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Pediatric lower extremity

Amanda Nicole Fletcher, Richard M Schwend, Mitchell Solano, Christopher Wester, Dale E Jarka
BACKGROUND: Unintentional injuries are the leading cause of morbidity and mortality among children 0 to 18 years of age in the U.S. An estimated 9,400 to 17,000 pediatric lawn-mower injuries occur each year. The aims of this study were to better define the epidemiology of lawn-mower injuries and to identify predictors of severe lawn-mower injuries to optimize public education and injury prevention. METHODS: All patients 0 to 18 years of age who presented to Children's Mercy Hospital (CMH), Kansas City, Missouri, during the period of 1995 to 2015 after sustaining a lawn-mower injury were identified using International Classification of Diseases, 9th Revision (ICD-9) codes...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi, Wissam Al-Issawi
Background: Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa. Case presentation: We report the case of a 13-year-old male adolescent complaining of progressive lower back pain and weakness of the lower extremities for 3 days. Initial magnetic resonance imaging revealed typical transverse myelitis. Subsequently, parasite serology showed a markedly elevated level of Schistosoma antibody titers, and cerebrospinal fluid analysis yielded normal results...
2018: Patient Safety in Surgery
A Andreacchio, F Alberghina, L Marengo, F Canavese
The main objective of this paper is to review the current literature on treatment of tibial and femur fractures in children and adolescents guided by body weight in patients weighing 50 kg (110 lb) or more. A secondary aim of this mini-review was to determine, as per literature review, whether weight  > 50 kg (110 lb) is an identifiable factor associated with increased complication rate. A search of the PubMed/MEDLINE, EMBASE and Cochrane Database of Systematic Reviews databases from 1954 to September 2017 was performed to identify papers related to pediatric tibia and femur fractures in children weighing more than 50 kg (110 lb)...
October 11, 2018: Musculoskeletal Surgery
Juhee Shin, Dong Hyun Lee, Nani Jung, Hee Joung Choi, Ye Jee Shim
Background: Reactive thrombocytosis (RT) is a common condition among children, although no studies have examined the etiology or clinical characteristics of RT among Korean children. Methods: This retrospective study evaluated children with RT at a single Korean tertiary center during a 10-year period. Results: RT accounted for 13.5% of children who were admitted to the pediatric ward (4,113/30,355): mild RT, 82.7%; moderate RT, 14.1%; severe RT, 1...
September 2018: Blood Research
Jun Ah Lee, Hea Lin Oh, Dong Ho Kim, Jung Sub Lim
Purpose: We aimed to determine the prognostic significance of lymphocyte counts and lymphocyte-monocyte ratio (LMR) in pediatric patients with osteosarcoma. Methods: We retrospectively reviewed the medical records of 27 pediatric patients with localized extremity osteosarcoma treated at Korea Cancer Center Hospital between May 2002 and March 2016. Pretreatment and day 14 of first cisplatin-doxorubicin chemotherapy leukocyte counts and LMR (LMR14) were evaluated...
October 1, 2018: Korean Journal of Pediatrics
Min Jeng Cho, Jihoon Kim, Sung Jeep Kim, Kyu Hyouck Kyoung, Min Ae Keum, Sung Kyun Park
Purpose: Several published policy statements have warned for risk of trampoline and have recommended safety guideline. However, few studies have focused on trampoline-related injuries in Korea. The aim of this study was to assess the incidence and characteristics of pediatric trampoline-related injuries presenting to our hospital. Methods: We retrospectively reviewed the medical record of children <16 years old with trampoline-related injuries who visited our emergency department from 2008 to 2017...
October 4, 2018: Korean Journal of Pediatrics
Erin E Doherty, Erica K Schallert, Alexandra M Stevens, Jyotinder N Punia, Jennifer H Foster
We report the case of a 3-year-old girl diagnosed with acute megakaryoblastic leukemia, who presented after >1 year of bilateral leg pain. At times the pain was severe enough to prevent ambulation, prompting visits to her primary care provider. However, it was not until acute respiratory failure occurred with subsequent hospitalization in the pediatric intensive care unit that severe anemia and thrombocytopenia were discovered and the diagnosis of acute myeloid leukemia was made. Bilateral lower extremity swelling was noted on admission and radiographs showed diffusely abnormal appearance of the long bones of her lower extremities with periosteal reaction and echogenic debris in the subperiosteal space, thought to represent leukemic cells...
October 9, 2018: Journal of Pediatric Hematology/oncology
S Keisin Wang, Natalie A Drucker, Jodi L Raymond, Thomas M Rouse, Andres Fajardo, Gary W Lemmon, Michael C Dalsing, Brian W Gray
OBJECTIVE: The purpose of this investigation was to determine our limb-related contemporary pediatric revascularization perioperative and follow-up outcomes after major blunt and penetrating trauma. METHODS: A retrospective review was performed of a prospectively maintained pediatric trauma database spanning January 2010 to December 2017 to capture all level I trauma activations that resulted in a peripheral arterial revascularization procedure. All preoperative, intraoperative, and postoperative continuous variables are reported as a mean ± standard deviation; categorical variables are reported as a percentage of the population of interest...
October 3, 2018: Journal of Vascular Surgery
Young-Eun Jang, Joon-Hee Lee, Hee-Chul Yoon, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
BACKGROUND: The lumbar plexus (LP) block is commonly used for analgesia for lower extremities. If the depth of the LP (LPD) can be predicted, the performance time and procedure-related complications could be reduced. METHODS: Three hundred sixty-one magnetic resonance images of pediatric patients (<18 years of age) were analyzed. Simple linear regression and multiple linear regression analyses were performed to predict the LPD using patient age, weight, height, and the distance between the midline and posterior superior iliac spine (midline-PSIS)...
October 3, 2018: Anesthesia and Analgesia
Helder Nogueira, Joana Pereira, André Couto, Jorge Alves, Daniel Lopes, Joana Freitas, Nuno Alegrete, Gilberto Costa
This is a case report of pyogenic sacroiliitis in a pediatric patient caused by Streptococcus intermedius . The patient is a 16-year-old boy who presented to an emergency department with sudden onset of back pain radiating to the left lower extremity. The diagnosis was confounded by the presence of isthmic spondylolisthesis. Plain radiography demonstrated mild isthmic spondylolisthesis but no radiographic signs of tumor, trauma, infection, arthritis, or other developmental problems. The C-reactive protein level was 23 mg/L...
July 2018: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Ippei Takahashi, Masayuki Ishihara, Taku Oishi, Masaki Yamamoto, Mitsuo Narita, Mikiya Fujieda
A few pediatric cases with brain vasculitis most frequently affecting the middle cerebral artery have been reported in association with Mycoplasma pneumoniae infection, but involvement of the common carotid artery (CCA) before the bifurcation has not been reported to date. We report herein a case of 10-year-old boy with common carotid arteritis and polymyalgia associated with Mycoplasma pneumoniae infection. His fever and cough began 2 weeks before, and his right upper and lower extremity pains began 2 days before admission...
September 28, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Andy Tsai, Paul K Kleinman, Tal Laor, James R Kasser
BACKGROUND: Fibular hemimelia is the most common congenital long-bone deficiency. It is usually unilateral and results in a limb-length discrepancy. The literature generally subscribes to the concept of constant inhibition, a process by which limb-length ratios between the shorter and longer extremity remain constant throughout growth, but scientific data supporting this concept are sparse. Additionally, recent literature suggests that these children have abnormal skeletal maturation...
September 29, 2018: Pediatric Radiology
Yunzhu Meng, Costin D Untaroiu
Pedestrian injuries are the fourth leading cause of unintentional injury-related death among children aged 1 to 19. The lower extremity represents the most frequently injured body region in car-to-pedestrian accidents. The goal of this study was to perform a systematic review of the data related to pedestrian lower extremity injuries, anatomy, anthropometry, structural, and mechanical properties, which can be used in the development of new pediatric computational models. The study began with a review of epidemiologic data related to pediatric pedestrian accidents...
2018: Applied Bionics and Biomechanics
David E Kurlander, Shirley Shue, Graham S Schwarz, Amir M Ghaznavi
BACKGROUND: Vascularized fibula epiphysis transfer for pediatric extremity reconstruction intends to preserve growth potential. However, few cases are reported, and outcomes are poorly characterized. METHODS: Systematic review was performed through a MEDLINE search using keywords "pediatric" or "epiphyseal" and "vascularized fibula." Patients were divided into upper extremity or lower extremity groups. Functional and growth outcomes were assessed, and indications, pedicle, complications, and need for secondary surgery were recorded...
September 20, 2018: Annals of Plastic Surgery
Giovanni Biondo, Giuseppe Pistone, Maria R Bongiorno
Targetoid hemosiderotic hemangioma represents an uncommon, distinctive, benign lympho-vascular lesion, with a variable clinical appearance, typically occurs in the lower limbs and trunk. Most patients are in their 20's or 30's. We describe three dermoscopic cases followed by the review of the literature. Dermoscopic images have been collected and have been evaluated for the presence of dermoscopic features. Concerning the review, we researched on pubmed and records were reviewed noting patient age of onset, sex, location, overall size, dermoscopic appearance...
October 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Omeshwar Singh, Sanjeev Gupta, Mohammad Azhar Ud Din Darokhan, Shakeel Ahmad, Sumeet Singh Charak, Anuradha Sen
Background: Trauma is emerging as an epidemic and a leading cause of morbidity and mortality in children. Children <15 years of age comprise about 32.8% or about 1/3rd of the total Indian population. In India, up to one fourth of hospital admissions and approximately 15% of deaths in children are due to injury. This study presents the epidemiology, various causes and pattern of musculoskeletal injuries in pediatric population of North India. Materials and Methods: This is an observational, prospective hospital-based study conducted in a tertiary care center of North India for 6 months from July to December 2016...
September 2018: Indian Journal of Orthopaedics
M Catherine Sargent
Use of a single-leg spica cast for femoral fractures in ambulatory children 1 to 5 years of age facilitates care and mobilization of the patient. It may allow a shorter duration of cast treatment than is possible with a traditional one and one-half-leg spica cast, particularly in patients 1 to 3 years of age. The single-leg spica is indicated for children who are small enough to be lifted safely in the cast and who have an isolated, closed, low-energy femoral shaft fracture. The procedure consists of the following steps:Step 1: Obtain adequate sedation...
September 28, 2017: JBJS Essential Surgical Techniques
Pietro Persiani, Filippo Maria Ranaldi, Lorena Martini, Anna Zambrano, Mauro Celli, Patrizia D'Eufemia, Ciro Villani
Osteogenesis imperfecta (OI) is a rare congenital osteodystrophy. Patients with OI present with osteoporosis, extreme bone fragility and severe deformities of the lower limbs, which predispose them to frequent fractures. The aim of our study is to describe the minimally invasive osteotomy technique to correct the tibial deformities in patients with OI type III, using the Fassier-Duval (FD) intramedullary nailing, which is considered the gold standard in this kind of surgery. We analyzed the results obtained from 14 patients with OI type III, treated for tibial deformities with the minimally invasive percutaneous osteotomy technique and osteosynthesis with the FD telescopic nail...
September 12, 2018: Journal of Pediatric Orthopedics. Part B
Kenichi Mishima, Hiroshi Kitoh, Masaki Matsushita, Tadashi Nagata, Yasunari Kamiya, Naoki Ishiguro
Localized scleroderma, also known as morphea, is a rare condition characterized by progressive sclerosis of the skin and associated atrophy of the underlying tissues. The linear type of localized scleroderma is the most frequent form in childhood, usually affecting unilateral extremities. Fibrosclerosis of the fasciae and muscles can spread across joints and impair the range of motion of the joint. Dysplastic and/or atrophic bones of the affected lower extremity can lead to clinically significant leg length discrepancy (LLD)...
2018: Case Reports in Orthopedics
Eun Seok Choi, Jae Ho Jang, Jae Hyug Woo, Ji Uk Choi, Jin Seong Cho, Hyuk Jun Yang
PURPOSE: Trampoline-related injuries are steadily increasing. To our knowledge, there have been very few studies on trampoline injuries in Asia. The purpose of this study is to report the characteristics of pediatric trampoline injuries in Korea. MATERIALS AND METHODS: We conducted a nationwide retrospective cohort study. Data were collected from prospective nationwide databases (Emergency Department-based Injury In-depth Surveillance databases of the Korea Centers for Disease Control and Prevention) for patients who visited emergency departments (EDs) after injuries during 2011-2016...
October 2018: Yonsei Medical Journal
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