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Pediatric extremity injury

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https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#1
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>15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and 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...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28316901/symptomatic-parietal-intradiploic-encephalocele-a-case-report-and-literature-review
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28277467/high-energy-pediatric-scapula-fractures-and-their-associated-injuries
#8
Steven F Shannon, Nicholas M Hernandez, Stephen A Sems, Annalise N Larson, Todd A Milbrandt
OBJECTIVES: The purpose of this study was to evaluate pediatric scapula fractures occurring in high-energy motorized vehicle accidents and their associated injury patterns in a pediatric patient population. METHODS: One thousand nine hundred sixty-eight pediatric patients who presented after either on-road or off-road motorized vehicle accidents between 1996 and 2015 were retrospectively reviewed. Thirty-eight patients were found to have scapula fractures and the remaining 1930 were identified as controls...
March 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28251323/bilateral-position-related-ulnar-neuropathy-at-elbow-in-pediatric-population-and-review-of-the-literature
#9
REVIEW
Mariana Balikova, Marta Neklanova, Igor Sulla, Martin Hönig, Jan Halek, Vladimir Mihal, Vladimir Balik
Perioperative ulnar neuropathies attributed to inappropriate arm positioning and padding during surgical procedures are commonly found in adults. However, their extremely rare incidence in the pediatric population may cause absent awareness of the risk of nerve injury in anesthetized pediatric patients. Furthermore, young patients respond to conservative treatment of neuropathy less favorably than adults and their response also depends on the pathomechanism of the ulnar nerve injury. A surgeon's or anesthetist's failure to recognize all of these specifics in children may result in substantial morbidity of young patients leading to lawsuits...
March 1, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28211259/liver-transplantation-from-a-deceased-donor-with-%C3%AE-thalassemia-intermedia-is-not-contraindicated-a-case-report
#10
Ersin Gumus, Osman Abbasoglu, Cahit Tanyel, Fatma Gumruk, Hasan Ozen, Aysel Yuce
The use of extended criteria donors who might have previously been deemed unsuitable is an option to increase the organ supply for transplantation. This report presents a pediatric case of a successful liver transplantation from a donor with β-thalassemia intermedia. A patient, 6-year-old female, with a diagnosis of cryptogenic liver cirrhosis underwent deceased donor liver transplantation from a thalassemic donor. Extreme hyperferritinemia was detected shortly after transplantation. The most probable cause of hyperferritinemia was iron overload secondary to transplantation of a hemosiderotic liver...
February 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28169980/epidemiologic-characteristics-of-pediatric-trauma-patients-receiving-prehospital-care-in-kigali-rwanda
#11
Adam R Aluisio, Olivier Félix Umuhire, Gabin Mbanjumucyo, Naomi George, Alexis Kearney, Naz Karim, Jeanne DʼArc Nyinawankusi, Eric Uwitonze, Sam Enumah, John W Scott, Zeta Mutabazi, Georges Ntakiyiruta, Sudha Jayaraman, Robert Riviello, Jean Claude Byiringiro, Adam C Levine
BACKGROUND: Pediatric trauma is a significant public health problem in resource-constrained settings; however, the epidemiology of injuries is poorly defined in Rwanda. This study describes the characteristics of pediatric trauma patients transported to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali by emergency medical services in Kigali, Rwanda. METHODS: This cohort study was conducted at the Centre Hospitalier Universitaire de Kigali from December 2012 to February 2015...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28146405/the-youth-throwing-score
#12
Christopher S Ahmad, Ajay S Padaki, Manish S Noticewala, Eric C Makhni, Charles A Popkin
BACKGROUND: Epidemic levels of shoulder and elbow injuries have been reported recently in youth and adolescent baseball players. Despite the concerning frequency of these injuries, no instrument has been validated to assess upper extremity injury in this patient population. Purpose/Hypothesis: The purpose of this study was to validate an upper extremity assessment tool specifically designed for young baseball players. We hypothesized that this tool will be both reliable and valid. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2...
February 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28121977/bilateral-upper-extremity-hyperesthesia-and-absence-of-neck-tenderness-in-four-adolescent-athletes-with-cervical-spine-injuries
#13
Jay Douglas Fisher, Elizabeth Lewis Thorpe
Cervical spine injury in the pediatric athlete is an uncommon but potentially devastating condition that can require a heightened index of suspicion to correctly diagnose. Although some cervical spine injuries present overtly with paraplegia due to cord transection, others can present more subtly with symptoms suggestive of bilateral peripheral neuropathy. Patients with traumatic brachial neuropraxia or "stinger" physiology can present similarly, but symptoms are exclusively unilateral. We present 4 patients with bilateral upper extremity hyperesthesias and absence of tenderness over the cervical vertebral landmarks who were subsequently diagnosed with cervical spine injuries...
January 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28069269/clinical-considerations-for-blunt-laryngotracheal-trauma-in-children
#14
REVIEW
Jeffrey Cheng, Matthew Cooper, Elisabeth Tracy
OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. REVIEW METHODS: A medical librarian was utilized. RESULTS: 329 titles and abstracts were identified, and 50 reports were included...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28060178/assessment-of-splints-applied-for-pediatric-fractures-in-an-emergency-department-urgent-care-environment
#15
Joshua M Abzug, Brandon S Schwartz, Aaron J Johnson
BACKGROUND: Fractures are common in the pediatric population. The initial evaluation is rarely by an orthopaedic surgeon, but commonly an emergency room or urgent care center physician/extender. This typically involves splint application by a nonorthopaedist to immobilize the extremity and provide stabilization. Iatrogenic injuries from inappropriate splint placement are a potential public health and legal concern that can lead to complications. The primary purpose of this study was to prospectively evaluate the adequacy of all splints placed on patients who presented to a pediatric orthopaedic office; secondary outcomes included assessing prevalence and types of complications that were associated with inadequate splints...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28058484/hoverboards-spectrum-of-injury-and-association-with-an-uncommon-fracture
#16
Andrew H Schapiro, Neil U Lall, Christopher G Anton, Andrew T Trout
BACKGROUND: Self-balancing electric scooters, commonly known as hoverboards, are a new and popular consumer item with recognized fall hazards. The spectrum of injuries associated with hoverboard use has not been studied. OBJECTIVE: The purpose of this study is to determine the spectrum of radiologically apparent injuries associated with hoverboard use. MATERIALS AND METHODS: We retrospectively reviewed all imaging studies interpreted at our institution for hoverboard-related injuries during an 8-month period...
January 6, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28040202/homemade-zipline-and-playground-track-ride-injuries-in-children
#17
Christine M Leeper, Christine McKenna, Barbara A Gaines
BACKGROUND/PURPOSE: Playground track ride and homemade zipline-related injuries are increasingly common in the emergency department, with serious injuries and even deaths reported. METHODS: Retrospective review of the National Electronic Injury Surveillance System (NEISS) database (2009-2015), followed by review of our academic pediatric trauma center's prospectively-maintained database (2005-2013). We included children ages 0-17years of age with zipline-related injuries...
December 20, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28024305/lower-extremity-reconstruction-with-free-gracilis-flaps
#18
Michael J Franco, Michael C Nicoson, Rajiv P Parikh, Thomas H Tung
Background There have been significant advancements in lower extremity reconstruction over the last several decades, and the plastic surgeon's armamentarium has grown to include free muscle and fasciocutaneous flaps along with local perforator and propeller flaps. While we have found a use for a variety of techniques for lower extremity reconstruction, the free gracilis has been our workhorse flap due to the ease of harvest, reliability, and low donor site morbidity. Methods This is a retrospective review of a single surgeon's series of free gracilis flaps utilized for lower extremity reconstruction...
March 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27982324/pediatric-vascular-trauma-in-manaus-amazon-brazil
#19
Cleinaldo DE Almeida Costa, José Emerson Dos Santos Souza, Antônio Oliveira DE Araújo, Flávio Augusto Oliva Melo, Isabelle Nascimento Costa, Paulo Henrique Klein
Objective: to assess the incidence of pediatric vascular injuries in patients treated at the Emergency Room of the Eastern Children's Hospital, in Manaus. Methods: we conducted a retrospective study of pediatric patients who suffered vascular injuries treated between February 2001 to February 2012. Results: we studied 71 patients, predominantly male (78.87%), with a mean age of 7.63 years. The predominant mechanism of injury was stab wound in 27 patients (38...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27955899/nasa-model-of-threat-and-error-in-pediatric-cardiac-surgery-patterns-of-error%C3%A2-chains
#20
Edward Hickey, Eric Pham-Hung, Yaroslavna Nosikova, Fredrik Halvorsen, Michael Gritti, Steven Schwartz, Christopher A Caldarone, Glen Van Arsdell
BACKGROUND: We introduced the National Aeronautics and Space Association threat-and-error model to our surgical unit. All admissions are considered flights, which should pass through stepwise deescalations in risk during surgical recovery. We hypothesized that errors significantly influence risk deescalation and contribute to poor outcomes. METHODS: Patient flights (524) were tracked in real time for threats, errors, and unintended states by full-time performance personnel...
December 9, 2016: Annals of Thoracic Surgery
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