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https://www.readbyqxmd.com/read/28027145/chance-fractures-in-the-pediatric-population-are-often-misdiagnosed
#1
Lindsay M Andras, Kira F Skaggs, Haleh Badkoobehi, Paul D Choi, David L Skaggs
BACKGROUND: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively. METHODS: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009800/is-there-value-in-having-radiology-provide-a-second-reading-in-pediatric-orthopaedic-clinic
#2
Vivek Natarajan, Patrick Bosch, Ozgur Dede, Vincent Deeney, Stephen Mendelson, Timothy Ward, Maria Brooks, Tanya Kenkre, James Roach
BACKGROUND: The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009798/vitamin-d-deficiency-the-missing-etiological-factor-in-the-development-of-juvenile-osteochondrosis-dissecans
#3
Gerrit S Maier, Djordje Lazovic, Uwe Maus, Klaus E Roth, Konstantin Horas, Jörn B Seeger
BACKGROUND: Vitamin D deficiency can result in rickets and hypocalcemia during infant and childhood growth. There is an increasing interest in the role of vitamin D with regards to childhood bone health. Osteochondrosis dissecans (OD) is a common disease affecting different joints. To date, the exact etiology of OD still remains unclear. The aim of this study was to evaluate a possible association of vitamin D deficiency and juvenile OD. METHODS: A retrospective chart review of the years 2010 to 2015 of all orthopaedic patients with an initial diagnosis of juvenile OD admitted to undergo operative treatment of the OD was performed...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009797/what-s-new-in-congenital-scoliosis
#4
Joshua M Pahys, James T Guille
BACKGROUND: Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27979366/does-the-saline-load-test-still-have-a-role-in-the-orthopaedic-world-a-systematic-review-of-the-literature
#5
Benjamin B Browning, Anthony V Ventimiglia, Anant Dixit, Emmanuel Illical, William P Urban, Julio J Jauregui
INTRODUCTION: The aim of this systematic review was to assess the efficacy of Saline load tests (SLTs) to evaluate extension of periarticular wounds into capsule in emergent settings. METHODS: We systematically reviewed the literature to evaluate the accuracy of the SLT in diagnosing penetrating joint injuries in the elbow, wrist, shoulder, knee, or ankle. RESULTS: The SLT values to determine knee arthrotomies vary from 73.8 mL to 194 mL with sensitivities ranging between 91% and 99% depending on the size of the laceration...
December 12, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27977498/evaluation-of-pediatric-questions-on-the-orthopaedic-in-training-examination-an-update
#6
Robert F Murphy, Leah Nunez, William R Barfield, James F Mooney
BACKGROUND: Pediatric orthopaedics is tested frequently on the Orthopaedic In-Training Examination (OITE). The most recent data on the pediatrics section of the OITE were generated from content 10 years old. The purpose of this study is to assess the pediatric orthopaedic questions on the 2011 to 2014 OITE, and to compare question categories and cognitive taxonomy with previous data. METHODS: Four years (2011 to 2014) of OITE questions, answers, and references were reviewed...
December 13, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27917331/percutaneous-cannulated-screw-fixation-for-pediatric-epiphyseal-ankle-fractures
#7
Özgür Çiçekli, Güzelali Özdemir, Mustafa Uysal, Vedat Biçici, İzzet Bingöl
BACKGROUND: Ankle injuries are among the most common injuries in children. The aim of this study was to compare the efficacies of two percutaneous fixation methods after closed reduction in physeal ankle fractures. METHODS: We reviewed the cases of 24 patients with a mean age of 12.29 years; 16 were male, and 8 were female. Only patients with fractures of Salter-Harris types 2, 3, and 4 with displacements greater than 2 mm were included in the study. Patients were treated with closed reduction manipulation and percutaneous screw fixation...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27826907/the-unstable-knee-in-congenital-limb-deficiency
#8
REVIEW
Gabriel T Mindler, Christof Radler, Rudolf Ganger
PURPOSE: Instability of the knee is a common finding in patients with congenital limb deficiency. The instability can be attributed to soft tissue abnormalities, frontal, sagittal or rotational deformity of the lower limb and bony dysplasia of the patella or of the femoral condyles. In most of the cases, these pathomorphologic changes stay asymptomatic in daily activity. However, instability can appear during deformity correction and bone-lengthening procedures, leading to flexion contracture or subluxation of the knee...
December 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27787808/evaluation-of-complications-associated-with-off-label-use-of-recombinant-human-bone-morphogenetic-protein-2-rhbmp-2-in-pediatric-orthopaedics
#9
Norbert Stiel, Tim N Hissnauer, Martin Rupprecht, Kornelia Babin, Carsten W Schlickewei, Johannes M Rueger, Ralf Stuecker, Alexander S Spiro
The off-label use of recombinant human bone morphogenetic protein-2 to promote bone healing in adults has significantly increased in recent years, while reports of recombinant human bone morphogenetic protein-2 application in children and adolescents are very rare. The aim of this study was to evaluate the safety of single and repetitive recombinant human bone morphogenetic protein-2 use in pediatric orthoapedics. Therefore we reviewed the medical records of 39 patients who had been treated with recombinant human bone morphogenetic protein-2 at our institution...
December 2016: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/27787459/are-the-appropriate-use-criteria-for-the-management-of-pediatric-supracondylar-humerus-fractures-useful-in-clinical-practice
#10
Cemal Kazimoglu, Ali Turgut, Ali Reisoglu, Önder Kalenderer, Burak Önvural, Haluk Agus
The aim of this study was to evaluate our treatment modalities in pediatric supracondylar humerus fractures according to the recently published Appropriate Use Criteria (AUC) by the American Academy of Orthopaedic Surgeons. A total of 991 patients with supracondylar humerus fractures were included. After reviewing medical records, 38 different clinical scenarios described in the AUC were observed. Of the 991 patients, 127 were type I, 423 were type II, and 405 were type III fractures according to the Gartland classification...
October 26, 2016: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27755642/incidence-and-complications-of-open-hip-preservation-surgery-an-abos-database-review
#11
Jon Hedgecock, P Christopher Cook, John Harrast, Judith F Baumhauer, Brian D Giordano
Hip preservation surgery encompasses various surgical procedures that have the goal of decreasing the progression of osteoarthritis, preserving normal hip function, and delaying the need for arthroplasty. These procedures can encompass arthroscopic, open, and combined techniques. This study investigated the trends and complications associated with open hip preservation surgery performed by candidates undergoing Part II of the American Board of Orthopaedic Surgery examination. The American Board of Orthopaedic Surgery Part II surgeon case database was queried from the years 2003 to 2013 for Current Procedural Terminology (CPT) codes related to open hip preservation surgery in patients 10 years and older...
October 18, 2016: Orthopedics
https://www.readbyqxmd.com/read/27720781/failed-primary-bladder-exstrophy-closure-with-osteotomy-multivariable-analysis-of-a-25-year-experience
#12
Pokket Sirisreetreerux, Kathy M Lue, Thammasin Ingviya, Daniel A Friedlander, Heather N Di Carlo, Paul D Sponseller, John P Gearhart
PURPOSE: Successful primary bladder exstrophy closure provides the best opportunity for patients to achieve a functional closure and urinary continence regardless of the method of repair. Use of osteotomy during initial closure has significantly improved success rates. However, failures can still occur. We identify factors that contribute to a failed primary exstrophy closure with osteotomy. MATERIALS AND METHODS: We reviewed a prospectively maintained institutional database for classic bladder exstrophy cases primarily closed with osteotomy at our institution or referred after primary closure between 1990 and 2015...
October 5, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27688914/the-prevalence-of-mrsa-nasal-carriage-in-preoperative-pediatric-orthopaedic-patients
#13
J J Walrath, W L Hennrikus, C Zalonis, A M Dyer, J E Latorre
Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been described as a risk factor for postsurgical infection. The purpose of this study is to determine the prevalence of MRSA in pediatric orthopaedic patients and whether being a MRSA carrier is a predictor of postoperative infection. Six hundred and ninety-nine consecutive pediatric patients who underwent MRSA nasal screening prior to surgery were studied. Postoperative cultures, total surgical site infections (SSIs), and epidemiological and surgical prophylaxis data were reviewed...
2016: Advances in Orthopedics
https://www.readbyqxmd.com/read/27662381/current-issues-affecting-the-practice-of-pediatric-orthopaedic-surgeons-results-of-the-2014-workforce-survey-of-american-academy-of-pediatrics-section-on-orthopaedics
#14
Pooya Hosseinzadeh, Lawson Copley, Holly Ruch-Ross, Richard M Schwend, Jeffrey R Sawyer
INTRODUCTION: The opinions of the pediatric orthopaedic workforce are shaped by market forces, regulatory processes, and local experience. The purpose of this report is to summarize the findings of the recent Workforce Survey of the American Academy of Pediatrics (AAP) Section on Orthopaedics (SOOr). This submission has been reviewed and approved by the Board of Directors of the Pediatric Orthopaedic Society of North America (POSNA). METHODS: In 2014, the AAP generated a survey to assess perceptions of pediatric orthopaedic surgeons about current issues that affect practice...
September 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27636917/decreasing-resource-utilization-using-standardized-clinical-assessment-and-management-plans-scamps
#15
Gaurav Luther, Patricia E Miller, Susan T Mahan, Peter M Waters, Donald S Bae
BACKGROUND: Standardized clinical assessment and management plans (SCAMPs) are a novel quality improvement initiative shown to improve patient care, diminish practice variation, and reduce resource utilization. Unlike clinical practice guidelines, a SCAMP is a flexible algorithm that undergoes iterative updates based on periodic data collection and review. We recently implemented a SCAMP for the closed treatment of pediatric torus fractures. The purpose of this study is to analyze the effect of SCAMP implementation on resource utilization, practice variability, cost of care, and outcomes...
September 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27636910/pediatric-injuries-at-an-annual-motocross-competition-rates-and-severity
#16
Brendan A Williams, James P McFadden, Tyler L Teurlings, Laurel C Blakemore
PURPOSE: Pediatric motocross injuries occur frequently and with significant associated morbidity; however, data are limited regarding injury occurring during competition. North Central Florida hosts an annual motocross competition with numerous pediatric competitors. We sought to evaluate the rate and severity of injuries sustained at this event over a multiyear period. Our primary hypothesis was that motocross injury rates and severity in competition exceed that of other competitive sports in this age group...
September 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27635147/septic-arthritis-of-the-pediatric-shoulder-from-infancy-to-adolescence
#17
Justin W Walker, William L Hennrikus
Background. Septic arthritis of the glenohumeral joint in the pediatric population (<18 yo) is not commonly described in the literature. There is a corresponding paucity of information regarding its presentation and treatment. Methods. An IRB approved review of patients treated with irrigation and debridement by the Orthopaedic Department was completed. This retrospective study includes four patients, presenting from 2005 to 2015, with septic arthritis of the shoulder. Results. The mean age (M age) at presentation was 5 years, with a range of 1 month to 15 years...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27603197/soft-tissue-injury-severity-is-associated-with-neurovascular-injury-in-pediatric-supracondylar-humerus-fractures
#18
Christine A Ho, David A Podeszwa, Anthony I Riccio, Robert L Wimberly, Brandon A Ramo
BACKGROUND: Neurovascular injury in pediatric supracondylar fractures (SCHFx) has been associated with fracture classification but not with soft tissue injury. The purpose of this study is to correlate clinical soft tissue damage to neurovascular injuries in SCHFx. METHODS: This is an institutional review board approved prospective study from January 2010 through December 2013 of 748 operatively treated pediatric SCHFx. Prospective data were gathered both preoperatively and intraoperatively regarding detailed neurovascular examination as well as soft tissue status, with qualitative descriptives for swelling (mild/moderate/severe), ecchymosis, abrasions, skin tenting, and skin puckering...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27603194/complication-rates-after-bone-morphogenetic-protein-bmp-use-in-orthopaedic-surgery-in-children-a-concise-multicenter-retrospective-cohort-study
#19
Sumeet Garg, James J McCarthy, Ryan Goodwin, Joel Kolmodin, Wudbhav N Sankar, Corinna Franklin, Douglas Armstrong, David Fryzel, Susan Hassenbein, Cara Meder
BACKGROUND: The use of bone morphogenetic protein (BMP) has been associated with a number of complications in adult patients. However, this association is less established in children. The aim of this study was to evaluate the safety of BMP use in children by determining the complication rates after BMP use at multiple institutions. METHODS: In a retrospective study (2000 to 2013), the medical records of all patients who received BMP at any of the 5 institutions were reviewed...
September 3, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27603189/subcapital-shortening-osteotomy-for-severe-slipped-capital-femoral-epiphysis-preliminary-results-of-the-french-multicenter-study
#20
Brice Ilharreborde, Vincent Cunin, Saad Abu-Amara
BACKGROUND: There is growing evidence that symptomatic femoroacetabular impingement (FAI) can develop after severe slipped capital femoral epiphysis (SCFE) fixed in situ. Realignment procedures have therefore gained popularity, but complication rates remain controversial. Among them, the subcapital shortening osteotomy without hip dislocation has been progressively adopted in France, but results have never been assessed to date. METHODS: All cases performed in 23 French university hospitals between January 2010 and March 2014 were reviewed to (1) describe the surgical procedure, (2) assess the radiologic and functional outcomes, and (3) report complications and more specifically the avascular necrosis rate (AVN) according to initial stability...
September 3, 2016: Journal of Pediatric Orthopedics
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