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The outcome of one-stage bilateral open reduction through a medial approach for the treatment of developmental dysplasia of the hip in children under 18 months was studied in 23 children, 18 girls and five boys. Their mean age at operation was 10.1 months (6 to 17) and the mean follow-up was 5.4 years (3 to 8). Acceptable clinical and radiological results were achieved in 44 (95.7%) and 43 (93.5%) of 46 hips, respectively. Excellent results were significantly evident in patients younger than 12 months, those who did not require acetabuloplasty, those whose ossific nucleus had appeared, and in those who did not develop avascular necrosis. One-stage bilateral medial open reduction avoids the need for separate procedures on the hips and has the advantages of accelerated management and shorter immobilisation and rehabilitation than staged operations.

Twenty eight patients with simple bone cyst that were treated by aspiration and percutaneous autogenous bone marrow injection were reviewed to evaluate the treatment outcome. There were 18 boys and ten girls. Their mean age was 10.9 +/- 2.75 years. Single injection was performed for 16 patients; the rest had double or triple injections. There were no operative complications. The mean follow-up was 34.7 +/- 6.87 months. The procedure succeeded in obtaining healing in 23 cysts (82%). Cysts with index of more than five and cortical thickness of less than 1 mm were significantly prone to pathological fractures and had significant poor results after treatment. Our results suggested that autogenous bone marrow injection is a safe and effective treatment method for simple bone cysts, but sometimes repeated injections are necessary. Cyst index and cortical thickness are good indicators for cyst aggressiveness and good predictors for treatment outcome.

The aim of this study is to define paediatric lateral humeral condyle fractures prone to later displacement. The authors reviewed 106 children who were treated surgically for this fracture. There were 74 boys and 32 girls with an age range of 3-10 years. The study included 27 minimally displaced and 79 displaced fractures. The average follow-up was 50 months. Binary logistic regression model indicated that 6-8-year-old children with minimally displaced fractures and who underwent immediate surgery have a better chance for satisfactory results. The authors concluded that routine use of 2 mm displacement for treatment decisions should be changed to avoid delayed surgery.

Acetabular cartilaginous angle is considered a reliable measurement to identify hips with DDH that will need later acetabuloplasty after successful closed reduction. The acetabular index is important in monitoring acetabular development, and reaching a value of less than 30 degrees 2 years after closed reduction is considered a good sign of acetabular development.

Level II retrospective study.

Background: The mechanism behind idiopathic scoliosis and its progression is not fully understood. Vitamin D insufficiency is known to play a role in the progression and/or occurrence of a variety of bone diseases. In this study, we aimed to estimate the prevalence of vitamin D insufficiency among patients with adolescent idiopathic scoliosis. Additionally, we aimed to calculate the differences in serum vitamin D levels, Cobb angles, spinal bone mass densities, and serum alkaline phosphatase levels between the sexes in the sample and to assess the possibility of a correlation between any of these factors. Methods: Demographic details, vitamin D levels, Cobb angle, spinal bone mass density, and alkaline phosphatase were collected from the records of 67 patients who were eligible for corrective surgery. These values were compared to normal levels and between the sexes within the study. Results: Of the 67 patients, 54 (80.6%) were female. The mean serum vitamin D level was 37.86 ± 26 nmol/L, and levels below normal were found in 92.5% of the patients. Statistical analysis showed significant differences (p = 0.002) in serum alkaline phosphatase levels between the sexes. No correlation was found between vitamin D levels and the Cobb angles, spinal and bilateral femoral neck bone mass densities, and serum alkaline phosphatase levels. Conclusions: Most adolescent idiopathic scoliosis patients had insufficient serum vitamin D levels and also suffered from low bone mineral density at an early age.

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