Objective To explore the effect of arthroscopy in diagnosis and treatment of osteochondritis dissecans of elbow joint in adolescent. Methods From May 2003 to February 2006, 11 patients with osteochondritis dissecans of elbowjoint were diagnosed and treated with arthroscopy. There were 6 males and 5 females, aging from 13 to 19 years. The left joints were involved in 4 cases and right joints in 7 cases. Seven patients had obvious history of injury. The interval of injury and operation was from 7 months to 12 years. The score of VAS was 80±10, the range of flexion and extend of joint 80±10°, the range of rotation of joint 100±5° preoperatively. The brachial plexus anesthesia, the elbow hung to traction, soft spot, interna and extrapathway were given to explore and debride elbow joint and remove corpus liberum. Results All patients recovered daily life and work 7 to 12 dayspostoperatively. There were no complications of blood vessel and nerve injuries. Eleven cases were followed up for 6 to 18 months (mean 12-5 months). The results wereexcellent in 7 and good in 4 according to HSS scoring system. At the final followup, the score of VAS was 32±15, showing statistically significant difference when compared with preoperation (Plt;0.05). The range of flexion and extend of joint was 110±10°，the range of rotation of joint was 120±5° postoperatively, showing statistically significant differences when compared with preoperation (Plt;0.05). Conclusion The elbow arthroscopy might be a reliable methodto diagnose and treat osteochondritis dissecans of elbow joint in adolescent with minor trauma，quick recovery，significant improving function and less complications.
Objective To review the advances in double-bundle anterior cruciate ligament (ACL) reconstruction in adolescents at home and abroad. Methods Recent literature about double-bundle ACL reconstruction in adolescents at home and abroad was extensively consulted, and the relationship between bone canal and epiphyseal plate, clinical verification of surgical safety, and clinical effectiveness of double-bundle ACL reconstruction in adolescents were summarized and analyzed. Results Double-bundle ACL reconstruction has certain advantages in clinical stability and re-rupture rate when compared with single-bundle ACL reconstruction in adolescents, and there is no significant difference in safety between them. Conclusion Double-bundle ACL reconstruction in adolescents can achieve lower re-rupture rate and better stability when compared with single-bundle reconstruction. However, the sample size of clinical research is too small, and the follow-up time is too short, so the effectiveness needs to be continuously observed.
Objective To explore the association between behavioral, emotional problems and life events among adolescents, and to determine which factors of life events correlate most highly with the behavioral, emotional problems. Method A total of 1 325 adolescents were investigated with Youth Self-Report (YSR) of Achenbach’s behavior checklist and Adolescent Self-Rating Life Events Checklist (ASLEC), and the data were analyzed with canonical correlation analysis. Results Canonical correlation was statistically significant. The correlation coefficients of the first pair of canonical variables in the male and female group were 0.631 3 and 0.621 1, respectively, and the cumulative proportion of the first two pairs of canonical variables was above 0.95. In the first pair of canonical variables, the loadings of anxious/depressed, interpersonal sensitivity and study pressure were higher, while in the second pair, withdrawal and punishment were the most important factors. Conclusions The effects of life events on emotional problems mainly contributed to interpersonal sensitivity and study pressure.
ObjectivesTo systematically review the clinical characteristics of pregnant females, newborns, children and adolescents with SARS infection.MethodsThe clinical characteristics of patients with SARS infection were searched using PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data and VIP databases. Descriptive analysis was performed to analyze the clinical characteristics of the patients, clinical manifestations, treatment and prognosis.ResultsA total of 13 studies including 19 pregnant females, 14 newborns, and 81 children and adolescents were identified. The ratio of male to female was 1 to 1.2 in children and adolescents patients aged 56 days to 17.5 years. Children under 12 years old accounted for 58.3% (28/48). Of the child patients, 34.0% (16/47) had close contact with patients with SARS. Fever (93.8%, 76/81) and cough (49.4%, 40/81) were the most common symptoms in children and adolescents with SARS infection, and 17.5% (11/63) occurred with shortness of breath or dyspnea. The positive ratio of nucleic acid detection for SARS-CoV was 9.2% (14/48), and the positive ratio of serum antibody was 92.9% (13/14). Peripheral blood lymphocyte reduction was approximately 65.7% (44/67). Approximately 70.8% (51/72) unilateral and 29.2% (21/72) bilateral lesions were found by thoracic X-ray or CT scan. No child fatalities were reported. As of maternal patients, aged 23 to 44 years, 10 cases (52.6%) were infected during early and middle pregnancy, and 9 cases (47.4%) during late pregnancy. Fever (100.0%, 19/19) and cough (78.9%, 15/19) were the main clinical symptoms, and shortness of breath/dyspnea occurred in 36.8% (7/19) of infected pregnant females. The positive ratio of nucleic acid detection for SARS-CoV was 50.0% (8/16), whereas the positive ratio of serum antibody was 93.3% (14/15). The ratios of thrombocytopenia, lymphopenia, and liver enzymes abnormalities were 38.9% (7/18), 61.1% (11/18) and 50.0% (3/6). All patients were identified for lesions by thoracic X-ray or CT scan examination. Seven cases were severe (36.8%). Five patients were treated with mechanical ventilation (26.3%). Three patients died (15.8%). Four patients were spontaneous abortion (40.0%, 4/10). Nine patients were cesarean sectioned (75.0%, 9/12). Six fetuses (46.2%, 6/13) with fetal distress, 7 cases (53.8%, 7/13) with premature delivery were identified. Three fetuses (23.1%) had intrauterine growth retardation. None of the fourteen newborns was diagnosed as SARS infection.ConclusionsThe clinical symptoms such as fever and cough in children and adolescents with SARS infection are similar to that of adult patients. However, children and adolescents are usually manifested as mild infection without reported death. There is no evidence to support that SARS-CoV could transmit vertically from infected mother to their fetuses.
ObjectiveTo systematically review the effect of Schroth therapy on adolescent idiopathic scoliosis. MethodsThe PubMed, EBSCO, Embase, Cochrane Library, Web of Science, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to November 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 14 RCTs involving 589 patients were included. The results of meta-analysis showed that Schroth therapy significantly reduced patients' Cobb angle (MD=−3.21, 95%CI −3.87 to −2.55, P<0.01) and angle of trunk rotation (ATR) (MD=−2.39, 95%CI −3.07 to −1.71, P<0.01), and improved SRS-22 quality of life score (MD=0.16, 95%CI 0.01 to 0.30, P=0.04) compared with the control group. Subgroup analysis results showed that Schroth therapy had a better effect on improving the quality of life in moderate patients. Schroth therapy for 1.5-3 months, 5-7 times therapy a week, and a single 30 minute and 40-60 minutes therapy showed better improvement in patients' quality of life. Conclusion Current evidence shows that Schroth therapy can effectively improve Cobb angle, ATR, and quality of life in adolescents with idiopathic scoliosis. The improvement effect on quality of life is influenced by the intervention period, frequency, and duration of each intervention.
ObjectiveTo systematically review vitamin D nutritional status among children and adolescents in China.MethodsCNKI, CBM, WanFang Data, VIP and PubMed databases were electronically searched to collect cross-sectional studies on vitamin D nutritional status among children and adolescents in China from inception to September, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 11.0 software.ResultsA total of 23 cross-sectional studies involving 38 047 total sample size were included.The results of meta-analysis showed that the combined vitamin D deficiency rate was 27.9% (95%CI 21.9% to 33.8%), and the inadequate rate was 31.6% (95%CI 25.7% to 37.6%).Subgroup analysis showed that vitamin D deficiency rate of females was higher than that of males (25.3% vs. 22.5%). The vitamin D deficiency rate of children aged 10 to 18 was higher than those aged 6 to 9 (44.9% vs. 32.9%). The vitamin D deficiency rate of children in the north was higher than that in south (36.1% vs. 14.8%). The vitamin D deficiency rate from 2015 to 2018 was higher than that from 2011 to 2014 (34.9% vs. 17.6%). In addition, the vitamin D deficiency rate ofurban children was higher than that of rural children (29.9% vs. 24.9%).ConclusionsThe incidence of vitamin D deficiency among children and adolescents is high in China. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
ObjectiveTo explore the effect of a new rehabilitation intervention model based on International Classification of Functioning, Disability and Healthy (ICF) concept in perioperative treatment on patients with adolescent idiopathic scoliosis (AIS).MethodsFrom June 2017 to January 2019, AIS patients with Cobb angle below 80° were randomly divided into experimental group and control group by the method of randomized block design. The patients in the control group received routine perioperative rehabilitation intervention, while the patients in the experimental group received rehabilitation mode intervention based on ICF concept. The therapeutic effect of the two groups including functional and activity dimensions was observed.ResultsA total of 40 patients were included, with 20 in each group. Two patients withdrew the control group. On the fourth day after surgery, the total score of Modified Barthel Index (50.55±8.87 vs. 18.99±5.63; t=13.264, P<0.001) and Scoliosis Research Society-22 (SRS-22) (3.68±0.13 vs. 3.27±0.11; t=10.355, P<0.001) in the experimental group were all better than those in the control group. In the SRS-22 scores, statistically significant differences in comparison of function (2.79±0.29 vs. 1.90±0.48; t=6.884, P<0.001), and self image (3.91±0.27 vs. 3.38±0.32; t=5.539, P<0.001) between the two groups were found. There was no statistically significant difference in pain indicators and muscle strength between the two groups in the two postoperative evaluations (P>0.05). ConclusionsThe treatment based on the concept of ICF can improve the daily living ability in the short term with the safe and acceptable premise. The concept of stimulating patient autonomy, improving patient independence, and promoting social treatment, may improve the overall state of the patients.
ObjectiveTo systematically review the effect of media multitasking on working memory and attention among adolescents. MethodsCNKI, CBM, WanFang Data, VIP, PubMed, Web of Science, and EMbase databases were electronically searched to collect cross-sectional studies on the effect of media multitasking on working memory and attention among adolescents from inception to January 1st, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies; then, meta-analysis was performed using Stata 15.1 software. ResultsA total of 16 cross-sectional studies were included. The results of meta-analysis showed that there were negative correlations between media multitasking and working memory (Cohen's d=0.40, 95%CI 0.14 to 0.66, P＝0.003), as well as in attention (Cohen's d=1.02, 95%CI 0.58 to 1.47, P<0.001). ConclusionCurrent evidence shows that media multitasking has negative impact on working memory and attention. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To explore the effectiveness of arthroscopic medial retinaculum pl ication (MRP) for recurrent patellar dislocation in adolescents. Methods Between March 2000 and October 2007, 30 adolescent patients with recurrent patellar dislocation underwent arthroscopic MRP, and 28 of them (12 left knees and 16 right knees) completed thefinal follow-up and were enrolled. There were 5 males and 23 females with an average age of 14.7 years (range, 12-19 years). The dislocation duration was 4 to 39 months with an average of 18.8 months. All patients experienced 2-4 episodes of dislocation. Before operation, all the patients showed positive apprehension test; the degree of lateral patellar translation was (2.9 ± 0.7)° and there was no hardness termination in lateral translation. The International Knee Documentation Committee (IKDC), Lysholm, Kujala, and Tegner scores were 47.7 ± 3.7, 52.6 ± 4.9, 66.7 ± 5.9, and 3.1 ± 1.3, respectively. All patients underwent arthroscopic MRP procedure. Results All incisions healed by first intention without compl ication. All the patients were followed up 2-7 years (4.8 years on average). During the follow-up, more and more patients showed positive apprehension test, and at 24 months of follow-up, 12 patients showed positive apprehension test; less and less patients had hardness termination in lateral translation, only 3 patients at 24 months of follow-up; the degree of lateral patellar translation increased, (2.3 ± 1.1)° at 24 months of follow-up. There were significant differences in positive apprehension test and hardness termination between preoperation and 24 months of follow-up (P lt; 0.05). Moreover, 6 patients suffered from redislocation, and 23 patients experienced patella instabil ity. The IKDC, Lysholm, Kujala, and Tegner scores at 24 months of follow-up were 62.5 ± 6.2, 70.7 ± 5.1, 76.6 ± 4.8, and 3.9 ± 0.7, respectively, showing significant differences when compared with preoperative scores (P lt; 0.05). CT examination showed that the congruence angle, lateral patellar angle, and patellar tilt angle were recovered to normal level after operation immediately, however, the final patellar position at 24 months of follow-up was not significantly betterthan that before surgery (P gt; 0.05). There was significant difference in the lateral patellar displacement between preoperation and 24 months of follow-up (P lt; 0.05). Conclusion Arthroscopic MRP is not rel iable for maintaining the corrected position of the patella for recurrent patellar dislocation in adolescents, though functional improvements are significant.
Adolescent idiopathic scoliosis refers to a three-dimensional spinal deformity or structural change that occurs in adolescence. The rotation of the vertebral body is greater than or equal to 10°. In order to avoid affecting the physical and mental health of patients, appropriate intervention and treatment of adolescent idiopathic scoliosis should be carried out as soon as possible. Based on the summary of non-surgical treatment of adolescent idiopathic scoliosis at home and abroad, this paper systematically introduces the mainstream early non-surgical treatment of adolescent idiopathic scoliosis, including observation and follow-up, electrical stimulation therapy, Chinese traditional chiropractic techniques, massage and manual reduction, functional training and exercise therapy, traction therapy and brace therapy, in order to provide a reference for the possible treatment research direction of adolescent idiopathic scoliosis in the future.