No abstract

Our data show, that successful treatment of unstable hips in neonates with the Tübingen splint is a comparably successful treatment modality relative to the Pavlik harness and Fettweis plaster.

Congenital clubfoot is one of the most common congenital skeletal deformities with an incidence of 1-2/1000 newborns. The deformity is characterized by pathological changes of joints, bones (especially the talus), muscles, tendons and soft tissues which result in subtalar malpositions known as talipes equinus, varus adductus and cavus. Secondary clubfoot is always part of an underlying systemic or neurologic disease and can occur at birth or develop over time. The treatment of clubfoot should start early after birth and is primarily conservative, involving manipulation and serial casting. Among conservative techniques available today, the Ponseti method is the treatment of choice. Applying this treatment protocol surgical therapy can be reduced in amount and extent. Extensive surgical therapy is only necessary in exceptional cases.

Purpose Slipped capital femoral epiphysis (SCFE) represents the preliminary stage of osteoarthritis. Reliable tools for outcome evaluation should be developed to prevent persisting defects. The functional outcome of SCFEpatients after growth arrest is analysed by instrumented 3D-gait analysis (GA). The results are matched to the clinical examination findings. Methods A total of 39 SCFE patients after growth arrest (18.8 years; BMI 26.5 kg/m²) with unilateral affection were included. The clinical results were classified according to Harris hip and clinical Heyman Herndon scores. 3D-GAparameters were evaluated and compared to the sound side and a group of 40 healthy adults (28.0 years; 21.9 kg/m²). The subgroup analysis was performed according to clinical results. Results The clinical examination revealed very good results. GA could detect even small alterations. Some parameters indicated sustained functional impairments: Compared to the control group patients' walking speed (p=0.022), step frequency (p<0.001) and single support of the slip side (p<0.001) decreased, while step width (p= 0.014), double support (p=0.004) and stance time of sound side increased (p=0.001). For kinematics patients, the sagittal range of motion (ROM) of pelvis (p<0.001) and the external rotation of the ankle on both sides increased (p=0.011) and sagittal ROM of hip (p=0.002) and knee flexion of slip side (p<0.001) decreased. The sagittal ROM of the ankle on the slip side decreased compared to the sound side (p=0.003). Subgroup analysis revealed a positive correlation between clinically unsatisfying results and GA parameters. Conclusions Functional impairments in SCFE-patients can be found even after growth arrest. Alterations are explained partly by the disease and partly by patients' constitution. BMI-matched controls and long-term follow-up are needed.