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https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#1
Shital N Parikh, Charles T Mehlman
Pediatric ankle fractures are common and have unique fracture characteristics because of the presence of distal tibial and fibular physes. When displaced (>3 mm widening of the physis or >2 mm intra-articular gap/step-off), these fractures are typically treated with anatomical reduction and internal fixation. Computed tomography is recommended for preoperative evaluation and surgical planning for intra-articular fractures. These fractures in younger children with substantial growth remaining should be followed closely to monitor for any growth disturbance...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053501/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-tibia-fracture-pearls-and-pitfalls
#2
Steven A Lovejoy, Charles T Mehlman
Tibial fractures in children present a wide array of challenges to the managing orthopaedic surgeon. Injuries cover a spectrum from subtle tibial spine fractures to comminuted high-energy shaft fractures requiring free flap coverage. Significant risks range from malunion and leg length discrepancy to infected nonunions and Volkmann ischemic contracture. This article offers evidence and experience-based advice that is aimed at helping the community orthopaedic surgeon taking call.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053500/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-femoral-shaft-fracture-pearls-and-pitfalls
#3
J Eric Gordon, Charles T Mehlman
Pediatric femoral shaft fractures present many challenging patient care decisions. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention is commonplace in virtually all older children. Treatment is determined primarily by patient age as modified by clinical factors including mechanism of injury, weight, and skeletal maturity. Infants can be successfully treated by placement into a Pavlik harness, whereas children younger than 5 years are most commonly treated by early reduction and spica cast immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053499/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-supracondylar-humeral-fracture-pearls-and-pitfalls
#4
Steven L Frick, Charles T Mehlman
Supracondylar humeral fractures are the most common type of pediatric elbow fracture. With proper treatment, these injuries usually heal well and the patients return to full function. However, a small percentage of these injuries may result in devastating complications and, thus, provoke anxiety in many surgeons treating them. This article provides tips for successful management of these injuries without complications and provides references for further study.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053498/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-forearm-shaft-fracture-pearls-and-pitfalls
#5
Martin J Herman, Matthew Simon, Charles T Mehlman
Pediatric forearm shaft fractures are the third most common fracture in children, and the forearm is the third most mobile joint in the body (with a nearly 180 degree arc of motion). The goals of treatment are aimed squarely at achieving satisfactory anatomic alignment (within defined parameters) as the consequences of malunion can be permanent forearm stiffness and deformity. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention has become increasingly common in older children...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053497/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-phalangeal-fracture-pearls-and-pitfalls
#6
Joshua M Abzug, Charles T Mehlman
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053496/pearls-and-pitfalls-in-pediatric-orthopaedic-trauma-the-community-orthopaedic-surgeon-taking-trauma-call
#7
Charles T Mehlman
No abstract text is available yet for this article.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29049267/variation-among-pediatric-orthopaedic-surgeons-when-treating-medial-epicondyle-fractures
#8
Meghan Hughes, Karan Dua, Nathan N O'Hara, Brian K Brighton, Theodore J Ganley, William L Hennrikus, Martin J Herman, Joshua E Hyman, J Todd Lawrence, Charles T Mehlman, Kenneth J Noonan, Norman Y Otsuka, Richard M Schwend, M Wade Shrader, Brian G Smith, Paul D Sponseller, Joshua M Abzug
BACKGROUND: Medial epicondyle fractures are a common pediatric and adolescent injury accounting for 11% to 20% of elbow fractures in this population. This purpose of this study was to determine the variability among pediatric orthopaedic surgeons when treating pediatric medial epicondyle fractures. METHODS: A discrete choice experiment was conducted to determine which patient and injury attributes influence the management of medial epicondyle fractures by pediatric orthopaedic surgeons...
October 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29040235/acetabular-fractures-in-children-and-adolescents-comparison-of-isolated-acetabular-fractures-and-acetabular-fractures-associated-with-pelvic-ring-injuries
#9
Christiane G Kruppa, Debra L Sietsema, Justin D Khoriaty, Marcel Dudda, Thomas A Schildhauer, Clifford B Jones
OBJECTIVES: To compare mechanism of injury, fracture pattern, displacement, clinical and radiographic outcome of isolated acetabular fractures (Group 1) versus acetabular fractures associated with a pelvic ring injury (Group 2). DESIGN: Retrospective cohort comparative analysis. SETTING: Private orthopaedic practice associated with a level one teaching trauma center. MAIN OUTCOME MEASUREMENTS: Mechanism of injury, fracture pattern, displacement and treatment, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), leg length discrepancy (LLD) and hip dysplasia...
October 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29020706/social-media-and-pediatric-scoliosis-an-analysis-of-patient-and-surgeon-use
#10
Heather S Haeberle, Anthony C Egger, Sergio M Navarro, Mary M Cornaghie, Prem N Ramkumar, Ryan C Goodwin, Michael A Mont
INTRODUCTION: The purpose of this observational study was to investigate and analyze the social media presence of both patients and surgeons in relation to pediatric scoliosis. First, patient Instagram (Instagram, Inc., San Francisco, California) posts were evaluated for 1) media format; 2) timing in relation to surgery; 3) tone; 4) perspective; 5) content; and 6) subject reference. To analyze reciprocal engagement, the presence and activity of pediatric scoliosis surgeons at five major academic centers were subsequently analyzed on Instagram, Twitter (Twitter Inc...
October 12, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29016432/is-systemic-inflammatory-response-syndrome-relevant-to-pulmonary-complications-and-mortality-in-multiply-injured-children
#11
Waleed Al-Mahdi, Mazen M Ibrahim, David A Spiegel, Alexandre Arkader, Michael Nance, Keith Baldwin
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is a well-recognized phenomenon in adult trauma populations. The "initial hit" of the traumatic event is often coupled with a systemic immune response characterized by changes in vital signs and laboratory indicators. A "second hit" from surgery during this time frame often results in acute lung injury, along with deterioration of the patient's clinical condition. We hypothesized that children and adolescents would experience SIRS physiology, but would not experience adult respiratory distress syndrome (ARDS) or "second hit" related death to the extent seen in the adult populations...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29016428/functional-outcomes-following-operative-treatment-of-tibial-tubercle-fractures
#12
Anthony I Riccio, Kirsten Tulchin-Francis, Grant D Hogue, Robert L Wimberly, Corey S Gill, DeRaan Collins, Lori A Karol
BACKGROUND: Quantitative evaluation of the functional results of surgically managed tibial tubercle fractures in adolescents is unreported in the orthopaedic literature. METHODS: All patients treated surgically for unilateral tibial tubercle fractures at a single institution from 2007 to 2011 were invited to return for functional evaluation. Fractures were classified using the Ogden classification system. Clinical examination at follow-up included passive knee range of motion and thigh circumference...
October 9, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28975135/quantifying-parental-influence-on-youth-athlete-specialization-a-survey-of-athletes-parents
#13
Ajay S Padaki, Christopher S Ahmad, Justin L Hodgins, David Kovacevic, Thomas Sean Lynch, Charles A Popkin
BACKGROUND: Youth athlete specialization has been linked to decreased enjoyment, burnout, and increased injury risk, although the impact of specialization on athletic success is unknown. The extent to which parents exert extrinsic influence on this phenomenon remains unclear. PURPOSE/HYPOTHESIS: The goal of this study was to assess parental influences placed on young athletes to specialize. It was hypothesized that parents generate both direct and indirect pressures on specialized athletes...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28951646/inpatient-orthopaedic-hardware-removal-in-children-a-cross-sectional-study
#14
Alexandre Boulos, Steven F DeFroda, Justin E Kleiner, Nathan Thomas, Joseph A Gil, Aristides I Cruz
INTRODUCTION: Few data describe the specific reasons for inpatient hardware removal in the pediatric population. This study was designed to understand the conditions necessitating inpatient removal following fracture surgery. Cost data was analyzed to understand the financial implications of these procedures. METHODS: The Kids' Inpatient Database (KID) was evaluated for the year 2012. Patients undergoing open reduction internal fixation following upper and lower extremity fractures as well as those undergoing hardware removal due to hardware complications were identified using ICD-9 CM diagnosis and procedure codes...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28945692/the-surgical-management-of-tibial-spine-fractures-in-children-a-survey-of-the-pediatric-orthopaedic-society-of-north-america-posna
#15
Taylor J Jackson, Eileen P Storey, Theodore J Ganley
BACKGROUND: Tibial spine fractures are rare, complex injuries. Management remains varied given a lack of consensus about the optimal approach. Thus, the purpose of this study is to determine prevailing strategies among pediatric orthopaedists and establish areas of agreement and ongoing controversy in the management of tibial spine fractures. METHODS: An electronic survey was distributed to the Pediatric Orthopaedic Society of North America (POSNA) membership. Surgeon demographics, experience, and responses to clinical vignettes were collected...
September 22, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28887279/sacral-alar-iliac-fixation-in-children-with-neuromuscular-scoliosis-minimum-5-year-follow-up
#16
Amit Jain, Brian T Sullivan, Anne Kuwabara, Khaled Kebaish, Paul D Sponseller
OBJECTIVE: The aim of our study was to investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac screws. METHODS: We reviewed clinical and radiographic records of patients ≤18 years old treated by 1 pediatric orthopaedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients, with a minimum 5-year radiographic follow-up (6.0 ± 1.2 years), were studied. Mean patient age was 13 ± 2...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28877095/hip-surveillance-for-children-with-cerebral-palsy-a-survey-of-the-posna-membership
#17
Benjamin J Shore, Michael W Shrader, Unni Narayanan, Freeman Miller, H Kerr Graham, Kishore Mulpuri
BACKGROUND: Currently, hip surveillance programs for children with cerebral palsy exist in Europe, Australasia, and parts of Canada, but a neuromuscular hip surveillance program has yet to be adopted in the United States. The purpose of this study was to report the current orthopaedic practice of hip surveillance in children with cerebral palsy, identify areas of practice variation, and suggest steps moving forward to generate guidelines for national neuromuscular hip surveillance. METHODS: The entire membership of the Pediatric Orthopaedic Society of North America (POSNA) was surveyed in 2016 for information regarding their practice for hip surveillance in children with cerebral palsy...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28875130/ipsilateral-femur-and-tibia-fractures-in-pediatric-patients-a-systematic-review
#18
Jason B Anari, Alexander L Neuwirth, B David Horn, Keith D Baldwin
AIM: To better understand how pediatric floating knee injuries are managed after the wide spread use of new orthopaedic technology. METHODS: We searched EMBASE, COCHRANE and MEDLINE computerized literature databases from the earliest date available in the databases to February 2017 using the following search term including variants and pleural counterparts: Pediatric floating knee. All studies were thoroughly reviewed by multiple authors. Reference lists from all articles were scrutinized to identify any additional studies of interest...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28870838/comparison-of-s2-alar-and-traditional-iliac-screw-pelvic-fixation-for-pediatric-neuromuscular-deformity
#19
Mark C Lee, Casey Jarvis, Matthew J Solomito, Jeffrey Thomson
Background Context Many pelvic fixation options exist for posterior spinal fusion of pediatric neuromuscular scoliosis, including standard iliac screws (SIS) or a more recently introduced S2-Alar (S2A) technique. However, little data exists comparing the clinical and radiographic outcomes of these techniques. Purpose Identify differences in clinical and radiographic outcomes for pediatric neuromuscular scoliosis patients treated with standard iliac screw (SIS) or S2-Alar (S2-A) pelvic fixation. Study Design/Setting Retrospective cohort study at a pediatric orthopaedic clinic...
September 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28867667/long-term-effects-of-orthoses-use-on-the-changes-of-foot-and-ankle-joint-motions-of-children-with-spastic-cerebral-palsy
#20
Xue-Cheng Liu, David Embrey, Channing Tassone, Kim Zvara, Brenna Brandsma, Roger Lyon, Karin Goodfriend, Sergey Tarima, John Thometz
BACKGROUND: Orthoses commonly are prescribed to children with cerebral palsy (CP) to provide foot correction and to improve ambulatory function. Immediate effects of ankle foot orthosis (AFOs) have been investigated, but long-term kinematic effects are lacking clinical evidence. OBJECTIVE: To determine changes in 3-dimensional ankle and foot segment motion in pediatric patients with CP between initial and follow-up visits (18-month average time differences) in both barefoot gait and gait with their AFO...
September 1, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
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