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Pediatric orthopaedic trauma

Kenneth Chin, Joshua M Abzug, Donald S Bae, Bernard D Horn, Martin Herman, Craig P Eberson
Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment...
February 15, 2016: Instructional Course Lectures
Brendan A Williams, James P McFadden, Tyler L Teurlings, Laurel C Blakemore
PURPOSE: Pediatric motocross injuries occur frequently and with significant associated morbidity; however, data are limited regarding injury occurring during competition. North Central Florida hosts an annual motocross competition with numerous pediatric competitors. We sought to evaluate the rate and severity of injuries sustained at this event over a multiyear period. Our primary hypothesis was that motocross injury rates and severity in competition exceed that of other competitive sports in this age group...
September 15, 2016: Journal of Pediatric Orthopedics
(no author information available yet)
Injury is still the number 1 killer of children ages 1 to 18 years in the United States ( Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region...
August 2016: Pediatrics
Christiane G Kruppa, Justin D Khoriaty, Debra L Sietsema, Marcel Dudda, Thomas A Schildhauer, Clifford B Jones
INTRODUCTION: With an incidence of less than 0.2% of all pediatric fractures, pelvic ring injuries are rare. Historically they were conservatively treated, but because malunion and long-term morbidity are associated with unstable injuries, a trend towards operative treatment can be observed. The purpose was to determine clinical and radiographic outcomes following these complex pediatric pelvic ring injuries. PATIENTS AND METHODS: This Level IV retrospective analysis was completed at a private orthopaedic practice in association with a Level One teaching trauma center...
October 2016: Injury
Steven F Shannon, Nicholas M Hernandez, Stephen A Sems, Annalise N Larson, Todd A Milbrandt
OBJECTIVES: The purpose of this study was to evaluate the type and severity of orthopaedic and associated injuries for snowmobile, All-terrain vehicles (ATV) and motorized dirtbike accidents in a pediatric patient population. METHODS: A total of 758 patients who presented following either snowmobile (n=87), ATV-related (n=308) or dirtbike (n=363)-related trauma at our institution between 1996 and 2015 were retrospectively reviewed. RESULTS: A total of 441 axial and appendicular fractures occurred requiring 533 procedures...
July 20, 2016: Journal of Pediatric Orthopedics
Kevin C Parvaresh, Vidyadhar V Upasani, James D Bomar, Andrew T Pennock
INTRODUCTION: Variable ossification patterns of the pelvis in skeletally immature patients can make the interpretation of pelvic radiographs challenging. Inconsistencies among prior studies and lack of sex comparisons underscore the need for a more comprehensive characterization of the secondary ossification centers. This study evaluates the chronology and sex differences for appearance and closure of pelvic and proximal femoral secondary ossification centers using computed tomography (CT)...
July 20, 2016: Journal of Pediatric Orthopedics
Brad Stone, Matthew Street, Warren Leigh, Haemish Crawford
BACKGROUND: Osteomyelitis shows a strong predilection for the tibia in the pediatric population and is a significant source of complications. The purpose of this article is to retrospectively review a large series of pediatric patients with tibial osteomyelitis. We compare our experience with that in the literature to determine any factors that may aid diagnosis and/or improve treatment outcomes. METHODS: A 10-year retrospective review was performed of clinical records of all cases of pediatric tibial osteomyelitis managed at the 2 children's orthopaedic departments in the Auckland region...
July 2016: Journal of Pediatric Orthopedics
John A Scolaro, Reza Firoozabadi, Milton L Chip Routt
BACKGROUND: Pediatric and adolescent pelvic ring injuries are frequently treated without surgery. In patients with unstable injuries to the pelvic ring, surgical stabilization aids in resuscitation, provides pain relief, and allows for mobilization. Percutaneous pelvic screw fixation is commonly performed in adult patients for unstable pelvic ring injuries, but a paucity of literature exists regarding their use in pediatric patients. The purpose of this study is to review the use, outcome, and management of percutaneous posterior pelvic screws in pediatric patients with unstable pelvic ring injuries...
June 2, 2016: Journal of Pediatric Orthopedics
Yongzeng Feng, Yang Yu, Xiaolong Shui, Xiaozhou Ying, Leyi Cai, Jianjun Hong
Open reduction and internal fixation has been widely used to treat displaced intra-articular calcaneus fractures in children. However, the complications of surgical trauma and the wound created through the extended lateral approach cannot be ignored. This study analyzed the outcomes of displaced intra-articular calcaneal fractures in children treated with closed reduction and percutaneous fixation. Medical records of pediatric patients who had displaced intra-articular calcaneus fractures and underwent closed reduction and percutaneous fixation at the study institution between January 2008 and January 2013 were reviewed...
July 1, 2016: Orthopedics
Kenneth Chin, Joshua Abzug, Donald S Bae, Bernard D Horn, Martin Herman, Craig P Eberson
Management of pediatric polytrauma patients is one of the most difficult challenges for orthopaedic surgeons. Multisystem injuries frequently include complex orthopaedic surgical problems that require intervention. The physiology and anatomy of children and adolescent trauma patients differ from the physiology and anatomy of an adult trauma patient, which alters the types of injuries sustained and the ideal methods for management. Errors of pediatric polytrauma care are included in two broad categories: missed injuries and inadequate fracture treatment...
2016: Instructional Course Lectures
Julio Urrutia, Mario Orrego, Ana C Wright, Diego Amenabar
BACKGROUND: The Chilean National Examination of Orthopaedic Surgery (EMNOT) has been administered since 2009. It was developed to determine whether individual residents are meeting minimal knowledge standards at the end of their training programs. METHODS: We performed a retrospective evaluation of the EMNOT for all years it has been administered (2009-2015). The test was analyzed for content, taxonomy of questions asked (1: direct recall; 2: diagnosis; 3: evaluation/decision-making), residents' performance, difficulty index and discrimination index...
2016: BMC Medical Education
Michael T Torchia, Lisa K Schroder, Brian W Hill, Peter A Cole
BACKGROUND: We describe a follow-up program for patients undergoing surgical procedures with documented results from short-term surgical mission trips to the developing world. The surgical procedures were all performed at a government hospital in Pucallpa, Peru, a remote city in the Amazon. METHODS: Between July 2007 and January 2012, ten surgical mission trips were completed with a mean time of six days on location and a mean number of 2.3 surgeons (range, two to five surgeons) per trip...
February 3, 2016: Journal of Bone and Joint Surgery. American Volume
Rishiram Poudel, Venkatesan Sampath Kumar, Ashok Kumar, Shah Alam Khan
BACKGROUND: Factors influencing publication of manuscripts in reputed journals have never been studied to the best of our knowledge. This study was conducted to evaluate the trend in publication within the Indian Journal of Orthopaedics (IJO). MATERIALS AND METHODS: A cross-sectional study was conducted by accessing the online database of the IJO. All the issues available online were included. Published articles were classified into one of the following thirteen categories: (i) Basic Sciences (ii) trauma (upper limb and lower limb) (iii) infections (iv) pediatric orthopedics (v) arthroplasty (vi) arthroscopy (vii) spine surgery (viii) musculoskeletal oncology (ix) hand and microvascular surgery (x) adult reconstruction (including the Ilizarov technique) (xi) general orthopedics and miscellaneous (xii) letter to editor (xiii) book review...
November 2015: Indian Journal of Orthopaedics
Allan C Beebe, Lindsay Arnott, Jan E Klamar, John R Kean, Kevin E Klingele, Walter P Samora
OBJECTIVE: Over the past decade, our institution has instituted three different scheduling models in an attempt to care for pediatric trauma at our Level I Trauma Center. This has been in response to a number of factors, including a limited number of physicians covering the call schedule, increasing competition for operating room (OR) time after hours (pediatric surgery, urology, neurosurgery), an attempt to fully utilize OR time during the daytime, fully staffed hours, and optimizing patients' timeliness to surgery...
November 2015: Orthopaedic Surgery
Christopher M Loftis, Jeffrey R Sawyer, James W Eubanks, Derek M Kelly
BACKGROUND: Although morbidity and mortality in children increases in motor vehicle collisions (MVC) if child restraints are not used, no data exist correlating specific injuries with proper or improper use of safety restraints or age. The purpose of this study was to evaluate correlations between childhood MVC injuries, age, and restraint status. METHODS: A medical record search for pediatric patients involved in a MVC was conducted at a pediatric hospital (level 1 trauma)...
January 11, 2016: Journal of Pediatric Orthopedics
Robert F Murphy, Manahil Naqvi, Patricia E Miller, Lanna Feldman, Benjamin J Shore
PURPOSE: Research on venous thromboembolism events (VTE), such as deep venous thrombosis (DVT) and pulmonary embolism (PE), in pediatric orthopaedic trauma patients is sparse. We describe the incidence in the USA of VTE associated with pediatric lower extremity orthopaedic trauma, and characterize injury patterns and VTE treatment methods. METHODS: The Pediatric Health Information System (PHIS) was queried from 2004 to 2013 using ICD-9 codes for lower extremity fractures (pelvis, femur, tibia, ankle, foot) and dislocations (hip, knee, ankle, subtalar) and VTE...
October 2015: Journal of Children's Orthopaedics
Anthony E Johnson, Tad L Gerlinger, Christopher T Born
A disaster is a catastrophic event that disrupts normal infrastructure to such a degree that normal response mechanisms and capabilities cannot manage what is required to respond appropriately to the event. Launched after the largest urban disaster in modern history--the 2010 Haiti Earthquake--the American Academy of Orthopaedic Surgeons/Society of Military Orthopaedic Surgeons/Orthopaedic Trauma Association/Pediatric Orthopaedic Association of North America (AAOS/SOMOS/OTA/POSNA) Disaster Response Course (DRC) is designed to prepare orthopaedic surgeons for service in disaster response and humanitarian assistance efforts in both the acute phases as well as in the recovery and reconstructions phases...
October 2015: Journal of Orthopaedic Trauma
Karl Grob, Mirjana Manestar, Timothy Ackland, Luis Filgueira, Markus S Kuster
BACKGROUND: The anterior approach to the hip joint is widely used in pediatric and adult orthopaedic surgery, including hip arthroplasty. Atrophy of the tensor fasciae latae muscle has been observed in some cases, despite the use of this internervous approach. We evaluated the nerve supply to the tensor fasciae latae and its potential risk for injury during the anterior approach to the hip joint. METHODS: Cadaveric hemipelves (n = 19) from twelve human specimens were dissected...
September 2, 2015: Journal of Bone and Joint Surgery. American Volume
Bryan A Reyes, Christine A Ho
BACKGROUND: To describe treatment methods and complication rates of all open Seymour fractures (Salter-Harris I/II or juxta-epiphyseal fractures of the distal phalanx of the hand with associated nailbed laceration) treated at or referred to a pediatric level 1 trauma center over a 10-year time period. We hypothesized that delayed treatment of Seymour fractures results in higher infectious complication rates. METHODS: We identified all patients treated for open Seymour fractures at the orthopaedic hand clinic at our level 1 pediatric trauma center between August 2002 and December 2012...
August 28, 2015: Journal of Pediatric Orthopedics
Deren T Bagsby, Randall T Loder, Karen Myung
BACKGROUND: The "July Effect" involves the influx of new interns and residents early in the academic year (July and August), which may have greater potential for poorer patient outcomes. Current orthopaedic literature does not demonstrate the validity of this concept in arthroplasty, spine, hand, and arthroscopy. No study has investigated the possibility of this effect on common pediatric orthopaedic procedures, such as closed reduction and percutaneous pin fixation of supracondylar humerus fractures...
August 11, 2015: Journal of Pediatric Orthopedics
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