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Children orthopedics

Megan E Narad, Megan Kennelly, Nanhua Zhang, Shari L Wade, Keith Owen Yeates, H Gerry Taylor, Jeffery N Epstein, Brad G Kurowski
Importance: After traumatic brain injury (TBI), children often experience impairment when faced with tasks and situations of increasing complexity. Studies have failed to consider the potential for attention problems to develop many years after TBI or factors that may predict the development of secondary attention-deficit/hyperactivity disorder (SADHD). Understanding these patterns will aid in timely identification of clinically significant problems and appropriate initiation of treatment with the hope of limiting additional functional impairment...
March 19, 2018: JAMA Pediatrics
Katarina Bojanić, Ruža Grizelj, Jurica Vuković, Lana Omerza, Marina Grubić, Tomislav Ćaleta, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: Patients with congenital diaphragmatic hernia (CDH) have a high residual morbidity rate. We compared self-reported health-related quality of life (HRQoL) between patients with CDH and healthy children. METHODS: Forty-five patients with CDH who were born from January 1, 1990, through February 15, 2015, were matched to healthy, age-matched control participants at a 1:2 ratio. The health records of the study participants were reviewed to determine comorbid conditions, and HRQoL was assessed by both the participants and their parents with the Pediatric Quality of Life Inventory (PedsQL)...
March 14, 2018: Health and Quality of Life Outcomes
L Krause, E Mauz
Recurring pain in children and adolescents can have a negative impact on health and well-being. This study investigates recurring headache, abdominal pain, and back pain in children and adolescents in Thuringia. Data is based on a representative sub-sample from the federal state module Thuringia (2010-2012, n = 4096, 3-17 years), carried out in KiGGS wave 1 (first follow-up interview of the "German Health Interview and Examination Survey for Children and Adolescents"). The 3‑month prevalence of recurrent headache, abdominal pain, and back pain is reported according to socio-demographic factors and is compared with the prevalence for the whole of Germany...
March 12, 2018: Der Schmerz
Cornelius Botha Groenewald
No abstract text is available yet for this article.
March 7, 2018: Evidence-based Nursing
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
Katharina Susanne Gather, Eva von Stillfried, Sebastien Hagmann, Sebastian Müller, Thomas Dreher
BACKGROUND: Most orthopedic surgeons prefer spica cast immobilization in children for 4 to 12 weeks after surgical hip reconstruction in children with developmental hip dysplasia. This challenging treatment may be associated with complications. Studies are lacking that focus on early mobilization without casting for postoperative care after hip reconstruction. METHODS: Twenty-seven children (3.4±2.0 years), including 33 hips with developmental hip dysplasia (DDH) and dislocation of the hip (Tönnis grade 1 to 4), who underwent hip reconstruction (Dega acetabuloplasty, varisation-derotation osteotomy and facultative open reduction) were retrospectively included in this study...
February 20, 2018: World Journal of Pediatrics: WJP
Michelle Kornbluth, Richard E Campbell, John Daskalogiannakis, Elizabeth J Ross, Patricia H Glick, Kathleen A Russell, Jean-Charles Doucet, Ronald R Hathaway, Ross E Long, Thomas J Sitzman
OBJECTIVE: To compare dental arch relationship, craniofacial form, and nasolabial aesthetic outcomes among cleft centers using distinct methods of presurgical infant orthopedics (PSIO). DESIGN: Retrospective cohort study. SETTING: Four cleft centers in North America. PATIENTS: One hundred ninety-one children with repaired complete unilateral cleft lip and palate (CUCLP). MAIN OUTCOME MEASURES: Dental arch relationship was assessed using the GOSLON Yardstick...
January 1, 2018: Cleft Palate-craniofacial Journal
Derek T Bernstein, Lee S Haruno, Shiva Daram, John R Dawson, Wei Zhang, Scott B Rosenfeld
Staphylococcus aureus is the most common causative organism in pediatric septic arthritis, with methicillin-resistant Staphylococcus aureus (MRSA) being responsible for a significant portion of these infections. Early identification and initiation of proper treatment may improve outcomes by minimizing potential morbidity. The purpose of this study was to identify variables obtained on initial patient presentation associated with MRSA septic arthritis. Sixteen factors were retrospectively evaluated in 109 consecutive pediatric patients diagnosed with culture-confirmed septic arthritis...
February 16, 2018: Orthopedics
Aaron I Karlen, Erik J Solberg, Deborah S Quanbeck, Ann E Van Heest
OBJECTIVE: The Orthopaedic In-Training Examination (OITE) is administered annually and is used to assess medical knowledge of orthopedic surgery residents. Beginning in the 2013 to 2014 academic year, the ACGME expanded the postgraduate year (PGY)-1 curriculum from 3 to 6 months of orthopedic surgery rotations. The purpose of this study is to evaluate the effect of increased PGY-1 orthopedic surgery exposure on medical knowledge as measured by the OITE. DESIGN: From 2011 to 2013, 24 PGY-2 residents completed 3 months of PGY-1 orthopedic training (Group 1)...
February 12, 2018: Journal of Surgical Education
Gaetano Ierardo, Valeria Luzzi, Iole Vozza, Antonella Polimeni, Maurizio Bossù
BACKGROUND: Reverse headgear (a facial mask) is one of the most frequently used interceptive orthodontic devices in patients with Class III malocclusion. It is a simple device but may present some drawbacks related to pressure on the skin generated by the forehead and chin supports linked to the maxillary intraoral appliance by elastics. This can cause injury to the chin and lips. METHODS: Patients between 7 and 8 years of age were selected from the Unit of Pediatric Dentistry...
April 2018: Minerva Stomatologica
Jun Wu, Hongxi Guo, Xing Liu, Ming Li, Yujiang Cao, Xiangyang Qu, Hai Zhou, Liuqi Weng
Background and purpose: Percutaneous autologous bone marrow transplantation (PABMT) is a minimally invasive therapeutic strategy for the treatment of delayed bone union in adults, which has been confirmed by many studies. However, there is no report on PABMT application in pediatric orthopedic surgery. The aim of this article was to analyze the therapeutic effect of PABMT in children with delayed union of limb bone and its influence in relation to delayed bone union therapy, transplantation period, patients' sex, fracture location, and fracture fixation...
2018: Therapeutics and Clinical Risk Management
Kathryn V Isaac, Ingrid M Ganske, Stephen A Rottgers, So Young Lim, John B Mulliken
OBJECTIVE: Infants with syndromic cleft lip and/or cleft palate (CL/P) often require more complex care than their nonsyndromic counterparts. Our purpose was to (1) determine the prevalence of CL/P in patients with CHARGE syndrome and (2) highlight factors that affect management in this subset of children. DESIGN: This is a retrospective review from 1998 to 2016. PATIENTS: Patients with CHARGE syndrome were diagnosed clinically and genetically...
March 2018: Cleft Palate-craniofacial Journal
Noam Shohat, Yossy Machluf, Rivka Farkash, Aharon S Finestone, Yoram Chaiter
BACKGROUND: Children and adolescents are commonly referred to an orthopedic surgeon to assess knee malalignment. OBJECTIVES: To assess the prevalence of genu varum and valgum among adolescents, and to identify correlates of these conditions. METHODS: A medical database of 47,588 candidates for military service presenting to the northern recruitment center during an 11 year period was analyzed to identify clinical knee alignment. Based on the standing skin surface intercondylar distance (ICD) or intermalleolar distance (IMD), the prevalence rates of genu varum (ICD ≥ 3 cm) and genu valgum (IMD ≥ 4 cm) were calculated...
February 2018: Israel Medical Association Journal: IMAJ
Rebecca E Rosenburg, Joshua A Abzug, David I Rappaport, Mark A Mazziotti, M Wade Shrader, David Zipes, Benedict Nwomeh, Lisa McLeod
To understand characteristics of pediatric hospitalist (PH) involvement in the care of children admitted to surgical services and explore surgeons' perspectives of PH effectiveness, we conducted a cross-sectional, web-based survey of pediatric surgical (PS) and pediatric orthopedic subspecialists (OS) from professional organizations. We used basic analyses to compare responses between the 2 surgical groups. The initial response rate was 48% (291/606) for PS and 59% (415/706) for OS. Among 185 PS and 212 OS unique programs, PH were routinely engaged (69% and 75%) in the care of surgical patients, particularly in patients with medical complexity (64% PS vs 81% OS; P = ...
February 6, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Guisheng Xu, Liang Gao, Ke Tao, Shengxiang Wan, Yuning Lin, Ao Xiong, Bin Kang, Hui Zeng
RATIONALE: For traumatic upper limb amputees, the prohibitive cost of a custom-made prosthesis brings an insufferable financial burden for their families in developing countries. Three-dimensional (3D) printing allows for creating affordable, lightweight, customized, and well-fitting prosthesis, especially for the growing children. PATIENT CONCERNS: We presented a case of an 8-year-old boy, who suffered a traumatic right wrist amputation as result of a mincing machine accident...
December 2017: Medicine (Baltimore)
Brett M Normandin, David J Tennent, Todd H Baldini, Alesia M Blanchard, Jason T Rhodes
Epiphysiodesis is performed to treat leg-length discrepancies and angular deformities in children. However, when placed across a physis to modulate growth, screws can bend or break postoperatively. This study evaluated the mechanical properties of 3 different screw designs commonly used when performing an epiphysiodesis. Six 4.0-mm cannulated, fully threaded; six 4.0-mm cannulated, partially threaded; and six 4.0-mm noncannulated, partially threaded cancellous screws underwent cantilever bending and tension testing in a simulated physis...
January 25, 2018: Orthopedics
Ram Venkatesh Anantha, Paul Zamiara, Neil H Merritt
BACKGROUND: Given that the management of severely injured children requires coordinated care provided by multiple pediatric surgical subspecialties, we sought to describe the frequency and associated costs of surgical intervention among pediatric trauma patients admitted to a level 1 trauma centre in southwestern Ontario. METHODS: All pediatric (age < 18 yr) trauma patients treated at the Children's Hospital - London Health Sciences Centre (CH-LHSC) between 2002 and 2013 were included in this study...
January 24, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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
Karen Boretsky, Maria A Hernandez, Elizabeth Eastburn, Cornelius Sullivan
BACKGROUND: The clinical reliability and reproducibility of ultrasound-guided lumbar plexus blocks is not established in pediatric populations. We present the results of a combined nerve stimulation ultrasound-guided lumbar plexus block using the vertebral body, transverse process, and psoas muscle as landmarks on a transverse lumbar paravertebral sonogram with mid-axillary transducer placement, "shamrock method," in children and adolescents. AIMS: Our primary objective was to determine the rate of achieving sensory changes in the lumbar plexus distribution...
January 23, 2018: Paediatric Anaesthesia
Marc O'Donnell, William F Lavelle, Mike H Sun
Spondylolysis is frequently seen in adolescents, typically at the L5 vertebral level. While there may be a congenital predisposition for spondylolysis, it has long been suggested that the defect results from a fatigue or stress fracture of the pars interarticularis. Spondylolisthesis may result from a bilateral spondylolytic defect and is frequently asymptomatic. There is a paucity of literature on infant and toddler spondylolysis, as the focus is primarily on school-aged children, typically those over ten years of age...
December 2017: Journal of Spine Surgery (Hong Kong)
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