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pediatrics orthopedics

P Osateerakun, I Thara, N Limpaphayom
PURPOSE: Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training. METHODS: The medical records of 87 children (87 elbows) with an average age of 5.9 ± 3.1 (range 1.3-14.1) years with SCHF Gartland 2 and 3 who underwent operative fixation were reviewed...
December 4, 2018: Musculoskeletal Surgery
Joshua T Bram, Andrew J Gambone, Christopher J DeFrancesco, Brendan M Striano, Theodore J Ganley
Joint immobilization after anterior cruciate ligament (ACL) reconstruction may lead to intra-articular adhesions and range of motion deficits. Some practitioners thus advocate for the use of postoperative continuous passive motion (CPM) machine protocols. However, previous studies have failed to show CPM to be effective in increasing postoperative range of motion. Continuous passive motion has, however, been shown to reduce rates of arthrofibrosis requiring manipulation under anesthesia (MUA) in adult populations...
November 26, 2018: Orthopedics
Christopher A Iobst
The ability to correct limb deformities is one of the core elements of pediatric orthopedics. The term, orthopedics, is derived from the Greek language and means straightening (ortho) children (paidos). New advances in the evaluation and management of children with limb alignment or limb length issues are constantly appearing. This review highlights some of the recent technologies that have been developed to improve the care of these children.
January 2019: Orthopedic Clinics of North America
Eliane Rioux Trottier, Marie Beauséjour, Stéphanie Lamer, Peter Glavas, Guy Grimard, Marie-Lyne Nault
PURPOSE: The Knee Injury Osteoarthritis Outcome Score (KOOS) questionnaire is one of the frequently used outcome scores in pediatric studies. However, a recent study demonstrated that the pediatric population had a limited understanding of some of its questions. Therefore, the KOOS-Child questionnaire was developed specifically for this population. Our team produced a French adaptation based on the English version. The objective of the current study was to validate the French adaptation of the KOOS-Child questionnaire...
November 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Ugonna E Ezeh, Harper N Price, Mohan V Belthur
We report on a rare case of allergic contact dermatitis (ACD) from Mastisol liquid adhesive. We are aware of a few reports in the medical literature, but none describes an allergic reaction during the third exposure to the offending agent. Our patient was a 20-year-old Caucasian man with a history of cerebral palsy spastic hemiplegia who underwent single-event multilevel soft-tissue surgery to optimize function of his left upper extremity. He developed a severe cutaneous allergic reaction after his third exposure to Mastisol...
September 2018: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Antoinette Esce, David A Rodeberg, David H Rothstein, Marybeth Browne, Derek Wakeman
BACKGROUND: Team training programs adapt crew resource management principles from aviation to foster communication and prevent medical errors. Although multiple studies have demonstrated that team training programs such as TeamSTEPPS improve patient outcomes and safety across medical disciplines, limited data exist about their application to pediatric surgical teams. The purpose of this study was to investigate usage and perceptions of team training programs by pediatric surgeons and anesthesiologists...
December 2018: Journal of Surgical Research
Elena Boccuzzi, Valentina A Ferro, Bianca Cinicola, Paolo M Schingo, Luisa Strocchio, Umberto Raucci
Leukemia is the most common childhood malignancy, and it is often characterized by pallor, fatigue, cytopenia, and organomegaly; sometimes musculoskeletal symptoms, mainly characterized by diffuse bone pain in the lower extremities, are the onset clinical characteristics of the disease. In these cases, the disease may initially be misdiagnosed as reactive arthritis, osteomyelitis, or juvenile idiopathic arthritis delaying appropriate diagnosis and management. Even if leukopenia, thrombocytopenia, and a history of nighttime pain are reported to be the most important predictive factors for a pediatric leukemia, blood examinations can sometimes be subtle or within normal limits, and this represents a further diagnostic difficulty...
November 19, 2018: Pediatric Emergency Care
J Syvänen, I Helenius, E Koskimies-Virta, A Ritvanen, S Hurme, Y Nietosvaara
BACKGROUND AND AIMS: There are no population-based studies about hospital admissions and need for surgical treatment of congenital lower-limb deficiencies. The aim is to assess the impact children with lower-limb deficiencies pose to national hospital level health-care system. MATERIALS AND METHODS: A population-based study was conducted using the national Register of Congenital Malformations and Care Register for Health Care. All 185 live births with lower-limb deficiency (1993-2008) were included...
November 19, 2018: Scandinavian Journal of Surgery: SJS
Lanair Amaad Lett, Whitney U Orji, Ronnie Sebro
OBJECTIVE: To evaluate trends in racial, ethnic, and sex representation at US medical schools across 16 specialties: internal medicine, pediatrics, surgery, psychiatry, radiology, anesthesiology, obstetrics and gynecology, neurology, family practice, pathology, emergency medicine, orthopedic surgery, ophthalmology, otolaryngology, physical medicine and rehabilitation, and dermatology. Using a novel, Census-derived statistical measure of diversity, the S-score, we quantified the degree of underrepresentation for racial minority groups and female faculty by rank for assistant, associate, and full professors from 1990-2016...
2018: PloS One
Katherine Stenman, Jennifer Christofferson, Melissa A Alderfer, Jessica Pierce, Carrie Kelly, Elizabeth Schifano, Samantha Klaff, Jennifer Sciolla, Janet Deatrick, Anne E Kazak
Children and their family members may experience potentially traumatic events during medical treatment that can result in pediatric medical traumatic stress reactions. Play is a normative part of childhood that may facilitate engagement in medical care and may be incorporated in trauma-informed care. This qualitative study used semistructured interviews to examine the role of play and its potential use in trauma-informed care. The perspectives of 30 multidisciplinary pediatric healthcare providers representing 5 divisions (Cardiology, Endocrinology, Oncology, Orthopedics, Pulmonology) in 2 children's hospitals were gathered...
November 15, 2018: Psychological Services
Hugo Rodrigues, Ricardo Cobucci, Antônio Oliveira, João Victor Cabral, Leany Medeiros, Karen Gurgel, Tházio Souza, Ana Katherine Gonçalves
BACKGROUND: Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). OBJECTIVE: To estimate burnout among different medical residency specialties. METHODS: A systematic review with meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases and grey literature was conducted, from inception to March 2018...
2018: PloS One
Lokesh Shah, Jobayer Hossain, Shirlly Xie, Joshua Zaritsky
BACKGROUND: Children who were born prematurely, those with a very low birthweight, or who have survived the neonatal intensive care unit (NICU) are at risk for the development of hypertension and chronic kidney disease (CKD), and thus require blood pressure screening less than 3 years of age, per American Academy of Pediatrics (AAP) 2004 and 2017 guidelines. METHODS: We reviewed the practice patterns of a large pediatric health care system and assessed adherence to the AAP clinical practice guidelines on blood pressure measurements in children less than 3 years of age for hypertension and CKD with the following risk factors: prematurity, very low birthweight, and a neonatal intensive care setting encounter...
November 7, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Thomas R Stark, Manuel Pozo-Alonso, Raj Daniels, Macario Camacho
Pediatric obstructive sleep apnea (OSA) is a serious medical condition with numerous health consequences. Dentists are well suited to recognize and provide medical referrals for pediatric patients at risk for OSA. Timely dental sleep medicine interventions may improve signs and symptoms of OSA in growing children. Orthodontic and dentofacial orthopedic treatment may decrease obstructive respiratory events in some pediatric patients. Palatal expansion may be part of a comprehensive orthodontic treatment plan to correct a malocclusion and treat OSA...
December 2018: Sleep Medicine Clinics
Jin Wan, Jing Feng, Fan Li, Jian Xu, Ming-Jing Li, Tao Hu
BACKGROUND Displaced intra-articular calcaneal fractures (DIACF) are a serious injury and are clinically considered to be an important source of disability. This study investigated therapeutic effects of internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision in pediatric DIACF. MATERIAL AND METHODS This retrospective study included pediatric DIACF patients admitted to our department from June 2010 to February 2014. Patients were divided into Sanders II, Sanders III, and Sanders IV groups...
November 3, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Michael Gottlieb, Kimbia Arno, Matthew Kuhns, Teresa M Chan
Introduction: There are over 200 emergency medicine (EM) residency programs in the United States. While there are basic criteria defined by the Accreditation Council for Graduate Medical Education (ACGME), there can be significant variation between programs with regard to rotation distribution. Therefore, it would be valuable to have a benchmark for programs to understand their rotation mix in the context of the national landscape. This study aimed to provide a breakdown of the length and percentage of EM residency programs with each clinical rotation in the United States...
October 2018: AEM education and training
Jane M Wick, Jing Feng, Ellen Raney, Michael Aiona
Cerebral palsy (CP) is a common motor disability that may be congenital or acquired. Children with CP often have gait, balance, and posture abnormalities, some of which may be severe enough to interfere with safe ambulation or other activities of daily living. Nonsurgical and surgical interventions are part of the management plan for children with CP. Historically, surgeons addressed gait deviations individually and sequentially with single-level surgeries. However, computerized motion analysis and advances in orthopedic internal fixation devices have improved the outcomes for patients undergoing single-event multilevel surgery...
November 2018: AORN Journal
Yoshino Ueki, Eisuke Sakuma, Ikuo Wada
We describe the pathology and treatment of flexible flat foot in children. The flexible flat foot is seen in the overly flexible foot and usually involves hypermobility of the subtalar joint. It typically occurs in childhood and may continue to adulthood. The arch develops spontaneously during the first decade of life in most children and comes within the normal range observed in adult feet. We prescribed orthoses for the treatment of flexible flat foot patients. Lateral weight-bearing radiographs and ultrasonography were helpful for the evaluation of the flat foot...
October 23, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Mitchel R Obey, Joseph Lamplot, Ena D Nielsen, Lindsay M Andras, Megan Mignemi, Jeffrey Sawyer, John M Flynn, Stephen A Albanese, Pooya Hosseinzadeh
BACKGROUND: Pediatric orthopaedic surgery has become increasingly subspecialized over the past decade. The purpose of this study was to analyze the volume of pediatric sports medicine cases performed by surgeons applying for the American Board of Orthopaedic Surgeons (ABOS) Part II certification exam over the past decade, comparing caseloads according to the type(s) of fellowship completed. METHODS: The ABOS database was reviewed for all surgeons applying for the ABOS Part II certification exam from 2004 to 2014...
November 20, 2018: Journal of Pediatric Orthopedics
Ismail Hadisoebroto Dilogo, Fajar Mujadid, Retno Wahyu Nurhayati, Aryadi Kurniawan
BACKGROUND: The treatment of congenital pseudoarthrosis of the tibia (CPT) remains challenging in pediatric orthopedics due to the difficulties in bone union, continuous angulation, joint stiffness, and severe limb length discrepancy. Mesenchymal stem cells (MSCs) therapy offers a complementary approach to improve the conventional surgical treatments. Although the autologous MSC treatment shows a promising strategy to promote bone healing in CPT patients, the quality of MSCs from CPT patients has not been well studied...
October 23, 2018: Journal of Orthopaedic Surgery and Research
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
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