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https://www.readbyqxmd.com/read/29053498/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-forearm-shaft-fracture-pearls-and-pitfalls
#1
Martin J Herman, Matthew Simon, Charles T Mehlman
Pediatric forearm shaft fractures are the third most common fracture in children, and the forearm is the third most mobile joint in the body (with a nearly 180 degree arc of motion). The goals of treatment are aimed squarely at achieving satisfactory anatomic alignment (within defined parameters) as the consequences of malunion can be permanent forearm stiffness and deformity. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention has become increasingly common in older children...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29051887/uncommon-floating-knee-in-a-teenager-a-case-report-of-ipsilateral-physeal-fractures-in-distal-femur-and-proximal-tibia
#2
Youssef Othman, Lassaad Hassini, Aymen Fekih, Issam Aloui, Abderrazek Abid
INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed and the fracture was seen on the post-operative radiographs...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29035980/incidence-of-symptomatic-pulmonary-embolus-and-deep-vein-thrombosis-after-knee-arthroscopy-in-the-pediatric-and-adolescent-population
#3
Brian C Lau, Jason Jagodzinski, Nirav K Pandya
OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29018973/clinical-significance-of-fecal-calprotectin-for-the-early-diagnosis-of-abdominal-type-of-henoch-schonlein-purpura-in-children
#4
Xu Teng, Cuiyun Gao, Mei Sun, Jie Wu
The objective of this study is to explore the value of fecal calprotectin (FC) for early screening of the abdominal type of Henoch-Schonlein purpura (AHSP) in children. The study cohort included 40 children with AHSP treated at Shengjing Hospital of China Medical University from November 2014 to November 2015, and 40 children hospitalized in the Division of Pediatric Orthopedics in the corresponding period were selected as a control group. Fresh fecal samples were collected in the acute phase of the first visit (FC1), 3 days after treatment (FC2), and 7 days after treatment (FC3) from the AHSP group and the control group...
October 10, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29018084/oral-morphine-versus-ibuprofen-administered-at-home-for-postoperative-orthopedic-pain-in-children-a-randomized-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Naveen Poonai, Natasha Datoo, Samina Ali, Megan Cashin, Amy L Drendel, Rongbo Zhu, Natasha Lepore, Michael Greff, Michael Rieder, Debra Bartley
BACKGROUND: Oral morphine for postoperative pain after minor pediatric surgery, while increasingly popular, is not supported by evidence. We evaluated whether oral morphine was superior to ibuprofen for at-home management of children's postoperative pain. METHODS: We conducted a randomized superiority trial comparing oral morphine (0.5 mg/kg) with ibuprofen (10 mg/kg) in children 5 to 17 years of age who had undergone minor outpatient orthopedic surgery (June 2013 to September 2016)...
October 10, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28977312/analysis-of-surgical-site-infections-in-pediatric-patients-after-orthopedic-surgery-a-case-control-study
#6
Mariana de Queiroz Leite Chagas, Ana Maria Magalhães Costa, Pedro Henrique Barros Mendes, Saint Clair Gomes
OBJECTIVES: To describe the rate of surgical site infections in children undergoing orthopedic surgery in centers of excellence and analyze the patients' profiles. METHODS: Medical records of pediatric patients undergoing orthopedic surgery in the Jamil Haddad National Institute of Traumatology and Orthopedics from January 2012 to December 2013 were analyzed and monitored for one year. Patients diagnosed with surgical site infection were matched with patients without infection by age, date of admission, field of orthopedic surgery and type of surgical procedure...
January 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28965455/single-stage-deformity-correction-in-children-with-neurogenic-kyphoscoliosis-nuances-and-a-proposal-for-risk-stratification
#7
Suhas Udayakumaran, Sajesh K Menon, Chiazor U Onyia, Naveen Tahasildar
OBJECTIVE Neurogenic kyphoscoliosis in pediatric patients has varied causes and diverse management options. The most common management strategy is to stage the orthopedic and neurosurgical aspects of the correction at an interval of 3-6 months from each other. The aim of this study was to report the authors' experience with correction of deformity in children with associated neurological abnormalities requiring intervention as a single-stage surgical treatment. METHODS Of 591 pediatric patients with scoliosis treated at the Amrita Institute of Medical Sciences and Research Centre between January 2001 and January 2011, the authors identified all patients with neurogenic kyphoscoliosis who underwent deformity correction and a neurosurgical procedure in the same surgical session when they were younger than 15 years...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28933808/pediatric-orthopedic-injuries-evidence-based-management-in-the-emergency-department-digest
#8
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/28926505/do-all-clavicle-fractures-in-children-need-to-be-managed-by-orthopedic-surgeons
#9
John Adamich, Andrew Howard, Mark Camp
OBJECTIVES: Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatric fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the health care system. METHODS: A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28926485/depression-and-depressive-symptoms-in-pediatric-traumatic-brain-injury-a-scoping-review
#10
Christianne Laliberté Durish, Rosemary S Pereverseff, Keith O Yeates
OBJECTIVE: This scoping review aimed to summarize the existing knowledge base regarding depression and depressive symptoms in pediatric traumatic brain injury (TBI) and to identify gaps in the literature in an effort to guide future research. METHODS: MEDLINE Ovid and PsycINFO Ovid databases were each searched by the authors using search terms intended to identify any original research study that examined depressive symptoms in children (ie, aged 0-18 years) with TBI...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28924357/developmental-dysplasia-of-the-hip-do-the-responsible-for-screening-know-what-to-do
#11
Bruno Gonçalves Schröder E Souza, Tiago Evangelista de Melo, Thiago Mattos Resende, Rafaela Clara Resende da Silva, Soraya Amanda Cruz, Valdeci Manoel de Oliveira
OBJECTIVE: To evaluate the knowledge on developmental dysplasia of the hip (DDH) by professionals involved in its diagnosis. METHODS: This is a cross-sectional study using questionnaires to assess the knowledge about DDH. Orthopedic surgeons and pediatricians, residents and medical students from a tertiary teaching hospital were included in the study. RESULTS: We evaluated 142 medical students, eight orthopedic residents, ten pediatric residents, seven pediatricians, and nine orthopedic surgeons; 50% declared not having examined any DDH case in the last year and only three had diagnosed more than 10 cases during their career...
November 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28899861/quality-initiative-to-introduce-pediatric-venous-thromboembolism-risk-assessment-for-orthopedic-and-surgery-patients
#12
Laura H Brower, Nathalie Kremer, Katie Meier, Christine Wolski, Molly M McCaughey, Emily McKenna, Jennifer Anadio, Emily Eismann, Erin E Shaughnessy
BACKGROUND AND OBJECTIVES: Pediatric hospital-acquired venous thromboembolism (VTE) is costly, has high morbidity, and is often preventable. The objective of this quality-improvement effort was to increase the percentage of general surgery and orthopedic patients ≥10 years of age screened for VTE risk from 0% to 80%. METHODS: At a freestanding children's hospital, 2 teams worked to implement VTE risk screening for postoperative inpatients. The general surgery team used residents and nurse practitioners to perform screening whereas the orthopedic team initially used bedside nursing staff...
September 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28887681/pediatric-spine-imaging-post-scoliosis-surgery
#13
Alaa N Alsharief, Ron El-Hawary, Pierre Schmit
Many orthopedic articles describe advances in surgical techniques and implants used in pediatric scoliosis surgery. However, even though postoperative spine imaging constitutes a large portion of outpatient musculoskeletal pediatric radiology, few, if any, radiology articles discuss this topic. There has been interval advancement over the last decades of the orthopedic procedures used in the treatment of spinal scoliosis in adolescents with idiopathic scoliosis. The goal of treatment in these patients is to stop the progression of the curve by blocking the spinal growth and correcting the deformity as much as possible...
September 8, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28880724/prevalence-of-recent-antimicrobial-exposure-among-elective-surgical-patients
#14
Christopher A Guidry, Robert G Sawyer
BACKGROUND: The annual prevalence of antimicrobial exposure is high in the outpatient setting and should be a common exposure for surgical patients. Antimicrobials have negative side effects and may be associated with poor outcomes. Logically, one would expect surgical patients to be particularly susceptible to any negative effects of recent antimicrobial exposure. Despite these observations, however, the prevalence of recent antimicrobial exposure among surgical patients remains undefined...
October 2017: Surgical Infections
https://www.readbyqxmd.com/read/28877328/procedural-sedation-with-ketamine-versus-propofol-for-closed-reduction-of-pediatric-both-bone-forearm-fractures
#15
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 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28870306/pediatric-perioperative-pain-management
#16
REVIEW
Kaela H Frizzell, Priscilla K Cavanaugh, Martin J Herman
Effective perioperative pain control in pediatric patients undergoing orthopedic surgery remains a challenge. Developing a successful pain control regimen begins preoperatively with assessment of the patient and discussion with the patient and family regarding expectations. Perioperative pain control regimens are customized based on the type of surgery, patient characteristics, and anticipated severity and duration of the postoperative pain. Recent study focuses on multimodal strategies and regional anesthesia options, allowing for decreased opioid use...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28864264/a-self-reported-needs-assessment-survey-of-pediatric-orthopaedic-education-in-haiti
#17
Rameez A Qudsi, Heather J Roberts, Abhiram R Bhashyam, Elena Losina, Donald S Bae, Francel Alexis, George S Dyer
OBJECTIVE: The burden of musculoskeletal disease remains high in low-income countries, with a high rate of pediatric disease. Efforts continue for orthopedic education, but there is little guidance on local needs and desires. Our aim was to determine the specific content and modalities that would be most useful for pediatric orthopedic educational programs abroad, and we demonstrate a practical method of identifying country-specific educational deficits through a self-reported needs survey in Haiti...
August 29, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28857958/is-there-a-role-for-a-child-life-specialist-during-orthopedic-cast-room-procedures-a-prospective-randomized-assessment
#18
John A Schlechter, Anna L Avik, Stephanie DeMello
Pediatric anxiety during cast room procedures is common and various methods to manage distress may be used. Certified Child Life Specialists (CCLS) are formally trained professionals with proficiency in helping children during taxing events. The utilization of a CCLS has not been well documented in a pediatric orthopedic cast room. The aim of this study was to assess the impact of a CCLS in this setting through a prospective randomized trial. 86 children, age range 2-10 years, who underwent cast room procedures were randomized: group I (42 children) had a CCLS present during their procedure...
November 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28854841/psychosocial-and-executive-function-recovery-trajectories-one-year-after-pediatric-traumatic-brain-injury-the-influence-of-age-and-injury-severity
#19
Heather T Keenan, Amy E Clark, RIchard Holubkov, Charles S Cox, Linda Ewing-Cobbs
Time since traumatic brain injury (TBI) and developmental stage at injury may affect the trajectory of outcomes associated with adjustment and school success. We prospectively enrolled a cohort of 519 children with either TBI or orthopedic injury (OI) aged 2.5 - 15 years to examine children's psychosocial and executive function outcomes at 3 and 12-months post-injury. Outcome measures included the Child Behavior Checklist (CBCL), Strengths and Difficulties Questionnaire (SDQ) and Behavior Rating Inventory of Executive Function (BRIEF) ratings...
August 30, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28852351/rapid-prototyping-3d-model-in-treatment-of-pediatric-hip-dysplasia-a-case-report
#20
Andrew M Holt, Zbigniew Starosolski, J Herman Kan, Scott B Rosenfeld
BACKGROUND: Rapid prototyping is an emerging technology that integrates common medical imaging with specialized production mechanisms to create detailed anatomic replicas. 3D-printed models of musculoskeletal anatomy have already proven useful in orthopedics and their applications continue to expand. CASE DESCRIPTION: We present the case of a 10 year-old female with Down syndrome and left acetabular dysplasia and chronic hip instability who underwent periacetabular osteotomy...
2017: Iowa Orthopaedic Journal
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