The purpose of this study was to review the demographic data of children and adolescents with aneurysmal bone cysts (ABCs). The authors performed a retrospective, multicenter, pediatric population-based analysis of 156 patients with primary ABCs. Only patients with histologic confirmation of the diagnosis were included. A review of French and English literature of 255 children and adolescents was included regarding sex, location of the lesion and age at diagnosis. There were 212 boys and 199 girls with a median age at diagnosis of 10.2 years (range, 1.5-17 years). Forty-four patients were under 5 years of age; 111 patients were between 5 and 10 years of age, and 139 were older than 10 years of age. The femur, tibia, spine, humerus, pelvis and fibula were the most common locations. In 256 cases (62.7%), ABCs occurred in long bones. We also studied the data and location of 161 ABCs of the mobile spine (13 cases from our series and 148 from the literature review). There were 48 ABCs in the cervical spine, 48 in the thoracic spine, and 65 in the lumbar spine. We found no main differences in site distribution and sex, between the children and the general population.
This study suggests that bone oncogenesis driven by TP53 or RB1 mutations occurs on a background of relative genetic stability and that the dedifferentiated OS subtype represents a clinico-pathological entity with distinct oncogenic mechanisms and thus requires different therapeutic management.
MCGR provides satisfactory deformity correction and avoids repeated surgical procedures for lengthening. However, it has substantial complication rate. Although less frequent than in GR, the law of diminishing returns also applies to MCGR.
We measured the clinical tibiofemoral (TF) angle and the intercondylar (IC) or intermalleolar (IM) distance in 427 normal European children (212 male and 215 female) aged from 10 to 16 years. In our study, girls had a constant valgus (5.5#{176}) and displayed an IM distance of <8 cm or an IC distance of <4 cm. By contrast, boys had a varus evolution (4.4#{176}) during the last two years of growth and displayed an IM distance of <4 cm or an IC distance of <5 cm. Values above these for genu varum or genu valgum may require careful follow-up and evaluation. J Bone Joint Surg [Br] 1995:77-B:729-32.
The goal of this study was to evaluate the results of meniscal repair in children and adolescents by a retrospective case series. Twelve arthroscopic-assisted meniscal repairs were performed on 12 patients younger than 17 years of age (8-16 years, mean 13 years). The anterior cruciate ligament was torn in three cases. Eight lesions involved the lateral meniscus and four involved the medial meniscus; there were no discoid menisci. All patients were seen at an average of 3 years 1 month follow-up (range, 2-4 years 10 months). Three patients required subsequent surgery for partial meniscectomy. We evaluated the remaining nine patients by clinical examination, International Knee Documentation Committee clinical score, Lyshölm score, Tegner's activity, and by computed tomography arthrogram or magnetic resonance imaging. Seven patients were asymptomatic at follow-up, two reported occasional pain, and none had experienced symptoms of locking. Their average Lyshölm score and Tegner's activity were 96.3 and 6.6, respectively. Eight patients were International Knee Documentation Committee A and one was International Knee Documentation Committee B. Healing status was assessed at follow-up in eight patients by computed tomography arthrogram or magnetic resonance imaging: the tear was considered as completely healed in three patients. The apparent failure rate was 66%. Indications for meniscal repair in children are not actually established. The pejorative outcome of meniscectomy at a young age has led us to consider symptomatic meniscal tears for repair. Objective results of meniscal healing are poor. The method to assess healing of the repaired menisci objectively is still a matter of debate.
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