Spontaneous resolution of a solitary osteochondroma of the distal femur: a case report and review of the literature.

Osteochondromata are common, benign tumours mainly affecting long-bone metaphyses. They comprise 35% of all primary benign bone tumours and 8% of all bone tumours overall, although their true incidence is unknown as many remain undiagnosed. They can cause multiple symptoms including pain and referral for excision is not uncommon. What is less recognized is their potential for spontaneous regression, a phenomenon that renders excision surgery, with its potential risks, unnecessary. We present an illustrated case of a spontaneously resolved, solitary osteochondroma in a young male, highlighting that solitary osteochondromata can actually resolve and in the asymptomatic child, a period of watchful waiting can be an appropriate option, avoiding a potentially unnecessary surgical excision with recognized complications.

Treatment of deformational plagiocephaly and torticollis using a weight distribution ring: a report of three cases.

Plagiocephaly, from the Greek 'plagios' (slanting) and 'kephale' (head), refers to a condition of an infant's head deformation by forces acting upon a malleable cranium. Marked plagiocephaly causes distress and stigma towards the baby and their family and has knock-on effects with craniofacial abnormalities, visual-field defects and delay in motor skills, and may also cause developmental difficulties. Current treatment methods have multiple drawbacks. This small, illustrated case series presents a novel, cost-effective, practical first-line treatment using a horseshoe-shaped gel head ring to redistribute pressure, allowing uniform growth and reshaping. Our early experience suggests that this method represents an effective treatment option with promising results so far.

The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy.

An interdisciplinary European group of clinical experts in the field of movement disorders and experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). A problem-orientated approach was used focussing on both published and practice-based evidence. In part I of the consensus the authors have tabulated the supporting evidence to produce a concise but comprehensive information base, pooling data and experience from 36 institutions in 9 European countries which involves more than 10,000 patients and over 45,000 treatment sessions during a period of more than 280 treatment years. In part II of the consensus the Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) based Motor Development Curves have been expanded to provide a graphical framework on how to treat the motor disorders in children with CP. This graph is named "CP(Graph) Treatment Modalities - Gross Motor Function" and is intended to facilitate communication between parents, therapists and medical doctors concerning (1) achievable motor function, (2) realistic goal-setting and (3) treatment perspectives for children with CP. The updated European consensus 2009 summarises the current understanding regarding an integrated, multidisciplinary treatment approach using Botulinum toxin for the treatment of children with CP.