Prevalence and Characteristics of Back Pain in Children and Adolescents from the Region of Murcia (Spain): ISQUIOS Programme

Puberty is a vulnerable period for musculoskeletal disorders due to the existence of a wide inter-individual variation in growth and development. The main objective of the present study was to describe the prevalence of back pain (BP) in the past year and month in school-aged children according to sex, age, maturity status, body mass index (BMI) and pain characteristics. This study involved 513 students aged between 9 and 16 years. Anthropometric measures were recorded to calculate the maturity stage of the students using a regression equation comprising measures for age, body mass, body height, sitting height and leg length. An ad hoc questionnaire composed of eight questions was used to describe BP prevalence in school-aged children. The results showed that the prevalence of BP in school-aged children was observed in 35.1% over the last year (45% boys and 55% girls), and 17.3% (40.4% boys and 59.6% girls, with an association found between female sex and BP) in the last month. The prevalence of back pain in the past year and month was higher the older the students were, or the more pubertal development they had experienced. The prevalence of BP in the last year was also higher in those with overweight or obesity. After adjustment for sex, there was an association between BP and older age and higher BMI in boys and an association between BP and higher pubertal development in girls. In summary, the present study showed that the prevalence of BP was related to the maturity stage and weight of the participants, with different prevalence patterns found according to sex.

Limb, joint and pelvic kinematic control in the quail coping with step perturbations

Small cursorial birds display remarkable walking skills and can negotiate complex and unstructured terrains with ease. The neuromechanical control strategies necessary to adapt to these challenging terrains are still not well understood. Here, we analyzed the 2D- and 3D pelvic and leg kinematic strategies employed by the common quail to negotiate visible step-up and step-down perturbations of 1 cm, 2.5 cm, and 5 cm. We used biplanar fluoroscopy to accurately describe joint positions in three dimensions and performed semi-automatic landmark localization using deep learning. Quails negotiated vertical perturbations without major problems and rapidly regained steady-state locomotion. When coping with step-up perturbations, the quail mostly adapted the trailing limb to permit the leading leg to step on the elevated substrate in a similar way as it did during level locomotion. When the quail negotiated step-down perturbations, both legs showed significant adaptations. For small and moderate perturbations (not inducing aerial running) the quail kept the function of the distal joints (i.e., their kinematic pattern) largely unchanged during uneven locomotion, and most changes occurred in proximal joints. The hip regulated leg length, while the distal joints maintained the spring-damped limb patterns. However, to negotiate the largest visible step perturbations, more dramatic kinematic alterations were observed. For these large perturbations, all joints contributed to leg lengthening/ shortening in the trailing leg and both the trailing and leading legs stepped more vertically and less abducted. This indicates a shift from a dynamic walking program to strategies that are focused on maximizing safety.

A comparison of 3 different methods for assessment of skeletal age when treating leg-length discrepancies: an inter- and intra-observer study

Background and purpose — Skeletal maturity is a crucial parameter when calculating remaining growth in children. We compared 3 different methods, 2 manual and 1 automated, in the radiological assessment of bone age with respect to precision and systematic difference. Material and methods — 66 simultaneous examinations of the left hand and left elbow from children treated for leg-length discrepancies were randomly selected for skeletal age assessment. The radiographs were anonymized and assessed twice with at least 3 weeks’ interval according to the Greulich and Pyle (GP) and Sauvegrain (SG) methods by 5 radiologists with different levels of experience. The hand radiographs were also assessed for GP bone age by use of the automated BoneXpert (BX) method for comparison. Results — The inter-observer intraclass correlation coefficient (ICC) was 0.96 for the GP and 0.98 for the SG method. The inter- and intra-observer standard error of the measurement (SEm) was 0.41 and 0.32 years for the GP method and 0.27 and 0.21 years for the SG method with a significant difference (p < 0.001) between the methods and between the experienced and the less experienced radiologists for both methods (p = 0.003 and p < 0.001). In 25% of the assessments the discrepancy between the GP and the SG methodwas > 1 year. There was no systematic difference comparing either manual method with the automatic BX method. Interpretation — With respect to the precision of skeletal age determination, we recommend using the SG method or preferably the automated BX method based on GP assessments in the calculation of remaining growth.

More than a feeling?—Overruling the preoperatively templated offset option leads to a minor offset increase in short stem total hip arthroplasty

Purpose Short stems are increasingly used in total hip arthroplasty (THA) because of advantages in bone and soft tissue preservation and reconstruction of hip geometry. Digital templating is essential in determining the correct offset option and stem size in THA. However, the preoperative template sizes might be intraoperatively overruled. Patients and methods We evaluated the effect of intraoperative overruling of the preoperatively templated offset option of a short curved stem on hip offset, leg length, implant positioning, and femoral canal fill index. The overruling was performed in case of intraoperative instability, telescoping, or both. A series of 1052 consecutive THAs with a cementless short curved stem and press-fit cup was retrospectively screened. One hundred patients with unilateral THA and a contralateral native and morphologically healthy hip as a reference met the inclusion criteria. Measurements were carried out on preoperative and 3 months anterior–posterior postoperative radiographs. Patients were divided according to the overruling by offset option or stem size. Results Hip offset was increased in all groups, but only with significant increase if an offset option + 1 was used intraoperatively (p = 0.025). LLD was restored without significance in all groups (p = 0.323; p = 0.157). Conclusion Intraoperative overruling of the preoperative digital template in cementless short stem total hip arthroplasty results in an increase of hip offset compared to a contralateral healthy hip. However, the increase is marginal and clearly under 5 mm compared to the contralateral healthy hip.

Restoration of Native Leg Length After Opening-Wedge High Tibial Osteotomy: An Intraindividual Analysis

Background: Opening-wedge high tibial osteotomy (OWHTO) has been shown to significantly increase leg length, especially in patients with large varus deformity. Thus, the current literature recommends closing-wedge high tibial osteotomy to correct malalignment in these patients to prevent postoperative leg length discrepancy. However, potential preoperative leg length discrepancy has not been considered yet. Hypothesis: It was hypothesized that patients have a decreased preoperative length of the involved leg compared with the contralateral side and that OWHTO would subsequently restore native leg length. Study Design: Case series; Level of evidence, 4. Methods: Included were 67 patients who underwent OWHTO for unilateral medial compartment knee osteoarthritis and who received full leg length assessment pre- and postoperatively. Patients with varus or valgus deformity (>3°) of the contralateral side were excluded. A musculoskeletal radiologist assessed imaging for the mechanical axis, full leg length, and tibial length of the involved and contralateral lower extremity. Statistical analysis determined the pre- and postoperative leg length discrepancy and the influence of the mechanical axis. Results: Most patients (62.7%) had a decreased length of the involved leg, with a mean preoperative mechanical axis of 5.0° ± 2.9°. Length discrepancy averaged –2.2 ± 5.8 mm, indicating a shortened involved extremity ( P = .003). OWHTO significantly increased the mean lengths of the tibia and lower limb by 3.6 ± 2.9 and 4.4 ± 4.7 mm ( P < .001), leading to a postoperative tibial and full leg length discrepancy of 2.8 ± 4.3 mm and 2.2 ± 7.3 mm ( P < .001 and P = .017, respectively). Preoperative leg length discrepancy was significantly correlated with the preoperative mechanical axis of the involved limb ( r = 0.292; P = .016), and the amount of correction was significantly associated with leg lengthening after OWHTO ( r = 0.319; P = .009). Patients with a varus deformity of ≥6.5° (n = 14) had a preoperative length discrepancy of –4.5 ± 1.6 mm ( P < .001) that was reduced to 1.8 ± 3.5 mm ( P = .08). Conclusion: Patients undergoing OWHTO have a preoperative leg length discrepancy that is directly associated with the varus deformity of the involved extremity. As OWHTO significantly increases leg length, restoration of native leg length can be achieved particularly in patients with large varus deformity.

Embryo development of hatching eggs of superior local broiler (ALPU) with Arab native chickens (Kamaras)

Efforts to improve the quality of local chickens, especially free-range chickens, are carried out by improving genetic traits, namely through a strict selection method to produce broilers with the name of Superior Local Broilers (ALPU) and laying purposes with Arab Kampung Chickens (Kamaras). This study was conducted to obtain information on the comparison of ALPU and Kamaras embryo development for genetic improvement as the basis for further research. This study used 105 ALPU hatching eggs and 105 Kamaras hatching eggs, the observations were carried out for 21 days. Eggs were collected for 7 days and then put into the incubator, then observed every day by breaking each 5 ALPU and Kamaras eggs to see 7 parameters of embryo development in the form of: body weight, body length, head circumference, neck length, beak length, wing length and leg length. The results showed that there was no significant developmental difference between ALPU and Kamaras embryos. However, the embryo weight and beak length of Kamaras tended to be larger than those of ALPU, while the head circumference and wing length of ALPU tended to be larger than that of Kamaras. In conclusion, the embryonic development between ALPU and Kamaras showed relatively similar embryo development during the hatching period.

Surgical Treatment of Leg Length Discrepancy and Knee Flexion Contracture Associated with a Congenital Absence of Quadriceps

We report the case of an 18-year-old male with congenital absence of quadriceps and hypoplasia of the patella who presented with a significant leg length discrepancy (LLD) and knee flexion contracture. Surgical management was aimed toward lengthening the limb, stabilizing the joint, and correcting the knee flexion contracture. Correction of a significant congenital LLD and knee flexion contracture poses challenges due to long-standing altered biomechanics. These are rare conditions for which no accepted surgical algorithms exist. It is essential to anticipate the biomechanical consequences of limb lengthening and flexion contracture correction that might arise and plan comprehensive interventions accordingly.

Anthropometry and Physical Condition Profile of Bhayangkara FC Professional Football Athletes

The purpose of this study was to investigate the anthropometry and physical condition profile of Bhayangkara FC professional football athletes. The research was conducted by survey. The research sample amounted to 19 athletes. Data were collected through anthropometric measurements including weight, height, and leg length as well as physical condition tests including 30 meter sprint, illinois, sit and reach, vertical jump, Yo Yo Fitness test. The data were analyzed by T-score and then categorized on a scale of very good to very poor. The results showed that the anthropometric profile of Bhayangkara FC professional football athletes were mostly in the moderate category (8 athletes/42.11%), while the others were in the poor category (5 athletes/26.32%), good (3 athletes/15.79%), good once (2 athletes/10.53 %), and less than once (1 athlete 5.26 %). The study also showed that the physical condition profile of Bhayangkara FC professional football athletes were mostly in the moderate category (10 athletes/52.63%), while the others were in the good category (4 athletes/21.05%), less (3 athletes/15.79%), very good (1 athlete/5.26 %), and very poor (1 athlete/5.26 %). In conclusion, the mean anthropometric profile of Bhayangkara FC professional football athletes showed a moderate category and the mean physical condition profile of Bhayangkara FC professional football athletes showed a moderate category.