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Pediatric + orthopaedic + review

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
Pokket Sirisreetreerux, Kathy M Lue, Thammasin Ingviya, Daniel A Friedlander, Heather N Di Carlo, Paul D Sponseller, John P Gearhart
PURPOSE: A 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. This study aimed to identify factors that contribute to a failed primary exstrophy closure with osteotomy. MATERIALS AND METHODS: A prospectively-maintained institutional database was reviewed for classic bladder exstrophy patients who were primarily closed with osteotomy at our institution or referred after primary closure from 1990 to 2015...
October 5, 2016: Journal of Urology
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
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
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
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
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
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
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
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
Lisa Phillips, Sasha Carsen, Anisha Vasireddi, Kishore Mulpuri
BACKGROUND: Patient-reported outcomes are increasingly used as primary measures of success and impact of health care services. There is no current consensus on the efficacy of functional health status (FHS) or health-related quality of life (HRQoL) evaluation in pediatric orthopaedic surgery. The purpose of this study was to quantify and characterize the use of such patient-reported outcomes in the pediatric orthopaedic literature over the last several years. METHODS: A cross-sectional review of 6 orthopaedic journals-Journal of Bone and Joint Surgery, Bone and Joint Journal, Spine, Journal of Pediatric Orthopaedics A, Journal of Pediatric Orthopaedics B, and Journal of Children's Orthopaedics, was conducted by 2 independent reviewers...
September 3, 2016: Journal of Pediatric Orthopedics
Eric Hohn, Nirav K Pandya
BACKGROUND: Medial patellofemoral ligament (MPFL) reconstruction is one of several surgical procedures used to treat patellofemoral instability. Use of allograft tissue can preserve autogenous tissue and may be preferable in patients with connective tissue disorders or ligamentous laxity. Although there are successful reports in adults, it is unclear if the use of allograft tissue in MPFL reconstruction can restore patellofemoral stability in children and adolescents. QUESTIONS/PURPOSES: (1) Does allograft tissue in MPFL reconstruction in pediatric and adolescent patients restore patellar stability? (2) What complications were associated with allograft MPFL reconstructions in children and adolescents? METHODS: Between June 2012 and August 2015, one surgeon (NKP) performed 26 MPFL reconstructions in 23 patients with gracilis allograft for traumatic patellar instability...
September 2, 2016: Clinical Orthopaedics and related Research
Joseph L Yellin, Peter D Fabricant, Alex Gornitzky, Elliot M Greenberg, Sara Conrad, Julie Ann Dyke, Theodore J Ganley
BACKGROUND: Anterior cruciate ligament (ACL) tears are increasingly prevalent in the pediatric population. ACL rehabilitation is an essential component of recovery following injury and reconstruction, yet there are few explicit descriptions of pediatric-specific ACL rehabilitation protocols in the literature, especially in the context of varying treatment interventions. Our aim was to systematically review the literature on rehabilitation following ACL tears in children in order to describe common principles among different treatment options and areas of future research...
January 19, 2016: JBJS Rev
Karan Dua, William C McAvoy, Sybil A Klaus, David I Rappaport, Rebecca E Rosenberg, Joshua M Abzug
PURPOSE: The benefits of hospitalist co-management of pediatric surgical patients include bettering patient safety, decreasing negative patient outcomes, providing comprehensive medical care, and establishing a dedicated resource to patients for postoperative care. The purpose of this study was to characterize the nature of patients co-managed by a pediatric hospitalist. The authors hypothesize that hospitalist co-management is safe and efficacious in pediatric orthopaedic surgical patients who are admitted to a community hospital...
2016: Maryland Medicine: MM: a Publication of MEDCHI, the Maryland State Medical Society
Steven F Shannon, Nicholas M Hernandez, Stephen A Sems, Annalise N Larson, Todd A Milbrandt
OBJECTIVES: The purpose of this study was to evaluate the type and severity of orthopaedic and associated injuries for snowmobile, All-terrain vehicles (ATV) and motorized dirtbike accidents in a pediatric patient population. METHODS: A total of 758 patients who presented following either snowmobile (n=87), ATV-related (n=308) or dirtbike (n=363)-related trauma at our institution between 1996 and 2015 were retrospectively reviewed. RESULTS: A total of 441 axial and appendicular fractures occurred requiring 533 procedures...
July 20, 2016: Journal of Pediatric Orthopedics
Kevin C Parvaresh, Vidyadhar V Upasani, James D Bomar, Andrew T Pennock
INTRODUCTION: Variable ossification patterns of the pelvis in skeletally immature patients can make the interpretation of pelvic radiographs challenging. Inconsistencies among prior studies and lack of sex comparisons underscore the need for a more comprehensive characterization of the secondary ossification centers. This study evaluates the chronology and sex differences for appearance and closure of pelvic and proximal femoral secondary ossification centers using computed tomography (CT)...
July 20, 2016: Journal of Pediatric Orthopedics
Nolan M Wessell, Jeffrey E Martus, Matthew A Halanski, Brian Snyder, Walter Truong
BACKGROUND: Early-onset scoliosis (EOS) affects roughly 1 to 2 out of 10,000 live births per year. Because this subset of patients has a yet to achieve a majority of their skeletal growth, a number of treatment challenges need to be addressed before surgical intervention. If left untreated, EOS can cause a number of problems throughout the patient's lifespan, particularly in regards to the growth of the thorax and pulmonary development. A wide variety of surgical systems and techniques are available to the treating surgeon...
July 11, 2016: Journal of Pediatric Orthopedics
Gherardo Pagliazzi, Matteo Baldassarri, Luca Perazzo, Francesca Vannini, Francesco Castagnini, Roberto Buda
BACKGROUND: Juvenile osteochondritis dissecans of the talus (JOCDT) is a focal idiopathic lesion primarily of the subchondral bone leading to subsequent cartilaginous damage. The majority of the papers dealing with JOCDT reported heterogeneous case studies of patients treated with different cartilage repair techniques. The purpose of this paper is to retrospectively review both clinical and radiologic results among 7 patients affected by JOCDT treated with arthroscopic bone marrow aspirate concentrate (BMAC) transplantation with the 1-step technique...
July 2, 2016: Journal of Pediatric Orthopedics
Brad Stone, Matthew Street, Warren Leigh, Haemish Crawford
BACKGROUND: Osteomyelitis shows a strong predilection for the tibia in the pediatric population and is a significant source of complications. The purpose of this article is to retrospectively review a large series of pediatric patients with tibial osteomyelitis. We compare our experience with that in the literature to determine any factors that may aid diagnosis and/or improve treatment outcomes. METHODS: A 10-year retrospective review was performed of clinical records of all cases of pediatric tibial osteomyelitis managed at the 2 children's orthopaedic departments in the Auckland region...
July 2016: Journal of Pediatric Orthopedics
John A Scolaro, Reza Firoozabadi, Milton L Chip Routt
BACKGROUND: Pediatric and adolescent pelvic ring injuries are frequently treated without surgery. In patients with unstable injuries to the pelvic ring, surgical stabilization aids in resuscitation, provides pain relief, and allows for mobilization. Percutaneous pelvic screw fixation is commonly performed in adult patients for unstable pelvic ring injuries, but a paucity of literature exists regarding their use in pediatric patients. The purpose of this study is to review the use, outcome, and management of percutaneous posterior pelvic screws in pediatric patients with unstable pelvic ring injuries...
June 2, 2016: Journal of Pediatric Orthopedics
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