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Pediatric extremity injury

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
Nozomi Idota, Mami Nakamura, Misa Tojo, Hiroaki Ichioka, Kaori Shintani-Ishida, Hiroshi Ikegaya
An 11-month-old boy with marked abdominal distension was found dead in the prone position at home. Since there were many bruises in the non-protruding regions of the head, face, and abdomen, a medicolegal autopsy was performed the following day. The boy was smaller than average (height: 68.5 cm; weight: 7.8 kg); his extremities were thin; and his abdomen was remarkably bulging. Chylous ascites (1600 mL) was observed in the peritoneal cavity and chylous pleural effusion (left: 5 mL; right: 10 mL) in the thoracic cavity...
February 16, 2018: Legal Medicine
Clint Rathje, Ashley Venegas, Stephen D Helmer, Rachel M Drake, Jeanette G Ward, James M Haan
Background: Agriculture is an industry where family members often live and work on the same premises. This study evaluated injury patterns and outcomes in children from farm-related accidents. Methods: A 10-year retrospective review of farm-accident related injuries was conducted of patients 17 years and younger. Data collected included demographics, injury mechanism, accident details, injury severity and patterns, treatments required, hospitalization details, and discharge disposition...
November 2017: Kansas Journal of Medicine
Christine M Leeper, Matthew D Neal, Timothy R Billiar, Jason L Sperry, Barbara A Gaines
BACKGROUND: Elevated INR is a marker of poor outcome but not necessarily bleeding or clinical coagulopathy in injured children. Conversely, children with traumatic brain injury (TBI) tend to be hypercoagulable based on rapid thromboelastography (rTEG) parameters. Many clinicians continue to utilize INR as a treatment target. METHODS: Prospective observational study of severely-injured children age<18 with rTEG on arrival and daily thereafter for up to 7 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
William Cody Sessions, Matthew Herring, Walter H Truong
The extensor mechanism of the knee-consisting of the four muscles of the quadriceps, the quadriceps tendon, the patella, and the patellar ligament-is essential for lower extremity function during both standing and ambulation. The presence of articular cartilage and growing physes in the pediatric knee, coupled with the generation of significant tensile force, creates an opportunity for pathology unique to the pediatric population.Tibial tubercle fractures and patella injuries are quite rare, and even pediatric-trained orthopaedic surgeons may not be exposed to these injuries on a regular basis...
February 6, 2018: Journal of Knee Surgery
Kristin Schoolman-Anderson, Roni D Lane, Jeff E Schunk, Nancy Mecham, Richard Thomas, Kathleen Adelgais
BACKGROUND: Pain management guidelines in the emergency department (ED) may reduce time to analgesia administration (TTA). Intranasal fentanyl (INF) is a safe and effective alternative to intravenous opiates. The effect of an ED pain management guideline providing standing orders for nurse-initiated administration of intranasal fentanyl (INF) is not known. The objective of this study was to determine the impact of a pediatric ED triage-based pain protocol utilizing intranasal fentanyl (INF) on time to analgesia administration (TTA) and patient and parent satisfaction...
January 16, 2018: American Journal of Emergency Medicine
Chiara Zanchi, Manuela Giangreco, Luca Ronfani, Claudio Germani, Rita Giorgi, Lorenzo Calligaris, Stefania Norbedo, Giulio Liccari, Giorgio Cozzi, Egidio Barbi
OBJECTIVES: Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture. METHODS: We conducted a retrospective study, considering all patients presenting to the ED of a children's hospital in Italy, with an accidental extremity injury, between May and December 2015...
January 23, 2018: Pediatric Emergency Care
Patrick T Reeves, Marc M Auerbach, Tuan D Le, Nicole W Caldwell, Mary J Edwards, Elizabeth A Mann-Salinas, Jennifer M Gurney, Zsolt T Stockinger, Matthew A Borgman
OBJECTIVES: The military uses "just-in-time" training to refresh deploying medical personnel on skills necessary for medical and surgical care in the theater of operations. The burden of pediatric care at Role 2 facilities has yet to be characterized; pediatric predeployment training has been extremely limited and primarily informed by anecdotal experience. The goal of this analysis was to describe pediatric care at Role 2 facilities to enable data-driven development of high-fidelity simulation training and core knowledge concepts specific to the combat zone...
January 23, 2018: Pediatric Critical Care Medicine
Richelle E M Senden, Kristin Keunen, Niek E van der Aa, Alexander Leemans, Ivana Isgum, Max A Viergever, Jeroen Dudink, Linda S de Vries, Floris Groenendaal, Manon J N L Benders
BACKGROUND: Preterm birth is associated with an increased risk of cerebellar injury. The aim of this study was to assess the impact of cerebellar hemorrhages (CBH) on cerebral white matter microstructural tissue organization and cerebellar volume at term equivalent age (TEA) in extremely preterm infants. Furthermore, we aimed to evaluate the association between CBH and neurodevelopmental outcome in late infancy. METHODS: 24 preterm infants with punctate CBH were included and each matched to two preterm control infants...
January 23, 2018: Pediatric Research
Itai Gross, Daniel J Weiss, Elior Eliasi, Miklosh Bala, Saar Hashavya
BACKGROUND: Electric bike (e-bike) usage is growing worldwide, and so is the e-bike-related injury rate. OBJECTIVE: This study was undertaken to characterize e-bike-related injuries. METHODS: Data of all e-bike-related injuries presenting to our level I trauma center between 2014 and 2016 were collected and analyzed. Adult and pediatric (<18 years of age) e-bike-related injuries were then analyzed separately and compared. RESULTS: Forty-eight patients suffering from e-bike-related injuries presented to our trauma center between January 1, 2014 and December 31, 2016...
January 15, 2018: Journal of Emergency Medicine
Sriram Ramgopal, Lauren Bealafeld Brungo, Michael Bykowski, Raymond Pitetti, Robert Hickey
AIM: To compare characteristics of gender, age, body part, and breed in dog bites. METHODS: We reviewed 14,956 dog bites (4,195 pediatric) reported to the Allegehny County Health Department, USA, between 2007-2015. Using pre-defined age groups, we performed linear regression to assess for subject age and bite frequency and used binary logistic regression to evaluate for differences in gender and body part and chi-squared tests with Bonferroni correction to evaluate for differences in reported breeds with age...
January 13, 2018: Acta Paediatrica
Kyle J Kalkwarf, Shane D Jensen, Myron Allukian, Matthew T Harting, Charles S Cox, Erin E Fox, Charles E Wade, Bryan A Cotton
BACKGROUND: Objective parameters predicting futility of care in severely injured pediatric patients are lacking. While futility of care has been investigated in a limited number of studies in trauma patients, none of these studies achieves a 100% success rate in a large cohort of pediatric patients. The purpose of the current study was to identify extreme laboratory values that could be used to predict 100% mortality in severely injured children. STUDY DESIGN: Registry-based, historical cohort of all severely injured children (level 1 trauma, <16 years old), who were not dead on arrival, between January 2010 and December 2016 from a single level 1 trauma center...
January 8, 2018: Journal of the American College of Surgeons
Karin Hermon, Tali Capua, Miguel Glatstein, Dennis Scolnik, Oren Tavor, Ayelet Rimon
BACKGROUND: Electric bicycles (E-bikes) are one of a wide range of light electric vehicles that provide convenient local transportation and attractive recreational opportunities. The aim of this study was to report E-bike-related injuries in children presenting to a trauma center. METHODS: Retrospective observational study, from December 2014 to November 2015, which included all pediatrics patients admitted to the emergency department with an injury related to E-bike use, was performed...
January 11, 2018: Pediatric Emergency Care
Eric W Glissmeyer, Ryan R Metzger, Robert Bolte
OBJECTIVE: The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. METHODS: Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014...
February 2018: Pediatric Emergency Care
Marc R Matthews, Joel C VanderVelde, Daniel M Caruso, Kevin N Foster
INTRODUCTION: Phytophototoxic dermatitis is a strong phototoxic reaction to ultraviolet A (UV-A) radiation exposure after cutaneous contact with citrus fruit containing furocoumarins, leading to skin injury. At the Arizona Burn Center (Phoenix, AZ), the majority of these injuries are managed in the outpatient setting. CASE REPORT: The authors present a pediatric admission for burn-like injuries following prolonged cutaneous exposure to lemons while playing in the Arizona sunshine...
December 2017: Wounds: a Compendium of Clinical Research and Practice
Femke J Drost, Kristin Keunen, Pim Moeskops, Nathalie H P Claessens, Femke van Kalken, Ivana Išgum, Elsbeth S M Voskuil-Kerkhof, Floris Groenendaal, Linda S de Vries, Manon J N L Benders, Jacqueline U M Termote
OBJECTIVE: To evaluate the association between severe retinopathy of prematurity (ROP), measures of brain morphology at term equivalent age (TEA) and neurodevelopmental outcome. PATIENTS AND METHODS: 18 infants with severe ROP (median gestational age (GA) 25.3 (range 24.6-25.9 weeks) were included in this retrospective case-control study. Each infant was matched to two extremely preterm control infants (n=36) by GA, birth weight, sex and brain injury. T2-weighted images were obtained on a 3T MRI at TEA...
January 10, 2018: Pediatric Research
Kyle Fink, Neil Kaushal, Jordan Gross, Himanshu Patel, Damon Delbello
Bucket-handle meniscal tears are extremely rare injuries in the pediatric population. Given the known sequelae of meniscal tears and the development of osteoarthritis, early diagnosis and treatment of pediatric meniscal tears are essential. The communication barrier between physicians and pediatric patients, however, creates difficulties in making the correct diagnosis of meniscal pathology. Providers should have a low threshold for obtaining further confirmatory advanced imaging if patients present with prolonged knee pain and swelling, with associated locking mechanical symptoms...
January 8, 2018: Orthopedics
Sudhir Shyam Kushwaha, Madhuresh Kumar, Kumar Shantanu, Deepak Kumar
Introduction: Dislocations of elbow constitute about 3-6% of all injuries occurring around elbow in children. Posterior dislocations are the most common type, whereas other types of dislocations, especially lateral dislocation in a child are extremely rare. Case Report: A 9-year-old boy with a history of trauma presented with complaints of pain, swelling, and difficulty to move his left elbow. Radiographs revealed lateral dislocation of elbow associated with avulsion of medial condyle...
September 2017: Journal of Orthopaedic Case Reports
Mehmet Demirel, Onur Tunali, Ismail Turkmen, Yavuz Saglam
Introduction: Although supracondylar fractures of the humerus are common in children, open fractures of are extremely rare injuries. Gustilo- Anderson Type-III fractures in the upper extremity are primarily associated with considerable bone loss resulting from high energy trauma. In this study, a case of open pediatric supracondylar humerus fracture treated by a joint and defect spanning multiplanar tubular external fixation is presented. Case Report: A boy aged 3 years suffered from a Gustilo-Anderson Type-IIIA supracondylar humerus fractures...
September 2017: Journal of Orthopaedic Case Reports
Dimitrios Patoulias, Ioannis Patoulias, Christos Kaselas, Maria Kalogirou, Chatzopoulos Kyriakos, Farmakis Konstantinos, Thomas Feidantsis, Papacrivou Eleni
Lymphangioma is a benign congenital malformation. The extremely rare and atypical localization of a lymphangioma in the chest wall was the real motive for the present case study. A 5-year-old boy was admitted to the Emergency Department of the 1st Department of Pediatric Surgery, Aristotle University of Thessaloniki, due to the presence of a mildly painful swelling in the left lateral chest wall, which was first noticed three months ago, after a blunt injury during sport. Physical examination revealed the presence of a palpable, spherical, painful, nut-sized subcutaneous lesion in the left lateral chest wall, respectively, with the anterior axillary line, at the height of the 6th to 7th intercostal space...
2017: Case Reports in Pediatrics
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