To quantitate the intrinsic error in measurement, fifty anteroposterior radiographs of patients who had scoliosis were each measured on six separate occasions by four orthopaedic surgeons using the Cobb method. For the first two measurements (Set I), each observer selected the end-vertebrae of the curve; for the next two measurements (Set II), the end-vertebrae were pre-selected and constant. The last two measurements (Set Ill) were obtained in the same manner as Set II, except that each examiner used the same protractor rather than the one that he carried with him. The pooled results of all four observers suggested that the 95 per cent confidence limit for intraobserver variability was 4.9 degrees for Set I, 3.8 degrees for Set II, and 2.8 degrees for Set III. The interobserver variability was 7.2 degrees for Set I and 6.3 degrees for Sets II and III. The mean angles differed significantly between observers, but the difference was smaller when the observers used the same protractor.
This study reviewed radiographs of non-ambulatory spastic tetraparetic cerebral palsy patients who underwent soft tissue hip surgery to address hip subluxation. Patients were under 10 years of age at surgery, had limited hip motion, and radiographic subluxation. At an average 7.4 years postoperatively, hips had a migration percentage in the normal range (0-15%) in 58 of 70 cases (83%). Hips with preoperative subluxation between 30 and 49% had a normal migration percentage in 18 of 21 cases (81%), and those over 50% in three of seven (43%) of cases. Soft tissue surgery alone, even in cases of moderate hip subluxation, can result in long-term radiographic hip stability.
This study reviewed 21 cases of hematogenous osteomyelitis of the calcaneus in skeletally immature patients. The average patient age was 2.9 years. Local tenderness, swelling, and erythema were the most common findings. The erythrocyte sedimentation rate was elevated in 20 (95%) of 21 patients, whereas the C-reactive protein was abnormal in only seven (47%) of 15 patients tested. Nine patients had positive cultures, with Staphylococcus aureus being the most common organism. Plain films showed a lytic lesion in 15 (71%) of 21 cases, whereas scintography was positive in all 16 cases scanned. Ten patients were treated with antibiotics alone, whereas 11 patients underwent surgical irrigation and debridement in association with antibiotic therapy. Seventeen patients returned for follow-up, and although only one was symptomatic, three of 10 follow-up radiographs revealed residual abnormalities of the calcaneus.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.