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Pediatric orthopedics

Vickie Plourde, Keith Owen Yeates, Brian L Brooks
OBJECTIVES: Individual differences in long-term psychosocial functioning after concussions in children and adolescents are poorly understood. The aim of the study was to investigate potential predictors of long-term psychosocial functioning and health-related quality of life in youth after prior concussion. METHODS: Participants (N=75; mean age=14.3 years old; 52% girls) with one prior concussion (n=24), multiple prior concussions (n=24), or a prior orthopedic injury and no concussion (n=27) were seen on average 2...
March 21, 2018: Journal of the International Neuropsychological Society: JINS
Ezekiel Maloney, Andrew M Zbojniewicz, Jie Nguyen, Yu Luo, Mahesh M Thapa
Ligamentous injuries of the pediatric wrist, once thought to be relatively uncommon, are increasingly recognized in the context of acute high-energy mechanism trauma and chronic axial loading, including those encountered in both recreational and high-performance competitive sports. Recent advances in MR-based techniques for imaging the pediatric wrist allow for sensitive identification of these often radiographically occult injuries. Detailed knowledge of the intrinsic and supportive extrinsic ligamentous complexes, as well as normal developmental anatomy and congenital variation, are essential to accurately diagnose injuries to these structures...
March 20, 2018: Pediatric Radiology
Annika Selvick, Rita Lloyd
The Nuss procedure has become the predominant reason for the use of metal implants by pediatric general and thoracic surgeons. Current guidelines recommend preimplant testing for all patients undergoing the Nuss procedure, which differs from the guidelines for all other orthopedic procedures. This review was done to further evaluate this discrepancy.
February 28, 2018: Dermatitis
Katarina Bojanić, Ruža Grizelj, Jurica Vuković, Lana Omerza, Marina Grubić, Tomislav Ćaleta, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: Patients with congenital diaphragmatic hernia (CDH) have a high residual morbidity rate. We compared self-reported health-related quality of life (HRQoL) between patients with CDH and healthy children. METHODS: Forty-five patients with CDH who were born from January 1, 1990, through February 15, 2015, were matched to healthy, age-matched control participants at a 1:2 ratio. The health records of the study participants were reviewed to determine comorbid conditions, and HRQoL was assessed by both the participants and their parents with the Pediatric Quality of Life Inventory (PedsQL)...
March 14, 2018: Health and Quality of Life Outcomes
Alan Blank, Norman Otsuka, Timothy Rapp
Bone abnormalities on pediatric radiographs are not uncommon findings for both the general orthopedist as well as the specialist. Although the majority of lesions encountered are benign, the treating physician should also be aware of more concerning diagnoses. General orthopedists and pediatric orthopedists should exhibit a basic level of comfort with working up and diagnosing these benign lesions. When evaluating the pediatric patient with a bone lesion it is crucial to keep in mind important aspects of the clinical history, physical exam, and radiographic findings...
March 2018: Bulletin of the Hospital for Joint Diseases
Samuel G Antoine, Alexander C Small, James M McKiernan, Ojas Shah
INTRODUCTION: Surgical subspecialty societies release clinical practice guidelines (CPGs) to provide topic-specific recommendations to healthcare providers. We hypothesize that there may be significant differences in statement strength and evidence quality both within the American Urological Association (AUA) guidelines and compared to those published by the American Academy of Orthopedic Surgeons (AAOS) and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). MATERIALS AND METHODS: CPGs issued through 2017 were extracted from the AUAnet...
February 2018: Canadian Journal of Urology
Keila M Maher, Kwadwo Owusu-Akyaw, Jingzhu Zhou, Mary Cooter, Allison K Ross, Robert K Lark, Brad M Taicher
INTRODUCTION: Surgical correction of pediatric scoliosis is associated with significant blood loss. Minimizing estimated blood loss and blood transfusion is beneficial as transfusions have been associated with increased morbidity, including risk of surgical site infections, longer hospitalizations, and increased cost. Although there is evidence that African-American or Black adults are more likely to require intraoperative blood transfusion compared with Caucasian or White adults, the reasons for this difference are unclear...
March 9, 2018: Paediatric Anaesthesia
Sungho Lim, Michael J Javorski, Pegge M Halandras, Paul C Kuo, Bernadette Aulivola, Paul Crisostomo
OBJECTIVE: Acute limb ischemia (ALI) in a pediatric patient is a rare condition but may result in lifelong disability. A paucity of evidence exists to derive treatment guidelines; some surgeons advocate conservative management over invasive measures. The purpose of this study was to evaluate the role of surgical revascularization in the pediatric population and outcomes of conservative vs surgical management. METHODS: The Healthcare Cost and Utilization Project State Inpatient Database (California, Iowa, and New York) between 2007 and 2013 was queried using International Classification of Diseases, Ninth Revision codes...
March 1, 2018: Journal of Vascular Surgery
Elizabeth W Hubbard, Anthony I Riccio
The management of pediatric fractures has evolved over the past several decades, and many injuries that were previously being managed nonoperatively are now being treated surgically. The American Academy of Orthopaedic Surgeons has developed clinical guidelines to help guide decision making and streamline patient care for certain injuries, but many topics remain controversial. This article analyzes the evidence regarding management of 5 of the most common and controversial injuries in pediatric orthopedics today...
April 2018: Orthopedic Clinics of North America
Annika Selvick, Rita Lloyd
The Nuss procedure has become the predominant reason for the use of metal implants by pediatric general and thoracic surgeons. Current guidelines recommend preimplant testing for all patients undergoing the Nuss procedure, which differs from the guidelines for all other orthopedic procedures. This review was done to further evaluate this discrepancy.
February 28, 2018: Dermatitis
Patrick M Carry, Amy K Nguyen, Glenn R Merritt, Christopher Ciarallo, Debnath Chatterjee, Jung Park, Nancy H Miller, Frank A Scott
OBJECTIVES: To use real-time ultrasonography to estimate the prevalence of persistent median arteries in a cohort of pediatric orthopedic patients. METHODS: With Institutional Review Board approval, patients between the ages of 3 months and 19 years were recruited for this cross-sectional study. Variables of interest included demographics, underlying diagnoses, and the presence of a Doppler-confirmed median artery. Ultrasonographic examinations were performed on both upper extremities by a single investigator...
February 26, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Oumama El Ezzi, Anthony S de Buys Roessingh, Michèle Bigorre, Guillaume Captier
BACKGROUND: Sebaceous nevus is a congenital malformation of the skin that usually occurs on the scalp or face. Syndromic forms do rarely exist with associated cerebral and ocular malformations. The skin lesions are pale at birth and become irregular by puberty. In the adult patient, tumors (usually benign) develop from sebaceous nevus. Their surgical excision during childhood can give a better result in terms of the definitive scar. OBJECTIVES: The aim of this study is to analyze our cases of syndromic sebaceous hamartoma, perform a review of the existing literature, and propose guidelines for the therapeutic plan...
February 16, 2018: International Journal of Dermatology
Derek T Bernstein, Lee S Haruno, Shiva Daram, John R Dawson, Wei Zhang, Scott B Rosenfeld
Staphylococcus aureus is the most common causative organism in pediatric septic arthritis, with methicillin-resistant Staphylococcus aureus (MRSA) being responsible for a significant portion of these infections. Early identification and initiation of proper treatment may improve outcomes by minimizing potential morbidity. The purpose of this study was to identify variables obtained on initial patient presentation associated with MRSA septic arthritis. Sixteen factors were retrospectively evaluated in 109 consecutive pediatric patients diagnosed with culture-confirmed septic arthritis...
February 16, 2018: Orthopedics
Aaron I Karlen, Erik J Solberg, Deborah S Quanbeck, Ann E Van Heest
OBJECTIVE: The Orthopaedic In-Training Examination (OITE) is administered annually and is used to assess medical knowledge of orthopedic surgery residents. Beginning in the 2013 to 2014 academic year, the ACGME expanded the postgraduate year (PGY)-1 curriculum from 3 to 6 months of orthopedic surgery rotations. The purpose of this study is to evaluate the effect of increased PGY-1 orthopedic surgery exposure on medical knowledge as measured by the OITE. DESIGN: From 2011 to 2013, 24 PGY-2 residents completed 3 months of PGY-1 orthopedic training (Group 1)...
February 12, 2018: Journal of Surgical Education
Gaetano Ierardo, Valeria Luzzi, Iole Vozza, Antonella Polimeni, Maurizio Bossù
BACKGROUND: Reverse headgear (a facial mask) is one of the most frequently used interceptive orthodontic devices in patients with Class III malocclusion. It is a simple device but may present some drawbacks related to pressure on the skin generated by the forehead and chin supports linked to the maxillary intraoral appliance by elastics. This can cause injury to the chin and lips. METHODS: Patients between 7 and 8 years of age were selected from the Unit of Pediatric Dentistry...
April 2018: Minerva Stomatologica
Jun Wu, Hongxi Guo, Xing Liu, Ming Li, Yujiang Cao, Xiangyang Qu, Hai Zhou, Liuqi Weng
Background and purpose: Percutaneous autologous bone marrow transplantation (PABMT) is a minimally invasive therapeutic strategy for the treatment of delayed bone union in adults, which has been confirmed by many studies. However, there is no report on PABMT application in pediatric orthopedic surgery. The aim of this article was to analyze the therapeutic effect of PABMT in children with delayed union of limb bone and its influence in relation to delayed bone union therapy, transplantation period, patients' sex, fracture location, and fracture fixation...
2018: Therapeutics and Clinical Risk Management
J-C Bernard, E Berthonnaud, J Deceuninck, L Journoud-Rozand, G Notin, E Chaleat-Valayer
Background: Scoliosis is a 3D deformity that can be reconstructed through 2D antero-posterior and lateral radiographs, which provide an upper view of the deformed spine as well as regional planes matching all vertebrae of elective plane for each curve. The objective of this study is to explore whether all idiopathic scoliosis classified Lenke 1A have the same 3D representation made with regional planes. Methods: All patients treated for idiopathic thoracic scoliosis during the growth period and classified Lenke 1A were included in this study conducted in the pediatric spinal orthopedic department of Centre des Massues...
2018: Scoliosis and Spinal Disorders
Rebecca E Rosenburg, Joshua A Abzug, David I Rappaport, Mark A Mazziotti, M Wade Shrader, David Zipes, Benedict Nwomeh, Lisa McLeod
To understand characteristics of pediatric hospitalist (PH) involvement in the care of children admitted to surgical services and explore surgeons' perspectives of PH effectiveness, we conducted a cross-sectional, web-based survey of pediatric surgical (PS) and pediatric orthopedic subspecialists (OS) from professional organizations. We used basic analyses to compare responses between the 2 surgical groups. The initial response rate was 48% (291/606) for PS and 59% (415/706) for OS. Among 185 PS and 212 OS unique programs, PH were routinely engaged (69% and 75%) in the care of surgical patients, particularly in patients with medical complexity (64% PS vs 81% OS; P = ...
February 6, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Pamela Clay, Casey Cruz, Keith Ayotte, Jeremy Jones, Susan B Fowler
PROBLEM: From 2014 to 2016, device related pressure injuries accounted for 62-81% of all hospital acquired pressure injuries. From January to June 2014, there were 5 BiPAP/CPAP pressure injuries noted, accounting for 3.579 injuries per 1000 ventilator days. In 2015, hospital data revealed that 26.5% of all hospital acquired pressure injuries occurred to prone surgical spine patients. METHODS: Collaborative teams including respiratory therapists and operating room staff were convened and crafted new strategies...
January 31, 2018: Journal of Pediatric Nursing
Hsiang-Yu Lin, Chih-Kuang Chuang, Shih-Chia Liu, Shuan-Pei Lin
No abstract text is available yet for this article.
January 9, 2018: Pediatrics and Neonatology
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