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https://www.readbyqxmd.com/read/28802910/inter-rater-reliability-of-physical-abuse-determinations-in-young-children-with-fractures
#1
Katherine E Buesser, John M Leventhal, Julie R Gaither, Victoria Tate, Daniel R Cooperman, Rebecca L Moles, Cicero T Silva, Lauren J Ehrlich, Melinda S Sharkey
As there is no "gold standard" in determining whether a fracture is caused by accident or abuse, agreement among medical providers is paramount. Using abstracted medical record data from 551 children <36months of age presenting to a pediatric emergency department, we examined the extent of agreement between specialists who evaluate children with fractures for suspected abuse. To simulate clinical scenarios, two pediatric orthopaedists and two child abuse pediatricians (CAPs) reviewed the full abstraction and imaging, whereas the two pediatric radiologists reviewed a brief history and imaging...
August 10, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28797015/pediatric-orbital-blowout-fractures
#2
Stella Y Chung, Paul D Langer
PURPOSE OF REVIEW: The current study reviews the recent literature on pediatric orbital blowout fractures and provides guidelines on their management. RECENT FINDINGS: The most common problem among patients requiring surgical revision of a previously repaired orbital floor fracture is an improperly placed orbital floor implant, usually erroneously placed under the posterior bony ledge. Although the transconjunctival incision can be combined with a lateral canthotomy and cantholysis, excellent surgical exposure can be obtained without the need for these latter relaxing maneuvers...
September 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28790003/a-modified-technique-for-occipitocervical-fusion-using-compressed-iliac-crest-allograft-results-in-a-high-rate-of-fusion-in-the-pediatric-population
#3
Rajiv R Iyer, Gerald F Tuite, Avner Meoded, Carolyn C Carey, Luis F Rodriguez
BACKGROUND: In children, high rates of occipitocervical (OC) fusion have been demonstrated using rigid instrumentation in combination with harvested autograft, with or without bone morphogenetic protein (BMP). Historically, the use of allograft materials demonstrated inferior OC fusion outcomes compared to autograft. However, autograft harvest harbors an increased risk of patient morbidity, and BMP use is costly and controversial in children. Thus, there remains a need for safer, less costly, yet efficacious techniques for OC fusion in the pediatric population...
August 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28777281/recovery-of-motor-nerve-injuries-associated-with-displaced-extension-type-pediatric-supracondylar-humerus-fractures
#4
Benjamin J Shore, Bryce T Gillespie, Patricia E Miller, Donald S Bae, Peter M Waters
BACKGROUND: Nerve injuries occur in approximately 11% of pediatric extension supracondylar humerus fractures (SCHF), yet there is scarce literature to guide clinicians on management. The primary goal of this study was to report the presentation, treatment, and outcome of motor nerve injuries associated with extension SCHF. Our secondary goal was to determine which injury and treatment factors were associated with prolonged motor nerve recovery. METHODS: Two hundred forty-four traumatic nerve injuries associated with extension SCHF treated at a single institution between 1996 and 2012 were reviewed...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28777278/elastic-intramedullary-nailing-versus-open-reduction-internal-fixation-of-pediatric-tibial-shaft-fractures
#5
Andrew T Pennock, Tracey P Bastrom, Vidyadhar V Upasani
BACKGROUND: The optimal fixation strategy for unstable pediatric tibia fractures is unclear with some favoring elastic intramedullary nails (EIN) and others favoring plate and screws [open reduction internal fixation (ORIF)]. The purpose of this study was to compare outcomes and complications of skeletally immature patients undergoing surgical stabilization of the tibia with either EIN or ORIF. METHODS: A retrospective review was performed on all patients undergoing EIN or ORIF of a diaphyseal fracture at a single pediatric level I trauma center between 2010 and 2016...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28777276/redefining-optimal-nail-to-medullary-canal-diameter-ratio-in-stainless-steel-flexible-intramedullary-nailing-of-pediatric-femur-fractures
#6
James S Shaha, Jason M Cage, Sheena R Black, Robert L Wimberly, Steven H Shaha, Anthony I Riccio
PURPOSE: The ideal canal fill for flexible intramedullary fixation of pediatric femoral shaft fractures is considered to be 80% based upon relatively few clinical studies. The purpose of this study is to assess the relationship between the summed nail to intramedullary canal diameter (ND/MCD) ratio and alignment at radiographic union following flexible intramedullary nailing (FIMN) of pediatric femoral shaft fractures. METHODS: An Internal Review Board approved, retrospective review of a consecutive series of patients who sustained a femoral shaft fracture treated by retrograde, stainless steel FIMN was performed at a single level 1 pediatric trauma center from 2005 to 2012...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28756567/growth-plate-injury-at-the-base-of-the-coracoid-mri-features
#7
Erin FitzGerald Alaia, Zehava Sadka Rosenberg, Ignacio Rossi, Jonathan Zember, Johannes B Roedl, Lynne Pinkney, Lynne S Steinbach
PURPOSE: To assess the MRI features of growth plate injury at the base of the coracoid process. MATERIALS AND METHODS: Subjects were identified through retrospective search of our department imaging database and teaching files and the teaching files of two outside academic institutions. The coracoid base growth plate was examined with attention to widening, irregularity, abnormal signal intensity of the growth plate, and the presence of adjacent soft tissue edema...
July 29, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28735119/a-case-series-of-pediatric-seymour-fractures-related-to-hoverboards-increasing-trend-with-changing-lifestyle
#8
A E Kattan, F AlShomer, A K Alhujayri, M Alfowzan, K A Murrad, H Alsajjan
BACKGROUND: Several recreational activities such as roller skating, skateboarding, and scooter riding create the risk for hand injuries, which are the fourth most commonly injured body part in relation to their use. Seymour first identified a specific pattern of digit injury as an open fracture affecting the distal phalangeal physis associated with nail avulsion from the eponychial fold. In this article, we report a series of Seymour fractures associated with misuse of the newly emerging recreational/transportation vehicle, the hoverboard...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#9
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
July 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28729046/bone-mineralization-and-fracture-risk-assessment-in-the-pediatric-population
#10
Halley Wasserman, Catherine M Gordon
Identifying children most susceptible to clinically significant fragility fractures (low trauma fractures or vertebral compression fractures) or recurrent fractures is an important issue facing general pediatricians and subspecialists alike. Over the last decade, several imaging technologies, including dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, have become useful to identify abnormal bone mineralization in children and in adolescents. This review aimed to summarize the latest literature on the utility of these modalities as they pertain to use in pediatrics...
July 17, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28723700/pediatric-supracondylar-humerus-fractures-is-surgeon-experience-a-surrogate-for-the-need-of-open-reduction
#11
Mauricio Silva, Maria Kazantsev, Bianka Aceves Martin, Erin M Delfosse
Although there are many factors that are likely to influence the need for open reduction and percutaneous pinning (ORPF) in the treatment of pediatric supracondylar humerus fractures (SCHFs), the role of surgeon's experience (as represented by the total number of surgically treated SCHFs) on the need for ORPF has seldom been investigated. We reviewed the data on all completely displaced, pediatric SCHFs that were treated surgically by a single, fellowship-trained, pediatric orthopedic surgeon over the first 10 years of the surgeon's clinical practice...
July 18, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28719546/fracture-table-application-for-pediatric-femur-fractures-incidence-and-risk-factors-associated-with-adverse-outcomes
#12
Brian A Kelly, Manahil Naqvi, Emily S Rademacher, Patricia E Miller, Daniel J Hedequist, Michael P Glotzbecker, Travis H Matheney, Benjamin J Shore
BACKGROUND: Flexible elastic nails, submuscular plating, and rigid locked intramedullary nails are common methods of fixation for pediatric femur fractures (PFF) in which the fracture table is used to aid reduction. Little is known about complications associated with fracture table application in PFF. The purpose of this study was to determine the incidence and risk factors associated with adverse outcomes related to fracture table application for the treatment of PFF. METHODS: A retrospective chart review of all children (younger than 18 y) treated for a femur fracture with the use of the fracture table between 2004 and 2015 at a single tertiary pediatric hospital was performed...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28704297/surgical-treatment-of-displaced-pediatric-lateral-condyle-fractures-of-the-humerus-by-the-posterior-approach
#13
William K Conaway, William L Hennrikus, Samine Ravanbakhsh, Zachary Winthrop, John Mahajan
The surgical approach for open reduction and internal fixation of lateral condyle fractures in children is controversial. Some authors recommend the lateral approach to the elbow over the posterior approach because of theoretical concern for injury to the vascular supply of the distal humerus and potential avascular necrosis (AVN). The purpose of this retrospective case series study is to report the outcomes of open reduction and internal fixation of displaced lateral condyle fractures of the humerus by the posterior approach...
July 12, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28699149/is-the-clavicula-pro-humero-technique-of-value-for-reconstruction-after-resection-of-the-proximal-humerus-in-children
#14
Dominique Barbier, Benoît De Billy, Philippe Gicquel, Sophie Bourelle, Pierre Journeau
BACKGROUND: There are several options for reconstruction of proximal humerus resections after wide resection for malignant tumors in children. The clavicula pro humero technique is a biologic option that has been used in the past, but there are only scant case reports and small series that comment on the results of the procedure. Because the longevity of children mandates a reconstruction with potential longevity not likely to be achieved by other techniques, the clavicula pro humero technique may be a potential option in selected patients...
July 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28686548/roles-of-vitamins-d-and-k-nutrition-and-lifestyle-in-low-energy-bone-fractures-in-children-and-young-adults
#15
Michał Karpiński, Janusz Popko, Katarzyna Maresz, Vladimir Badmaev, Sidney J Stohs
The research on skeletal system health in children and young adults, while recognizing the important role of calcium and vitamin D, goes beyond these nutritional standards. This review focuses on the role of vitamin K in combination with vitamin D and other factors in bone health. The current understanding is that maintaining bone health and prevention of low-energy fractures in any pediatric population includes nutritional factors combined with an active lifestyle. Calcium, vitamin D, and vitamin K supplementation contribute independently and collectively to bone health...
July 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28672793/vitamin-d-daily-vs-monthly-use-in-children-and-elderly-what-is-going-on
#16
Luca Dalle Carbonare, Maria Teresa Valenti, Francesco Del Forno, Elena Caneva, Angelo Pietrobelli
Vitamin D deficiency is highly prevalent among children and adults worldwide. Agreement exists that vitamin D deficiency should be corrected. However, the definitions of vitamin deficiency and effective vitamin D replacement therapy are inconsistent in the literature. Not only is the dosing regimen still under debate, but also the time and period of administration (i.e., daily vs. monthly dose). In pediatric as well as elderly subjects, dosing regimens with high vitamin D doses at less frequent intervals were proposed to help increase compliance to treatment: these became widespread in clinical practice, despite mounting evidence that such therapies are not only ineffective but potentially harmful, particularly in elderly subjects...
June 24, 2017: Nutrients
https://www.readbyqxmd.com/read/28660405/xanthogranulomatous-osteomyelitis-of-the-humerus-in-a-pediatric-patient-with-alagille-syndrome-a-case-report-and-literature-review
#17
Adnan Cheema, Alexandre Arkader, Bruce Pawel
Xanthogranulomatous osteomyelitis (XO) is an exceedingly rare disease characterized by infiltration of histiocytes and foamy macrophages. Both on gross examination and on radiographs, XO can mimic malignancy. We describe the case of a 5-year-old female with Alagille syndrome who presented with a pathologic fracture of the right humerus. Initial radiographs revealed multiple osteolytic lesions in the distal humerus while MRI showed a large soft tissue mass. Biopsy confirmed the diagnosis of XO, which has hitherto not been described in a patient with Alagille syndrome...
June 28, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28654505/avulsion-of-the-anterior-inferior-iliac-spine-rehabilitation-in-a-rural-private-practice
#18
Damon Burn
An unusual case is presented of an 11-year-old girl presenting for treatment to a semirural private physical therapy practice, not specializing in pediatric care, following an avulsion fracture of the anterior inferior iliac spine. The patient presented initially non-weight-bearing, with little hip movement due to pain. Following treatment, the patient returned to preinjury status including return to full participation in netball. A review of the literature regarding healing and rehabilitation is described...
July 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28640089/functional-outcomes-of-gartland-iii-supracondylar-humerus-fractures-with-early-neurovascular-complications-in-children-a-retrospective-observational-study
#19
COMPARATIVE STUDY
Sung Il Wang, Tae Young Kwon, Hong Pil Hwang, Jung Ryul Kim
This was a retrospective observational study. The aim of this study was to evaluate functional outcomes in children treated for Gartland III supracondylar humerus (SCH) fracture with neurovascular (NV) injuries using validated outcome measures. A secondary goal was to determine whether clinical parameters such as age at injury, sex, weight, fracture site, and/or direction of displacement could predict NV injury at the time of fracture or long-term functional outcomes in these patients.One hundred fifty-four patients of Gartland III SCH fractures between March 2004 and May 2013 were studied retrospectively...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#20
Jeremy Korsh, Stephen Adolfsen
Salter-Harris type I (SH-I) fractures of the distal fibula are commonly encountered in pediatric orthopedics. We describe 2 unique cases of adolescents with completely displaced SH-I distal fibula fractures that were treated operatively. In the first case, a closed reduction attempt failed and the patient required open reduction and internal fixation of the distal fibula and syndesmosis. The syndesmotic ligaments were avulsed from the distal fibular metaphysis. In the second case, closed reduction of the distal fibula fracture was partially successful, but anatomic reduction could not be achieved without open reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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