[Possibilities of ambulation in children with myelodysplasia]. / Mozliwosci lokomocji u dzieci z przepuklina oponowo-rdzeniowa.

The authors discuss the possibility of ambulation of children with myelodysplasia, employing different types of orthopedic devices. According to the personal experience of 23 myelodysplastic patients, the indications and results of using reciprocal gait orthoses have been described. The paper emphasizes the significance of interdisciplinary team in the treatment of this disease.

[Surgical treatment of congenital cleft foot]. / Leczenie operacyjne wrodzonego rozszczepu stopy.

Results of surgical treatment for congenital cleft foot in 3 patients (5 foot) are reported. Two foot were classified type IIIA, 1--IIIB and 2--IVB according to Blauth and Borisch. Mean age of the patients at the surgery was 97 months, mean follow-up was 39 months. Wedge resection of the metatarsals with screw fixation was followed by performing skin syndactyly in all patients. No complications occurred, all patients wear commercial shoes and are satisfied with the result of surgery.

[Melorheostosis: a case review and review of literature]. / Melorheostosis--opis przypadku i przeglad pismiennictwa.

The authors present a review of the literature and the diagnostic difficulties in a case of melorheostosis in a 6 year old boy. Melorheostosis is characterized by longitudinal foci of subcutaneous sclerosis, limitation of motion in the joints and swelling of the knee and ankle joints. Radiologically numerous foci of hyperostosis similar to wax flowing down a burning candle have been noted.

[Duplication of the lumbar spine--case report]. / Zdwojenie kregoslupa ledzwiowego (duplicatio caudalis)--opis przypadku.

A case of a child with duplicated lumbar spine and concomitant multiple defects within alimentary tract, urogenital system, deformities and pareses of lower extremities is presented. After many operations, at the age of 5 he could walk unaided for 300 meters.

[Anterior traumatic dislocation of the shoulder in children]. / Przednie urazowe zwichniecie stawu ramiennego u dzieci--opis dwóch przypadków.

The authors present two cases (two boys, aged 11.5 and 13.5 years) with traumatic dislocation of the shoulder following traffic accidents. Proper diagnostic management and closed reduction gave good final results. A review of literature on this type of dislocation, rarely seen in children is presented.

[Septic arthritis in newborns and infants. Treatment of hip arthritis]. / Ropne zapalenia stawów u noworodków i niemowlat Leczenie zapalen stawu biodrowego.

Results of treatment of 83 septic hip joints in 75 newborns and infants have been presented. Mean age at the onset of symptoms was 41 days (from 1 to 330 days), mean follow-up was 72 months (from 12 to 252). In 26 cases systemic antibiotics were administered. Single joint puncture was done in 7 cases, in 23 patients multiple puncture and intraarticular antibiotic therapy were employed, arthrotomy and drainage of the joint was performed in 27 joints. Radiographic results achieved, according to Hunk classification were as follows: Type I-26 joints, Type IIA-6 joints, Type IIB-18 joints, Type III-5 joints, Type IVA-7 joints, type IVB-8 joints, Type V13 joints. The authors conclude, that in majority of cases the treatment of choice should include arthrotomy from antero-lateral approach, suction drainage for 24-48 hours, systemic intravenous antibiotic therapy, abduction position of extremity in Frejka pillow and early physiotherapy.

Capsulorrhaphy versus capsulectomy in open reduction of the hip for developmental dysplasia.

Capsulorrhaphy and capsulectomy were prospectively compared in open reduction of the hip for developmental dysplasia. There were 39 patients: 16 capsulorrhaphy and 23 capsulectomy. Follow-up averaged 22 months postsurgery. The surgical technique included innominate osteotomy, and femoral shortening and derotation. Avascular necrosis developed in one capsulorrhaphy patient. Postoperative redislocation occurred in three capsulorrhaphy and no capsulectomy patients. Three capsulorrhaphy and three capsulectomy patients had acetabular dysplasia. Neither capsulorrhaphy nor capsulectomy produced superior hip motion at last examination.

[Septic arthritis in neonates and infants--treatment of septic arthritis in the shoulder]. / Ropne zapalenia stawów u noworodków i niemowlat--leczenie zapalen stawu ramiennego.

Results of treatment of 55 acute hematogenous arthritis of the shoulder in newborns and infants are presented. There were 14 good results, 15 fair and 26 poor ones. The authors consider arthrotomy as the most efficient mode of treatment.

[Septic arthritis in newborns and infants--the value of arthrography in diagnosis of post-inflammatory knee defects]. / Ropne zapalenia stawów u noworodków i niemowlat--wartosc artrografii w diagnostyce pozapalnych uszkodzen kolana.

Double-contrast arthrography of the knee was performed on 16 knees in 14 children, who after septic arthritis of the knee in newborn and neonatal period, showed defects of the secondary ossification centers of the femur or tibia on plain radiographs. Cartilaginous epiphysis, normal in shape and volume, was present in 11 cases. In 3 cases cartilaginous epiphysis of the femur was present, but had diminished size.

[Septic arthritis in newborns and infants--clinical epidemiology]. / Ropne zapalenia stawów u noworodków i niemowlat--epidemiologia kliniczna.

Septic arthritis in 99 newborns and 58 infants was analyzed epidemiologically. Multiple localization of septic process has been found in 37.4% of newborns and 16.0% of infants included in this study. The hip joint, knee and shoulder were affected most frequently in both groups. In 45.2% of newborns septic condition of the skin and in 37.1% otitis media was the source of infection. In infants septic arthritis was related to otitis media in 36.8%, septic condition of the skin in 23.3% and respiratory tract infection also in 23.3%. Staphylococcus aureus was the most frequent joint aspirate culture finding.

[Modified Van Nes operation for treatment of congenital proximal femoral focal deficiency]. / Zmodyfikowana operacja Van Nesa w leczeniu wrodzonego braku blizszego konca kosci udowej.

Van Nes rotation plasty was done in 5 children with congenital proximal femoral focal deficiency. Mean age at the operation was 8.7 years (range 38 months-16 years), mean follow-up was 16 months (6-30 months). In 3 children full rotation at the level of knee joint was done; in 2 cases additional rotation at the level of tibial shaft was necessary. No neural and vascular complications were observed. In all children the ankle is at the level of the knee of normal extremity. The range of flexion of the prostetic knee is between 70 degrees and 90 degrees. The review of the literature concerning the treatment of the most severe cogenital proximal femoral deficiencies is presented.

[Congenital posterior and posteromedial bowing of the tibia and fibula]. / Wrodzone tylne i tylno-przysrodkowe wygiecie kosci piszczelowej oraz kosci strazalkowej.

Five children with congenital posteromedial bowing of the tibia and fibula and 1 child with posterior bowing of the tibia and fibula have been followed-up. At the final examination age of the patients ranged from 6 months of 16 years (mean 69 months). In most of the cases the angulation had a tendency to decrease, shortening of the tibia remained constant. Pseudoarthrosis appeared in one of the children in 4th month of life at distal tibial diaphysis/metaphysis junction but healed spontaneously in 13 months time.

[Personal experience in the use of closed reduction and transcutaneous K-wire fixation for displaced supracondylar fractures of the humerus in children]. / Doswiadczenia wlasne w stosowaniu zamknietej repozycji i przezskórnego zespolenia drutami kirschnera w leczeniu przemieszczonych zlaman nadklykciowych kosci ramiennej u dzieci.

The method of closed reduction and percutaneous K-wire fixation has been used for treatment of 20 children with displaced supracondylar fracture of the humeral bone. No infection, vascular or neural complication has been observed. In all cases good clinical and radiological results have been achieved. The authors conclude the method presented above should be used as a treatment of choice for displaced supracondylar fracture of the humerus in children.

Septic arthritis of the wrist in infancy.

Seven septic wrists in six patients were examined. The average follow-up was 7 years 5 months. The ages at diagnosis ranged from 3-145 days. All patients had one or more joints infected other than the wrist. Three patients cultured organisms. Three wrists were not diagnosed at the time of infection and had no surgical treatment. Four wrists were treated with multiple aspiration. All received antibiotics for 35-48 days. On follow-up no patient complained of pain or lack of function. Combined palmarflexion and dorsiflexion was > or = 50 degrees in all wrists. Two wrists were radiographically normal, whereas five were not. Three of these five had marked distortion of anatomy.

Radial-nerve palsy associated with septic shoulder in neonates.

Four neonates presented with septic shoulders after delays in diagnosis of 7-20 days. All lacked active extension of the wrist and thumb, and three lacked active extension of the fingers. Two had positive cultures for Staphylococcus aureus, and one had a positive Escherichia coli culture. Surgical treatment was one single aspiration and three arthrotomies. Recovery of extension began in 10-21 days and was normal at 18-35 days post-treatment. At follow-up 9-13 months later, all limbs were neurologically normal. Cadaver dissections showed that the radial nerve passed close to the shoulder joint, and when the capsule was distended, it impinged on the nerve.

[Surgical treatment of post-injection contracture of the hip in children]. / Leczenie operacyjne poiniekcyjnych przykurczy stawu biodrowego u dzieci.

Abduction contracture of the hip has been treated by two methods; the results of both have been compared. Modified Campbell's procedure has been performed in 5 children (6 hips). In 8 patients (9 hips) gluteal fascia and fibrotic scarring within the gluteal muscles has been transversely dissected. The mean follow-up was 26 months in either group. Dissection of the fascia and the scars resulted in doubled range of adduction and better cosmetic result compared to Campbell's method.

[Chronic recurrent multifocal osteomyelitis--personal experience]. / Przewlekle nawracajace wieloogniskowe zapalenie kosci--doswiadczenia wlasne.

Chronic recurrent multifocal osteomyelitis is a rare entity with obscure etiology. A review of literature concerning clinical appearance, diagnostics and management of this condition is presented. Own material embraces a group of 7 children who have chronic recurrent multifocal osteomyelitis. Mean follow-up was 2.5 years. On the basis of results achieved the authors believe this condition is of good prognosis and should be differentiated with chronic osteomyelitis and neoplastic changes.

Sequelae from septic arthritis of the knee during the first two years of life.

Fifty septic knees in patients younger than 2 years old at diagnosis were examined. Follow-up ranged from 1.1 to 21.3 years (average, 6.2). Twenty-four knees were deformed in varus or valgus of 5-40 degrees. Deformity was present within 10 months of infection and thereafter was stable. It was due to displacement of the epiphysis into a metaphyseal defect, loss of epiphyseal cartilage, or both. Growth did not compensate for deformity. Ossific nuclei partly or completely disappeared after infection. They were slow to reappear, and until maturity, their size and shape did not represent the cartilaginous epiphysis. Arthrograms were necessary to evaluate accurately the epiphyseal shape and volume.

Septic arthritis of the shoulder during the first 18 months of life.

Forty-six septic shoulders in 42 patients < 18 months old at diagnosis were followed for an average of 6 +/- 10 years. Eight were not diagnosed at the time of infection. Five patients complained of intermittent, mild pain with use. All could touch their mouth and back of their head with the hand on their affected side. Flexion and abduction averaged 150 degrees; internal and external rotation averaged 60 degrees. Nineteen percent of the shoulders had < 130 degrees of flexion. Discrepancy in humeral length was 0-9 cm (average 2.4 cm). Only 7% of the humeral heads were entirely normal. The shapes of the remainder were quite variable, and range of motion could not be predicted from these shapes.

[Orthopedic problems in children after surgical treatment for lipoma of the conus medullaris]. / Problemy ortopedyczne u dzieci po leczeniu operacyjnym tluszczaków stozka rdzeniowego.

Deformities locomotor system in 24 children who have been operated on because of lipoma of conus medullaris are presented. At follow-up examination 6 patients were deformity free. The remaining group had feet deformities either present at birth or developed on average in 19th month of life. They mostly progressed and tended to recur after surgical correction. Trophic skin ulcer or chronic osteomyelitis of the foot was present in 30% of children; in 17% of cases they induced amputation. In 60% of cases scoliosis was found with mean angle of 10.2 degrees.