Maternal Height and Infant Body Mass Index Are Possible Risk Factors for Developmental Dysplasia of the Hip in Female Infants

Developmental dysplasia of the hip (DDH) is a wide-spectrum disease with a multifactorial etiology and, despite its prevalence, no definitive etiology has yet been established. The aim of this study was to investigate new risk factors for DDH by evaluating newly defined potential risk factors. A total of 71 infants were separated into 2 groups:Group I, 28 female first-born infants diagnosed with DDH and their mothers;and Group II, 43 healthy female first-born infants and their mothers. The maternal height and weight before pregnancy, infant height and weight at birth, and body mass index (BMI) of both mother and infant were determined. Calculations were made of the ratios between these parameters. Of the examined risk factors, only maternal height and the ratio of maternal height to infant BMI (MH/I-BMI) were found to be significant for DDH in infants. In conclusion, the results of this study show that a short maternal height and a low MH/I-BMI increase the risk of DDH. Further studies with a larger series are necessary to confirm these results

Bilateral Transverse (Bowdler) Fibular Spurs with Hypophosphatasia in an Adolescent Girl

Hypophosphatasia is a clinically heterogeneous inheritable disorder characterized by defective bone mineralization and the deficiency of serum and tissue liver/bone/kidney alkaline phosphatase activities. Due to the mineralization defect of the bones, various skeletal findings can be radiologically observed in hypophosphatasia. Bowing and Bowdler spurs of long bones are the characteristic findings. The Bowdler spurs reported on in the previous pertinent literature were observed in the perinatal aged patients and these lesions have rarely involved adolescents. We herein report on a 14-year-old girl with fibular Bowdler spurs

A rarely seen multilevel thoracic vertebral fracture after a nocturnal hypoglycemic convulsion attack.

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulin-induced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack

Case Report A Rarely Seen Multilevel Thoracic Vertebral Fracture after a Nocturnal Hypoglycemic Convulsion Attack

A 49-year-old male presented with acute midthoracic severe back pain following a witnessed nocturnal convulsion attack. There was no history of trauma and the patient had a 23-year history of Type I diabetes mellitus. MRI scans of the thoracic spine revealed compression fractures at T5, T6, T7, and T8 vertebrae. The patient was treated conservatively. At 17 months after the initial diagnosis, the complaints of back pain had been resolved and the patient was able to easily undertake daily living activities. Hypoglycaemia is a common problem in diabetic patients treated with insulin. Convulsions may occur as a consequence of insulininduced hypoglycemia. Nontraumatic compression fractures of the thoracic spine following seizures are a rare injury. Contractions of strong paraspinal muscles can lead to compression fracture of the midthoracic spine. Unrecognized hypoglycaemia should be considered to be a possible cause of convulsions in insulin-dependent diabetic patients. The aim of this report is to point out a case of rarely seen multilevel consecutive vertebrae fractures in a diabetic patient after a nocturnal hypoglycaemic convulsion attack

Transfer of latissmus dorsi and teres major tendons without subscapularis release for the treatment of obstetrical brachial plexus palsy sequela

Background: Patients with obstetrical brachial plexus palsy (OBPP) sequela exhibit adduction and internal rotation contractures. The muscular imbalance may result in secondary bony changes. Tendon transfers and muscular releases may improve shoulder function in these patients. The aim of this study is to evaluate the functional and radiological results of pectoralis major tendon Z-plasty with transfer of latissimus dorsi and teres major tendons to rotator cuff tendons without release of subscapularis muscle in patients with mild sequela of OBPP

The Effect Of Body Mass Index On Bone Mineral Density In Postmenopausal Women - Original Investigation

Aim: We aimed to determine the relationship between bone mineral density and body mass index in postmenopausal women. Material and Methods: 54 postmenopausal women were included in the study. Age and time of menopause were recorded. Smoking, alcohol and exercise status were also recorded. Weight and height were measured and body mass index was calculated. The patients were separated into four groups according to their body mass index, as underweight, ideal weight, over-weight and obese. Bone mineral density in all the patients was assessed via dual energy X-ray absorptiometry from antero-posterior lumbar and right proximal femoral regions. For L2-4 and the femoral neck, bone mineral density and t scores were determined. Results: The study was performed in 54 postmenopausal women, ranging in age from 51 to 79 years. 22 (%40.8) of the patients were obese, 24 (%44.4) were overweight and 8 (%14.8) had ideal weight. There were no patients in underweight group. There were no difference in age, smoking, time of menopause, bone mineral density and t-scores among the groups. There was statistically significant correlation between body mass index and bone mineral density of the femoral neck (r =0.407, p=0.002), and femoral neck t-scores (r =0.297, p=0.029). There was no significant correlation between the body mass index and lumbar bone mineral density and lumbar t-scores (p >0.05). Conclusion: Body mass index was found to be related to bone mineral density of the femoral neck. Our findings suggest that maintenance of adequate body mass is important for the prevention of postmenopausal bone loss. (From the World of Osteoporosis 2007;13:56-9

Colocação segura de pinos percutâneos em fraturas subcapitais do quinto metacarpo: um estudo anatômico Safe percutaneous pinning for subcapital fifth metacarpal fractures: an anatomical study

OBJETIVOS: Durante o tratamento de fraturas fechadas do colo do metacarpo do dedo mínimo (fraturas do boxeador) usando fixação percutânea com fio K transversal e outros procedimentos, pode ocorrer lesão iatrogênica do ramo digital dorsal do dedo mínimo (RDDDM) do ramo dorsal do nervo ulnar (RDNU). Neste estudo, visamos descrever a relação do RDDDM do RDNU e os pontos de inserção na face lateral do quinto metacarpo durante fixação percutânea com fio K transversal de fraturas subcapitais. MÉTODOS: Foram realizadas dissecações e medições desse ramo depois de colocação de pino transversal percutâneo na parte distal do quinto osso do metacarpo em dez mãos de cadáveres fixadas em formalina. RESULTADOS: Os resultados desse estudo confirmam a grande proximidade da trajetória do pino e desse ramo, e demonstram sua possível lesão iatrogênica durante a fixação do fio K no quinto metacarpo. CONCLUSÕES: Para evitar a penetração desse nervo e limitar as chances de lesão iatrogênica, é importante conhecer o trajeto desse nervo. Os autores descrevem os pontos de inserção anatômica e acreditam que com uso do conhecimento da anatomia das fraturas subcapitais do quinto metacarpo, elas podem ser tratadas sem risco de déficits sensoriais futuros.OBJECTIVES: When treating closed fractures of the neck of the little finger metacarpal (boxer fractures) with percutaneous transverse K-wire fixation and other procedures, there may be iatrogenic injury to the dorsal digital branch to the little finger (DDBLF) of the dorsal branch of the ulnar nerve (DBUN . In this study we aimed to describe the relationship of the DDBLF of the DBUN and the insertion points on the external side of the fifth metacarpal during percutaneous transverse K-wire fixation of subcapital fractures. METHODS: Dissections and measurements regarding this branch were performed after percutaneous transverse pinning to distal part of fifth metacarpal bones in ten cadaver hands formalin fixed. RESULTS: The results of this study confirm the close proximity of the trajectory of the with this branch and demonstrate its potential iatrogenic injury during K-wire fixation of the fifth metacarpal. CONCLUSIONS: To avoid penetration of this nerve and limit the chances of iatrogenic injury it is important to know its course. The authors describe the anatomical insertion points and believe that using the anatomical knowledge, subcapital fifth metacarpal fractures can be treated without risk of sensory deficits

Knee Joint Pain May Be an Indicator for a Hip Joint Problem in Children: A Case Report

Knee joint pain is one of the most common complaints related to the skeletal system encountered by paediatricians. Knee joint pain generally occurs as the result of hypermobility and growing pains, though disorders manifesting as arthritis/arthralgia and orthopaedic problems should be considered in the differential diagnosis. A thorough and careful physical examination and laboratory and radiological findings are of importance for an accurate diagnosis. Although treatment should be based on the aetiology of the knee pain, non-steroid anti-inflammatory drugs can be used to alleviate the pain. A 7-year-old male patient presented with recurring pain in the left knee. Physical examination of the patient, laboratory tests, and radiological examination of the knee joint were normal; roentgenograms performed for a presumed hip joint problem revealed a focal cortical defect on the left femoral head and an increased effusion in the left hip joint space compared with the right counterpart. With this case report, we would like to highlight that paediatric health and diseases specialists (paediatricians) should consider hip joint pathologies when patients present with knee pain, particularly knee pain with an unidentified aetiology