Trunk Control Measurement Scale (TCMS): Psychometric Properties of Cross-Cultural Adaptation and Validation of the Spanish Version

The aim of this study was to develop a Spanish Version of the Trunk Measurement Scale (TCMS-S) to analyze its validity and reliability and determine the Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) in children with Cerebral Palsy (CP). Participants were assessed twice 7–15 days apart with the TCMS-S and once with the Gross Motor Function Measurement-88 (GMFM-88), Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT), Cerebral Palsy Quality of Life (CPQoL), and Gross Motor Classification System (GMFCS). Internal consistency was evaluated using Cronbach’s alpha, and the intraclass correlation (ICC) and kappa coefficients were used to investigate the agreement between the assessments. Finally, 96 participants with CP were included. The TCMS-S showed excellent internal consistency (Cronbach’s alpha = 0.95 [0.93 to 0.96]); was highly correlated with the GMFM-88 (rho = 0.816) and the “mobility” subscale of the PEDI-CAT (rho = 0.760); showed a moderate correlation with the “feeling about functioning” CPQoL subscale (rho = 0.576); and differentiated between the GMFCS levels. Excellent test–retest agreement was found for the total and subscale scores (ICC � 0.94 [0.89 to 0.97). For the total TCMS-S score, an SEM of 1.86 and an MDC of 5.15 were found. The TCMS-S is a valid and reliable tool for assessing trunk control in children with CP.Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería)Fac. de Enfermería, Fisioterapia y PodologíaTRUEUniversidad Europea de Madridpu

Normal ossification of the glenoid mimicking a glenoid fracture in an adolescent patient: a case report

A 13-year-old male was diagnosed with a glenoid fracture following direct shoulder trauma, for which surgical treatment was considered. After referral to a center for pediatric orthopedic care, physical examination, contralateral shoulder X-ray, and detailed computed tomography examination ruled out the presence of fracture; these findings were later confirmed by magnetic resonance imaging. Normal ossification patterns in the adolescent shoulder may simulate a fracture in traumatic settings. To accurately diagnose and manage pediatric shoulder pathology, orthopedic surgeons must be aware of the normal anatomy of the growing shoulder, its secondary ossification centers, and growth plates. Level of evidence V

Expectativas de los pacientes en la cirugía del hallux valgus

La cirugía de hallux valgus (HV) es una de las más comunes en nuestro medio. El objetivo principal de este trabajo es determinar las expectativas preoperatorias de los pacientes que se van a intervenir de HV y analizar el grado de entendimiento, mediante un cuestionario, de lo explicado en las consultas de traumatología.Para ello se facilitó, por correo convencional, una encuesta a todos los pacientes que iban a ser intervenidos de cirugía de HV. El cuestionario comprendía distintas variables como la edad, el sexo, el pie que iba a ser intervenido y distintas preguntas relacionadas con la intervención, los cuidados postoperatorios y la recuperación tras la cirugía.Se revisaron un total de 50 pacientes, los cuales indicaron, en el cuestionario facilitado, que el principal motivo por el que deseaban la cirugía era para conseguir una disminución del dolor, seguido de mejora para la marcha y la utilización de calzado convencional.Es importante tener en cuenta las expectativas prequirúrgicas del paciente para así mejorar los resultados de la cirugía de HV. Es necesario hacer mayor hincapié en la explicación de la intervención así como de los cuidados posteriores ya que, en la mayoría de los casos, los pacientes desconocen el protocolo a seguir. De esta manera mejoraremos la calidad asistencial y la satisfacción de nuestra población.Hallux valgus is one of the most common cases in orthopaedic surgery. The main two objectives are: (i) to assess the preoperative expectations of patients and, (ii) to analysis the degree of understanding of these patients.For that, it has been elaborated a survey remitted by postal mail. The survey includes different variables such as: age, sex, foot with pathology, postoperative care and recovery after surgery.Fifty patients were analyzed. The most important expectation was reduced pain, followed by improved walking and wearing daily shoes.The results show how a better communications between patients and surgeons is needed. Therefore, it is important to take into account the preoperative expectations of patients with the aim to improve outcomes of surgery for hallux valgus

Can We Extend the Indications for Multilevel Surgery to Non-Ambulatory Children with Neuromuscular Diseases? A Safety and Efficacy Study

A retrospective study that aims to analyze the safety and efficacy of single-event multilevel surgery (SEMLS) involving bifocal femoral osteotomy (BFO) performed in nine non-ambulatory children with neuromuscular diseases (NMD), with a median age of 12.86 years, to resolve both hip subluxation and ipsilateral knee flexion contracture that impaired standing, and to evaluate patient and caregiver satisfaction. Results: Median surgical time was 4 h 15 min (2 h 35 min–5 h 50 min). Hip flexion deformity improved by a median of 30° (15–35), while median improvement in knee flexion deformity was 30° (20–50). Only two patients could use a standing frame prior to surgery, although with increasing difficulty, while all children could use it following SEMLS. Mean follow-up was 27.47 months (24.33–46.9). Significant blood loss requiring transfusion was the only complication recorded (8/9). All caregivers reported slight, moderate, or significant improvement in all domains of the questionnaire, and all would undergo the procedure again and recommend it to others, as nearly all (8/9) were very satisfied. Conclusion: The findings of this study suggest that SEMLS including BFOs in non-ambulatory children with NMD can correct hip, knee, and foot deformities and simultaneously realign lower limbs to restore functional standing and wheelchair transfer. The functional results, safety, and degree of satisfaction achieved justify offering this strategy to families

Percutaneous Lengthening with an Intramuscular Needle of the Gastrocsoleus Complex Improves Critical Ankle Kinematic Values in Resistant Pediatric Equinus: A Pilot Study

Retrospective analytical study that aims to evaluate the kinematic and kinetic results obtained after percutaneous lengthening with an intramuscular needle (PLIN) of gastrocsoleus complex (GSC) zones I, II, and III, performed outside the operating room between 2018 and 2019, in pediatric patients with equinus gait resistant to non-operative treatment. Gait analysis was performed prior to treatment and 6 months post treatment in 48 ankles (30 patients), with a median patient age of 10.11 (2.85) years. Twelve patients had a diagnosis of idiopathic equinus, twelve spastic hemiplegia, and six spastic diplegia. Statistical analysis included pre–post comparison, correlation, and linear regression of critical kinematic and kinetic ankle values. Significant improvement was observed for the following parameters: ankle angle at initial contact, −4.57(10.31)/0.05(3.04)°; maximum ankle dorsiflexion in the stance phase (mADFStP), 3.70(7.56)/10.42(4.52)°; and maximum ankle dorsiflexion in the swing phase (mADFSwP), −6.54(8.41)/−0.35(6.17)°. In addition, an inversely proportional correlation with pre-intervention values was obtained for those parameters, with rho values of −0.864, −0.755, and −0.696, respectively (p 2 = 0.797 (p 2 = 0.829 (p < 0.0005). To conclude, the addition of the GSC in patients with resistant equinus significantly improves ankle initial contact, mADFStP, and mADFSwP, with greater changes occurring with worse initial values. The regression formulas used to estimate post-procedure results will allow therapeutic indications to be adjusted