Prediction of Radial Head Subluxation and Dislocation in Patients with Multiple Hereditary Exostoses
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My Approach to Spinal Stenosis in Achondroplasia
As I treat individuals with Achondroplasia from around the world and of all ages, spinal stenosis with its inherent pain, weakness and eventual bladder and bowel dysfunction, is the most common complaint and reason for disability that I see. From an eight-year-old boy living in constant pain who could not sit to a 60 year old woman who can no longer walk in her house, spinal stenosis impacts all ages, in Achondroplasia. IT IS PREVENTABLE AND TREATABLE .
Yearly examinations and discussions of symptoms are required. If symptoms are occurring, even mild, an MRI will demonstrate the extent and location of the spinal compression. Surgery to decompress the stenosis to unroof the compression is often curative.
Fusion is necessary if the decompression requires removal of the joints or if there is kyphosis (hunch back) as often encountered in Achondroplasia. I often hear, "OH not a fusion- that is terrible". Completely untrue- when performed correctly and for the right indications, it allows the individuals to return to normal. It is not simple and recovery but it is often the only way to avoid ending up with a terrible spinal deformity after decompression. In order to enhance the fusion, I now do a minimally invasive side surgery at the same time at the lowest level to assure fusion, which is a problem when so much bone is removed to decompress. To decompress I utilize an ultrasonic scalpel which is more accurate, safer and involves much less blood loss.
Below is a questionnaire that we administer to all of our Achondroplastic patients and none of us at the Paley Institute would lengthen a patient until their spine is cleared.
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Novel Approach to Improving Knee Range of Motion in Arthrogryposis with a New Working Classification
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Anatomic Relationship of the Femoral Neurovascular Bundle in Patients With Congenital Femoral Deficiency
Congenital femoral deficiency (CFD) is a rare condition that affects the morphology of the hip and surrounding soft tissues. Bony deformity and distorted muscular anatomy are well known, but no studies have described the relationship of the femoral neurovascular (NV) bundle to surgically relevant anatomic landmarks. The authors compared the location of the femoral NV bundleontheaffectedsidein patientswithCFDwith theunaffected side.
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Legg-Calvé-Perthes Disease
Provides a comprehensive, evidence-based discussion of all aspects of LCPD, including assessment and treatment
Takes a well-balanced approach toward all treatment methods, including trends and controversies
Written by experts in the treatment of LCPD
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A Predictive Risk Index for 30-day Readmissions Following Surgical Treatment of Pediatric Scoliosis
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A Randomized Clinical Trial Comparing Intralesional Bone Marrow and Steroid Injections for Simple Bone Cysts
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Accuracy of Correction of Tibia Vara
Acute Versus Gradual Correction
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Articulated Hip Distraction
A Treatment Option for Femoral Head Avascular Necrosis in Adolescence
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Calculation of rotational deformity in pediatricsupracondylar humerus fractures
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Costs and complications of increased length of stay followingadolescent idiopathic scoliosis surgery
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Current Practice in the Management of SlippedCapital Femoral Epiphysis
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Distraction Osteogenesis of the Fibula to Correct Ankle Valgus in Multiple Hereditary Exostoses
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Early complications encountered using a self-lengtheningintramedullary nail for the correction of limb length inequality
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Evaluation of an Algorithmic Approachto Pediatric Back Pain
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Interobserver and intraobserver reliability of radiographicevidence of bone healing at osteotomy sites
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Interobserver and Intraobserver Reliability in Lower-Limb
Deformity Correction Measurements
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Intra-Articular Osteotomy for Genu Valgum in theKnee with a Lateral Compartment Deficiency
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Limited atlantooccipital and cervical range of motionin patients with familial dysautonomia
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Femoral Deformity Correction in Children and Young AdultsUsing Taylor Spatial Frame
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Outcomes analysis after routine removal of implantsin healthy pediatric patients
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Peripheral Arthropathy in Hereditary Sensory andAutonomic Neuropathy Types III and IV
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Not All Hip Dysplasias are the Same: Preoperative CTVersion Study and the Need for Reverse BernesePeriacetabular Osteotomy
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The Etiology of Cam-type FemoroacetabularImpingement: A Cadaveric Study
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Thoracic adolescent idiopathic scoliosis: selectionof fusion level
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Wound Closure in Nonidiopathic Scoliosis:Does Closure Matter?
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Accuracy of Closed Reduction of Pediatric Supracondylar Humerus Fractures Is Training in Pediatric Orthopedic Surgery Necessary?
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Arthrogryposis
Calculation of Rotational Deformity in Pediatric Supracondylar Humerus Fractures”
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Back Pain
Evaluation of an Algorithmic Approach to Pediatric Back Pain
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Bone Healing
Interobserver and Intraobserver Reliability of Radiographic Evidence of Bone Healing at Osteotomy Sites
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Arthrodesis
Hip Arthrodesis in Adolescents Using External Fixation
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Scoliosis
A Predictive Risk Index for 30-day Readmissions Following Surgical Treatment of Pediatric Scoliosis
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Osteoarthritis
Osteoarthritis Associated with Osteopetrosis Treated by Resurfacing Arthroplasty
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Congenital Dislocation
How To Avoid Missing Congenital Dislocation of the Hip
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Dysplasia
Genu Valgum Secondary to Focal Fibrocartilaginous Dysplasia of the Distal Femur
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Hip Fracture
Clinical Efficacy of Aspirin and Dextran for Thromboprophylaxis in Geriatric Hip Fracture Patients
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Neurosurgery
Subfascial Implantation of Intrathecal Baclofen Pumps in Children Technical Note
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Pediatric Orthopaedics
Use of the Foot Abduction Orthosis Following Ponseti Casts
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Employing The Kid Friendly Approach
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The Use of Bone Scan to Investigate Back Pain in Children and Adolescents
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Clubfoot
A Method for the Early Evaluation of the Ponseti (Iowa) Technique for the Treatment of Idiopathic Clubfoot
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Percutaneous Fixation in Clubfoot Surgery A Radiographic and Gait Study
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Predicting the Need for Tenotomy in the Ponseti Method for Correction of Clubfeet
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Others
Calculation of Rotational Deformity in Pediatric Supracondylar Humerus Fractures”
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Hinged Distraction of the Adolescent Arthritic Hip
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Management of Unstable Acute Slipped Capital Femoral Epiphysis Survey Results
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Correction of Tibia Vara With Six-Axis Deformity Analysis and the Taylor Spatial Frame
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Congenital Pseudoarthrosis of the Tibia
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