Bernard David Horn

BACKGROUND: Titanium elastic nails are commonly used to stabilize femoral fractures in school-aged children, but there have been few studies assessing the risks and benefits of this procedure compared with those of traditional traction and application of a spica cast. This prospective cohort study was designed to evaluate these two methods of treatment, with a specific focus on the first year after injury, the period when the treatment method should have the greatest impact.

METHODS: ...

BACKGROUND: Gadolinium-enhanced perfusion MRI (pMRI) after closed reduction/spica casting for developmental dysplasia of the hip (DDH) has been suggested as a potential means to identify and avoid avascular necrosis (AVN). To date, however, no study has evaluated the effectiveness of pMRI in clinical practice or compared it with other approaches (such as postreduction CT scan) to show a difference in the proportion of AVN.

QUESTIONS/PURPOSES: (1) Can a pMRI-based protocol be used ...

This study investigates the hypothesis that the integrity of the cartilage hinge at the distal humeral epiphysis determines the stability of fractures of the lateral humeral condyle. Sixteen patients with lateral humeral condyle fractures were studied with radiographs and magnetic resonance imaging (MRI). The clinical course of each patient was compared using these imaging studies to determine whether initial fracture displacement and the integrity of the cartilage hinge correlated with ...

STUDY DESIGN: Prospective study.

OBJECTIVE: To compare variability in Cobb angle between digitally and traditionally acquired scoliosis radiographs.

SUMMARY OF BACKGROUND DATA: Previous studies have shown that the 95% confidence interval for Cobb angle can vary from 2.6 degrees to 8.8 degrees. No study directly comparing Cobb angles measured from traditional and digitally acquired radiographs has been reported.

METHODS: A spine model simulating 25 single right thoracic curves (range, 20 ...

BACKGROUND: : Distal femoral epiphyseal fractures are uncommon but have a high incidence rate of complications. It is not clear whether there are any reliable predictor factors and whether the type of fracture, displacement (degree and direction), and treatment method alter the outcome.

METHODS: : We retrospectively reviewed the medical charts and images of all patients who sustained a distal femoral epiphyseal fracture and were treated at 2 large level I pediatric centers during the ...

BACKGROUND: A single-leg, walking hip spica cast has been shown to be a safe and effective treatment for a low-energy femoral shaft fracture in young children. We designed a prospective cohort trial comparing walking and traditional hip spica casting to determine whether a walking hip spica cast was superior to a traditional hip spica cast following a low-energy femoral shaft fracture in children one to six years old.

METHODS: We studied forty-five consecutive low-energy femoral shaft ...

Cubitus varus may occur after supracondylar humerus fractures. Poor fixation, however, complicates operative treatment of cubitus varus. We discuss the use of external fixation in the treatment of cubitus varus. Five patients had humeral osteotomies with external fixation. The preoperative humeroulnar angle (HUA) averaged -24.2 degrees. The immediate postoperative HUA averaged 12 degrees, and the final angle averaged 13 degrees. Duration of external fixation averaged 8.9 weeks. ...

This study evaluated the accuracy of plain radiographs and computerized tomography (CT) in assessing juvenile Tillaux fractures of the distal tibia. A simulated Tillaux fracture was made in four cadaver specimens and displaced 0, 1, 2, 3, and 5 mm. Plain radiographs and CT were performed on each specimen at each amount of displacement, and the results were compared with the actual amount of displacement present. Plain radiographs and CT were accurate within 1 mm in depicting the actual ...

Stubbing injuries to the great toe can be a cause of occult open fractures and osteomyelitis. Five such patients were identified after conducting a retrospective review of injuries to the hallux between January 1998 and December 1998. The study was conducted to draw attention to the association between this trivial trauma and its possible complications. All five children had open fractures of the distal phalanx of the great toe. Osteomyelitis did not develop in the children whose ...

PurposeThe purpose of this study is to compare the efficacy of percutaneous Achilles tenotomy (AT) to combined open Achilles tenotomy and posterior capsulotomy (PC+AT) in the correction of residual equinus deformity in congenital talipes equinovarus after Ponseti serial casting in both idiopathic and non-idiopathic clubfeet.MethodsThe authors retrospectively reviewed 591 patients treated for congenital talipes equinovarus between January 1, 2001 and January 1, 2011. Available medical and ...

Summary: This study evaluated the accuracy of plain radiographs and computerized tomography (CT) in assessing juvenile Tillaux fractures of the distal tibia. A simulated Tillaux fracture was made in four cadaver specimens and displaced 0, 1, 2, 3, and 5 mm. Plain radiographs and CT were performed on each specimen at each amount of displacement, and the results were compared with the actual amount of displacement present. Plain radiographs and CT were accurate within 1 mm in depicting the ...

BackgroundBlount’s disease is a multi-planar deformity affecting the pediatric population which leads to varus alignment of the lower extremities. The Multi-Axial Correction (MAC) monolateral external fixation system (Biomet, Parsippany, NJ, USA) is a non-circular fixator that was developed as a response to the technical difficulty for both patients and physicians of placing, managing, and tolerating a circular fixator. The purpose of this study was to determine the efficacy of the MAC ...

BACKGROUND: Radial club hand is a well-recognized congenital malformation characterized by hypoplasia of bone and soft tissue on the radial aspect of the forearm and hand. The modalities of treatment have traditionally varied from stretching casts with soft-tissue procedures to the use of multiple corrective osteotomies. These osteotomies can be stabilized by a variety of methods, including external fixators that allow the possibility of gradual distraction with neohistiogenesis. This ...