Faculty Bibliography

Growing pains are leg pains that appear in a significant number of children 3 to 12 years of age and cease with maturity. They occur at the end of the day or may awaken the child from sleep. Their pathogenesis is unknown. The diagnosis should be one of exclusion only, and treatment is supportive.

Idiopathic clubfeet in children three years of age or older which have not been treated previously or which have recurred, can be treated successfully by using the Ilizarov technique. The authors report on four feet in three children which were treated by this method. Follow-up examinations at 11-24 months found all corrections successfully maintained.

Fixation of the osteotomy site in the proximal femur is technically demanding. A new system, which includes cannulated chisels and a cannulated one-piece plate that can be inserted over a guide wire, is suggested. The new system simplifies the procedure and provides stable fixation

Four deformed feet in three patients were corrected completely using the new limited intervention technique of Ilizarov. One foot in the younger patient was corrected by soft tissue distraction only. In three feet in the older patients V osteotomies were needed to initiate the distraction. Two complications occurred: herpes simplex infected two of the osteotomy sites, which were treated successfully with local treatment. The detailed method and indications are outlined.

The results obtained in a study of 32 patients with 45 idiopathic clubfoot deformities treated by complete soft-tissue release between 1985 and 1986 were investigated retrospectively. The evaluation was based on a specifically designed functional rating system. The results were graded as follows: 51% excellent, 25% good, 18% fair, and 6% poor.

Primary skin closure after the surgical correction of severe club-foot may be difficult. We describe the use of a tissue expander to provide sufficient skin, and review some aspects of the use of the method