{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T13:50:08Z","timestamp":1772459408899,"version":"3.50.1"},"reference-count":61,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"1","license":[{"start":{"date-parts":[[2006,1,1]],"date-time":"2006-01-01T00:00:00Z","timestamp":1136073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2006,1]]},"abstract":"<jats:p>Morbid obesity and its association with obstructive sleep apnoea syndrome have been increasingly recognised in children. Orthopaedic surgeons are often the primary medical contact for older children with tibia vara, which has long been associated with obesity, but are unfamiliar with the evaluation and treatment of sleep apnoea in children.<\/jats:p><jats:p>We reviewed all children with tibia vara treated surgically at one of our institutions over a period of five years. Thirty-seven patients were identified; 18 were nine years of age or older and 13 of these (72%) had morbid obesity and a history of snoring.<\/jats:p><jats:p>Eleven children were diagnosed as having sleep apnoea on polysomnography. The incidence of this syndrome in the 18 children aged nine years or older with tibia vara, was 61%. All these patients required pre-operative non-invasive positive-pressure ventilation; tonsillectomy and adenoidectomy were necessary in five (45%). No peri-operative complications related to the airway occurred.<\/jats:p><jats:p>There is a high incidence of sleep apnoea in morbidly obese patients with tibia vara. These patients should be screened for snoring and, if present, should be further evaluated for sleep apnoea before corrective surgery is undertaken.<\/jats:p>","DOI":"10.1302\/0301-620x.88b1.16918","type":"journal-article","created":{"date-parts":[[2005,12,19]],"date-time":"2005-12-19T17:28:34Z","timestamp":1135013314000},"page":"100-103","source":"Crossref","is-referenced-by-count":36,"title":["Obstructive sleep apnoea syndrome in morbidly obese children with tibia vara"],"prefix":"10.1302","volume":"88-B","author":[{"given":"J. E.","family":"Gordon","sequence":"first","affiliation":[{"name":"Washington School of Medicine, St. Louis Shriners Hospital for Children, 2001 S. Lindbergh Boulevard, St. Louis, Missouri 63131, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. S.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Washington School of Medicine, St. Louis Shriners Hospital for Children, 2001 S. Lindbergh Boulevard, St. Louis, Missouri 63131, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Washington School of Medicine, St. Louis Shriners Hospital for Children, 2001 S. Lindbergh Boulevard, St. Louis, Missouri 63131, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. A.","family":"Szymanski","sequence":"additional","affiliation":[{"name":"Washington School of Medicine, St. Louis Shriners Hospital for Children, 2001 S. Lindbergh Boulevard, St. Louis, Missouri 63131, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. L.","family":"Schoenecker","sequence":"additional","affiliation":[{"name":"Washington School of Medicine, St. Louis Shriners Hospital for Children, 2001 S. Lindbergh Boulevard, St. Louis, Missouri 63131, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Parker","sequence":"additional","affiliation":[{"name":"St. Louis Children\u2019s Hospital, One Children\u2019s Place, St. Louis, Missouri 63110, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. C.","family":"Uong","sequence":"additional","affiliation":[{"name":"St. Louis Children\u2019s Hospital, One Children\u2019s Place, St. Louis, Missouri 63110, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Dietz WH.Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101:518\u201325.","DOI":"10.1542\/peds.101.S2.518"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.22.2845"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012578"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199709000-00021"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Thompson GH, Carter JR.Late-onset tibia vara (Blount\u2019s disease): current concepts. Clin Orthop 1990;255:24\u201335.","DOI":"10.1097\/00003086-199006000-00004"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Beskin JL, Burke SW, Johnston CE 2nd, Roberts JM.Clinical basis for a mechanical etiology in adolescent Blount\u2019s disease. Orthopedics 1986;9:365\u201370.","DOI":"10.3928\/0147-7447-19860301-09"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Henderson RC, Kemp GJ Jr, Greene WB.Adolescent tibia vara: alternatives for operative treatment. J Bone Joint Surg [Am] 1992;74-A:342\u201350.","DOI":"10.2106\/00004623-199274030-00004"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199607000-00008"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(82)80305-3"},{"key":"R10","unstructured":"Henderson RC, Kemp GJ.Assessment of the mechanical axis in adolescent tibia vara. Orthopedics 1991;14:313\u201316."},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200007000-00006"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198403000-00007"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198401000-00016"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Gordon JE, Heidenreich F, Carpenter CJ, Kelly-Hahn J, Schoenecker PL.Comprehensive treatment of late-onset tibia vara. J Bone Joint Surg [Am] 2005;87-A: 1561\u201370.","DOI":"10.2106\/00004623-200507000-00019"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-199704000-00012"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1097\/01202412-199807000-00009"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1007\/BF00266605"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200103000-00026"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)30982-8"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80738-3"},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Sher AE.Obstructive sleep apnea syndrome: a complex disorder of the upper airway. Otolaryngol Clin North Am 1990;23:593\u2013608.","DOI":"10.1016\/S0030-6665(20)31240-8"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950140202"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/146.5_Pt_1.1235"},{"key":"R24","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/146.5_Pt_1.1231"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/148.6_Pt_1.1697"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950160208"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1177\/019459989411100512"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1996.tb01316.x"},{"key":"R29","unstructured":"Pillar G, Schnall R, Peled R, Lavie P.Surgical treatment of sleep apnea syndrome. Isr J Med Sci 1996;32:710\u201315."},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1136\/adc.68.3.360"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.157.4.9704080"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950040304"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/20.12.1185"},{"key":"R34","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/26.8.999"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.1542\/peds.102.3.616"},{"key":"R36","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70331-8"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.4.704"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp012849"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(91)90094-4"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.4.850"},{"key":"R41","doi-asserted-by":"crossref","unstructured":"O\u2019Brien LM, Gozal D.Behavioral and neurocognitive implications of snoring and obstructive sleep apnoea in children: facts and theory. Paediatr Respir Rev 2002;3: 3\u20139.","DOI":"10.1053\/prrv.2002.0177"},{"key":"R42","doi-asserted-by":"crossref","unstructured":"Waters KA, McBrien F, Stewart P, Hinder M, Wharton S.Effects of OSA, inhalational anesthesia, and fentanyl on the airway and ventilation of children. J Appl Physiol 2002;92:1987\u201394.","DOI":"10.1152\/japplphysiol.00619.2001"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440360178019"},{"key":"R44","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005113421901"},{"key":"R45","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-5-199403010-00005"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1542\/peds.109.4.e69"},{"key":"R47","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/86.2.254"},{"key":"R48","doi-asserted-by":"crossref","unstructured":"Thompson GH, Carter JR.Late-onset tibia vara (Blount\u2019s disease): current concepts. Clin Orthop 1990;255:24\u201335.","DOI":"10.1097\/00003086-199006000-00004"},{"key":"R49","unstructured":"Rechstschaffen A, Kales A.A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects.Washington, DC National Institute of Health, 1968."},{"key":"R50","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.153.2.8564147"},{"key":"R51","doi-asserted-by":"crossref","unstructured":"No authors listed.EEG arousals: scoring rules and examples: a preliminary report from the sleep disorders atlas task force of the American sleep disorders association. Sleep 1992;15:183\u20134.","DOI":"10.1093\/sleep\/15.2.174"},{"key":"R52","unstructured":"Kuczmarski RJ, Ogden CL, Guo SS, et al.2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat 2002;246:1\u2013190."},{"key":"R53","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.155.1.9001310"},{"key":"R54","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(01)00261-6"},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2002.36147"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.1016\/S1089-9472(99)80082-3"},{"key":"R57","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X9001800417"},{"key":"R58","doi-asserted-by":"crossref","unstructured":"Strauss SG, Lynn AM, Bratton SL, Nespeca MK.Ventilatory response to CO2 in children with obstructive sleep apnea from adenotonsillar hypertrophy. Anesth Analg 1999;89:328\u201332.","DOI":"10.1213\/00000539-199908000-00015"},{"key":"R59","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/32.12.2723"},{"key":"R60","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-5-356"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.1053\/smrv.2001.0256"}],"container-title":["The Journal of Bone and Joint Surgery. British volume"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.88B1.16918","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/full-xml\/10.1302\/0301-620X.88B1.16918","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/pdf\/10.1302\/0301-620X.88B1.16918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T23:06:59Z","timestamp":1683328019000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.boneandjoint.org.uk\/doi\/10.1302\/0301-620X.88B1.16918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1]]},"references-count":61,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,1]]}},"alternative-id":["10.1302\/0301-620X.88B1.16918"],"URL":"https:\/\/doi.org\/10.1302\/0301-620x.88b1.16918","relation":{},"ISSN":["0301-620X","2044-5377"],"issn-type":[{"value":"0301-620X","type":"print"},{"value":"2044-5377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,1]]}}}