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Pediatric extremity injury

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https://www.readbyqxmd.com/read/28493614/accuracy-of-physical-exam-ankle-brachial-index-and-ultrasonography-in-the-diagnosis-of-arterial-injury-in-patients-with-penetrating-extremity-trauma-a-systematic-review-and-meta-analysis
#1
Ian S deSouza, Roshanak Benabbas, Sean McKee, Bardiya Zangbar, Ashika Jain, Lorenzo Paladino, Leon Boudourakis, Richard Sinert
BACKGROUND: Penetrating Extremity Trauma (PET) may result in arterial injury, a rare but limb- and life-threatening surgical emergency. Accurate and timely diagnosis is vital to enable potential intervention and prevent significant morbidity. OBJECTIVES: Using a systematic review/meta-analysis approach, we determined the utility of Physical Examination (exam), Ankle-Brachial Index (ABI), and Ultrasonography (US) in the diagnosis of arterial injury in ED patients who have sustained PET...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28486265/effect-of-family-presence-on-advanced-trauma-life-support-task-performance-during-pediatric-trauma-team-evaluation
#2
Karen J OʼConnell, Elizabeth A Carter, Jennifer L Fritzeen, Lauren J Waterhouse, Randall S Burd
IMPORTANCE: In many hospitals, family members are separated from their children during the early phases of trauma care. Including family members during this phase of trauma care varies by institution and is limited by concerns for adverse effects on clinical care. OBJECTIVE: The aim of this study is to evaluate the effect of family presence (FP) on advanced trauma life support primary and secondary survey task performance by pediatric trauma teams. We hypothesized that trauma care with FP would be noninferior to care when families were absent...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28469948/identifying-potential-child-abuse-through-oral-examination
#3
Jillian N Printz, Aaron Baker, Michele Carr
Limited reports of oropharyngeal trauma exist in the literature even though this type of injury is extremely common in pediatric populations. There are no widely agreed upon diagnostic and management tools for such injuries in abuse cases, emphasizing the importance of reporting rare cases of orofacial trauma. This case report of a soft palate laceration demonstrates an instance of initially unrecognized potential child abuse. We aim to clarify understanding of such injuries. Furthermore, the report highlights the need for recognition of oral signs of child abuse in order to promote early detection, reporting, and appropriate management...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28443277/pediatric-hand-surgery-training-in-nicaragua-a-sustainable-model-of-surgical-education-in-a-resource-poor-environment
#4
Mary Claire B Manske, Jairo J Rios Roque, Gabriel Ramos Zelaya, Michelle A James
Recent reports have demonstrated that nearly two-thirds of the world's population do not have access to adequate surgical care, a burden that is borne disproportionately by residents of resource-poor countries. Although the reasons for limited access to surgical care are complex and multi-factorial, among the most substantial barriers is the lack of trained surgical providers. This is particularly true in surgical subspecialties that focus on life-improving, rather than life-saving, treatments, such as pediatric hand and upper extremity surgery, which manages such conditions as congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy)...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28436285/musculoskeletal-injuries-associated-with-hoverboard-use-in-children
#5
Cecilia Monteilh, Prina Patel, John Gaffney
Hoverboards burst onto the scene with wide popularity only to be quickly deemed unsafe and banned in many arenas. We conducted a retrospective cohort study of 35 patients seen in our outpatient pediatric orthopedic office over a 1-year period. The mean age of injured patients was 11.14 years; 18 patients were male (51.4%), and 17 were female (48.5%). The highest number of injuries occurred in children 10 to 14 years old who had 57.1% of the injuries. There were a total of 31 fractures in 27 patients. Most of the fractures were in the upper extremities (93...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28423460/individual-and-neighborhood-characteristics-of-children-seeking-emergency-department-care-for-firearm-injuries-within-the-pecarn-network
#6
Patrick M Carter, Lawrence J Cook, Michelle L Macy, Mark R Zonfrillo, Rachel M Stanley, James M Chamberlain, Joel A Fein, Elizabeth R Alpern, Rebecca Cunningham
OBJECTIVE: To describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network, and assess the influence of both individual and neighborhood factors on firearm-related injury risk. METHODS: This was a retrospective, multicenter cross-sectional analysis of children (<19-years-old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent. Neighborhood variables were derived from home address data...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28420263/an-unusual-cause-of-frequent-sudden-transient-unexplained-falls-and-new-onset-status-epilepticus-case-report-and-mini-review
#7
Dinesh Singh, Alford Dyer, Sherry Gu, Patrick McCarville, Annie Hess, Olugbenga Akingbola, Jane El-Dahr, Stephen Nelson
We report a 14-year old adolescent Caucasian female, who presented with frequent, sudden, transient, and unexplained falls leading to multiple serious injuries to her head and extremities requiring several visits to the emergency department. She was evaluated numerous times and imaging studies, echocardiogram, electrocardiogram, and electroencephalogram studies were all normal. She eventually presented to outside emergency department with dystonic posturing and status epilepticus and was transferred to our pediatric intensive care unit for further management...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419085/neonatal-outcomes-of-moderatelyly-preterm-infants-compared-to-extremely-preterm-infants
#8
Michele C Walsh, Edward F Bell, Sarah Kandefer, Shampa Saha, Waldemar A Carlo, Carl T D'Angio, Abbot R Laptook, Pablo J Sanchez, Barbara J Stoll, Seetha Shankaran, Krisa P Van Meurs, Noah Cook, Rosemary D Higgins, Abhik Das, Nancy S Newman, Kurt Schibler, Barbara Schmidt, C Michael Cotten, Brenda B Poindexter, Kristi L Watterberg, William E Truog
BACKGROUND: Extremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the U.S., yet these infants are focus of most published research. Moderately preterm neonates (MPT, 29-33(6/7) weeks), are an understudied group of high-risk infants. METHODS: Objective: To determine the neonatal outcomes of MPT across the gestational age spectrum, and to compare these to EPT. A prospective observational cohort was formed in 18 Level 3-4 NICUs in the Eunice Kennedy Shriver NICHD Neonatal Research Network...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28414102/parental-knowledge-of-trampoline-safety-in-children
#9
S Beno, A Ackery, K Colaco, K Boutis
OBJECTIVES: Recreational trampoline use is increasing in popularity, with a resulting increase in significant trampoline-related injuries in children. Parents are the best advocates for the safety of their children during recreational trampoline use. Our primary objective was to determine the proportion of parents who were aware of five key recommendations for safer recreational trampoline use in children. METHODS: This was a cross-sectional survey of parents whose children presented to a tertiary care pediatric emergency department (ED) with an extremity injury...
April 13, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28398941/the-season-of-hoverboards-a-case-series-of-fractures
#10
Chester J Donnally, Charles M Lawrie, Augustus J Rush, Avi C Baitner
OBJECTIVE: The aim of this study was to identify the types of pediatric orthopedic extremity fractures that are sustained as a result of hoverboard (self-balancing, self-propelling, 2-wheeled boards) use. METHODS: We performed a retrospective review of all orthopedic consultations from the emergency department at our institution from December 1 to 31, 2015. Data was collected on the injury mechanism, fracture location, management, and patient characteristics including sex, age, and hand dominance...
May 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28398934/pediatric-lawnmower-injuries
#11
Tina S Lee, Jan D Luhmann, Scott J Luhmann, Kimberly S Quayle
OBJECTIVE: The aim of this study was to evaluate demographics, characteristics, and mechanisms of injuries caused by lawnmowers in children. METHODS: Chart review from 1990 to 2010 at a level I pediatric trauma center identified patients younger than 18 years with lawnmower injuries. Demographics and characteristics of the injuries were analyzed by descriptive statistical analysis. RESULTS: The study identified 88 subjects, with 80% males and 42% of the subjects younger than 5 years...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28394218/poor-sleep-in-adults-with-pediatric-onset-spinal-cord-injury-associations-with-pain-health-and-activity
#12
Alicia M January, Kathy Zebracki, Kathleen M Chlan, Lawrence C Vogel
OBJECTIVE: To investigate medical complications that increase risk for poor sleep in adults with pediatric-onset spinal cord injury (SCI) and explore the relation of poor sleep to psychosocial outcomes. METHOD: This was a cross-sectional study of individuals with pediatric-onset SCI interviewed between 2011-2015. Participants were recruited from a pediatric specialty hospital and answered questions about demographics, injury characteristics, pain, and medical complications and completed standardized outcome measures, including: Pittsburgh Sleep Quality Index, SF12v2 Health Survey, Craig Handicap Assessment and Recording Technique (CHART), and Subjective Happiness Scale...
April 10, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28350717/missed-fractures-in-infants-presenting-to-the-emergency-department-with-fussiness
#13
Jamie S Kondis, Jared Muenzer, Janet D Luhmann
OBJECTIVES: The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. METHODS: This was a retrospective chart review of infants younger than 6 months who presented to the pediatric emergency department (ED) between January 1, 2006, and December 31, 2011. Inclusion criteria included age 0 to 6 months, discharge diagnosis including "fracture," "broken" (or break), or "trauma" or any child abuse diagnosis or chief complaint of "fussy" or "crying" as documented in the electronic medical record by the triage nurse...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#14
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS greater than 15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and Abbreviated Injury Scale (AIS) to predict mortality and define optimal thresholds of severe injury in pediatric trauma. METHODS: Patients from the Pennsylvania trauma registry 2000-2013 were included...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28316901/symptomatic-parietal-intradiploic-encephalocele-a-case-report-and-literature-review
#15
Chen Shi, Bruno Flores, Stephen Fisher, Samuel L Barnett
Encephalocele is a rare condition that consists of herniation of cerebral matter through openings of dura and skull. A majority of encephaloceles are congenital and manifest in childhood. We present a case of a 45-year-old man presenting with contralateral hemiparesis and found to have an extremely rare phenomenon of a symptomatic posttraumatic parietal intradiploic encephalocele (IE) manifesting 36 years following pediatric traumatic head injury. Computed tomography and magnetic resonance imaging confirmed herniation of brain tissue into the intradiploic space...
January 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28302281/the-art-and-science-of-pediatric-damage-control
#16
REVIEW
Anthony Tran, Brendan T Campbell
Damage control is a surgical strategy that has evolved and expanded considerably over the past 25 years. The approach was initially developed as a "bail out" procedure to control bleeding with severe abdominal injuries in the setting of unmitigated hemorrhagic shock. Damage control is now more broadly applied as a comprehensive management plan for the resuscitation and surgical treatment of injured patients with exhausted physiologic and metabolic reserve. This article reviews the most current concepts in damage control that are important and relevant to the practicing pediatric surgeon...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28291142/lower-extremity-avulsion-fractures-in-the-pediatric-and-adolescent-athlete
#17
Jonathan Schiller, Steven DeFroda, Travis Blood
Lower extremity avulsion fractures are uncommon in the pediatric population and can be misdiagnosed without proper imaging and/or clinical suspicion for these injuries. The most common locations of avulsion injuries are the ischial tuberosity, anterior superior iliac spine, and anterior inferior iliac spine. Less often, avulsion fractures occur in the tibial tubercle, calcaneus, and greater and lesser trochanters. When treated properly with rest and altered weight bearing, most of these injuries heal without complication...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28287684/the-value-of-sleep-on-athletic-performance-injury-and-recovery-in-the-young-athlete
#18
Elizabeth A Copenhaver, Alex B Diamond
Adequate sleep can easily become compromised as student-athletes try to balance the multiple demands on their time. People with sleep deficiency are at increased risk for acute illnesses, traumatic sports injuries, and development of chronic diseases. Training sessions or competitions during extremely early or late hours can interfere with circadian and homeostatic rhythms. Adjusting the training schedule to improve sleep duration has a significantly positive impact on several aspects of athletic performance...
March 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28286625/radiographic-evaluation-of-common-pediatric-elbow-injuries
#19
REVIEW
Steven F DeFroda, Heather Hansen, Joseph A Gil, Ashraf H Hawari, Aristides I Cruz
Normal variations in anatomy in the skeletally immature patient may be mistaken for fracture or injury due to the presence of secondary centers of ossification. Variations in imaging exist from patient to patient based on sex, age, and may even vary from one extremity to the other on the same patient. Despite differences in the appearance of the bony anatomy of the elbow there are certain landmarks and relationships, which can help, distinguish normal from abnormal. We review common radiographic parameters and pitfalls associated in the evaluation of pediatric elbow imaging...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28284770/point-of-care-ultrasonography-to-assist-in-the-diagnosis-and-management-of-subluxation-of-the-radial-head-in-pediatric-patients-a-case-series
#20
Faruk Güngör, Taylan Kılıç
BACKGROUND: A subluxation of the radial head (SRH) is a clinical condition that commonly occurs in children under 6 years of age. History and physical examination findings typically include a child who presents with an elbow held in extension and with forearm pronation, after having suffered significant longitudinal traction on the arm, or after a fall on an outstretched hand. The diagnosis is often clinically obvious. The injury responds dramatically to closed reduction, and usually no imaging is required...
March 8, 2017: Journal of Emergency Medicine
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