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https://www.readbyqxmd.com/read/29227524/pediatric-scoliosis-and-kyphosis-an-overview-of-diagnosis-management-and-surgical-treatment
#1
Diane Dudas Sheehan, John Grayhack
Evaluation of pediatric spinal deformity requires knowledge of special orthopaedic testing and radiographic interpretation. The determination of recommendations for treatment of spinal abnormalities in children can be challenging and at times complex, as treatment options are dependent upon a variety of factors. The etiology of scoliosis or kyphosis, presence or absence of vertebral anomalies, symptoms, magnitude of the curve, physiologic/skeletal age, and evidence of and risk of progression all require consideration and play a role in the shared decision-making process...
December 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29227371/a-quality-improvement-initiative-reduces-cast-complications-in-a-pediatric-hospital
#2
Julie Balch Samora, Walter P Samora, Kevin Dolan, Kevin E Klingele
BACKGROUND: Casts, while frequently used as routine treatment in pediatric orthopaedic practice, are not without complications. At our large tertiary care pediatric hospital, the baseline rate of all casting complications was 5.6 complications per 1000 casts applied (0.56%). We tested the hypothesis that we could use quality improvement (QI) methodology to decrease the overall cast complication rate and improve patient care. METHODS: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act cycles, to decrease our cast complication rate...
December 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29219942/the-new-order-at-the-journal-of-pediatric-orthopaedics
#3
Robert N Hensinger
No abstract text is available yet for this article.
January 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29219855/determining-hinge-abduction-in-legg-calv%C3%A3-perthes-disease-can-we-reliably-make-the-diagnosis
#4
Benjamin J Shore, Patricia E Miller, Ira Zaltz, Perry L Schoenecker, Wudbhav N Sankar
BACKGROUND: Although hinge abduction is recognized as an important finding in children with Legg-Calvé-Perthes disease, variable diagnostic criteria exist. The purpose of this study was (1) to test the interobserver and intraobserver agreement of the current definition of hinge abduction and (2) to develop consensus regarding key diagnostic features that could be used to improve our diagnostic criteria. METHODS: Four orthopaedic surgeons with subspecialty pediatric hip interest independently assessed 30 randomly ordered cases of Legg-Calvé-Perthes disease...
December 6, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29219854/reconstruction-of-the-scapula-in-pediatric-and-adolescent-patients-after-total-scapulectomy-a-report-of-10-patients-treated-by-extracorporeal-irradiation-and-reimplantation-of-the-scapula
#5
Ahmed M El Ghoneimy, Mohamed S Zaghloul, Iman Zaky, Hala Taha, Ahmed Elgammal, Magdy El Sherbiny, Nehal Kamal
BACKGROUND: Ewing sarcoma of the scapula is uncommon. Restoration of shoulder function after total scapulectomy is challenging. Extracorporeal irradiation and reimplantation is a well-known method of biological reconstruction in orthopaedic oncology; yet very few reports in the literature describe its specific use in tumors of the scapula. PATIENTS AND METHODS: Ten patients with the diagnosis of Ewing sarcoma of the scapula were surgically treated by total scapulectomy and extracorporeal irradiation and reimplantation of the scapula...
December 6, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29206799/simulation-based-educational-module-improves-intern-and-medical-student-performance-of-closed-reduction-and-percutaneous-pinning-of-pediatric-supracondylar-humeral-fractures
#6
Bennet A Butler, Cort D Lawton, Jamie Burgess, Earvin S Balderama, Katherine A Barsness, John F Sarwark
BACKGROUND: Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. METHODS: Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29189536/incidence-of-fractures-from-perioperative-blood-pressure-cuff-use-tourniquet-use-and-patient-positioning-in-osteogenesis-imperfecta
#7
Brian T Sullivan, Adam Margalit, Vaibhav S Garg, Dolores B Njoku, Paul D Sponseller
BACKGROUND: Osteogenesis imperfecta (OI) is a rare connective tissue disease with varying severity. Patients with OI are highly susceptible to skeletal fractures. Optimal perioperative management of these patients is not well defined. We investigated the risks associated with intraoperative use of noninvasive blood pressure (NIBP) cuffs, tourniquets, and intra-arterial catheters, and patient positioning in children with OI. METHODS: We retrospectively reviewed records of patients younger than 21 years with OI who underwent surgery with general anesthesia from 2010 to 2016 at our tertiary care center...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189534/pediatric-orthopaedic-surgeons-dissatisfied-in-on-call-practices-despite-improving-call-conditions-the-2015-posna-membership-survey-regarding-trauma-care
#8
Allison Lind, Kevin Latz, Mark R Sinclair, David D Williams
BACKGROUND: To examine the current trends in trauma call coverage of pediatric orthopaedic surgeons in North America and to identify predictors of surgeon on-call satisfaction. METHODS: In 2015, ∼1200 active members of the Pediatric Orthopaedic Society of North America (POSNA) were surveyed regarding emergency room on-call practices. In total, 410 members completed the survey with a response rate of 35%. Information collected included call frequency, practice setting and satisfaction with call...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189529/trends-in-management-and-complications-of-anterior-cruciate-ligament-injuries-in-pediatric-patients-a-survey-of-the-prism-society
#9
Charles A Popkin, Margaret L Wright, Andrew T Pennock, Laura A Vogel, Ajay Padaki, Lauren H Redler, Christopher S Ahmad
BACKGROUND: Anterior cruciate ligament (ACL) injuries have been recognized and treated with increasing frequency in children and adolescents. ACL reconstruction (ACLR) in skeletally immature patients has unique considerations and there is a large practice variation in the management of these injuries. The purpose of this study was to survey the members of the Pediatric Research in Sports Medicine (PRiSM) Society regarding their experience with the management and complications of pediatric ACL injuries...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29189528/incidence-and-diagnostic-evaluation-of-postoperative-fever-in-pediatric-patients-with-neuromuscular-disorders
#10
Mohamed A A Yousef, Darius Dranginis, Scott Rosenfeld
BACKGROUND: Children with neuromuscular disorders have a significant chance of developing scoliosis and/or hip dislocation during childhood and adolescence and often undergo surgical reconstruction. Because of their high rate of medical comorbidities, these patients are at higher risk of postoperative complications and are therefore often comanaged, along with orthopaedics, by pediatric medicine and critical care teams. Fever during the postoperative stay is a frequent occurrence and often prompts extensive diagnostic workup which increases the cost and burden on the health system but have unclear effects on the care of the patient...
November 16, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29182138/dealing-with-sub-trochanteric-fracture-in-a-child-with-osteopetrosis-a-case-report
#11
P Behera, A Khurana, B Saibaba, S Aggarwal
Osteopetrosis is a rare hereditary condition which may have autosomal recessive or autosomal dominant inheritance. Patients tend to present most commonly with fractures but involvement of cranial nerves and hematopoetic system is not uncommon. Patients with infantile and intermediate type tend to present more often with problems other than orthopaedic problems. While diagnosis can be made on the basis of radiographs, management needs to be customized for every patient. Non operative and operative management both have their advantages and disadvantages...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29136254/completion-of-multiple-fellowships-by-orthopedic-surgeons-analysis-of-the-american-board-of-orthopaedic-surgery-certification-database
#12
J Mason DePasse, Alan H Daniels, Wesley Durand, Brandon Kingrey, John Prodromo, Mary K Mulcahey
Orthopedic surgeons have become increasingly subspecialized, and recent studies have shown that American Board of Orthopaedic Surgery (ABOS) Step II applicants are performing a higher percentage of their cases within their chosen subspecialties. However, these studies focused exclusively on surgeons who have completed a single fellowship; little data exist on those who pursue a second fellowship. All applicants to the ABOS Part II examination from 2004 to 2016 were classified by their self-reported fellowship training history using the ABOS Part II examination database...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29130608/impact-of-web-based-clinical-practice-guidelines-on-paediatric-fracture-clinics
#13
Mark W Camp, James R Barnes, Mohita Damany, Leo T Donnan
BACKGROUND: In an effort to standardize management and reduce over-treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web-based paediatric fracture pathways. The aim of this study was to determine the impact of web-based fracture pathways on the clinic volume at a tertiary-care paediatric fracture clinic. METHODS: A comparative retrospective review was performed at a large, urban, tertiary-care children's hospital...
November 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29112006/modified-lumbosacral-angle-and-modified-pelvic-incidence-as-new-parameters-for-management-of-pediatric-high-grade-spondylolisthesis
#14
Zhenjiang Ma, Changqing Zhao, Kai Zhang, Lin Du, Jianping Tian, Xiaojiang Sun, Jie Zhao
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: We aimed to introduce new parameters that can better describe the pelvic morphology and lumbosacral segmental deformity in children with high-grade spondylolisthesis of the L5 vertebra: modified pelvic incidence (mPI) and modified lumbosacral angle (mLSA). Also, we aimed to establish the mLSA as a convenient, reliable measurement method and criteria to evaluate the reduction of L5 vertebral slippage. SUMMARY OF BACKGROUND DATA: Numerous parameters and methods exist to evaluate segmental deformity and reduction of L5 vertebral slippage, but no definitive standard for accurately and conveniently describing lumbosacral kyphosis and degree of reduction exists...
November 3, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29080040/pediatric-orthopaedics-from-kirschner-wires-to-titanium
#15
EDITORIAL
Patricia M M B Fucs, Marius M Scarlat
No abstract text is available yet for this article.
December 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29056227/intravenous-regional-anaesthesia-bier-s-block-for-pediatric-forearm-fractures-in-a-pediatric-emergency-department-experience-from-2003-to-2014
#16
Ivan S Y Chua, S L Chong, Gene Y K Ong
STUDY OBJECTIVES: To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures. METHODS: This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block...
October 16, 2017: Injury
https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#17
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
#18
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
#19
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
#20
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
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