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Pediatric fracture

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https://www.readbyqxmd.com/read/28929265/-fractures-of-the-lower-extremities-in-childhood-part-1-fractures-of-the-thigh-and-in-the-proximity-of-the-knee
#1
L Kremer, M Voth, I Marzi
Fractures in children are a major challenge in everyday clinical practice. The decision about the correct treatment of fractures follows the consideration of individual factors. The age of the child and the resulting residual growth play an essential role. This article aims to facilitate a structured approach with respect to examination, diagnostics and treatment in clinical practice. This first part of this series deals with fractures of the thigh and in the proximity of the knee joint in children. The peculiarity of pediatric bone lies in its growth, which results not only in a much faster healing tendency than in adults but also possesses a greater correction potential...
September 19, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28926505/do-all-clavicle-fractures-in-children-need-to-be-managed-by-orthopedic-surgeons
#2
John Adamich, Andrew Howard, Mark Camp
OBJECTIVES: Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatric fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the health care system. METHODS: A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed...
September 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28926487/the-frequency-of-nonaccidental-trauma-in-children-under-the-age-of-3-years-with-femur-fractures-is-there-a-better-cutoff-point-for-universal-workups
#3
Jochen P Son-Hing, Z Deniz Olgun
The purpose of this study was to evaluate narrower age groups in children aged 0-4 years to determine whether guidelines should be refined when investigating femur fractures for nonaccidental trauma (NAT). This was a retrospective review of the pediatric trauma database at our level 1 pediatric trauma center. The database was examined from 2009 to present. We examined rates of NAT in the less than or equal to 12-month, 13-24-month, 25-36-month, and 37-48-month age groups. χ was used to compare rates of NAT between these groups, and P less than 0...
September 18, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#4
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#5
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28918873/use-of-ganga-hospital-open-injury-severity-scoring-for-determination-of-salvage-versus-amputation-in-open-type-iiib-injuries-of-lower-limbs-in-children-an-analysis-of-52-type-iiib-open-fractures
#6
K Venkatadass, Tarani Sai Prasanth Grandhi, S Rajasekaran
INTRODUCTION AND AIMS: Open injuries in children are rare compared to adults. In children with major open injuries, there is no specific scoring system to guide when to amputate or salvage the limb. The use of available adult scoring systems may lead to errors in management. The role of Ganga Hospital Open Injury Severity Scoring (GHOISS) for open injuries in adults is well established and its applicability for pediatric open injuries has not been studied. This study was done to analyse the usefulness of GHOISS in pediatric open injuries and to compare it with MESS(Mangled Extremity Severity Score)...
September 12, 2017: Injury
https://www.readbyqxmd.com/read/28918531/penetrating-orbital-trauma-leading-to-trans-orbital-brain-herniation
#7
Siddharth Vankipuram, Chittij Srivastava, B K Ojha, Sushant Sahoo
INTRODUCTION: Development of a posttraumatic herniation of brain parenchyma through the orbit is a rare complication of orbital roof fracture. Mostly, the injury is due to a direct impact to the frontal region resulting in orbital roof fracture with dural defect and herniation of cerebrospinal fluid or brain parenchyma. These patients present with acute or gradually progressive proptosis with impending risk of loss of vision and mandate surgical decompression of optic nerve with watertight closure of the dural defect...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#8
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28914710/effect-of-time-to-operative-intervention-on-motility-outcomes-following-orbital-floor-fracture-repair-in-children
#9
Viraj J Mehta, James G Chelnis, Qingxia Chen, Louise A Mawn
PURPOSE: To evaluate the relationship between time to surgical intervention and extraocular motility outcomes in children following repair of an orbital floor fracture with inferior rectus entrapment. METHODS: After institution review board's approval, a retrospective, consecutive case series of 28 children with unilateral orbital floor fractures entrapping the inferior rectus muscle was conducted. Clinical examinations and CT images were performed on all children...
September 12, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28913320/pediatric-orbital-medial-wall-trapdoor-fracture-with-normal-computed-tomography-findings
#10
Hyun Rok Lee, Gyu Yong Jung, Dong Lark Lee, Hea Kyeong Shin
With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable...
June 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28904159/pediatric-elbow-fracture-diagnosis-using-3-d-mr-imaging
#11
Marrit Thorkelson, Robyn Augustyn, Craig E Barnes
No abstract text is available yet for this article.
September 2017: Radiologic Technology
https://www.readbyqxmd.com/read/28902088/obesity-increases-risk-of-loss-of-reduction-after-casting-for-diaphyseal-fractures-of-the-radius-and-ulna-in-children-an-observational-cohort-study
#12
Christopher J DeFrancesco, Benjamin H Rogers, Apurva S Shah
OBJECTIVES: To determine if high body mass index (BMI) increases the risk of loss of reduction (LOR) following closed reduction and casting for displaced concomitant fractures of the radial and ulnar shafts in pediatric patients. DESIGN: Retrospective cohort study SETTING:: A single tertiary care, urban children's hospital PATIENTS/PARTICIPANTS:: Pediatric patients aged 2-18 years with closed, displaced, concomitant diaphyseal fractures of the radius and ulna (AO/OTA 22-A3) who underwent closed reduction and casting at the study site...
August 26, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28894358/therapy-with-pamidronate-in-children-with-osteogenesis-imperfecta
#13
Otilia Marginean, Raluca Corina Tamasanu, Niculina Mang, Ioana Mozos, Giorgiana Flavia Brad
Osteogenesis imperfecta (OI) is a genetic disease characterized by excessive bone fragility with fractures consecutive to minor trauma. Considering lack of standardization of therapy with pamidronate in children, it was our aim to present our experience over a period of 10 years regarding evolution and treatment in patients diagnosed with osteoporosis and OI. Nine patients diagnosed with OI were admitted to the First Pediatric Clinic, Timisoara. They were investigated (clinical, biomarkers of bone metabolism and imaging studies), and a quality-of-life questionnaire was used to evaluate the impact of OI...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28893419/telenephrology-current-perspectives-and-future%C3%A2-directions
#14
Rajeev Rohatgi, Michael J Ross, Sandawana W Majoni
There is increasing interest in telemedicine among physicians and patients; however, the evidence regarding the quality of care delivered by telemedicine, and telenephrology in particular, compared with in-person care is limited. In this review, different electronic modalities used to deliver nephrology care are reviewed and critiqued, with a focused analysis from the Australian and United States perspectives. Both countries are geographically expansive with significant rural populations where access to nephrology care is limited...
September 8, 2017: Kidney International
https://www.readbyqxmd.com/read/28890619/prevalence-of-traumatic-dental-injuries-to-the-permanent-anterior-teeth-among-9-to-14-year-old-schoolchildren-of-navi-mumbai-kharghar-belapur-region-india
#15
Rahul Hegde, Geet Agrawal
AIMS AND OBJECTIVES: To measure the prevalence of anterior teeth trauma in 9- to 14-year-old schoolchildren and their association with predisposing factors, such as lip competence, molar relationship, overjet, and variables, such as age, gender, and cause of trauma. MATERIALS AND METHODS: Epidemiological cross-sectional study was carried out among 3,012 schoolchildren aged 9 to 14 years in Navi Mumbai (Kharghar-Belapur region). The sample size was derived using the stratified random sampling method; we picked six schools from the region...
April 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28890610/evaluation-of-novel-glass-fiber-reinforced-composite-technique-for-primary-anterior-teeth-with-deep-carious-lesions-a-12-month-clinical-study
#16
Ajinkya Sawant, Yusuf Chunawalla, Abdul Morawala, Nupur S Kanchan, Kapil Jain, Rohan Talathi
BACKGROUND: Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and man-dibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth...
April 2017: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28889364/open-complete-anterior-dislocation-of-the-sacro-iliac-joint-in-a-4-year-old-boy-a-case-report-of-a-rare-injury-with-5-year-follow-up
#17
Walid A Elnahal, Mahmoud Fahmy, Mehool Acharya
Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh...
September 9, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28887279/sacral-alar-iliac-fixation-in-children-with-neuromuscular-scoliosis-minimum-5-year-follow-up
#18
Amit Jain, Brian T Sullivan, Anne Kuwabara, Khaled Kebaish, Paul D Sponseller
OBJECTIVE: The aim of our study was to investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac screws. METHODS: We reviewed clinical and radiographic records of patients ≤18 years old treated by 1 pediatric orthopaedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients, with a minimum 5-year radiographic follow-up (6.0 ± 1.2 years), were studied. Mean patient age was 13 ± 2...
September 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28880998/impaired-bone-and-muscle-development-in-young-people-treated-with-antiepileptic-drugs
#19
Peter J Simm, Sebastian Seah, Alex Gorelik, Lauren Gilbert, Jenning Nuguid, George A Werther, Mark T Mackay, Jeremy L Freeman, Sandra J Petty, John D Wark
OBJECTIVE: Antiepileptic drugs (AEDs) are associated with reduced bone density, balance impairment, and increased fracture risk in adults. However, pediatric data are limited. Therefore, we aimed to examine bone, muscle, and balance outcomes in young patients taking AEDs. METHODS: We undertook a case-control study utilizing an AED exposure-discordant matched-pair approach. Subjects were aged 5-18 years with at least 12 months of AED exposure. Pairs were twins, nontwin siblings and first cousins, sex- and age-matched (to within 2 years), allowing for greater power than with unrelated control subjects...
September 7, 2017: Epilepsia
https://www.readbyqxmd.com/read/28877328/procedural-sedation-with-ketamine-versus-propofol-for-closed-reduction-of-pediatric-both-bone-forearm-fractures
#20
Todd Morrison, Chris Carender, Brendan Kilbane, Raymond W Liu
Effective treatment of pediatric both bone forearm fractures consists of timely restoration of anatomic alignment with manipulation and immobilization, often accomplished with the aid of procedural sedation in the emergency department setting. The current lack of consensus regarding a safe and optimal regimen may result in inadequate sedation, compromised quality of reduction, or patient harm. The current study was conducted to answer the following questions for pediatric both bone forearm fractures treated with closed reduction with either ketamine or propofol procedural sedation: (1) Is there a difference in the rate of unacceptable alignment 4 weeks after reduction? (2) Is there a difference in the rates of major sedation-related complications? Medical records, data on procedural sedation, and radiographs of 74 skeletally immature patients with diaphyseal or distal metaphyseal both bone forearm fractures treated with manipulation were reviewed (ketamine sedation, 26; propofol sedation, 48)...
September 6, 2017: Orthopedics
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