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Pediatric upper extremity

Branislav Kollar, Sotirios Tasigiorgos, Miguel I Dorante, Matthew J Carty, Simon G Talbot, Bohdan Pomahac
In the past 20 years, reconstructive transplantation (RT) has emerged as a viable reconstructive option for carefully selected patients. More than 100 upper extremity and 40 face transplants have been performed worldwide to date. Concomitantly, the portfolio of reconstructive transplantation has been extended by additional procedures such as lower extremities, abdominal wall, neck, uterus, genitourinary, and pediatric transplants. In the present review article, we aim to summarize the current state of knowledge about this exciting field...
August 11, 2018: Journal of Surgical Oncology
William D Gerull, Ugochi C Okoroafor, Jason Guattery, Charles A Goldfarb, Lindley B Wall, Ryan P Calfee
BACKGROUND: This study was designed to quantify the performance of the pediatric Patient-Reported Outcome Measurement Information System (PROMIS) when delivered as part of routine care to children with upper extremity (UE) fractures. METHODS: This cross-sectional study analyzed 964 new pediatric patients presenting with an UE fracture. All patients completed PROMIS computer adaptive tests for pain interference, peer relationships, UE function, and mobility domains at clinic registration...
August 6, 2018: Hand: Official Journal of the American Association for Hand Surgery
Shaun D Mendenhall, Stav Brown, Oded Ben-Amotz, Michael W Neumeister, L Scott Levin
BACKGROUND: Upper extremity transplantation is a quality-of-life enhancing treatment for select patients with upper extremity loss. This article reviews the preoperative, intraoperative, and postoperative challenges in the upper extremity transplantation process and the lessons learned from the first 2 decades of hand transplantation. METHODS: Key components of the author's hand transplantation protocol including patient selection, donor screening, surgical rehearsal, donor procurement, transplantation, immunosuppression, and patient outcome reporting/follow-up are reported to assist other teams who wish to establish a hand transplantation program...
July 31, 2018: Hand: Official Journal of the American Association for Hand Surgery
Maria L Avila, Brian M Feldman, Suzan Williams, Leigh C Ward, Madeline I Montoya, Jennifer Stinson, Alex Kiss, Jennifer Vincelli, Celeste Lumia, Leonardo R Brandão
Background: Pediatric tools for diagnosis of post-thrombotic syndrome (PTS) include the assessment of limb edema as a symptom (patient/proxy-reported) and as a sign. However, it is unclear whether these two approaches refer to the same clinical aspect of PTS. This could result in overestimation of disease severity. We sought to evaluate the correlation among different techniques to assess limb edema as a sign and as a symptom in children who sustained upper extremity (UE) or lower extremity (LE) deep vein thrombosis (DVT) and were, therefore, at risk of PTS...
July 2018: Research and Practice in Thrombosis and Haemostasis
Maria L Avila, Jennifer Stinson, Celeste Lumia, Suzan Williams, Madeline I Montoya, Brian M Feldman, Leonardo R Brandão
Essentials: <AbstractText Label="Background" NlmCategory="UNASSIGNED">Symptoms and function in pediatric post-thrombotic syndrome (PTS) remain poorly characterized. Methods: The present cross-sectional study describes the characteristics of pain, other symptoms, and impaired function in pediatric PTS in a cohort of children with history of upper or lower limb deep vein thrombosis and PTS diagnosis. The frequency of clinical findings was compared between patients with and without pain, and between patients with upper and lower extremity PTS...
April 2018: Research and Practice in Thrombosis and Haemostasis
Ahmed A M Ezzat, Mohamed A R Soliman, Amr A Hasanain, Mohamed A Thabit, Hesham Elshitany, Hitham Kandeel, Sameh H Abdel-Bari, Ahmed Ghoul, Ahmed Abdullah, Mohamed F M Alsawy, Ammar Ali, Ahmed Al Menabbawy, Ahmed A Marei, Bassante Abd El Razik, Henry W S Schroeder, Sascha Marx, Ahmed Zohdi, Ehab El Refaee
BACKGROUND: Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in the treatment of hydrocephalus. VP shunt migration can occur at different sites. The aim of the study was to present different sites of abnormal distal shunt location, pathophysiology and the management in each situation. METHODS: Between 2014 and 2017 all patients with hydrocephalus in the department of neurosurgery, Cairo University, were gathered in a prospectively. All pediatric patients below the age of 12 years with shunt migration of the distal end of the VP shunt were identified...
July 19, 2018: World Neurosurgery
Ivan Baltadzhiev, Ina Geneva, Nedialka Popivanova
Guillain-Barré syndrome (GBS) belongs to the group of peripheral immune-mediated neuropathies often preceded by an inflammatory episode. GBS is rarely associated with hepatitis A virus (HAV) infection, the latter as a rule antecedent of the neurological disorders. This association is quite rare in childhood, and so far, only isolated cases have been described. We report an unusual case of pediatric GBS which development coincided with the development of HAV IgM (+) viral hepatitis A. From the second to the 14th day after admission to the hospital for mild jaundice of the skin and sclera in a 12-yr-old boy, the following neurological disorders have developed: absent Achilles and knee-jerk reflexes, diminished brachioradialis reflex, moderately decreased muscle power in the upper extremities and more pronounced power loss in the lower extremities...
2018: Iranian Journal of Child Neurology
Carla Moscheo, Alessandro Campari, Marta Giorgia Podda, Giovanna Riccipetitoni, Paola Collini, Salvatore Lorenzo Renne, Claudio Vella, Marcello Napolitano, Roberto Luksch
INTRODUCTION: Peripheral neuroblastic tumors (PNTs) account for 8%-10% of all pediatric tumors. Adrenal glands and sympathetic ganglia are the commonest site of tumor growth. In the clinicopathologic spectrum of PNTs, neuroblastoma and ganglioneuroma are the most primitive and the most mature tumor form, while ganglioneuroblastoma represents an intermediate state of maturation. Surgical resection is the therapy of choice in localized disease, but can lead to serious complications when performed in the presence of certain imaging-defined risk factors...
July 1, 2018: Tumori
María Consuelo Giordano L, Alicia de la Fuente L, María Bernardita Lorca J, Daniela Kramer H
INTRODUCTION: Nail alterations in children are an important cause of parent anxiety and derive in multiple and unnecessary consultations. The onychomadesis corresponds to the complete and pain less detachment of the nail plate from the proximal fold. This self-resolving nail finding has been described as a late complication of hand-foot-mouth disease, a frequent viral exanthema in the pedia tric age. OBJECTIVE: To describe a classic pediatric case of hand-foot-mouth disease with subsequent onychomadesis...
June 2018: Revista Chilena de Pediatría
Karan Dua, Charles J Blevins, Nathan N O'Hara, Joshua M Abzug
BACKGROUND: Closed reduction and percutaneous pinning (CRPP) is traditionally performed following full surgical prep and draping. The semisterile technique utilizes minimal prep and draping, which was proven to be a viable alternative when treating pediatric supracondylar humerus fractures. The purpose of this study was to investigate the safety and benefits of the semisterile technique for CRPP of pediatric upper extremity fractures. METHODS: A retrospective cohort study was conducted of pediatric patients who underwent CRPP of an upper extremity fracture over a 4-year period...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Young Mee Choi, Kristen Campbell, Claire Levek, John Recicar, Steven Moulton
INTRODUCTION: Antibiotic or silver-based dressings are widely used in burn wound care. Our standard method of dressing pediatric extremity burn wounds consists of an antibiotic ointment or nystatin ointment-impregnated nonadherent gauze (primary layer), followed by rolled gauze, soft cast pad, plaster and soft casting tape (3M™ Scotchcast™, St. Paul, MN). The aim of this study was to compare our standard ointment-based primary layer versus Mepitel Ag® (Mölnlycke Health Care, Gothenburg, Sweden) in the management of pediatric upper and lower extremity burn wounds...
June 18, 2018: Journal of Pediatric Surgery
Kathleen D Rickert, Pooya Hosseinzadeh, Eric W Edmonds
BACKGROUND: Skeletal trauma is a primary tenet of pediatric orthopaedics. Many high-quality studies have been published over the last few years with substantial relevance to the clinical practice of pediatric orthopaedic trauma. Because of the volume of literature on the subject, this review excludes upper extremity trauma and focuses on the publications affecting the lower extremity. METHODS: An electronic search of the PubMed database was performed utilizing keywords for pediatric lower extremity trauma: pelvic injuries, femur fractures, tibial shaft fractures, femur fractures, ankle fractures, and foot fractures...
July 2, 2018: Journal of Pediatric Orthopedics
Pooya Hosseinzadeh, Clarabelle A DeVries, Ena Nielsen, Lindsay A Andras, Megan Mignemi, Jeffrey R Sawyer, John M Flynn, Stephen A Albanese
BACKGROUND: There has been an increase in the number of the graduates of pediatric orthopaedic fellowship programs over the past decade creating the potential for increased competition in the field. The purpose of this study was to analyze the effect of increased number of pediatric orthopaedic fellowship graduates on case volume as well as the type of procedures performed by recent graduates of pediatric orthopaedic fellowship programs from 2004 to 2014. METHODS: Case logs submitted for the American Board of Orthopaedic Surgery Part II examination by applicants with the self-declared subspecialty of pediatric orthopaedics from 2004 to 2014 were analyzed...
June 18, 2018: Journal of Pediatric Orthopedics
Joseph R Keen, Robert E Ayer, Asma Taha, Alexander Zouros
STUDY DESIGN: Retrospective review. OBJECTIVE: Evaluate radiographic and clinical outcomes for the largest and youngest series of children, who underwent rigid occipito-cervical fixation for traumatic craniocervical dissociation (tCCD). SUMMARY OF BACKGROUND DATA: Traumatic craniocervical dissociation is devastating. Children are at high risk but make up a large number of survivors. Non-rigid fixation has traditionally been favored over screw and rod constructs due inherent challenges involved with instrumenting the pediatric craniocervical junction...
June 11, 2018: Spine
Venus Vakhshori, Gabriel J Bouz, Cory K Mayfield, Ram K Alluri, Milan Stevanovic, Alidad Ghiassi
BACKGROUND: Traumatic upper extremity amputation in a child can be a life-altering injury, yet little is known about the epidemiology or health care costs of these injuries. In this study, using the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID), we assess these trends to learn about the risk factors and health care costs of these injuries. METHODS: Using the HCUP KID from 1997 to 2012, patients aged 20 years old or younger with upper extremity traumatic amputations were identified...
May 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Jonathan Stevens G, María Teresa Dossi C, Gianna Muñoz M
INTRODUCTION: Flagellated dermatitis is an infrequent pathology, with characteristic skin lesions, which is developed due to the use of bleomycin. Clinically it occurs as erythematous or hyperpigmented maculae of linear disposition with flagellar pattern, in trunk and/or upper extremities. It presents self-limited evolution, therefore, its treatment varies from expectant management to the use of topical or oral corticosteroids. OBJECTIVE: Presentation of a clinical case of flagellated dermatitis secondary to bleomycin in a pediatric patient with history of central nervous system neoplasia...
April 2018: Revista Chilena de Pediatría
Ru-Lan Hsieh, Hui-Ling Peng, Wen-Chung Lee
BACKGROUND: Limited evidence is available regarding the effects of insoles on pediatric flexible flatfoot because of the heterogeneity and low methodological quality of previous studies. The purpose of this prospective trial is to examine the short-term effects of customized arch support insoles on symptomatic flexible flatfoot in children by using the International Classification of Functioning, randomized controlled Disability, and Health (ICF) framework. METHODS: This study was conducted in a rehabilitation outpatient clinic of a teaching hospital...
May 2018: Medicine (Baltimore)
Menno van der Holst, Yvonne Geerdink, Pauline Aarts, Duco Steenbeek, Willem Pondaag, Rob Ghh Nelissen, Alexander Ch Geurts, Thea Pm Vliet Vlieland
OBJECTIVE: To investigate construct validity and test-retest reliability of the parent-rated Hand-Use-at-Home questionnaire (HUH) in children with neonatal brachial plexus palsy or unilateral cerebral palsy. DESIGN AND SUBJECTS: For this cross-sectional study, children with neonatal brachial plexus palsy or unilateral cerebral palsy, aged 3-10 years, were eligible. MAIN MEASURES: The HUH, Pediatric Outcome Data Collection Instrument Upper Extremity Scale (neonatal brachial plexus palsy only), and Children's Hand-Use Experience Questionnaire (unilateral cerebral palsy only) were completed...
May 1, 2018: Clinical Rehabilitation
Emily S Ho, Anne Ayling Campos, Karen Klar, Kristen Davidge
STUDY DESIGN: Narrative Review. INTRODUCTION: Hand surgeons and therapists play an important role in the early identification of children at risk of developing chronic or recurrent pain after an upper extremity injury. Early identification of children at risk of developing a pain syndrome is critical because their physical, psychological, and/or social functioning may decline quickly without proper management due to the multidimensional nature of pain. PURPOSE OF THE STUDY: This article outlines one approach to evaluating upper extremity pain in children to help identify those with, or at risk of, chronic pain...
April 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Ke Shi, Hong-Ling Gao, Zhi-Gang Yang, Hui-Jie Feng, Xi Liu, Ying-Kun Guo
PURPOSE: As an extremely rare abnormity, type IIA pulmonary artery sling (PAS) tracheobronchial anomalies should be differentiated from normal airway for therapeutic decision-making. This study aimed to investigate the quantitative characteristics of type IIA PAS tracheobronchial anomalies using dual-source computed tomography (DSCT). MATERIALS AND METHODS: From January 2009 to December 2016, there were 11 type IIA PAS patients enrolled for analysis and compared with 32 controls...
May 2018: European Journal of Radiology
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