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Pediatric foot fracture

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)...
January 26, 2017: Emergency Radiology
Stefan Rammelt, Alexandre Leme Godoy-Santos, Wolfgang Schneiders, Guido Fitze, Hans Zwipp
Foot and ankle fractures represent 12% of all pediatric fractures. Malleolar fractures are the most frequent injuries of the lower limbs. Hindfoot and midfoot fractures are rare, but inadequate treatment for these fractures may results in compartment syndrome, three-dimensional deformities, avascular necrosis and early post-traumatic arthritis, which have a significant impact on overall foot and ankle function. Therefore, the challenges in treating these injuries in children are to achieve adequate diagnosis and precise treatment, while avoiding complications...
November 2016: Revista Brasileira de Ortopedia
Özgür Çiçekli, Güzelali Özdemir, Mustafa Uysal, Vedat Biçici, İzzet Bingöl
BACKGROUND: Ankle injuries are among the most common injuries in children. The aim of this study was to compare the efficacies of two percutaneous fixation methods after closed reduction in physeal ankle fractures. METHODS: We reviewed the cases of 24 patients with a mean age of 12.29 years; 16 were male, and 8 were female. Only patients with fractures of Salter-Harris types 2, 3, and 4 with displacements greater than 2 mm were included in the study. Patients were treated with closed reduction manipulation and percutaneous screw fixation...
2016: SpringerPlus
Jaime R Denning
Ankle fractures account for 5% and foot fractures account for approximately 8% of fractures in children. Some complications are evident early in the treatment or natural history of foot and ankle fractures. Other complications do not become apparent until weeks, months, or years after the original fracture. The incidence of long-term sequelae like posttraumatic arthritis from childhood foot and ankle fractures is poorly studied because decades or lifelong follow-up has frequently not been accomplished. This article discusses a variety of complications associated with foot and ankle fractures in children or the treatment of these injuries...
January 2017: Orthopedic Clinics of North America
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
Lisa M Knijnenberg, Siem A Dingemans, Maaike P Terra, Peter A A Struijs, Niels W L Schep, Tim Schepers
BACKGROUND: Injuries to the Lisfranc joint in children and adolescents are rare. The incomplete ossification of the bones of the foot makes it difficult to detect injuries.The aim of this study was to determine age-specific radiographic measurements of the Lisfranc joint to provide guidance to the radiologist, emergency physicians, and surgeons to decrease misdiagnosis of Lisfranc injuries and improve detection. METHODS: We retrospectively reviewed all foot radiographs without traumatic injury made between August 2014 and February 2015 in all patients younger than 18...
September 3, 2016: Journal of Pediatric Orthopedics
Justin Brantley, Aditi Majumdar, J Taylor Jobe, Antony Kallur, Christina Salas
BACKGROUND: Percutaneous pin fixation is often used in conjunction with closed-reduction and cast immobilization to treat pediatric distal tibia fractures. The goal of this procedure is to maintain reduction and provide improved stabilization, in effort to facilitate a more anatomic union. We conducted a biomechanical study of the torsional and bending stability of three commonly used pin configurations in distal tibia fracture fixation. METHODS: A transverse fracture was simulated at the metaphyseal/diaphyseal junction in 15 synthetic tibias...
2016: Iowa Orthopaedic Journal
Abizer Kapadia, Vedprakash R Cheruvu, Jerry R John, Satyaswarup Tripathy, Ramesh K Sharma
Composite defects of the leg often involve microsurgical reconstruction. Microsurgery is technically demanding in post-trauma situations in very young children. There is renewed interest in cross leg flaps in this scenario. Children aged up to 5 years, who had open fractures or exposed bones in the leg, were followed up prospectively. Eight children, with a mean age of 4 years, underwent nine flaps for extensive tissue defects over the leg and foot. Six of these flaps were cross leg flaps. No flap failed and all wounds acquired early stable cover...
March 2017: Journal of Pediatric Orthopedics. Part B
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
Kelly Wallin, Hienvu Nguyen, Lindsay Russell, Daniel K Lee
Acute compartment syndrome of the lower leg and foot is a not widely reported, but serious, potential complication that can develop after fractures, crush injuries, or high-velocity trauma of the lower extremity. Early recognition and treatment are critical in preventing morbidity and permanent complications. Although compartment syndrome of the lower leg and foot has been well-studied and documented in adults, its occurrence in the pediatric population is rare. We performed a systematic review of the published data and present the case of the youngest patient with isolated ACS of the foot...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jennifer M Weiss, Hooman Nikizad, Kevin G Shea, Samvel Gyurdzhyan, John C Jacobs, Peter C Cannamela, Jeffrey I Kessler
BACKGROUND: The frequency of osteochondritis dissecans (OCD), a disorder of the subchondral bone and articular cartilage, is not well described. PURPOSE: To assess the frequency of pediatric OCD lesions that progress to surgery based on sex, joint involvement, and age. STUDY DESIGN: Descriptive epidemiology study. METHODS: A retrospective chart review (2007-2011) was performed on OCD. Inclusion criteria included OCD of any joint and patients aged 2 to 19 years...
March 2016: Orthopaedic Journal of Sports Medicine
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
Matthew R Wagoner, Corine L Creech, Christine K Nolan, Andrew J Meyr
UNLABELLED: This pictorial review presents basic principles of the types of hardware extraction commonly encountered in foot and ankle surgical practice. We review the indications, contraindications and complications of hardware removal including pain, intra-articular fixation, and carcinogenesis, as well as special considerations in pediatric patients and in the setting of infection. Figures are then used to describe the appropriate techniques for use of the screwdriver shafts, conical extraction screws, extraction bolts, hollow reamers, and other instruments found in most hardware extraction sets...
August 2015: Foot & Ankle Specialist
Derek A Seehausen, Liam R Harris, Robert M Kay, J Lee Pace
BACKGROUND: Accessory navicular (AN) is a common anatomic variant that is known to cause medial foot pain. Surgery may be required for excision if conservative measures fail. Often, the medial border of the navicular is excised in addition to the AN during surgery. The purpose of this radiographic study is to determine if the presence of an AN is associated with a wider or more prominent navicular in pediatric patients compared with normal controls. METHODS: This study included pediatric patients who received an initial plain anteroposterior foot radiograph between January 1, 2004 and December 31, 2012 and were between the ages of 10 and 20 years...
July 2016: Journal of Pediatric Orthopedics
Mansur Halai, Bilal Jamal, Paul Rea, Mobeen Qureshi, Anand Pillai
BACKGROUND: Injuries around the foot and ankle are challenging. There is a paucity of literature, outside that of specialist orthopedic journals, that focuses on this subject in the pediatric population. DATA SOURCES: In this review, we outline pediatric foot and ankle fractures in an anatomically oriented manner from the current literature. Our aim is to aid the emergency department doctor to manage these challenging injuries more effectively in the acute setting...
February 2015: World Journal of Pediatrics: WJP
Michael J Sumko, William Hennrikus, Jennifer Slough, Kelly Jensen, Douglas Armstrong, Stephen King, Kenneth Urish
BACKGROUND: Previous literature has underreported radiation exposure with the use of mini C-arm during pediatric forearm fracture reductions. The purpose of this study is to report an accurate amount of radiation exposure during fracture reductions using a mini C-arm that records the amount of kilovolts, milliamps, and the number of seconds of foot pedal use. METHODS: Eighty-six consecutive pediatric patients undergoing upper extremity fracture reduction in the emergency department were studied...
March 2016: Journal of Pediatric Orthopedics
Kevin M Estillore, Gerto L Quevedo, Lauro R Bonifacio
BACKGROUND: Vacuum Assisted Closure (VAC) is an established method that can be used in order to cover for soft tissue defects. This study focuses on the use of a modified suction machine in the form of an aquarium pump as an economical substitute for the VAC dressing. The improvised suction apparatus was a regular aquarium pump, which was altered in order to draw air in instead of expelling it. The patients were followed-up for a period of three weeks in the wards. METHODS: VAC was applied over the soft tissue defects...
July 2013: Malaysian Orthopaedic Journal
Sameer M Naranje, Shawn R Gilbert, Matthew G Stewart, Jeremy K Rush, Craig A Bleakney, Jack E McKay, William C Warner, Derek M Kelly, Jeffrey R Sawyer
INTRODUCTION: Gunshot injuries are a potentially significant cause of morbidity and mortality in the pediatric population. The objective of this study was to evaluate the epidemiology, fracture locations, associated injuries, types of treatment, and complications of gunshot-associated fractures in children and adolescents treated at two level 1 trauma centers. METHODS: The clinical and radiographic records of all children and adolescents who had a gunshot-associated fracture treated at 1 of 2 level 1 pediatric trauma centers between January, 2005, and April, 2013, were reviewed...
January 2016: Journal of Pediatric Orthopedics
Joanne N Wood, Oludolapo Fakeye, Valerie Mondestin, David M Rubin, Russell Localio, Chris Feudtner
OBJECTIVE: To develop guidelines for performing an initial skeletal survey (SS) for children <24 months of age presenting with bruising in the hospital setting, combining available evidence with expert opinion. METHODS: Applying the Rand/UCLA Appropriateness Method, a multispecialty panel of 10 experts relied on evidence from the literature and their own clinical expertise in rating the appropriateness of performing SS for 198 clinical scenarios characterizing children <24 months old with bruising...
February 2015: Pediatrics
Sermet Inal, Canan Inal
BACKGROUND: Pediatric comminuted talar fractures are reported to be rare, and treatment options such as minimal internal K-wire fixation without using a tourniquet to prevent avascular necrosis have not previously been investigated. CASE DESCRIPTION: We report a case of a comminuted talar body and a non-displaced neck fracture with dislocation of the tibiotalar, talonavicular and subtalar joints with bimalleolar epiphyseal fractures in an 11-year-old boy due to a fall from height...
2014: Iowa Orthopaedic Journal
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