Importance of calculating various casting indices in predicting radiological outcomes of paediatric forearm fractures

Background: The present study is aimed at determining the importance of various casting indices in predicting the outcome of paediatric forearm fractures treated with closed reduction and plaster application in our department.Methods: Thirty children, aged 5 to 15 years, with closed forearm fractures not requiring surgical fixation were included to assess their casting indices and radiological outcomes using X-rays. After satisfactory casting, patients were followed up weekly till 6 weeks with anteroposterior (AP) and lateral X-ray.Results: Acceptable reduction was achieved in 26 cases, while re-manipulation was done in 4 cases. Cast Index ranged from 0.80±0.09 at first week to 0.78±0.09 at 6 weeks, Padding Index was 0.30±0.04 at first week and increased to 0.31±0.03 at 6 weeks, Canterbury Index was 1.07±0.24 at first week and 1.07±0.78 at 6 weeks, Gap Index 0.15±0.02 remained the same throughout, and Three Point Index changed from 0.81±0.08 at first week to 0.77±0.18 six weeks. Radial bow of children showed no significant change at various time points of assessment. Rotational mal-alignment was observed in 5 patients, one had a 0.5 cm radial overlap, while none had an ulnar overlap. Radial angulation was observed in five and six children on AP and lateral X-ray respectively. Ulnar angulation was seen in two and one child on AP and lateral X-ray respectively.Conclusions: Continued use of these casting indices to assess paediatric forearm cast adequacy is supported by this study

Are We Looking at a Paradigm Shift in the Management of Adolescent Idiopathic Scoliosis? Comprehensive Retrospective Analysis of 75 Patients of Nonfusion Anterior Scoliosis Correction with 2–5-Year Follow-up: A Single Center Experience

Study Design Retrospective cohort study. Purpose This study aimed to evaluate the clinical and radiological outcomes of nonfusion anterior scoliosis correction (NFASC) in patients with idiopathic scoliosis and comprehensively analyze its principles. Overview of Literature NFASC is a novel revolutionary motion-preserving surgery for idiopathic scoliosis. However, clinical data related to this procedure remain scarce, with no conclusive guidelines regarding case indications, proper technique, and possible complications. Methods This study included patients with adolescent idiopathic scoliosis (AIS) who were treated with NFASC for a structural major curve (Cobb angle, 40°–80°) with more than 50% flexibility on dynamic X-rays. The mean follow-up was 26±12.2 months (range, 12–60 months). Clinical and radiological data such as skeletal maturity, curve type, Cobb angle, surgery details, and Scoliosis Research Society-22 revised (SRS-22r) questionnaire were collected. Statistically significant trends were examined by post hoc analysis following repeated measures analysis of variance test. Results A total of 75 patients (70 females, five males) were included, with a mean age of 14.96±2.69 years. The mean Risser and Sanders scores were 4.22±0.7 and 7.15±0.74, respectively. The mean main thoracic Cobb angles at the first and second follow-up (17.2°±5.36° and 16.92°±5.06°, respectively) were significantly lower than the preoperative Cobb angles (52.11°±7.74°) (p<0.05). Similarly, the mean thoracolumbar/lumbar Cobb angle significantly improved from the preoperative period (51.45°±11.26°) to the first follow-up (13.48°±5.11°) and last follow-up (14.24°±4.85°) (p<0.05). The mean preoperative and postoperative SRS-22r scores were 78.0±3.2 and 92.5±3.1, respectively (p<0.05). None of the patients had any complications until the most recent follow-up. Conclusions NFASC offers promising curve correction and curve progression stabilization in patients with AIS, with a low risk for complications and preservation of spinal mobility and sagittal parameters. Thus, it proves to be a favorable alternative to fusion modality