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paediatric orthopaedics

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https://www.readbyqxmd.com/read/29419321/the-potential-role-of-variations-in-juvenile-hip-geometry-on-the-development-of-legg-calv%C3%A3-perthes-disease-a-biomechanical-investigation
#1
Manuel da Silva Pinheiro, Catherine Dobson, Nicholas M Clarke, Michael Fagan
Legg-Calvé-Perthes disease (LCP) is one of the most poorly understood diseases in paediatric orthopaedics. One common trait of LCP is the marked morphological difference between healthy and pathological hips, early deviations of which (i.e. prior to disease onset) have been suggested to lead to the overload and collapse of the epiphysis. Here, the impact of common variations in geometry is investigated with a finite element model of a juvenile femur under single leg standing and landing. Here, the impact of typical variations in geometry is investigated with a finite element model of a juvenile femur under single leg standing and landing...
February 8, 2018: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29387916/incidence-of-knee-height-asymmetry-in-a-paediatric-population-of-corrected-leg-length-discrepancy-a-retrospective-chart-review-study
#2
Louis-Nicolas Veilleux, Mohammed AlOtaibi, Noémi Dahan-Oliel, Reggie C Hamdy
PURPOSE: The purpose of the study is to provide a methodology to quantify knee height asymmetry (KHA) and to establish the incidence of knee height asymmetry in a patient population visiting the limb length discrepancy clinic in a paediatric-orthopaedic hospital centre. METHOD: A retrospective chart review was performed on all patients who attended the limb length discrepancy clinic and underwent corrective surgery at the Shriners Hospital for Children-Canada from December 2009 to December 2015...
February 1, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29383243/a-brodie-s-abscess-with-soft-tissue-collection-complicating-an-already-difficult-diagnosis
#3
Ben Gabbott, Giles Faria, George Lawson, Karen Daly
A healthy 14-year-old boy with a 3-month history of thigh pain and swelling is referred to a specialist centre with an uncertain diagnosis. After extensive tests and imaging a Brodie's abscess is diagnosed. The abscess is complicated by a fistula (cloaca) through the cortical bone of the femur, resulting in a large complex soft tissue collection. This is a presentation, we are unaware has been documented in any literature. After specialist multi-team combined management (Paediatric Trauma and Orthopaedic and Paediatric Infectious Diseases), the patient undergoes two surgical procedures, and extensive antibiotic cover...
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#4
REVIEW
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
https://www.readbyqxmd.com/read/29327733/orthopaedic-treatment-effects-of-functional-therapy-on-the-sagittal-pharyngeal-dimensions-in-subjects-with-sleep-disordered-breathing-and-class-ii-malocclusion
#5
C Pavoni, E Cretella Lombardo, R Lione, P Bollero, F Ottaviani, P Cozza
The purpose of this cephalometric study was to evaluate the craniofacial changes induced by functional treatment of mandibular advancement with special regard to pharyngeal sagittal airway dimensions, tongue and hyoid bone position in subjects with sleep-disordered breathing (SDB) and dentoskeletal Class II malocclusions compared with an untreated Class II control group. 51 subjects (24 female, 27 male; mean age 9.9 ± 1.3 years) with Class II malocclusion and SDB consecutively treated with a functional appliance (Modify Monobloc, MM) were compared with a control group of 31 subjects (15 males, 16 females; mean age 10...
December 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29326858/improving-management-of-paediatric-buckle-fracture-in-orthopaedic-outpatients-a-completed-audit-loop
#6
M N Baig, C Egan
Introduction Paediatric patient bone fractures are the source of a large number of orthopaedic outpatient visits, especially for fracture clinics. The National Institute for Health and Care Excellence (NICE) guideline NG38 provides guidance on assessing and managing non-complex fractures, such as buckle (i.e., torus) fractures in paediatric patients. Objective We retrospectively audited outpatient records of children younger than 12 years presenting with distal radius buckle fractures for May and June 2017...
November 8, 2017: Curēus
https://www.readbyqxmd.com/read/29317415/examining-changes-in-the-equity-of-physician-distribution-in-japan-a-specialty-specific-longitudinal-study
#7
Koji Hara, Susumu Kunisawa, Noriko Sasaki, Yuichi Imanaka
OBJECTIVES: In this longitudinal study, we examined changes in the geographical distribution of physicians in Japan from 2000 to 2014 by clinical specialty with adjustments for healthcare demand based on population structure. METHODS: The Japanese population was adjusted for healthcare demand using health expenditure per capita stratified by age and sex. The numbers of physicians per 100 000 demand-adjusted population (DAP) in 2000 and 2014 were calculated for subprefectural regions known as secondary medical areas...
January 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29306854/successful-management-of-a-24-year-old-pregnant-woman-with-necrotising-fasciitis-of-the-forearm
#8
Sam Nahas, Anne McKirdy, Arjuna Imbuldeniya
A 24-year-old woman who was 24 weeks pregnant presented to the emergency department with septic shock and an elbow wound that had become infected. She sustained an injury to the tip of the right elbow on a light switch 4 days prior. In the space of 1 day, she developed a necrotising soft tissue infection, which was rapidly spread to the forearm with florid sepsis. Her initial serum C reactive protein was 392 mg/L, and white cell count was 32×109/L. The patient was treated promptly with aggressive surgical debridement and broad-spectrum antibiotics...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29213170/prune-belly-syndrome-a-report-of-15-cases-from-sudan
#9
Abdelmoneim E M Kheir, Eltigani M A Ali, Safaa A Medani, Huda S Maaty
Prune belly syndrome is a rare congenital malformation of unknown aetiology, composed of a triad of deficient abdominal wall muscle, cryptorchidism and urinary tract anomalies. The majority of patients have associated pulmonary, skeletal, cardiac, and gastrointestinal defects. This was a prospective, case finding study that was conducted in the main paediatric hospitals in Khartoum state, during the period December 2015 to September 2016. A total of 15 patients with prune belly syndrome were collected. Patients' characteristics were noted including socio-demographic data, laboratory and radiological investigations and any medical or surgical intervention...
2017: Sudanese Journal of Paediatrics
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#10
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29196274/neuromuscular-diseases-diagnosis-and-management
#11
REVIEW
P Mary, L Servais, R Vialle
Neuromuscular diseases (NMDs) affect the peripheral nervous system, which includes the motor neurons and sensory neurons; the muscle itself; or the neuromuscular junction. Thus, the term NMDs encompasses a vast array of different syndromes. Some of these syndromes are of direct relevance to paediatric orthopaedic surgeons, either because the presenting manifestation is a functional sign (e.g., toe walking) or deformity (e.g., pes cavus or scoliosis) suggesting a need for orthopaedic attention or because orthopaedic abnormalities requiring treatment develop during the course of a known NMD...
November 28, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29179907/management-and-outcomes-of-isolated-paediatric-tibial-spine-fractures
#12
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...
November 16, 2017: Injury
https://www.readbyqxmd.com/read/29170353/56%C3%A2-manipulation-and-reduction-of-paediatric-forearm-fractures-using-es-ketamine-in-a-paediatric-emergency-department-a-5-year-study
#13
Shirley Mulvaney
BACKGROUND: Forearm fractures are the most common paediatric injury presenting to A+E.1,2 Literature supports safe and effective treatment of these injuries in A+E using a variety of sedation methods, including ketamine.3,4 The Paediatric Orthopaedic Trauma Snapshot (POTS) study showed that only 35% of A+Es nationally allow manipulation of these injuries in the department. METHODS: A retrospective analysis was undertaken of all patients presenting with fractures of the forearm between January 2012 to December 2016 who were treated with reduction and manipulation in the Alder Hey A+E department using Es-ketamine...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29132430/hospital-choice-in-germany-from-the-patient-s-perspective-a-cross-sectional-study
#14
Werner de Cruppé, Max Geraedts
BACKGROUND: In many countries health policy encourages patients to choose their hospital, preferably by considering information of performance reports. Previous studies on hospital choice mainly have focused on patients undergoing elective surgery. This study examined a representative sample of hospital inpatients across disciplines and treatment interventions in Germany. Its research questions were: How many patients decide where to go for hospital treatment? How much time do patients have before admission? Which sources of information do they use, and which criteria are relevant to their decision? METHODS: Cross-sectional observational study covering 1925 inpatients of 46 departments at 17 hospitals in 2012...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29130608/impact-of-web-based-clinical-practice-guidelines-on-paediatric-fracture-clinics
#15
Mark W Camp, James R Barnes, Mohita Damany, Leo T Donnan
BACKGROUND: In an effort to standardize management and reduce over-treatment of uncomplicated paediatric fractures, the Victorian Pediatric Orthopaedic Network and the Royal Children's Hospital, Melbourne, created publically available web-based paediatric fracture pathways. The aim of this study was to determine the impact of web-based fracture pathways on the clinic volume at a tertiary-care paediatric fracture clinic. METHODS: A comparative retrospective review was performed at a large, urban, tertiary-care children's hospital...
November 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29098134/a-review-of-epidemiological-distribution-of-different-types-of-fractures-in-paediatric-age
#16
M N Baig
Introduction Treating paediatric patient fractures comprises a large part of any orthopaedic trauma service. The majority of fractures take place during sports and recreational activities. In this study, we examined the incidence of fractures and their distribution according to patient age. Methods We collected retrospective data from all the paediatric age group patients (under age 18) referred to our orthopaedic service from August 2015 to July 2016. We collected data for 1022 patients during one calendar year...
August 28, 2017: Curēus
https://www.readbyqxmd.com/read/29081857/analysis-of-a-paediatric-orthopaedic-network-a-six-year-experience-in-the-south-west-of-the-united-kingdom
#17
D Bruce, C Kocialkowski, F Bintcliffe, F Monsell, J Barnes, R Brown
PURPOSE: We report our experience of a paediatric orthopaedic network, based on a 'hub and spoke' model, covering the South West of the United Kingdom. We identify the areas of most clinical concern, the effect of the network on stream-lining patient management and the benefits of the network to the clinician. METHODS: Prospective data were collected from the minutes of the bi-annual meetings of the South West Paediatric Network (UK) between November 2006 and May 2012...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081850/obstacles-to-reduction-in-infantile-developmental-dysplasia-of-the-hip
#18
K Studer, N Williams, P Studer, M Baker, A Glynn, B K Foster, P J Cundy
PURPOSE: Identification of anatomical structures that block -reduction in developmental dysplasia of the hip (DDH) is -important for the management of this challenging condition. Obstacles to reduction seen on arthrogram are well-known. However, despite the increasing use of MRI in the assessment of adequacy of reduction in DDH, the interpretation of MRI patho-anatomy is ill-defined with a lack of relevant literature to guide clinicians. METHOD: This is a retrospective analysis of the MRI of patients with DDH treated by closed reduction over a five-year period (between 2009 and 2014)...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29081847/an-independent-assessment-of-reliability-of-the-melbourne-cerebral-palsy-hip-classification-system
#19
M W Shrader, A L Koenig, M Falk, M Belthur, C Boan
PURPOSE: Neuromuscular (NM) hip dysplasia is common in patients with cerebral palsy (CP). Traditionally, migration percentage (MP) has been used to measure the severity of NM hip dysplasia; however, the MP has some limitations. The purpose of this study is to determine the intra- and inter-reliability of the Melbourne Cerebral Palsy Hip Classification System in the typical paediatric population of patients with CP. METHODS: A total of 65 anteroposterior pelvis radiographs in patients (age range 12 years to 21 years) with CP spanning all grades (I to VI) of the classification system were identified and collected for analysis in this institutional review board approved study...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29068288/timing-of-surgical-intervention-for-developmental-dysplasia-of-the-hip-a-randomised-controlled-trial-hip-op
#20
Charlotte L Williams, Susie Weller, Lisa Roberts, Isabel Reading, Andrew Cook, Louisa Little, Wendy Wood, Louise Stanton, Andreas Roposch, Nicholas Mp Clarke
BACKGROUND: Developmental dysplasia of the hip (DDH) is a very common congenital disorder, and late-presenting cases often require surgical treatment. Surgical reduction of the hip may be complicated by avascular necrosis (AVN), which occurs as a result of interruption to the femoral head blood supply during treatment and can result in long-term problems. Some surgeons delay surgical treatment until the ossific nucleus (ON) has developed, whereas others believe that the earlier the reduction is performed, the better the result...
October 2017: Health Technology Assessment: HTA
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