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Pediatric orthopedic

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https://www.readbyqxmd.com/read/28079742/the-hybrid-method-for-the-treatment-of-congenital-talipes-equinovarus-preliminary-results-on-92-consecutive-feet
#1
Federico Canavese, Mounira Mansour, Guillemette Moreau-Pernet, Yannael Gorce, Alain Dimeglio
Over the past 4 years, our pediatric orthopedic unit has developed a new hybrid protocol combining the advantages of Ponseti's method and the French functional physiotherapy method. Sixty-one patients (92 feet) completed treatment. Clubfoot was unilateral in 30 (49.2%) patients and bilateral in 31 (50.8%) patients. The mean Dimeglio score at the start of treatment was 13.5/20 (range: 6/20-19/20). All patients had clinical and radiographic follow-up for at least 2 years (range: 2-4 years). If orthopedic treatment was ineffective and feet showed no improvement, further surgery was performed...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28079740/venous-thromboembolism-among-pediatric-orthopedic-trauma-patients-a-database-analysis
#2
Daniel Guzman, Samir Sabharwal, Caixia Zhao, Sanjeev Sabharwal
Using the 2012 Kids Inpatient Database, we assessed records of pediatric patients (<21 years old) with fractures of the upper limb, lower limb, spine, pelvis, and multiple locations and calculated the overall prevalence of venous thromboembolism (VTE) and associated potential risk factors. 387 (0.68%) of 57 183 patients with one or more fractures were diagnosed with VTE. Children sustaining fractures of the axial skeleton and those with multiple fractures had a higher prevalence of VTE than those with isolated extremity fractures...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28063517/the-increasing-problem-of-subclinical-and-overt-hypervitaminosis-d-in-india-an-institutional-experience-and-review
#3
Lokesh Kumar Sharma, Deep Dutta, Neera Sharma, Adesh Kisanji Gadpayle
OBJECTIVE: The aim of this study was to determine the changes in serum vitamin D distribution at an institute in India over the past 6 y and compare it with global trends. METHODS: We conducted an audit of 25-hydroxyvitamin D (25-OHD), calcium, and plasma intact parathyroid hormone (iPTH) reporting from January 2011 to February 2016. References for review were identified through searches of PubMed, Medline, and Embase for articles published until February 2016 using keywords "hypervitaminosis D" (MeSH Terms) OR "vitamin D toxicity" (All Fields) OR "vitamin-D intoxication" (All Fields)...
February 2017: Nutrition
https://www.readbyqxmd.com/read/28057478/developments-in-ambulatory-surgery-in-orthopedics-in-france-in-2016
#4
REVIEW
C Hulet, G Rochcongar, C Court
Under the new categorization introduced by the Health Authorities, ambulatory surgery (AS) in France now accounts for 50% of procedures, taking all surgical specialties together. The replacement of full hospital admission by AS is now well established and recognized. Health-care centers have learned, in coordination with the medico-surgical and paramedical teams, how to set up AS units and the corresponding clinical pathways. There is no single model handed down from above. The authorities have encouraged these developments, partly by regulations but also by means of financial incentives...
November 15, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28029391/off-hour-surgery-among-orthopedic-subspecialties-at-an-urban-quaternary-care-level-1-trauma-center
#5
Amanda Lans, Stein J Janssen, David Ring
PURPOSE: We sought to determine and quantify which subspecialties of orthopedic surgeons are operating off hours in an urban, quaternary-care, level 1 trauma center. MATERIALS AND METHODS: We used our clinical registry to identify 43,211 orthopedic surgeries performed between January 2008 and December 2011. Our outcome measures were the number and proportion of off-hour surgeries performed as well as the number and proportion of off-hours per subspecialty. The denominators were the total number of surgeries and the total number of surgical hours worked per subspecialty...
October 28, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027279/the-influence-of-the-route-of-antibiotic-administration-methicillin-susceptibility-vancomycin-duration-and-serum-trough-concentration-on-outcomes-of-pediatric-staphylococcus-aureus-bacteremic-osteoarticular-infection
#6
J Chase McNeil, Sheldon L Kaplan, Jesus G Vallejo
BACKGROUND: Bacteremia is often one factor used in deciding the need for prolonged intravenous antimicrobial therapy in osteoarticular infections (OAI). We examined treatment practices and outcomes of bacteremic S. aureus osteoarticular infections (BOAI) evaluated at Texas Children's Hospital (TCH). METHODS: Cases of acute hematogenous OAI in children with positive blood cultures for S. aureus at TCH from 2011-2014 were reviewed. Orthopedic complications included chronic osteomyelitis, growth arrest, pathologic fracture, avascular necrosis and chronic dislocation...
December 23, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28011445/drivers-and-barriers-to-acceptance-of-web-based-aftercare-of-patients-in-inpatient-routine-care-a-cross-sectional-survey
#7
Severin Hennemann, Manfred E Beutel, Rüdiger Zwerenz
BACKGROUND: Web-based aftercare can help to stabilize treatment effects and support transition after inpatient treatment, yet uptake by patients seems limited in routine care and little is known about the mechanisms of adoption and implementation. OBJECTIVE: The aim of this study was to (1) determine acceptance of Web-based aftercare and (2) explore its drivers and barriers in different subgroups of a mixed inpatient sample. METHOD: In a cross-sectional design, 38...
December 23, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28009537/overweight-and-obese-pediatric-patients-have-an-increased-risk-of-developing-a-surgical-site-infection
#8
Brian P Blackwood, Colin D Gause, Jamie C Harris, Christina M Theodorou, Irene Helenowski, Timothy B Lautz, Julia Grabowski, Catherine J Hunter
BACKGROUND: Obesity is a known risk factor in adult surgical site infections (SSIs), but its significance in pediatrics is unclear. We hypothesized that overweight and obese children have increased risk for SSI. PATIENTS AND METHODS: A National Surgical Quality Improvement Program-Pediatric (NSQIP-P) file and single-center reviews identified surgical patients (2-18 years) who developed SSIs. Patients were classified as underweight, normal, overweight, or obese based on body mass index (BMI)...
December 23, 2016: Surgical Infections
https://www.readbyqxmd.com/read/28009137/osteonecrosis-as-a-complication-in-pediatric-patients-with-acute-lymphoblastic-leukemia
#9
Ilaria Riccio, Elvira Pota, Marco Marcarelli, Maria Carmen Affinita, Daniela Di Pinto, Cristiana Indolfi, Nicola Del Regno, Marco Esposito
Osteonecrosis is a significant adverse effect of treatment administered to children suffering from acute lymphoblastic leukemia (ALL) that may have a negative effect on the quality of life. The purpose of this study is to evaluate the rate of secondary vascular osteonecrosis (ON) in a population of pediatric patients with ALL treated with corticosteroids and cytostatic agents. A retrospective analysis of prospectively collected data of the medical records of 328 patients with ALL identified 4 cases with ON, corresponding to 1...
November 28, 2016: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/27990193/does-weather-matter-the-effect-of-weather-patterns-and-temporal-factors-on-pediatric-orthopedic-trauma-volume
#10
Kristin S Livingston, Patricia E Miller, Anneliese Lierhaus, Travis H Matheney, Susan T Mahan
OBJECTIVES: Orthopaedists often speculate how weather and school schedule may influence pediatric orthopedic trauma volume, but few studies have examined this. This study aims to determine: how do weather patterns, day, month, season and public school schedule influence the daily frequency of pediatric orthopedic trauma consults and admissions? METHODS: With IRB approval, orthopedic trauma data from a level 1 pediatric trauma center, including number of daily orthopedic trauma consults and admissions, were collected from July 2009 to March 2012...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27984340/predictors-of-long-term-victimization-after-early-pediatric-traumatic-brain-injury
#11
Anna H Hung, Amy Cassedy, Hanna M Schultz, Keith Owen Yeates, Hudson Gerry Taylor, Terry Stancin, Nicolay Chertkoff Walz, Shari L Wade
OBJECTIVE: Pediatric traumatic brain injuries (TBIs) adversely affect long-term functional and social outcomes. Limited research suggests children with TBI are more likely to be victimized by peers than noninjured children. Deficits in social information processing (SIP), cognitive ability, and executive functioning (EF) may contribute to increased victimization risk. This study examined rates of peer victimization/bullying in children with early TBI compared with children with orthopedic injuries (OIs) and the role of processing speed, executive function (EF), and SIP as mediators of the association of TBI and peer victimization...
January 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/27939800/changes-in-blood-pressure-and-heart-rate-during-sedation-with-ketamine-in-the-pediatric-ed
#12
Adam C Patterson, Shernaz A Wadia, Douglas J Lorenz, Michelle D Stevenson
BACKGROUND: Ketamine is commonly used in the emergency department for short, painful procedures. We describe changes in blood pressure (BP) and heart rate (HR) during procedural sedation with ketamine, as these changes have not been well described in children. METHODS: We performed a secondary analysis of a prospective, observational study involving children aged 8 to 18 years who received procedural sedation with ketamine in a pediatric emergency department. Serial vital signs and sedation scores were recorded from baseline until recovery from ketamine procedural sedation...
October 11, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#13
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27927507/sacral-alar-iliac-fixation-in-pediatric-deformity-radiographic-outcomes-and-complications
#14
Amit Jain, Khaled M Kebaish, Paul D Sponseller
STUDY DESIGN: Retrospective case series. OBJECTIVES: To assess the radiographic outcomes and complications of sacral-alar-iliac (SAI) fixation in children. SUMMARY OF BACKGROUND DATA: Pelvic fixation in children undergoing spinal deformity surgery can be challenging because of complex anatomy, compound biomechanical forces at the lumbosacral junction, and poor bone quality. METHODS: Radiographic and clinical records of 80 consecutive patients aged 18 years or younger who underwent posterior spinal fusion surgery with SAI fixation by one pediatric orthopedic surgeon and who had a minimum 2 years of follow-up (mean follow-up: 3...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#15
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#16
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
February 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#17
Giorgio Veneziano, Jennifer Tripi, Dmitry Tumin, Mumin Hakim, David Martin, Ralph Beltran, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND: Femoral nerve blockade (FNB) provides effective postoperative analgesia in children undergoing arthroscopic knee surgery as evidenced by their opioid-sparing effects and decreased postoperative pain scores. Increasing the local anesthetic concentration in peripheral nerve blockade for adults undergoing orthopedic surgery has been shown to be beneficial, increasing block success rate, and providing a longer duration of analgesia. The effect of increasing the concentration of local anesthetic in extremity blocks in children remains largely unexplored...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27920572/home-peripheral-nerve-catheters-the-first-24-months-of-experience-at-a-children-s-hospital
#18
Andrew Gable, Candice Burrier, Jenna Stevens, Sharon Wrona, Kevin Klingele, Tarun Bhalla, David P Martin, Giorgio Veneziano, Joseph D Tobias
CONTEXT: Home peripheral nerve catheters (PNCs) have become common practice for adult patients after major orthopedic surgery. However, use in pediatric patients is a recent application. OBJECTIVES: The purpose of this study was to review the demographics and outcomes of pediatric patients receiving a PNC at our institution. METHODS: This retrospective study included patients from October 2012 through October 2014 undergoing orthopedic procedures with a PNC placed for postoperative pain management...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#19
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27877097/preoperative-antibiotic-orders-protocol-initiated-pharmacist-order-entry
#20
Ben B Hyde, Richard K Ogden, Ron D Berger, Brad W VanBrimmer, Leslie M Stach
OBJECTIVE: To evaluate the antibiotic selection of preoperative orders before and after a pharmacist order entry protocol for patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization. METHODS: A retrospective chart review of orthopedic surgery procedures on patients with MRSA colonization at a free-standing, academic pediatric hospital, between February 2010 and February 2012. RESULTS: Procedures that were performed pre protocol (n = 27) implementation had a 63% rate of appropriate antibiotic selection compared to 81% in the postprotocol group (n = 32; p = 0...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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