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https://www.readbyqxmd.com/read/29781820/management-of-pediatric-femoral-neck-fracture
#1
Joseph T Patterson, Jennifer Tangtiphaiboontana, Nirav K Pandya
In the pediatric population, femoral neck fracture is a relatively uncommon injury with a high complication rate, despite appropriate diagnosis and management. The anatomy and blood supply of the proximal femur in the skeletally immature patient differs from that in the adult patient. Generally, these fractures result from high-energy trauma and are categorized using the Delbet classification system. This system both guides management and aids the clinician in determining the risk of osteonecrosis after these fractures...
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29762118/pediatric-orthopaedic-consults-from-chiropractic-care
#2
Andy B Awwad, William L Hennrikus, Douglas G Armstrong
Alternative medicine in pediatrics is expanding, with chiropractic now a common choice for families seeking alternative medical care. Currently, there is sparse information in the literature exploring the role of chiropractic in orthopaedic pathology. The objective of this case series is to present pediatric patients who received treatment from chiropractors and orthopaedic physicians as well as to review the respective existing research. Data collected included chiropractic diagnosis, orthopaedic diagnosis, imaging studies, treatments, and complications...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29742531/spontaneous-healing-of-a-bucket-handle-posterior-labral-detachment-after-hip-dislocation-in-a-five-year-old-child-a-case-report
#3
R Carter Clement, Daniel P Carpenter, Anna V Cuomo
CASE: We report the case of a 5-year-old girl who sustained a traumatic hip dislocation and a spontaneous reduction that was complicated by nonconcentric reduction and a large bucket-handle labral detachment. This injury was managed, via an anterior approach, with capsulotomy and reduction of the large interposed labral tear with an attached osteochondral fragment from the posterior aspect of the acetabulum. No additional surgical treatment was employed for the labral tear. CONCLUSION: The patient ultimately demonstrated radiographic healing and an asymptomatic, clinically stable hip...
May 9, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29730703/narrowing-of-ischiofemoral-and-quadratus-femoris-spaces-in-pediatric-ischiofemoral-impingement
#4
Shlomit Goldberg-Stein, Avi Friedman, Qi Gao, Jaeun Choi, Jacob Schulz, Eric Fornari, Benjamin Taragin
OBJECTIVE: To correlate MRI findings of quadratus femoris muscle edema (QFME) with narrowing of the ischiofemoral space (IFS) and quadratus femoris space (QFS) in children, and to identify threshold values reflecting an anatomic architecture that may predispose to ischiofemoral impingement. MATERIALS AND METHODS: A case-control retrospective MRI review of 49 hips in 27 children (mean, 13 years) with QFME was compared to 49 hips in 27 gender and age-matched controls...
May 5, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29706289/urinary-antimicrobial-peptides-potential-novel-biomarkers-of-obstructive-uropathy
#5
S Gupta, A R Jackson, D G DaJusta, D J McLeod, S A Alpert, V R Jayanthi, K McHugh, A R Schwaderer, B Becknell, C B Ching
INTRODUCTION: Antimicrobial peptides (AMPs) have historically been evaluated for their role in protecting against uropathogens. However, there is mounting evidence to support their expression in noninfectious injury, with unclear meaning as to their function. It is possible that AMPs represent urothelial injury. Urinary tract obstruction is known to alter the urothelium; however, AMPs have not been evaluated for expression in this noninfectious injury. OBJECTIVE: A pilot study to compare urinary AMP expression in children undergoing surgical intervention for ureteropelvic junction obstruction (UPJO) with nonobstructed controls...
March 29, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29698303/closed-reduction-osteotomy-and-fibular-graft-are-effective-in-treating-pediatric-femoral-neck-pseudarthrosis-after-infection
#6
Rajesh Kumar Kanojia, Sumit Gupta, Ajay Kumar, Bachha Kanakeya Reddy
BACKGROUND: When treatment of acute septic arthritis of the hip is delayed, severe sequelae can occur. This may take the form of coxa breva, vara, or valga. Pseudoarthrosis of the femoral neck is a rare complication with only a few studies to guide treatment. QUESTION/PURPOSES: In a small series of patients with pseudarthrosis of the femoral neck after acute septic arthritis, we wanted to determine (1) whether femoral neck union can be achieved using a variety of surgical approaches; (2) whether these patients satisfied criteria outlined by Hunka and Choi, defined as a stable hip, a flexion arc ≥ 70° and no fixed adduction or abduction contractures, fixed flexion deformity not more than 20°, pain relief, and restoration of activities of daily living after surgery; and (3) any treatment-related complications if observed...
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29698292/does-the-watson-jones-or-modified-smith-petersen-approach-provide-superior-exposure-for-femoral-neck-fracture-fixation
#7
Paul M Lichstein, John P Kleimeyer, Michael Githens, John S Vorhies, Michael J Gardner, Michael Bellino, Julius Bishop
BACKGROUND: A well-reduced femoral neck fracture is more likely to heal than a poorly reduced one, and increasing the quality of the surgical exposure makes it easier to achieve anatomic fracture reduction. Two open approaches are in common use for femoral neck fractures, the modified Smith-Petersen and Watson-Jones; however, to our knowledge, the quality of exposure of the femoral neck exposure provided by each approach has not been investigated. QUESTIONS/PURPOSES: (1) What is the respective area of exposed femoral neck afforded by the Watson-Jones and modified Smith-Petersen approaches? (2) Is there a difference in the ability to visualize and/or palpate important anatomic landmarks provided by the Watson-Jones and modified Smith-Petersen approaches? METHODS: Ten fresh-frozen human pelvi underwent both modified Smith-Petersen (utilizing the caudal extent of the standard Smith-Petersen interval distal to the anterosuperior iliac spine and parallel to the palpable interval between the tensor fascia lata and the sartorius) and Watson-Jones approaches...
April 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29680494/femur-loading-in-feet-first-fall-experiments-using-an-anthropomorphic-test-device
#8
Angela Thompson, Gina Bertocci, Craig Smalley
BACKGROUND: Femur fractures are a common orthopedic injury in young children. Falls account for a large portion of accidental femur fractures in young children, but there is also a high prevalence of femur fractures in child abuse, with falls often provided as false histories. Objective information regarding fracture potential in short distance fall scenarios may aid in assessing whether a child's injuries are the result of abuse or an accidental fall. Knowledge of femur loading is the first step towards understanding likelihood of fracture in a fall...
March 31, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29679731/changes-in-pediatric-dxa-measures-of-musculoskeletal-outcomes-and-correlation-with-quantitative-ct-following-treatment-of-acute-lymphoblastic-leukemia
#9
Sogol Mostoufi-Moab, Andrea Kelly, Jonathan A Mitchell, Joshua Baker, Babette S Zemel, Jill Brodsky, Jin Long, Mary B Leonard
We previously reported significant gains in pQCT measures of tibia trabecular bone mineral density (BMD) and cortical structure following completion of therapy in children and adolescents with acute lymphoblastic leukemia (ALL). The objective of this study was to examine changes in DXA measures used in clinical practice and expressed as Z-scores using robust national reference data. Children and adolescents, ages 5 to 18 years were enrolled within 2 (median 0.8) years of completing ALL therapy. DXA total-body less-head bone mineral content (TBLH-BMC), and spine, total hip, femoral neck, and 1/3rd radius areal BMD (aBMD) were assessed in 45 participants at enrollment and 12-months later...
April 18, 2018: Bone
https://www.readbyqxmd.com/read/29662652/guided-bone-regeneration-using-a-bone-tissue-engineering-complex-consisting-of-a-poly-dl-lactide-membrane-and-bone-mesenchymal-stem-cells
#10
Dahui Wang, Yifeng Lin, Lian Chen, Yueqiang Mo, Peng Huang, Ruixue Ma
Developmental dysplasia of the hip (DDH) is one of the most common diseases encountered in pediatric orthopedic departments. Current treatment strategies seek to improve acetabular coverage, the principal defect of acetabular dysplasia, but are not very successful. We developed a guided bone regeneration (GBR) strategy to improve acetabular coverage via bone tissue engineering (BTE). Poly- dl -lactide (PDLLA) membranes were seeded with bone marrow mesenchymal stem cells (BMSCs) to form a BTE complex, which was then implanted into the superior margin of the acetabulum in a rabbit DDH model...
March 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29650492/robotically-driven-orthoses-exert-proximal-to-distal-differential-recovery-on-the-lower-limbs-in-children-with-hemiplegia-early-after-acquired-brain-injury
#11
Elena Beretta, Erika Molteni, Emilia Biffi, Roberta Morganti, Paolo Avantaggiato, Sandra Strazzer
Robotically-driven orthoses (RDO) are promising for treating gait impairment in children with hemiplegia after acquired brain injury (ABI). Despite this, existing literature on the employment of RDO in ABI is scanty, and cohorts' age spans throughout the adult age, with no specific focus on the developmental age. We aim to compare a treatment solely based on conventional physiotherapy (CP) with a program combining RDO training with CP, and to examine the effect of time following ABI on recovery. A prospective two-cohorts study was conducted in a rehabilitation hospital...
March 23, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29627931/athletes-experience-a-high-rate-of-return-to-sport-following-hip-arthroscopy
#12
REVIEW
Muzammil Memon, Jeffrey Kay, Philip Hache, Nicole Simunovic, Joshua D Harris, John O'Donnell, Olufemi R Ayeni
PURPOSE: The purpose of this systematic review was to evaluate the rate at which patients return to sport following arthroscopic hip surgery. METHODS: The databases MEDLINE, EMBASE, and PubMed were searched by two reviewers, and titles, abstracts, and full-text articles screened in duplicate. English language studies investigating hip arthroscopy with reported return to sport outcomes were included. A meta-analysis of proportions was used to combine the rate of return to sports using a random effects model...
April 7, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29594178/arthroscopic-management-of-pigmented-villonodular-synovitis-of-the-hip-in-children-and-adolescents
#13
S Clifton Willimon, Tim Schrader, Crystal A Perkins
Background: Pigmented villonodular synovitis (PVNS) is a benign proliferative synovial disorder most commonly described to affect the knee in adults. Literature describing PVNS in the pediatric population is limited to 2 small case series and a handful of single-patient case reports. Within these studies, only 2 patients with PVNS of the hip are described. Purpose: To describe the presentation, management, and outcomes of a single-center series of pediatric patients with PVNS of the hip treated with arthroscopic synovectomy...
March 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29581924/distinguishing-pediatric-lyme-arthritis-of-the-hip-from-transient-synovitis-and-acute-bacterial-septic-arthritis-a-systematic-review-and-meta-analysis
#14
Aristides I Cruz, Jason B Anari, Jose M Ramirez, Wudbhav N Sankar, Keith D Baldwin
Objective Lyme arthritis is an increasingly recognized clinical entity that often prompts orthopaedic evaluation in pediatric patients. While Lyme arthritis is most common in the knee, the clinical presentation of Lyme arthritis of the hip can be similar to both acute bacterial septic arthritis and transient synovitis. Accurately distinguishing these clinical entities is important since the definitive treatment of each is distinct. Because there is limited literature on monoarticular Lyme arthritis of the hip, the purpose of this study was to perform a systematic review and meta-analysis of clinical and laboratory parameters associated with Lyme arthritis (LA) of the hip and compare them to septic arthritis (SA) and transient synovitis (TS)...
January 25, 2018: Curēus
https://www.readbyqxmd.com/read/29570157/femoral-head-wedge-resection-for-the-treatment-of-avascular-necrosis-of-the-femoral-head-after-pediatric-femoral-neck-fracture-a-case-report
#15
Ha Yong Kim, Yong Han Cha, Won Sik Choy, Sang Wook Jeung, Yeon Seung Min
This research focuses on femoral head wedge resection for the treatment of avascular necrosis (AVN) of the femoral head. A 9-year-old girl presented to the emergency room complaining of right hip pain that occurred after a pedestrian car accident. After 8 months of internal fixation using cannulated screws for Delbet-type 2 fracture of the femoral neck, AVN of the femoral head developed in the patient. Even though valgus-derotation-extension intertrochanteric osteotomy was performed for the treatment of AVN, it progressed further and femoral head wedge resection was performed to recover the femoral head sphericity...
May 2018: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/29554020/what-s-new-in-pediatric-hip
#16
Matthew R Schmitz, Todd J Blumberg, Susan E Nelson, Julieanne P Sees, Wudbhav N Sankar
BACKGROUND: Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis...
March 17, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29530356/characterization-of-pediatric-golf-cart-injuries-to-guide-injury-prevention-efforts
#17
Joseph R Starnes, Purnima Unni, Cherie A Fathy, Kelly A Harms, Shelby R Payne, Dai H Chung
BACKGROUND: Golf cart injuries represent an increasing source of morbidity and mortality in the United States. Characterization of the circumstances of these injuries can inform injury prevention efforts. METHODS: This study retrospectively reviews a prospective trauma registry at a level-one pediatric trauma center for golf cart-related injuries in patients under 18years of age admitted to the hospital between 2008 and 2016. RESULTS: The 40 identified crashes were associated with 82 hospital days, 17 ICU days, and more than $1 million in hospital charges over the study period...
March 2, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29525344/prevention-of-dislocation-after-total-hip-arthroplasty
#18
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...
May 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29510709/a-comparison-of-10-accelerometer-non-wear-time-criteria-and-logbooks-in-children
#19
Eivind Aadland, Lars Bo Andersen, Sigmund Alfred Anderssen, Geir Kåre Resaland
BACKGROUND: There are many unresolved issues regarding data reduction algorithms for accelerometry. The choice of criterion for removal of non-wear time might have a profound influence on physical activity (PA) and sedentary time (SED) estimates. The aim of the present study was to compare 10 different non-wear criteria and a log of non-wear periods in 11-year-old children. METHODS: Children from the Active Smarter Kids study performed 7-days of hip-worn accelerometer monitoring (Actigraph GT3X+) and logged the number of non-wear periods each day, along with the approximate duration and reason for non-wear...
March 6, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29496562/impaired-bone-mineral-density-in-pediatric-patients-with-chronic-graft-versus-host-disease
#20
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplantation (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk for endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We report 33 patients with cGVHD who were referred to the National Institutes of Health (NIH) for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessment via dual-energy X-ray absorptiometry (DEXA)...
March 1, 2018: Biology of Blood and Marrow Transplantation
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