PURPOSE OF THE STUDY Fixation of osteochondral fragments are relatively common procedures in pediatric orthopaedic surgery. The use of biodegradable magnesium implants in these indications appears to be a promising alternative to polymer implants due to their favorable mechanical properties and biological behavior. The purpose of this study is to evaluate the short-term clinical and radiological outcomes of the fixation of unstable or displaced osteochondral fractures and osteochondritis dissecans lesions in the knee joint using MAGNEZIX® screws and pins in pediatric patients. MATERIAL AND METHODS In this study, 12 patients (5 girls, 7 boys) were included. The inclusion criteria were as follows (1) age below 18 years; (2) unstable or displaced osteochondral fragments secondary to trauma or as a result of osteochondritis dissecans, Grades III and IV in the ICRS (International Cartilage Repair Society) score, confirmed by imaging methods and indicated for surgical fixation; (3) fixation performed using screws or pins made of the magnesium-based MAGNEZIX® alloy; (4) minimum postoperative interval of 12 months. X-rays and clinical evaluation were assessed 1 day, 6 weeks, 3, 6, and 12 months after the operation. MRIs were performed 1-year postoperatively for evaluation of bone response and degradation behavior of implants. RESULTS The mean age at surgery was 13.3 ± 1.6 years. A total of 25 screws were used in 11 patients, a mean of 2.4 ± 1 per patient, 4 pins were used in 1 patient. In 2 patients, fixation with screws was complemented with fibrin glue. The mean follow-up was 14.2 ± 3.3 months. All patients exhibited complete functional recovery while showing no signs of pain at 6 months postoperatively. No adverse local reactions were observed. At 1-year follow-up, no implant failure has been reported. Complete radiographic healing occurred in 12 cases. Mild radiolucent zones were observed around the implants. CONCLUSIONS The use of screws and pins MAGNEZIX® has been found to provide satisfactory outcomes in terms of fracture healing and very good functional outcomes at 1 year postoperatively. Key words: biodegradable implants, magnesium-based implants, osteochondral fracture, osteochondritis dissecans, MAGNEZIX®.

• MeSH
• Child MeSH
• Fractures, Bone * MeSH
• Fracture Healing MeSH
• Magnesium MeSH
• Knee Joint diagnostic imaging   surgery   MeSH
• Bone Nails MeSH
• Humans MeSH
• Adolescent MeSH
• Follow-Up Studies MeSH
• Osteochondritis Dissecans * diagnostic imaging   surgery   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Minimally Invasive Surgical Procedures methods   MeSH
• Osteochondritis Dissecans * surgery   diagnostic imaging   veterinary   MeSH
• Dogs MeSH
• Shoulder Joint surgery   pathology   MeSH
• Treatment Outcome MeSH
• Animals MeSH
• Check Tag
• Dogs MeSH
• Animals MeSH
• Publication type
• Case Reports MeSH

PURPOSE OF STUDY Osteochondritis dissecans (OCHD) is an increasingly diagnosed disease among adolescent patients. It is a condition affecting subchondral bone and the lining cartilage. If left untreated, it can cause destruction of cartilage of the affected joint leading to early development of arthrosis. Mostly affected joints are knees and ankles, but affected elbow and other joints have been described too. The purpose of our study is to present the patients diagnosed and treated surgically at our clinic with arthroscopic drilling in the period 2010-2015, and subsequently the clinical findings obtained at follow-up checks after the surgery. MATERIAL AND METHODS Between 2010 and 2015, a total of 34 patients (36 joints) underwent surgical treatment at our clinic. Their age ranged from 6 to 19 years at the time of surgery, 17 girls and 17 boys underwent the surgery. All the patients were treated with transarticular antegrade arthroscopic drilling. Each patient was diagnosed based on the clinical finding, radiographs, or MRI. The patients were followed after 6 weeks, thereafter 3, 6, and 12 months after the surgery. Each patient was evaluated based on the clinical findings (presence of swelling, range of motion, and pain according to VAS), and radiographs. RESULTS The preoperative VAS was 2.9 and dropped down to 1.5 at the first follow-up visit. None of the patients complained of pain at 1-year follow-up. 34 (out of 36) patients suffered joint swelling preoperatively, 6 weeks after the surgery only 9 patients presented with ongoing swelling, at 1-year follow-up no patient reported this problem. The X-ray findings showed regression in 35 of 36 patients one year after the surgery. One female patient underwent redo surgery because of an ongoing restriction of movement and X-ray finding persistence. DISCUSSION Majority of patients with OCHD can be treated conservatively. Physical activity modification and temporary immobilization are commonly used treatment methods of this condition. If conservative treatment is unsuccessful, arthroscopy should be considered. Stable lesions have a high chance of spontaneous healing without surgery. There is a variety of arthroscopic treatment methods. Mostly transarticular transchondral drilling is used to treat this condition. CONCLUSION Treatment of OCHD with arthroscopic drilling shows promising results in our cohort of patients. We recommend to use arthroscopic drilling in patients in stage I to III according to X-ray when 3 months of conservative treatment do not improve the clinical symptoms, swelling and restriction of movement. Antegrade drilling is the most frequently used treatment method in OCHD at our clinic, we consider this technique a simple and effective, with short surgical time needed. Key words: osteochondritis dissecans, treatment, arthroscopy, drilling.

• MeSH
• Arthroscopy methods   MeSH
• Child MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Adolescent MeSH
• Young Adult MeSH
• Follow-Up Studies MeSH
• Osteochondritis Dissecans diagnostic imaging   surgery   MeSH
• Radiography MeSH
• Severity of Illness Index MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH

V dětském a adolescentním věku přibývá intraartikulárních poranění kolenního kloubu. Včasná a správná diagnostika je klíčová vzhledem k indikaci nejvhodnější léčby s cílem správného ošetření a prevence trvalých následků. Hlavní diagnostickou metodou zůstává klinické vyšetření, nezbytnou součástí je vyšetření zobrazovacími metodami, na jejichž základě volíme nejvhodnější způsob ošetření. Vzhledem k dobrým regeneračním schopnostem u dítěte dosahujeme ve srovnání s dospělým vhodně cílenou a správně indikovanou léčbou velmi dobrých výsledků. Léčba intraartikulárního poranění u dětského pacienta patří do specializovaných center vybavených adekvátní technologií a zkušenostmi s danou problematikou. Následující článek čtenářům podává přehled o nejčastějších intraartikulárních úrazech kolenního kloubu u dětských pacientů.

There is an increased incidence of intra-articular injuries in children and adolescence. Early and accurate diagnosis is critical to ensure adequate clinical management to avoid permanent damage. The physical examination remains the backbone to obtain appropriate diagnosis, on the other hand additional imaging is an essential part of examination in order to determine specifically what type of treatment is required. Children have a unique healing ability in comparison with adults, therefore specifically indicated treatment line can lead to optimal results. Treatment of the intra-articular injuries in children should take place in specialized centers with adequate background, technology and experience. The following article offers the reader an overview of the most common intra-articular injuries of the knee in pediatric patients and their treatment.

• MeSH
• Child MeSH
• Cartilage, Articular surgery   injuries   MeSH
• Foot Joints * diagnostic imaging   surgery   injuries   MeSH
• Knee Joint diagnostic imaging   surgery   MeSH
• Humans MeSH
• Menisci, Tibial surgery   MeSH
• Adolescent MeSH
• Orthopedic Procedures methods   MeSH
• Osteochondritis Dissecans diagnostic imaging   surgery   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Context: Heterozygous mutations in the aggrecan gene (ACAN) cause autosomal dominant short stature with accelerated skeletal maturation. Objective: We sought to characterize the phenotypic spectrum and response to growth-promoting therapies. Patients and Methods: One hundred three individuals (57 females, 46 males) from 20 families with autosomal dominant short stature and heterozygous ACAN mutations were identified and confirmed using whole-exome sequencing, targeted next-generation sequencing, and/or Sanger sequencing. Clinical information was collected from the medical records. Results: Identified ACAN variants showed perfect cosegregation with phenotype. Adult individuals had mildly disproportionate short stature [median height, -2.8 standard deviation score (SDS); range, -5.9 to -0.9] and a history of early growth cessation. The condition was frequently associated with early-onset osteoarthritis (12 families) and intervertebral disc disease (9 families). No apparent genotype-phenotype correlation was found between the type of ACAN mutation and the presence of joint complaints. Childhood height was less affected (median height, -2.0 SDS; range, -4.2 to -0.6). Most children with ACAN mutations had advanced bone age (bone age - chronologic age; median, +1.3 years; range, +0.0 to +3.7 years). Nineteen individuals had received growth hormone therapy with some evidence of increased growth velocity. Conclusions: Heterozygous ACAN mutations result in a phenotypic spectrum ranging from mild and proportionate short stature to a mild skeletal dysplasia with disproportionate short stature and brachydactyly. Many affected individuals developed early-onset osteoarthritis and degenerative disc disease, suggesting dysfunction of the articular cartilage and intervertebral disc cartilage. Additional studies are needed to determine the optimal treatment strategy for these patients.

• MeSH
• Aggrecans genetics   MeSH
• Anthropometry methods   MeSH
• Brachydactyly genetics   MeSH
• Intervertebral Disc Degeneration genetics   MeSH
• Child MeSH
• Adult MeSH
• Phenotype MeSH
• Heterozygote MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Mutation * MeSH
• DNA Mutational Analysis methods   MeSH
• Dwarfism drug therapy   genetics   MeSH
• Osteochondritis Dissecans congenital   genetics   MeSH
• Child, Preschool MeSH
• Pedigree MeSH
• Growth genetics   MeSH
• Growth Hormone therapeutic use   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Intervertebral Disc Displacement genetics   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH

Syphilis congenita recens je vzácná forma syphilis způsobená transplacentárním přestupem treponemat do vyvíjejícího se plodu od 4. měsíce gravidity, tj. po dokončení vývoje placenty (1). Manifestace onemocnění je určená stadiem syphilis matky, adekvátností, načasováním léčby matky a také imunologickými reakcemi plodu. Je-li matka ve stadiu pozdní sekundární syphilis, je placenta méně postižena (menší množství treponemat) a matka porodí dítě živé s klinickými příznaky vrozené syphilis, tedy syphilis congenita recens (1, 4). V následujícím článku jsou uvedena dvě krátká kazuistická sdělení dětí s diagnózou syphilis congenita recens stanovené na základě pozitivního sérologického vyšetření po narození, u nichž byla pozitivní rodinná anamnéza stran této STI (Sexually Transmitted Infections). V obou případech byla tato forma syphilis potvrzena pozitivním rentgenologickým vyšetřením dlouhých kostí – osteochondritis luetica.

Syphilis congenita recens is rare form of syphilis caused by transplacentar transfer of Treponema pallidum during embryonic developementof child since fourth month of pregnancy, that means just after the development of placenta (1). Disease symptomsare defined by mother´s syphilis stage, adequacy and timing of the mothers´s treatment and by imunological reactions of foetus.If mother is in the late secondary syphilis stage, then the placenta infliction is lesser ( smaller amount of Treponema pallidum) andthe child is born alive with clinical attributes of early congenital syphilis, syphilis congenita recens (1,4). The following article bringsto your attention two short case reports of children with early congenital syphilis where diagnosis was determined by positiveserology tests. In both cases there was positive history of syphilis in mother (Sexually Transmitted Infections). Such form of syphiliswere comfirmed by X-ray examination of bones, when osteochondritis syphilitica was found in both cases.

• MeSH
• Anti-Bacterial Agents MeSH
• Penicillin G Benzathine administration & dosage   therapeutic use   MeSH
• Pregnancy Complications, Infectious diagnosis   MeSH
• Humans MeSH
• Infant, Newborn MeSH
• Osteochondritis MeSH
• Syphilis Serodiagnosis methods   MeSH
• Syphilis, Congenital * diagnosis   drug therapy   MeSH
• Rare Diseases MeSH
• Check Tag
• Humans MeSH
• Infant, Newborn MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Arthralgia * MeSH
• Chondrocalcinosis diagnosis   etiology   MeSH
• Chondromatosis diagnosis   etiology   MeSH
• Diagnosis, Differential * MeSH
• Arthritis, Gouty diagnosis   etiology   MeSH
• Physical Examination methods   MeSH
• Hemorrhagic Disorders diagnosis   etiology   MeSH
• Arthritis, Infectious diagnosis   etiology   MeSH
• Humans MeSH
• Elbow Joint * abnormalities   physiopathology   pathology   MeSH
• Neoplastic Processes MeSH
• Arthropathy, Neurogenic diagnosis   etiology   MeSH
• Orthopedics MeSH
• Osteoarthritis MeSH
• Osteochondritis Dissecans MeSH
• Rheumatic Diseases MeSH
• Arthritis, Rheumatoid diagnosis   etiology   MeSH
• Rheumatology MeSH
• Spondylarthritis diagnosis   etiology   MeSH
• Check Tag
• Humans MeSH

Osteochondritis dissecans(OCD) of the knee is identified with increasing frequency in the adolescent patient. Left untreated, OCD can cause significant impairment and restriction in physical activity and development of osteoarthritis at an early age. The diagnosis of lesions of OCD can be confirmed on plain radiographs. MRI has emerged as the gold standard to evaluate the stability of the lesion and the integrity of the overlying articular cartilage. Treatment of OCD lesions depend on the stability of the lesion. Stable lesions can be treated conservatively by physical activity modification and immobilization. Unstable lesions and stable lesions not responding to conservative measures should be treated surgically. Surgical options range from arthroscopic drilling, either transarticular or extra-articular drilling for stable lesions or salvage procedures such as autologous chondrocyte transplantation (ACT), mosaicplasty to restore joint and cartilage congruency.

• MeSH
• Child MeSH
• Knee Joint * MeSH
• Humans MeSH
• Adolescent MeSH
• Osteochondritis Dissecans pathology   radiography   surgery   MeSH
• Retrospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Osteochondrální léze talu je lokalizovaný defekt chrupavky a subchondrální kosti, nejčastěji způsobený jedním nebo opakovaným traumatem, které vede k částečnému nebo úplnému uvolnění chondrálního nebo osteochondrálního fragmentu. Často se projevuje jako pozdní komplikace po poranění hlezenného kloubu. V klinickém obrazu přetrvává chronická bolest po předešlém úrazu. Časná a správná diagnóza je zásadní pro správný léčebný postup poraněného hlezna. Pro akutní, nedislokované léze je indikován konzervativní postup, který zahrnuje imobilizaci bez zátěže končetiny. Operační terapie je vyhrazena pro dislokované nebo nestabilní léze a pro chronické stavy po selhání konzervativní léčby.

Osteochondral lesion of the talus is a localised defect in the cartilage and subchondral bone, usually caused by a single or repeated trauma, which leads to a partial or complete release of the chondral or osteochondral fragment. It often encountered as a late complication of distension of the ankle joint. Chronic pain persists after the preceding accident in the clinical picture. Early and accurate diagnosis is essential for correct treatment of the injured ankle. For acute, non-displaced lesions, conservative treatment is indicated, which involves immobilization of the limb without load. Surgical therapy is reserved for displaced or unstable lesions and chronic conditions following failure of conservative treatment.

• Keywords
• mozaiková plastika, návrty,
• MeSH
• Transplantation, Autologous MeSH
• Cartilage * physiopathology   MeSH
• Fractures, Bone surgery   radiography   therapy   MeSH
• Ankle Joint radiography   MeSH
• Immobilization MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Orthopedic Procedures methods   MeSH
• Osteochondritis Dissecans surgery   complications   MeSH
• Ankle Injuries * surgery   radiography   therapy   MeSH
• Athletic Injuries MeSH
• Talus * surgery   radiography   injuries   MeSH
• Fracture Fixation, Internal methods   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Case Reports MeSH

Based on the analysis of clinical, anatomical and functional results of operative treatment of osteochondrosis of the lumbosacral spine to develop optimal, pathogenic, orthopedic surgical treatment of these category patients. The study included 272 patients undergoing surgery for poor primary interventions 78 (28.6 %) (group A) and 194 (71.3 %) patients initially applied for surgical treatment in view of orthopedic factors (group B). The results of treatment were studied during period from 3 to 24 months. The dynamics of neurological status, pain intensity on visual analog scale and Oswestry index was studied. The most influence on the outcome of treatment had the following factors: the instability of the segment, spinal stenosis and a damage of the form of the lumbosacral spine. There were proved the advantages of the current methods of surgical correction taking into account the orthopedic factors compared to traditional methods of treatment. There was obtained 97.4 % of good and satisfactory results during the two-year follow-up. Leading pathomorphological changes in lumbar osteochondrosis is spinal canal stenosis and segmental instability. Therefore, the optimal methods of surgical treatment of osteochondrosis should be recognized those which provide simultaneous resolving of the dual task - to carry out the decompression of neurovascular formations of the spinal canal and to stabilize the affected vertebral segment.

• MeSH
• Lumbar Vertebrae * surgery   pathology   radiography   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Orthopedics MeSH
• Osteochondritis * surgery   pathology   MeSH
• Spine surgery   pathology   radiography   MeSH
• Spinal Stenosis MeSH
• Severity of Illness Index MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Publication type
• Case Reports MeSH