INTERNATIONAL ABSTRACTS 1013

tation of adult-type polycystic kidney disease in children may allow a nonoperative diagnosis to be made.--George Holcomb, Jr

Sonographic Assessment of Renal Length in Normal Children. D.H. Rosenbaum. E. Korngold, and R.L. Teele. Am J Roenlgenol 142:467-469, (March), 1984.

Utilizing measurements taken in 203 patients, renal size by sonography in normal patients yielded two regression equations. In the patient <1 year of age renal length (cm) - 4.98 + 0.155 • age (months) and for patients >1 year of age renal length (cm) =6.79 + 0.22 • age (years). Tables depicting mean length and length plotted v age are presented.--Randall W. Powell

MUSCULOSKELETAL SYSTEM

Changes in the Cervical Spine in Juvenile Rheumatoid Arthritis. R.N. Hensinger, P.D. OeVito, and C.G. Ragsdale. J Bone Joint Surg 68A:189 198, (February), 1986.

One hundred twenty-one patients with juvenile rheumatoid arthri- tis were reviewed. Fifty-seven patients with pauci-articular-onset juvenile rheumatoid arthritis, with one minor exception, had no cervical disease. Only 12 patients had pain as a complaint. Clinical stiffness and x-ray changes were seen however, in 51 patients with polyarticular onset of disease and 13 patients with a systemic onset of the disease. The most common x-ray changes were (1) limited motion of the leading edge. of CI; (2) ankylosis of the apopyseal joint; and (3) decrease in vertebral growth. Less frequent changes included anterior erosion of the odontiod process, subaxial subluxa- tion, or subluxation of CI on C2. The authors conclude that in severe pain, one should look for a fracture, infection, or tumors; this is not a typical clinical sign. This is a thorough review of the relationship and findings of cervical spine disease in juvenile rheumatoid arthritis. A.H. Alter

The Effectiveness of Salter Innominate Osteotomy in the Treat- ment of Congenital Dislocation of the Hip. W.P. Barrett, L.T. Staheli, and T.E. Chew. J Bone Joint Surg 68A:79-87, (January), 1966.

Sixty-eight innominate osteotomies performed on 54 patients were reviewed with average follow-up of 8.3 years. The preoperative criteria outlined by Dr Salter were followed, with the minimum age at 18 months and the oldest at 1 I years and 7 months. Traction was used preoperatively, except in the category of patients treated with concomitant femoral-shortening procedures. Follow-up evaluation was based on determination of pain, leg lengths, muscle strength, and the x-ray determination of the acetabular index and the center- edge angle of Wiberg. Twenty-five percent of the patients had fair or poor clinical results that could be trace to technical errors. The procedures predictably gave good clinical results with good acetabu- lar coverage if performed according to Dr Salter's criteria and with his technique. Eight complications included loss of graft position in three patients, a procedure done at the level of the false acetabulum in one patient, and redislocation in two additional patients. One patient had a delayed union at the graft site plus a superficial wound infection. This is an excellent long-term review.--A.H. Alter

The Long-Term Results of the Surgical Management of Paralytic Pes Cavus by Soft Tissue Relesae and Tendon Transfer. M.D.G. Shanahan, D.L. Douglas, W.J.W. Sharrard, et al. Z Kinderchir 40:37 41, (December), 1985 (suppl 1).

Twenty-six patients with paralytic pes cavus were managed by early soft tissue correction and tendon transfer. Eighteen had spina bifida, 6 had peroneal muscular atrophy and 2 had cerebral palsy.

The most frequent operations were flexor hallucis longus tenodesis, Girdlestone's flexor to extensor tendon transfer, and plantar release. The indications for these procedures are discussed and the results presented with particular reference to static and dynamic foot pressure studies performed at review. Follow-up averaged 5.2 years. Toe correction was found to be successful in most cases, but plantar release failed in 55% of feet, with many progressing to fusion. Many failed feet had presented at an earlier age, and it was felt that the initial procedures had delayed the need for bony correction thus minimizing growth disturbance.-- Thomas A. Angerpointer

NERVOUS SYSTEM

Cerebellar Calcification and Lead. M.D. Benson and J. Price. J Neurol Neurosurg Psych 48:814-818, (August), 1985.

The authors examined CT scans of 17 elderly patients who were brought up in Queensland, Australia, where children frequently ate flakes of sweet-tasting lead acetate paint from garden fences. There was a strong correlation between exposure to leads and perivascu)ar calcification of the cerebellum, although this did not seem to cause symptoms.--R.J. Brereton

Neurological and Neuropsychological Effects of Cerebral Spinal Fluid Shunting in Children with Assumed Arrested ("Normal Pressure") Hydrocephalus. R.D. Torke/son, L.G. Leibrock, J.L. Gustavson, et al. J Neurol Neurosurg Psych 48:799 806, (August), t985.

Normocephalic children with long-standing neurological disor- ders were being investigated for academic achievment, IQ, and neuropsychological functioning. During investigation they were found to have ventriculomegaly. These children then underwent radioactive iodinated serum cistenography, preshunt, and postshunt electrophysiologic studies, and radiology and CT scanning of the skull. Following insertion of a ventricular peritoneal shung, four children were than reviewed more than 1 year later. All had improvement in EEG and CT scans, and particularly in psychomet- ric findings accompanied by some improvement in IQ. Those who achieved the greatest gains were those who were not substantially impaired in IQ at discovery of the ventriculomegaly.--R.J. Brere- lon

Prognosis for Babies with Meningomyelocele and High Lumbar Paraplegia at Birth. R.G. Menzies, J.M. Parkin, and E.N. Hey. Lancet 8462:993-995, (November), 1985.

The life expectation of babies with paralytic lumbar meningomy- elocele not offered immediate surgery at birth appears to be influenced by the extent to which parents are involved in the child's early care. Eight out of the 27 children offered family-centered care in one hospital in 1971 to 1980 and not offered immediate surgery survived to school entry. None of these children has since died. All are chairbound and incontinent, but none is intellectually retarded and many are no more handicapped than the children offered immediate surgical treatment at birth. The choice before the family at birth does not have to be presented as an urgent and immediate choice between life and death.--Prem Puri

Gender and Spina Bifida--Some Misconceptions. A.P. Lonton. Z Kinderchir 40:34-36, (December), 1985 (suppl 1).

A series of 1,367 survivors (997 mye)omeningoceles, 207 menin- goceles, 81 lipomas of the cauda equina, and 82 encepha)oceles) is presented. Contrary to widespread opinion, very few differences were observed. Myelomeningocele patients had significantly lower IQs, smaller heads, and thinner brains. However, these differences