is an open access repository that collects the work of Arts et Métiers ParisTech researchers and makes it freely available over the web where possible. CT-scans of 48 children, aged four months to 15 years. The geometry of the sternum was detailed 40 and nine parameters were used to describe the ribs and rib cages. A "costal index" was defined as 41 the ratio between cartilage length and whole rib length to evaluate the cartilage ratio for each rib 42 level. For all children, the costal index decreased from rib level one to three and increased from 43 level three to seven. For all levels, the cartilage accounted for 45 to 60% of the rib length, and was 44 longer for the first years of life. The mean costal index decreased by 21% for subjects over three 45 years old compared to those under three (p<10 -4 ). The volume of the sternebrae was found to be 46 highly age dependent. Such data could be useful to define the standard geometry of the paediatric 47 thorax and help to detect clinical abnormalities. 48

IV: retrospective study.

No abstract

Background Acetabular fractures are rare in children and can be complicated by premature fusion of the triradiate cartilage resulting in secondary acetabular dysplasia. Early recognition and treatment of a physeal bar in this location can be difficult. The purpose of this case report was to investigate whether early intervention could restore acetabular growth and prevent secondary acetabular dysplasia as measured on plain radiographs. Case Description We report a series of three patients (3, 4, and 5 years old) who underwent physeal bridge resection and methylmethacrylate or fat interposition through an extended Pfannenstiel approach. The mean followup was 6 years. After resection of the osseous bridge the physis initially remained open with evident acetabular

No abstract

Background: Multiple epiphyseal dysplasia (MED) and pseudoachondroplasia (PSACH) are congenital skeletal disorders characterized by irregular epiphyses, mild or severe short stature and early-onset osteoarthritis which frequently affect the hips. The current study evaluates the long-term results of the Chiari osteotomy in MED and PSACH patients. Methods: Twenty patients (14 MED and 6 PSACH) were retrospectively included. Clinical assessment used the Postel Merle d’Aubigné (PMA) score and the Hip disability and Osteoarthritis Outcome Score (HOOS). Risser index, Sharp angle, acetabular depth index, center-edge angle, Tönnis angle, and femoral head coverage were measured on the preoperative radiographs and at last follow-up. The Treble index, which identifies the hip at risk in MED patients, was also determined. Stulberg classification (grades I to V) was used to evaluate the risk of osteoarthritis in the mature hips. Statistical analyses determined differences between preoperative and postoperative data. The Kaplan Meier method was used to calculate the survival rate of the operated hips using total hip arthroplasty as the endpoint. Results: Thirty-three hips which underwent a Chiari osteotomy were reviewed. The average follow-up was 20.1 years. The PMA scores were significantly better at last follow-up than preoperatively. All radiographic parameters significantly improved. Moreover, the Sharp angle, center-edge angle, and femoral head coverage improved to a normal value at hip maturity. All of the operated hips had a Treble index of type I. At hip maturity, a majority of hip were aspherical congruent (Stulberg grades of III and IV). The survival rate of the operated hips was 80.7% at 24 years postoperative. Conclusions: The Chiari osteotomy is a satisfying solution for severe symptomatic hip lesions in MED and PSACH patients. At long-term follow-up, this procedure lessens pain and improves hip function, which delays total hip arthroplasty indication. Level of Evidence: Level IV.

In our study, tibiotalar arthrodesis in young patients with haemophilia resulted in good long-term functional outcome with a low surgery-related complication rate.

Pejorative influencing factors were injuries in zones I, II, and III; children younger than 5 years (P < 0.05), and complete tendon laceration. Articular involvement had no significant influence on final outcome.