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https://www.readbyqxmd.com/read/28807427/paediatric-fracture-clinic-re-design-incorporating-a-virtual-fracture-clinic
#1
Paul M Robinson, Francis Sim, Mark Latimer, Piers D Mitchell
INTRODUCTION: The use of virtual fracture clinics (VFCs) and home management protocols is increasing. The main aim of this research is to determine whether a paediatric home management programme and VFC can be used safely to manage a range of suitable fractures in children. MATERIALS AND METHODS: Protocols for the home management of stable paediatric fractures were designed by two consultant paediatric orthopaedic surgeons. These were for children between the ages of 18 months and 15 years 364 days...
August 4, 2017: Injury
https://www.readbyqxmd.com/read/28777286/electronic-medical-record-use-and-satisfaction-among-pediatric-orthopaedic-surgeons
#2
Lawson A Copley, Chester H Sharps, Joseph A Gerardi, Sumit K Gupta, Kelly L Vanderhaave, John F Lovejoy, John P Lubicky, Stephen A Albanese, Chanhee Jo
INTRODUCTION: Electronic medical record (EMR) use among pediatric orthopaedic surgeons has evolved substantially within the past decade. In response to the Patient Protection and Affordable Care Act, large hospitals and tertiary pediatric medical centers rapidly acquired and implemented EMRs with uncertainty as to the potential impact on patient care and operational efficiency of subspecialists. This study reviews the background and regulatory framework for Meaningful Use of EMR and assesses the current landscape of EMR utilization by pediatric orthopaedic surgeons...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28753234/manipulative-interventions-for-reducing-pulled-elbow-in-young-children
#3
REVIEW
Marjolein Krul, Johannes C van der Wouden, Emma J Kruithof, Lisette Wa van Suijlekom-Smit, Bart W Koes
BACKGROUND: Pulled elbow (nursemaid's elbow) is a common injury in young children. It often results from a sudden pull on the arm, usually by an adult or taller person, which pulls the radius through the annular ligament, resulting in subluxation (partial dislocation) of the radial head. It can also be caused by a fall or twist. The child experiences sudden acute pain and loss of function in the affected arm. Pulled elbow is usually treated by manual reduction of the subluxed radial head...
July 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28735160/longitudinal-assessment-of-gait-quality-in-children-with-bilateral-cerebral-palsy-following-repeated-lower-limb-intramuscular-botulinum-toxin-a-injections
#4
Felicity A Read, Roslyn N Boyd, Lee A Barber
BACKGROUND: Serial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS). AIM: To determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures...
July 20, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28710227/advancing-concussion-assessment-in-pediatrics-a-cap-a-prospective-concurrent-cohort-longitudinal-study-of-mild-traumatic-brain-injury-in-children-protocol-study
#5
Keith Owen Yeates, Miriam Beauchamp, William Craig, Quynh Doan, Roger Zemek, Bruce Bjornson, Jocelyn Gravel, Angelo Mikrogianakis, Bradley Goodyear, Nishard Abdeen, Christian Beaulieu, Mathieu Dehaes, Sylvain Deschenes, Ashley Harris, Catherine Lebel, Ryan Lamont, Tyler Williamson, Karen Maria Barlow, Francois Bernier, Brian L Brooks, Carolyn Emery, Stephen B Freedman, Kristina Kowalski, Kelly Mrklas, Lianne Tomfohr-Madsen, Kathryn J Schneider
INTRODUCTION: Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#6
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28574172/prevention-of-hip-displacement-in-children-with-cerebral-palsy-a-systematic-review
#7
REVIEW
Stacey D Miller, Maria Juricic, Kim Hesketh, Lynore Mclean, Sonja Magnuson, Sherylin Gasior, Emily Schaeffer, Maureen O'donnell, Kishore Mulpuri
AIM: To conduct a systematic review and evaluate the quality of evidence for interventions to prevent hip displacement in children with cerebral palsy (CP). METHOD: A systematic review was performed using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Searches were completed in seven electronic databases. Studies were included if participants had CP and the effectiveness of the intervention was reported using a radiological measure...
June 2, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28538532/identification-and-management-of-obese-patients-in-a-pediatric-orthopaedic-clinic
#8
Natalia Davila, Joy Vess, Emily E Johnson
BACKGROUND: Childhood obesity is a complex healthcare problem that affects all aspects of a child's health. The American Academy of Pediatrics and the Expert Committee recommends that all children be evaluated for current medical conditions including the risk for obesity by identifying elevated body mass index (BMI), physical activity habits, and diet. Childhood obesity is defined as a BMI of 95th percentile or greater on standardized age-based growth charts. Abdominal and visceral fat mass has a negative effect on bone formation during childhood and adolescence...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28471818/spectrum-of-diagnosis-and-disposition-of-patients-referred-to-a-pediatric-orthopaedic-center-for-a-diagnosis-of-intoeing
#9
Shawne Faulks, Kaitlyn Brown, John G Birch
BACKGROUND: Orthopaedic surgeons frequently evaluate otherwise healthy children for concern of intoed gait. Intoeing in otherwise healthy young children due to metatarsus adductus, internal tibial torsion, and increased femoral anteversion do not typically require orthopaedic treatment. This study reviewed the actual diagnosis, management, and disposition of patients referred to a pediatric orthopaedic specialty hospital for a diagnosis of intoeing; the efficacy of an Advanced Practice Provider (APP) assessment program to screen and triage patients with a primary complaint of intoeing; and parental satisfaction with that program...
May 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28461955/diagnostic-work-up-and-recognition-of-primary-bone-tumours-a-review
#10
REVIEW
James Plant, Stephen Cannon
Benign abnormalities of bone are common, especially in children.Malignant bone sarcomas are aggressive and have a poor outcome, particularly if treatment is delayed or initiated in a non-specialist centre.Conversely, specialist tumour centres are overwhelmed with referrals for benign disease, a predictable outcome of an increasingly litigious medical environment. This review aims to arm the general orthopaedic surgeon or general practitioner with information to better discern a benign bone lesion from a malignant one, and explain the process of investigation and onward referral for those in whom malignant disease is suspected...
June 2016: EFORT open reviews
https://www.readbyqxmd.com/read/28452860/osteonecrosis-of-the-shoulders-in-pediatric-patients-treated-for-leukemia-or-lymphoma-single-institutional-experience
#11
Sue C Kaste, Brian M DeFeo, Michael D Neel, Kenneth S Weiss, Israel Fernandez-Pineda, Kiri K Ness
BACKGROUND: Osteonecrosis of the hips and knees is an often debilitating adverse event in children treated with glucocorticoids for leukemia and lymphoma but the impact of shoulder involvement has been understudied. Thus, we investigated the severity and functional impairment of shoulder osteonecrosis in a well-characterized population of pediatric patients treated for acute lymphoblastic leukemia or lymphoma. METHODS: We retrospectively reviewed orthopaedic clinic and physical therapy evaluations to determine range of motion (ROM), pain, and impact of magnetic resonance-defined osteonecrosis (ON) on activities of daily living...
April 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28442470/late-outcomes-in-children-with-langerhans-cell-histiocytosis
#12
Tin Wai Chow, Wing Kwan Leung, Frankie Wai Tsoi Cheng, Shekhar Medhukar Kumta, Winnie Chiu Wing Chu, Vincent Lee, Matthew Ming Kong Shing, Chi Kong Li
INTRODUCTION: Langerhans cell histiocytosis (LCH) is a rare disease with diverse clinical courses. Despite improvement in survival outcomes in the recent decades, sequelae of the disease remain a concern. This study aimed to provide information on the long-term outcomes in patients with LCH, particularly on the sequelae and any associated factors. METHOD: Medical records of patients with diagnosis of LCH and being managed in our centre were retrospectively reviewed...
April 25, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#13
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28424853/long-term-results-of-ankle-arthrodesis-in-children-and-adolescents-with-haemophilia
#14
Nicolas de l'Escalopier, Alina Badina, Jean Paul Padovani, Annie Harroche, Laurent Frenzel, Philippe Wicart, Christophe Glorion, Chantal Rothschild
INTRODUCTION: Ankle arthrodesis in patients with haemophilia is a joint-non-preserving treatment option often resulting in substantial pain relief and termination of haemarthrosis by osseous consolidating of the joint. However, limited data are available regarding ankle arthrodesis in young patients. AIM: The aim of this study was to evaluate the long-term clinical and radiographic results with a minimum follow-up of ten years in children with haemophilia who underwent ankle arthrodesis...
August 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#15
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28384146/effect-of-house-officer-clerking-on-short-term-outcomes-in-paediatric-orthopaedic-patients
#16
Yassar Alamri
AIM: Children who are admitted with acute orthopaedic problems are often fit and healthy. The house officer (ie, intern) is required to carry out the formal clerking/admission of inpatients. However, they are often also busy with sick ward patients, which leads to delays in formal clerking of these children until after they have been to the operating theatre (OT). The aim of this study was to assess what information, if any, is missed in children who were seen by a house officer prior to going to OT, compared to those who were not...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28241727/-analysis-of-outcomes-of-one-stage-operation-for-treatment-of-late-diagnosed-developmental-dysplasia-of-hip
#17
Y Liu, J Sun
Objective: To evaluate and identify the middle-term results of one-stage open reduction of patients in late-diagnosed developmental dysplasia of the hip, and to explore the best age group for treatment. Methods: A total number of 311 patients (390 hips) with LDDH in Department of Pediatric Orthopaedic of Anhui Provincial Children's Hospital from June 2006 to December 2010 were retrospectively reviewed. The patients were divided into 3 groups according to age at the start of surgical treatment: 1.5-2.5 years, 2...
March 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28241720/-proximal-junctional-kyphosis-after-posterior-hemivertebra-resection-and-instrumented-fusion-in-young-children-with-congenital-scoliosis
#18
X Sun, X Chen, Z H Chen, Z Z Zhu, F Zhu, Z Liu, B P Qian, B Wang, J Qiao, Y Qiu
Objective: To investigate the risk factors of proximal junctional kyphosis(PJK) in young children who underwent posterior hemivertebra resection and instrumented fusion. Methods: This study reviewed the charts and radiographs of 136 consecutive young children with congenital scoliosis who underwent posterior hemivertebra resection and instrumented fusion in Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2009 to June 2014, including 75 males and 61 females, with an average age of (5...
March 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28213747/bone-morphogenetic-protein-2-for-the-treatment-of-congenital-pseudarthrosis-of-the-tibia-or-persistent-tibial-nonunion-in-children-and-adolescents-a-retrospective-study-with-a-minimum-2-year-follow-up
#19
Tim N Hissnauer, Norbert Stiel, Kornelia Babin, Martin Rupprecht, Michael Hoffmann, Johannes M Rueger, Ralf Stuecker, Alexander S Spiro
There is a lack of studies reporting on rhBMP-2 application in pediatric orthopaedics, although few reports demonstrated promising results of the use of rhBMP-2 in children, especially for spine fusion and for the treatment of congenital pseudarthrosis of the tibia. The objectives of this study were (1) to examine clinical and radiographic healing after rhBMP-2 application for the treatment of congenital pseudarthrosis of the tibia (CPT) or persistent tibial nonunion in children and adolescents, and (2) to investigate the safety of rhBMP-2 use in these cases...
April 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28141693/time-to-return-to-school-after-10-common-orthopaedic-surgeries-among-children-and-adolescents
#20
Samuel C Willimon, Marjorie M Johnson, Mackenzie M Herzog, Michael T Busch
BACKGROUND: Return to school among adolescents is often overlooked in orthopaedic outcome studies. The purpose was to measure the time missed from school after 10 common orthopedic surgeries. METHODS: Patients, 5 to 19 years old enrolled in elementary, middle, or high school, who underwent treatment for fixation of type III supracondylar humerus fracture, midshaft femur fracture fixation, isolated anterior cruciate ligament reconstruction, isolated partial menisectomy, adolescent idiopathic scoliosis fusion, closed reduction of both-bone forearm fracture, arthroscopic Bankart repair, hip arthroscopy with femoroacetabular impingement correction, limb length discrepancy correction, or surgical fixation of slipped capital femoral epiphysis during the 2014/2015 and 2015/2016 school years were identified for this Institutional Review Board-approved study...
January 30, 2017: Journal of Pediatric Orthopedics
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