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https://www.readbyqxmd.com/read/28933808/pediatric-orthopedic-injuries-evidence-based-management-in-the-emergency-department-digest
#1
Jamie Lien, Kathryn H Pade
Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed...
September 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28926487/the-frequency-of-nonaccidental-trauma-in-children-under-the-age-of-3-years-with-femur-fractures-is-there-a-better-cutoff-point-for-universal-workups
#2
Jochen P Son-Hing, Z Deniz Olgun
The purpose of this study was to evaluate narrower age groups in children aged 0-4 years to determine whether guidelines should be refined when investigating femur fractures for nonaccidental trauma (NAT). This was a retrospective review of the pediatric trauma database at our level 1 pediatric trauma center. The database was examined from 2009 to present. We examined rates of NAT in the less than or equal to 12-month, 13-24-month, 25-36-month, and 37-48-month age groups. χ was used to compare rates of NAT between these groups, and P less than 0...
September 18, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28914710/effect-of-time-to-operative-intervention-on-motility-outcomes-following-orbital-floor-fracture-repair-in-children
#3
Viraj J Mehta, James G Chelnis, Qingxia Chen, Louise A Mawn
PURPOSE: To evaluate the relationship between time to surgical intervention and extraocular motility outcomes in children following repair of an orbital floor fracture with inferior rectus entrapment. METHODS: After institution review board's approval, a retrospective, consecutive case series of 28 children with unilateral orbital floor fractures entrapping the inferior rectus muscle was conducted. Clinical examinations and CT images were performed on all children...
September 12, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28902088/obesity-increases-risk-of-loss-of-reduction-after-casting-for-diaphyseal-fractures-of-the-radius-and-ulna-in-children-an-observational-cohort-study
#4
Christopher J DeFrancesco, Benjamin H Rogers, Apurva S Shah
OBJECTIVES: To determine if high body mass index (BMI) increases the risk of loss of reduction (LOR) following closed reduction and casting for displaced concomitant fractures of the radial and ulnar shafts in pediatric patients. DESIGN: Retrospective cohort study SETTING:: A single tertiary care, urban children's hospital PATIENTS/PARTICIPANTS:: Pediatric patients aged 2-18 years with closed, displaced, concomitant diaphyseal fractures of the radius and ulna (AO/OTA 22-A3) who underwent closed reduction and casting at the study site...
August 26, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28893419/telenephrology-current-perspectives-and-future%C3%A2-directions
#5
Rajeev Rohatgi, Michael J Ross, Sandawana W Majoni
There is increasing interest in telemedicine among physicians and patients; however, the evidence regarding the quality of care delivered by telemedicine, and telenephrology in particular, compared with in-person care is limited. In this review, different electronic modalities used to deliver nephrology care are reviewed and critiqued, with a focused analysis from the Australian and United States perspectives. Both countries are geographically expansive with significant rural populations where access to nephrology care is limited...
September 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28889364/open-complete-anterior-dislocation-of-the-sacro-iliac-joint-in-a-4-year-old-boy-a-case-report-of-a-rare-injury-with-5-year-follow-up
#6
Walid A Elnahal, Mahmoud Fahmy, Mehool Acharya
Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh...
September 9, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28887279/sacral-alar-iliac-fixation-in-children-with-neuromuscular-scoliosis-minimum-5-year-follow-up
#7
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/28877328/procedural-sedation-with-ketamine-versus-propofol-for-closed-reduction-of-pediatric-both-bone-forearm-fractures
#8
Todd Morrison, Chris Carender, Brendan Kilbane, Raymond W Liu
Effective treatment of pediatric both bone forearm fractures consists of timely restoration of anatomic alignment with manipulation and immobilization, often accomplished with the aid of procedural sedation in the emergency department setting. The current lack of consensus regarding a safe and optimal regimen may result in inadequate sedation, compromised quality of reduction, or patient harm. The current study was conducted to answer the following questions for pediatric both bone forearm fractures treated with closed reduction with either ketamine or propofol procedural sedation: (1) Is there a difference in the rate of unacceptable alignment 4 weeks after reduction? (2) Is there a difference in the rates of major sedation-related complications? Medical records, data on procedural sedation, and radiographs of 74 skeletally immature patients with diaphyseal or distal metaphyseal both bone forearm fractures treated with manipulation were reviewed (ketamine sedation, 26; propofol sedation, 48)...
September 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28875130/ipsilateral-femur-and-tibia-fractures-in-pediatric-patients-a-systematic-review
#9
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/28872531/flexion-type-supracondylar-humeral-fractures-ulnar-nerve-injury-increases-risk-of-open-reduction
#10
Kelly Flynn, Apurva S Shah, Christopher M Brusalis, Kelly Leddy, John M Flynn
BACKGROUND: The vast majority of displaced pediatric supracondylar humeral fractures can be treated successfully with closed reduction and percutaneous pinning. The need for open reduction is difficult to determine a priori and is typically due to the failure of closed reduction attempts or persistent limb ischemia. The aims of this study were to determine the prevalence of flexion-type supracondylar humeral fractures, the rate of open reduction for flexion-type fractures, and the predictive impact of ulnar nerve injury on the need for open reduction for flexion-type supracondylar humeral fractures...
September 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28866061/staged-trapping-of-traumatic-basilar-trunk-pseudoaneurysm-a-case-report-and-review-of-literature
#11
Nanthiya Sujijantarat, Matthew Pierson, Joanna Kemp, Jeroen Coppens
BACKGROUND: Traumatic intracranial aneurysms (TICAs) of the posterior circulation in the pediatric populations are rare. Only a few reports in literature document basilar artery TICA in the pediatric population. These cases were typically associated with a clival fracture and commonly diagnosed weeks to months after trauma. We present a case of a patient with a basilar TICA diagnosed after a motor vehicle collision treated with staged trapping and review of the literature. CASE DESCRIPTION: We present a case of a 14-year-old boy who sustained a high speed motor vehicle collision and developed a basilar trunk TICA identified on admission...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28856575/muscle-bone-interactions-in-pediatric-bone-diseases
#12
REVIEW
Louis-Nicolas Veilleux, Frank Rauch
PURPOSE: Here, we review the skeletal effects of pediatric muscle disorders as well as muscle impairment in pediatric bone disorders. RECENT FINDINGS: When starting in utero, muscle disorders can lead to congenital multiple contractures. Pediatric-onset muscle weakness such as cerebral palsy, Duchenne muscular dystrophy, spinal muscular atrophy, or spina bifida typically are associated with small diameter of long-bone shafts, low density of metaphyseal bone, and increased fracture incidence in the lower extremities, in particular, the distal femur...
August 30, 2017: Current Osteoporosis Reports
https://www.readbyqxmd.com/read/28852352/closed-and-open-reduction-of-displaced-pediatric-lateral-condyle-humeral-fractures-a-study-of-short-term-complications-and-postoperative-protocols
#13
Caitlin Justus, Lee S Haruno, Mary K Riordan, Lisa Wilsford, Tyler Smith, Shannon Antekeier, Scott D McKay
BACKGROUND: Displaced lateral condyle humeral fractures in children are treated operatively to maximize function and growth of the elbow. Traditionally an open approach is used for reduction of the fracture, but recent series have shown promising results with closed reduction. Percutaneous pins are typically used for fixation, no matter the reduction method. This retrospective review compares our experience with early complications after open and closed reduction of these fractures. METHODS: We retrospectively reviewed charts and radiographs of operatively treated lateral condyle fractures...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28844421/adolescent-clavicle-nonunions-potential-risk-factors-and-surgical-management
#14
Andrew T Pennock, Eric W Edmonds, Donald S Bae, Mininder S Kocher, Ying Li, Frances A Farley, Henry B Ellis, Philip L Wilson, Jeffrey Nepple, J Eric Gordon, Samuel C Willimon, Michael T Busch, David D Spence, Derek M Kelly, Nirav K Pandya, Coleen S Sabatini, Kevin G Shea, Benton E Heyworth
BACKGROUND: Clavicle nonunions in adolescent patients are exceedingly rare. The purpose of this study was to evaluate a series of clavicle nonunions from a pediatric multicenter study group to assess potential risk factors and treatment outcomes. METHODS: A retrospective review of all clavicle nonunions in patients younger than 19 years was performed at 9 pediatric hospitals between 2006 and 2016. Demographic and surgical data were documented. Radiographs were evaluated for initial fracture classification, displacement, shortening, angulation, and nonunion type...
August 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28844419/pediatric-elbow-arthroscopy-indications-and-safety
#15
Steven M Andelman, Kristen M Meier, Amanda L Walsh, Joung Heon Kim, Michael R Hausman
BACKGROUND: Elbow arthroscopy is a minimally invasive means by which to treat a variety of acute and chronic elbow conditions. Although the safety and efficacy is well documented in the adult population, comparatively little information is available about the role of elbow arthroscopy in the pediatric population. This study reports the indications for and safety of elbow arthroscopy in a series of pediatric patients. METHODS: A retrospective review was performed from 2001 to 2015 of a surgical database at a single institution...
August 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28840195/pediatric-posterior-cruciate-ligament-avulsion-fracture-of-the-tibial-insertion-case-report-and-review-of-the-literature
#16
Yannick Hurni, Vincenzo De Rosa, Jorge Gabriel Gonzalez, Mario Mendoza-Sagaon, Flurim Hamitaga, Giorgia Pellanda
Background  Posterior cruciate ligament (PCL) avulsion fracture of the tibial insertion is a very rare injury in children. In addition to performing an attentive clinical examination, radiologic studies are fundamental for its correct diagnosis and treatment. Its management may be either conservative or operative. So far, only a few cases treated conservatively have been reported in the pediatric population, with controversial results. Methods  We prospectively collected and reviewed clinical and radiographic data of an 11-year-old boy with avulsion fracture of the tibial insertion of the PCL...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28830650/basics-of-bone-metabolism-and-osteoporosis-in-common-pediatric-neuromuscular-disabilities
#17
REVIEW
Evren Yaşar, Emre Adigüzel, Mutluay Arslan, Dennis J Matthews
Bone modeling is a process that starts with fetal life and continues during adolescence. Complex factors such as hormones, nutritional and environmental factors affect this process. In addition to these factors, physical conditioning and medications that have toxic effects on bony tissue should be carefully considered in patient follow-up. Osteoporosis is a significant problem in pediatric population because of ongoing growth and development of skeletal system. Two types of osteoporosis are primary and secondary types and children with neuromuscular disabilities constitute a major group with secondary osteoporosis...
August 10, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28830302/regenerative-medicine-approaches-for-the-treatment-of-pediatric-physeal-injuries
#18
Nichole Shaw, Christopher Erickson, Stephanie Bryant, Virginia Ferguson, Melissa Diane Krebs, Nancy Hadley-Miller, Karin A Payne
The physis, or growth plate, is a cartilaginous region at the end of children's long bones that serves as the primary center for longitudinal growth and characterizes the immature skeleton. Musculoskeletal injury including fracture, infection, malignancy, or iatrogenic damage has risk of physeal damage. Physeal injuries account for 30% of pediatric fractures and may result in impaired bone growth. Once damaged, cartilage tissue within the physis is often replaced by unwanted bony tissue, forming a 'bony bar' that can lead to complications such as complete growth arrest, angular or rotational deformities, and altered joint mechanics...
August 22, 2017: Tissue Engineering. Part B, Reviews
https://www.readbyqxmd.com/read/28825959/pediatric-orthopedic-injuries-evidence-based-management-in-the-emergency-department
#19
Jamie Lien
Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed...
September 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28823022/long-term-bisphosphonate-therapy-in-osteogenesis-imperfecta
#20
REVIEW
A Biggin, C F Munns
PURPOSE OF REVIEW: Osteogenesis imperfecta (OI) is a genetic bone disorder resulting in bone fragility. It has a heterogeneous phenotype which typically includes reduced bone mass, multiple fractures, deformity, and chronic disability. Bisphosphonate treatment remains the first-line medical management, but there is still debate on aspects of its effectiveness. This review summarizes current knowledge about long-term bisphosphonate use in OI with recommendations on clinical application...
August 19, 2017: Current Osteoporosis Reports
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