Journal of Pediatric Orthopaedics B 

About: Journal of Pediatric Orthopaedics B is an academic journal published by Wolters Kluwer. The journal publishes majorly in the area(s): Medicine & Deformity. It has an ISSN identifier of 1060-152X. Over the lifetime, 2652 publications have been published receiving 40224 citations. The journal is also known as: Journal of Pediatric Orthopaedics. Part B & Journal of pediatric orthopedics. Part B.

Classification of clubfoot.

Abstract: Clubfeet must be classified according to severity to obtain reference points, assess the efficacy of orthopaedic treatment, and analyze the operative results objectively. A scale of 0-20 was established on the basis of four essential parameters: equinus in the sagittal plane, varus deviation in the frontal plane and derotation around the talus of the calcaneo-forefoot (CFF) block and adduction of forefoot on hindfoot in the horizontal plane. Four grades of clubfeet can be individualized: (a) Benign feet so-called "soft-soft feet," grade I, similar to postural feet, with a score of 5 to 1 (these mild feet must be excluded from any statistics as they tend to increase good results); (b) moderate feet, so-called "soft > stiff feet," grade II (reducible but partly resistant, with a score of 5-10); (c) severe feet, so-called "stiff > soft feet," grade III (resistant but partly reducible, with a score of 10-15); and (d) very severe, pseudoarthrogryposic feet, so-called "stiff-stiff feet," grade IV (score of 15-20 points). To avoid risks of errors, our method is based on a very complete checklist and on diagrams. Our training material inculdes an audiovisual package.

Epidemiology of children's fractures

Abstract: Fractures constitute 10% to 25% of all pediatric injuries and are more common in boys than in girls, and after age 13 or 14 years are twice as common. The results from an epidemiologic study in Malmo indicate that a child's risk of sustaining a fracture is 42% in boys and 27% in girls from birth to age 16 years. Fractures of the distal end of the radius are the most common injury, followed by fractures of the phalanges of the hand. From 1950 to 1979 there was a twofold increase in the risk of fracture, due to an increase in light-energy trauma, mainly sporting activities. Since the end of the 1970s there has been no further increase in the fracture risk. The data also indicate that preventive measures have been effective in decreasing severe accidents.

An update on the treatment of gait problems in cerebral palsy.

Abstract: This article summarizes our experience with cerebral palsy over the past 20 years. The primary and secondary deformities that occur with cerebral palsy are described. Following this, there is a brief overview of the nature and role of gait analysis in the treatment of gait problems in cerebral palsy. The concept of lever-arm dysfunction is introduced. Our current treatment algorithm is then presented along with a brief discussion of our current treatment program, which is illustrated by a case example. Finally, a brief study of a group of patients with spastic diplegia or quadriplegia is presented to illustrate our current method of evaluating treatment outcomes and the need for team management in the treatment of this complex condition.

Osteochondritis dissecans : a multicenter study of the European Pediatric Orthopedic Society

Abstract: To assess of the value of conservative and operative treatment of osteochondritis dissecans of the knee, a multicenter study was performed. In 12 European countries, 798 cases of osteochondritis of the knee have been collected from 44 hospitals. Results were based on 452 patients with 509 affected knees with minimum follow-up was 1 year (mean follow-up, 3 years and 11 months) and sufficient data for evaluation: 61% were male patients; 39% female patients; 318 affected knees were found in juvenile patients; 191 affected knees were in adult or premature patients. The localization was the medial femoral condyle on the lateral side in 51% (typical site) of patients. Various other sites were involved. Of the 509 affected knees, 154 were treated conservatively, 355 were treated surgically (many with multiple operations). For evaluation, the initial situation (at the time of the diagnosis) was favorable in 198 patients (no effusion, diameter of the lesion < 20 mm and no gross dissection on imaging) and unfavorable (one of the parameters did not meet these prerequisites) in 311 patients. The results were better in young patients than in adult patients. However, in the adolescent group, 22% of patients had abnormal knee at follow-up. The classical localization has a better prognosis than an unusual one. Patients with a favorable situation at diagnosis have significantly better results after conservative treatment than those who have undergone operation. When there are signs of dissection, the results are better after operative than after conservative treatment.

Arthrogryposis multiplex congenita: etiology, genetics, classification, diagnostic approach, and general aspects.

Abstract: Arthrogryposis is a sign associated with many specific conditions and syndromes. It is a term used to describe the presence of multiple joint contractures that are present at birth. It can be seen in isolation or in association with other congenital abnormalities as part of a syndrome with or without central nervous system involvement. The exact pathogenesis of arthrogryposis is unknown, but all involve fetal akinesia (decreased fetal movement) with subsequent joint contractures. In this article I describe the causes, genetic aspects, classification, and approach to diagnosis.