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https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#1
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28427119/-genetic-analysis-of-posterior-cranial-fossa-morphology-in-families-of-chiari-malformation-type-%C3%A2
#2
X X Yuan, Y Li, S F Sha, W X Sun, Y Qiu, Z Liu, W G Zhu, Z Z Zhu
Objective: To explore genetic characteristic of posterior cranial fossa morphology in families of Chiari malformation type Ⅰ (CMI). Methods: From April 2010 to May 2016, a total of 47 cases of CMI families (CMI group) and their 94 parents (CMI-P group)collected were retrospectively reviewed in Department of Spinal Surgery, Drum Tower Hospital, School of Medicine, Nanjing University.Another cohort of 50 asymptomatic adults was enrolled to serve as the control group.Patients with skull fracture or other diseases which can lead to secondary CMI were excluded...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28427053/growing-skull-fracture-and-the-orbitocranial-variant-nuances-of-surgical-management
#3
Vikram Singh, Gopalakrishnan M Sasidharan, Dhananjaya Ishwar Bhat, Bhagavatula Indira Devi
AIMS: Growing skull fracture (GSF) is a rare complication resulting from diastatic enlargement of a pediatric skull fracture. Orbitocranial GSF is a distinct variant with more complex management issues due to the displacement of the globe. This study aims to discuss surgical considerations in the management of GSF, with particular reference to orbitocranial variants. METHODS: We conducted a retrospective analysis of 7 children operated for GSFs at our institute from 2008 to 2015...
April 21, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28422876/low-complication-rate-of-elastic-stable-intramedullary-nailing-esin-of-pediatric-forearm-fractures-a-retrospective-study-of-202-cases
#4
Christiane Kruppa, Pamela Bunge, Thomas A Schildhauer, Marcel Dudda
Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28416429/-life-threatening-sleepwalking-elpenor-s-syndrome-in-a-10-year-old-child
#5
M-A Madigand-Tordjman, P-J Egler, F Bertran, M Jokic, F Guénolé
Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. OBSERVATION: This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28409337/surgical-considerations-with-the-operative-fixation-of-unstable-paediatric-pelvic-ring-injuries
#6
Mohamed Kenawey
INTRODUCTION: The operative treatment of unstable pelvic injuries in paediatrics is not frequently indicated. The detailed modes of pelvic ring failure, surgical techniques, fixation choices, and peri-operative difficulties are not well reported. METHODS: From September 2010 to March 2016, 62 paediatric patients were admitted to an academic level I trauma center with the diagnosis of pelvic ring injury. Of them, 29 (17 males and 12 females) had operative fixation of unstable pelvic injuries...
April 13, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28403495/-diagnosis-and-therapeutic-management-in-kidney-ureter-and-bladder-trauma
#7
Karin Hirsch, Marco Heinz, Bernd Wullich
Trauma refers to the destruction of tissues or organs by external forces and it is the most common cause of mortality and morbidity in children (1, 2). Injuries of the genitourinary tract may be the result of blunt (falls, sport injuries, motor vehicle accidents and sexual abuse) or penetrating (stab wounds, gun shots, falling onto sharp objects) injuries. The genitourinary tract is significantly injured in 2.9% of paediatric trauma patients 4.In the paediatric population, the kidney is the most affected organ in the genitourinary tract (>60% of all genitourinary tract injuries) 4...
February 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28403046/bacterial-osteomyelitis-or-nonbacterial-osteitis-in-children-a-study-involving-the-german-surveillance-unit-for-rare-diseases-in-childhood
#8
MULTICENTER STUDY
Veit Grote, Colen C G Silier, Agnes M Voit, Annette F Jansson
BACKGROUND: Although bacterial osteomyelitis (BO) is a commonly recognized diagnosis in pediatrics, it is often difficult to distinguish from nonbacterial osteitis (NBO). The goal of our study was to distinguish between the 2 disease entities and better define NBO. METHODS: Using the German Surveillance Unit for Rare Diseases in Childhood (Erhebungseinheit für Seltene Paediatrische Erkrankungen in Deutschland), this prospective study during a 5-year period captured 657 patients at first diagnosis of either BO (n = 378) or NBO (n = 279) while analyzing epidemiologic, clinical and radiologic data...
May 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28400870/a-prospective-cohort-study-of-the-therapeutic-patterns-challenges-and-outcomes-of-paediatric-femoral-fractures-in-a-cameroonian-tertiary-center
#9
Joel Noutakdie Tochie, Marc Leroy Guifo, Marie-Ange Ngo Yamben, Roger Moulion, Ibrahim Farikou
BACKGROUND: Knowledge of the therapeutic patterns, challenges and outcomes of treatment of paediatric femoral fractures (PFF) helps to better choose the ideal therapeutic modality which is still controversial. However, this data is scarce in the sub-Saharan African literature. OBJECTIVE: To determine the therapeutic patterns, treatment challenges and outcomes of treatment of PFF in a tertiary care centre in Cameroon. METHOD: We conducted a prospective cohort study of all consenting consecutive cases of femoral fractures in patients younger than 16 years managed between 2011 and 2015 at the surgical unit of Yaoundé University Teaching Hospital, Cameroon...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28399423/bone-mineral-density-and-vitamin-d-concentration-the-challenges-in-taking-care-of-children-and-adolescents-infected-with-hiv
#10
Fabiana Bononi Carmo, Maria Teresa Terreri, Regina Célia de Menezes Succi, Suenia Vasconcelos Beltrão, Aida de Fátima Tomé Barbosa Gouvea, Erica Regina Cruz Paulino, Daisy Maria Machado
The increase in life expectancy for patients living with human immunodeficiency virus (HIV) infection has resulted in health complications related to a chronic disease. OBJECTIVES: To evaluate the prevalence of bone mineral density (BMD) alterations and vitamin D concentrations in HIV-infected children and adolescents and to verify the variations in those parameters during a 12-month interval. METHODS: A prospective cohort study with a dual period of evaluation was conducted in 57 patients perinatally HIV-infected and one patient with sexual abuse in early infancy...
April 8, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28399048/pediatric-femoral-shaft-fractures-a-multicenter-review-of-the-aaos-clinical-practice-guidelines-before-and-after-2009
#11
John D Roaten, Derek M Kelly, Joseph L Yellin, John M Flynn, Micaela Cyr, Sumeet Garg, Alexander Broom, Lindsay M Andras, Jeffrey R Sawyer
BACKGROUND: To determine if the AAOS clinical practice guidelines (CPG) for the treatment of pediatric femoral shaft fractures (2009) changed treatment, we analyzed pediatric femoral shaft fractures at 4 high-volume, geographically separated, level-1 pediatric trauma centers over a 10-year period (2004 to 2013). METHODS: Consecutive series of pediatric femoral shaft fractures (ages, birth to 18 y) treated at the 4 centers were reviewed. Treatment methods were analyzed by age and treatment method for each center and in aggregate...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28398934/pediatric-lawnmower-injuries
#12
Tina S Lee, Jan D Luhmann, Scott J Luhmann, Kimberly S Quayle
OBJECTIVE: The aim of this study was to evaluate demographics, characteristics, and mechanisms of injuries caused by lawnmowers in children. METHODS: Chart review from 1990 to 2010 at a level I pediatric trauma center identified patients younger than 18 years with lawnmower injuries. Demographics and characteristics of the injuries were analyzed by descriptive statistical analysis. RESULTS: The study identified 88 subjects, with 80% males and 42% of the subjects younger than 5 years...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28395008/derivation-and-validation-of-a-serum-biomarker-panel-to-identify-infants-with-acute-intracranial-hemorrhage
#13
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
April 10, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28394107/prevalence-type-and-etiology-of-dental-and-soft-tissue-injuries-in-children-in-croatia
#14
Josip Škaričić, Marko Vuletić, Sandra Hrvatin, Jesenka Jeličić, Ivana Čuković-Bagić
The prevalence, type and etiology of dental and soft tissue injuries and relationship between the time of arrival and sustaining soft tissue injury were analyzed in this retrospective study conducted at the Department of Pediatric Dentistry, University Dental Clinic in Zagreb, Croatia, during the 2010-2014 period using documentation on 447 patients (264 male and 183 female) aged 1-16 years with injuries of primary and permanent teeth. The highest prevalence of traumatic dental injury (TDI) was found in the 7-12 age group and maxillary central incisors were most frequently affected (80...
June 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/28393739/prenatal-exposure-to-vitamin-d-from-fortified-margarine-and-risk-of-fractures-in-late-childhood-period-and-cohort-results-from-222-000-subjects-in-the-d-tect-observational-study
#15
Mina Nicole Händel, Peder Frederiksen, Clive Osmond, Cyrus Cooper, Bo Abrahamsen, Berit L Heitmann
Prenatal low vitamin D may have consequences for bone health. By means of a nationwide mandatory vitamin D fortification programme, we examined the risk of fractures among 10-18-year-old children from proximate birth cohorts born around the date of the termination of the programme. For all subjects born in Denmark during 1983-1988, civil registration numbers were linked to the Danish National Patient Registry for incident and recurrent fractures occurring at ages 10-18 years. Multiplicative Poisson models were used to examine the association between birth cohort and fracture rates...
April 10, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#16
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28391440/paediatric-lateral-humeral-condylar-fracture-outcomes-at-twelve-years-follow-up-as-compared-with-age-and-sex-matched-paired-controls
#17
Juha-Jaakko Sinikumpu, Tytti Pokka, Sarita Victorzon, Eija-Leena Lindholm, Willy Serlo
INTRODUCTION: Lateral humeral condylar fractures are the second most common elbow fractures in children. We present the long-term clinical and radiographic results. MATERIAL AND METHODS: All children (<16 years) in the geographic catchment area with lateral condylar fracture were asked to participate and 32 (76.2%) patients enrolled. Clinical and functional results are compared with randomly selected but age and sex matched normal controls at 12.4 years (range 10...
April 8, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#18
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#19
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28383417/short-double-elastic-nailing-of-severely-displaced-distal-pediatric-radial-fractures-a-new-method-for-stable-fixation
#20
Marcell Varga, Gergő Józsa, Balázs Fadgyas, Tamás Kassai, Antal Renner
RATIONALE: Short double elastic nailing is a minimal invasive, modified ESIN (elastic stable intramedullary nailing) technique for severely displaced distal radial fracture in children. The aim of this technical report is to introduce our new method and evaluate the final results of the procedure. PATIENT CONCERNS: We reviewed retrospectively 24 patients who underwent short double elastic nailing due to distal radial fractures between November 2012 and December 2015...
April 2017: Medicine (Baltimore)
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