Pediatric Orthopaedic Consults From Chiropractic Care.

Alternative medicine in pediatrics is expanding, with chiropractic now a common choice for families seeking alternative medical care. Currently, there is sparse information in the literature exploring the role of chiropractic in orthopaedic pathology. The objective of this case series is to present pediatric patients who received treatment from chiropractors and orthopaedic physicians as well as to review the respective existing research. Data collected included chiropractic diagnosis, orthopaedic diagnosis, imaging studies, treatments, and complications. Twenty-three patients were studied. Scoliosis, Legg-Calvé-Perthes disease, developmental dysplasia of the hip, cerebral palsy, skeletal dysplasia, and slipped capital femoral epiphysis were diagnoses included. Children had multiple sessions of chiropractic for management of these conditions. The parents' perception for chiropractic was positive in every case. Delayed referral, misdiagnosis, adverse events from manipulative therapy, and ineffective treatments were observed in the present study. More research is indicated to validate chiropractic in children with orthopaedic pathology. (Journal of Surgical Orthopaedic Advances 27(1):58-63, 2018).

Displasias óseas: a propósito de una historia familiar / Bone dysplasias: a presentaion of a family history

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A further case of opsismodysplasia with hydrocephalus.

We present a case of opsismodysplasia, a very rare skeletal dysplasia, in a term newborn female who had short length, short extremities and markedly short fingers. Radiological studies demonstrated severe platyspondyly, absence of epiphyseal ossification centers, short tubular bones, especially severe in hands and feet, with metaphyseal cupping. She also had hydrocephaly, a rare finding in opsismodysplasia. In our literature review we have found 24 cases, 17 born alive and seven terminations of pregnancy (TOPs).

Ocular findings of Beals syndrome.

BACKGROUND: In this report of two Okinawan patients with Beals syndrome and accompanying ocular complications, the symptoms of Beals syndrome and Marfan syndrome are compared. The etiology of these two syndromes is considered in relation to fibrillin. CASES: Case 1 was a 5-year-old boy who showed blue sclera and bilateral enlargement of optic disc cupping. Case 2 was a 24-year-old man who had partial coloboma of the lens, mild cataract, and bilateral glaucomatous disc cupping. OBSERVATIONS: Beals syndrome was diagnosed in these two patients based on the initial examination. In further investigations, while the patients were being observed without treatment, the intra ocular pressure of both patients remained within normal range. Funduscopy showed that the cup-to-disc ratio was 0.8 bilaterally in both patients. Case 1 was followed up for 6 years with no changes. Ultrasound biomicroscopy examination in case 2 revealed hypoplasia of the ciliary body, leading to a diagnosis of glaucoma. This patient remains under observation. CONCLUSIONS: Two cases of Beals syndrome with ocular complications including glaucomatous optic disc cupping are reported. Ophthalmic examinations are recommended to identify the ocular complications of Beals syndrome. Further studies are needed to elucidate the relation between fibrillin abnormality and ocular complications in Beals syndrome.

Effect of hyperbaric oxygenation on femoral head osteonecrosis in spontaneously hypertensive rats.

We investigated the effects of hyperbaric oxygenation (HBO) on ischemic osteonecrosis and on ossification disturbance of the femoral heads in growing, spontaneously hypertensive rats (SHR). 10 male SHRs aged 5 weeks (Group A) and another 10 male SHRs aged 8 weeks (Group B) were treated with HBO at 2.8 atmosphere absolute (ATA) for 6 weeks in a total of 30 hours. The control animals, 10 male SHRs (Group C) and 10 male wistar Kyoto rats (WKY, Group D), were kept under normal laboratory conditions. All the rats were killed at the age of 17 weeks for microscopic examination. In Group A, there was no evidence of osteonecrosis, and only 2 femoral heads with ossification disturbance were observed. In Group B, there were 2 femoral heads with osteonecrosis and 1 with ossification disturbance. In contrast, there were 6 femoral heads with osteonecrosis and 4 with ossification disturbance in Group C. It was concluded that HBO prevented osteonecrosis and ossification disturbance of the femoral heads in SHR.

[A rare bone disease, but one not to be ignored: osteopathia striata]. / Une affection osseuse rare, mais à ne pas méconnaître: l'ostéopathie striée.

A case of osteopathia striata is reported, and this rare bone dysplasia reviewed. Normally asymptomatic, diagnosis of the disorder depends upon the finding of characteristic bone striation on radiological examination. A rarely isolated lesion, osteopathia striata is generally associated with other affections, which require systematic investigation in cases demonstrating typical radiological anomalies.