Primary hyperparathyroidism in children and adolescents is rare and often symptomatic at presentation. A 15-year-old boy presented with bilateral genu valgum for two years. Biochemical results were consistent with primary hyperparathyroidism. Calcium levels normalized two months after removal of a left inferior parathyroid adenoma.
parathyroid neoplasms ; genu valgum ; adolescent ; Hyperparathyroidism, Primary

PURPOSE: We analyzed the results of lateral retinacular release(LRR) and proximal realignment for recurrent patellar instability after trauma according to the anatomical predisposing factors. MATERIALS AND METHODS: Twelve patients of fifteen cases of recurrent patellar instability had been evaluated. Clinical assessment were performed by Q-angle, apprehension test, passive patellar tilt test and general joint laxity. The anatomical predisposing factors assessed by plain radiographs included patella alta, sulcus angle, femoral trochlear dysplasia, genu valgum and patellar dysplasia. Clinical results were assessed by Kujala scoring system. Radiographic results were assessed by congruence angle. The results were analyzed according to the predisposing factors. RESULTS: Patella alta was observed in eight, increased sulcus angle in six, trochlear dysplasia in twelve, genu valgum in five and patella dysplasia in four cases. The result of treatment (Kujala score / congruence angle) was 85.8 / 9.7degrees in group A(predisposing factors > or = 3) and 91.4 / -5.3degrees in group B (predisposing factors<3)(p=0.036). We had 4 cases of recurrence after operation and genu valgum was related with recurrence rate. CONCLUSION: The clinical results of LRR and proximal realignment for recurrent patellar instability developed after trauma were worse in cases with more anatomical predisposing factors.
Causality* ; Genu Valgum ; Humans ; Joint Instability ; Patella ; Recurrence

Habitual dislocation of patella is a rare disorder. Sometimes it is associated with angular deformity such as genu valgum. We experienced habitual patella dislocation associated with genu valgum that was treated with corrective osteotomy of distal femur and soft tissue realignment procedure including lateral release and medial reefing.
Congenital Abnormalities ; Dislocations ; Femur ; Genu Valgum ; Osteotomy ; Patella

PURPOSE: Recurrent patellar dislocation is often associated with genu valgum. The purpose of this study was to analyze the short-term results of single-incision, closing-wedge distal femoral osteotomy (CWDFO) combined with medial reefing and lateral release for recurrent patellar instability with genu valgum. MATERIALS AND METHODS: Combined CWDFO/medial reefing/lateral release was performed on 10 knees. Clinical evaluation was based on pre- and postoperative Knee Society Score (KSS) and Kujala patellofemoral score. Radiographic evaluation was performed with reference to the weight-bearing line (WBL), the femorotibial angle (FTA), and the mechanical lateral distal femoral angles in the knee-standing view. RESULTS: At a mean follow-up of 20±11.7 months (range, 12–42 months), KSS scores improved significantly, from 46.7±5.2 preoperatively to 87±4.4 postoperatively (p<0.001), as did the Kujala score, from 44±8 preoperatively to 86.6±6.8 postoperatively (p<0.001). The WBL decreased significantly, from 76±7% preoperatively to 41±11% postoperatively (p<0.001). The FTA was improved significantly, from 12.7±1.7° preoperatively to 4±4° postoperatively (p<0.001), as was the mLDFA, from 83±4° preoperatively to 91±1.3° postoperatively (p<0.001). CONCLUSION: Use of single-incision CWDFO combined with medial reefing and lateral release prevents patellar dislocation, corrects deformity, and improves clinical outcomes.
Congenital Abnormalities ; Follow-Up Studies ; Genu Valgum* ; Knee ; Osteotomy* ; Patellar Dislocation* ; Weight-Bearing

Dysplasia epiphysealis hemimelica (DEH), known as Trevor's disease, tarsoepiphyseal aclasis or la tarsomegalie, is a rare disease characterized by cartilaginous overgrowth of one-half of a single limb. Until now only three cases have been reported in Korea. The ages at initial diagnosis were 2.3 years, 2.5 years and 11.5 years, and patients were two boys and one girl by sex. The chief complaints were genu valgum (2 cases) and valgus of the foot (1 case). Plain radiographs showed bony overgrowth and asymmetrical ossification centers in all cases. MRI showed a definite cartilaginous or osteocartilaginous lesion (T1-weighted: intermediate signal intensity (SI) and T2-weighted: intermediate SI mixed inner high SI). Arthroscopic removal of the loose body was performed in one case and spontaneous regression of the genu valgum was noted in one case. We report upon three additional cases and review the literature.
Diagnosis ; Extremities ; Female ; Foot ; Genu Valgum ; Humans ; Korea ; Magnetic Resonance Imaging ; Rare Diseases

A case of dysplasia eplphyseaalis hemlmelica (Fairbank, 1956) in a 8 years old boy, showlng typical clinical and roentgenographical appearance, is reported together wlth a brief review of literature in this paper. This condition is a rare developmental disorder of childhood in which there is a asymmetrical cartilaginous overgrowth of one or more than one epiphysis, or of a tarsal or carpal bone. Thls disorder is usually Iimited to elther the medial or lateral half of a single extremity. The disease is characterised radiographically by delay in the appearance of the epiphyseal nucleus, which is mottied and of irregular density. The most common deformities were genu valgum or varum and valgus or equinus deformity of the ankle. These deformities tended to increased wlth growth but the size of the lesion increased in proportion to the growth of the normal bone. Concomitant involvement of the knee and ankle is the rule, and in those cases the affected limb Is usually longer than Its mate. The lesion Is often microscopically indistingulshable from an osteochondroma.
Ankle ; Carpal Bones ; Congenital Abnormalities ; Epiphyses ; Equinus Deformity ; Extremities ; Genu Valgum ; Humans ; Knee ; Male ; Osteochondroma

Morquio's syndrome is a very rare disease, which is characterized by dwarfism, flattening of the vertebral body, marked spinal kyphosis, widespread affection of the epiphyses and normal intelligence. The authors experienced a case of Morquio's syndrome with typical clinical and radiological findings. The patient underwent bilateral supracondylar varus osteotomies for severe genu valgum deformities.
Congenital Abnormalities ; Dwarfism ; Epiphyses ; Genu Valgum ; Humans ; Intelligence ; Kyphosis ; Mucopolysaccharidosis IV ; Osteotomy ; Rare Diseases

BACKGROUND: The hemiepiphyseal stapling has both positive and negative effects on effective leg length. The purpose of this study was to analyze change in effective leg length after angular correction by hemiepiphyseal stapling, and to validate in clinical cases. METHODS: Mathematical analysis of a hemiepiphyseal stapling model was conducted. The induced formula was validated in 6 cases fulfilling the assumptions of the model. Anatomical parameters involved in this formula were measured in additional 21 cases undergoing hemiepiphyseal stapling or hemiepiphysiodesis. RESULTS: Effective leg length increased or decreased according to three parameters in this model: 1) limb length distal to the operated physis (L), 2) width of the operated physis (d), and 3) the amount of angular deformity to be corrected (theta). Actual change in effective leg length of 6 cases similar to this model coincided with the predicted change at least in its direction. L/d ratio was 4.82 +/- 0.51. CONCLUSIONS: Considering the narrow range of the L/d ratio, hemiepiphyseal stapling is likely to decrease effective leg length if the amount of angular correction is less than 10degrees, whereas to increase it if the amount of angular correction is larger than 16degrees. This should be taken into consideration when selecting the surgical method for angular deformity correction in skeletally immature patients.
Adolescent ; Child ; Epiphyses/growth & development/*surgery ; Female ; Genu Valgum/*surgery ; Genu Varum/*surgery ; Humans ; Leg Length Inequality/diagnosis/*etiology ; Male ; *Surgical Stapling/adverse effects

PURPOSE: The purposes of this study were to evaluate the efficacy of deformity correction of the knee and leg lengthening by the Ilizarov method in patients with vitamin D resistant rickets (VDRR) . MATERIALS AND METHODS: There were 7 patients with average age of 13 years and 6 months. 5 patients had genu varum and 2, genu valgum. 3 patients underwent deformity correction alone in 4 femora, and the remaining 4 patients underwent concomitant deformity correction and lengthening in 5 femora, and 12 tibiae and fibulae. RESULTS: Angular correction averaged 22.6. and the amount of lengthening averaged 3.5 cm. The healing index (H.I) averaged 2.1 month/cm. But those who had serum phosphate level more than 2.5 mg/dL showed rapid regenerate bone healing (H.I: 1.6 month/cm) . There was a statistically negative correlation between H.I and the level of serum phosphate. CONCLUSION: Maintenance of appropriate serum phosphate level (> or = 2.5 mg/dL) is important for satisfactory regenerate bone healing in due time in patients with VDRR. The recurrence rate of deformity appears to be relatively higher in immature patients.
Child* ; Congenital Abnormalities* ; Familial Hypophosphatemic Rickets* ; Fibula ; Genu Valgum ; Genu Varum ; Humans ; Ilizarov Technique* ; Knee* ; Leg* ; Recurrence ; Tibia ; Vitamin D* ; Vitamins*

Familial hypophosphatemic ricket (Vitamin D-resistant ricket), first described by Albright in 1937, has been known to be transmitted as an X-linked dominant trait in most families. Children with this disease would show growth retardation with characteristic clinical features such as congenital alopecia, genu varum or genu valgum, coxa vara and waddling gait. Although the physical features associated with this disease have been documented frequently, the potential involvement of auditory pathway due to abnormal bone formation in skull has not been explored frequently. We report a twenty six-month-old female child with familial hypophosphatemic ricket who presented abnormal findings of brainstem auditory evoked potential study. The impaired hearing function should be alerted as one of possible accompanying disabilities of the disease.
Alopecia ; Auditory Pathways ; Child* ; Coxa Vara ; Evoked Potentials, Auditory, Brain Stem ; Female ; Gait ; Genu Valgum ; Genu Varum ; Hearing ; Humans ; Osteogenesis ; Rickets, Hypophosphatemic* ; Skull