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Paediatric spine

Norman Ma, Sarah Mills, Craig McBride, Roy Kimble, Michael Redmond
BACKGROUND: Skateboarding is a popular recreation among children and adolescents. Injuries that result in presentation to emergency departments are varied including head injuries. The study aims to assess the type and severity of neurological damage to the brain and spine in children from injuries incurred while using a skateboard. METHODS: After obtaining Ethics approval, a retrospective case review was performed of all admissions to all Brisbane, Australia public hospital neurosurgery departments of children 18 years and less who experienced injuries to the brain and spine for the years 2010-2014...
March 6, 2018: ANZ Journal of Surgery
John E Lawrence, Danish Saeed, Jonathan Bartlett, Andrew D Carrothers
We report the case of a 55-year-old woman who presented to the emergency department having woken from sleep with right sided thigh swelling. Pelvic radiographs revealed bilateral atypical subtrochanteric femoral fractures (ASFFs). In the two years leading up to this admission, the patient had experienced gradually increasing pain and weakness in her legs which had resulted in a decrease in her mobility from fully mobile to bed-bound. During this time a neurologist had organised a magnetic-resonance imaging (MRI) scan of the brain and spine which was normal...
September 2017: Clinical Cases in Mineral and Bone Metabolism
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
I S Komang-Agung, S B Dwi-Purnomo, A Susilowati
Introduction: Scoliosis is a lateral spinal deformity of 10 degrees or more, resulting in a C-shaped or S-shaped curve of the spine. Information about adolescent idiopathic scoliosis (AIS) prevalence rate is important not only for paediatric health care planning strategy but also for parent's awareness. This study aims to find the suitable inclination cut-off angle and the prevalence rate of AIS in Surabaya, Indonesia. Materials and Methods: This is a descriptive cross-sectional study conducted in 2010. We performed stratified random sampling of 784 Elementary and Junior High School students in Surabaya between 9-16 years of age...
November 2017: Malaysian Orthopaedic Journal
J Bouaoud, A Joly, A Picard, B Thierry, E Arnaud, S James, I Hennessy, B McGarvey, P Cairet, A Vecchione, E Vergnaud, C Duracher, R H Khonsari
Massive swelling of the tongue can occur after posterior fossa and craniofacial surgery. Several hypotheses have been proposed to explain the occurrence of such severe postoperative macroglossia, but this phenomenon is still poorly understood. Severe postoperative macroglossia can be a life-threatening condition due to upper airway obstruction. Three cases of severe postoperative macroglossia that occurred after cervical spine, craniofacial, and posterior fossa surgical procedures are reported here. These cases required specialized maxillofacial management and a prolonged stay in the intensive care unit...
January 1, 2018: International Journal of Oral and Maxillofacial Surgery
Swapnil Kothadia, Umesh Birole, Ashish Ranade
Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning...
November 27, 2017: BMJ Case Reports
A B Scrimshire, M Gawad, R Davies, H George
Paediatric fractures of the tibial spine are relatively rare and controversy remains around how these injuries are best managed (Gans et al., 2014; Hargrove et al., 2004). Consequently most non-specialised paediatric units have limited experience of managing these injuries. This study aims to review the management and outcomes of isolated paediatric tibial spine fractures in a tertiary paediatric orthopaedic centre between 2008 and 2016. Data were collected on patient demographics, mechanism of injury, imaging, Meyers and McKeever grade of injury (Meyers and McKeever), management and outcomes, including Cincinnati and Lysholm-Tegner knee scores at a mean of 36 months post-operatively...
February 2018: Injury
Andrew G Georgiadis, Pam Thomason, Kate Willoughby, H Kerr Graham
The clinical care of children with physical disabilities is a major priority for paediatricians and paediatric orthopaedic surgeons. Cerebral palsy (CP) is the prototypical condition and remains the most common cause of physical disability in developed countries. The incidence is approximately 2 per 1000 live births, translating to between 600 and 700 new children per annum in Australia, with approximately 34 000 children and adults currently living with CP. This figure is predicted to rise inexorably over the next 20 years...
November 2017: Journal of Paediatrics and Child Health
Deborah Aloi, Liliana Belgioia, Salvina Barra, Flavio Giannelli, Francesca Cavagnetto, Fabio Gallo, Claudia Milanaccio, MariaLuisa Garrè, Sonia Di Profio, Natascia Di Iorgi, Renzo Corvò
PURPOSE: To evaluate neuroendocrine late effects in paediatric patients with low grade glioma (LGG) who underwent radiotherapy. METHODS AND MATERIAL: We performed a retrospective evaluation of 40 children with LGG treated from July 2002 to January 2015 with external radiotherapy. Tumour locations were cerebral hemisphere (n=2); posterior fossa (n=15); hypothalamic-pituitary axis (HPA, n=15); spine (n=5). Three patients presented a diffuse disease. We looked for a correlation between endocrine toxicity and tumour and treatment parameters...
November 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Vrinda Saraff, Jaskiran Sahota, Nicola Crabtree, Sophia Sakka, Nicholas J Shaw, Wolfgang Högler
Intravenous pamidronate has been used in the treatment of osteogenesis imperfecta (OI) in children for over 20 years. The more potent zoledronate is an attractive alternative as it is administered less frequently. This study compares the clinical efficacy of intravenous pamidronate (1.5 mg/kg/day over 2 days, every 3 months) versus zoledronate (0.05 mg/kg/dose every 6 months) in 40 children (20 per group) with mild to moderate OI and the treatment costs of the two drugs in a tertiary centre for children with osteoporosis...
October 7, 2017: Archives of Disease in Childhood
D H Kim, J Y Yoo, S Y Ha, Y J Chae
Background: We compared the performances of the paediatric blade of a Pentax Airway Scope and an Ovassapian airway in fibreoptic tracheal intubation in patients whose necks were stabilized by semi-rigid neck collars. Methods: Ninety patients were enrolled in this prospective, open-label, randomized controlled trial. Patients were randomly allocated to one of two groups (Group OVA-FOB and Group AWS-FOB). The time to tracheal intubation, success rate of tracheal intubation, number of optimization manoeuvres (jaw thrust), and difficulty of manipulation of the fibreoptic bronchoscope were compared between the groups...
November 1, 2017: British Journal of Anaesthesia
Florence Julien-Marsollier, Raphaelle David, Julie Hilly, Christopher Brasher, Daphné Michelet, Souhayl Dahmani
BACKGROUND: Numerous publications describe chronic pain following surgery in both adults and children. However, data in the paediatric population are still sparse and both prevalence of chronic pain after surgery and risk factors of this complication still undetermined. METHODS: We prospectively evaluated the prevalence of chronic pain and its neuropathic pain component at 1 year following correction of idiopathic scoliosis in children less than 18 years of age...
September 22, 2017: Scandinavian Journal of Pain
J Chu, S McNally, F Bruyninckx, D Neuhauser
INTRODUCTION: Autonomous twitch elicitation at myofascial trigger points from spondylotic radiculopathies-induced denervation supersensitivity can provide favourable pain relief using electrical twitch-obtaining intramuscular stimulation (ETOIMS). AIM: To provide objective evidence that ETOIMS is safe and efficacious in migraine and persistent pain management due to decades-old injuries to head and spine from paediatric American football. METHODS AND MATERIALS: An 83-year-old mildly hypertensive patient with 25-year history of refractory migraine and persistent pain self-selected to regularly receive fee-for-service ETOIMS 2/week over 20 months...
April 2017: BMJ Innovations
Heather Carol Deane, Catherine L Wilson, Franz E Babl, Stuart R Dalziel, John Alexander Cheek, Simon S Craig, Ed Oakley, Meredith Borland, Nicholas G Cheng, Michael Zhang, Elizabeth Cotterell, Tibor Schuster, David Krieser
BACKGROUND: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) performs multicentre research in Australia and New Zealand. Research priorities are difficult to determine, often relying on individual interests or prior work. OBJECTIVE: To identify the research priorities of paediatric emergency medicine (PEM) specialists working in Australia and New Zealand. METHODS: Online surveys were administered in a two-stage, modified Delphi study...
August 30, 2017: Emergency Medicine Journal: EMJ
Neige M Y Journy, Serge Dreuil, Nathalie Boddaert, Jean-François Chateil, Didier Defez, Hubert Ducou-le-Pointe, Jean-Marc Garcier, Joël Guersen, Bouchra Habib Geryes, Andreas Jahnen, Choonsik Lee, Jacqueline Payen-de-la-Garanderie, Jean-Pierre Pracros, Dominique Sirinelli, Isabelle Thierry-Chef, Marie-Odile Bernier
OBJECTIVES: To describe computed tomography (CT) scanning parameters, volume CT dose index (CTDIvol) and dose-length product (DLP) in paediatric practice and compare them to current diagnostic reference levels (DRLs). METHODS: The survey was conducted in radiology departments of six major university hospitals in France in 2010-2013. Data collection was automatised to extract and standardise information on scanning parameters from DICOM-header files. CTDIvol and DLP were estimated based on Monte Carlo transport simulation and computational reference phantoms...
August 23, 2017: European Radiology
P R P Rushton, I Siddique, R Crawford, N Birch, M J Gibson, M J Hutton
The MAGnetic Expansion Control (MAGEC) system is used increasingly in the management of early-onset scoliosis. Good results have been published, but there have been recent reports identifying implant failures that may be associated with significant metallosis surrounding the implants. This article aims to present the current knowledge regarding the performance of this implant, and the potential implications and strategies that may be employed to identify and limit any problems. We urge surgeons to apply caution to patient and construct selection; engage in prospective patient registration using a spine registry; ensure close clinical monitoring until growth has ceased; and send all explanted MAGEC rods for independent analysis...
June 2017: Bone & Joint Journal
A Stančák, J Kautzner, T Trč, V Havlas
INTRODUCTION: Paediatric avulsion fractures of the pelvis and hip joint are rare injuries most commonly associated with a rapid muscle contraction of the respected apophysis, which is the weakest component of the growing skeleton. The chosen therapy option can be either conservative or surgical. METHODS: We present a cohort of 69 patients treated for an apophyseal avulsion fracture of the anterior superior / inferior iliac spine, the lesser and greater trochanters iliac crest and the ischial tubercle...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Euden Bhutia, Dinesh Kumar, Mohan Kundal, Sunil Kishore, Atul Juneja
BACKGROUND: The objective of the study was to describe the clinical characteristics of atypical articular presentations during the initial outbreak and recurrence in patients with acute rheumatic fever (ARF) in the paediatric age group. METHODS: This was a retrospective, observational study conducted between January 2012 and December 2014 on all suspected cases of acute rheumatic fever (ARF) fulfilling either WHO 2004 or Australian guidelines with atypical articular manifestations ie, presence of at least one of the following features: duration of symptoms more than three weeks; monoarthritis/arthralgia; involvement of small joints of hand and feet and/or cervical spine and/or hip joint; and, not responding to salicylates in one week...
April 24, 2017: Heart, Lung & Circulation
F F Alqahtani, F Messina, E Kruger, H Gill, M Ellis, I Lang, P Broadley, A C Offiah
AIM: To assess observer reliability and diagnostic accuracy in children, of a semi-automated six-point technique developed for vertebral fracture (VF) diagnosis in adults, which records percentage loss of vertebral body height. MATERIALS AND METHODS: Using a semi-automated software program, five observers independently assessed T4 to L4 from the lateral spine radiographs of 137 children and adolescents for VF. A previous consensus read by three paediatric radiologists using a simplified algorithm-based qualitative technique (i...
October 2017: Clinical Radiology
S Frisch, B Timmermann
As an alternative to conventional photon-based radiotherapy, radiation with protons is recognised to offer considerable advantages. Today, central nervous system tumours, various sarcomatous tumours, childhood cancer and head and neck tumours are commonly treated with proton therapy. This review evaluates current data from clinical and dosimetric trials on the treatment of selected sarcomatous tumours like rhabdomyosarcoma, osteosarcoma, chordoma, chondrosarcoma and Ewing sarcoma. Special considerations for paediatric tumours and future prospects of proton therapy are outlined...
August 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
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