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Pediatric fracture

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https://www.readbyqxmd.com/read/28343905/the-dana-farber-consortium-protocol-for-the-treatment-of-adolescents-and-young-adults-with-acute-lymphoblastic-leukemia-a-single-institution-experience-in-saudi-arabia
#1
Amal S Alabdulwahab, Hussein G Elsayed, Mohamed A Sherisher, Wafa M Elbjeirami, Nelly Alieldin
BACKGROUND: Recent retrospective analyses and phase II trials have shown differential outcomes in adolescents and young adults when treated with pediatric compared with adult protocols. The aim of this study was to evaluate the efficacy and toxicity of the Dana Farber Consortium Protocol (DFCP) in Saudi young adults diagnosed with de novo acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: In this retrospective study we included 38 patients with de novo ALL who presented to King Abdulla Medical City in the period from June 2010 to March 2015 and received the DFCP (Princess Margret modified version)...
February 16, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28338594/the-association-of-non-accidental-trauma-with-historical-factors-exam-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#2
Mauricio A Escobar, Marc Auerbach, Katherine Flynn-O'Brien, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly Falcone, Rita Burke, John M Cox, Sabine Maguire
Early identification of non-accidental trauma (NAT) is a critical component of pediatric trauma care. Literature searches were conducted related to the association of NAT with seven key areas: history, exam findings (burns, oral trauma, bruising) and imaging (fractures, abdominal and brain injuries). When available, odds ratios (OR) with 95% confidence intervals (CI) for associations with NAT are presented. Systematic reviews have been published in six of the seven key areas and are described. The operational definition of NAT was widely variable across studies, prohibiting meta-analysis...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#3
Yoshito Okumura, Nestor Maldonado, Kyle Lennon, Bryan McCarty, Philipp Underwood, Mathew Nelson
BACKGROUND: Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. CASE REPORT: We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28331905/asymmetrical-pedicle-subtraction-osteotomy-for-progressive-kyphoscoliosis-caused-by-a-pediatric-chance-fracture-a-case-report
#4
Satoshi Suzuki, Nobuyuki Fujita, Tomohiro Hikata, Akio Iwanami, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND: Although most pediatric Chance fractures (PCFs) can be treated successfully with casting and bracing, some PCFs cause progressive spinal deformities requiring surgical treatment. There are only few reports of asymmetrical osteotomy for PCF-associated spinal deformities. CASE PRESENTATION: We here report a case of a 10-year-old girl who suffered an L2 Chance fracture from an asymmetrical flexion-distraction force, accompanied by abdominal injuries. She was treated conservatively with a soft brace...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28328742/treatment-of-proximal-humerus-fractures-in-children-with-a-modified-palm-tree-technique
#5
Ayman M Ali, Sallam I Fawzy, Medhat Moaty, Mohamed Abelaziz
Although most pediatric proximal humeral fractures can be successfully treated conservatively with satisfactory results, many operative techniques have been described for the treatment of displaced proximal humeral fractures. The aim of this study is to evaluate the efficacy of percutaneous fixation using a modified palm tree technique for proximal humerus fractures in children. Between March 2011 and May 2013, the modified palm tree technique was used for the management of 30 children (20 boys and 10 girls) with displaced proximal humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28328740/comparison-of-the-lateral-and-posterior-approaches-in-the-treatment-of-pediatric-supracondylar-humeral-fractures
#6
Gökçer Uzer, Fatih Yildiz, Mehmet Elmadağ, Kerem Bilsel, Tunay Erden, Anil Pulatkan, Derya Çelik, Volkan Gürkan
This study explored the radiological, functional, and cosmetic results of treatment of supracondylar humeral fractures with open reduction and percutaneous pinning, comparing posterior triceps V-splitting (group I, n=22) and lateral (group II, n=25) approaches. The time to union, the functional and cosmetic results, and the flexor and extensor muscle strengths were measured and compared with the contralateral extremities. There were no statistical differences between the groups. The V-splitting posterior approach is as safe and effective as the lateral approach in the surgical treatment of pediatric supracondylar humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#7
Christopher J DeFrancesco, Wudbhav N Sankar
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28302103/age-and-the-risk-of-all-terrain-vehicle-related-injuries-in-children-and-adolescents-a-cross-sectional-study
#8
Lianne McLean, Kelly Russell, Steven McFaull, Lynne Warda, Milton Tenenbein, Jonathan McGavock
BACKGROUND: The study was designed to determine if youth <16 years are at a greater risk of serious injuries related to all-terrain vehicle (ATV) use compared to older adolescents and adults. METHODS: We performed cross sectional study of children and adults presenting to pediatric and adult emergency departments between 1990 and 2009 in Canada. The primary exposure variable was age <16 years and the primary outcome measure was moderate to serious injury determined from physician report of type and severity of injury...
March 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28291142/lower-extremity-avulsion-fractures-in-the-pediatric-and-adolescent-athlete
#9
Jonathan Schiller, Steven DeFroda, Travis Blood
Lower extremity avulsion fractures are uncommon in the pediatric population and can be misdiagnosed without proper imaging and/or clinical suspicion for these injuries. The most common locations of avulsion injuries are the ischial tuberosity, anterior superior iliac spine, and anterior inferior iliac spine. Less often, avulsion fractures occur in the tibial tubercle, calcaneus, and greater and lesser trochanters. When treated properly with rest and altered weight bearing, most of these injuries heal without complication...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28290112/protecting-bone-health-in-pediatric-rheumatic-diseases-pharmacological-considerations
#10
REVIEW
Yujuan Zhang, Diana Milojevic
Bone health in children with rheumatic conditions may be compromised due to several factors related to the inflammatory disease state, delayed puberty, altered life style, including decreased physical activities, sun avoidance, suboptimal calcium and vitamin D intake, and medical treatments, mainly glucocorticoids and possibly some disease-modifying anti-rheumatic drugs. Low bone density or even fragility fractures could be asymptomatic; therefore, children with diseases of high inflammatory load, such as systemic onset juvenile idiopathic arthritis, juvenile dermatomyositis, systemic lupus erythematosus, and those requiring chronic glucocorticoids may benefit from routine screening of bone health...
March 13, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28289906/pediatric-chest-ct-at-chest-radiograph-doses-when-is-the-ultralow-dose-chest-ct-clinically-appropriate
#11
Javier E Villanueva-Meyer, David M Naeger, Jesse L Courtier, Michael D Hope, Jack W Lambert, John D MacKenzie, Andrew S Phelps
PURPOSE: Computed tomography (CT) use in emergency departments represents a significant contribution to pediatric patients' exposure to ionizing radiation. Here, we evaluate whether ultralow-dose chest CT can be diagnostically adequate for other diagnoses and whether model-based iterative reconstruction (MBIR) can improve diagnostic adequacy compared to adaptive statistical iterative reconstruction (ASIR) at ultralow doses. METHODS: Twenty children underwent chest CTs: 10 standard-dose reconstructed with ASIR and 10 ultralow-dose reconstructed with ASIR and MBIR...
March 14, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28288688/postoperative-brachial-artery-entrapment-associated-with-pediatric-supracondylar-fracture-of-the-humerus-a-case-report
#12
David Latz, Jan Grassmann, Erik Schiffner, Sebastian Gehrmann, Mansur Duran, Joachim Windolf, Pascal Jungbluth
BACKGROUND: Severely displaced supracondylar fractures of the humerus in children are frequently associated with complications including neurovascular injuries, non-union, or compartment syndrome. In the current literature, no report exists about postoperative brachial artery entrapment in combination with an inconspicuous preoperative neurovascular examination. CASE PRESENTATION: We present a case of a 6-year-old white boy with a pulseless radial and ulnar artery after open reduction and internal fixation of a severely displaced supracondylar fracture of his right humerus (Gartland type III) using four K-wires...
March 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#13
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28286625/radiographic-evaluation-of-common-pediatric-elbow-injuries
#14
REVIEW
Steven F DeFroda, Heather Hansen, Joseph A Gil, Ashraf H Hawari, Aristides I Cruz
Normal variations in anatomy in the skeletally immature patient may be mistaken for fracture or injury due to the presence of secondary centers of ossification. Variations in imaging exist from patient to patient based on sex, age, and may even vary from one extremity to the other on the same patient. Despite differences in the appearance of the bony anatomy of the elbow there are certain landmarks and relationships, which can help, distinguish normal from abnormal. We review common radiographic parameters and pitfalls associated in the evaluation of pediatric elbow imaging...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28277468/the-outcomes-of-nonelongating-intramedullary-fixation-of-the-lower-extremity-for-pediatric-osteogenesis-imperfecta-patients-a-meta-analysis
#15
Joseph P Scollan, Julio J Jauregui, Christina M Jacobsen, Joshua M Abzug
BACKGROUND: Osteogenesis imperfecta is usually due to autosomal dominant mutations in type I collagen, leading to an increase in fractures and bone deformities, especially in the long bones of the lower extremities. The use of nonelongating intramedullary rods is an established surgical intervention to address such deformities. The rate of surgical complications has been reported to be as high as 187%, with revision rates as high as 90%, although exact global rates are unknown. As such, we sought to determine the published rates of (1) bone-related complications (including both fracture and deformity), (2) rod migration, and (3) complications that require reoperation...
March 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28277467/high-energy-pediatric-scapula-fractures-and-their-associated-injuries
#16
Steven F Shannon, Nicholas M Hernandez, Stephen A Sems, Annalise N Larson, Todd A Milbrandt
OBJECTIVES: The purpose of this study was to evaluate pediatric scapula fractures occurring in high-energy motorized vehicle accidents and their associated injury patterns in a pediatric patient population. METHODS: One thousand nine hundred sixty-eight pediatric patients who presented after either on-road or off-road motorized vehicle accidents between 1996 and 2015 were retrospectively reviewed. Thirty-eight patients were found to have scapula fractures and the remaining 1930 were identified as controls...
March 8, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28277416/incidence-and-risk-factors-of-hardware-related-complications-after-proximal-femoral-osteotomy-in-children-and-adolescents
#17
Myung Ki Chung, Soon-Sun Kwon, Byung Chae Cho, Gye Wang Lee, Jaeyoung Kim, Seung Jun Moon, Jae Woo Lee, Chin Youb Chung, Ki Hyuk Sung, Kyoung Min Lee, Moon Seok Park
Proximal femoral osteotomy has been used in cerebral palsy, Perthes disease, hip dysplasia, idiopathic femoral anteversion, and various hip diseases in children and adolescents. Conventionally, a blade plate (BP) has been used. However, the pediatric locking compression plate (LCP) has recently been applied widely. We compared the hardware-related complications of the BP and the LCP as well as the factors influencing these complications in patients who have undergone a proximal femoral osteotomy in children and adolescents...
March 8, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28271807/2016-the-year-that-was-bone-strength
#18
Kathleen F Janz
Of all the lifestyle strategies for increasing bone strength during the growing years, physical activity is one of the most efficacious. This commentary highlights two exceptional 2016 publications addressing bone strength in children and adolescents with an eye toward reduced fracture risk later in life. The first by Weaver et al. was selected due to its comprehensive approach to understanding bone development. The second by Mitchell et al explores a new field of inquiry, that is, genetic-environment interaction as represented by bone mineral density-lowering alleles and high-impact physical activity...
February 2017: Pediatric Exercise Science
https://www.readbyqxmd.com/read/28271302/pediatric-osteoporosis-diagnosis-and-treatment-considerations
#19
REVIEW
Edoardo Marrani, Teresa Giani, Gabriele Simonini, Rolando Cimaz
Osteoporosis is now increasingly recognized in children due to the increased prevalence of disorders associated with bone loss. Fragility fractures represent the cardinal clinical features of pediatric osteoporosis and children presenting with fragility fractures deserve an accurate assessment to rule out a secondary cause. Indeed, in the pediatric population, a low bone mass is often a consequence of a chronic disease or its treatment; genetic bone disorders represent the cause of only a small fraction of cases...
March 7, 2017: Drugs
https://www.readbyqxmd.com/read/28267045/supplementation-with-2000-iu-of-cholecalciferol-is-associated-with-improvement-of-trabecular-bone-mineral-density-and-muscle-power-in-pediatric-patients-with-ibd
#20
Ondrej Hradsky, Ondrej Soucek, Klara Maratova, Jana Matyskova, Ivana Copova, Kristyna Zarubova, Jiri Bronsky, Zdenek Sumnik
BACKGROUND: Inflammatory bowel diseases (IBD) are associated with altered bone health and increased risk for fractures. Vitamin D deficiency is frequently found in IBD; however, the effect of vitamin D supplementation on bone health of children with IBD is poorly understood. We aimed to observe the changes in volumetric bone density and dynamic muscle functions after vitamin D substitution in a cohort of pediatric patients with IBD. METHODS: This was a prospective observational study of 55 patients (aged 5-19 years) with IBD...
April 2017: Inflammatory Bowel Diseases
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