Lower Limb Diseases and Injuries in Children and Adolescents

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 7147

Special Issue Editor

IRCCS Orthopedic Institute Galeazzi, Via Galeazzi 4, 20161 Milan, Italy
Interests: knee surgery; arthroscopy; arthroplasty; unicompartmental knee replacement; total knee replacement; regenerative medicine; ACL; cartilage; patella
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Special Issue Information

Dear Colleagues,

Growing children and adolescents are susceptible to a number of pathologies and injuries to their lower extremities of varying degrees of severity that in most cases are a source of significant parental anxiety. The diagnosis and management of these conditions can be challenging. Furthermore, a dramatic increase in youth competitive athletic activity, early sport specialization, and year-round training and competition, along with increased awareness about injuries in children, have led to a commensurate increase in the frequency of lower limb trauma in the skeletally immature, such as anterior cruciate ligament tears and patella dislocation.

This Special Issue aims to cover common disorders affecting the hip, the knee, and the foot in order to improve clinical practice in recognizing developmental norms, differentiating physiological from pathological conditions, and identifying the best treatment option available.

Dr. Riccardo D'Ambrosi
Guest Editor

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Keywords

  • lower limb
  • hip
  • knee
  • foot
  • ACL
  • developmental dysplasia of the hip
  • clubfoot
  • varus/valgus knee

Published Papers (2 papers)

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Research

10 pages, 260 KiB  
Article
PlA2 Polymorphism of Platelet Glycoprotein IIb/IIIa and C677T Polymorphism of Methylenetetrahydrofolate Reductase (MTHFR), but Not Factor V Leiden and Prothrombin G20210A Polymorphisms, Are Associated with More Severe Forms of Legg–Calvé–Perthes Disease
by María Dolores García-Alfaro, María Isabel Pérez-Nuñez, María Teresa Amigo, Carmelo Arbona, María Ángeles Ballesteros and Domingo González-Lamuño
Children 2021, 8(7), 614; https://0-doi-org.brum.beds.ac.uk/10.3390/children8070614 - 20 Jul 2021
Cited by 3 | Viewed by 1528
Abstract
The possible association of common polymorphic variants related to thrombophilia (the rs6025(A) allele encoding the Leiden mutation, rs1799963(A), i.e., the G20210A mutation of the prothrombin F2 gene, the rs1801133(T) variant of the methylenetetrahydrofolate reductase (MTHFR) gene that encodes an enzyme involved in [...] Read more.
The possible association of common polymorphic variants related to thrombophilia (the rs6025(A) allele encoding the Leiden mutation, rs1799963(A), i.e., the G20210A mutation of the prothrombin F2 gene, the rs1801133(T) variant of the methylenetetrahydrofolate reductase (MTHFR) gene that encodes an enzyme involved in folate metabolism, and rs5918(C), i.e., the ‘A2’ allele of the platelet-specific alloantigen system that increases platelet aggregation induced by agonists), with the risk of Legg–Calvé–Perthes disease (LCPD) and the degree of hip involvement (Catterall stages I to IV) was analyzed in a cohort study, including 41 children of ages 2 to 10.9 (mean 5.4, SD 2.2), on the basis of clinical and radiological criteria of LCPD. In 10 of the cases, hip involvement was bilateral; thus, a total of 51 hips were followed-up for a mean of 75.5 months. The distribution of genotypes among patients and 118 controls showed no significant differences, with a slightly increased risk for LCPD in rs6025(A) carriers (OR: 2.9, CI: 0.2–47.8). Regarding the severity of LCPD based on Catterall classification, the rs1801133(T) variant of the MTHFR gene and the rs5918(C) variant of the platelet glycoprotein IIb/IIIa were associated with more severe forms of Perthes disease (Catterall III–IV) (p < 0.05). The four children homozygous for mutated MTHFR had a severe form of the disease (Stage IV of Catterall) and a higher risk of non-favorable outcome (Stulberg IV–V). Full article
(This article belongs to the Special Issue Lower Limb Diseases and Injuries in Children and Adolescents)
11 pages, 23397 KiB  
Article
Surgical Treatment of Clubfoot in Children with Moebius Syndrome
by Maurizio De Pellegrin, Lorenzo Marcucci, Lorenzo Brogioni and Giovanni Prati
Children 2021, 8(4), 310; https://0-doi-org.brum.beds.ac.uk/10.3390/children8040310 - 19 Apr 2021
Viewed by 4869
Abstract
Moebius syndrome (MS) is a rare disease, with paralysis of the VI and VII cranial nerves, frequently associated with clubfoot (CF). The aim of this study was to evaluate surgical treatment of CF in MS, providing its peculiarities. Between 1990 and 2019, we [...] Read more.
Moebius syndrome (MS) is a rare disease, with paralysis of the VI and VII cranial nerves, frequently associated with clubfoot (CF). The aim of this study was to evaluate surgical treatment of CF in MS, providing its peculiarities. Between 1990 and 2019, we collected data of 11 MS patients with unilateral (n = 5) or bilateral (n = 6) CF, for a total of 17 feet (9R,8L). Six patients (3M,3F) for a total of 10 feet (6R,4L) were treated elsewhere, performing first surgery at an average age of nine months, and in our hospital for relapse surgery at an average age of 4.5 years (Group 1). Five patients (3M, 2F), for a total of seven feet (3R,4L), were primarily treated in our hospital with a peritalar release according to McKay at an average age of 9.4 months (Group 2). Diméglio score was used to assess CF severity. Three questionnaires were submitted for evaluation of subjective and functional results: American Orthopedics Foot and Ankle Society for Hindfoot (AOFAS), Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). Average AOFAS/FAOS/FAMM scores were 82.8, 84.8, and 82.3 for Group 1, and 93.2, 94.7, and 95.1 for Group 2 at an average follow-up of 16.9 and 13.3 years, respectively. The average Diméglio score improved from 15.5 to 4.8 in the long-term follow-up in Group 1 and from 14.6 to 3.8 in Group 2. The comparison between the groups showed better results for AOFAS, FAOS, and FAAM scores for Group 2, particularly for pain, function, and foot alignment and for the post-surgical Diméglio score. CF in MS is more severe and presented a higher relapse rate (58.8%) than idiopathic CF. Peritalar release showed no relapse and better subjective and functional results in the long-term follow-up compared to other surgical techniques Full article
(This article belongs to the Special Issue Lower Limb Diseases and Injuries in Children and Adolescents)
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