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https://www.readbyqxmd.com/read/28643552/drug-induced-physeal-abnormalities-in-preclinical-toxicity-studies
#1
Kendall S Frazier
Most toxic physeal changes are characterized microscopically by altered chondrocyte development, proliferation, or maturation in the growth plate and eventually result in disordered appositional bone growth. Many therapeutic drugs directly or indirectly target proteins involved in chondrocytic differentiation and maturation pathways, so toxic physeal injury has become increasingly common in preclinical toxicologic pathology. While physeal dysplasia has been associated with several different drug classes including bisphosphonates, vascular endothelial growth factor receptor inhibitors, fibroblast growth factor receptor inhibitors, transforming growth factor beta receptor inhibitors, and vascular targeting agents, physeal changes often share similar morphologic features including thickening and disorganization of the hypertrophic layer, increased numbers of hypertrophic chondrocytes, altered mineralization of endochondral ossification, and/or increased thickness of subphyseal bone...
January 1, 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#2
Jeremy Korsh, Stephen Adolfsen
Salter-Harris type I (SH-I) fractures of the distal fibula are commonly encountered in pediatric orthopedics. We describe 2 unique cases of adolescents with completely displaced SH-I distal fibula fractures that were treated operatively. In the first case, a closed reduction attempt failed and the patient required open reduction and internal fixation of the distal fibula and syndesmosis. The syndesmotic ligaments were avulsed from the distal fibular metaphysis. In the second case, closed reduction of the distal fibula fracture was partially successful, but anatomic reduction could not be achieved without open reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28612581/surgical-options-for-anterior-cruciate-ligament-reconstruction-in-the-young-child
#3
Meghan J Price, Lionel Lazaro, Frank A Cordasco, Daniel W Green
Injury to the anterior cruciate ligament (ACL) is becoming increasingly common in the skeletally immature population. Historically, there was a reluctance to operate on skeletally immature patients due to potential damage to the physis and subsequent growth disturbances; however, more recently, ACL reconstruction techniques specifically developed for this young population have shown good outcomes and low complication rates. In this article, we briefly discuss the modifiable and non-modifiable risk factors for ACL injury in children, options for conservative management for ACL rupture, and outcomes for delayed operative management...
August 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28607872/vascularized-fibula-based-physis-transfer-a-follow-up-study-of-longitudinal-bone-growth-and-complications
#4
Ronnie L Shammas, Yash J Avashia, Alfredo E Farjat, Anthony A Catanzano, L Scott Levin, William C Eward, Brian E Brigman, Detlev Erdmann
BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up of longitudinal growth patterns and outcomes after free fibula epiphyseal transfer in upper extremity reconstruction. METHODS: A retrospective review of 4 patients who underwent free fibula epiphyseal transfer after oncologic resection of the proximal humerus for osteosarcoma was performed...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28601942/anatomic-reconstruction-of-the-medial-patellofemoral-ligament-in-children-and-adolescents-using-a-pedicled-quadriceps-tendon-graft-shows-favourable-results-at-a-minimum-of-2-year-follow-up
#5
Manfred Nelitz, Jens Dreyhaupt, Sean Robert March Williams
PURPOSE: In adults, reconstruction of the medial patellofemoral ligament (MPFL) has shown good results. Treatment for recurrent patellar instability in children and adolescents with open growth plates, however, requires alternative MPFL reconstruction techniques. This study presents the outcomes of a minimally invasive technique for anatomic reconstruction of the MPFL in children using a pedicled superficial quadriceps tendon graft, hardware-free patellar graft attachment, and anatomic femoral fixation that spares the distal femoral physis...
June 10, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28601180/musculoskeletal-traumatic-injuries-in-children-characteristic-imaging-findings-and-mimickers
#6
REVIEW
Victor M Ho-Fung, Matthew A Zapala, Edward Y Lee
Musculoskeletal traumatic injuries in children demonstrate characteristic imaging findings. The physis is the most susceptible structure to traumatic injury. The periosteum in children plays a key role in rapid bone healing and stability. The main complications of fractures in children are premature physeal closure, potential limb length discrepancy, and angular deformities. Understanding the normal bone growth, healing, and complications of pediatric fractures is crucial for appropriate imaging diagnosis. This article discusses currently available imaging modalities with up-to-date techniques, underlying mechanisms, and characteristic imaging findings of musculoskeletal traumatic injuries and mimickers encountered in daily clinical practice...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28594520/pediatric-metacarpal-fractures
#7
Jenna Godfrey, Roger Cornwall
Metacarpal fractures account for 10% to 35% of all pediatric hand fractures. Pediatric metacarpal fractures commonly occur in patients aged 13 to 16 years, with most injuries sustained during sports activities. Pseudoepiphyses can be confused with metacarpal fractures; however, a careful physical examination can help physicians distinguish the two. Thumb metacarpal base fractures that involve the physis warrant special attention. Thumb metacarpal base fractures with lateral metaphyseal fragments and pediatric Bennett fracture variants (Salter-Harris type III and type IV fractures) are unstable and require surgical management...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594518/pediatric-phalanx-fractures
#8
Joshua M Abzug, Karan Dua, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Phalangeal fractures are the most common type of hand fracture that occurs in the pediatric population and account for the second highest number of emergency department visits in the United States for fractures. The incidence of phalangeal fractures is the highest in children aged 10 to 14 years, which coincides with the time that most children begin playing contact sports. Younger children are more likely to sustain a phalangeal fracture in the home setting as a result of crush and laceration injuries. Salter-Harris type II fractures of the proximal phalanx are the most common type of finger fracture...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28593062/elastic-intramedullary-nailing-of-a-medial-clavicle-fracture-in-a-pediatric-patient
#9
Michael J Stark, Michael J DeFranco
INTRODUCTION: Injuries to the medial clavicle in pediatric patients typically involve the physis and/or sternoclavicular joint. Clavicle fractures are one of the most common injuries in children, but ones at its medial end are rare. Most medial clavicle fractures are treated nonoperatively, but surgery is indicated in some cases. This original case report is unique in describing the use of an elastic intramedullary nail for fixation of a completely displaced medial clavicle fracture in a pediatric patient...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28529662/femoral-and-acetabular-re-alignment-in-slipped-capital-femoral-epiphysis
#10
M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529660/biomechanical-considerations-in-slipped-capital-femoral-epiphysis-and-insights-into-prophylactic-fixation
#11
E Leblanc, J M Bellemore, T Cheng, D G Little, O Birke
PURPOSE: Slipped capital femoral epiphysis (SCFE) is a deformity of the proximal femur secondary to widened and unstable physis. In stabilising the slip, gold standard treatments stop growth and involve premature physeal closure, which prevents the remodelling of the acquired deformity and creates a leg length discrepancy that may be significant in younger patients. METHODS: We measured the impact of placing threaded screws across the proximal femoral physis by measuring the centre-trochanteric distance (CTD) and articulo-trochanteric distance (ATD) in participants with or without prophylactic fixation...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529654/histological-histochemical-and-ultrastructural-study-of-slipped-capital-femoral-epiphysis
#12
I Tresoldi, A Modesti, M Dragoni, V Potenza, E Ippolito
PURPOSE: The purpose of our study was to investigate the histological, histochemical and ultrastructural aspects of the proximal femoral growth plate in slipped capital femoral epiphysis (SCFE). METHODS: Eight core biopsies of the proximal femoral growth plate were performed during in situ epiphysiodesis in patients with SCFE that was at the pre-slipping stage in two cases and at the mild slipping stage (Southwick angle < 30°) in six cases. After fixation, the specimens were processed for either histological or histochemical or ultrastructural studies...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28520461/clinical-outcome-after-arthroscopic-debridement-and-microfracture-for-osteochondritis-dissecans-of-the-capitellum
#13
Rens Bexkens, Kim I M van den Ende, Paul T Ogink, Christiaan J A van Bergen, Michel P J van den Bekerom, Denise Eygendaal
BACKGROUND: Various surgical treatment techniques have been developed to treat capitellar osteochondritis dissecans; however, the optimal technique remains the subject of ongoing debate. PURPOSE: To evaluate clinical outcomes after arthroscopic debridement and microfracture for advanced capitellar osteochondritis dissecans. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 2008 and 2015, the authors followed 77 consecutive patients (81 elbows) who underwent arthroscopic debridement and microfracture, and loose body removal if needed, for advanced capitellar osteochondritis dissecans...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28513428/slipped-capital-femoral-epiphysis-a-review-of-management-in-the-hip-impingement-era
#14
Mahmoud A Mahran, Mostafa M Baraka, Hany M Hefny
Slipped capital femoral epiphysis (SCFE) remains the most common adolescent hip disorder. Most cases present with stable slips, and in situ fixation is the most commonly adopted treatment worldwide. The introduction of the concept of femoroacetabular impingement and subsequent studies have revealed SCFE-related hip impingement to be a significant pre-arthritic condition, and the previously suggested remodeling of the proximal femur after in situ fixation has been called into question. Complex proximal femoral osteotomies and more recently intra-articular procedures via surgical hip dislocation have been employed...
2017: SICOT-J
https://www.readbyqxmd.com/read/28502605/transphyseal-separation-of-the-distal-humerus-in-newborns
#15
Cosimo Gigante, Sunil Gurpur Kini, Carlo Origo, Andrea Volpin
Obstetric traumatic separation of the distal humeral epiphysis is a very uncommon injury, which presents a diagnostic challenge. These case serials reviewed the functional outcomes of 5 patients who had sustained a fracture-separation of the distal humeral epiphysis at birth. The diagnosis was made at a mean time of 40.8 h after delivery. All the patients were treated with gentle close manipulation, reduction under fluoroscopy and above-elbow cast application. After discharge, the patients were followed up for a mean of 30 months...
April 14, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28492928/local-changes-to-the-distal-femoral-growth-plate-following-injury-in-mice
#16
Lauren M Mangano Drenkard, Meghan E Kupratis, Katie Li, Louis C Gerstenfeld, Elise F Morgan
Injury to the growth plate is associated with growth disturbances, most notably premature cessation of growth. The goal of this study was to identify spatial changes in the structure and composition of the growth plate in response to injury to provide a foundation for developing therapies that minimize the consequences for skeletal development. We used contrast-enhanced micro-computed tomography (CECT) and histological analyses of a murine model of growth plate injury to quantify changes in the cartilaginous and osseous tissue of the growth plate...
May 8, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28482317/physi-chemical-and-sorption-properties-of-biochars-prepared-from-peanut-shell-using-thermal-pyrolysis-and-microwave-irradiation
#17
Gang Chu, Jing Zhao, Fangyuan Chen, Xudong Dong, Dandan Zhou, Ni Liang, Min Wu, Bo Pan, Christian E W Steinberg
Microwave irradiation (MW) is an effective technique in heating and pyrolysis. This study compared the properties of peanut shell-biochars produced using MW and muffle furnace (FN). At the same pyrolysis temperature, MW biochars preserved more biomass (as indicated by their higher yields and higher abundance of functional groups) and possessed larger surface areas due to the high abundance of micropores. MW biochars generally exhibited higher adsorption of carbamazepine (CBZ) and bisphenol A (BPA) than FN biochars...
August 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28473935/surgical-fixation-of-bilateral-simultaneous-avulsion-fractures-of-the-proximal-tibia-in-a-12-year-old-with-history-of-conservatively-managed-unilateral-tibial-avulsion-fracture
#18
Christopher Newman, Dharsh Musiienko, Samuel Law
Fractures of the proximal tibial epiphysis are rare, representing less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are extremely rare. The specific anatomical and histological features of the proximal tibial epiphysis make it vulnerable to a specific fracture pattern that occurs when the tensile force of the quadriceps is greater than the fibrocartilaginous tissue underlying the tibial tuberosity. We report the first case to our knowledge of a 12-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed unilateral tibial tuberosity avulsion fracture...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28455719/valgus-slipped-capital-femoral-epiphysis-with-contralateral-pre-slip
#19
Dana E Amiraian, Zahir Sarwar, William R Bireley, Elizabeth Moran
Slipped capital femoral epiphysis (SCFE) is a common hip disorder in older children and adolescents, classically with medial and posterior slippage of the proximal femoral epiphysis. However, valgus SCFE is a very rare entity, where the proximal femoral epiphysis slips laterally and posteriorly. To our knowledge, valgus SCFE with magnetic resonance imaging (MRI) features of contralateral pre-slip has not yet been reported. We present a case of a 9 year old girl with symptomatic valgus SCFE on the left and asymptomatic contralateral pre-slip on the right with concurrent radiographic, sonographic, and MRI findings...
April 28, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28444758/intraoperative-use-of-a-transarticular-circular-fixator-construct-to-facilitate-reduction-and-stabilisation-of-a-proximal-tibial-physeal-fracture-in-a-dog
#20
M D Johnson, D D Lewis, M D Winter
CASE REPORT: A 4-month-old female intact American Pit Bull Terrier was presented for right pelvic limb lameness 1 day after the dog had been hit by an all-terrain vehicle. Orthogonal radiographs of the right stifle revealed a Salter-Harris type IV fracture through the proximal tibial physis extending caudodistally through the proximal tibial metaphysis. The distal tibia was markedly displaced cranially, laterally and proximally, resulting in complete overriding of the fracture segments...
May 2017: Australian Veterinary Journal
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