Locating Multiethnic Families in a Globalizing World

To derive new insights into the growing number of multiethnic, immigrant, transnational families in the United States and abroad, we need to incorporate the concept of globalization into our analysis. As the world becomes increasingly interconnected, an ever‐growing number of heterogeneous individuals are associating with each other and being exposed to new lifestyles, behaviors, and cultural values. This exposure is leading to increased heterogamous relationships and families. The fluidity, flow, and dynamism that characterizes contemporary social life is a critical aspect of understanding multiethnic, immigrant, transnational families. To conduct research and design policies that encourage the well‐being of families, we need to integrate into family scholarship a focus on economics, migration, and varied beliefs and values.     

Single-event Multilevel Acute Total Correction of Complex Equinocavovarus Deformity in Skeletally Mature Patients with Spastic Cerebral Palsy Hemiparesis

Complex multiplanar ankle/foot deformity as equinocavovarus is a common problem in patients with spastic cerebral palsy hemiparesis. The data from 30 consecutive patients (30 feet), treated between March 2009 and March 2010, with equinocavovarus and toe clawing secondary to spastic cerebral palsy hemiparesis, aged 16 to 18 years, were analyzed clinically and radiographically. All the patients had received conservative physiotherapy treatment and ankle/foot orthoses before undergoing combined soft tissue and bony surgical procedures performed in a single session to correct the complex toe clawing, cavus, varus, and equinus deformities. Preoperative measurements of certain foot angles were compared with their corresponding postoperative values. A grading system for evaluation of the results using a point scoring system was used to accurately evaluate both the clinical and the radiographic results after an average follow-up period of 2.5 years. Of the 30 patients (30 feet), 18 (60%) had excellent, 9 (30%) good, 3 (10%) fair, and 0 had poor outcomes. Neither vascular problems nor nonunion occurred. Significant improvement was seen postoperatively (p < .0333). Neither staged surgical procedures nor gradual distraction techniques using external fixators are ideal modalities to correct complex ankle/foot equinocavovarus deformity in patients with spastic cerebral palsy. Single-event, multilevel surgery with complete soft tissue and bony correction appears to be the treatment of choice in such cases. It shortens the treatment period and avoids patient dissatisfaction associated with multiple procedures, without major complications.