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Fracture + pediatric + review

Andy Tsai, Patrick R Johnston, Jeannette M Perez-Rossello, Micheál A Breen, Paul K Kleinman
BACKGROUND: The distal tibia is a common location for the classic metaphyseal lesion (CML). Prior radiologic-pathologic studies have suggested a tendency for medial, as opposed to lateral, cortical injury with the CML, but there has been no formal study of the geographic distribution of this strong indicator of abuse. OBJECTIVE: This study compares medial versus lateral cortical involvement of distal tibial CMLs in a clinical cohort of infants with suspected abuse...
March 14, 2018: Pediatric Radiology
Jonathan Porter, Robert Porter, Kevin Joseph Chan
OBJECTIVES: The purpose of this study is to determine the predictive value of clinical suspicion for scaphoid fracture in children aged 4 to 11 years, to look at the efficiency and practicality of current management of children presenting to the emergency department, and to help quantify the burden of the treatment strategy of immobilization for 10 to 14 days on clinical grounds despite negative or equivocal x-rays on presentation. METHODS: We performed a retrospective chart review study of a consecutive sample of all children aged 4 to 11 years old who presented to a tertiary pediatric emergency department from January 1, 2009, to December 31, 2013, within 24 hours of a wrist injury, with a clinical suspicion sufficient to order a scaphoid x-ray...
March 12, 2018: Pediatric Emergency Care
Andrew Chia Chen Chou, Ho Yin Kevin Wong, Sumanth Kumar, Arjandas Mahadev
BACKGROUND: Distal humerus physeal separations are rare pediatric elbow fractures that are often misdiagnosed and difficult to treat. Adequate reduction is often technically challenging and up to 71% of children develop postoperative cubitus varus. We propose using the medial and lateral humeral lines as an adjunct to elbow arthrography in order to guide intraoperative fixation of distal humerus physeal separations to reduce the incidence of postoperative cubitus varus. METHODS: From 2009 to 2014, all pediatric patients under the age of 3 diagnosed with a distal humerus physeal separation and treated surgically at our institution were included for analysis...
March 5, 2018: Journal of Pediatric Orthopedics
Ali Gemici, Aysegul Alkilic, Pinar Guleryuz, Selcuk Tunali, Betul Orhan Kilic, Pınar Ozisik
AIM: To discuss a special type of skull lesion detected after delivery. We reviewed our experience on scalp swelling in term neonates to further investigate the relationship between cranial injuries and labour process. MATERIAL AND METHODS: A total of 55 Newborns with scalp swellings were assessed with medical records retrospectively between January 2007- July 2017. A radiologist and a pediatric neurosurgeon reanalyzed all skull X-ray images via picture archiving and communication system of the hospital Results: A special type of skull fracture, called Kanat (wing) fracture was detected...
February 4, 2018: Turkish Neurosurgery
Clint Rathje, Ashley Venegas, Stephen D Helmer, Rachel M Drake, Jeanette G Ward, James M Haan
Background: Agriculture is an industry where family members often live and work on the same premises. This study evaluated injury patterns and outcomes in children from farm-related accidents. Methods: A 10-year retrospective review of farm-accident related injuries was conducted of patients 17 years and younger. Data collected included demographics, injury mechanism, accident details, injury severity and patterns, treatments required, hospitalization details, and discharge disposition...
November 2017: Kansas Journal of Medicine
Lindsay R Lavin, Cody H Penrod, Cristina M Estrada, Donald H Arnold, Benjamin R Saville, Meng Xu, Deborah E Lowen
Approximately one fourths of infant fractures are due to abuse. Recognition of abuse is important to avoid further morbidity/mortality. There is limited knowledge regarding how frequently pediatric emergency department clinicians consider abuse in infants with fractures. Our primary objective was to estimate the percentage of infants with fractures for whom abuse was considered, and to examine characteristics associated with abuse consideration. We performed a retrospective review of infants <1 year of age presenting to a pediatric emergency department...
February 1, 2018: Clinical Pediatrics
Stefano Nobile, Richard J Grand, Helen M Pappa
OBJECTIVE: In pediatric inflammatory bowel disease (IBD), the prevalence of low bone mineral density (BMD) and bone fractures and the relationship between these are still debated. Our aim was to report data from a cohort of pediatric patients with IBD. PATIENTS AND METHODS: Cross-sectional assessment of growth and BMD [(dual-energy x-ray absorptiometry (DXA)] and retrospective chart review were performed to report the lifetime prevalence of bone fractures and clinical associations with patients' data...
February 12, 2018: European Journal of Gastroenterology & Hepatology
Andrew T Chen, William Z Morris, Lewis G Zirkle, Raymond W Liu
OBJECTIVES: To report the clinical results following treatment of pediatric femoral shaft fractures with the SIGN Fracture Care International (SIGN) pediatric and standard fin nails. DESIGN: Retrospective review of prospectively collected data SETTING:: Sixteen global SIGN centers from 2003-2013 PATIENTS/PARTICIPANTS:: One hundred and twelve pediatric patients who sustained a diaphyseal pediatric femoral shaft fracture INTERVENTION:: Intramedullary fixation with the standard or pediatric SIGN nail MAIN OUTCOME MEASUREMENTS:: Main outcome measurements include clinical and radiographic healing and postoperative complications RESULTS:: The mean age of the pediatric fin patients was 9...
January 24, 2018: Journal of Orthopaedic Trauma
Hailey Allen, Kirkland W Davis, Kenneth Noonan, Yoshimi Endo, Jie C Nguyen
Fractures are common in children with some requiring surgical reduction and fixation to maintain anatomical alignment. Although various surgical techniques and principles are shared between children and adults, certain unique considerations in children can influence the surgical approach and device selection. In particular, for skeletally immature children, it is of utmost importance to protect certain critical open growth plates because permanent injury can produce severe growth disturbances. The often robust healing response and potential limited patient compliance can also influence the treatment algorithm and decision making...
February 2018: Seminars in Musculoskeletal Radiology
William Cody Sessions, Matthew Herring, Walter H Truong
The extensor mechanism of the knee-consisting of the four muscles of the quadriceps, the quadriceps tendon, the patella, and the patellar ligament-is essential for lower extremity function during both standing and ambulation. The presence of articular cartilage and growing physes in the pediatric knee, coupled with the generation of significant tensile force, creates an opportunity for pathology unique to the pediatric population.Tibial tubercle fractures and patella injuries are quite rare, and even pediatric-trained orthopaedic surgeons may not be exposed to these injuries on a regular basis...
February 6, 2018: Journal of Knee Surgery
Claire K Sandstrom, Joel A Gross, Stephen A Kennedy
Fractures of the distal clavicle represent 15-30% of all clavicle fractures. The local osseoligamentous anatomy and deforming forces result in increased risk of delayed union and nonunion than fractures in other parts of the clavicle. These factors also contribute to challenges in fracture repair. Understanding these injuries and their imaging features enhances care and ensures patients are directed to appropriate management. We review the anatomy of the distal clavicle and surrounding ligaments, options for radiographic evaluation, relevant classification systems, and current concepts in management...
February 3, 2018: Emergency Radiology
Mahmut Kalem, Ercan Şahin, Hakan Kocaoğlu, Kerem Başarır, Hakan Kınık
INTRODUCTION: This paper aims to compare the clinical and radiological results of children operated using elastic stable intramedullary nailing as described by Métaizeau to those with the closed reduction and percutaneous pinning (CRPP). METHODS: Results of 21 pediatric patients with radial neck fracture who were treated by two pediatric surgeons between January 2011 and December 2013 were reviewed retrospectively. 10 were treated with the Métaizeau method versus 11 with the CRPP...
January 25, 2018: Injury
Stephanie M Young, Yan Tong Koh, Errol W Chan, Shantha Amrith
The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16...
March 2018: Craniomaxillofacial Trauma & Reconstruction
Neal Rupani, Nicholas Riley, Ian McNab
Background  Scaphoid fractures in the pediatric population are rare. The majority of nondisplaced fractures tend to unite; however, there is an increased risk of nonunion in proximal pole fractures. Limited evidence exists in their outcomes, owing to the scarcity of the fracture pattern. Case Description  A 13-year-old boy who presented late after developing a traumatic proximal pole scaphoid fracture developed nonunion. He was treated conservatively owing to it being asymptomatic and developed union at 18 months...
February 2018: Journal of Wrist Surgery
Mauricio Silva, Erin M Delfosse, Howard Park, Hemali Panchal, Edward Ebramzadeh
INTRODUCTION: The Appropriate Use Criteria for the treatment of supracondylar humerus fractures (SCHFs), developed by American Academy of Orthopaedic Surgeons, recommends pinning for all type II SCHFs. However, previous studies have suggested that, with close follow-up some of the less severe type II SCHF's can be successfully treated without surgery. Our purpose was to analyze data collected prospectively on a large cohort of type II SCHF's. METHODS: We reviewed clinical and radiographic information on all type II pediatric SCHF (n=1120) that were enrolled in a prospective registry and were followed for a minimum of 8 weeks...
January 24, 2018: Journal of Pediatric Orthopedics
Chiara Zanchi, Manuela Giangreco, Luca Ronfani, Claudio Germani, Rita Giorgi, Lorenzo Calligaris, Stefania Norbedo, Giulio Liccari, Giorgio Cozzi, Egidio Barbi
OBJECTIVES: Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture. METHODS: We conducted a retrospective study, considering all patients presenting to the ED of a children's hospital in Italy, with an accidental extremity injury, between May and December 2015...
January 23, 2018: Pediatric Emergency Care
JongChan Ryu, Seong Jong Yun, Sun Hwa Lee, Yoon Hee Choi
OBJECTIVES: Facial bone fractures secondary to head trauma are more common in children than in adults. Recently, multidetector row computed tomography (CT) has been considered superior to conventional radiography. Some studies have reported that facial soft tissue injuries require both facial and brain CT and that brain CT is helpful in screening facial bone fractures. However, these studies included only adult patients. The aim of this study was to evaluate the diagnostic performance of brain CT and the need for additional facial CT to detect facial bone fractures in emergency pediatrics...
January 23, 2018: Pediatric Emergency Care
Kranti V Peddada, Brian T Sullivan, Adam Margalit, Paul D Sponseller
BACKGROUND: It is important to estimate the likelihood that a pediatric fracture is caused by osteogenesis imperfecta (OI), especially the least severe type of OI (type 1). METHODS: We reviewed records of 29,101 pediatric patients with fractures from 2003 through 2015. We included patients with closed fractures not resulting from motor vehicle accidents, gunshot wounds, nonaccidental trauma, or bone lesions. Patients with OI of any type were identified through International Classification of Diseases-9 code...
January 19, 2018: Journal of Pediatric Orthopedics
Songkiat Thanacharoenpanich, Sarah Bixby, Michael A Breen, Young-Jo Kim
BACKGROUND: Traumatic posterior hip dislocations in children and adolescents requires emergent closed reduction. Postreduction imaging is necessary to assess the concentricity of reduction and structural injuries to the hip. There is no a consensus for which imaging is a modality of choice in such condition. The purposes of this study are to describe magnetic resonance imaging (MRI) findings of traumatic posterior hip dislocations and to compare the effectiveness of MRI with computerized tomography (CT) in detecting structural abnormalities of the hip that impact patient management...
January 19, 2018: Journal of Pediatric Orthopedics
Steven F DeFroda, Jonathan D Hodax, Kalpit N Shah, Aristides I Cruz
Displaced tibial eminence fractures are commonly encountered in pediatric patients and are often considered to be functionally equivalent to an anterior cruciate ligament (ACL) rupture. While a variety of techniques are available for fixation of this injury, we describe an anchorless technique relying on suture fixation tied over a bone bridge. This technique also relies on two intra-articular Hewson suture passers to quickly and effectively pass and shuttle sutures through the ACL and tibial bone tunnels in order to reduce and fix the fracture fragment...
August 2017: Arthroscopy Techniques
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