No abstract

The authors studied the long-term results of femoral derotational osteotomy (FDO) for medial femoral torsion in ambulatory children with cerebral palsy. Thirty children with 45 femurs that underwent distal FDO were followed for a mean of 6.5 years. Although correction was achieved after surgery, recurrence occurred during follow-up in 15 femurs. Preoperative mean external hip rotation of 10.7 +/- 7.2 degrees increased to 41.3 +/- 16.6 degrees 1 year after surgery and decreased to 28.2 +/- 14.7 degrees 5 years after surgery. On kinematic data, maximum hip rotation in stance of 30 degrees before surgery decreased to 8.7 degrees 1 year after surgery and increased to 16.1 degrees 5 years after surgery. Minimum hip rotation of 10.4 degrees before surgery was corrected to -4.3 degrees 1 year after surgery and was 0.8 degrees 5 years after surgery. Passive hip external rotation and kinematic hip rotation showed progressive deterioration of the initial correction. Patients having surgery prior to age 10 were more likely to show deterioration.

Anatomic reconstruction of the lateral ankle ligaments using the long extensor tendon of the fourth toe appears to be an effective surgical option for chronic insufficiency of the lateral ankle ligament.

No abstract

Both arthroscopic and posterior endoscopic excisions of the os trigonum were safe and effective in treating PAIS. The arthroscopic procedure was more demanding, especially in cases of a large os trigonum. The posterior endoscopic approach had the advantage of addressing problems in the posterior ankle joint and allowed a more extensive release of the flexor hallucis longus.