Cystic transphyseal bone tuberculosis: a report of two cases.

We present two cases of tuberculosis osteomyelitis mimicking subacute osteomyelitis and treated without extensive debridement. Tuberculous osteomyelitis should be considered in the differential diagnosis of proximal tibial infections in children and early diagnosis and treatment is possible without extensive debridement.

Vascularity and histology of fetal labrum and chondrolabral junction: its relevance to chondrolabral detachment tears.

PURPOSE: Recently, acetabular labral tears were recognized as a source of hip pain. Most of these tears were found to be localized at the chondrolabral junction. The purpose of this study was to evaluate the chondrolabral junction in reference to its collagen fiber orientation and its vascularity, which might be used to explain the preponderance of labral tears. METHODS: Eighteen formalinized fetuses with a mean gestational age of 17 weeks (range: 11-24 weeks) were examined. The acetabuli were removed en bloc with the proximal femur for ease of orientation. The acetabuli were prepared and examined in four quadrants, namely, anterior, superior, posterior, and inferior. RESULTS: The staining pattern of the posteroinferior labrum was more dense than the anterosuperior labrum, due to its high collagen content. Collagen fibers in the posteroinferior quadrants were oriented perpendicularly to the chondrolabral junction, while those in the anterosuperior quadrants had a parallel oriented. Perpendicular collagen orientation and high collagen content may explain the stronger anchorage of the labrum to the bony acetabulum in posteroinferior quadrants. All of the vessels supplying the labrum originate from the capsular connective tissue and traverse the body of the labrum to reach the articular side. None of these vessels traverse the chondrolabral junction to reach the bony acetabulum. The total number of blood vessels was significantly higher in the capsular zone than in the articular zones. The number of blood vessels did not differ between the acetabular quadrants. CONCLUSIONS: In an effort to understand the chondrolabral junction tears, we can conclude that collagen content and fiber orientation may represent the histological basis for the predominance of tears at the anterosuperior region.

Congenital constriction ring syndrome with foot deformity: two case reports.

INTRODUCTION: Congenital peripheral constriction ring originating from soft tissues of the leg that is characterized with compression in the soft tissue usually involving the deep fascia surrounding the leg at the time of birth is occasionally observed in lower extremity. At the region of the constriction, fractures of tibia and fibula and foot deformities like clubfoot can be observed. CASE PRESENTATION: In our report, 6-month and 8-month old infants with congenital constriction band and ipsilateral clubfoot were presented. They were treated with multiple Z plasties for their constricting bands and Ponseti method of serial casting for their clubfoot deformities. CONCLUSION: Congenital-constricting bands can be effectively released with multiple Z plasties. Ponseti method of correcting club foots of various causes can be applied to club foot deformities accompanying constricting bands.

A previously unreported etiology of trigger toe.

Trigger toe is a rare entity, with only a few cases reported in the literature. It is usually seen in ballet dancers as a result of compression of the flexor hallucis longus tendon in the tarsal tunnel beneath the medial malleolus. We report a case of trigger toe due to a constricting lesion on the extensor hallucis longus tendon.

[A treatment algorithm for developmental dysplasia of the hip for infants 0 to 18 months of age and its prospective results]. / Gelisimsel kalça displazisinde 0-18 aylik bebekler için tedavi algoritmasi ve prospektif sonuçlarimiz.

OBJECTIVES: We evaluated the results of treatment in patients who were treated according to an algorithm established for developmental dysplasia of the hip (DDH) during the first 18 months of life. METHODS: We developed an algorithm for DDH to be used in infants at 0 to 18 months of age. Patients who did not respond to, or who did not have the indication for, the use of Pavlik harness were treated according to our algorithm and evaluated prospectively. Thirty-three hips (24 patients; 21 girls, 3 boys; mean age 7.4 months; range 2.5 to 18 months) were followed-up for a mean of 42 months (range 15 to 90 months). Ultrasonographic evaluation was performed using the Graf method. Avascular necrosis was evaluated according to the Kalamchi and MacEwen classification, and radiological results according to the Severin classification. RESULTS: The mean acetabular index angles before and after treatment were 37.3 degrees (range 20 degrees to 58 degrees ) and 21.8 degrees (range 15 degrees to 30 degrees ), respectively. According to the Kalamchi and MacEwen classification, six hips (18.2%) had type I, three hips (9.1%) had type II, and one hip (3%) had type III avascular necrosis. According to the Severin criteria, 21 hips were considered in group I, 10 in group II, and two hips in group III. Acetabular osteotomies were performed in four hips. All patients had full range of motion without any pain and limp. CONCLUSION: Successful clinical results obtained in the hips treated according to this algorithm for DDH may serve to justify its use as a standard algorithm in the treatment of infants at ages 0 to 18 months.