Paralytic dislocation of the hip in children.

Despite the progress made in the past decades, hip disorders are one of the most common orthopedic problems in the context of paralysis. The etiology can be congenital (malformation such as myelomeningoceles, genetic neuromuscular disorders) or acquired (cerebral palsy, post-traumatic). In these conditions, the orthopedic deformities are minimal at birth. They can develop as the child grows, at different ages, depending on the etiology, severity of the neuromuscular disorder and functional potential. Hip subluxation and dislocation can compromise standing and walking capacities, but also the quality of the seated position and the personal care. Daily life activities and participation are restricted and influence the disabled person's quality of life. Paralytic dislocation of the hip is the orthopedic deformity that has be biggest impact on day-to-day life, general health and the overall orthopedic result in adulthood. Neuro-orthopedic care is challenging. However, there are basic principles that one must know to ensure good long-term quality of life in patients suffering from paralytic dislocations of the hip. When planning the treatment strategy, it is essential to take into consideration the day-to-day life and to integrate the patient's experiences and needs, along with those of their caretakers. The objective of this review is to outline the differences in paralytic dislocations of the hip of diverse etiology, to present evaluation principles useful in daily clinical practice and to help practitioners in choosing a treatment strategy.

[Periosteum entrapped in growth plate cartilage in patients with epiphyseal fracture-separation: about a case]. / Incarcération du périoste dans le cartilage de croissance dans une fracture-décollement épiphysaire: à propos d'un cas.

Foreign body entrapment in growth plate cartilage is a rare disease. It often occurs in patients with epiphyseal separation. Its diagnosis is radiological, based on brain magnetic resonance imaging (MRI). We here report a case of a 13-year-old girl who presented with a painful left post traumatic knee. The clinical examination and the standard radiographs performed were in favor of a Salter-Harris type 1 epiphyseal detachment. The first-line treatment, which consisted of immobilization in a cast for three weeks, was unsatisfactory. Faced with this therapeutic failure, an MRI was performed and demonstrated an incarceration of a foreign body in the conjugation cartilage. Secondary management was based on surgery, without sequelae.

Multifocal Pigmented Villonodular Synovitis in the Noonan Syndrome.

Noonan-like/multiple giant cell lesion (NS/MGCL) is a rare condition overlapping with Noonan syndrome. Once thought to be a specific and separate entity, it is now suggested to be a variant of the Noonan syndrome spectrum. We report the case of an 8-year-old boy with a typical clinical picture of Noonan syndrome with a de novo germline mutation of PTPN11 (c.854 T>C). During his follow-up, the patient developed multifocal pigmented villonodular synovitis which first affected the left knee and shortly after both elbows.