required based on the stage of progression. * Treatments are correlated with the pathologic state of the disorder * Discusses disorders from earliest onset to the final state showing how the altered biology leads to progressively greater clinical deformity * Initial chapter focuses on development bone biology stressing a broad based approach involving histologic, gene and molecular, and biomechanical features * Subsequent chapters discuss the pathogenesis of the various deformities, natural history, radiographic and imaging findings and orthopaedic and surgical management

Table of Contents

Preface xvii
Acknowledgments xix
PART I Basic Information
Developmental Bone Biology
Terminology
3(2)
Overview
3(1)
Theories of Embryogenesis-Preformationism and Epigenesis
3(1)
Epiphysis
4(1)
Endochondral Ossification
4(1)
Intramembranous Ossification
4(1)
Perichondrial Ossification Groove of Ranvier
5(1)
Early Scientific Understandings of Bone Growth
5(3)
Hales and Belchier
5(1)
Nesbitt
5(2)
Duhamel
7(1)
Hunter
7(1)
Howship
7(1)
Flourens
8(1)
Embryology of the Limbs
8(5)
Timing and Staging of Human Limb Development
8(1)
Outline of Embryonic Development of Long Bones
9(4)
Bone Development at the Light Microscopic Level Following Delineation of the Cell Theory and Advances in Microscopy and Histochemistry
13(3)
More Detailed Histologic Studies of Bone Formation
16(3)
Histogenesis of Bone
16(1)
Chondrocyte Shape and Orientation in Epiphyseal and Physeal Cartilage: Mineralization and Vascularization in the Endochondral Sequence (Dodds)
17(1)
Cellular Components
18(1)
Fate of the Hypertrophic Chondrocyte as Interpreted from Light Microscopic Studies
19(2)
Chondrocyte Survival, Dedifferentiation, and Reemergence to a Bone Forming Cell Line
19(1)
Direct Transformation of Cartilage Cells to Bone Cells
20(1)
Death of Cartilage Cells
20(1)
Variable Responses
21(1)
Structural Development of the Epiphyseal Regions Including the Joints, the Metaphyses, and the Diaphyses
21(32)
Epiphyses
21(1)
Secondary Ossification Center Formation
21(4)
Physis-Structure and Relation to Function
25(14)
Perichondrial Ossification Groove of Ranvier
39(1)
Periosteum and Its Relationship to the Epiphyses, Metaphyses, and Diaphyses
39(2)
Cortical (Diaphyseal) Bone Formation-Woven Bone and Lamellar Bone
41(3)
Development of Joints-General Description
44(2)
Epiphyseal Blood Supply
46(5)
Development of the Articular Cartilage
51(2)
Axes along Which Bones are Patterned
53(5)
Signaling Regions That Affect the Patterns of Bone Development
53(1)
Models of Tissue Patterning
53(2)
Positional Information Mechanisms
55(2)
Prepattern Mechanisms
57(1)
Determination Wave Mechanisms
57(1)
Rearrangement Mechanisms
57(1)
Cell Lineage Mechanisms
57(1)
Gene and Molecular Controls of Limb Development
58(24)
Apical Ectodermal Ridge
58(1)
Progress Zone
58(1)
Polarizing Region
58(1)
Dorsal Nonridge Ectoderm
58(16)
Overview of Gene Controls of Limb Development
74(1)
Homeobox Genes
74(3)
Specific Details Concerning Gene and Molecular Controls on Limb Development and the Hox Gene Network
77(1)
Expression of Hoxa and Hoxd Genes during Normal Limb Development
77(1)
Expression of Hoxc Genes in the Chick Limb Bud
78(1)
Expression of Hoxb Genes
78(1)
Signaling Molecules along Developing Limb Axes
78(3)
Matrix Metalloproteinases (MMPs) and Tissue Inhibitors of Matrix Metalloproteinases (TIMPs)
81(1)
Chemistry of the Extracellular Matrix
82(11)
Collagen
82(5)
Collagen Groups
87(1)
Detailed Review of Specific Cartilage Collagens
88(1)
Proteoglycans
89(1)
Glycoproteins and Noncollagenous Proteins
90(2)
Cell Surface Proteoglycans
92(1)
Temporal and Spatial Changes in Specific Molecular Expression within the Endochondral Sequence
92(1)
Mineralization
93(3)
Epiphyseal Growth
96(3)
Physeal Chondrocyte Metabolism
96(1)
Studies of Cell Proliferation in Physeal Cartilage Using Tritiated Thymidine Autoradiography
96(1)
Kinetics of Epiphyseal Growth
96(1)
Amount of Growth at Each Epiphyseal Plate
97(1)
Growth Slowdown and Growth Arrest Lines (Harris Lines)
98(1)
Responses of Developing Bones and Epiphyses to Mechanical Stresses
99(12)
Normal Responses to Mechanical Factors
99(4)
Normal Relationship of Epiphyseal Plates to Compressive and Tensile Stresses
103(2)
Mechanical Stresses and Their Differences and Effects on Skeletal Development
105(2)
Responses of Physes to Abnormal Pressures-Pathogenesis of Creation and Correction of Deformity in Developing Bones
107(2)
The Effects of Pressure on Epiphyseal Growth
109(2)
Radiographic Characteristics in Development of Major Long Bone Epiphyses
111(7)
General Information
111(1)
Proximal Humerus
111(1)
Distal Humerus
112(3)
Proximal Radius
115(1)
Distal Radius
115(1)
Proximal Ulna
115(1)
Distal Ulna
115(1)
Proximal Femur
115(1)
Distal Femur
116(1)
Proximal Tibia
116(1)
Distal Tibia
116(1)
Proximal Fibula
117(1)
Distal Fibula
117(1)
Relationship of Proximal and Distal Tibial and Fibular Physes
117(1)
Time and Pattern of Physeal Closure
117(1)
Distal Tibial Growth Plate Closure
117(1)
Proximal Femoral, Proximal Tibial, Metatarsal, and Phalangeal Growth Plate Closure
117(1)
Why Epiphyses Form and the Evolution of Epiphyses
118(11)
References
119(10)
Imaging Approaches for Epiphyseal Assessment
Dr. Diego Jaramillo
Introduction
129(1)
Technical Considerations
129(4)
Ultrasonography
129(1)
Magnetic Resonance Imaging
130(2)
Computed Tomography (CT)
132(1)
Scintigraphy
132(1)
Imaging Characteristics
133(2)
Cartilage
133(2)
Bone
135(1)
Bone Marrow
135(1)
Normal and Abnormal Growth and Ossification
135(7)
Imaging of Abnormalities by Location: Disorders of the Lower Extremity
142(5)
Disorders of the Hip
142(3)
Disorders of the Knee
145(2)
Disorders of the Distal Tibia and Fibula
147(1)
Imaging of Disorders by Location: Disorders of the Upper Extremity
147(6)
Shoulder
147(1)
Elbow
148(1)
Wrist
148(1)
References
148(5)
PART II Disorders of the Developing Hip and Knee
Developmental Dysplasia of the Hip
Terminology
153(1)
Development of the Hip-Embryonic and Fetal Periods
154(6)
General Aspects of Hip Development
154(4)
Embryonic, Fetal, and Postnatal Development of the Femur
158(1)
Embryonic, Fetal, and Postnatal Development of the Acetabulum
159(1)
Primary Etiologies of Hip Maldevelopment
160(1)
Etiology and Pathoanatomy of Developmental Dysplasia of the Hip
161(31)
Early Clinical-Pathoanatomic Descriptions
161(15)
Later Clinical-Pathoanatomic Descriptions
176(3)
Most Recent Clinical-Pathoanatomic Descriptions with an Emphasis on Early Capsular Laxity
179(8)
Multifactorial Causes of DDH Involving Late Stage Structural Modifications of the Hip, Mesenchymal Tissue Abnormalities, and Intrauterine Mechanical Stresses Due to Positioning
187(3)
Experimental Reproduction of Hip Dislocation
190(2)
Epidemiology and Its Relation to Pathophysiology
192(3)
Sex Incidence
192(1)
Incidence and Side of Hip Instability
193(1)
Effects of Intrauterine Environment
193(1)
Extrauterine Postnatal Environment
194(1)
Genetic Considerations
194(1)
Ethnic Considerations
194(1)
Spontaneous Stabilization of Hips without Treatment
194(1)
Summary of Pathoanatomic and Pathophysiologic Findings and Discussion of Pathogenetic Sequences
195(3)
Overview
195(1)
Capsular Laxity
195(1)
Acetabular Dysplasia
196(1)
Proximal Femoral Dysplasia
196(1)
Adductor Muscle Tightness
196(1)
Soft Tissue Deformation
196(1)
Idiopathic and Teratologic Dysplasia
197(1)
Worsening of Secondary Changes with Time
197(1)
Natural History of Hip Dislocations, Subluxations, and Dysplasia
198(1)
Natural History of Complete Dislocations
198(1)
Natural History of Dysplasia and Subluxation
198(1)
Osteoarthritis in Adult Life Following Childhood CDH
198(1)
Brief History of Treatment Approaches in Developmental Dysplasia of the Hip
199(14)
Gradual Development of Reasonably Effective Closed and Open Treatments
199(4)
Progressively Earlier Diagnosis and Treatment of Congenital Dislocation
203(2)
Assessments of Congenital Hip Dislocation Treated by Closed Reduction
205(1)
Treatment by Open Reduction
206(2)
Acetabular Corrective Procedures for Treatment of Hip Dysplasia
208(4)
Proximal Femoral Osteotomies
212(1)
Combined Acetabular and Proximal Femoral Osteotomies
213(1)
Imaging Techniques Used to Assess Hip Position
213(19)
Plain Radiographic Indices
214(4)
Arthrography in Assessing Hip Position and Anatomy
218(3)
Ultrasonography in the Diagnosis of Newborn Developmental Dysplasia of the Hip
221(9)
Long-Term Studies of Sonographic Indices in Normal and Abnormal Hip Development
230(1)
CT Scan to Assess Hip Structure
230(1)
MR Imaging to Assess Position and Vascularity of the Femoral Head Postreduction
231(1)
Assessments of Hip Growth and Development Following Closed and Open Treatments
232(2)
Growth and Development of the Hip Following Closed Reduction in Early Infancy
232(1)
Acetabular Development Following Hip Reduction by Closed, Open, or Varus Osteotomy Treatments
232(1)
Acetabular Development after Removal of the Limbus in Infancy
233(1)
Acetabular Growth Following Acetabular Surgery
234(1)
Growth Disturbance Lines in Proximal Femur: O'Brien
234(1)
Proximal Femoral Growth Following Femoral Osteotomy
234(1)
Treatment Based on the State of the Underlying Pathoanatomy, Including Secondary Changes
234(5)
General Overview
234(1)
Diagnosis Made in the Newborn Period
235(1)
Diagnosis Made at 3 Months of Age
236(1)
Diagnosis Made at 6 Months of Age
237(1)
Diagnosis Made at 12 Months of Age
238(1)
Diagnosis Made at 18 Months of Age
238(1)
Diagnosis Made between 18 Months and 4.5 Years of Age
238(1)
Imperfect Hip Structure after 5 Years of Age
239(1)
Preadolescent-Adolescent Hip Dysplasia
239(1)
Avascular Necrosis as a Complication of Treatment of Developmental Dysplasia of the Hip
239(33)
Blood Supply of the Proximal Femur
239(6)
Epiphyseal Blood Supply: Cartilage Canals
245(1)
Recognition of the Problem of Avascular Necrosis as a Complication of Treatment for Developmental Dysplasia of the Hip
246(1)
Efforts to Understand and Treat the Causes of Avascular Necrosis
247(4)
Classification of Patterns of Avascular Necrosis Following Treatment of Developmental Dysplasia of the Hip
251(2)
Avascular Necrosis Associated with Immobilization Devices Other Than a Hip Spica
253(1)
More Recent Reports of the Incidence of AVN in Developmental Dysplasia of the Hip
254(4)
Long-Term Results Following AVN in Childhood CDH-DDH
258(1)
MR Imaging to Detect Hip Ischemia Due to Extreme Immobilization Positioning
258(4)
References
262(10)
Legg-Calve-Perthes Disease
Definition
272(1)
Original Recognition of Disorder
272(4)
General Review
272(1)
Legg
273(1)
Calve
273(2)
Perthes
275(1)
Waldenstrom
275(1)
Sourdat
276(1)
Clinical Profile
276(5)
General Features
276(1)
Epidemiologic Features of Legg-Calve-Perthes Disease
277(4)
Early Pathologic Reports of Cell and Tissue Changes in Legg-Calve-Parthes Disease
281(4)
Zemansky, 1928
281(1)
Schwarz, 1914
282(1)
Phemister, 1920
282(1)
Axhausen, 1923
282(1)
Heitzmann, 1923
283(1)
Riedel, 1923
283(1)
Walter, 1925
283(1)
Konjetzny, 1926, 1934
283(1)
Delchef, 1926
284(1)
Rockemer, 1927
284(1)
Lippmann, 1929
284(1)
Nagassaka, 1930
284(1)
Summary of Histopathologic Changes after Two Decades of Study (Zemansky)
285(1)
Subsequent Pathologic Reports with Better Defined Clinical and Radiographic Correlations
285(12)
Ferguson and Howorth, 1934
285(1)
Gall and Bennett, 1942
286(1)
Haythorn, 1949
287(1)
Jonsater, 1953
287(2)
Ponseti, 1956
289(1)
Mizuno, Hirrayama, Kotani, and Simazu, 1966
289(1)
Dolman and Bell, 1973
290(1)
Larsen and Reiman, 1973
290(1)
McKibbin and Ralis, 1974; McKibbin, 1975
290(2)
Jensen and Lauritzen, 1976
292(1)
Inoue, Freeman, Vernon-Roberts, and Mizuno, 1976
292(1)
Inoue, Ono, Takaoka, Yoshioka, and Hosoya, 1980
292(1)
Catterall et al., 1982a,b
293(2)
Ponseti et al., 1983
295(2)
Early Correlation of Radiographic with Histopathologic and Clinical Features of Legg-Perthes from the Incipient Stage to the Residual Stage
297(1)
Pathoanatomic Changes and Their Relation to the Clinical, Radiologic, and Other Imaging Findings
297(24)
Overview of Plain Radiographic Changes in Legg-Perthes Disease
297(3)
Pathologic Changes and Their Demonstration by Varying Imaging Modalities Including Ultrasonography, Scintigraphy, Magnetic Resonance Imaging, and Computerized Axial Tomography
300(4)
Subsequent Pathologic Changes Presenting as a Realtive Decrease in Size of the Involved Secondary Ossification Center
304(1)
Nutrition of the Proximal Femoral Epiphysis and Its Bearing on Legg-Calve-Perthes Disease
304(1)
Gage Sign-Catterall Sign: Lateral-Proximal Neck Convexity-Lateral Epiphyseal Lysis
304(1)
Subchondral Fracture and Crescent Sign
304(1)
Increased Radiodensity of the Secondary Ossification Center
305(1)
Alternating Areas of Radiodensity and Radiolucency
306(1)
Responses of the Cartilage Model of the Femoral Head
307(4)
Assessment of Cartilage Model of Proximal Femur Using Arthrography
311(1)
Responses of the Physis
312(1)
Sagging Rope Sign
313(1)
Responses of the Femoral Neck (Metaphysis)
313(3)
Femoral Neck Anteversion
316(1)
Responses of the Greater Trochanter
316(1)
Responses of the Acetabulum
316(2)
Remodeling in the Residual Phase of the Disease between the Termination of Healing and Skeletal Maturity
318(1)
Imperfect Healing of Legg-Calve-Perthes with Persistence of an Osteochondritis Dissecans Lesion at Skeletal Maturity
319(1)
Hinge Abduction: Imperfect Healing with a Flattened Femoral Head and a Superolateral Prominence Impeding Smooth Abduction
319(1)
Femoral Shortening as a Sequel to Legg-Perthes Disease
319(2)
Lower Extremity Length Discrepancies with Legg-Perthes Disease
321(2)
Maximum Total Femoral and Tibial Discrepancy during Growth Years
321(1)
Femoral and Tibial Discrepancy at Skeletal Maturity
321(1)
Maximum Femoral Discrepancy
321(1)
Maximum Tibial Discrepancy
321(1)
Developmental Patterns of Discrepancies in Legg-Perthes Disease
321(2)
Prognostic Indicators during the Active Disease Process
323(6)
General Considerations
323(1)
Age of Occurrence of the Disease
323(1)
Plain Radiographic Classifications
324(5)
Comparison of Classification Schemes
329(1)
More Recent Clarifications of Poor Prognostic Signs
329(1)
Classifications Defining Results Based on Appearances at Skeletal Maturity at the End of Repair
329(7)
General Considerations
329(1)
Sundt Classification
330(1)
Quantitative Indices of Femoral Head-Acetabular Repair
330(3)
Stulberg Classification
333(2)
Butel, Borgi, and Oberlin Grading System
335(1)
Additional Long-Term Studies of Adult Responses to a Childhood Perthes Disorder
335(1)
Treatment Approaches to Legg-Perthes Disease
336(40)
Early Major Reviews of Treatment Approaches
336(3)
Range of Approaches to the Disorder
339(21)
Other Factors Concerning Results
360(2)
Late-Stage Surgical Intervention to Treat the Sequelae of Legg-Perthes Disease
362(2)
Summary of Treatment Approaches
364(4)
References
368(8)
Coxa Vara in Developmental and Acquired Abnormalities of the Femur
Slipped Capital Femoral Epiphysis, Proximal Femoral Focal Deficiency, Infantile Coxa Vara, Coxa Vara with Congenital Short Femur, Coxa Vara with Skeletal Dysplasias
Coxa Vara-General Overview
376(2)
Terminology
376(1)
Causes of Coxa Vara
376(2)
Clinical Presentation of Coxa Vara
378(1)
Imaging Assessments in Coxa Vara
378(1)
Slipped Capital Femoral Epiphysis
378(58)
Terminology
378(1)
Evolving Clinical Awareness and Description of the Disorder
379(2)
Etiology of Slipped Capital Femoral Epiphysis
381(2)
Pathoanatomy
383(6)
Interpretation of the Studies on Pathogenesis and Pathoanatomy
389(3)
Medical Disorders Predisposing to Slipped Capital Femoral Epiphysis
392(4)
Types of Classification for the SCFE Entity
396(2)
Epidemiologic Characteristics of Slipped Capital Femoral Epiphysis: Age, Sex, Weight, Symptom Time, Bilaterality, and Associated Disorders
398(6)
Diagnostic Imaging Studies
404(1)
Therapy
404(32)
Coxa Vara Due to Other Acquired Causes
436(1)
Developmental Abnormalities of the Femur
436(7)
Terminology
436(1)
Proximal Femoral Focal Deficiency
436(6)
Congenital Short Femur
442(1)
Distal Femoral Developmental Abnormalities
442(1)
Infantile Coxa Vara
443(19)
Terminology
443(1)
Clinical and Radiographic Presentation of Infantile Coxa Vara
443(1)
Pathoanatomy of Infantile Coxa Vara
444(2)
Evolution of Radiographic Change
446(1)
Pathomechanics of Deformity in Infantile Coxa Vara
447(1)
Clinical-Radiographic Correlations
448(1)
Management of Infantile Coxa Vara
449(6)
References
455(7)
Developmental Disorders of the Knee
Distal Femur, Proximal Tibia, and Proximal Fibula
Normal Developmental Variability
462(3)
Physiologic Genu Varum and Genu Valgum in Childhood
462(1)
Normal Radiographic Developmental Variants of the Distal Femoral and Proximal Tibial Epiphyses
462(3)
Osteochondritis Dissecans of Distal Femur
465(14)
Disease Profile
465(1)
Original Descriptions by Paget, Teale, and Koenig
466(1)
Three Stages of the Disorder
467(1)
Age of Occurrence
468(1)
Regions of Involvement of Distal Femur
468(1)
Etiology
468(2)
Pathogenesis and Pathoanatomic Findings
470(4)
Current Understanding of the Disease Entity
474(1)
Radiographic and Other Imaging Findings
475(2)
Age at Occurrence, Treatment, and Relation to Healing
477(1)
Summary of Treatment Approaches in Childhood OD
478(1)
Infantile Tibia Vara (Blount's Disease)
479(14)
Terminology
479(1)
Clinical and Radiographic Profile of Infantile Tibia Vara
480(1)
Clinical-Radiographic Grading Scheme of Langenskiold, Types I-VI
481(1)
Pathogenesis of Varus Deformity
481(3)
Pathoanatomy
484(2)
Imaging Assessments in Relation to Tibia Vara
486(1)
General Management Considerations
487(1)
Recurrent Deformity Following Osteotomy
488(2)
Spontaneous Correction
490(1)
Surgical Approaches to Tibia Vara
490(1)
Adult Sequelae of Childhood Tibia Vara
491(2)
Adolescent Tibia Vara
493(4)
Terminology
493(1)
Clinical Profile
493(2)
Variable Opinions on Whether Late-Onset Tibia Vara is Superimposed on a Preexisting Varus Deformity
495(1)
Physeal Height and the Question of Distal Femoral Varus Tilt
495(1)
Association of Femoral Varus with Tibia Vara in Late-Onset Blount's Disease
496(1)
Radiographic Assessments
496(1)
Pathoanatomy of Adolescent Tibia Vara
496(1)
Treatment
497(1)
Osgood-Schlatter Disease (Tibial Tubercle Chronic Traumatic Apophysitis)
497(10)
Terminology and Outline
497(1)
Pathophysiology
497(1)
Tibial Tuberosity Development
498(3)
Pathoanatomic Changes in Osgood-Schlatter Disease
501(3)
Clinical and Radiologic Features of Osgood-Schlatter Disease
504(1)
Clinical Symptoms and Management
504(3)
Congenital Dislocation of the Knee
507(3)
Definition and Clinical Profile
507(1)
Classification
507(1)
Pathoanatomy
508(1)
Diagnostic Considerations
509(1)
Treatment Approaches
509(1)
Valgus Angulation Following Proximal Tibial Metaphyseal Fractures in Childhood
510(1)
Description and Clinical Profile
510(1)
Etiological Considerations Underlying Valgus Deformation
510(1)
Guidelines for Treatment
511(1)
Disorders of the Proximal Fibular Epiphysis
511(8)
Congenital Proximal Tibial-Fibular Synostosis
511(1)
Proximal Fibular Elongation
511(1)
Hypoplasia of Fibula
511(1)
Hereditary Multiple Exostosis
512(1)
Proximal Fibular Overgrowth Secondary to Damage to the Proximal Tibial Physis
512(1)
References
512(7)
PART III Deformities Due to Disorders Primarily Affecting the Epiphyses and Metaphyses
Epiphyseal Growth Plate Fracture-Separations
Introduction: Pre-radiographic Era, Pathoanatomic Approaches, and Pathophysiologic Approaches
519(1)
Clinical and Experimental Investigations of Growth Plate Fracture-Separations in the Preradiographic Era
519(12)
Early Clinical Descriptions
519(1)
Important Studies Establishing the Validity of the Entity of Epiphyseal Growth Plate Fracture-Separations
520(2)
Relatively Slow Acceptance by Many of the Existence of Epiphyseal Fractures
522(1)
Pathoanatomic Studies of Epiphyseal Growth Plate Fracture-Separations
523(5)
Understanding of Growth Plate Fracture-Separations at the End of the Pre-radiographic Era
528(3)
Clinical Approaches to Growth Plate Fracture-Separations in the Radiographic Era
531(6)
Pathoanatomic Classifications
531(4)
Mechanistic Considerations
535(2)
Negative Sequelae of a Growth Plate Fracture-Separation
537(1)
Pathophysiologic Approaches to Growth Plate Fracture-Separations
537(19)
Pathophysiologic Classification-Shapiro
537(2)
Experimental Approaches to Growth Plate Structure, Blood Supply, and Function
539(9)
Pathogenesis of Growth Deformity
548(1)
MR Imaging in Assessment of Growth Plate Fracture-Separations
549(7)
General Clinical Profile of Growth Plate Fracture-Separations
556(4)
Overview
556(1)
Distribution of Physeal and Nonphyseal Fractures in Childhood
557(1)
Incidence of Epiphyseal Growth Plate Fracture-Separations in Males and Females
558(1)
Incidence of Epiphyseal Growth Plate Fracture-Separations at Specific Epiphyses
558(1)
Age at Occurrence of Physeal Fractures
558(1)
Distribution of Specific Salter-Harris Types per Long Bone Region
559(1)
Epiphyseal Fracture-Separations with Difficult Births
559(1)
Clinical Features of Acute Epiphyseal Fracture-Separations
560(32)
General Principles of Management
560(1)
Proximal Humerus
561(1)
Distal Humerus
562(8)
Proximal Radius
570(1)
Distal Radius
570(4)
Distal Ulna
574(1)
Metacarpals and Phalanges
574(1)
Triradiate Acetabular Cartilage
574(1)
Proximal Femur
575(1)
Distal Femur
576(6)
Proximal Tibia
582(3)
Distal Tibia
585(6)
Proximal and Distal Fibula
591(1)
Growth Patterns Following Distal Tibial and Fibular Growth Plate Fracture-Separations Using Roentgen Stereophotogrammetry
591(1)
Ligament Damage Following Distal Femoral and Proximal Tibial Physeal Fractures
592(1)
Traumatic Damage to Growth Plates by Pathologic, Chronic Repetitive, and Indirect Effects
592(4)
Pathologic Epiphyseal Growth Plate Fracture-Separations
592(2)
Premature Physeal Closure Following Seemingly Unrelated Fractures of the Ipsilateral Diaphysis and Metaphysis
594(1)
Physeal Separation Due to the Stress Injury Caused by Chronic Repetitive Activity
595(1)
Genu Recurvatum after Skeletal Traction Involving Inadvertent Placement of the Proximal Tibial K-Wire through the Tibial Tubercle-Physeal Area
596(1)
Management of Negative Sequelae of Growth Plate Fracture-Separations
596(10)
General Considerations
596(1)
Management of Early Bone Bridge Formation
596(1)
Management of Late Sequelae of Bone Bridges: Bone Bridge Excision, Physical Interposition Materials, and Transphyseal Chondrodiatasis
597(1)
References
597(9)
Lower Extremity Length Discrepancies
Terminology
606(1)
Clinically Significant Length Discrepancies
606(4)
General Guidelines Concerning Extent of Clinically Significant Length Discrepancies
606(1)
Percentage of Individuals with Equal Limb Lengths
606(2)
Clinical Effects of Lower Extremity Length Discrepancies
608(2)
Limb Length Determination
610(1)
Clinical Measurements
610(1)
Segments to Be Considered in Assessing Lower Extremity Length Discrepancies
611(1)
Radiographic and Other Imaging Documentation of Lower Extremity Length Discrepancies
611(1)
Causes of Lower Extremity Length Discrepancies
611(1)
Developmental Patterns in Lower Extremity Length Discrepancies
612(3)
Patient Population
612(3)
Classification of Developmental Patterns in Lower Extremity Length Discrepancies
615(1)
Lower Extremity Length Discrepancies in Specific Disease Entities: Pathoanatomy, Pathophysiology, Developmental Patterns, and Ranges of Discrepancies
615(38)
Congenital Limb Deficiencies
615(10)
Skeletal Dysplasias with Asymmetric Involvement
625(2)
Destroyed Physes
627(1)
Abnormal Growth Following Use of Neonatal Umbilical or Femoral Catheters
627(1)
Poliomyelitis
627(2)
Hemiparetic Cerebral Palsy
629(1)
Septic Arthritis of the Hip
630(1)
Tuberculosis
631(1)
Premature Epiphyseal Fusion at the Knee Complicating Prolonged Lower Extremity Immobilization
632(1)
Osteomyelitis
633(1)
Meningococcemia
634(1)
Physeal Damage Following Irradiation for Childhood Tumors
635(1)
Fractured Femoral Diaphysis
636(3)
Fractured Tibial Diaphysis
639(1)
Hemihypertrophy and Hemiatrophy (Anisomelia)
639(9)
Neurofibromatosis
648(1)
Juvenile Rheumatoid Arthritis
649(1)
Thalassemia
650(1)
Hemophilia
651(1)
Synovial Hemangioma of the Knee Joint
651(1)
Legg-Calve-Perthes Disease
651(1)
Slipped Capital Femoral Epiphysis
652(1)
Limb Length Discrepancies Due to External Causes
652(1)
Infantile Cortical Hyperostosis-Caffey's Disease
652(1)
Projection of Limb Length Discrepancies by the Time Skeletal Maturity is Reached
653(8)
Percentages of Growth at Each End of Major Long Bones
653(1)
Systems for Projecting Limb Length Discrepancy at Skeletal Maturation
653(6)
Discussion of Methods
659(2)
Use of the Developmental Pattern Classification in Projecting Limb Length Discrepancies
661(2)
Type I
661(1)
Type II
662(1)
Type III
662(1)
Type IV
662(1)
Type V
662(1)
Management of Lower Extremity Length Discrepancies
663(43)
General Considerations
663(1)
Procedures to Shorten the Longer Limb
663(29)
Procedures to Lengthen the Shorter Limb
692(14)
Direct Operation on Epiphyses to Enhance Growth Potential by Removing Focal Transphyseal Tethers
706(27)
Bone Bridge Resection
706(1)
Varieties of Interpositional Materials
706(1)
Treatment of Premature Physeal Closure by Means of Growth Plate Transplantation
706(9)
Comparative Studies in Experimental Animal Models of Differing Focal Physeal Implants
715(1)
Transplantation of Entire Physes and Epiphyses
715(4)
Implantation of Chondrocyte Suspensions
719(1)
Treatment of Premature Physeal Closure by Means of Physeal Distraction
719(1)
References
720(13)
Skeletal Dysplasias
Terminology
733(1)
Classification Approaches
733(5)
Prevalence of Skeletal Dysplasias
738(1)
Diagnosis of Skeletal Dysplasias
738(6)
Overview
738(2)
Prenatal Assessment
740(1)
Clinical Examination
740(3)
Radiographic Examinations
743(1)
Laboratory Studies
743(1)
Chromosome Abnormality Sites in Skeletal Dysplasias
744(1)
Genetic and Molecular Abnormalities in Skeletal Dysplasias
744(11)
Mutation Families
744(8)
Molecular Function Defects
752(2)
Phase of the Developmental Cycle in Which Abnormality Has Its Negative Effect
754(1)
Lethal Perinatal Skeletal Dysplasias
755(6)
Diagnostic Profile
755(1)
Thanatophoric Dysplasia
756(2)
Homozygous Achondroplasia
758(1)
Osteogenesis Imperfecta
759(1)
Achondrogenesis
759(1)
Hypochondrogenesis
759(1)
Atelosteogenesis
759(1)
Chondrodysplasia Punctata, Rhizomelic Form
759(1)
Campomelic Dysplasia
760(1)
Hypophosphatasia
760(1)
Short Rib Syndromes
760(1)
Asphyxiating Thoracic Dystrophy (Jeune)
761(1)
Microstructural-Morphologic Abnormalities of the Epiphyses and Metaphyses in Skeletal Dysplasias
761(8)
General Considerations
761(1)
Structure of Developing Epiphyses and Adjacent Metaphyses Including the Periphyseal Tissues of the Groove of Ranvier
761(1)
Histopathologic Classification of Skeletal Dysplasias
762(7)
Interpretation of the Pathogenesis of Skeletal Dysplasias in Relation to the Structural Approach
769(1)
Histopathologic Changes in Specific Chondrodysplasias
769(9)
Lethal Chondrodysplasias
769(4)
Histopathologic Changes in Nonlethal Chondrodysplasias
773(5)
Orthopedic Deformities in Skeletal Dysplasias-Regional Abnormalities and Their Relation to Clinically Significant Deformity
778(16)
Overview
778(1)
Cervical Spine Abnormalities
779(3)
Thoracolumbar Spine Abnormalities: Scoliosis, Kyphosis, and Kyphoscoliosis
782(1)
Lumbar Spinal Stenosis and Lumbar Lordosis
783(2)
Abnormalities of the Skull
785(1)
Abnormalities of the Clavicles
785(1)
Abnormalities of the Extremities
785(2)
Abnormalities of the Hip Region
787(3)
Knee Abnormalities
790(3)
Ankle Abnormalities
793(1)
Foot Abnormalities
794(1)
Abnormalities of the Upper Extremities
794(1)
Limb Lengthening
794(1)
Review of Specific Skeletal Dysplasias: Pathobiology, Clinical and Radiographic Characteristics, and Orthopedic Management
794(66)
Achondroplasia
794(7)
Hypochondroplasia
801(1)
Multiple Epiphyseal Dysplasia
801(2)
Dysplasia Epiphysealis Hemimelica
803(1)
Metatropic Dysplasia
804(1)
Kniest Dysplasia
804(1)
Chondrodysplasia Punctata
804(1)
Spondyloepimetaphyseal Dysplasia
804(1)
Diastrophic Dysplasia
805(2)
Spondyloepiphyseal Dysplasia
807(1)
Dyggve-Melchior-Claussen Dysplasia and Smith-McCort Dysplasia
808(1)
Pseudo-achondroplasia
808(1)
Mucopolysaccharidoses
808(4)
Metaphyseal Dysplasia
812(1)
Spondylometaphyseal Dysplasia
812(1)
Cleidocranial Dysostosis (Dysplasia)
813(1)
Hereditary Arthro-opthalmopathy (Stickler) Syndrome
813(1)
Dyschondrosteosis
813(1)
Other Mesomelic Dysplasias
813(1)
Acromesomelic Dysplasia
813(2)
Acromelic Syndromes (Acrodysplasias)
815(1)
Larsen's Syndrome
816(1)
Ollier's Disease
816(5)
Maffucci Syndrome
821(1)
Hereditary Multiple Exostoses
821(15)
Metachondromatosis
836(1)
Osteopetrosis
837(9)
Pycnodysostosis
846(1)
Osteogenesis Imperfecta
847(13)
Trichorhinophalangeal Dysplasia
860(1)
Anesthetic Implications in the Skeletal Dysplasias
860(12)
Occipital and Cervical Structural Abnormalities
861(1)
Airway Abnormalities
861(1)
Pulmonary Abnormalities
861(1)
Neurologic Abnormalities
861(1)
Abnormalities of Thermal Regulation
861(1)
Cardiac Abnormalities
861(1)
References
861(11)
Epiphyseal and Metaphyseal Involvement with Metabolic, Inflammatory, Neoplastic, Infectious, and Hematologic Disorders
Rickets
872(17)
Terminology
872(1)
Pathogenesis of Rickets
872(1)
Experimental Models of Rickets
872(2)
Pathology of Human Nutritional Vitamin D Deficiency Rickets
874(2)
Classification of Types of Rickets
876(13)
Inflammatory Disorders
889(5)
Juvenile Rheumatoid Arthritis
889(5)
Pigmented Villonodular Synovitis
894(1)
Neoplastic Disorders of Epiphyses
894(3)
Primary Involvement of Epiphyseal Regions
894(1)
Secondary Involvement of Epiphyseal Regions from Primary Metaphyseal Foci of Benign and Malignant Disorders
895(2)
Osteomyelitis and Septic Arthritis
897(12)
Primary Subacute-Chronic Epiphyseal Osteomyelitis
897(1)
Epiphyseal Osteomyelitis Secondary to Transphyseal Spread from Subacute or Chronic Metaphyseal Foci
897(1)
Acute Neonatal-Infantile Osteomyelitis and Its Damaging Effects on Epiphyses
898(7)
Summary of Effects of Epiphyseal and Metaphyseal Infection on Epiphyseal Growth
905(1)
Tuberculosis
906(3)
Hematologic Disorders
909(26)
Hemophilia
909(15)
Von Willebrand Disease
924(1)
Hemoglobinopathies: Sickle Cell Anemia and Thalassemia
925(2)
References
927(8)
Index 935

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Reviews for Pediatric Orthopedic Deformities (9780126386516)