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Pediatric + dislocation

Gregory C Fanelli, David G Fanelli
The posterior cruciate ligament (PCL)-based multiple ligament injury, or dislocated knee, is often part of a multisystem injury complex that not only includes the knee ligaments, but may also include blood vessels, skin, nerves, fractures, and other organ system trauma. These factors must be considered in the scope of treating this complex knee injury. These complex knee ligament injuries can result in significant functional instability for the affected individual. This article will discuss multiple ligament knee injury evaluation, treatment, and special considerations in the pediatric and adolescent population...
March 13, 2018: Journal of Knee Surgery
Marjan Kamiloski, Lazar Todorovik, Shaban Memeti, Lazo Jovcevski, Slavica Shuperliska, Zlatko Aleksovski
BACKGROUND: The fractures of the distal radius are one of the most frequent cases in the pediatric population. The primary way of treating these fractures is conservative, with manual reduction and cast immobilisation. In patients where reduction and retention of the fracture cannot be achieved, a surgical approach is the treatment of choice. AIM: To evaluate the benefits of using the minimally invasive surgical treatment of closed reduction using Sommer - pins in the treatment of the fractures of the distal radius in the pediatric population with the method of the Kapandji technique...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Fiachra E Rowan, Biju Benjamin, Jurek R Pietrak, Fares S Haddad
BACKGROUND: Prevention of dislocation after primary total hip arthroplasty (THA) begins with patient preoperative assessment and planning. METHODS: We performed a literature search to assess historical perspectives and current strategies to prevent dislocation after primary THA. The search yielded 3458 articles, and 154 articles are presented. RESULTS: Extremes of age, body mass index >30 kg/m2 , lumbosacral pathology, surgeon experience, and femoral head size influence dislocation rates after THA...
March 7, 2018: Journal of Arthroplasty
Xiangsheng Tang, Liang Dong, Mingsheng Tan, Ping Yi, Feng Yang, Qingying Hao
OBJECTIVE: The goal of this study was to evaluate the impact of C1-C2 pedicle screw fixation on the occipitoatlantal angle and subaxial cervical spine for a pediatric population, and the clinical efficacy and adjacent-segment degeneration after C1-C2 pedicle screw fixation with a minimum of 2 years of follow-up. METHODS: Twenty-two pediatric patients with atlantoaxial dislocation who were enrolled in this study underwent atlantoaxial pedicle screw fixation. The correlation between C0-C1, C2-C7, and C1-C2 pre- and postoperative sagittal angles was assessed using plain radiographs, and adjacent-segment degeneration (ASD) and JOA scores (Japanese Orthopaedic Association scores) were evaluated after atlantoaxial pedicle screw fixation...
March 8, 2018: Pediatric Neurosurgery
B Lin, Z D Chen, T Y Cai, S S Wu, Z M Guo
Objective: To investigate the clinical curative effect of C(1)-C(2) pedicle screw fixation for pediatric atlantoaxial dislocation after a long-term follow-up. Methods: From March 2005 to April 2011, a total of 12 male and 9 female patients were included, with age from 3 to 9 years old (mean, 6.1 years old). Among them, 14 cases (67%) had typeⅠinstability atlantoaxial dislocation, 7 cases (33%) had type Ⅱ reducible atlantoaxial dislocation. All 21 pediatric patients with atlantoaxial dislocation underwent posterior pedicle screw fixations...
February 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Parveen Sen, Vinay Kumar S, Pramod Bhende, Pukhraj Rishi, Ekta Rishi, Chetan Rao, Dhanashree Ratra, Pradeep Susvar, Sreelakshmi Kummamuri, Sufiyan Shaikh, Lingam Gopal
OBJECTIVE: To study the outcome and complications of sutured scleral fixated intraocular lenses (SSFIOL) in children. DESIGN: Retrospective study. SUBJECTS: A total of 279 eyes of 230 children who underwent SSFIOL at ≤18 years of age in a tertiary eye care centre in India. METHODS: Treatment-naive children having traumatic cataract or subluxated lens underwent a single-sitting lensectomy and pars plana vitrectomy (PPV), along with SSFIOL insertion...
February 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Shinya Takazawa, Tetsuya Ishimaru, Kanako Harada, Kyoichi Deie, Akinari Hinoki, Hiroo Uchida, Naohiko Sugita, Mamoru Mitsuishi, Tadashi Iwanaka, Jun Fujishiro
BACKGROUND: Pediatric robot-assisted surgery is increasingly being performed, but it is difficult to perform this procedure in infants. A pediatric thoracoscopic model of a 1-year-old patient was developed in our previous study, and this model was used to evaluate the use of a surgical robot for infant surgery. METHODS: Eight pediatric surgeons performed an intracorporeal suturing and knot-tying task using the da Vinci Xi Robotic Surgical System. The task completion time, number of needle manipulations, and force applied during suturing of the robot-assisted thoracoscopic surgery (RATS) group were compared with those of the video-assisted thoracoscopic surgery (VATS) group whose data had been collected from the same 8 surgeons in our previous study...
February 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Narjes Jafari, Karl Golnik, Mansoor Shahriari, Parvaneh Karimzadeh, Sayena Jabbehdari
Purpose: We aimed to present the ophthalmic manifestations of neuro-metabolic disorders. Methods: Patients who were diagnosed with neuro-metabolic disorders in the Neurology Department of Mofid Pediatric Hospital in Tehran, Iran, between 2004 and 2014 were included in this study. Disorders were confirmed using clinical findings, neuroimaging, laboratory data, and genomic analyses. All enrolled patients were assessed for ophthalmological abnormalities. Results: A total of 213 patients with 34 different neuro-metabolic disorders were included...
January 2018: Journal of Ophthalmic & Vision Research
Kathryn L Bauer
Osteochondral injuries in pediatric patients may occur as a result of a traumatic injury or secondary to an osteochondritis dissecans (OCD) lesion. Lateral patella dislocation is a common traumatic cause of osteochondral injury that typically occurs at the medial facet of the patella or at the lateral aspect of the distal femur. Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur...
January 30, 2018: Journal of Knee Surgery
Songkiat Thanacharoenpanich, Sarah Bixby, Michael A Breen, Young-Jo Kim
BACKGROUND: Traumatic posterior hip dislocations in children and adolescents requires emergent closed reduction. Postreduction imaging is necessary to assess the concentricity of reduction and structural injuries to the hip. There is no a consensus for which imaging is a modality of choice in such condition. The purposes of this study are to describe magnetic resonance imaging (MRI) findings of traumatic posterior hip dislocations and to compare the effectiveness of MRI with computerized tomography (CT) in detecting structural abnormalities of the hip that impact patient management...
January 19, 2018: Journal of Pediatric Orthopedics
Mohsen Karami, Mehryar Soleimani, Reza Shiari
BACKGROUND: Pigmented villonodular synovitis (PVNS) is a rare proliferative process in children that mostly affects the knee joint. CASE PRESENTATION: The study follows the case of a 3-year-old boy presenting recurrent patellar dislocation and PVNS. Due to symptoms such as chronic arthritis, he had been taking prednisolone and methotrexate for 6 months before receiving a definitive diagnosis. After a period of showing no improvements from his treatment, he was referred to our center and was diagnosed with local PVNS using magnetic resonance imaging (MRI)...
January 17, 2018: Pediatric Rheumatology Online Journal
Taylor J Jackson, Todd J Blumberg, Apurva S Shah, Wudbhav N Sankar
BACKGROUND: Musculoskeletal injuries are among the most common reasons for emergency department (ED) visits in the pediatric population. Many such injuries can be managed with a single follow-up outpatient visit. However, untimely (ie, premature) referrals by emergency physicians to orthopaedic surgeons are common and may inadvertently create need for a second visit, generating unnecessary expenditures. We sought to elucidate the cost of premature musculoskeletal follow-up visits to the patients, families, and the health care system...
January 10, 2018: Journal of Pediatric Orthopedics
Xuemin Lu, Guisen Yan, Ming Lu, Yuan Guo
This study was conducted to explore epidemiologic features of traumatic elbow dislocation with associated fractures in pediatric population following appropriate treatment options.Incidence of elbow dislocation with associated fractures was analyzed in 67 children using elbow radiographs. Treatment for the displaced elbow joint was performed by closed reduction and proper immobilization. Surgical intervention was applied to restore the correct alignment of the fracture. Mayo Elbow Performance Score (MEPS) was used to measure elbow joint function...
December 2017: Medicine (Baltimore)
Andrej Pala, Fadi Awad, Michael Braun, Michal Hlavac, Arthur Wunderlich, Bernd Schmitz, Christian Rainer Wirtz, Jan Coburger
OBJECTIVE The gold standard for evaluation of ventriculoperitoneal (VP) shunt position, dislocation, or disconnection is conventional radiography. Yet, assessment with this modality can be challenging because of low image quality and can result in repetitive radiation exposure with high fluctuation in the radiation dose. Recently, CT-based radiation doses have been significantly reduced by using low-dose protocols. Thus, whole-body low-dose CT (LDCT) has become applicable for routine use in VP shunt evaluation...
January 5, 2018: Journal of Neurosurgery
Sudhir Shyam Kushwaha, Madhuresh Kumar, Kumar Shantanu, Deepak Kumar
Introduction: Dislocations of elbow constitute about 3-6% of all injuries occurring around elbow in children. Posterior dislocations are the most common type, whereas other types of dislocations, especially lateral dislocation in a child are extremely rare. Case Report: A 9-year-old boy with a history of trauma presented with complaints of pain, swelling, and difficulty to move his left elbow. Radiographs revealed lateral dislocation of elbow associated with avulsion of medial condyle...
September 2017: Journal of Orthopaedic Case Reports
Antti Stenroos, Topi Laaksonen, Yrjänä Nietosvaara
Traumatic hip dislocations constitute approximately 5% of all pediatric dislocations and typically result from high-energy trauma. However, pediatric hip dislocations can also occur as a result of minor energy due to flexibility of the joint structures of the immature hip. Children with a posteriorly dislocated hip present with the injured hip in flexion, adduction and internal rotation. Spontaneous relocation of hip dislocation is frequent and a thorough physical examination of the whole lower extremity is always required to reduce the chance of missing hip dislocation/subluxation...
2017: Duodecim; Lääketieteellinen Aikakauskirja
Andrew F Miller, Michael C Monuteaux, Florence T Bourgeois, Eric W Fleegler
OBJECTIVES: Describe the trends in pediatric sedation use over time and determine variation in use of procedural sedation across children's hospital emergency departments (EDs). METHODS: We analyzed ED data from 35 hospitals within the Pediatric Health Information System for patients <19 years old who received sedation medications and were discharged from 2009 to 2014. Patients with chronic comorbidities or undergoing intubation were excluded. We determined frequency and trends in use of sedation and compared these between EDs...
January 2018: Hospital Pediatrics
Zhi-Da Chen, Jin Wu, Cheng-Wu Lu, Wen-Rong Zeng, Zhuan-Zhi Huang, Bin Lin
BACKGROUND: There are few studies reporting the use of atlantoaxial pedicle screws and the long-term effects of C1-C2 posterior fusion in children. Our study is to investigate the initial results of C1-C2 pedicle screw fixation for pediatric atlantoaxial dislocation (AAD) and assessed spontaneous change of postoperative radiography after a long-term follow-up period. METHODS: Posterior pedicle screw fixations were performed in 21 pediatric patients with AAD. All the patients underwent implant removal 1 year after their initial surgery and had regular follow-up with an average duration of 76...
December 8, 2017: Journal of Pediatric Orthopedics
Ahmed M El Ghoneimy, Mohamed S Zaghloul, Iman Zaky, Hala Taha, Ahmed Elgammal, Magdy El Sherbiny, Nehal Kamal
BACKGROUND: Ewing sarcoma of the scapula is uncommon. Restoration of shoulder function after total scapulectomy is challenging. Extracorporeal irradiation and reimplantation is a well-known method of biological reconstruction in orthopaedic oncology; yet very few reports in the literature describe its specific use in tumors of the scapula. PATIENTS AND METHODS: Ten patients with the diagnosis of Ewing sarcoma of the scapula were surgically treated by total scapulectomy and extracorporeal irradiation and reimplantation of the scapula...
February 2018: Journal of Pediatric Orthopedics
Pravin Salunke
Introduction: The deformed joints seen in congenital atlantoaxial dislocation (CAAD) are often associated with vascular anomalies. It is important to identify these vascular anomalies and address them appropriately without compromising the manipulation and fusion of C1-C2 joints. The small bones in pediatric age group pose an additional challenge. Materials and Methods: Data of fifty-six children with CAAD operated in the last 4 years was analyzed. A computed tomography angiogram was obtained preoperatively to assess for the course of the third segment of vertebral artery (VA)...
July 2017: Journal of Pediatric Neurosciences
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