[A solitary osteochondroma of the scapula: Uncommon location for a common tumor]. / Osteocondroma solitario de la escápula: localización poco habitual para un tumor frecuente.

Osteochondroma is a benign bone tumor that usually affects children and young adults. It is typically located in the metaphysis of long bones around the knee, although it could also affect flat bones like scapula. We report the case of a 11-year-old child with one year of evolution painful tumor at the dorsal surface of the scapula. He was diagnosed with osteochondroma of the scapula, uncommon location for this tumor. Due to the persistence of the symptomatology surgical excision was performed.

El osteocondroma es un tumor óseo benigno que afecta, en general, a niños y adultos jóvenes. Se localiza habitualmente en las metáfisis de los huesos largos alrededor de la rodilla, aunque también puede afectar a huesos planos como la escápula. Se presenta el caso clínico de un niño de 11 años con tumoración dolorosa en la superficie dorsal de la escápula de un año de evolución. Se diagnostica un osteocondroma escapular, localización poco frecuente para este tumor. Debido a la persistencia de la sintomatología, se realizó exéresis quirúrgica.

Osteocondroma solitario de la escápula: localización poco habitual para un tumor frecuente / A solitary osteochondroma of the scapula: Uncommon location for a common tumor

El osteocondroma es un tumor óseo benigno que afecta, en general, a niños y adultos jóvenes. Se localiza habitualmente en las metáfisis de los huesos largos alrededor de la rodilla, aunque también puede afectar a huesos planos como la escápula.Se presenta el caso clínico de un niño de 11 años con tumoración dolorosa en la superficie dorsal de la escápula de un año de evolución. Se diagnostica un osteocondroma escapular, localización poco frecuente para este tumor. Debido a la persistencia de la sintomatología, se realizó exéresis quirúrgica

Osteochondroma is a benign bone tumor that usually affects children and young adults. It is typically located in the metaphysis of long bones around the knee, although it could also affect flat bones like scapula. We report the case of a 11-year-old child with one year of evolution painful tumor at the dorsal surface of the scapula. He was diagnosed with osteochondroma of the scapula, uncommon location for this tumor. Due to the persistence of the symptomatology surgical excision was performed.

Tratamiento de las malformaciones en extremidades en el síndrome de bridas amnióticas: a propósito de un caso / Amniotic band syndrome: management of skeletal limb abnormalities. A case report

El síndrome de bridas amnióticas es un complejo de anomalías congénitas causadas por la rotura prematura del amnios, por lo que se originan bandas fibrosas que comprimen determinadas regiones del feto. Afecta a entre 1:1200 y 1:15 000 recién nacidos vivos según las series consultadas.La clínica típica consiste en alteraciones en las extremidades (anillos de constricción, amputaciones asimétricas más o menos distales, sindactilias y pie zambo), y se han descrito alteraciones toracoabdominales o faciales. Recientes trabajos han demostrado la utilidad del método de Ponseti en el tratamiento del pie zambo asociado al síndrome de bridas amnióticas. Se presenta el caso de un recién nacido que padecía un síndrome de bridas amnióticas y se ahonda en el manejo y la resolución quirúrgica de las malformaciones en las extremidades. En especial, se analiza la utilización del método de Ponseti en el tratamiento del pie zambo congénito sindrómic

Amniotic band syndrome consists in a group of congenital abnormalities caused by strands of the amniotic sac that entangle some parts of the fetus. Those strands result from premature rupture of amnios. The incidence of amniotic band syndrome is 1:1200 to 1:15,000 live births, depending on case studies.Mostly affected parts of fetus are limbs (asymmetric amputations, syndactyly and clubbed foot) but facial and thoracoabdominal abnormalities have also been described.Recent works have proved the utility of Ponseti method to treat clubfoot associated with amniotic band syndrome. We report the case of a newborn with amniotic band syndrome focusing on management and surgical repair of limbs deformities. Especially, we highlight the use of Ponseti method in treatment of syndromic clubfoot

[Amniotic band syndrome: management of skeletal limb abnormalities. A case report]. / Tratamiento de las malformaciones en extremidades en el síndrome de bridas amnióticas: a propósito de un caso.

Amniotic band syndrome consists in a group of congenital abnormalities caused by strands of the amniotic sac that entangle some parts of the fetus. Those strands result from premature rupture of amnios. The incidence of amniotic band syndrome is 1:1200 to 1:15,000 live births, depending on case studies. Mostly affected parts of fetus are limbs (asymmetric amputations, syndactyly and clubbed foot) but facial and thoracoabdominal abnormalities have also been described. Recent works have proved the utility of Ponseti method to treat clubfoot associated with amniotic band syndrome. We report the case of a newborn with amniotic band syndrome focusing on management and surgical repair of limbs deformities. Especially, we highlight the use of Ponseti method in treatment of syndromic clubfoot.

El síndrome de bridas amnióticas es un complejo de anomalías congénitas causadas por la rotura prematura del amnios, por lo que se originan bandas fibrosas que comprimen determinadas regiones del feto. Afecta a entre 1:1200 y 1:15 000 recién nacidos vivos según las series consultadas. La clínica típica consiste en alteraciones en las extremidades (anillos de constricción, amputaciones asimétricas más o menos distales, sindactilias y pie zambo), y se han descrito alteraciones toracoabdominales o faciales. Recientes trabajos han demostrado la utilidad del método de Ponseti en el tratamiento del pie zambo asociado al síndrome de bridas amnióticas. Se presenta el caso de un recién nacido que padecía un síndrome de bridas amnióticas y se ahonda en el manejo y la resolución quirúrgica de las malformaciones en las extremidades. En especial, se analiza la utilización del método de Ponseti en el tratamiento del pie zambo congénito sindrómico.

Osteocondromatosis sinovial de rodilla: una causa infrecuente de gonalgia en edad pediátrica / Synovial chondromatosis of the knee. A rare cause of knee pain in pediatric age

La osteocondromatosis sinovial es una metaplasia benigna de la membrana sinovial que afecta a 1 de cada 100 000 personas, en su mayoría adultos, y es extremadamente infrecuente en edad pediátrica. Predomina en grandes articulaciones, sobre todo la rodilla, y la sintomatología es, por lo general, inespecífica. Dado que la radiografía simple no suele ser concluyente, se recurre a la resonancia magnética nuclear y a la tomografía axial computarizada para orientar el diagnóstico. Se expone el caso de una paciente de 10 años de edad con gonalgia y dismorfia en la patela izquierda de seis meses de evolución, con diagnóstico de osteocondromatosis sinovial. Se presenta el caso dado que se trata de una entidad muy rara en niños, pero que requiere un tratamiento quirúrgico precoz para evitar sus posibles complicaciones, como la destrucción articular progresiva o la malignización a condrosarcoma.

Synovial osteochondromatosis consists of a synovial metaplasia which affects 1 per 100 000 people. It is a very rare disease among children. It typically affects large joints of the body, especially the knee. Due to the lack of specificity of the signs and symptoms and X-Ray images, imaging tests such as nuclear magnetic resonance or computerized tomography are frequently needed for diagnosis.We report a case of a ten-year-old female patient with a six months history of pain and deformity of left patella which was diagnosed with synovial osteochondromatosis. This case highlights the importance of clinical suspicion, not only because it is an extremely rare disease in children, but also because it needs a surgical treatment as soon as possible in order to avoid consequences it might have in pediatric age, as joint destruction or malignization to chondrosarcoma.

[Synovial chondromatosis of the knee. A rare cause of knee pain in pediatric age]. / Osteocondromatosis sinovial de rodilla: una causa infrecuente de gonalgia en edad pediátrica.

Synovial osteochondromatosis consists of a synovial metaplasia which affects 1 per 100 000 people. It is a very rare disease among children. It typically affects large joints of the body, especially the knee. Due to the lack of specificity of the signs and symptoms and X-Ray images, imaging tests such as nuclear magnetic resonance or computerized tomography are frequently needed for diagnosis. We report a case of a ten-year-old female patient with a six months history of pain and deformity of left patella which was diagnosed with synovial osteochondromatosis. This case highlights the importance of clinical suspicion, not only because it is an extremely rare disease in children, but also because it needs a surgical treatment as soon as possible in order to avoid consequences it might have in pediatric age, as joint destruction or malignization to chondrosarcoma.

La osteocondromatosis sinovial es una metaplasia benigna de la membrana sinovial que afecta a 1 de cada 100 000 personas, en su mayoría adultos, y es extremadamente infrecuente en edad pediátrica. Predomina en grandes articulaciones, sobre todo la rodilla, y la sintomatología es, por lo general, inespecífica. Dado que la radiografía simple no suele ser concluyente, se recurre a la resonancia magnética nuclear y a la tomografía axial computarizada para orientar el diagnóstico. Se expone el caso de una paciente de 10 años de edad con gonalgia y dismorfia en la patela izquierda de seis meses de evolución, con diagnóstico de osteocondromatosis sinovial. Se presenta el caso dado que se trata de una entidad muy rara en niños, pero que requiere un tratamiento quirúrgico precoz para evitar sus posibles complicaciones, como la destrucción articular progresiva o la malignización a condrosarcoma.

Diagnóstico, tratamiento y cuidados de la displasia de desarrollo de cadera. Nuestra experiencia y resultados en 36 pacientes pediátricos / Diagnosis, treatment and care of developmental dysplasia of the hip: experience and results in 36 pediatric patients

Introducción. La displasia de desarrollo de cadera (DDC) es una patología que abarca desde una sutil displasia acetabular hasta luxaciones de cadera irreductibles. Ampliar el conocimiento sobre la DDC y sus posibilidades terapéuticas puede mejorar los cuidados de estos niños. Para ello, se aporta nuestra experiencia en el complicado cuidado de estos pacientes en nuestro centro hospitalario. Material y métodos. Se realizó un estudio descriptivo retrospectivo mediante la revisión de las historias clínicas de 36 pacientes diagnosticados de DDC y se recogieron datos epidemiológicos, antecedentes personales, clínicos de la exploración física y pruebas complementarias, tipo de tratamiento, complicaciones y resultados. Resultados. La DDC fue más frecuente en niñas (94 %) y la edad media al diagnóstico fue de 15 semanas de vida. Un 61 % se trató de forma conservadora, mientras que el resto requirió cirugía. Las complicaciones más frecuentes del arnés de Pavlik fueron debidas al roce con los tirantes. Hubo dos casos de necrosis avascular de cadera. Las complicaciones más frecuentes de la tracción percutánea y el yeso pelvipédico fueron dermatológicas. En la reducción abierta fue la fiebre y la anemia. Discusión. El tratamiento de la DDC es multidisciplinar e implica la colaboración de distintos profesionales sanitarios. Son precisas un gran número de intervenciones enfermeras en el cuidado de estos pacientes. Conclusiones. Los enfermeros tienen un papel significativo en el cuidado de estos pacientes y es fundamental su asesoramiento y apoyo a los padres de estos niños en tratamiento (AU)

Introduction. Developmental dysplasia of the hip (DDH) includes a wide spectrum of pathologic conditions, ranging from subtle acetabular dysplasia to irreductible hip dislocations. Expanding knowledge about DDH and its therapeutic possibilities can improve care for pediatric patients. We therefore provide our experience in the complicated care of these patients in our hospital. Method. A restrospective descriptive study was performed by means of the review of clinical records of 36 patients diagnosed with DDH. Epidemiological data, medical history, physical examination and additional tests, treatment modalities, complications and results were collected. Results. DDH was more common in girls (94 %) and the mean age at diagnosis was 15-weeks-old babies. 61 % of the cases were treated conservatively, and the rest of the patients were treated by means of surgery. In the case of Pavlik Harness, complications were more frequent due to friction with straps. There were two cases of avascular necrosis of the hip. In cases of percutaneous traction and closed reduction with spica cast, the most frequent complication was dermatological. In the case of open reduction, fever and anemia were the most common complications. Discusion. The treatment of DDH is multidisciplinary and involves the collaboration of different health professionals. A large number of nursing interventions are required in the care of these patients. Conclusions. Nurses have a significant role in the care of DDH patients. Their advise and support of these children’s parents during treatment is essential (AU)

Correlation between Topographic Parameters Obtained by Back Surface Topography Based on Structured Light and Radiographic Variables in the Assessment of Back Morphology in Young Patients with Idiopathic Scoliosis.

STUDY DESIGN: Optical cross-sectional study. PURPOSE: To study the correlation between asymmetry of the back (measured by means of surface topography) and deformity of the spine (quantified by the Cobb angle). OVERVIEW OF LITERATURE: The Cobb angle is considered the gold standard in diagnosis and follow-up of scoliosis but does not correctly characterize the three-dimensional deformity of scoliosis. Furthermore, the exposure to ionizing radiation may cause harmful effects particularly during the growth stage, including breast cancer and other tumors. METHODS: Patients aged 13.15±1.96 years (range, 7-17 years; n=88) with Cobb angle greater than 10° were evaluated with X-rays and our back surface topography method through three variables: axial plane (DHOPI), coronal plane (POTSI), and profile plane (PC). Pearson's correlation was applied to determine the correlation between topographic and radiographic variables. One-way analysis of variance and Bonferroni correction were used to compare groups with different grades of scoliosis. Significance was set at p<0.01 and, in some cases, at p<0.05. RESULTS: We detected a positive, statistically significant correlation between Cobb angle with DHOPI (r=0.810) and POTSI (r=0.629) and between PC variables with thoracic kyphosis angle (r=0.453) and lordosis lumbar angle (r=0.275). In addition, we found statistically significant differences for DHOPI and POTSI variables according to the grade of scoliosis. CONCLUSIONS: Although the back surface topography method cannot substitute for radiographs in the diagnosis of scoliosis, correlations between radiographic and topographic parameters suggest that it offers additional quantitative data that may complement radiologic study.

Clinical application of back surface topography by means of structured light in the screening of idiopathic scoliosis.

We present the results of the clinical validity in the screening of idiopathic scoliosis with a nonharming method of back surface topography by means of structured light projection. A total of 155 patients were evaluated (mean age 13.3 years). They were divided into two groups: pathologic patients (scoliosis) and nonpathologic patients (control and asymmetries). An analytical case-control study was carried out. Our topographic method obtained 92% sensitivity and 74% specificity as a screening test in identifying patients with scoliosis (P=0.05). We could quantify the vertebral deformity of scoliosis in the three spatial planes by means of three topographic variables, Horizontal Plane Deformity Index, Posterior Trunk Symmetry Index and Columnar Profile, and to elaborate a combined screening algorithm with good reliability parameters.

Quantification of topographic changes in the surface of back of young patients monitored for idiopathic scoliosis: correlation with radiographic variables.

Idiopathic scoliosis requires a close follow-up while the patient is skeletally immature to detect early progression. Patients who are monitored by radiographs are exposed to high doses of ionizing radiation. The purpose of this study is to evaluate if an optic noninvasive method of back surface topography based on structured light would be clinically useful in the follow-up of young patients with idiopathic scoliosis. This could reduce the number of radiographs made on these children. Thirty-one patients with idiopathic scoliosis were submitted twice to radiograph and our topographic method at intervals of 6 months to 1 year. Three topographical variables were applied horizontal plane deformity index (DHOPI), posterior trunk symmetry index (POTSI), and columnar profile (PC). A statistically significant correlation was found between variations of Cobb angle with DHOPI (r=0.720, p<0.01) and POTSI (r=0.753, p<0.01) during the monitoring period. Hence, this topographic method could be useful in clinical practice as an objective adjuvant tool in routine follow-up of scoliosis.

Lesion de Monteggia equivalente de presentacion tardia en una nina de 6 anos. A proposito de un caso / Late equivalent Monteggia injury in a 6-year-old girl: a case report

Las lesiones de Monteggia en los niños pueden pasar desapercibidas con facilidad, sobre todo, las variantes equivalentes. Es importante su diagnóstico y tratamiento precoces para evitar una cronificación de la lesión y, por lo tanto, una secuela funcional y cosmética, cuyo tratamiento es controvertido y puede conllevar graves complicaciones. Se presenta un caso poco frecuente de lesión de Monteggia equivalente en una niña de 6 años, que consiste en una deformidad plástica del cúbito proximal con un desplazamiento posterolateral de la cabeza del radio. Se trató al mes de la lesión mediante una reducción cerrada de la cabeza del radio, asociada a una osteotomía dorsal en cuña de cierre y extensora de unos 2 mm del cúbito proximal; se obtuvo un buen resultado.

Monteggia injuries in children can be missed easily, especially the equivalent variants. Early diagnosis and treatment are important to prevent chronicity of the injury, because treatment is controversial and it can cause serious complications. A rare case of Monteggia equivalent lesion in a 6-year-old girl is presented. It consists of a plastic deformity of the proximal ulna with posterolateral displacement of radio head. Patient was successfully treated with a closed reduction of radial head and a dorsal closing-wedge osteotomy (2 mm wedge) of the proximal ulna, one month after injury, with good results.