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pediatrics orthopedics

Lei Tong, Mingjing Li, Fan Li, Jian Xu, Tao Hu
The aim of this study was to analyze the management of displaced intra-articular calcaneal fractures in children at our pediatric orthopedic and to determine the results following open reduction via minimally invasive sinus tarsi approach and fixation with Kirschner wires (K-wires). Overall, 25 available cases of calcaneal fractures in children with mean age of 9.8 years were treated by open reduction from January 2010 to December 2015. All patients were followed up from 12 to 30 months (mean: 19 months). Clinical functional outcomes were graded using the American Orthopedic Foot and Ankle Society hindfoot scores...
August 15, 2018: Journal of Pediatric Orthopedics. Part B
Thomas A Boyle, Kittu A Rao, Davis B Horkan, Marguerite L Bandeian, Juan E Sola, Charles A Karcutskie, Casey Allen, Eduardo A Perez, Edward B Lineen, Anthony R Hogan, Holly L Neville
BACKGROUND: Unintentional injury is the leading cause of death in children and adolescents. Injuries occurring during boating and recreational water sports are poorly described in the literature. Herein, we compare injuries from water sports to those resulting from motor vehicle collisions, which are better described in existing literature. METHODS: A retrospective review of 1935 consecutive pediatric trauma patients, as defined by age < 18 years, admitted to a single level-1 pediatric trauma center between January 2000 and August 2013 was performed...
August 13, 2018: Pediatric Surgery International
Fadi Bouri, Walid El Ansari, Shady Mahmoud, Ahmed Elhessy, Abdulla Al-Ansari, Mohamed Al Ateeq Al-Dosari
Pain is a challenge for orthopedic healthcare professionals (OHCP). However, pain studies examined the competencies of a single OHCP category, did not consider various pain management domains or barriers to optimal pain service, and are deficient across the Arabic Eastern Mediterranean region. We surveyed OHCP's recognition and knowledge of pain and perceived barriers to optimal pain service (361 OHCP, five hospitals). Chi square compared doctors' ( n = 63) vs. nurses/physiotherapists' ( n = 187) views. In terms of pain recognition, more nurses had pain management training, confidently assessed pediatric/elderly pain, were aware of their departments' pain protocols, and felt that their patients receive proper pain management...
August 13, 2018: Healthcare (Basel, Switzerland)
Sible Antony, Harshad Gurnaney, Arjunan Ganesh
Despite the widespread use of ambulatory continuous peripheral nerve blocks in adults, its use in children has been sporadic. Indications for the use of ambulatory continuous peripheral nerve block in children involve orthopedic procedure, where significant pain is anticipated beyond 24 hours. Techniques to place the perineural catheters in children are similar to that used in adults. The incidence of serious side effects in pediatric ambulatory continuous peripheral nerve block is extremely rare. When this is combined with the potential to increase patient and family satisfaction and decrease opioid-related side effects, ambulatory continuous peripheral nerve block become a compelling choice...
September 2018: Anesthesiology Clinics
Ting Zhang, Charles T Price, James J McCarthy, Jie Nguyen, Kenneth J Noonan
Unicameral/aneurysmal bone cysts can lead to pain, fracture, and limb deformity. In this study, the authors evaluated the outcome of triphasic bone graft to treat unicameral/aneurysmal bone cysts. They retrospectively evaluated 41 immature patients from a prospectively enrolled cohort from 2 institutions treated from May 9, 2007, to November 1, 2014. Medical record review and evaluation of radiographs and computed tomography scans were performed. The authors characterized replacement of the material by normal bone or recurrent cyst at final follow-up...
August 9, 2018: Orthopedics
Laura W Lewallen, Amy L McIntosh, S Andrew Sems
The purpose of this study was to determine whether pelvic fracture pattern is associated with transfusion requirements or concomitant injuries in pediatric patients. This was a single-institution, retrospective review from 1970 to 2000. Pelvic ring injuries were classified using the Orthopaedic Trauma Association system. Injury Severity Scores were assigned. Ninety patients were included in this study. There were 27 A-type (30.0%), 51 B-type (56.7%), and 12 C-type (13.3%) injuries. Mean Injury Severity Scores were 8...
August 9, 2018: Orthopedics
Jéssica S Venturine, Gabriel M T Pires, Monique L Pereira, Michelle G M Monteiro, Ney Meziat-Filho, Leandro C Nogueira, Felipe J J Reis
Background: Education about pain (pain education) for health professionals during undergraduate studies may be an important step in changing ineffective pain management practices. Objective: The objective of this study was to assess the extent of pain education in current accredited physical therapist education programs in Brazil. Design: This study was designed as a cross-sectional (survey) study. Methods: Brazilian physical therapist education programs accredited by the Ministry of Education participated in this study...
August 6, 2018: Physical Therapy
N G Grün, P Holweg, S Tangl, J Eichler, L Berger, J J J P van den Beucken, J F Löffler, T Klestil, A M Weinberg
Fracture treatment in children needs new implant materials to overcome disadvantages associated with removal surgery. Magnesium-based implants constitute a biocompatible and bioresorbable alternative. In adults and especially in children, implant safety needs to be evaluated. In children the bone turnover rate is higher and implant material might influence growth capacity, and the long-term effect of accumulated particles or ions is more critical due to the host's prolonged post-surgery lifespan. In this study we aimed to investigate the degradation behavior of ZX00 (Mg-0...
July 29, 2018: Acta Biomaterialia
Eric W Edmonds, John W Kemppainen, Joanna H Roocroft, John Munch, Tracey P Bastrom
Maintenance of certification (MOC) within a medical society requires continuing medical education that demonstrates life-long learning, cognitive expertise, and practice-based self-assessment. This prospective study sought to evaluate whether a self-directed Practice Improvement Module (PIM) would improve pediatric orthopedic patient outcomes, thus demonstrating evidence of life-long learning (Part II MOC credit) in treating supracondylar humerus fractures. Six surgeons and 113 patients were included. There was no significant difference in actual fracture outcome before or after PIM at any level of surgeon experience regarding radiographic appearance or need for reoperation ( p > 0...
2018: Advances in Orthopedics
Seema Toso, Meryle Laurent, Elise Dupuis Lozeron, Pauline Brindel, Marirosa Cristallo Lacalamita, Sylviane Hanquinet
BACKGROUND: Increased computational power allows computed tomography (CT) software to process very advanced mathematical algorithms to generate better quality images at lower doses. One such algorithm, iterative metal artifact reduction (iMAR) has proven to decrease metal artifacts seen in CT images of adults with orthopedic implants. OBJECTIVES: To evaluate artifact reduction capability of the algorithm in lower-dose pediatric CT compared to our routine third-generation advanced modeled iterative reconstruction (ADMIRE) algorithm...
July 28, 2018: Pediatric Radiology
Stefan Bogdanov, Naomi Brookes, Adrienne Epps, Sharon L Naismith, Arthur Teng, Suncica Lah
OBJECTIVES: To characterize the sleep disturbance in children with moderate or severe traumatic brain injury (TBI), and to identify associated factors. SETTING: An urban tertiary pediatric healthcare facility. PARTICIPANTS: Children aged 5 to 15 years with a moderate TBI (n = 21), severe TBI (n = 23), or an orthopedic injury (OI; n = 38) comparable in age, gender, and socioeconomic status. DESIGN: Cohort study. MEASURES: Primary: Sleep Disturbance Scale for Children (SDSC)...
July 24, 2018: Journal of Head Trauma Rehabilitation
Erin D Bigler, Chris Finuf, Tracy J Abildskov, Naomi J Goodrich-Hunsaker, Jo Ann Petrie, Dawn-Marie Wood, John R Hesselink, Elisabeth A Wilde, Jeffrey E Max
This investigation explored whether differences in cortical thickness could be detected in children who sustained a mild traumatic brain injury (mTBI) compared to those with orthopedic injury (OI) and whether cortical thickness related parental reporting of symptoms. To achieve this objective, FreeSurfer®-based cortical thickness measures were obtained in 330 children, 8 to 15 years of age, with either a history of mTBI or OI. Imaging was performed in all participants with the same 3 Tesla MRI scanner at six-months post-injury, where a parent-rated Post-Concussion Symptom Inventory (PCSI) was also obtained...
July 21, 2018: International Journal of Psychophysiology
Corey Montgomery, Austin Porter, Christopher Parks, Brant Sachleben, R Dale Blasier, Brien Rabenhorst
Football remains a popular sport in the United States despite sometimes significant injuries, such as fractures and dislocations, occurring. The objective of this study was to evaluate pediatric extremity fractures and dislocations related to football. A retrospective review was conducted at a level 1 pediatric trauma center to identify patients who were treated specifically for American football-related injuries (International Classification of Diseases, Ninth Revision, code E007.0). All patients with football-related injuries presenting to the emergency department during a 6-year period (2007-2012) were reviewed for inclusion in the study...
July 1, 2018: Orthopedics
Z Deniz Olgun, Stephanie Maestre
PURPOSE OF REVIEW: Summarize classic and recent information regarding the unique subset of ankle fractures in children with open growth plates and share the authors' decision-making and surgical techniques. RECENT FINDINGS: Recent research on pediatric ankle fractures has centered on the accurate prediction and prevention of growth arrest following fractures of the distal tibia. Another source of discussion is the necessity and benefit of CT scanning in classification and treatment approach...
July 9, 2018: Current Reviews in Musculoskeletal Medicine
Emily Foxen-Craft, Eric L Scott, Kristin A Kullgren, Reilly Philliben, Caroline Hyman, Marianna Dorta, Anne Murphy, Terri Voepel-Lewis
BACKGROUND: Pain location and widespread pain are important but underexamined dimensions of pediatric pain. Body map tools to assess pain location in youth have been used for several decades, but few studies have established reliability and validity of these measures. The purpose of this study was to explore the reliability and validity of a pain body map among youth with orthopedic conditions before surgery. METHOD: Youth ages 10-17 years completed the body map and other self-reported outcomes at their preoperative clinic visit and at their day of surgery...
July 5, 2018: European Journal of Pain: EJP
Jonathan Bourget-Murray, Mathew A Clarke, Sydney Gorzitza, Lisa A Phillips
BACKGROUND: Venous thromboembolism, specifically pulmonary embolism, is a rare complication following elective pediatric orthopedic surgery. Bilateral pulmonary embolism with associated pulmonary hemorrhage/infarct without concomitant deep vein thrombosis has never been reported following routine anterior cruciate ligament reconstruction in an adolescent. CASE PRESENTATION: A 16-year-old white girl presented with acute onset shortness of breath and pleuritic chest pain 6 days following elective anterior cruciate ligament reconstruction...
July 6, 2018: Journal of Medical Case Reports
Nicholas P Guys, Ahsan Mir, Peter F Svider, Anthony Sheyn
OBJECTIVES: Swimming has been reported as the most common recreational activity among American youths, while diving remains a popular youth activity as well. We characterize the most common facial injuries occurring during these activities and evaluate facial fracture mechanisms and demographic trends, as this information may be helpful in preventative counseling as well as diagnosis. METHODS: The National Electronic Injury Surveillance System was assessed for swimming- and diving-related facial injuries in children from 2007 to 2016...
August 2018: International Journal of Pediatric Otorhinolaryngology
Kelly Carmichael, Daniel Torres, Carlos J Jimenez, Matthew C Comley, Ernest B Evans
In this article, we report a case series on spanning external fixation for the treatment of open joint burn injuries in a pediatric population. We reviewed the case logs of all orthopedic surgeons from 2000 to 2010 at a burn hospital to identify pediatric patients with open joints secondary to burn injuries. Nine patients who sustained open joint injuries after a burn and treated with a spanning external fixator (SEF) were identified. Characteristics of the burns included: five elbow, four knee; seven flame, two electrical; average total body surface area affected 49...
April 16, 2018: Curēus
Yoon Hae Kwak, Jae-Hyun Kim, Young-Chang Kim, Kun-Bo Park
Background and purpose: Closed reduction and lateral-only pin fixation is one of the common treatment methods for displaced supracondylar fracture in children. However, several risk factors related to the stability have been reported. The aim of this study was to evaluate the medial comminution as a potential risk factor related to the stability after appropriate lateral-only pin fixation for Gartland type III supracondylar humerus fracture. Methods: Sixty-seven patients with type III supracondylar fractures who were under the age of 12 years were included...
2018: Therapeutics and Clinical Risk Management
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
June 15, 2018: Pediatric Critical Care Medicine
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