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https://www.readbyqxmd.com/read/28520680/acute-pediatric-monteggia-fractures-a-conservative-approach-to-stabilization
#1
Ian Foran, Vidyadhar V Upasani, Charles D Wallace, Elise Britt, Tracey P Bastrom, James D Bomar, Andrew T Pennock
BACKGROUND: In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. METHODS: This institutional review board approved retrospective study evaluated all Monteggia fractures presenting to a level 1 pediatric trauma center between 2008 and 2014...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28473948/purely-ligamentous-flexion-distraction-injury-in-a-five-year-old-child-treated-with-surgical-management
#2
Ryan M Schiedo, William Lavelle, Nathaniel R Ordway, Tarush Rustagi, Mike H Sun
Chance fractures by definition are a type of flexion-distraction injury with concomitant vertebral body fracture. Although uncommon in the pediatric population, they are associated with motor vehicle accidents and typically involve the thoraco-lumbar spine. Injury occurs when the spine rotates about a fixed axis, such as a lap belt. Our case reports the management of a five-year-old girl involved in a head-on collision who suffered a purely ligamentous flexion-distraction injury (Chance-type injury, without bone involvement) at the L2-L3 vertebral level...
April 3, 2017: Curēus
https://www.readbyqxmd.com/read/28471915/incidence-of-delayed-diagnosis-of-orthopaedic-injury-in-pediatric-trauma-patients
#3
Jeremy D Podolnick, Daniel S Donovan, Alfred W Atanda
TITLE: Incidence of delayed diagnosis of orthopaedic injury in pediatric trauma patients OBJECTIVE:: Determine the incidence of the delayed diagnosis of orthopaedic injuries in pediatric trauma patients. DESIGN: Cross-sectional retrospective analysis. SETTING: Level I pediatric trauma center. PATIENTS/PARTICIPANTS: All patients with an orthopaedic consultation following a trauma activation with a diagnosis of fracture, dislocation, traumatic arthrotomy, neurovascular injury, amputation, and tendon or ligament injury requiring intervention...
April 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28442527/a-novel-fibrillin-1-gene-mutation-leading-to-marfan-syndrome-in-a-korean-girl
#4
Hyo-Kyoung Nam, Myung-Hyun Nam, Kee-Soo Ha, Young-Jun Rhie, Kee-Hyoung Lee
Marfan syndrome is an autosomal dominant genetic disorder caused by a connective tissue defect. A nine-year-old girl was referred to our pediatric endocrinology clinic for tall stature. Physical examination revealed a lens dislocation with strabismus, high palate, positive wrist and thumb signs, joint hypermobility, and pes planus. Transthoracic echocardiography revealed dilatation of the aortic root. She was diagnosed with Marfan syndrome based on the revised Ghent diagnostic criteria. Molecular investigation identified a heterozygous c...
March 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28441281/incarcerated-medial-epicondyle-fractures-with-elbow-dislocation-risk-factors-associated-with-morbidity
#5
Carley Vuillermin, Kyna S Donohue, Patricia Miller, Andrea S Bauer, Dennis E Kramer, Yi-Meng Yen
BACKGROUND: Incarcerated medial epicondyle fractures in association with elbow trauma are rare and an absolute indication for intervention. Because of the infrequent nature, outcomes following this injury are not well documented. We studied a large cohort of these injuries to determine factors associated with functional outcomes. It was hypothesized that a greater duration between initial presentation and time of surgery would lead to poorer outcomes. METHODS: A total of 32 patients aged 18 and under who underwent surgical treatment for an incarcerated medical epicondyle fracture at a level-1 pediatric trauma center from 2003 to 2015 were identified...
April 24, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28387614/reduction-of-atlantoaxial-dislocation-prevented-by-pathological-position-of-the-transverse-ligament-in-fixed-irreducible-os-odontoideum-operative-illustrations-and-radiographic-correlates-in-41-patients
#6
Brian J Dlouhy, Bruno A Policeni, Arnold H Menezes
OBJECTIVE Os odontoideum (OO) is a craniovertebral junction (CVJ) abnormality in which an ossicle (small bone) is cranial to a hypoplastic dens by a variable gap. This abnormality can result in instability, which may be reducible or irreducible. What leads to irreducibility in OO is unclear. Therefore, the authors sought to better understand the causes of irreducibility in OO. METHODS A retrospective review was conducted, which identified more than 200 patients who had undergone surgical treatment for OO between 1978 and 2015 at the University of Iowa Hospitals and Clinics...
April 7, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28381125/brachial-artery-transection-after-a-closed-traumatic-isolated-medial-epicondyle-fracture-in-a-pediatric-patient-a-case-report
#7
Brandon S Schwartz, Ebrahim Paryavi, W Andrew Eglseder, Raymond A Pensy, Joshua M Abzug
BACKGROUND: Medial epicondyle fractures in pediatric patients might be associated with an occult elbow dislocation and neurovascular damage. METHODS: A single case of a medial epicondyle fracture presenting with brachial artery transection was reviewed. Presentation, clinical course, and early outcome are reported. RESULTS: A 14-year-old patient presenting with an apparently isolated medial epicondyle fracture was found to have examination and diagnostic test findings consistent with brachial artery transection...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28353323/pediatric-patellar-dislocation-a-review
#8
Baobiao Gao, Yingchun Shi, Fengfei Zhang
Acute patellar dislocation affects approximately 1:1000 healthy children 9- 15 years of age, and up to 50% are at risk for recurrent dislocations. In adults the condition is associated with long-term complications, such as osteoarthritis and impairment of knee function. However, literature describing the outcome in a pediatric population is sparse. The present review article evaluate the long-term effects on knee function and cartilage quality after traumatic patellar dislocation in childhood, and also to evaluate the reliability of two clinical tests of medio-lateral knee position, in healthy children...
March 27, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28321388/association-of-atlanto-occipital-dislocation-retroclival-hematoma-and-hydrocephalus-management-and-survival-in-a-pediatric-patient
#9
Isaac L Lee, Luis F Vasquez, Alan H Tyroch, Todd T Trier
Atlanto-occipital dislocation (AOD) is an injury with high morbidity and mortality. We present a case of survival of a pediatric patient with the diagnoses of AOD, retroclival hematoma, and resulting hydrocephalus. The patient's cervical spine was stabilized until occipital-cervical fusion provided definitive treatment, and the hydrocephalus was treated with a ventriculostomy. The patient survived with no neurological deficits. A better understanding and awareness of the radiologic criteria of AOD will lead to earlier recognition of AOD and improved outcomes, even in the presence of complications from AOD...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28286603/closed-reduction-with-or-without-adductor-tenotomy-for-developmental-dysplasia-of-the-hip-presenting-at-walking-age
#10
Ahmed Samir Barakat, Abou Bakr Zein, Amr Said Arafa, Mostafa Abdelmaboud Azab, Walid Reda, Mohamed Mahmoud Hegazy, Hassan Magdy Al Barbary, Mohamed Abdelhalim Kaddah
BACKGROUND: Many children with developmental dislocation of the hip especially in underdeveloped countries reach walking age and still remain undiagnosed, which can be detrimental to their growth and development. Because of the lack medical services often encountered in these regions, it would be attractive to find a cheap and effective treatment. Our work evaluated the results of treatment of these children by closed reduction with or without adductor tenotomy in a prospective study...
March 2017: Current Orthopaedic Practice
https://www.readbyqxmd.com/read/28249791/an-evaluation-of-forearm-deformities-in-hereditary-multiple-exostoses-factors-associated-with-radial-head-dislocation-and-comprehensive-classification
#11
Ah Reum Jo, Sung Taek Jung, Myung Sun Kim, Chang Seon Oh, Byung Ju Min
PURPOSE: This study attempted to evaluate a series of patients with hereditary multiple exostoses (HME) who could not be categorized according to the widely accepted Masada classification and to identify radiographic variables such as radial bowing, ulnar shortening, ulnar variance, radial articular angle, and carpal slip predictive of deformity. METHODS: We retrospectively reviewed data on 102 upper limbs of 53 pediatric patients with HME. Demographics, site of forearm involvement, and radiographic parameters were documented...
February 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28241727/-analysis-of-outcomes-of-one-stage-operation-for-treatment-of-late-diagnosed-developmental-dysplasia-of-hip
#12
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/28210820/update-review-and-clinical-presentation-in-adult-inferior-dislocation-of-hip
#13
REVIEW
Kevin Syam, Balaji Saibaba, Sameer Aggarwal, Sivaswaminathan Santhanam, Gopinath Palanisamy
Inferior dislocation of the hip is a rare clinical entity, wherein closed reduction maneuver could be challenging, especially if the attending surgeon is not familiar with the specific anatomy associated with this injury. Due to the rarity of this type of injury, large case series are lacking in the literature; hence, case reports form the major source of our knowledge regarding the clinical presentation and management. An extensive literature search revealed a change in age group presenting with this specific injury, with a male predilection...
February 16, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28197752/surgical-dislocation-for-pediatric-and-adolescent-hip-deformity-clinical-and-radiographical-results-at-3%C3%A2-years-follow-up
#14
Nicola Guindani, Oliver Eberhardt, Thomas Wirth, Michele F Surace, Francisco F Fernandez
INTRODUCTION: The aim of this study is to evaluate the clinical, radiographic short-term results and complications after surgical hip dislocation in young patients (≤18 years). MATERIALS AND METHODS: Clinical and radiographic outcomes were assessed in patients who underwent a surgical hip dislocation Ganz-type approach between 2008 and 2012. Diagnosis included Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, femoroacetabular impingement, osteonecrosis of the femoral head, multiple hereditary exostoses and pigmented villonodular synovitis...
April 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28190665/intranasal-fentanyl-and-inhaled-nitrous-oxide-for-fracture-reduction-the-fan-observational-study
#15
J Hoeffe, E Doyon Trottier, B Bailey, D Shellshear, M Lagacé, C Sutter, G Grimard, R Cook, F E Babl
INTRODUCTION: Procedural sedation and analgesia (PSA) are frequently used for fracture reduction in pediatric emergency departments (ED). Combining intranasal (IN) fentanyl with inhalation of nitrous oxide (N2O) allow for short recovery time and obviates painful and time-consuming IV access insertions. METHODS: We performed a bicentric, prospective, observational cohort study. Patients aged 4-18years were included if they received combined PSA with IN fentanyl and N2O for the reduction of mildly/moderately displaced fracture or of dislocation...
January 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28168131/radiological-and-functional-outcome-of-medial-epicondyle-fracture-treated-surgically-in-children-and-adolescents-a-retrospective-study
#16
Sagar Panthi, Kishor Khatri, Krishna Kharel, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
PURPOSE: Fractures of the medial humeral epicondyle represent approximately 10% of all pediatric elbow fractures. Surgically treated pediatric fractures of the medial humeral epicondyle were analyzed retrospectively for their epidemiological, clinical, radiological and surgical parameters. The evaluation includes the Mayo elbow performance score (MEPS). METHODS: Twenty-five surgically treated fractures of the medial humeral epicondyle were analyzed...
January 4, 2017: Curēus
https://www.readbyqxmd.com/read/28165417/characteristics-of-traditional-chinese-medicine-use-in-pediatric-dislocations-sprains-and-strains
#17
Chung-Yen Lu, Hen-Hong Chang, Fung-Chang Sung, Pei-Chun Chen
BACKGROUND AND OBJECTIVES: Dislocations, sprains and strains are common childhood musculoskeletal injuries, requiring medical attention. We investigated the characteristics associated with using traditional Chinese medicine (TCM) for children suffering from these injuries. METHODS: From a nationwide representative insurance database of Taiwan, this cross-sectional study identified 50,769 children with dislocations, sprains and strains under 18 years of age, newly diagnosed between 1999 and 2009, without previous TCM experience...
February 4, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28156214/a-2d-threshold-of-the-condylar-c1-interval-to-maximize-identification-of-patients-at-high-risk-for-atlantooccipital-dislocation-using-computed-tomography
#18
Vijay M Ravindra, Jay Riva-Cambrin, Kevin P Horn, Jason Ginos, Russell Brockmeyer, Jian Guan, John Rampton, Douglas L Brockmeyer
OBJECTIVE Measurement of the occipital condyle-C1 interval (CCI) is important in the evaluation of atlantooccipital dislocation (AOD) in pediatric trauma patients. The authors studied a large cohort of children with and without AOD to identify a 2D measurement threshold that maximizes the diagnostic yield of the CCI on cervical spine CT scans obtained in trauma patients. METHODS This retrospective, single-center study included all children who underwent CT of the cervical spine at Primary Children's Hospital from January 1, 2011, through December 31, 2014, for trauma evaluation...
April 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28140383/pavlik-harness-disease-revisited-does-prolonged-treatment-of-a-dislocated-hip-in-a-harness-adversely-affect-the-%C3%AE-angle
#19
Alex L Gornitzky, Emily K Schaeffer, Charles T Price, Wudbhav N Sankar
BACKGROUND: Current dogma contends that prolonged treatment of a dislocated hip in Pavlik harness beyond 3 weeks will cause "Pavlik harness disease." To our knowledge, however, no previous studies have documented objective morphologic changes to the acetabulum from continued treatment of a persistently dislocated hip. METHODS: We retrospectively reviewed a consecutive series of infants with developmental dysplasia of the hip, below 6 months old, who failed Pavlik treatment from a single, tertiary-care pediatric hospital and a multicenter, international study group...
June 27, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28124724/number-of-positive-radiographic-findings-in-pediatric-trauma-patients
#20
Thomas Ruffing, Tim Danko, Thomas Henzler, Christel Weiss, Alexander Hofmann, Markus Muhm
PURPOSE: Conventional radiography is frequently performed in pediatric patients in whom fractures and dislocations are suspected. However, until now, the rate of positive findings of the most commonly performed radiographic examinations in pediatric patients is unknown. The aim of this study was to evaluate the number of positive findings in the 20 most frequently requested standard radiographic examinations in pediatric patients in a level 1 trauma center systematically. METHODS: A transversal cohort study was conducted at a level 1 trauma center in Germany (2008-2014)...
June 2017: Emergency Radiology
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