Surgical treatment of carpal tunnel syndrome and trigger digits in children with mucopolysaccharide storage disorders
Orthopedics; Surgery; bone-marrow transplantation; hurler-syndrome; tone and motor problems; MPSI; MPSIII; MPSVI; surgical intervention; annular pulley release; partial flexor digitorum superficialis tendon resection
The role of surgical intervention for carpal tunnel syndrome (CTS) and trigger digits in children with mucopolysaccharide storage disorders (MPSDs) has not been clearly defined, particularly as the treatment of the underlying disease has advanced to include bone marrow transplantation. This study reviews our experience in the treatment of CTS and trigger digits in 22 children With MPSDs who were evaluated for CTS by electromyographic (EMG)/nerve conduction velocity (NCV) testing. Seventeen children were diagnosed with CTS by EMG/NCV testing and were treated with bilateral open surgical release with or without flexor tenosynsvectomy. The EMG/NCV testing revealed normal results in 5 patients who are subsequently being monitored. Forty-five digits in 8 children were diagnosed clinically with trigger digits. Nineteen digits were treated by annular pulley release alone. Twenty-six digits were treated by annular pulley release with partial flexor digitorum superficialis tendon resection. The average age at the time of hand surgery was 6.3 years, and at the lime of follow-up, 9.6 years. Postoperative EMG/NCV testing in 7 children showed 1 with improvement and 6 with normalization. None of the patients undergoing carpal tunnel release went on to develop thenar atrophy or absent sensibility, as has been reported in ii untreated cases. Patients were evaluated for triggering digits both by preoperative tendon palpation and by intraoperative flexor tendon excursion at the time of open carpal tunnel release. All patients undergoing trigger release had improved active digital flexion seen at the final follow-up visit. Because of the very high incidence of CTS and trigger digits in this population, the authors currently recommend routine screening of EMG/NCV for all children with MPSDs. Early surgical intervention for nerve compression and stenosing flexor tenosynovitis can maximize hand function in these children. Copyright (C) 1998 by the American Society for Surgery of the Hand.
Van Heest A E; House J; Krivit W; Walker K
Journal of Hand Surgery
1998
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/s0363-5023(98)80120-2" target="_blank" rel="noreferrer noopener">10.1016/s0363-5023(98)80120-2</a>
Temporal and spatial gait parameters in children with Cri du Chat Syndrome under single and dual task conditions
Children; Orthopedics; motor; Gait; Neurosciences & Neurology; walking; Sport Sciences; performance; concurrent task; Cri du Chat Syndrome; Dual-task; older-adults; parkinsons-disease; tone and motor problems; trajectory; characteristics
Aim: To describe temporal and spatial gait characteristics in individuals with Cri du Chat syndrome (CdCS) and to explore the effects of performing concurrent manual tasks while walking. Methods: The gait parameters of 14 participants with CdCS (mean age 10.3, range 3-20 years) and 14 age matched controls (mean age 10.1, range 3-20 years) were collected using the GAITRite (R) instrumented walkway. All participants first walked without any concurrent tasks and then performed 2 motor dual task walking conditions (pitcher and tray). Results: Individuals with CdCS took more frequent, smaller steps than controls, but, on average, had a comparable gait speed. In addition, there was a significant task by group interaction. Participants decreased gait speed, decreased cadence, decreased step length, and increased% time in double limb support under dual task conditions compared to single task conditions. However, the age-matched controls altered their gait for both manual tasks, and the participants with CdCS only altered their gait for the tray task. Interpretation: Although individuals with CdCS ambulate with a comparable gait speed to age-matched controls under single task conditions, they did not significantly alter their gait when carrying a pitcher with a cup of water inside, like controls. It is not clear whether or not individuals with CdCS had difficulty attending to task demands or had difficulty modifying their gait. (C) 2016 Elsevier B.V. All rights reserved.
Abbruzzese L D; Salazar R; Aubuchon M; Rao A K
Gait & Posture
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.gaitpost.2016.08.006" target="_blank" rel="noreferrer noopener">10.1016/j.gaitpost.2016.08.006</a>
Advances that are changing the diagnosis and treatment of malignant bone tumors
Humans; Medical Oncology; Antineoplastic Agents; Bone Neoplasms/diagnosis/etiology/secondary/therapy; Carcinoma/diagnosis/etiology/secondary/therapy; Orthopedics; Prostheses and Implants; Sarcoma/diagnosis/etiology/secondary/therapy
PURPOSE OF REVIEW: Several neoplastic conditions may affect bone. These include primary bone tumors as well as metastatic disease from distant primary sites. Often, these entities produce symptoms that may be difficult to distinguish from those of various rheumatologic entities. The purpose of this review is to discuss recent developments in orthopedic oncology, with special attention given to advances that are changing the diagnosis and treatment of bone sarcomas and carcinomas metastatic to bone. RECENT FINDINGS: Much effort in the field of musculoskeletal oncology has been dedicated to the elucidation of the molecular mechanisms underlying bone sarcomas, especially in the case of osteogenic sarcoma and Ewing family tumor. Telomere maintenance mechanisms are emerging as potential targets for anticancer therapy. The most exciting advances have been in the development of novel treatments for cancers affecting bone. The anticancer effects of bisphosphonates, cyclooxygenase-2 inhibitors, and statins may expand their indications to the treatment of primary bone tumors. Finally, new expandable implants have been developed for the treatment of bone tumors in growing children. These devices may help solve some of the problems encountered with reconstruction of the growing skeleton. SUMMARY: Recent discoveries in the molecular mechanisms of bone sarcomas may help to elucidate the pathogenesis of these rare diseases. This, combined with the recent findings of the anticancer effects of bisphosphonates, cyclooxygenase-2 inhibitors, and statins, may lead to the development of novel treatments for sarcomas of bone and of carcinomas metastatic to bone.
2005
Casas-Ganem J; Healey JH
Current Opinion In Rheumatology
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1097/01.bor.0000146608.03927.16" target="_blank" rel="noreferrer">10.1097/01.bor.0000146608.03927.16</a>