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Pediatric rib fractures

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https://www.readbyqxmd.com/read/27339476/identifying-non-accidental-fractures-in-children-aged-2%C3%A2-years
#1
Laura A Leaman, William L Hennrikus, James J Bresnahan
PURPOSE: Fractures are the second most common presentation of child abuse following soft-tissue bruising and burns. It is often difficult to determine potential abuse in a child presenting with a non-rib fracture(s) and without soft-tissue injuries. METHODS: One hundred and fifteen consecutive patients aged ≤2 years who presented with a fracture between January 2010 and June 2012 to our emergency department (ED) or pediatric fracture clinic were retrospectively analyzed...
August 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27093358/child-maltreatment-a-review-of-key-literature-in-2015
#2
Alice W Newton
PURPOSE OF REVIEW: This review addresses some of the more salient articles in the field of child maltreatment published in 2015, with a goal of helping the general practitioner understand the evolution of research in the field of child abuse pediatrics (a board-certified specialty since 2009). RECENT FINDINGS: Researchers continue to refine the database for child abuse pediatrics. Several articles focus on the inconsistencies in approach to the evaluation of possible physical child abuse between hospitals and practitioners...
June 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/26713973/no-breakpoint-for-mortality-in-pediatric-rib-fractures
#3
MULTICENTER STUDY
Graeme Rosenberg, Alex K Bryant, Kimberly A Davis, Kevin M Schuster
BACKGROUND: Rib fracture number correlates with mortality in adult trauma patients, sharply rising above six fractured ribs. Because of the pliability of younger ribs, pediatric ribs are believed to require more energy to fracture. We hypothesized this will result in a different rib fracture-associated pediatric mortality rate. METHODS: We queried the National Trauma Data Bank (American College of Surgeons, Chicago, Illinois) for patients younger than 21 years with and without rib fractures (2002-2009), abstracting the number of rib fractures, diagnoses, procedures, and outcomes...
March 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26438705/testing-for-abuse-in-children-with-sentinel-injuries
#4
Daniel M Lindberg, Brenda Beaty, Elizabeth Juarez-Colunga, Joanne N Wood, Desmond K Runyan
OBJECTIVE: Child physical abuse is commonly missed, putting abused children at risk for repeated injury and death. Several so-called sentinel injuries have been suggested to be associated with high rates of abuse, and to imply the need for routine testing for other, occult traumatic injuries. Our objective was to determine rates of abuse evaluation and diagnosis among children evaluated at leading children's hospitals with these putative sentinel injuries. METHODS: This is a retrospective secondary analysis of the Pediatric Health Information System database...
November 2015: Pediatrics
https://www.readbyqxmd.com/read/26118312/thoracic-epidural-analgesia-in-a-child-with-multiple-traumatic-rib-fractures
#5
REVIEW
Brian M Keech
The morbidity and mortality associated with blunt thoracic trauma are significant and can be multisystem in nature. Of these, pulmonary complications, including ventilatory impairment secondary to pain, have been recognized to be the most consequential. Although several analgesic strategies have emerged, thoracic epidural analgesia (TEA) has arguably demonstrated superior efficacy and is used frequently in adults. Unfortunately, TEA is rarely used in children after blunt thoracic trauma, but may be of considerable benefit...
December 2015: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/25705803/vitamin-d-deficiency-in-children-undergoing-vertical-expandable-prosthetic-titanium-rib-treatment
#6
Ying Li, Nahbee Jong, Michelle S Caird, Allison Tenfelde, Philip Nowicki, Kerby Shedden, Virginia S Nelson, Frances A Farley
BACKGROUND: Vitamin D deficiency is prevalent in the pediatric population and multiple risk factors have been identified. Low vitamin D levels can result in poor bone mineralization and have been associated with a significantly higher risk of forearm fracture in children. Vitamin D deficiency has also been associated with pediatric critical illness. The purpose of this study was to determine whether children undergoing vertical expandable prosthetic titanium rib (VEPTR) treatment have low vitamin D levels...
December 2015: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/25611996/ultrasound-guided-paravertebral-block-facilitated-tracheal-extubation-in-a-5-week-old-infant-with-rib-fractures-and-respiratory-failure
#7
Nishanthi Kandiah, Kathryn Walker, Karen Boretsky
The use of regional anesthesia including paravertebral blocks has been advocated for the treatment of pain from rib fractures in adults. Although paravertebral nerve blocks have been used in pediatric patients to manage postoperative pain for surgeries to the thorax and abdomen, their use for analgesia after rib fractures and thoracic trauma has not been reported. We report the use of a T7 continuous paravertebral nerve block for pain relief in a 5-week-old, 5-kg infant who suffered T7 and T8 rib fractures and a pulmonary contusion to the left chest secondary to a gunshot wound...
May 15, 2014: A & A Case Reports
https://www.readbyqxmd.com/read/25568576/back-pain-in-children-and-diagnostic-value-of-99m-tc-mdp-bone-scintigraphy
#8
Khaled Alkhawaldeh, Ali Al Ghuweri, Jane Kawar, Amany Jaafreh
AIM: The aim of our study is to assess the diagnostic value of Technituim-(99m)-Methyle diphosphonate ((99m)Tc-MDP) Bone scintigraphy in the assessment of children with back pain. METHODS: Included in this retrospective study were 68 child referred to us complaining of back pain (mean age of 13+ 2). There were 45 boys and 23 girls. All children have been investigated with conventional x-ray which revealed normal or inconclusive result. All underwent bone scintigraphy after the injection of (99m)Tc-MDP with calculated doses according to there body weights...
October 2014: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/25388901/a-proposed-scheme-for-classifying-pediatric-rib-head-fractures-using-case-examples
#9
Deborrah C Pinto, Jennifer C Love, Sharon M Derrick, Jason M Wiersema, Marcella Donaruma-Kwoh, Christopher S Greeley
Pediatric rib head fractures are typically described as "posterior" or "costovertebral," terms lacking specificity. To resolve this issue, a scheme was developed to describe the location of rib head fractures observed in a pediatric forensic population. The scheme uses three anatomical landmarks, terminus (tip), tubercle, and costovertebral articular surface to divide the rib head into two subregions, costovertebral and costotransverse. Examples of five cases of infants with rib head fractures are presented using this scheme...
January 2015: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/25382601/bilateral-first-rib-anomalous-articulations-with-pseudarthroses-mimicking-healing-fractures-in-an-infant-with-abusive-head-injury
#10
Melissa A Pasquale-Styles, Christian M Crowder, Jeannette Fridie, Sarah S Milla
Bilateral symmetric bone nodules were observed in the anterolateral first ribs of an infant with shaking injuries at autopsy. The location prompted diagnostic considerations of healing fractures versus anomalous articulations with pseudarthroses. The forensic pathologist worked with forensic anthropologists and pediatric radiologists to evaluate autopsy findings and compare premortem and postmortem X-rays. Gross examination of the bones by the pathologist and anthropologists confirmed bilateral, callus-like bone nodules in first-rib locations associated with pseudarthroses...
November 2014: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/25260951/the-effect-of-age-on-the-structural-properties-of-human-ribs
#11
Amanda M Agnew, Michelle Schafman, Kevin Moorhouse, Susan E White, Yun-Seok Kang
Traumatic injury from motor vehicle crashes is a major cause of morbidity and mortality in the United States. The thorax is particularly at risk in motor vehicle crashes and is studied extensively by the injury biomechanics community. Unfortunately, most samples used in such research generally do not include children or the very elderly, despite the common occurrence of thorax injuries at both ends of the age spectrum. Rib fractures in particular, are one of the most common injuries, especially in the elderly, and can greatly affect morbidity, mortality, and quality of life...
January 2015: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/24917069/morphometric-analysis-of-variation-in-the-ribs-with-age-and-sex
#12
Ashley A Weaver, Samantha L Schoell, Joel D Stitzel
Rib cage morphology changes with age and sex are expected to affect thoracic injury mechanisms and tolerance, particularly for vulnerable populations such as pediatrics and the elderly. The size and shape variation of the external geometry of the ribs was characterized for males and females aged 0-100 years. Computed tomography (CT) scans from 339 subjects were analyzed to collect between 2700 and 10 400 homologous landmarks from each rib. Rib landmarks were analyzed using the geometric morphometric technique known as Procrustes superimposition...
August 2014: Journal of Anatomy
https://www.readbyqxmd.com/read/24832239/rib-fractures-comparison-of-associated-injuries-between-pediatric-and-adult-population
#13
COMPARATIVE STUDY
Boris Kessel, Jasmin Dagan, Forat Swaid, Itamar Ashkenazi, Oded Olsha, Kobi Peleg, Adi Givon, Ricardo Alfici
BACKGROUND: Rib fractures are considered a marker of exposure to significant traumatic energy. In children, because of high elasticity of the chest wall, higher energy levels are necessary for ribs to fracture. The purpose of this study was to analyze patterns of associated injuries in children as compared with adults, all of whom presented with rib fractures. METHODS: A retrospective cohort study involving blunt trauma patients with rib fractures registered in the National Trauma Registry was conducted...
November 2014: American Journal of Surgery
https://www.readbyqxmd.com/read/24771095/frequency-of-intrathoracic-injuries-in-children-younger-than-3-years-with-rib-fractures
#14
Stephen E Darling, Stephen L Done, Seth D Friedman, Kenneth W Feldman
BACKGROUND: Research documents that among children admitted to trauma intensive care units the number of rib fractures sustained indicates the child's likelihood of having and severity of intrathoracic injury. This has been misused in court to argue that children with multiple rib fractures who lack intrathoracic injury have abnormal bone fragility rather than inflicted injury. OBJECTIVE: To determine frequency of intrathoracic injuries in children younger than 3 years with rib fractures in cases of child abuse and accidental trauma...
October 2014: Pediatric Radiology
https://www.readbyqxmd.com/read/24660718/is-the-new-acr-spr-practice-guideline-for-addition-of-oblique-views-of-the-ribs-to-the-skeletal-survey-for-child-abuse-justified
#15
Megan B Marine, Donald Corea, Scott D Steenburg, Matthew Wanner, George J Eckert, S Gregory Jennings, Boaz Karmazyn
OBJECTIVE: The purpose of our study was to determine whether adding oblique bilateral rib radiography to the skeletal survey for child abuse significantly increases detection of the number of rib fractures. MATERIALS AND METHODS: We identified all patients under 2 years old who underwent a skeletal survey for suspected child abuse from January 2003 through July 2011 and who had at least one rib fracture. These patients were age-matched with control subjects without fractures...
April 2014: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/24636360/cardiopulmonary-resuscitation-cpr-related-posterior-rib-fractures-in-neonates-and-infants-following-recommended-changes-in-cpr-techniques
#16
MULTICENTER STUDY
I Franke, A Pingen, H Schiffmann, M Vogel, D Vlajnic, R Ganschow, M Born
Posterior rib fractures are highly indicative of non-accidental trauma (NAT) in infants. Since 2000, the "two-thumbs" technique for cardiopulmonary resuscitation (CPR) of newborns and infants has been recommended by the American Heart Association (AHA). This technique is similar to the grip on an infant's thorax while shaking. Is it possible that posterior rib fractures in newborns and infants could be caused by the "two-thumbs" technique? Using computerized databases from three German children's hospitals, we identified all infants less than 12 months old who underwent professional CPR within a 10-year period...
July 2014: Child Abuse & Neglect
https://www.readbyqxmd.com/read/24432505/emergency-management-of-blunt-chest-trauma-in-children-an-evidence-based-approach
#17
REVIEW
Denis R Pauzé, Daniel K Pauzé
Pediatric trauma is commonly encountered in the emergency department, and trauma to the head, chest, and abdomen may be a source of significant morbidity and mortality. As children have unique thoracic anatomical and physiological properties, they may present with diagnostic challenges that the emergency clinician must be aware of. This review examines the effects of blunt trauma to the pediatric chest, as well as its relevant etiologies and associated mortality. Diagnostic and treatment options for commonly encountered injuries such as pulmonary contusions, rib fractures, and pneumothoraces are examined...
November 2013: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/24327218/treatment-of-thoracic-trauma-in-children-literature-review-red-cross-war-memorial-children-s-hospital-data-analysis-and-guidelines-for-management
#18
REVIEW
Arjan Bastiaan van As, Rodgers Manganyi, Andre Brooks
INTRODUCTION: Thoracic injuries continue to be a leading cause of childhood trauma, despite the government's efforts to curb the scourge of this problem. Our review focuses on the incidence, etiology, and management of thoracic trauma in the pediatric population with reference to the recent experience at our institution in a developing country. METHODS: For the literature review, the National Library of Medicine's PubMed database was searched for the following terms: "pediatric," "chest trauma," "hemothorax," "hemopneumothorax," "pneumothorax," "diaphragmatic," "esophageal," and "mediastinal injury...
December 2013: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/24048087/complications-in-pediatric-spine-surgery-using-the-vertical-expandable-prosthetic-titanium-rib-the-french-experience
#19
MULTICENTER STUDY
Grégory Lucas, Gérard Bollini, Jean-Luc Jouve, Jérome Sales de Gauzy, Franck Accadbled, Pierre Lascombes, Pierre Journeau, Claude Karger, Jean François Mallet, Petre Neagoe, Jérome Cottalorda, Benoit De Billy, Jean Langlais, Bernard Herbaux, Damien Fron, Philippe Violas
STUDY DESIGN: Multicenter retrospective study of 54 children. OBJECTIVE: To describe the complication rate of the French vertical expandable prosthetic titanium rib (VEPTR) series involving patients treated between August 2005 and January 2012. SUMMARY OF BACKGROUND DATA: Congenital chest wall and spine deformities in children are complex entities. Most of the affected patients have severe scoliosis often associated with a thoracic deformity...
December 1, 2013: Spine
https://www.readbyqxmd.com/read/23907336/the-response-of-pediatric-ribs-to-quasi-static-loading-mechanical-properties-and-microstructure
#20
Amanda M Agnew, Kevin Moorhouse, Yun-Seok Kang, Bruce R Donnelly, Kiel Pfefferle, Angela X Manning, Alan S Litsky, Rod Herriott, Mahmoud Abdel-Rasoul, John H Bolte
Traumatic injury is a major cause of death in the child population. Motor vehicle crashes account for a large portion of these deaths, and a considerable effort is put forth by the safety community to identify injury mechanisms and methods of injury prevention. However, construction of biofidelic anthropomorphic test devices and computational models for this purpose requires knowledge of bone properties that is difficult to obtain. The objective of this study is to characterize the relationship between mechanical properties and measures of skeletal development in the growing rib...
December 2013: Annals of Biomedical Engineering
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