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  • 1
    Online Resource
    Online Resource
    The influence of backpack weight in school children: gait, muscle activity, posture and stability
    Springer Science and Business Media LLC ; 2021
    In:  Der Orthopäde Vol. 50, No. 6 ( 2021-06), p. 446-454
    Details
    In: Der Orthopäde, Springer Science and Business Media LLC, Vol. 50, No. 6 ( 2021-06), p. 446-454
    Abstract: Wearing a school backpack every day may cause postural problems and affect the gait pattern of children and adolescents. The aim of the present study was to analyze the influence of a 4 kg backpack load on the gait pattern and postural sway. Objectives The aim of the present study was to analyze the influence of a backpack load of 4 kg on the gait and postural sway of elementary school children. Material and methods In this prospective study, a group of 12 elementary school children aged between 7 and 10 years without neurological or orthopedic problems participated. The measurements included a clinical examination, three-dimensional gait analysis with electromyographic recordings and measurement of postural sway on a force plate. Results The backpack load, on average 15% of the body weight, led to a slower walking speed, shorter step length and increased double-support phase. Increased anterior pelvic and trunk tilt, as well as hip flexion were also observed. Furthermore, the muscle activity and postural sway of the children were affected by the increased load. Conclusions School backpacks weighing 4 kg caused changes in gait, muscle activity, posture and stability in elementary school children. Due to the weight of the backpack, the centre of mass shifted backwards and the children became less stable. During gait, this was compensated by increased anterior pelvic and trunk tilt and increased hip flexion. The activity of the paraspinal muscles was decreased and indicates that the backpack is carried passively. This may cause a negative long-term effect.
    Type of Medium: Online Resource
    ISSN: 0085-4530 , 1433-0431
    URL: Article
    DOI: 10.1007/s00132-020-04047-8
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 3122958-X
    detail.hit.zdb_id: 1462973-2
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  • 2
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    Online Resource
    Cover letter
    ECO-Vector LLC ; 2020
    In:  Pediatric Traumatology, Orthopaedics and Reconstructive Surgery Vol. 8, No. 3 ( 2020-10-06), p. 269-274
    Details
    In: Pediatric Traumatology, Orthopaedics and Reconstructive Surgery, ECO-Vector LLC, Vol. 8, No. 3 ( 2020-10-06), p. 269-274
    Abstract: Background. Brace treatment is frequently used in adolescent idiopathic scoliosis (AIS). However, due to different brace models, long-term results on spinal deformity development at the end of Chneau brace treatment are not often described and differ in results. Aim. The aim of this work was to analyze clinical and radiological data of AIS patients treated with Chneau braces from the beginning of treatment until the end of growth and brace therapy in order to define realistic treatment results and expectations in an everyday setting. Materials and methods. 52 AIS patients with Chneau brace treatment were followed from the beginning of treatment until the end of growth. Clinical data such as the initial Risser sign, age at treatment, gender, curve patterns and body mass index were analyzed. Results. At the beginning of brace therapy, the average age was 13.1 years and patients showed a mean scoliotic curve angle of 30.9. Four months of brace use reduced the scoliotic curve to 20.1. Nine months after the end of brace treatment and an average treatment duration of 17 months, scoliosis has increased up to 30.3 again. In children with a lower maturity status, the initial scoliotic curve was less than in more mature patients leading to less spinal deformity at the end of treatment. In addition, obese children had less scoliosis correction during brace therapy than normalweight children. Conclusion. In patients with AIS treated with a Chneau brace, the initial curvature correction was 35%. Nine months after the end of brace treatment, scoliotic curves identical to the deformities at the beginning of treatment could be observed.
    Type of Medium: Online Resource
    ISSN: 2410-8731 , 2309-3994
    URL: Issue
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.17816/PTORS.83
    DOI: 10.17816/PTORS34039
    DOI: 10.17816/PTORS34039-21271
    DOI: 10.17816/PTORS34039-21272
    DOI: 10.17816/PTORS34039-21273
    DOI: 10.17816/PTORS34039-21274
    Language: Unknown
    Publisher: ECO-Vector LLC
    Publication Date: 2020
    detail.hit.zdb_id: 3046142-X
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  • 3
    Online Resource
    Online Resource
    "zusammen.wachsen" : 1. KKOU-Kongress im Mai 2023
    Springer Science and Business Media LLC ; 2023
    In:  Orthopädie und Unfallchirurgie Vol. 13, No. 4 ( 2023-08), p. 21-21
    Details
    In: Orthopädie und Unfallchirurgie, Springer Science and Business Media LLC, Vol. 13, No. 4 ( 2023-08), p. 21-21
    Type of Medium: Online Resource
    ISSN: 2193-5254 , 2193-5262
    URL: Article
    DOI: 10.1007/s41785-023-3893-0
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
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  • 4
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    Online Resource
    Health-related quality of life in early-onset-scoliosis patients treated with growth-friendly implants is influenced by etiology, complication rate and ambulatory ability
    Springer Science and Business Media LLC ; 2019
    In:  BMC Musculoskeletal Disorders Vol. 20, No. 1 ( 2019-12)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2019-12)
    Abstract: Progressive Early-Onset Scoliosis (EOS) in children may lead to surgical interventions with growth-friendly implants, which require repeated lengthening procedures in order to allow adequate growth. Quality of life was studied using the validated German version of the EOS-Questionnaire (EOSQ-24-G) in surgically treated EOS children with different lengthening modalities. Methods EOSQ-24-G and the KINDL R questionnaire were given to families with EOS children who had been treated by either vertical expandable prosthetic titanium rib implants and repetitive lengthening surgeries every 6 months or children who had received a magnetically expansion controlled implant, which was externally lengthened every 3 months. Results were compared according to differences between the two tests, and with possible influencing factors such as surgical method, severity of scoliosis, relative improvement of curvature, etiology, weight, age, travelling distance, complications, ambulatory ability and others. Results 56 children with an average curve angle of 69° corrected to 33° (52%; average age 5.6 yrs) answered the EOSQ-24-G and the KINDL R after an average follow-up of 3.9 years. Health-related quality of life (HRQoL) was not affected by the initial scoliosis correction, the number of surgeries or the implant type. However, there was a negative correlation with non-ambulatory status, complications during treatment and for children with a neuromuscular scoliosis. Conclusion Using the validated EOSQ-24-G, no statistically significant differences were found between the group of children receiving repetitive surgeries and children with external lengthening procedures without surgery. However, results were influenced by the etiology, complication rate or ambulatory ability. Level of Evidence/Clinical relevance Therapeutic Level IV
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-019-2969-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2041355-5
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  • 5
    Online Resource
    Online Resource
    Sonographic Differentiation of Stable and Unstable Lateral Condyle Fractures of the Humerus in Children
    Ovid Technologies (Wolters Kluwer Health) ; 2001
    In:  Journal of Pediatric Orthopaedics, Part B Vol. 10, No. 2 ( 2001-04), p. 138-141
    Details
    In: Journal of Pediatric Orthopaedics, Part B, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 2 ( 2001-04), p. 138-141
    Type of Medium: Online Resource
    ISSN: 1060-152X
    URL: Article
    DOI: 10.1097/00009957-200104000-00011
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2001
    detail.hit.zdb_id: 2071269-8
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  • 6
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    Online Resource
    Limited trunk motion and posterior pelvic tilting in ambulatory children treated with bilateral rib to pelvis implants for spinal deformity control
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of Pediatric Orthopaedics B Vol. 31, No. 1 ( 2022-01), p. 72-77
    Details
    In: Journal of Pediatric Orthopaedics B, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 1 ( 2022-01), p. 72-77
    Abstract: In young children, growth-friendly spinal implants with bilateral rib to pelvis fixation are used to control progressive spinal deformity. Whereas curve progression, complications and side-effects have been extensively studied in this patient population, no data are available on gait pattern changes and postural body adjustments. Our study evaluates whether gait pattern changed for ambulatory children treated with bilateral rib to pelvis implants compared to age-matched healthy children. In this small cohort study, gait analysis was performed using spatiotemporal and kinematic parameters of four ambulatory children with severe scoliosis and growth-friendly spinal implants using the bilateral rib to pelvis fixation. Data were statistically analyzed and compared to seven healthy age-matched children. Between both groups, no differences were seen in walking speed, cadence and stride length. The treated patients showed a lower range of motion of the pelvic obliquity and of the trunk obliquity and rotation, but a higher knee flexion. Growth-friendly spinal implants with bilateral rib to pelvis fixation are commonly used in wheelchair children and rarely indicated in ambulatory patients. The presented data show reduced trunk and pelvis motion using this implant construct. These findings help to understand body postural adjustments and add valuable information for families and care providers when considering this surgery. Level of evidence: Therapeutic level IV.
    Type of Medium: Online Resource
    ISSN: 1060-152X
    URL: Article
    DOI: 10.1097/BPB.0000000000000858
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2071269-8
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  • 7
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    Online Resource
    Altered bone development with impaired cartilage formation precedes neuromuscular symptoms in spinal muscular atrophy
    Oxford University Press (OUP) ; 2020
    In:  Human Molecular Genetics Vol. 29, No. 16 ( 2020-09-29), p. 2662-2673
    Details
    In: Human Molecular Genetics, Oxford University Press (OUP), Vol. 29, No. 16 ( 2020-09-29), p. 2662-2673
    Abstract: Spinal muscular atrophy (SMA) is a fatal neurodegenerative disease of newborns and children caused by mutations or deletions of the survival of motoneuron gene 1 resulting in low levels of the SMN protein. While neuromuscular degeneration is the cardinal symptom of the disease, the reduction of the ubiquitously expressed SMN additionally elicits non-motoneuron symptoms. Impaired bone development is a key feature of SMA, but it is yet unknown whether this is an indirect functional consequence of muscle weakness or caused by bone-intrinsic mechanisms. Therefore, we radiologically examined SMA patients in a prospective, non-randomized cohort study characterizing bone size and bone mineral density (BMD) and performed equivalent measurements in pre-symptomatic SMA mice. BMD as well as lumbar vertebral body size were significantly reduced in SMA patients. This growth defect but not BMD reduction was confirmed in SMA mice by μCT before the onset of neuromuscular symptoms indicating that it is at least partially independent of neuromuscular degeneration. Interestingly, the number of chondroblasts in the hypertrophic zone of the growth plate was significantly reduced. This was underlined by RNAseq and expression data from developing SMA mice vertebral bodies, which revealed molecular changes related to cell division and cartilage remodeling. Together, these findings suggest a bone intrinsic defect in SMA. This phenotype may not be rescued by novel drugs that enhance SMN levels in the central nervous system only.
    Type of Medium: Online Resource
    ISSN: 0964-6906 , 1460-2083
    URL: Article
    DOI: 10.1093/hmg/ddaa145
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 1474816-2
    SSG: 12
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  • 8
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    Online Resource
    Spontaneous humeral torsion deformity correction after displaced supracondylar fractures in children
    Springer Science and Business Media LLC ; 2021
    In:  BMC Musculoskeletal Disorders Vol. 22, No. 1 ( 2021-12)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2021-12)
    Abstract: After displaced supracondylar humerus fractures (SCHF) in children, residual deformities are common with cubitus varus (CV) being the clinically most visible. Distal fragment malrotation may lead to instability, fragment tilt and subsequent CV. Detection and assessment of malrotation is difficult and the fate of post-traumatic humeral torsion deformity is unknown. The aim of this study was to evaluate the incidence of humeral torsion differences in children with surgically treated SCHF and to observe spontaneous changes over time. Methods A cohort of 27 children with displaced and surgically treated SCHF were followed prospectively from the diagnosis until twelve months after trauma. Clinical, photographic, sonographic and radiological data were obtained regularly. Differences in shoulder and elbow motion, elbow axis, sonographic humeral torsion measurement and radiological evaluation focusing on rotational spur were administered. Results Six weeks after trauma, 67% of SCHF children had a sonographically detected humeral torsion difference of 〉  5° (average 14.0 ± 7.6°). Of those, 44% showed a rotational spur, slight valgus or varus on radiographs. During follow-up, an average decrease of the difference from 14° (six weeks) to 7.8° (four months) to 6.5° (six months) and to 4.9° (twelve months) was observed. The most significant correction of posttraumatic humeral torsion occurred in children 〈  5 years and with internal malrotation 〉  20°. Conclusion After displaced and surgically treated SCHF, most children had humeral torsion differences of both arms. This difference decreased within one year after trauma due to changes on the healthy side or correction in younger children with severe deformity. Level of Evidence/Clinical relevance Therapeutic Level IV
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-021-04909-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2041355-5
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  • 9
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    Online Resource
    High Correlation Between Achieved and Expected Distraction Using Magnetically Controlled Growth Rods (MCGR) With Rib to Pelvis Fixation in Pediatric Spine Deformity
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of Pediatric Orthopaedics Vol. 39, No. 5 ( 2019-05), p. e334-e338
    Details
    In: Journal of Pediatric Orthopaedics, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 5 ( 2019-05), p. e334-e338
    Abstract: Magnetically controlled implant systems have been established to treat severe progressive spinal deformity in children. The purpose of this study was to evaluate (1) the ratio between achieved and expected distraction length, (2) the complication rate and its risk factors as well as (3) the correlation of the distraction length and the length of the spine. Methods: A total of 40 patients with an average follow-up of 34 (14 to 57) months were prospectively included in the study. Children underwent lengthening procedures every three months. The ratio between the distraction lengths was determined by comparing the measured distraction length of the rod on radiographs with the distraction length displayed on the external remote controller for the magnetically controlled growing rod (MCGR). Age, weight, height, and complications were repeatedly recorded. Results: The analysis of 746 procedures showed the actual distraction to be 94.4% of the expected one. No difference between implants on the concave and convex spinal side was observed. The overall complication rate was 4.6% mainly because of failure of the implant or lack of implant extension, which was directly related to an increased BMI. There was also a strong correlation between achieved implant distraction length and gain in spinal length. Conclusions: Our study demonstrates a high ratio (0.94) between achieved and expected distraction length of magnetically controlled spinal rods. The complication rate was low (4.6%) and correlated to a high BMI. The correlation between the achieved implant distraction length and spinal length indicates the efficiency of the MCGR therapy. Level of Evidence: Therapeutic Level IV.
    Type of Medium: Online Resource
    ISSN: 0271-6798
    URL: Article
    DOI: 10.1097/BPO.0000000000001303
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2049057-4
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  • 10
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    Online Resource
    Continuous lengthening potential after four years of magnetically controlled spinal deformity correction in children with spinal muscular atrophy
    Springer Science and Business Media LLC ; 2020
    In:  Scientific Reports Vol. 10, No. 1 ( 2020-12-30)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-12-30)
    Abstract: Magnetically controlled growing rods (MCGR) are commonly implanted for the treatment of early-onset scoliosis. While most authors report favorable short-term results, little is known about long-term deformity correction. This prospective cohort study assesses spinal deformity control in a homogeneous spinal muscular atrophy (SMA) patient group treated with MCGR implants, a standardized lengthening protocol and a minimum follow-up of four years. 17 SMA patients with progressive scoliosis were treated with MCGR implanted parallel to the spine with rib-to-pelvis fixation. Radiologic measurements were performed before and after MCGR implantation and during external lengthening procedures. These included measurements of the scoliotic curve, kyphosis, lordosis, pelvic obliquity and the spinal length. Additional clinical data of the complications were also analyzed. 17 children (mean age 7.4 years) were surgically treated and underwent a total of 376 lengthenings. Complication rates were 3.5% in respect to all interventions or 41% of the patients had complications during 3.5% of the lengthening sessions. The initial implantation significantly reduced the main scoliotic curve by 59%, with the correction remaining constant throughout the follow-up. Pelvic obliquity was also significantly and permanently corrected by 72%, whereas kyphosis and lordosis were not influenced. The spinal length could be significantly increased mostly during the first year of treatment. Bilateral implantation of MCGRs for correction of spinal deformity in children with SMA showed no decrease of the lengthening potential during a four-year follow-up. Therefore, the previously described ‘law of diminishing returns’ could not be applied to this patient population. Level of Evidence/Clinical relevance: Therapeutic Level IV.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-020-79821-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2615211-3
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