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pediatrics orthopedics

Norman Ramirez, Jose L Ortiz-Fullana, Norma Arciniegas, Altagracia Fullana, Pablo Valentin, Juan Carlos Orengo, Ivan Iriarte, Simon Carlo
PURPOSE: There is a lack of knowledge about whether low vitamin D levels increase the risk of pediatric low-energy fractures among Hispanic population. The objective of this study is to determine whether there is a direct relationship between low vitamin D levels and the incidence of low-energy fractures in Hispanic children. METHOD: Cases included all consecutive patients evaluated with low-energy fractures in the pediatric orthopedic clinic. The control group consisted of all pediatric patients evaluated, without fractures, who had bone and joint pain complaints in the general pediatric clinic...
October 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Masood Umer, Javeria Saeed, Nida Zahid
INTRODUCTION: Aggressive fibromatosis or Desmoid fibromatosis is a benign tumor which originated form mesenchymal tissues of the body. This tumor has strong potential of recurrence and infiltration but it does not metastasize to other organs of the body. This case series is focused to determine the treatment outcomes for pediatric patients of aggressive fibromatosis. METHODOLOGY: It is a retrospective case series conducted on 7 patients presented to section of Orthopedics, department of surgery of our institute in Karachi...
October 4, 2018: International Journal of Surgery Case Reports
Najeeb Alqarni, Ran D Goldman
Question A 2-year-old boy presented to my office 2 days after he started limping. The history, physical examination, and radiology assessment revealed a toddler's fracture (TF). I understand that there is considerable variation in practice regarding management of TF. What is the best method to confirm the diagnosis? What method should be used to immobilize the affected limb and for how long? Is follow-up with a pediatric orthopedic surgeon needed? Answer Toddler's fracture, also called childhood accidental spiral tibial fracture or CAST fracture , is a fracture unique to ambulatory infants and young children...
October 2018: Canadian Family Physician Médecin de Famille Canadien
M Denise Dowd
Trampolines hold the promise of fun and enjoyment for many children, but they are associated with a significant number of orthopedic and other injuries. Injuries vary from minor to severe, and the most common are extremity injuries. Although most injuries are associated with residential (ie, backyard) trampolines, a growing number of injuries now occur in trampoline parks. Adult supervision has not been effective for prevention. Emerging data on trampoline park-related injuries indicate that caution should be exercised in these settings as well...
October 1, 2018: Pediatric Annals
Stine B Runge, Nicolaj L Christensen, Kim Jensen, Ib E Jensen
PURPOSE: To evaluate the need for general anesthesia (GA) in MRI in children aged 4-6 years, using a multi-faceted concept, Children Centered Care (CCC), compared to a standard setup. MATERIALS AND METHODS: In this prospective study of 81 children, we developed and tested a multi-faceted concept, CCC, for MRI in children aged 4-6 without GA, comparing it to a standard setup. The CCC included: 1) an interactive app, 2) a trained pediatric team, 3) a children's lounge with a toy-scanner, and 4) a child-friendly multimedia environment in the MRI room...
October 2018: European Journal of Radiology
Amiereza Vafaee, Taghi Baghdadi, Sara Norouzzadeh
A 7-yr-old patient was referred to pediatric orthopedic clinic of Imam hospital (2016) with the diagnosis of cerebral palsy (CP). His parents were concerned about some inconsistency of his disease progression. After initial evaluations, the diagnosis of CP was incorrect. The true diagnosis was suspected and confirmed with molecular genetic analysis. A rare autosomal recessive disorder -Cockayne syndrome- was diagnosed. Although untreatable, it can be prevented by appropriate prenatal diagnostic tests for their future children...
2018: Iranian Journal of Child Neurology
Erica M Carlisle, Laura A Shinkunas, Lauris C Kaldjian
BACKGROUND: Shared decision-making (SDM) is touted as the preferred approach to clinical counseling. However, few data exist regarding whether patients prefer SDM over surgeon-guided discussions for complex surgical decision-making. Even fewer data exist regarding surgeon preferences. Such issues may be especially pronounced in pediatric surgery given the complex decision-making triad between patients/parents and surgeons. The objective of this systematic review was to evaluate patient/parent and surgeon attitudes toward SDM in pediatric surgery...
November 2018: Journal of Surgical Research
Avraam Ploumis, Vikas Trivedi, Jae-Hyuk Shin, Kirkham B Wood, Brian E Grottkau
Βackground: Both limb length inequality and scoliosis are associated with pelvic obliquity. Methods: This is an observational study of adolescents with growth potential presenting for evaluation of thoracic or thoracolumbar idiopathic scoliosis at an outpatient pediatric orthopedic clinic. Patients were evaluated for limb length discrepancy (LLD) (using bilateral femoral head height difference), pelvic obliquity (using bilateral iliac crest height difference and sacral takeoff angle), and scoliotic curve (using Cobb angle and rotation) on full spine standing radiographs...
2018: Scoliosis and Spinal Disorders
Om Lahoti, Anand Arya
Multiply injured child is a unique challenge to the medical communities worldwide. It is a leading cause of preventable mortality and morbidity in children. Common skeletal injuries include closed or open fractures of tibia and femur and pelvic injuries. Initial management focuses on saving life and then saving limb as per pediatric advanced life support and advanced trauma life support. Orthopedic management of open fracture includes splinting the limb, administration of prophylactic antibiotic, and surgical debridement of the wound when safe...
September 2018: Indian Journal of Orthopaedics
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
Robert B Lewis, Omar Hariri, Marilyn E Elliott, Chan-Hee Jo, Brandon A Ramo
BACKGROUND: Health care in America continues to place more importance on providing value-based medicine. Medicare reimbursements are increasingly being tied to this and future policy changes are expected to reinforce these trends. Recent literature has shown pediatric femur fractures in preschool-age children have equivalent clinical and radiographic outcomes when treated with spica casting or flexible intramedullary nails (IMN). We compared hospital care statistics including charges for nonoperative versus operative treatment for closed femur fractures in 3- to 6-year-olds...
September 18, 2018: Journal of Pediatric Orthopedics
Ugochi C Okoroafor, William Gerull, Melissa Wright, Jason Guattery, Brinkley Sandvall, Ryan P Calfee
PURPOSE: Although social deprivation is acknowledged to influence physical and mental health in adults, it is unclear if and how social deprivation influences perceived health in children. This study was conducted to evaluate the impact of social deprivation on Patient-Reported Outcomes Measurement Information System (PROMIS) scores in children presenting for treatment of upper extremity fractures. METHODS: This cross-sectional evaluation analyzed data from 975 new pediatric patients (8-17 years old) with upper extremity fractures presenting to a tertiary orthopedic center between June 1, 2016, and June 1, 2017...
October 2018: Journal of Hand Surgery
James Rizkalla, Matthew Jeffers, Paul Salama, Maher Rizkalla
Background: Femoral neck fractures are common injuries managed by orthopedic surgeons across the world. From pediatrics to geriatrics, disruption of the blood supply to the femoral neck is a well-recognized source of morbidity and mortality, oftentimes resulting in avascular necrosis of the femoral head. This devastating complication occurs in 10-45% of femoral neck fractures. Therefore, it is vital for orthopedic surgeons provide efficient treatment of this injury, in order to optimize the patient's potential outcome and prevent long-term sequelae...
December 2018: Journal of Orthopaedics
Sherwin Chan
Digital tomosynthesis (DTS) is an emerging technology that provides cross-sectional, three-dimensional imaging similar to computed tomography (CT) at a fraction of the radiation dose and cost. In this article, we describe multiple cases where our pediatric orthopedic surgeons have used DTS imaging to help in clinical management of fracture healing.
July 2018: Missouri Medicine
Zachary A Mosher, Jeffrey R Sawyer, Derek M Kelly
The literature within the last 10 years on MRI use in patients with orthopedic implants is reviewed. A literature search returned 15 relevant articles. Only 2 discussed pediatric patients. Overall, significant displacement of implants was infrequent. Radiofrequency-induced heating of implants differed among the studies, but most reported increases of less than 1°C. The authors conclude MRI is safe in patients with orthopedic implants because implant displacement and heating pose little risk to patients. A risk-to-benefit ratio is warranted, however, to assess the clinical utility and necessity of the study...
October 2018: Orthopedic Clinics of North America
George C Balazs, Ronald B Doria, Bobby G Yow, Ashley B Anderson, Syed I Ahmed, Jefferson W Jex
Previous studies have shown relatively high rates of inappropriate referrals to pediatric orthopedic surgery. The purpose of this study was to determine the rate of inappropriate referrals in an egalitarian healthcare system. We reviewed all 400 referrals to our pediatric orthopedic surgery practice over a 2-year period and assessed the appropriateness of each based on the American Academy of Pediatrics guidelines. A total 206 (52%) referrals were deemed appropriate. There is a high rate of inappropriate referral to pediatric orthopedic surgery even within a closed, egalitarian healthcare system...
September 15, 2018: Journal of Pediatric Orthopedics. Part B
A Hardy, V Sabatier, O Rosello, B Salauze, F Barbut, R Vialle
INTRODUCTION: Surgical site infection (SSI) following orthopedic surgery can have a substantial impact on patients and families. The rate remains high, ranging from 0.5% to 8.5% in pediatric spine surgery. It is common to allow children to bring a teddy bear (or similar toy) to the surgical ward to help reduce the stress of surgery. We hypothesize that despite their known benefits for children, teddies would increase the bacterial load in the surgical room. METHODS: A blinded descriptive study was conducted from June 2015 to September 2016...
September 13, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Sergio Charles Lozoya, Joaquín Darío Treviño Báez, Jesús María Rangel Flores, Jesús Miguel Brizuela Ventura, Omar Araiza Topete, Andrea Alcázar Juárez
Objective: The aim of this study is to estimate the inter- and intra-observer agreement of the Weiss and Milch classification systems in radiological studies of fractures of the lateral humeral condyle in pediatric patients. Methods: An agreement study was performed with non-probability sampling of consecutive cases with a sample size of a hundred radiological studies, which were evaluated by three experienced orthopedic surgeons and three resident physicians; following a thorough comparison of both inter- and intra-observer agreements over a six-week period based on the Fleiss' kappa, which was used to determine the inter- and intra-observer agreement rates of both classifications...
2018: Acta Ortopedica Brasileira
O Ruíz-Mejía, J A Oribio-Gallegos, J Pimentel-Rangel, G Valle-De Lascurain
Congenital analgesia is a rare condition, reporting in the international literature in rare cases since 1932, when it was first described. Its cause has been the subject of development of multiple theories and studies through the years. Currently various studies and experiments as its origin point mutation in the gene encoding SC9NA sodium channels, which have an important role in nociceptive transmission signals in the human body. The purpose of this study is to present two cases that were valued in the department of pediatric orthopedics at UMAE HTYOLV, patients whose insensitivity to pain has produced significant injuries that were once cause for valuation of the hospital...
March 2018: Acta Ortopédica Mexicana
Taghi Baghdadi, Nima Bagheri, Seyyed Saeed Khabiri, Hadi Kalantar
Background: Developmental dysplasia of the hip (DDH) is one of the most important and challenging conditions in the field of pediatric orthopedics; if not diagnosed and treated in time, it would lead to remarkable morbidity. Methods of treatment based on the patient's age can vary. The aim of this study is to compare the outcomes of Salter osteotomy surgery in two groups of patients under and over three years old. Methods: In this retrospective study, medical records of patients who had undergone innominate Salter osteotomy, within the past ten years, due to non-pathological DDH were collected...
July 2018: Archives of Bone and Joint Surgery
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